Yoga with Scoliosis & Spinal Fusion: 4 Key Actions

Sometimes I really struggle with meme culture. I dislike the idea of boiling a complex topic down to a few words - especially when that complex topic is yoga philosophy, human movement, or emotional wellbeing.

At the same time, I recognize the value of simplicity - of taking a seemingly impenetrable topic, and distilling it down into a few key principles, so that we can start somewhere. The key, I think, is to remember just that: that summaries, catchy phrases, and memes allow us to start somewhere - they are not the end.

So with this in mind, I wish to present to you:

Yoga with Scoliosis & Spinal Fusion: 4 Key Actions

And its working subtitle:

A Starting Point, and A Few Things to Try When Practicing Asana with A Curvy and/ or Fused Spine

And my disclaimer:

Please listen to your body and remember that I do not know what is best for you; only you know what is best for you.

Scoliosis and spinal fusion are complex - yoga is even more complex. But my hope is that keeping these four actions in mind can open some doors to deeper listening, and greater understanding. So with all that build up, here they are:

1. Length

2. Strength

3. Side-bends

4. Twists

These are the four actions that I focus on with all of my clients with scoliosis and/ or spinal fusion. Yes, I am aware that backbending (spinal extension) and forward bending (spinal flexion) are not on this list; some would argue they should be. Maybe I’ll add them one day, but right now, these are my areas of focus. Here’s why:

1. Length (or, as the nerds call it, “axial extension”). This is one of the simplest ways to bring relief to the spine - especially spines with scoliosis. We can do through by using traction (ie, applying an external force to bring more length, like hanging from a pull up bar, or dangling from an inversion table), or not (ie, reaching your arms up as high as you can, or lifting your hips up and back in downward dog). In bringing length, we are simply bringing more space between our vertebrae, giving our discs some breathing room, and lengthening the muscles that surround our spines. It feels great for most folks, and you don’t even have to know where your scoliotic curves are to do it safely! Fun!

2. Strength (in nerd-talk, “muscular engagement”). The cool thing about strength is that you can build it in different ways, namely isotonic (where your muscles engage and your bones move as a result), and isometric (where your muscles engage, but your bones stay put). For folks with scoliosis but no spinal fusion, much of the engagement I encourage around the spine is isotonic (bones moving); for students with spinal fusion, we will often explore a bit more isometric engagement (simply because fused vertebrae typically don’t move!). Some of the strength work I encourage is symmetrical (ie, locust pose, plank pose, etc.), and some is asymmetrical (ie, bird dog, side plank, twists, etc.) - all of it is meant to bring stability and balance to the spine and core.

3. Side-bends (ie, “lateral flexion). This is where it’s really important to know where your curves are, and which direction they go! It’s also important to know where your spinal fusion is, if you have it. X-rays are very helpful for this. If you don’t have a scoliosis x-ray (and you really do have to ask for a “scoliosis x-ray”), get one if you can. And make sure the sides are clearly labeled “Left” and “Right” on the x-ray film. Once you know your curves, you can tailor your side-bends in a way that brings more space to your concave side (ie, the side you’re leaning/ falling toward), and more strength to your convex side (the side where your side and back ribs typically flare out). If you’re fused, I don’t recommend side bending, as much as using your limbs to create more space - you can still stretch an engage your muscles without moving your vertebrae or rods - please don’t try to bend your rods!

4. Twists (“rotation”). Not only is it important to know your scoliotic curves are when thinking about twisting, but it’s also important to know this key thing about the spine: The higher up the spine you travel, the more potential your spine has to twist (unless of course you have spinal fusion, in which case, hang tight - I’ll speak to you in a moment!). In folks without spinal fusion, the lumbar spine typically has between 6 and 20 degrees of rotation, the thoracic, between 45 and 65 degrees, and the cervical, up to 90 degrees. This means that most of the rotation in twists comes from the rib cage up. and what this means is that, when we’re twisting, we’re mostly working with the vertebrae involved in our thoracic (and cervical) scoliotic curves, not our lumbar. De-rotating our lumbar spine through twisting is something we can attempt gently, but it should not, in my opinion, be the emphasis. And if you have fusion, don’t sweat it! You may not be able to twist much (or at all), but you can access some of the same sensations and strength through breath work and isometric muscular engagement.

You can see why memes exist - this shit is complex! But the great news is, we don’t have to learn it all at once. As Sarah Robinette, one of my teaching mentors says, “Start where it’s easy.” If all you remember from this piece is “Lengthening my spine is good,” great! If all you remember is, “Scoliosis is complicated,” great! Just promise that you won’t stop there. There is so much to learn about these bodies we live in - perhaps starting with your spine is a wonderful entry point! That’s how it started for me, and I've tried to keep learning, every day since.

If the above content intrigued, delighted, or even confused you, you are in luck: I’ll be leading a Yoga with Scoliosis & Spinal Fusion workshop that discusses each of these actions in greater detail on Sat, Oct 23 & Sun, Oct 24, 9:30-11am PT. I'd love to see you there!

Yoga with Scoliosis & Spinal Fusion

Keep loving those bodies, y'all.