Working on clients with kyphosis and scoliosis

[Old Hippie]

So.. when it rains it pours! This past week I have had 2 clients that presented with kyphosis and 1 with scoliosis. Just curious if anyone has some advice as far as specialized treatment for these conditions>? I did full body sessions for all 3, focusing some extra time on the back and the neck/shoulders and chest. I don't have much experience with this type of structural dysfunction, but my new practice has a lot of older clientele and my intakes are becoming longer and more complex! I would appreciate any help!!!

 

[Rachael E]

Working on clients with kyphosis and scoliosis

First, check out the book Clinical Massage Therapy by Rattray. It has specifics for Scoliosis.
You could also check out the website http://www.DeepTissue.com.

 

[TheRightInfo]

Working on clients with kyphosis and scoliosis

Is that structural dysfunction the reason they were getting massage? If it is, referring to someone with the specialized training is in order. But, if it was, they probably would have gone looking for someone with the specialized training. First....ask what they want in their session. Then find out if they WANT an on-going treatment plan. Some will jump at it, some will just want to get a massage when they want a massage.

As you have time, interest, money and energy, get whatever specialized training you want and need. Clients and their bodies will pique your interest in many ways. Go for it and learn, and if they want that, try out techniques - I'm assuming a few people will chime in here with technique tips for you - just be careful of assuming that because you are presented with something, you are expected to fix it right now. It IS fascinating and fun!!! Hang onto that curiosity.....but know what the client wants.

 

[Chihuahua Addict]

Working on clients with kyphosis and scoliosis

I've actually observed these conditions being greatly reduced & gradually cleared through good Structural Integration techniques such as Aaron Mattes's
Active Isolated Stretching (AIS), as well as the KMI method by Tom Meyers. It does require multiple sessions & that the client to do some serious work to strengthen their weaker side, as well as releasing the tension/restriction from the regions that are overly tight. But the results are amazing!

Hopefully Jason will chime in as he has training in this modality.

 

[Tim S]

Working on clients with kyphosis and scoliosis

I've seen a number of clients over the years with kyphosis/scoliosis who all have shown improvements in posture/pain. With kyphosis it is important to open the anterior soft tissue and osseous structures, from the pelvis up through the neck. Balancing the pelvis is crucial. With scoliosis, the pelvis is often the place to start. A pelvic obliquity can frequently be the original stimulus for the scoli. Loosening structure higher up will often fail to hold if the pelvic obliquity remains. There will be tightness on both sides of the trunk that must be released. Having a "tight side" is, in my opinion, just an illusion. Due to the three dimensional nature of the spinal curve and the resultant compensation in the soft tissue and ribs, the entire torso must be released. With a more level base (pelvis), the likelihood of the client retaining the more neutral posture improves.

Exercise is always an asset, but there truly is not a weak side.

 

[FUHummer]

Working on clients with kyphosis and scoliosis

Thanks for all the great advice so far!

Walt - Can you explain a little more about working the anterior torso? Would I be focusing on releasing areas like the illiospoas and the abdominal muscles? And how far up should I work? Like the rib and pectoral areas?

 

[wild.boy]

Working on clients with kyphosis and scoliosis

The anterior structures would be the entire trunk (abs, intercostals, psoas, anterior shoulders/pecs, etc.) Use positional aids, for example working with your client extended over a pillow or bolster to aid in opening them up into extension. Don't forget the pelvis and upper thighs, as they play a big role in holding the person forward.

 

[Chimichanga]

Working on clients with kyphosis and scoliosis

These conditions are stubborn and require the client to assume responsibility for their recovery, perform any assigned "homework", and review back on how their body responds to the movements. Neuromuscular reeducation is a process of reprogramming the software to realign and alter the hardware.

I have seen some significant success with these conditions. In all cases I used Active Isolated Stretching (AIS) as the primary modality. There is a strengthening aspect to AIS protocols that MTs may be able to employ when working with these conditions.

As a personal trainer, I used AIS but also found it useful to also use a variety of other exercises targeted to develop strength in "weak" areas through a gradually increasing range of motion. (i.e. Cobra pose, Hindu pushups, Divebombers, Table pose, Wheel pose (bridges), etc. for hyperkyphosis).

Another aspect to these conditions: Frequency of bodywork sessions can play a huge role. Weekly for 2-4 months should be a minimum depending on severity. Ideally, I'd prefer 2-3 sessions per week for 2-4 months. This would be enough for them to see/feel significant changes and develop sufficient compensatory strengths to reasonably expect long term positive results.

 

[Beetle-[Mania]]

Working on clients with kyphosis and scoliosis

Thanks for all of the great imput, I'm really interested in trying out some of these new moves!

 

[Mrs. C]

Working on clients with kyphosis and scoliosis

Thanks for all of the great imput, I'm really interested in trying out some of these new moves!

Let us know how your continuing ed experiences work for you. AIS, Structural Integration/Rolfing, and MFR are broad and deep modalities that offer both complementary AND contradictory approaches to treating complex conditions. I feel that the common points among them are more easily understood once you grasp the concept of biotensegrity. The text Anatomy Trains does a nice job of exploring the concept and the role of fascia, serving as a good introductory text. It is a great complement to the diverse texts available on AIS, MFR, etc.

 

[Pompal 09.]

Working on clients with kyphosis and scoliosis

Use positional aids, for example working with your client extended over a pillow or bolster to aid in opening them up into extension.

Walt! Thanks for this comment. Obviously it makes great sense. Now why have I never used it?!? Will get to that, this week.

 

[wella]

Working on clients with kyphosis and scoliosis

I really love everyone's input on this board! Everyone has really inspired me to try new things! I feel like my style is constantly evolving as I begin to incorporate more new things into my sessions! I had a client come in for a 80 min hot stone at the beginning of Jan, and she returned last week for another, and commented on how I did "something" different this session. She said it was really great that I "remembered" the things and areas she liked and how it was even better than her last session. (Side note, I always try to update my soap notes right after a session so I can mark the areas we worked, what the client did and didn't like, etc and then I just refresh before the session!) I told her all of my sessions are individualized to the clients needs and wants, and since I have a "whole bag of tricks" I would be happy to show her a variety of techniques as we continued working together. =) It's so wonderful to be able to educate clients on the many different things massage can offer!