Dangers for Scoliotic Performing Yoga Exercises Problems with Hatha Yoga for Scoliosis
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Dangers for Scoliotic Performing Yoga Exercises
Problems with Hatha Yoga for Scoliosis
by Christa Lehnert‐Schroth
In recent years announcements and articles in the internet as well as journals even in
specialized books recommend Yoga for Scoliosis and train teachers for it.
Teachers in Pilates circles also tackle the topic. There is even a “Yoga for Scoliosis Teacher
Training Journal” in which a Yoga practitioner is trained in five days to be a teacher for all
scoliosis cases, see http//www.triciavilleyoga,cin/7.html.
Yoga is not only a treatment but a spiritual belief system, therefore it seems that when we
question part of the system, the whole system feels challenged
Here we enumerate the problems we’ve exposed. Many Yoga Poses can be harmless or
beneficial to a scoliotic body. For instance arm‐ and leg exercises and stretching exercises
without turning or bending. Hatha Yoga is fundamentally unsuited to treat scoliosis because
the exercises were not distigned for the tasks inherent in treating a complex asymmetrical
muscular and spinal pathology.
Yoga exercises are increasibly used by some instructors to treat scoliosis, but without full
understanding of their effects. Scoliosis poses unique problems to the therapist because of
its inherently and asymmetrical configuration, while therapeutically to a patient’s
pathologically asymmetrical torso without comprehensive physiological and anatomical
knowledge and expertise which no Yoga practitioner has jet demonstrated in any publication
related to scoliosis.
In the above mentioned Yoga and Pilates exercises all photos show partipiciants in clothing
that covers their bodies doing fantastic‐looking movements, which often have an artistic
effect. But Yoga practitioners tend in such exercises not to observe the uncovered back of
the patients. If they did, they would neccessarily notice that the exercises described below
make the scoliosis worse and that pain must neccessarily develope. Even if these exercises
are performed to both sides. The ribs altogether bend or twist atleast in a wrong form.
In these days I’ve got an e‐mail from India: “I am the mother of a 13 years old girl who has
been diagnosed with adolescent idiopathic strucrural thoracolumbar scoliosis about six
month back. My daughter has just been for her six monthly check‐up and as per the X‐rays
the curve seems to have gotten much worse. It has progressed by a whopping 11 degrees in
these six months. During this time she has actively practiced Iyengar Yoga and done a bit of
swimming. These obviously do not seem to have helped. Even though the doctor did
mention that she is remarkably well balanced visually. Cobb angle of time of the dedection
33 degrees for the lumbar curve.
Cobb angle currently 44 degrees.
The doctor has suggested to go for a full fusion surgery sooner than later. Especially in view
of the fact she still has at least one year of groth spurt left.”
Therefore it is high time to examine these Hatha Yoga exercises and their effect more
closely, in order to open the eyes of the Yoga and Pilates practitioners and show them the
demage that such exercises do to scoliosis patients. But for all other persons Hatha Yoga is
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very good. In this article I refer exclusively the pictures in my book “Three‐Dimensional
Scoliosis Treatment” (www.schrothmethod.com)
Anatomy
First it is important to understand the normal anatomy of the spine and rib cage from behind
and from the front.
Normally one sees in an anatomy book the spinous processes of the 24 vertebrae point
dorsally, see fig. 1 and 2.
Every vertebra has a pair of transverse processes on the left and right, by which the ribs are
attached via joints to the thoracic spine, see fig. 1. The ribs pass from the rear laterally
around the chest cavity and forward to the sternum to which they are again attached via
joints. Only the 11th and 12th pairs of ribs hang free in the waist musculature, Each vertebral
body has two more joints processes pointing cranially towards the skull and two caudally
towards the sacrum.
Fig 1
Fig 2
2
Fig.3
In fig.1 on the right side in side view. There are three physiological
curves observed. Lumbar forward (lordotic), thoracic backward
(kyphotic), cervical forward (lordotic).
Fig 4
The rib articulations and transvers processes of the thoracic vertebrae posteriorly, see fig. 4 and
band 10th ribs all attaching to the 7th rib. The 11th and 12th ribs are free floating ribs, only articulating
with the 11th and 12th thoracic vertebra.
In a wrong posture the discs , fig. 5, then no longer push us straight up, but rather in the direction
which provides less resistence. See fig. 5b
Therefore, when considering the anatomical joint position of the spine and rib cage the body is
cabable of many movements. For instance bending forward and backward and belaterally.
It is important to consider the intervertebral discs with these various movements and what effect
these may have on the discs. These movements allow the nucleus to lateralize to the less loaded
side, which offers limited resistance.
Of course, these movements not only affected the vertebrae but also the adjacent intervertebral
discs in this direction.
Bending forward.
When forward bending of the upper body occurs, the intervertebral discs are gliding to the rear. If
the patient does that for constant, than the physiological curve (thoracic kyphosis) can become
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pathological. A rib hump can form as a result. When the body is in the upright position the nucleus
pulposus (gel. substance) moves into a neutral position in the center of the intervertebral disc,
assuming that the body has not established a hyperkyphotic form, in a thoracic curvature to the rear
the intervertebral discs will grow wedge‐shaped.
Bending backward
Fig 5:
from the left side from the right side
Consider now extension of the upper body or bending backward, which creates straightening of the
thoracic kyphosis (hypokyphosis in sagittal plane ). But this creates increased pressure in the
physiological lumbar curvature anteriorly. This results in a ‘hollow back’, since the corresponding
vertebrae shift anteriorly (forward) and the nucleus pulposus (gel) is forced forward in the
intervertebral discs. Certainly this is an indication of the person’s flexibility. However, the abdominal
muscles are stretched and the intestines protrude forward and place themselves into the stomach.
Even though the appearance is good – but unhealthy and often it initiates back pain.
Another pose referenced in Yoga Journal, May 2006 is the Salabhasana – (Locust pose.) showing
the patient in prone position lifting and turning the left hand upward and elevaiting the right leg, and
the left arm simultaneously – or both legs and/or both arms together, fig. 9.
The pose creates increased lumbar lordosis and increases the already existing all upper curves.
The following back bending poses patients with mal posture must avoid, too:
Dhanuras, Camel Pose (Ustrasana), One‐legged Pigeon Pose (Eka Pada Raiakapotasana), Crescent
Pose (Anjaneyasana) , Cobra pose (Bhujangasana).
Why is bending to the rear with the upper body harmful? Because the root of the rib hump, that is
the beginning of the abnormal rounding of the back commences directly out of the the lumbar
lordosis to bend rearward and to bend forward again at the rib point of the rib hump. Thus
phenomenon increases during a rear bending exercise of the torso and thus disfigures the figure. So
we cancel these exercises for scoliosis
The therapeutic goal should be to reverse the imbalance of trunk and strengthen and stabilize while
the patient is in a corrected position accounting for all the spinal and trunk deviations, as well as the
lateral and sagittal dysfunctions. Corrective exercises do not involve bending and twisting since
these maneuvers will increase spinal loading which will be detrimental to the wrong posture:
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Bow (Dhanuras), Camel Pose (Ustrasana) , One‐legged Pigeon Pose (Eka Pada Raiakapotasana),
Crescent Pose (Anjaneyasana) , Cobra pose (Bhujangasana), Half Moon, Wheel, Bow and Scorpion.
The therapeutic goal should be to reverse the imbalance of the body and strengthen and stabilize
while the patient is in a corrected position accounting for all the spinal and trunk deviations, as well
as the (lateral and) sagittal dysfunctions. These corrective exercises do not involve bending and
twisting since these maneuvers will increase spinal loading which will be detrimental especially to
the scoliotic patients.
Bending sideward
In a sideways bending of the upper body similar things happen. In a bend to the right the vertebrae
with their soft and gelatinous intervertebral cores shift to the left and press into the left side, as they
are squeezed in the right. One can now easily breath into the left side.
It is recommended for a normal builded body to do this lateral bending also towards the left side,
whereby the right side can be ventilated.
When performing a sideways bend (lateral flexion) of the upper body the following occurs:
A lateral bend to the right will create also a wedge of the upper body with closed end on the
right and open wedge on the left. Now the intervertebral discs with the soft gelatinous
substance being compressed on the right (waist) – and this fluid now accumulating on the
left.
The ribs 11 and 12 are in soft tissue musculature. They run almost horicontally
into the abdomen because the soft musculature does not offer support.
As a result asymmetric loading occurs on the spinal joints. If position is held for a prolonged
period of time the person is subject to advanced spinal degeneration, developing spinal
spurs (osteophytes), disc herniation which can lead to spinal stenosis. Spinal stenosis is a
narrowing of the central and/or lateral neural canal. When this occurs sciatic nervs
impingement is likely thereby. The person can develop leg pain. Therefor the goal is to
perform a revers lateral bend to the other side ‐ in normal builded bodies.
Trunk rotation
Trunk rotation is performed when the pelvis is fixed (stationary) and the shoulder girdle is
rotated against the pelvic girdle. For example, in a seated position rotate the right shoulder
backward and the left shoulder forward. This creates an oblique tension on the ventral
(front) side. The left chest is contracted, the right expanded. When observing from behind
the thoracic right rib cage and the spine is full rounded creating a larger lung space. Now,
when the person breathes, the breath is increasingly directed into the right lung space. Now
the person should take also the other side to ventilate each side.
Now let us discuss in more details bending movements by Hatha Xoga exercises in
scoliosis:
Forward bending pose
When the upper body assumes forward flexion rounding of the back in a thoracic kyphosis and the
lumbar lordosis decreases in lumbar kyphosis, too.
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Plow (halasana).Fig.6
When the legs are extended from supine position vertically
upward, the entire weight of legs and pelvis stretches the stomach muscles in length and power
before the legs are bent over the head. The weight of legs and pelvis rests on the shoulder girdle.
The back is rounded all inhaled air flows into the rib hump. The head is pressed forward, the upper
breast is narrow. What an effect shall have such an exercise for scoliosis? We leave it.
Shoulder stand or Candle: Fig.7
Assuming a pose that places body weight upon the shoulder will invariably prove deleterious for a
scoliosis patient. See Fig.7
In the shoulder stand pose the entire weight of legs, pelvis and trunk rests upon the shoulder girdle.
The effect is to compress the shoulder girdle including claviculae, and to increase the rib hump. The
cervical spine is forced into forward flexion which creates a cervical kyphosis instead of a cervical
lordosis in a normal spine. This pose compromises breath in, since all inhaled air is forced into the
right convex area, further enlarging the rib hump on the right.
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Please, turn the fig. 7 180° so that the person stands on feet. He looks depressively down and feels
the rounding of the upper body. We leave this exercise.
Now to the Back bending Poses
A second type of contraindicated exercises for scoliosis patients is the back bend. In the article in
Yoga Journal May 2006 patients with scoliosis are directed to perform an exercise referred to as the
Reclining Backbend. In this pose the position of the spine compromises its sagittal alingnment.
Referring to the illustration in Yoga Journal May 2006 we see a model in supine position placed a
bolster under the thoracic spine which is already hypokyphotic on the concave side, the effect will
be to create a thoracic lordosis or thoracic extension. This is desirable if the patient is hyperkyphotic
but the majority of scoliosis patients are in fact hypokyphotic on the concave side. We can see it in
X‐rays in side view. For these patients the bolster creates spinal instability in the sagittal plane. The
Yoga spine therapy continues to bend further laterally and rotates, creating still more lumbar
instability .
Fig 8 a Fig 8b Fig 8c
The back bend pose shortens the thoracic muscle groups, especially rhomboids, latissimus dorsi,
trapecius and erector spinae. In the same process the abdominal muscles are lengthened and
weakened, though the scoliosis patient needs to shorten the abdominals, not to stretch them.
Unfortionately these poses increase thoracic extension which is contraindicated for most scoliotics,
see book Weiss “Best practices” due to the fact that it creates increased spinal instability, You don’t
think that one size fits all with scoliosis, but to the contrary, each patient and each curve pattern
must be addressed individually or the result could be progression rather than improvement.
Upward facing dog, fig 8a
When bending the upper body backward (thoracic extension) the stomach muscles are
oberstretched. It is not the rib hump which is desired to reduce but rather the lumbar lordosis
increases. The rib hump starts with thoracic extension, starting at the lumbar area, which occurs on
the rib hump side in scoliosis. Therefore, one should absolutely avoid backward bending of the upper
body! See also the explaining about the root of the rib hump!
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Fig. 9 prone position, one arm or one leg raising.
The similar happens in prone position. The lumbar muscles have to work and to raise the upper body.
This exercise may be suitable for lumbar kyphosis.
Side bending in Yoga Poses or exercises in scoliosis
Now let us discuss these exercises in a scoliosis body.
First the anatomical and physiological consideration.
In the clinical dictionary Pschyrembel scoliosis is defined as: “Greek scolios, crocked.
Curvature of the spine with rotation of the individual vertebrae (torsion) and stiffening in
this section”. This definition is lacking for several reasons. But scoliosis includes more than
spine alone. The entire chest is involved since the ribs articulate with the transverse
processes of the thoracic vertebrae. This articulation is responsible for the rib distorsion
which creates an unbalanced rib cage which makes the rib hump visible ‐ especially with
forward flexion of the trunk.
Located between two vertebrae in the cervical, thoracic and lumbar spine are intervertebral
discs excluding the first and second cervical vertebrae where no disc is present. All discs are
composed of the annulus fibrosus and nucleus pulposus. The annulus fibrosus has
intertwined collagenous fibers which surrounds the nucleus pulposus. The nucleus pulposus
consists of a liquid, gelatinous substance. The vertebrae consists of osseous structures which
include the spinous process which points posteriorly bilateral
The transverse processes pointing laterally. These transverse processes in the thoracic spine
articulate with ribs bilaterally.
Fig.10
In fig. 10 we see normal muscles on the back,
for instance longissimus, iliocostalis, erector spinae etc
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Fig 11
In fig 11 we see a patient with a seriously distorted
scoliotic trunc. In the drawing of a right thoracic scoliosis
( fig 14 ) is seen that the spinous processes in scoliosis no
longer point backward because the trunk stands no
longer axially correctly, instead property vertically
aligned, but are rotated towards the concave side of the
curvature. Simultaneously the ribs on the inner arc
(concave side) pressed more together, while on the
convex side of the curve they stand further apart. So the rib pleura is connected with the lung pleura
by vacuum (membrane) and contributes to asymmetric lung expansion – increasing the already
abnormal curvature of the scoliotic spine.
In the same picture we see not only one side bending curvature – but also two smaller compensatory
curves in the opposite direction. These compensatory curves serve as counterbalance. A balanced
body is now observed,but it is pathological called scoliotic balance.
Simultaneously the ribs on the concave side are narrow while on the convex side widening of the
intercostal space is present. (spreading the rib space apart) .
In the drawing is seen that the spinous processes no longer point backward, but are rotated towards
the concave side of the curvature. Simultaneously the ribs on the inner arc side are pressed more
together, while on the convex side of the curve they stand further apart. Since the rib pleura is
connected with the lung pleura by vacuum (membrane), and the lung is better ventilated on the right
side by unilateral rib tension, each breath will contributes to asymmetric lung expansion increasing
the already abnormal curvature of the spine.
Now it is apparent why adeveloping scoliosis worsens. Primarily because the intervertebral discs
have become wedge‐shaped and their nucleus pulposus (inner gelatinous substance) is being forced
into an abnormal position.
Side bending exercises
Fig. 12 small side bending to the right and to the left
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Standing, arms stretched vertically. This little bending prooves the flexibility of the trunk.
In scoliosis is that not to recommend, because a side bending to the right or to the left , may be in a
thoracic or in a lumbar curve, works always into an existing curve. So we cancel this exercise for
scoliosis.
Fig.13 X‐rays of a 4 years old girl.
In the first X‐ray the vertebral line by 19°. The second X‐ray shows a follow up X‐ray after 1 ½ years.
The lumbar spine now deviates 30° from the vertical line which represents a significant deterioration.
Both X‐rays were taken in resting position.
The third X‐Ray was taken on the same day as the second during exercise. It shows a very distinct
flattening on the main scoliotic curve. ‐ If the pelvis would be not visible, it may imagine that the
spine may have been straight up by this exercise. However, turning the X‐ray so that the pelvis is
horizontal, like the forth picture shows, that the body has been unbalanced even further by this
exercise. The flowting ribs at the right have moved even clother to the pelvic crest than the first
picture. The same happens by Hatha Yoga bending exercises. The person shall recognice what
happens by bending the upper trunk laterally only to recognize what happens by treating lateral
flexion when only one curvature of the spine is seen or pay attension for it.
With other words: We have to treat all three or four curves ‐ of trunk segments ‐ otherwise all of
the spinal curvatures will worsen.
Each case of scoliosis is a sum of malpostures which have developed into one wrong shape. For this
reason it is not enough to correct only one specific malposture, since those remaining spoil the
overall result. It disturbes the body’s balance. The rib hump increases and requires the opposite hip
to shift laterally (outward) to maintain balance. This creates a lumbar hump to the opposite side of
the rib hump. Now the head can’t remain shifted to the right, but rather belongs in the middle of the
body (above the spine) with the shoulder girdle section wedging towards the thoracic concave
side. Thus the three developing spinal curvatures are strengthened and worsened .
In contrast the purpose of scoliosis treatment via a physical exercise approach, is to account for these
spinal and trunk imbalances in three dimensions. Often the sagittal profile is not overlooked. A
common mistake made by unknowing instructors or patients attempting to self classify . Their
10curvatures are to mistakenly determine that unilateral scapula winging is automatically associated
with a thoracic hyperkyphosis when in reality the majority of the times the patient has a thoracic
hypokyphosis. This leads to trouble when determining which exercises to perform for one’s own
scoliosis.
Fig. 14 Triangle Pose
On page 6 Yoga Journal, May 2006 examine the person Triangle pose. Note, there is a wide stance
and her torso bends to the right, the right hand outstretched toward the right foot, and the left arm
stretched over the head created a reversal of the right thoracic curve. The goal is to open the left
thoracic concavity (widen the left rib cage) allowing increased respiration into the collapsed side. This
is appropriate. However, other anatomical joints and muscles must be considered. The negative
(contraindicated) effect occurs when considering the lumbar spine. The right lumbar concavity is
further compressed, thereby shortening (concentric) the musculature and increasing asymmetric
loading on the spinal joints. The right free floating ribs (11th and 12th) are shifted to the left creating
an increased left lumbar convexity, which acerbates the left lumbar hump (prominence). This results
in muscle lengthening and rotating of the left lumbar musculature , which needs to be shortened. If
the exercise is performed to the opposite side, then the left thorax concavity and right rib hump
(convexity) increases. Therefore, this maneuver cannot be performed hoping to achieve balance
when mechanically it is incorrect. This must be avoided as it aggravates the existing imbalance.
Schroth does the opposite, for instance the exercise muscle cylinder, fig. 15
11Schroth leans the upper body to the left ( concave) side, to strengthen the right lumbar muscles.
The back muscles erector spinae, longissimus dorsi and others can now pull together the rib hump
from below. So the “roof” of the rib hump stands vertically again.
In this exercise the pelvis is fixed in the best derotated position (right picture), Now the rib cage can
be derotated with the “leaded” Schroth breathing in three‐dimesional manner for the right waist, the
left ribs, the frontal rght ribs. The head pulls with a thrust of the fontanelle cranially.
When all is done, we firm the today best result of exercise with an isometric tension round about the
whole trunk.
Fig. 16 This picture in side laying belongs also to the rubric “Side bending”.
The patient has a pronounced three‐curve scoliosis, lumbar
left, thoracic right (fig. 11) in order to correct the thoracic
curve, but the lumbar curve increases, because the upper
body becomes heavier on the right. This requires – because
of correction of balance ‐ that the left hip protrudes. Since
the left lumbar musculature must now attempt to hold the
body in balance. It tightens up and draws the lumbar spine
towards the left. But not only that. The shoulder girdle is
drawn out of its horizontal position and pulls the thoraco‐
cervical curve along towards the left. This creates another shoulder hump.
As well, in addition, in this position the right ribs are pressed of the weight. But that doesn’t be with
the side ribs because of the trunk rotation. What is pressed now, are a parts of the front‐side ribs.
And these ribs are not allowed to go inward. They have to breath forward‐upward. One can see in
the picture that the right front part is turned rearward. After this knowledge we have to leave this
posture or exercise !
Fig. 17 Schoth imagine the different movings
Remark: When evalueting a right thoracic curve laterally in flexion
to the right increases thoracic curvature, since the already
lengthened muscles are further lengthened via stretching, while
simultaneously increasing spinal joint loading and vertebral wedging.
However, if translation (side shift) is performed in the coronal
(frontal) plane, the convex muscles shorten while the concave
lengthen and spinal joint loading is decreased. fig.17
The drawing fig 17 shall make clear how Schroth imagines the
different movings:
1 = a straight trunk 2 = scoliosis thoracic right 3 = bending the upper trunk to the right
4 = result while doing this. The trunk sinks together, the spine is shorter 5 = according to Schroth
lean (not bend) the trunk to the left. All curvatures are longer and stretched.
Fig l8 drawing
12A = the point where one bow goes into the next one
B= upper lumbar bow
C= low thoracic bow
D= upper thoracic bow
E= low shoulder‐neck bow
One bow goes into the next one in the same direction. When one
direction changes, the bows grow bigger.
Here I may tell you, what happened, as I wrote to a senior Iyengar Yoga specialist, that he has to stop
such side bending exercises for thoracic right scoliosis because the right lumbar area grows narrow
and the lumbar spine deviates to the left. The rib 11 and 12 and the laterally in soft tissue
musculature on the right waist are pressed. They run almost horizontally. In case of a severe scoliosis
these two ribs reach vertically into the abdomen because the soft tissue musculature does not offer
support and is atrophic. The weight of the overhanging rib hump produses a deep fold. The lumbar
spine is displaced and pushed over to the opposite side. I sent him a part of my article.
He answered: “Triangle pose (Trikonasana). The subject in a Triangle Pose assumes a wide stance
and bends her torso to the right. Her right hand reaches towards her right foot and her left arm
stretches over her head. ‘If a patient with a right –side lumbar concavity is told to take her bottom
hand towards her right foot and then her left arm stretches over her head’, clearly, the patient is
practicing with a woefully unadaequate teacher. Because on the rudimentary level, assuming
Triangle Pose to the right side with a right lumbar concavity should have the right arm STRETCHED
PARALLEL to the floor and the right arm, AWAY from the right foot and placed on a chair at the
height of the right side ribs. Then the left arm, instead of streching up should also be brought up
and over the head, PARALLEL to the floor and the right arm ‐‐ the left hand on the top of the same
chair, so that BOTH SIDES OF THE LUMBAR SPINE AND CORRESPONDING ERECTOR SPINAE MUSCLES
ARE EQUALLY EXTENDED, wITH EVEN AND BALANCED LOADING ON BOTH SIDES OF THE VERTEBRAE”
‐
“Furthermore: In the author’s description (mine!) the author (me!) descripts,of the pose she
assumes that when Triangle Pose is performed to the right side the lumbar right waist is SHORTENED
and the floating ribs (11th and 12th) pushed toward the left side, further aggravating the already
atrophied right‐side muscles. The autor writes: “The right free floating ribs (11th and 12th) are shifted
to the left, downward and medially.” But this is ABSOLUTELY INCORRECT ! WHEN Triangle Pose is
done to the right side, the head of the right femur is supposed to be absorbed sufficiently into the
hip, the right side buttock bone resisted sufficiently forward so that the right‐side floating ribs are
extended AWAY from the right side waist. LENGTHENING the right‐side quadratus lumborum. NOT
SHORTENING IT . Also Triangle Pose is not a lateral bend, but it is a lateral extension, NOT a lateral
bend.”
13What shall one say to that?
This expert doesn’t know, that we all have three parts of the trunk and not only one in the middle.
He doesn’t see the lumbar area, which is as the cellar of a house. And a cellar has to be horizontal,
so that the other parts can built exactly vertically upon. The same we have to think about our body,
The expert doesn’t want to look at the lumbar and pelvis part. He doesn’t see that the left lumbar
muscles pull the lumbar spine to the left and rotate it. That is also the case when he “stretches” the
right waist, because all the body weight hangs on these left lumbar muscles.
He has a similar strange explanation for ‘Back Bending’.
He writes: ”To my eyes and understanding she is making false conclusions regarding the ‘effects’ of
the practice. She is choosing one photo of one posture, perhaps orchestrated and arranged by
somebody unqualified. This one photo may very well be ill advised. The exercise is being done
incorrectly. We have a whole array of different shaped wedges. foams, bandages. ropes, poles,
triangles. etc to modify the unwanted counter‐actions of the spine, in order to create a harmoneus
balanced manageable spinal extension.
There is not supposed to be accent on dorsal extension in the backbends. Conversely the spine, from
the tip of the anterior coccyx all the way up into the atlas is supposed to have a balanced and a
harmoneus extension where space is created evenly between the vertebrae, with an emphasis on
anterior gapping. But this anterior gapping is not supposed to pinch, close, and/or rotate the spine in
any compromised way. And if it does, the posture is being done incorrectly and on a body that is not
ready for such an action. In which case the posture must be thrown to the side‐ a correctly
assembled back bend creates traction for the spine ‐ not compression and lateral rotation.”
( I say: Where we can find something written about the different aids to use? And Schroth has no
patient who is not jet ready for this or that exercise.)
Hed says: “The author then contends that the backward extension shorten the thoracic muscle
groups (I mean the lumbar muscles) and that the abdominal muscles get weakened.
In a classic backbend the dorsal muscles are momentarily contracted. Yes. But does that give the
author the freedom to proclaim, the muscles are shortened? One could easily use the words ‘toned’,
‘rinsed’. ‘strengthened’, ‘charged or flushed’…”
( I say: He misunderstood: The overstretched abdominal muscles are growing weak because they are
now in the exercise long and later they are unable to pull themselves together. So that the intestines
can sink forward and down. The patient gets a ‘big stomach’ and a lumbar lordosis.)
He says:“If Locust Pose is practiced in a way that creates ‐ as the author points out‐ increased
lordosis, then yes, it is counterproductive when trying to address scoliosis.
Why should it create lordosis which is an abnormal overextension/arch of the lumbar spine? Any
senior Iyengar Yoga teachers for example know that any patient with spinal condition must
emphasize in the ‘back arches’ know that a spinal condition must emphasize the longitudinal
extension of the spine in “putting very accent on any arch.”
( I say: That is nowhere written or shown. But with his ‘back extension” the lumbar lordosis stays
nevertheless!)
14He says: “Salabasaba is practiced with a folded blanket placed crosswise just below the navel at the
level of L5, encouraging the anterior face of L5 to move posteriorly. The patient stretches both
arms forward, lifting the wrists/hands upon to a chair seat, keeping the head down so as not to push
the lumbar further into lordosis. The properly trained teacher then stands above the patient at the
level of his/her pelvis. And with a trained foot, the teacher moves the sacrum strongly down (distally)
and into (anteriorly) the body.
Then the patient is told, not to arch, but to extend the anterior spine, along with the arms in a
longitudinal extension, balanced left to right and front to back. This does not create lumbar
overarching (lordosis). On the contrary, it gaps L5/S1 and creates traction for the lower spine.”
( I say: When the arms are lying upon the chair seat, the thoracic back muscles work in a good
extension. But the front rib bow glisses forward and creates a lumbar lordosis. What shall the head
to keep forward? That creates only a kyphosis in the upper trunk. ‐ And what about a trained foot? Is
this chiropractic? Schroth does never do something to correct with the foot.)
What shall one say about?
You can do spinal extensions, but the wrong position of the pelvis stays and works worsening.
When you bend the upper trunk to one side, it pulls always another lumbar push into the opposite
lumbar direction.
Fig. 19 The three trunk blocks in a three curve right thoracic scoliosis with the deviations in frontal
plane
The first drawing shows a normal body and its trunk areals: from down: The pelvis block, the
thoracic block and the shoulder girdle block with head.
The second drawing showes a mild scoliosis. The three “blocks” shift laterally against each other:
The pelvis block shifts to the left, the thoracic block shifts to the right. The shoulder girdle block
shifts to the left.
The third drawing shows a decompensated scoliosis, not only sideways, but also turned against each
other. The blocks are now wedge shaped and the trunk sinks together.
15The fourth drawing showes a patient in resting position who has such a form. The pelvis is moved to
the left, the left hip stands out, is prominent because the body weight is on the right leg. The upper
body sinks to the right.
If the upper trunk is wrong bent to the right and the pelvis moved to the left, the trunk is balanced
over the center of gravity. But it is a scoliotic balance. This is why the bodyweight rests more on the
right leg while standing ‐ and on the right buttock while sitting. This position represents a
disadvantage for scoliosis patients.
Once more:
Each case of scoliosis is a sum of malposture which have developed into one wrong shape. For this
reason it is not enough to correct only one spezific malposture, since those remaining spoil the
overall result.
Fig. 20 The four trunk blocks in a four curve scoliosis
In this case the pelvic girdle is divided into a lumbar and a pelvic section. So the blocks turn against
each other. All have shifted laterally against each other and turn against each other, too. The blocks
sink together. The drawing on the right shows a patient with such a form. The right hip stands out, is
protruded. That is very important for the training:
In resting position of a dorsal right scoliosis with four curves the body‐weight is on the left side. The
body sags to the left, the lumbar spine showes a big curve. This position represents quite a
disadventage for scoliosis patients. The consequence would be in reversal exerczises: The pelvis
shall move to the left, but the lumbar curve shall turn against inward‐forward. The body weight shall
rests more in the middle while standing or sitting. The drawing on the right depicts an rotated trunk
with a right thoracic trunk. The right hip is prominent.
All this the therapist needs to know. He has to understand, why this or that exercise is called for one
scoliosis and another is prohibited in scoliosis.
Now for the Torso rotation or/and Twist, fig. 21
That is a combination Pose.. A torso twist occurs when the shoulder girdle together with the thorax
section rotate against a fixed pelvis as in the Chair Twist Pose.
16Fig. 21 the Torso Rotation Pose
The patient (left picture) turns the right shoulder rear, the left shoulder forward. One sees, the right
hump rounded side‐ and backward because the pelvis is turned to the opposite.
The right picture shows the turning left shoulder back, right shoulder forward. The right rib hump
aggravates, too., because the left front rib bow pushs forward.
One sees the right hump rounded side and backward because the pelvis is sitting fixed turned to the
opposite.
You can turn and twist the trunk, it is wrong, when shoulder girdle is turned against the pelvis,
because the middle of the trunk, the rib cage with the rib hump is out of seeing. Nobody thinks
about of our three blocks. All are seeing only two., the shouler and the pelvis.
A person who does not recognize these elements perform such harmful exercises or prescribes them
for others, without attempting to determine exactly their physiological effects.
But the Yoga expert writes: “The author is describing a very poorly performed twist whose emphasis
appears to be on rotation and not the unique spinal extension that is supposed to be explored in
relationship to a gradually increased reasonable torque of spinal rotation ‐ especially for scoliosis
patients.”
The patients want to try all exerzises on pictures of Yoga‐books and articles about twisting and
bending. And this is doing dangerous. These exercises must avoid since there is no way to perform it
without counterproductive effects.
All Yoga teachers talk about Lyengar , from whom they learned these exercises for scoliosis. He is
the headman of Yoga and all pay him tribute. Lyengar was born 1918 and offered his ‘foundings for
scoliosis’ in the middle of the last century. But unfortionately he also didn’t think about scoliosis
more. For him was the most important thing to open the concavity. He gave curses for scoliosis. And
all his students agree and don’t look behind these exercises.
Lyengar didn’t realize our three trunk blocks (pelvis, rib cage, shoulder‐neck). He twists the shoulder
girdle together with the rib cage against the pelvis.
In bending he does the same: He bends the upper body = the shoulder girdle together with the rib
cage sideways against the pelvis, not thinking about the result of these movements while not looking
on an undressed thorax. But we can see that in the pictures:
17Schroth in a thoracic right scoliosis brings the right shoulder rear, but the right breast forward – and
the right pelvis once more rear. All this the expert didn’t see in his created exercises which he gave
his learning students and all other teachers, too. And they follow him ‐ till today!
Fig.22 The Schoth derotation–sit on chair
Katharina Schroth recognized this. She created counter exercises which work correctly on all spinal
curves and torso rotations. See fig. 22 above or my Schroth‐book .
The practitioner who wishes really to help the patients, finds a way out of the scoliotic misery – will
have to think about more than “How nice this exercise is looking!” The patient has to learn what
he/she has done wrong before and how it has to be performed correctly.
Conceived wrong exercises usually also causes the patients pain, because the spinal joints positioned
unphysiologically, and finally one bone section will begin to rub against another, causing pain
because the skin that encloses the bone is the most sensitive part.
Often a faulty load causes a rotation of vertebrae, so that the spine forms a flight of stairs ( to one
centimeter or more) in some vertebrae which strongly irritates the spine and also the patient. In
sever causes the only thing that can help is a surgical intervention.
All that would not be necessary if therapist and patient know exactly why they have to practice this
exercise and avoid that one. It is necessary to know and to understand the Schroth concept and to
train with thoughts, to acknowledge them and incorporate them into the therapy program.
Performing exercises without understanding the precise function and effects of each is a waste of
time and often harmful.
Katharina Schroth recognized this. She created counter exercises which work correctly on all spinal
curves and torso rotations. While do the Schroth ‐derotation‐sit, stretching the outward rotated
right leg rear the upper body has to lean forward exactly in prolongation of the stretched leg. So the
right waist is open for breathing according to Schroth. So the floating ribs can breathed laterally‐
cranially and rear and once more cranially till they will find their normal position. A push with the
heel helps to open the waist. All other concavities will be breathed three dimensional (left concave
side, right front ribs). When all is done the whole trunk shall firme all muscles of the trunk with an
isometric tension during exhalation. But Yoga exercises loosen muscles and joints.
18Now I want to show an example with a patient of mine in former times:
Fig 23
He always sat after my treatment with him in this Yoga sit.
I forbit him that, but he didn’t hear. He didn’t want to stop
it he feels very well with it. He did it till it knocked
(knackte) in his spine. As I gave him his photos, he was
shocked and immediately he stopped this Yoga‐sit.
We see: His scoliosis is only a little to see. But when he
turns to the right or to the left, the rib hump aggravates.
When the back is almost fully exposed, thus the viewer clearly recognizes that the rib hump on the
right side rotates greatly outward and backwards and that the left side of the back shifts forward,
which is surely not the goal of this exercise. If a patient performs this rotational exercise regulary, the
abnormal curvature angles of the scoliosis will quickly increase and the doctor may recommend
surgery as soon as possible.
No matter, how the patient rotates, turns or bends, it will always be wrong when the goal is only to
improve the thoracic spinal curve. This is because a scoliosis consists not only of a single spinal curve.
A thoracic curve is soon accompanied, below by a lumbar curve and above by a shoulder‐neck curve.
All spinal curves enlarge when these Hatha Yoga exercises are practiced.
Fig.24 on the meadow in earlier times
19Schroth does the opposite of that what the scoliotic body shows:
The left picture shows bending to the right. It presses the flowting ribs together and enlarges
the left lumbar convexity. The pelvis is out of balance.
On the right picture we see a Schroth exercise. The body stands upright without these above
described mistakes.
Fig. 25 The 16 years old boy shows us what he had done before
Fig 25
We see on the picture a very disdorted
trunk with a big hump under the neck.
He trained formely these wrong
exercises for four years, not knowing
what he does. And no one told him to
stop that.
The picture shows him torso‐twisting:
right shoulder girdle rearward, but right
hip forward for holding balance. The rib
hump turns further to the rear and
enlarges. No one did recognize that. And
the boy thought it is all right.
Fig.26
Fig. 26: Schroth opens the narrow right waist. These muscles have now to carry the weight
of the upper body. In the same time the concave side is wide, air can stream in, three‐
dimensional leaded. All is combined with the most possible derotated pelvis and derotated
shoulder girdle. The head pulls cranially. The spine is now as long as possible. After all the
patient tenses all muscles isometrically while exhaling.
20Fig.27: two results of different conservative treatments
a) The 12 years‐ old boy after a three month
treatment by Katharina Schroth.
b) Four years later The same boy at the age of 16
years. Meanewhile he trained bending and
twisting exercises in another practice.
c) 10 years‐old girl at the beginning of Schroth
treatment.
d) The same girl at the age of 15 years at the end of
four in‐patient times with the Schroth method.
On Breathing
Previously breathing was only mentioned cursorily. However, it is an essential part of
Schroth therapy, in fact the most essential part. There is no other way to fill out the
collapsed torso sections. Only air pressure from within can widen and fill them out.
Therefore when correcting sunken upper body sections, the Schroth method always begins
with the constricted ribs, in order to push them apart. If one would merely press the ribs
inward that have shifted laterally and rearward, these ribs would have no room to move,
because the collapsed ribs and the stiff spine would hinder them. A derotation of rib cage
and spine can only happen when the torso is extended to its greatest possible length. Thus
the Schroth method engages the so‐called right‐angle breathing (RAB) technique, which is
described in detail in my Schroth manual.
In RAB the patient breathes the ribs outward from the middle – that is the first direction –
and directly afterwards upward along the vertical axis of a right angle as the complementary
second direction. The upward direction means stretching the spine and thereby the whole
torso. Outward means away from the crooked spine, which is then drawn into the corrective
position.
To reduce the rib hump, the only method is to fill the rear torso cavities, whereby the ribs
serve as levers for the abnormally rotated vertebrae. This of course is only the outward
movement of the breath (ribs). A correct Schroth RAB action also includes an inward
movement of the breathing technique, a consciously one‐sided lowering of the diaphragm.
21Perhaps this article will give qualified readers an incentive to compare the two methods,
yoga and Schroth, and their results. It is really high time to do this, because Yoga for Scoliosis
is spreading all over the world.
Fig.28 Four different forms of thoracic right scoliosis
Here we see four different forms of scoliosis. All patients have thoracic right curves.
a) the body is well balanced
b) the patient has an enormous shoulder hump
c) the left hip stands out in a three curve scoliosis
d) the right hip stands out in a four curve scoliosis
The therapist has to know what is to do for all single patient.
Let me stress again that I do not wish to demonize Hatha Yoga exercises because they are in
fact conceived very well for normal builded bodies as noted above. But they are
inappropriate for scoliosis patients. So scoliotic patients have to leave them.
I would be glad to get answers, may be agreeing or against my explanations, via e‐mail:
info@schroth‐skoliosebehandlung.de
Links:
The Schroth exercises I have set out in detail in my richly illustrated text book „Three‐Dimensionale Treatment
for Scoliosis ‐ A Physiotherapeutic Method for Deformities of the Spine” now in the 8th edition in German.by
Urban & Fischer Elsevier, München. Not jet translated. The translated 7th edition is still available by
www.schrothmethod.com
www.schroth‐skoliosebehandlung.de
www.scoliosistreatment‐schroth.com
book HR Weiss„Best practice“, Pflaum‐Verlag München
Hr.Weiss : www.scoliosisXpert.com
www.scoliosisPT.com
www.scoliosisjournal/content//6/1/17
Elise Browning Miller in Yoga Journal May 2006
Marcia Monroe, book
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