Lahela’s Spine Class and Pilates for Scoliosis:
Originally posted on January 8, 2011 with revisions on April 7, 2017 and August 3, 2018 by Lahela Hekekia
Well, it’s nice to see that it only took a few days to spark some interest in my special Scoliosis class, which is Pilates on the Mat and Professional Equipment. This class comes up every so often as a Workshop. And I’ve gotten support from local Chiropractors and Osteopathic Physicians for my work. Even a Neurosurgeon who performs spinal surgeries. And because of my own personal journey, I have built up a specialty with Scoliosis clients. I also have a (usually full) Lahela’s Spine Class, which has been running for a year with 3-4 regulars. I can start a new one! Let’s connect!
My personal Story – who gets “taller” at age 40? I did!
In brief: I was diagnosed with Scoliosis at age 10 and started having chronic pain at age 19. During stressful times like exams, I was downing handfuls of Ibuprofen and getting massages, just to survive. And for years, I experienced very one-sided sports injuries. Right hip, right knee, right ankle, right foot. It all makes sense now.
I found Pilates in my 30s. In about two years of daily practice, I changed my spine. Dr. Chip Abbadessa looked at the xray in 2009 and said, “Are you telling me that you used to have Scoliosis? Look at this…” Thanks, Dr. Chip! And yes, I got close to an inch “taller.”
I no longer have those constant headaches and pinching pain between the shoulder blades — and no longer floored by spasms in the low back that would happen with seemingly no warning. My weight didn’t really change, but I feel much lighter on my feet, can reach higher, and haven’t been this flexible since middle school. (Keep in mind, I became a long distance runner in middle school, and running tends to decrease flexibility. I also got lazy about stretching at age 18). I felt “old” at 25 and feel “young” and bouncy now, in my late 40s. Well my goal is to be bouncy at 97.
DISCLAIMER: This blog is not intended to diagnose, treat, or cure a disease. This blog is also not intended as medical advice or services, and you should not ignore any medical advice to the contrary. Nor should you fail to get medical advice or treatment if you are experiencing a health episode. Please get a diagnosis from those licensed to do so, such as a Physician. I cannot give guarantees or estimates as to how long it would take to see measurable results. I only have my own personal experience and those of clients working with me. Their information is confidential.
Here are some answers to questions fielded so far:
- Q: What is Scoliosis? A: It’s categorized as an abnormal curve of the spine, which can be anywhere from mild to severe. If you want to see some extreme xrays, you can go onto Facebook and see some of the groups listed under Scoliosis. It may be deemed medically advisable to have a surgery. That is between you and your Physician. Some cases are so severe that it can affect the vital organs. Such as breathing.
But it’s so much more than just that. Scoliosis affects the entire body – the feet, the knees, the hips, the shoulders, the arms, you name it. Even if it’s a mild case, there is still an effect. If your therapy has only been focusing on the spine, that is only part of the picture. Spinal surgeries will not address what has been happening in the pelvis, knee joints, feet, etc., nor the muscle imbalances that have developed from being a certain way for a long time. I’m grateful to have shared ideas with a local Neurosurgeon who said that I gave him cause to think about some of the methods used in spinal surgeries which are part of the protocol (affecting the Psoas Major muscle), and therefore, what may be useful to patients after they recuperate from surgery.
- Q: What causes Scoliosis: A: It’s often unknown. Theories abound, including: injury; viral infections; structural abnormalities at birth; muscular imbalances that accumulate over time (especially with one-sided sports like GOLF or TENNIS); spinal degeneration with age, and uneven development during puberty. Many people are diagnosed during puberty, while others ‘develop’ abnormal curves in adulthood. The condition is generally diagnosed by xray.
- What are telltale signs of Scoliosis? A. Uneven shoulders and hips. One leg appearing to be “longer” than the other. Do a slight forward-bend and have someone run their fingers along the spine to detect a lateral curvature, or a “rib hump.” If you see these, you might want to confirm with a diagnosis. Hey, here’s a great website article with photos, like the one below. It’s from:
- Q: What are the risks of having Scoliosis? A: There are quite a few. Here are some: a) According to Stott International in 2011 (now Merrithew Health and Fitness), about 75% of women with Scoliosis age 65 and over have an osteoporosis fracture in the spine. One could infer that the abnormal curve plus gravity puts unusual pressure on the spine. Here’s an article about osteoporosis fractures being often in the spine.b) Often, Scoliosis comes with chronic pain — the more severe the curve, the more likely the person will experience pain in his or her lifetime. From age 19, I had a lot of back pain which wasn’t helped by all those hours slouched in front of the computer and hunched over books (English major, Law School, yay); and it usually got really bad during exams. From my mid-20s, I had a lot of chronic pelvic pain. All this pain went away within the first couple of months of daily Pilates, but it wasn’t just from attending classes. It was also because I spent a lot of time improving my posture and really getting “deep into” my body and feeling whether the spine was articulating or “stuck,” and really understanding my unique combination of muscular imbalances, and issues with my overall posture.c) Severe cases of Scoliosis can cause problems with the organs — for instance, development of the lungs, trouble breathing, and so on. In this case, surgery might have to be the answer. For a very complicated case, I’d be happy to provide referrals for Physicians and Licensed Physical Therapists.d) We have heightened chances of sports injury, with imbalances in the hip and shoulder. We may lean more to one side of the body. Muscles designed to stabilize joints don’t do their job properly. Muscles also get used for purposes that aren’t their original “design,” which then limits mobility and flexibility. This sets up a vicious cycle of over- and under-use, and the end result is often a chronic sports injury. In my many years of running, I noticed that the injuries all occurred on the right side of the body, including: an inguinal hernia, shin splints, ankle sprains, stress fractures in the foot and tibia (lower leg), and Iliotibial Band Syndrome.
- Q: Can medications help with Scoliosis? A: Well — Not really, except mask the pain. If the doctor prescribes pain medications — that will lessen the sensation, but it will not target the root cause. And the curvature could worsen as you age (with degeneration of spine and disks). In the case of osteoporosis, specific medications may help prevent bone loss, but they won’t improve the curvature that exists — and apparently they don’t reduce fracture risk, since the biggest risk is falling. Consider as well, potential side effects. That said, talk to your doctor about all options and risks, then decide together.
- Q: Can Therapeutic Bodywork can help with Scoliosis? Can Pilates supplement my Health Care Provider’s Treatment? A: I have seen great results by combining Pilates (muscle re-training) with a good licensed Chiropractor, Osteopath, Physical Therapist, and Rolfer. You can also consider Graston Technique®, I am a Provider. Before embarking on a new program, you should get a professional assessment. An xray will let you know if you have spinal degeneration or other complications. A posture/alignment analysis will help you understand your muscular imbalances. With that, you have a road map for your wellness plan, which may also include therapeutic massage, and exercise that is kind to your body.
If you have a severe and/or complicated case of Scoliosis, you may need physical therapy and/or surgery, instead of me. At the very least, you will need medical clearance. And I highly recommend doing that before embarking on any fitness program anyway — especially if you are experiencing chronic pain or undergoing pain management therapy.
- Q: Will Yoga in a very hot environment improve my Scoliosis? A: If you want Yoga – then choose someone truly experienced in therapeutic Yoga to help you —even better if the program is developed by a specialist, such as a Physiotherapist. If you do find someone with proven results, then I would be very enthusiastic. As for now, it sure seems as if hot Yoga comes with a high rate of injury. The extreme heat allows us to stretch beyond our normal capacity, so we really have to be careful about using the proper muscles to stabilize the spine. Frankly, I’m not enthusiastic about hot Yoga. And if the teacher has little understanding about anatomy and physiology — go find someone else. Look for someone who advertises that specialty, with verifiable results. In my personal opinion, Yoga Therapy in normal room temperature is a safer option.
- Q: What do Scoliosis Management lessons involve? A: Very specialized exercises on the Mat, Reformer, and Cadillac, as well as changing the way you breathe, sit, stand and walk. To make meaningful changes, you must devote a little bit of time and energy to yourself every day, whether in the studio or at home. There is a huge emphasis on Osteopathic Sciences. The mental attitude is also highly focused — I give a lot of feedback from what I see with my eyes, and I also provide lots of cues, often hands-on. Be prepared to hit plateaus and brush off the frustration. The body will not always do what you want. Stay calm. Focus. Communicate between mind and body to note what you feel, how a particular movement feels today, and compare it with how you felt last week, last month, etc. My program also involves exercises which were devised by a physiotherapist and other specialists. And it includes modifications of Pilates exercises, because the standard exercises may encourage imbalances rather than help. Yes — especially on the Reformer.
- Q: So how can I attend the Scoliosis Management Workshop? A: First, while it’s always best to check in with your Doctor before embarking on any new program, mild cases in healthy individuals are fairly easy. I generally do these workshops in conjunction with Physical therapy businesses to provide a whole network of support. With a serious case of Scoliosis or something more complicated like a Stenosis (narrowing of the spinal canal), or Spondylolisthesis (forward slippage of a vertebra), you should get medical clearance and instructions from your doctor, and maybe Physical Therapy first. This is for your safety. We must know what’s going on, to design a proper program for you. Second, it helps to start with private lessons so that we can customize your workout and give you a strong foundation in Pilates, for a group class. That’s really where you get the most help, and your own personal practice to continue at home.
- Q: How long will it take to improve my spine? A: There is no easy answer. Scoliosis is something that we will need to work on for life. We have unique bodies, different ages, varying jobs which tax our bodies accordingly (desk work, manual work), different diet and lifestyle habits, and widely divergent levels of ability to commit to muscle reconditioning (time, motivation, finances, etc.).
- Q: Will Insurance cover this class? A: At the moment, no. If you would like Insurance to cover treatments, I can refer you to a number of fantastic Physical Therapists located in Honolulu, as well as Kailua, Hawaii. I love giving referrals to others because they give back. And then, I have a great list of licensed Physical Therapists who would be able to help you, if you are allowed to go anywhere you want. Some companies require you to stay in-house, such as Kaiser.
- Q: Can I take your class while receiving Physical Therapy or other treatments from someone else? A: That is up to your Physical Therapist and Doctor. If they allow it, then welcome! Keeping in mind: you may be doing specific exercises in Physical Therapy that are different, with different “cues”; and you may have specific limitations from your Physician. If their directions seem to be in conflict with my Method, then please — either finish their sessions first, or have specific written instructions from them to me. I want to work with your team.
Do you have any other questions? I’d love to answer them.
Malama Pono,
Lahela Hekekia
Pilates Method Alliance and STOTT PILATES® Certified Pilates Teacher
Franklin Method® Level 3 Certified Movement Educator
Graston Technique® Provider
Licensed Massage Therapist (MAT#6286) and Board Certified (NCBTMB#307766-00)
You could definitely see your expertise in the work you write brimstone.fun. The world hopes for even more passionate writers like you who are not afraid to say how they believe. Always go after your heart.
Ahhh, thank you!