Book reviews

Book Review: Scolio Pilates

Title : Scolio Pilates – Exercise for Scoliosis, A Proactive Guide
Author: Karena Thek Lineback
Publisher: Pilates Teck Publications
Year: 2011
Format: Paperback – spiral-bound
Pages: 121
Availability: order at, price 54.95
Description and Review:
Karena Thek Lineback is a former professional dancer who discovered pilates as a dance student. A sufferer of scoliosis herself, Karena has worked extensively with fitness and rehabilitation clients, has authored three books, The Pilates Golf Athlete, Osteo-Pilates and Scolio-Pilates, and is currently working on a new project, Neuro-Pilates. She travels around the world teaching workshops and also continues to work intensively with scoliosis sufferers, many of whom travel from far away to work with her, often as a last resort after having tried a number of therapies. I recently attended her Scolio Pilates workshop in Paris a few months ago. She is actually one of the nicest people I have met in the pilates industry, down to earth and funny. I would describe her as having a very sunny personality. One of the things that struck me about her was her genuine desire to help people suffering from scoliosis. She went out of her way to put the people who had come in to serve as “models” for the workshop at ease. She reminded me and my fellow teacher attendees (before the models arrived) to be sensitive to the feelings of the model and not to, for example, gasp aloud with surprise at the crookedness of the spine we were viewing. This may seem like common sense, but sometimes we pilates teachers, like anyone else, although we love our students and aim to help them, have our insensitive moments where we may forget that the spine we are viewing is attached to a real live human being.
The book begins with a description of scoliosis-definition, causes, treatment and negative effects. According to the book, scoliosis is generally treated in one of three ways – observation, bracing or surgery. Oddly enough, especially to pilates teachers, exercise is not widely acknowledged as a viable treatment option despite decades-old studies proving its usefulness of in combating the negative effects of scoliosis. Other studies have corroborated the usefulness of exercise, showing that exercise can reduce curves sometimes significantly, improve lung capacity and breathing, slow the progression of scoliosis and reduce pain in those who do not have surgery as well as those who opt for spinal fusion, and ease the transition from brace wearing to non-brace wearing.
About twenty percent of scoliosis is caused by disease. The other eighty percent of scoliosis cases are considered idiopathic, meaning that they have no known cause. The curvature of the spine, which is considered to be scoliotic when the curves exceed ten degrees, is not limited to one dimension, but instead exists in three dimensions. This three dimensional nature is of utmost importance in treating the scoliosis through exercise. The scoliotic spine can be compared to a spiral staircase. However, unlike the staircase, the spirals in the spine change directions two or more times. Katherina Schroth, who published a widely known study in 1924 describing the effectiveness of exercise to treat scoliosis, was the first person to describe working with scoliosis in three dimensions. Her work using breath to treat and elongate the spine is discussed in the manual written by her daughter entitled Three Dimensional Treatment for Scoliosis. Karena has incorporated the Schroth Method’s use of breath into her treatment protocols for scoliosis, which use breathwork, elongation and pilates exercises to lengthen, strengthen and straighten scoliotic spines. I have not read the Schroth book (although it is on my list of books to read) so I do not know what other elements of the Schroth method have inspired Karena. Perhaps Karena herself can comment on this.
The next part of the book describes the scoliotic spine in more detail. Although no two spines are alike, the most common manifestation is what Karena refers to as the Ashlyn 3-curve, named after one of Karena’s clients. In the Ashlyn three curve, which is referred to as a S curve because of the shape the spine takes, the hip protrudes on the left side and there is a posterior right convexity (or bump). The student with this “typical” scoliosis will generally shift their weight onto their left leg. Other telltale signs to look for are pronation in the left foot, left waistband higher than the right, winged scapula on the right, right ear tilting toward the shoulder. In the “Becky four curve” scoliotic spine, the lumbar-sacral spine will exhibit an extra curve. These are the most common cases; however, there are infinite variations. The spine can have several curves in the thoracic spine and the scoliosis may take the form of a C rather than an S in some cases. The curves may also be three or four curves, similar to the Becky or Ashlyn curves, but in opposite directions. During the workshop, Karena reassured the group that it may be difficult to make a determination about the spine’s curvature, particularly if the person is athletic and their spine is well supported by their musculature or if have been doing pilates! The curves can be measured using a scoliometer or a pseudo scoliometer application that can be downloaded onto a smartphone . Karena also suggests reviewing the student’s X-rays. Even with a very experienced eye like Karena’s, the X-rays or scolimeter results sometimes reveal surprises.
In the next part of the book, Karena explains the Scolio Pilates methodology. Unlike what many pilates schools often teach, which involves placing a pad under the spinal concavity and having the student press into the pad, the Scolio Pilates method takes the opposite approach. The pads or scolio-wedges (sold on the website) are first placed under the convexity, (the “bump”). This lifts the convexity and allows concave side to lower with the help of gravity. The pads are used to bring the spine closer to neutral, allowing tight muscles to lengthen and over-stretched muscles to shorten so that the muscles may then be worked more effectively. The pads help the student to realign her body, but neither the student nor the teacher is passive. The teacher must cue to the student to elongate and de-rotate the body. When the primary curve is addressed, the resulting compensations will become more visible and actually easier to correct. As Karena explains, the spine does not just curve to one side, it spirals around. The primary curve is the catalyst for the other curves. The non primary curves are the spine’s way of reorganizing itself, so to speak, to compensate for the primary curve so that the head is more or less in the center of the body. Because the Ashlyn 3 curve and the Becky four curve are the most common manifestations of the scoliotic spine, Karena provides “correction keys”, which explain in detail how to place the wedges for students with similar curves, a sort of “cheat sheet” This is very useful if your client’s scoliosis follows the same or similar pattern. If not, the methodology is easy to understand, “prop what is dropped” so that teachers can figure out where to place the pads, although they may have to play around with them to find the perfect placement. With respect to cuing and spotting, pilates teachers are already used to helping their students find optimal alignment, so if they follow their eyes and their instinct, they should be successful. Once the pads are in place, the student will then perform a number of breathing or pilates exercises to strengthen the body in its more optimal alignment.
Next, the book provides a number of different exercises to give to students with scoliosis. Some of them are breathing and elongation exercises; some are classical exercises (footwork on the reformer, the hundred, and double leg stretch, for example) on the mat and on the apparatuses -reformer, caddy, wunda chair, barrels; and many are contemporary, or at least exercises with which I was unfamiliar. Although many of them require the padding, some, like hanging from a bar, do not. The book includes detailed instructions and photos of the exercises. Once a teacher understands the basic concept of the wedging, the elongation and the breathing, however, he or she can adapt pretty much every pilates exercise for his or her student.
To buy or borrow: does it work? I have used these techniques on one of my students who has scoliosis and the approach definitely makes teaching easier. She also has a greater understanding of her body and can work on her own. I have also tried it out on myself. Although I do not have a real scoliosis, my left pelvis shifts back and when I extend my left leg, there is often a bit of a pop in my thoracic spine despite my best efforts to stabilize. When I place a small pad under the slight left convexity in my lower back and pelvis and then correct the compensations by shifting my ribs leftward, miracle – no more popping. Hopefully, over time, I can use this method to correct the pelvic shift and won’t need the padding any more. I was recently discussing this technique with a friend of mine, who is a wonderfully talented pilates teacher with decades of experience. She tried it because she too has a pelvic shift and reported that she felt straighter and her students did as well. At 54.95, the book is a bit expensive, as are the wedges and triangles because they are not mass produced. You can probably make your own for less if you are handy with a sewing machine. I chose to buy them. They come in very groovy patterns. The rectangles and triangles can be made by cutting up an old airex mat. If you work with students with scoliosis or have scoliosis yourself. I would definitely recommend this book and the seminar with Karena. I feel that they are worth the investment. This is material that you will refer to time and time again.