Massage is widely used in the treatment of scoliosis, although it is only effective in combination with other methods. It is prescribed both in the initial stage and with progressive curvature, and the intensity and type of impact is determined by the condition of the spinal column. What does spinal massage do for scoliosis, can it be done at home, and does it have any contraindications?
Spinal massage for scoliosis
What is spinal scoliosis
Scoliosis is a persistent deviation of the spinal column from its axis in the frontal plane. Depending on which direction the displacement occurred, right-sided or left-sided scoliosis of the spine is distinguished. The disease most often occurs during periods of intensive skeletal growth, that is, at the ages of 4–7 years and 11–15 years.
In adolescents and children, the cause of scoliosis may be:
- Weak back muscles due to lack of sufficient physical activity.
- Unbalanced diet with deficiency of microelements and vitamins.
- Carrying briefcases or bags on one shoulder.
- Incorrect posture while studying at the table.
- Congenital defects of the musculoskeletal system (vertebrae, ligaments and muscles).
Sometimes scoliosis is combined with curvature of the spine in the sagittal (antero-posterior) plane. This lesion is called kyphoscoliosis.
Risk factors
There are many myths about why scoliosis develops in childhood. It is important to remember that:
- The problem is not related to sleeping on a soft mattress.
- Curvature cannot occur due to wearing a heavy backpack or bag.
- The cause of the pathology cannot be sitting for a long time at the TV or computer.
But a very real risk factor is heredity and congenital pathologies. Very often, scoliosis is caused by genetic factors. It is known that parents with scoliosis in approximately 30–40% of cases give birth to children with the same problem.
Many doctors recommend that when identifying a disease in a child, diagnose his brothers and sisters over 10 years of age, since there is a high probability of a “positive” family history.
Basic principles
Preliminary examination. It is necessary to identify the stage of the disease, as well as the presence or absence of contraindications to treatment. Massage should only be performed by a specialist who has undergone special training. Incorrectly performed procedures can be harmful to health.
It is not recommended to eat for two hours before the session and for an hour after it. The room should be warm. The optimal number of sessions is 15–20. It is recommended to undergo 2-3 courses of treatment throughout the year. The surface on which the massage is performed should be smooth and moderately hard. The best option is a special massage table.
Contraindications
Gymnastics for the back with scoliosis
Massage cannot be performed in the following cases:
- Inflammatory processes of any localization.
- Increased body temperature.
- Arterial hypertension.
- Skin diseases.
- Neoplasms.
- Period of menstruation.
- Diseases of the nervous system.
- The period of exacerbation of any chronic diseases.
- Surgery within the last 6 months.
- Any discomfort on the day of the procedure.
Working out biologically active points helps to quickly relieve muscle tension and relieve back pain.
How to do it without causing harm
To ensure that the prescribed procedures bring only a positive effect, it is recommended to visit a doctor before them. He will determine whether there are any contraindications for the massage. The list of them for therapeutic massage is wider than for hygienic:
- diseases of the hematopoietic system;
- purulent abscesses;
- predisposition to bleeding;
- acute inflammatory diseases;
- skin diseases in the massage area;
- mechanical damage to the skin on the back;
- inflammation of the lymph nodes;
- vascular pathologies;
- active form of tuberculosis;
- acute respiratory diseases;
- hypertension;
- mental illnesses and central nervous system defects.
General contraindications include:
- diseases of the cardiovascular system;
- liver/kidney diseases;
- pulmonary artery embolization;
- thrombosis and thrombophlebitis.
Types of massage
The effect can be general, when the whole body is massaged, and private, when certain areas are worked on. Types of therapeutic massage can be as follows:
- Manual. The massage therapist exerts the influence with his own hands.
- Canned. The therapeutic effect is achieved due to the vacuum created in special jars installed on the patient’s back. During the procedure, the specialist moves the cups along the spine in straight, circular or zigzag movements. This effect has a pronounced lymphatic drainage effect and significantly improves blood circulation in the tissues.
- Spot. The essence of this technique is to influence special acupuncture points of the body.
- Differentiated. With this type, different methods of influence are applied to different areas.
- Hardware. The procedure is carried out using special devices: a massage chair, a massage pillow, a special hand massager, a vibrating body massager and others. There are strict indications for such a massage, so using the devices yourself is not recommended.
Only a doctor can determine which type to use in each specific case.
The beneficial effects of massage on the body
A professionally performed massage heals, restores, and relaxes the entire body. A correctly selected technique will not only help get rid of a certain disease, but will even prevent its development in the future.
Massage has a complex effect:
- blood and lymph flow in tissues accelerates;
- blood supply to joints and muscles improves, resulting in improved mobility and flexibility of movements;
- dead epidermal cells are removed, the skin becomes smoother and more elastic, the functioning of the sebaceous and sweat glands is normalized;
- fat deposits are broken down;
- blood flow to internal organs is stimulated;
- the reaction of nerve cells to mechanical stimuli is accelerated, the nervous system receives a powerful flow of positive impulses, nervous excitability is reduced, and increased irritability is eliminated.
Execution technique
Depending on which part of the spine the deformity occurred in, as well as the severity of the disease, different treatment techniques are used. The main task when performing a massage is to relax overly tense muscles and tone weakened ones.
General rules:
- The massage is performed with the patient lying on his stomach. The arms lie freely along the body. A special cushion is placed under the ankle joints to maximize relaxation of the lower back muscles.
- First, the muscles are warmed up and blood flow in them is increased.
- More intense stage. First, the muscles on the side of the convex segment of the spinal column are massaged. There the muscles are stretched and often atrophied, so the massage therapist uses special techniques to improve muscle tone.
- Next, the concave segment is affected. Here the muscle fibers are spasmed and shortened. By influencing them, the massage therapist achieves muscle relaxation and restoration of normal functioning.
- Finish the session with stroking movements along the entire back.
Can massage make scoliosis worse?
Some researchers believe that one of the causes of acquired scoliosis is constant muscle tension located along the spinal column. Of course, such a pathology will not cause serious structural changes in bone tissue, but it can trigger pathological processes. Thus, relieving muscle tone will have a positive effect on the condition of the spine.
But can a massage therapist put so much pressure on the spinal column that the curvature worsens?
In fact, the spine is almost impossible to move with the movement of the hands. That is why corsets and plaster casting are prescribed for treatment, and massage is called only a means of symptomatic therapy.
However, unprofessional massage for teenagers with scoliosis can actually worsen their health. In particular, the use of uncertified aids will provoke allergies.
Theoretically, if an unqualified chiropractor works with a patient, then physical injuries and displacement of intervertebral discs are possible. To avoid complications, it is recommended to choose massage therapists with real reviews. Before the first procedure, it is worth checking the documents confirming the qualifications of the specialist.
If the chosen massage therapist asks for the child's medical record and x-rays, this is a good sign.
Features of the procedure for varying degrees of scoliosis
The massage effect for each degree of the disease has its own characteristics.
Massage for scoliosis 1st degree
At the first stage, the change in the position of the spine is not clearly identified, so it is enough to carry out kneading and rubbing movements in the area between the shoulder blades and along the spine. Massage for scoliosis in children can be carried out at home after the parents have completed a training course in the basic techniques of a specialist. To correct the curvature of the spine at the initial stage, massage is often sufficient to carry out several courses in combination with therapeutic exercises.
Massage for scoliosis 2 and 3 degrees
In order to tone weakened muscles, it is necessary to gradually increase the impact both during the current procedure and from session to session. With the second and third degrees of curvature, it is advisable to influence acupuncture points and know the features of massage when various parts of the spine are affected. Therefore, for scoliosis of degree 2 and higher, it is better to entrust children’s massage to a specialist rather than harm the baby’s health through inept actions.
Basic techniques: stimulation, relaxation, retraction
Features of massage effects
Each type of massage is characterized by certain techniques and features that affect the success and efficiency of its implementation. For therapeutic treatment for scoliosis, the following set of requirements applies:
- a certain body position is used, which helps correct spinal curvature;
- application of a set of developed technical techniques;
- The massage table is located below the standard level so that the specialist can use his own body weight to work on certain problem areas.
Features of implementation in adults
Treatment of scoliosis in adults is much more difficult. Here the specialist deals with a mature musculoskeletal system, and not a plastic one, like a child’s. In addition, in adults, scoliosis is often combined with osteochondrosis. However, if the disease is not advanced, then even in adults, massage will help correct it.
In the first stages, an intense shallow effect is performed in order to increase the overall tone of the body. At the stage of deformity correction and stabilization of the achieved results, the massage becomes deeper, more intense and longer. In adults, special attention is paid to the effects on the muscles of the chest, abdomen, neck and buttocks. There is often a need for deep treatment of the lower extremities when there is curvature of the spine in the lumbar region.
It is important that massage is always used in conjunction with exercise therapy (physical therapy), physiotherapy and, if necessary, medications. Only in this case can effective treatment of scoliosis in adults be achieved. Often the patient is recommended to wear a special corset or belt.
Thus, back massage for scoliosis in both children and adults is a mandatory component of therapy, and the earlier the stages of the disease it is started, the more effective it is. An important condition is compliance with the massage technique, as well as the combination of massage with other treatment methods recommended by the doctor.
Text of the book “Massage for diseases of the musculoskeletal system”
Scoliosis
Scoliosis is a severe progressive disease of the spine, which manifests itself in an arched curvature in the frontal plane and twisting of the vertebrae around a vertical axis - torsion (Fig
.
Rice. 8. Possible displacements of the spine with scoliosis
At the last stage of the disease, a costal protrusion first forms, and then a costal hump - the gibbus.
Scoliosis is not only a cosmetic defect, it is numerous dysfunctions of internal organs, especially the cardiovascular and respiratory systems. Scoliosis is no longer just a violation of posture, but a disease.
Causes of scoliosis
Very rarely, scoliosis can be congenital and caused by improper development of the vertebrae. Much more often, scoliotic disease occurs between the ages of 5 and 15 years, when the spine grows. Scoliosis is more common in girls.
There are usually several causes for this disease. It is not always possible to establish what led to its development.
Factors causing scoliotic disease are usually divided into three groups.
1. Congenital or acquired primary pathological factors that lead to impaired growth and development of the spine.
As an illustration, we can give an example when a child has a congenital wedge-shaped or semi-wedge-shaped vertebra. His body grows asymmetrically. As the spine grows, it takes the shape of an arch, and the pathological vertebra is located at the apex of scoliosis.
Scoliotic curvature of the spine can be caused by the congenital absence of one rib or, conversely, by the presence of an extra rib on either side.
Scoliosis also develops as a result of fusion of the fifth lumbar vertebra with the sacrum or the transition of the first sacral vertebra to the lumbar region.
Acquired factors include rickets, improperly treated compression fracture of the spine, tuberculous lesions of the vertebrae.
2. Statodynamic factors, when, as a result of prolonged asymmetrical body position, compensatory curvature of the spine occurs.
A long-term asymmetrical position of the body is observed, for example, in cases where one leg is shorter than the other from birth, or there is flat feet on one leg, or there is a congenital dislocation of the hip. The same situation occurs with an incorrectly healed fracture of the bones of one of the lower extremities. All these pathologies lead to an oblique position of the pelvis and the possible subsequent development of scoliosis. In addition to the above reasons, an oblique position of the pelvis and deformation of the spine cause paralysis of one half of the body, large soft tissue burns and sometimes surgical interventions.
Sometimes the patient takes a curved position for a long time to reduce pain resulting from certain diseases of the spine and peripheral nervous system, and as a result scoliosis develops.
In adults, scoliosis can occur due to prolonged asymmetrical loads on the back muscles - the so-called. scoliosis of violinists, seamstresses, porters. In these cases, when the growth of the skeleton is already complete, the curvature develops more slowly and rarely reaches the same degree as in children.
3. General pathological factors. Scoliosis often develops in children who are weakened as a result of a serious illness or, for example, during puberty, when the balance of the endocrine glands is disturbed.
Treatment of scoliosis should take into account its etiology. The first of these factors does not always lead to the development of scoliosis or its progression. They are very dangerous in combination with factors of the second group, but the latter can often be cured. The greatest concern should be caused by a combination of factors from all three groups.
Idiopathic scoliosis is caused by uncertain factors, when clear causes of scoliosis cannot be established. Most often in this case they talk about neuromuscular insufficiency and inferiority of bone tissue. Such scoliosis is very difficult and progresses quickly.
The general physical culture of the child is also important. Scoliosis often occurs in children who are delayed in physical development or have poor posture.
Scoliosis degrees
There are 4 degrees of scoliosis depending on its severity. At the same time, attention is paid to differences in the shape of the scoliosis arc, in the angle of deviation of the primary arc from the vertical line, in the severity of torsion changes and in the persistence of existing deformations.
I degree of scoliosis.
When the back muscles get tired, the spine deviates slightly to the side. After rest, the curvature disappears. The arc of curvature is simple, in the form of the Russian letter C. The angle of deviation of the spine is no more than 10°, as can be seen on an x-ray taken in the supine position. Torsion changes during examination of the patient are weakly expressed, but the radiograph shows asymmetry of the roots of the arches and a slight deviation of the spinous processes of the vertebrae from the midline. The curvature of the spine is noticeable in a standing position. In a relaxed state, for example in a lying position, it appears less.
II degree of scoliosis.
The changes are significant. With active straightening by force of will, the curvature does not disappear. Only when suspended by arms (stretching the spine under the weight of the body) does the spine straighten, but not in every case. Often the spine is curved in the shape of the Latin letter S as a result of the appearance of a compensatory arch. The angle of deviation of the main arc of curvature is up to 30°. Torsion changes are noticeable not only on photographs, but also when examining the patient: costal protrusion, muscle roll. In a lying position with slight extension, the curvature is almost the same as in a standing position. Spinal deformities become more stable. His mobility decreases sharply. Any physical exercise is tiring. Patients often complain of muscle and intercostal pain (neuralgia).
III degree of scoliosis.
The spine has at least two arches. When hanging by hand, the curvature does not disappear. Immobility occurs in the area of curvature. The angle of deviation of the main arc on the radiograph is up to 60°. Torsion changes: significant deformation of the chest, the presence of a rib hump. Deformities of the spine and chest are stable. Violations of internal organs and neurological disorders appear.
IV degree of scoliosis.
The formation of kyphoscoliosis with spinal deformation in both the lateral and anteroposterior directions, caused by progressive lateral deviation of the spine and twisting along its axis. The presence of anterior and posterior costal hump, deformation of the pelvis and chest. The angle of deviation of the spine from the vertical axis exceeds 60°. The patient's general condition worsens. The activity of the respiratory organs, heart and nervous system is disrupted.
Diagnosing scoliosis by degree is important for selecting the most appropriate treatment measures and assessing their effectiveness. Establishing the degree of scoliosis occurs under the same conditions as for postural defects.
On the side of the back, there is a costal protrusion in grade II and a costal hump in grade III. In stage I scoliosis, costal protrusion is detected when the torso is tilted forward.
In standing and lying on the stomach, lateral deviation of the spine, the presence of counter-curvatures, costal protrusion or costal gibbus, muscle roll, etc. are noted.
When diagnosing scoliosis, the level of standing of the shoulder blades and their rotation around the axis are clarified by measuring the distance from the spinous processes to the angle of the scapula on the right and left and the distance between horizontal lines drawn at the level of the angles of the shoulder blades.
In addition, general measurements are taken, determining body weight, height, chest circumference, dynamometry, spirometry, etc. The results show a general physical retardation and disproportionality in the physical development of patients with scoliosis.
To diagnose scoliosis, an X-ray examination is necessary, which is carried out with the patient standing and lying down.
Prevention of scoliosis
Preventing scoliosis is much easier than curing it. Prevention of childhood scoliosis, including school scoliosis, is ensured by: a flat bed, proper sitting at a desk and table, good and proper lighting of the workplace, exposure to fresh air, outdoor games, good nutrition, adequate sleep, morning exercises, self-massage.
The basis for the prevention of scoliosis and postural disorders should be considered the correct physical education of children in the family and school, and the general strengthening of the child’s body. Physical education and sports are especially important in childhood and during puberty.
Prevention of occupational scoliosis consists of maintaining the correct work and rest schedule and having physical exercise breaks during work. Sports play a big role.
Of great importance in the prevention of childhood scoliosis is the correct placement of children in the classroom, and sometimes desks.
Physical education sessions – several corrective exercises performed in the classroom when children are most tired – have a beneficial effect on the child’s body. All teachers need to be able to conduct such exercises. The initiator of organizing such physical education sessions should be the school doctor.
The prevention of scoliosis should also be discussed at parent-teacher meetings. Conversations and lectures on this topic are necessary for both parents and students. It is possible to involve all means of education (cinema, posters).
Mode for children with scoliosis
In addition to systematic treatment in the clinic, sick children need to create conditions at home that promote a favorable course of treatment.
During the day, children need to spend as much time as possible outdoors. Night sleep should be long enough. Children should be taught to go to bed early and get up early.
The bed should be flat and relatively hard. Featherbeds and spring mattresses are not suitable for patients with scoliosis. It is better to use a thin mattress or cotton bedding. The pillow must be small and relatively flat. Children should fall asleep on their back. If they turn around in their sleep, then, of course, you shouldn’t wake them up.
Sleeping for an hour during the daytime, after lunch, is very beneficial for children. During the day, you also need to sleep or lie on your back, with your arms along your body. You should not take a book or toy to bed.
Sick children should be fed in a timely manner, preferably at the same hours. Food needs to be varied, with sufficient amounts of proteins and vitamins, especially vitamins C and D.
Home corrective gymnastics should be carried out 2 times a day: in the morning, an hour after breakfast (with well-fed children - on an empty stomach), and in the afternoon (2 hours after meals). In summer, you can do gymnastics outdoors in the shade. Ball games are recommended, especially throwing the ball over your head. Older children can play amateur volleyball.
Breaststroke swimming and rowing with two oars are useful. However, it is better for those with scoliosis not to participate in competitions. Young children can play active games without sudden turns or jumps. In winter you can go for leisurely skiing and ice skating.
Children are not recommended to play sitting on the sand or on the ground. The sandbox needs to be high. To play with dolls, you must use a table.
Sedentary activities (drawing, modeling, etc.) are carried out at a desk, the height of which should be approximately 3 cm above the elbow of the lowered arm.
In summer, it is advisable to play less sedentary games. They must be alternated with moving or physical training sessions every 20 minutes. The same applies when preparing homework.
Children with scoliosis should not carry heavy objects, jump, or ride a bicycle. Housework that requires prolonged periods of bending should be limited.
In summer, you need to spend as much time as possible in the sun, alternating this with staying in the shade. Swimming in open water is allowed no more than 2 times a day for 5, 10, 15 minutes (depending on the age of the child).
It is better not to use board games.
Treatment of scoliotic disease
Favorable results in the treatment of scoliosis are possible with the maximum efforts of doctors, parents and the sick child himself. Complex treatment that can be successful includes orthopedic measures, physical therapy and massage, general therapeutic agents, and hygiene measures. Sometimes wearing a corset is indicated. The use of only one of the components of treatment is ineffective. In severe cases, surgery is sometimes performed.
Correction of grade I scoliosis must be carried out in schools, kindergartens and at home. Through comprehensive measures it is possible not only to stop the progression of deformities, but also to achieve their reverse development.
The teaching of physical education is important, the lessons of which must be used to correct scoliosis and posture. It is important for children to participate in the sports life of the school. In the initial stage of scoliosis, swimming on the chest is extremely useful as a general strengthening and corrective remedy. Skiing and skating, athletics, and sports games have a good effect.
For children with severe pre-scoliotic conditions, it is advisable to organize additional classes such as therapeutic exercises at school, especially for rural schools.
Treatment of severe forms of scoliosis is carried out in special orthopedic institutions. Currently, surgical treatment methods are used. Osteoplastic fixation of the spine using an autograft or homograft with systematic complex treatment both before and after surgery is widely used.
After surgery, the spine is usually fixed using a special corset. Wearing orthopedic corsets is most effective in combination with active therapeutic exercises.
Physical therapy for scoliosis
Exercise therapy is important in the treatment of scoliosis. It influences the formation and development of the osseous-ligamentous apparatus of the spine through the functional state of the muscular system. A sufficient amount of physical exercise has a general strengthening effect on the body, improves metabolism, trophism of the muscles of the back and spine. This creates conditions under which the progression of the disease slows down and the necessary corrections occur.
The development of the back muscles helps create the muscle corset necessary to support the spine and keep it in the most straightened state. If straightening the spine is no longer possible, a well-developed muscle corset helps prevent the progression of the disease.
The method of exercise therapy in each specific case depends on the clinical characteristics of the disease, the degree of scoliosis, and the goals of general therapy. Treatment of stage I–II scoliosis with the help of exercise therapy is long-term, at least 6–8 months. Classes are carried out 3 times a week in the physical therapy room and daily at home on your own.
Therapeutic exercise is designed to solve the following problems:
1. Creation of physiological prerequisites for restoring the correct body position, namely the development and gradual increase in strength and endurance of the trunk muscles, the formation of a muscle corset.
2. Stabilization of the scoliotic process. At its initial stage, it is possible to correct existing violations.
3. Education and consolidation of the skill of correct posture.
4. Normalization of the action of other body systems: cardiovascular, respiratory, etc.
5. Increasing the body's resistance to pathological factors.
The complex of therapeutic exercises for scoliosis includes exercises for the back and abdominal muscles, which are usually performed in a lying position. This position helps not only to build up the muscle corset, but also to consolidate the maximum correction that is noted in this position.
The development of the iliopsoas and gluteal muscles helps create the preconditions for restoring normal body position.
Exercises aimed at eliminating existing violations are of two types: symmetrical and asymmetrical.
When performing symmetrical exercises, the middle position of the spinal column is maintained, which is not easy to achieve with scoliosis, since the muscles receive unequal tension: on the convex side they are quite tense, and on the concavity side they are slightly stretched. Thus, over time, muscle traction on both sides is leveled, asymmetry is smoothed out, partially weakened, and muscle contracture on the concavity side of the scoliotic arch decreases.
Special studies have shown that symmetrical exercises do not violate the compensatory adaptations that the patient has developed and do not lead to the development of counter-curvatures. Such exercises are advantageous in that they are relatively easy to select and then carry out.
Asymmetrical exercises act locally, on a specific area of the spine. Thus, by moving the leg towards the convexity of the scoliosis arch, one achieves a change in the position of the pelvis and a decrease in the angle of the arch. By raising the arm from the side of the concavity, the position of the shoulder girdle is changed, and the arch of scoliosis is thus smoothed out.
There is no template for choosing asymmetrical exercises for scoliosis. For each child, they are selected individually, while the localization of the process and the nature of the impact of the selected exercises on the curvature are strictly taken into account. The wrong choice of asymmetrical exercises can aggravate the situation and contribute to either an increase in the curvature of the spinal arch or an increase in counter-curvature. A doctor should prescribe asymmetrical corrective exercises.
Symmetrical exercises are safer in this regard and are more widely used.
General developmental exercises indicated for scoliosis include exercises for balance and coordination of movements, for the chest muscles, and for other muscles. They are carried out from different starting positions, with a gradually increasing load.
The exercise therapy complex for scoliosis necessarily includes breathing exercises, static and dynamic. They help normalize the respiratory function impaired as a result of scoliosis.
Great importance is attached to the education and consolidation of the skill of correct posture. The patient is shown what posture should be. The skills acquired during classes are consolidated through self- and mutual control.
Much attention is paid to creating a child's muscular sense, which will allow him to maintain the correct body position while lying, sitting, standing and when walking.
Exercises aimed at developing spinal mobility for scoliosis should be used with great caution so as not to disrupt the compensatory mechanisms that prevent the progression of the disease. However, such exercises can be useful in cases where surgical intervention is required. A more mobile spine is easier to straighten during surgery.
If surgical correction is not expected, mobilizing exercises are used in small doses and only after creating a muscle corset.
Mobilizing exercises include crawling on all fours, mixed hangs, and exercises on an inclined plane.
Physical therapy and massage for scoliotic disease are by no means the only methods of therapy. They are combined with positional treatment, the correct regimen of movements and static loads, taking the necessary medications and special orthopedic methods.
Physical exercises for postural disorders and scoliosis
A. Exercises to develop and consolidate the skill of correct posture:
1. Starting position (i.p.) – standing. Take correct posture, touching the wall with the back of your head, shoulder blades, buttocks, calves and heels.
2. Take correct posture, as in exercise 1. Move 1 - 2 steps away from the wall, maintaining body position.
3. Take correct posture against the wall, take 2 steps forward, sit down, stand up. Regain correct posture.
4. Take correct posture against the wall, take 2 steps forward, relax the muscles of the neck, shoulder girdle, arms and torso. Adopt correct posture.
5. Adopt correct posture against the wall. Raise yourself on your toes and hold in this position for 3 – 4 seconds. Return to i. P.
6. The same exercise, but without a wall.
7. Adopt correct posture. Squat down with your knees spread apart. The head and spine are straight. Stand up slowly. Accept and. P.
8. I. p. - sitting on a gymnastic bench. Take correct posture, touching the wall with the back of your head, shoulder blades and buttocks.
9. I. p. the same as in exercise 8. Adopt correct posture. Consistently relax your neck muscles, drop your head, relax your shoulders and back. Return to i. P.
10. I. p. - lying on your back. The head, torso and legs are extended in a straight line, arms are pressed to the body. Raise your head and shoulders, check the straight position of your body. Return to i. P.
11. I. p. - lying on your back in the correct position. Press your lower back to the floor. Stand up. Adopt correct posture. Place your lower back in the same position as it was originally.
Rice. 9. Therapeutic walking
12. I. p. - standing. Adopt correct posture. Walking around the hall with stops (Fig. 9)
. Maintain your posture.
13. I. p. – standing with correct posture, holding a bag of sand on your head. Sit down, trying not to drop the bag. Return to i. P.
14. Walking with a bag on your head while maintaining correct posture.
15. The same with stepping over obstacles (over a rope, a gymnastic bench) with periodic posture checks.
16. Adopt correct posture with the bag on your head. Catch the ball. Throw it with both hands from the chest to your partner. Maintain your posture.
17. Difficult walking with a bag on the head: in a half-squat, with high knees, etc.
B. Exercises to create and strengthen the muscle corset
For back muscles:
1. I. p. - lying on your stomach, hands placed on top of each other under the chin. Place your hands on your belt, raising your head and shoulders, bringing your shoulder blades together, but do not raise your stomach. Hold this position for 3 – 4 seconds.
2. The same exercise, but move your hands to your shoulders or behind your head. 3. I. p. the same. Raising your head and shoulders, slowly move your arms up, to the sides and towards your shoulders (as when swimming breaststroke).
4. I. p. the same. Movement of the arms to the sides and back, to the sides and up.
5. I. p. the same. Raise your head and shoulders. Hands to the side. Squeeze and unclench your hands.
6. I. p. the same as in exercise 5, but make circular movements with straight arms.
7. I. p. - lying on your stomach, hands under your chin. Alternately raising straight legs without lifting the pelvis from the floor. The pace is slow.
8. I. p. the same. Simultaneously raising straight legs and holding them for 4 - 5 seconds.
9. I. p. the same. Raise your right leg, then, without lowering it, lift your left leg. Hold in this position for 5 seconds. Lower your right leg, then your left leg.
10. I. p. the same. Raise your straightened legs, spread them apart, connect them and lower them to the floor.
11. I. p. - partners lie on their stomachs opposite each other, one holds the ball in bent arms in front of him.
Rolling the ball to a partner, catching the ball while maintaining an elevated position of the head and shoulders.
12. I. p. the same. Raise your head and shoulders, holding the ball in front of your chest with your elbows bent. Throw the ball to your partner, arms up, head and chest raised, catch the ball.
13. I. p. the same. Exercises with a gymnastic stick held on the chest. Throw the stick to your partner and catch it, grabbing it from above and below.
14. I. p. - lying on a gymnastic bench with your head towards your partner. Raise your head, chest and straightened legs. Hold for 3 – 5 seconds.
15. I. p. the same. Perform movements with your arms and legs as when swimming breaststroke.
16. I. p. the same. Roll the ball to your partner.
For the abdominal muscles:
1. I. p. for exercises - lying on your back, your lower back pressed against the support. Bend and straighten one leg at the knee and hip joints, then the other.
2. Bend both legs, straighten them, and slowly lower them.
3. Exercise “bicycle” - alternately bend and straighten your legs while weighted.
4. Hands behind your head. Raise your straight legs one by one.
5. Hands up, slowly raise both straight legs and just as slowly lower them into position. P.
6. Bend your legs, straighten them and lift them at an angle of 45° to the floor, spread your straight legs to the sides, connect them and slowly lower them.
7. Holding the ball between your knees, bend your legs, straighten them at an angle of 45° to the floor, then raise them to an angle of 90°, and slowly lower them.
8. Same exercise, but holding the ball between your ankles.
9. Circular movements of straight legs and legs raised at right angles.
10. Raising and crossing straight legs.
11. From and. n. lying on your back, move to a sitting position, while maintaining the correct position of your back and head.
12. Arms to the sides, slowly raise your head and torso to a sitting position, return to i. P.
13. Hands up, raise straight legs, at the same time as you swing your arms, sit down, move your hands to your belt, take the correct posture.
14. The legs are fixed by the bottom rail of the gymnastic wall or held by a partner. Slowly transition to a sitting position and return to i. P.
15. I. p. - sitting astride a gymnastic bench. Lean back to a lying position, keeping your legs straight, return to i. P.
16. A similar exercise, but in combination with different arm movements or using objects.
For the lateral muscles of the trunk:
1. I. p. - lying on the right side, the right arm is extended upward, the left is along the body. Keeping your body lying on your side, raise and lower your left leg.
2. The same exercise on the left side. Raise and lower your right leg.
3. I. p. - lying on the right side, the right arm is extended upward, the left arm is bent and rests the palm on the floor. Raise both straightened legs, hold them for 3 - 5 seconds, slowly lower them into position. P.
4. The same exercise on the left side.
5. I. p. - lying on your side. Raise one leg, then, holding it, the other, lower your legs, return to i. P.
6. The same on the other side.
B. Corrective exercises
Symmetrical:
1. I. p. - lying on your stomach, chin on the back of your hands, placed on top of each other, elbows to the sides (the straight position of the torso and legs is checked by the instructor). Straighten your arms up, stretch in the direction of your arms, without raising your chin and torso. Return to i. P.
2. The same exercise, but with performing a loud count according to the instructions of the instructor up to 5 - 10.
3. I. p. the same. Raise both straightened legs, arms up, and stretch your entire torso in the direction of your arms.
4. I. p. - lying on your stomach, hands under your chin. Maintaining the middle position of the spine, move your arms straight back and raise your straight legs (“fish”).
5. I. p. the same. Raise your head and chest, stretch your arms up, raise your legs straight. Maintaining the correct body position, swing several times.
6. I. p. - lying on your back, arms along the body. Raise your arms up through your sides, stretch without raising your head, shoulders and torso.
7. I. p. the same. Hands up while raising straightened legs. Stretch, trying not to increase the distance between the lower back and the support.
8. The same exercise, but with alternate crossing of straight legs.
Asymmetrical:
1. I. p. - standing in front of the mirror. Adopt correct posture. Raise the shoulder with medial rotation on the side of the concavity of thoracic scoliosis.
2. I. p. the same. Lower the shoulder and rotate it outward on the side of the thoracic scoliosis.
3. I. p. - main stance. Raise one hand on the side of the thoracic scoliosis, palm up, to a horizontal position, bringing the scapula to the midline, raise the other hand and rotate inward, retracting the scapula.
4. The same exercise, but with dumbbells or clubs.
5. I. p. – main stance. Move your arms to the sides, at the same time raise your straight leg back (“swallow”). Support on the leg from the side of lumbar scoliosis.
6. Walking on a gymnastic bench with a bag on the head and abduction of the leg from the side of lumbar scoliosis.
7. Walking on a gymnastic bench with a half-squat on the leg on the side of lumbar scoliosis and lowering the leg on the side of lumbar retraction.
8. I. p. - lying on your stomach, arms up, holding the bar of the gymnastic wall. Raise your tense legs and move them towards the lumbar scoliosis.
9. The same on an inclined plane.
10. I. p. - lying on your side with a bolster under the area of thoracic scoliosis. Raise both straightened legs. You can do the exercise on an inclined plane, holding the ball between your knees or ankles.
11. I. p. - standing on all fours. Raise your arm on the side of the concavity of thoracic scoliosis and move the straightened leg back on the side of the concavity of lumbar scoliosis.
Massage for scoliosis
With the help of massage you can increase the effectiveness of therapeutic exercises. Without massage, it is impossible to treat paralytic scoliosis, as well as scoliosis in children who suffer from somatic diseases and for this reason cannot withstand sufficient physical activity.
Massage helps improve the overall tone of the body; normalizes the functions of the heart, blood vessels and respiratory organs; participates in the formation of correct posture; strengthens the muscles of the torso and promotes the formation of a muscle corset.
The massage is performed taking into account its physiological effect. On the side of spastically contracted muscles in the area of concavity of scoliosis, relaxation techniques (vibration, stroking) are used. On the side of the relaxed muscles in the area of the scoliosis convexity, the massage should increase the tone, all techniques are used there in significant dosage. When the patient is lying on his stomach, the massage therapist is on the right; lying on your back - on the left; if on the opposite side of thoracic scoliosis, then stand behind your back.
The massage technique is determined strictly individually. In a complex case, when the curvature of the spine is S-shaped, the massage procedure is conventionally divided into 4 parts.
Procedure for massage for scoliosis
The patient's position is lying on his stomach. The massage therapist is on the side of the thoracic scoliosis (Fig. 10)
. Begin the massage by stroking the entire surface of the back. All types of this technique are used: flat, grasping, rake-shaped, ironing. The massage therapist then tries to relax the trapezius muscle to induce sedation. To do this, stroking, circular rubbing with fingers, and continuous vibration are performed. After this, they begin local massaging at an elevation in the area of thoracic scoliosis, using the following techniques: comb-like rubbing, forceps-like kneading over the long back muscles, intermittent vibration (effleurage, chopping), designed to tone the muscles. Next, relaxing massage techniques (stroking, rubbing, continuous vibration) are performed in the area of the lumbar concavity.
Rice. 10. Patient position during massage
The patient changes position, turning onto his left side. Next, techniques of pulling on the right iliac crest are performed.