Structure, Function, Integration / December 2018 www.rolf.

org

Scoliosis: A Way
of Growing
By Pierpaola Volpones, Rolfing® Instructor, Rolf Movement® Instructor

ABSTRACT Scoliosis isn’t just a shape in the spine; it’s a dynamic action
throughout the body. It’s not a disease but a way of growing, a strategy the body
has adopted. In light of this, when working with scoliosis, practitioners want to be
cognizant of not just the body but also the client’s perception, coordination, and
meaning, including body image and body schema.

Pierpaola Volpones

Figure 1: An olive tree. Figure 2: Bamboo.

During my years of practice as a Rolfer™, I “Scoliosis is a sideways curvature of the

have come to think of scoliosis as a way of spine that occurs most often during the
growing. There are trees that grow straight growth spurt just before puberty. While
toward the sky and others that twist and scoliosis can be caused by conditions
torque: bamboo and olives trees. Both are such as cerebral palsy and muscular
beautiful (see Figures 1 and 2). dystrophy, the cause of most scoliosis is
People with scoliosis remind me of olive unknown . . .
trees. With this in mind, my interventions Signs and symptoms of scoliosis
when I work with somebody with may include:
scoliosis are intended to remind the body
that there are several ways to grow up; • Uneven shoulders
that there are different options to grow • One shoulder blade that appears
that are less twisted, with more length. more prominent than the other
I stand at the client’s side imagining • Uneven waist
myself as a gardening tutor, planting a
small tree. • One hip higher than the other
If a scoliosis curve gets worse, the
spine will also rotate or twist, in
What Is Scoliosis? addition to curving side to side. This
Searching ‘scoliosis’ on Google, this is causes the ribs on one side of the
the first definition I encounter: body to stick out farther than on the
other side” (Mayo Clinic).

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 Scoliosis

If I didn’t know what scoliosis is, what I asymmetry, more recent research suggests interesting. I have the client sit on the
would take from such a definition is that it that swimming helps but does not really bench facing the massage table, with
consists of a lateral deviation of the spine correct scoliosis. Kinesis therapy is also hands resting on the table. I touch each
due to unknown causes. But this is an recommended: it aims at lengthening spinous process and ask the client to
overly simplified description. We will see the muscles on the side where they are move that vertebra toward my fingers. It is
that scoliosis is not limited to the shape too short, and toning the muscles on the often at the place where the spine changes
of the spine. side where they are too weak. Again, this direction that the client is confused.
What is interesting to me is that, in seems logical, but it does not really work Asking the client to push more with one
the definition above, under ‘signs and as it seems to further strengthen the side foot or/and one hand helps him/her to
symptoms’ we find only ‘signs’: in itself, that is already too strong. find that vertebra, or group of vertebrae,
scoliosis does not create any pain. and at the same time to de-rotate it/them.
‘Symptoms’ are generally manifestations Finally, using a mirror helps to reset the
of pain due to a disease or illness. With
Scoliosis Has a Dynamic cortical map. In addition to seeing himself
scoliosis, adolescents find themselves or herself looking straighter, the client is
A woman in her fifties came to see me
having to go see a doctor, even if they able to add the inner sensation of more
because of back pain. She told me a story
don’t feel pain, and they receive a equal volume in the thorax and can begin
that touched me, and taught me a lot about
diagnosis of something that they don’t to integrate this new information.
scoliosis. She had a severe scoliosis, and
recognize as an illness. when she was twenty years old decided to Hubert Godard has stated that for people
This discrepancy sometimes creates have surgery to straighten the spine. The with scoliosis, the space outside the body
frictions, an obstacle in the relationship surgeon inserted a rod that was locked – the kinesphere – is no longer round; it
with the therapist or the Rolfer: clients with screws. A few months later, the rod seems to have ‘holes’, as if at the side of the
are told that something is wrong, but broke: the thrust of her spine was stronger spinal concavity the space outside the body
they can’t perceive what it is. When they than the rod. She had to undergo another does not exist or is not available. Somatic
stand in front of a mirror, they can see surgery to take the rod away. Experiencing® affirms something similar: in
that one shoulder or one hip is higher particular circumstances, the space outside
What I understood is that a scoliosis isn’t
than the other, but if they close their eyes, the body is perceived as if it is no longer
just a shape in the spine; it’s a movement,
they don’t feel any asymmetry. They feel available and not safe and the body shrinks
a dynamic action that travels throughout
perfectly fine, straight. Accordingly, this in response. The body may lose its ability to
the body. As a consequence, there needs
is an area where I place quite a bit of orient, or the capacity to scan the horizon
to be an agreement with the client –
attention: to finding congruence between fully and freely, and this may translate, to
spoken or unspoken – to reverse or modify
what the clients perceive from the inside give one example, into a sidebend of the
the vector of growth that that person has
and what they see from the outside. head. Therefore, our work with people with
embedded in her/his structure. Knowing
scoliosis also involves giving back to our
that, as Dr. Rolf said, “I think there’s more
clients the possibility of inhabiting space
than the body, but the body is all you can
How Do People Perceive get your hands on,” my work as a Rolfer
inside and outside the body.
Their Scoliosis? is not only to touch the physical structure All these observations brought me to think
but also to address and have in mind other that scoliosis is not a disease but a way of
In working with adults who wore a corset structures: the structures of perception, growing: it is a strategy that, for whatever
for scoliosis when they were young, I’ve coordination and meaning, which also reason, the biology or physiology of that
been struck by a couple of things: first, that includes body image and body schema. particular person has adopted.
their torso is ‘frozen’, rigid, immobile, as if
the person were still wearing the corset;
second, that the corset has left signs – Ways of Working Examining Scoliosis:
callouses where it pushed the client’s spine
into a straighter position. Where the corset Talking with clients, it is clear that they Assessment and Positioning
pushed on a hip or the ribs, the person don’t perceive their spines as twisted – in for Work
often resisted the push because his/ the client’s brain, his/her spine is straight.
So our work needs to affect the cortical Scoliosis is a movement that happens in
her body schema did not recognize that all three planes and travels throughout
something was crooked in the first place. maps where the spine is located. How
do we do this? What I have tried is to the body. We often hear that one hip
The corset pushed on something perceived being higher than the other is due
as straight; the body resisted the push. bring awareness to the inner motion of
the breath and to the volume occupied to a ‘shorter’ opposite leg, and it is
When I have asked clients if the corset was conventionally treated with a lift of that
helpful, the reply almost always comes by the breath in the thoracic cavity, and
the response of the pelvis and the back leg. If we look more closely, we might see
back, “The doctor said that it was helpful to that this so-called ‘shorter leg’ may have
stop the situation getting any worse.” to the movement of breathing into the
pelvis and pelvic floor. I use my hands a pronated foot, a valgus knee, a rotation
Swimming is often recommended in cases as a reference that clients can reach with at the femoral head (take a look at the
of scoliosis, and the logic behind this is the breath, particularly where the ribs are orientation of the lesser trochanter of the
very simple: with the water’s buoyancy, closer and narrow. ‘shorter’ leg). A precise body reading and
there is less effect on the body from intervention is key to normalizing the two
gravity. But while the symmetrical activity Having the client visualize and move the legs and balancing the pelvis.
of the limbs in swimming can balance the vertebrae with micromovement is also
The sidebend and rotation of the thoracic

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 Structure, Function, Integration / December 2018 www.rolf.org

Figure 3:
Working the
convex side of
the scoliosis
with the client
in the SIMS
position.

vertebrae obviously affects the ribs. At head is both forward and internally rotated. particularly of the liver or stomach. There
the concave side, the ribs will be closer to Looking at the movement of her eyes, is no question that disordered structure
each other, rotated anteriorly, and flatter. I noticed that, when I asked her to look at the level of the costovertebral and
The opposite will be true at the other side. to her left, her right eye would converge costochondral joints and ligaments is
A strategy for the thorax is 1) to work the more than her left one. It seemed that the directly in dialogue with the parietal pleura
convex side, put the client in the SIMS right eye was more caught, medially, by attaching on the sternum and the vertebrae
position (Figure 3) resting on the concave the ocular muscles. Very gently I touched and creates a consequent disorder of
side, and work the ribs of the convex side her closed eyeball, with the intent to the membranous system of the thoracic
anteriorly; 2) to work the concave side, put release the medial pull, and this helped the organs, and the organs themselves.
the client in a regular sidelying position shoulder to open! Just below the diaphragm, the liver and
lying on the convex side, allowing you
Peter Schwind has suggested that its ligaments, and the stomach with its
to mobilize and encourage more space
between the ribs on the concave side. some cases of scoliosis originate in sphincters and ligaments, are in close
a torsional movement of the organs, contact with each other and with the
Sometimes the sidebend and rotation
appear in the shoulders and arms. In
Figure 4 we see a schematic with contours
drawn from a photo of a young person with
scoliosis. We see a right rotation of the ribs
Shoulder Shoulder
on the right side; an anterior right shoulder
forward backward
and posterior left one; internal rotation of
the right humerus, and external rotation
of the left humerus; and the left forearm
seeming to compensate with pronation.

Arm externally rotated

The Visceral System
Another aspect of structural organization
that appears to have a strong impact on
scoliosis is the visceral contents of the
thorax and abdomen. I have not yet explored
in detail how to address the visceral content
of the head (the tongue, eyes, and brain), but
I have observed and worked with sidebends
and torsions of the skull and jaw. We have
more work to do to understand the visceral
content of the head.
Recently I did an experiment. I have been Pronation
working with a twelve-year-old girl who
Figure 4: Schematic of a
has a scoliosis where the right humeral
young person with scoliosis.

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 Scoliosis

diaphragm. Work around the diaphragm is

more effective when it also includes work
on these membranous structures. If we
think about the space in front of the spine,
the psoas muscles are often asymmetrical,
and the kidneys share that space. Indirectly
mobilizing the kidneys by addressing the
psoas can also be very effective.
The iliacus and its fascia, reaching in
front of the sacroiliac joint, encases the
inner surface of the pelvis. Likewise the
subperitoneal organs with their lamina
and ligaments spread between the pubis
and the sacrum and coccyx. Thus, the
pelvic floor and the overall balance of the
pelvis are interrelated with the action and
position of the subperitoneal organs.

Additional Considerations for

Work
Working with people with scoliosis
requires asymmetrical work: every
session has to be tailored to that person
and that moment. No two scolioses are
exactly the same. Some clients have a Figure 5:
lateral shift of the thorax, others of the
A corset for scoliosis.
pelvis; often the dorsal kyphosis is lost.
Some have two, three, or more curves of
the spine. Sometimes scoliosis emerges might ask the client to use one foot more Bibliography
after adjustments of the teeth. than the other, to rotate to one side and
open to the space on that side, to breathe May Clinic, ‘Scoliosis’. Available from:
I often work the suboccipital and into a specific area, to shift one of his/her https://www.mayoclinic.org/diseases-
lumbosacral areas to free the spine. sit bones, and so on. conditions/scoliosis/symptoms-causes/
Then the table work continues, moving syc-20350716 [accessed 1 September
between the sleeve and the core, and 2018]
back again: the myofascial layers, the Working with a Corset Pierpaola Volpones discovered Rolfing
ligamentous bed, and the visceral-
Sometimes clients have to wear a corset Structural Integration through bodywork
membranous system. That day’s body
for the scoliosis during the day, and they and her research into well-being and
reading provides a suggestion of where
don’t like it! After a few sessions in which I somatic expression. She studied in Munich
to work in each session. Often I close
aim to build rapport, confidence, and trust with Stacey Mills and Michael Salveson
the session with bench work, inviting
between us (and enhance adaptability in for her Basic Rolfing Training and with
the client to negotiate how s/he deals
their structures), I ask the client to bring the Michael Salveson and Jeffrey Maitland
with gravity, to recognize old and new
corset. During bench work, I work first of all for her Advanced Rolfing Training. Her
patterns, and to find new options while I
with the client in front of the mirror to untwist Rolf Movement Training took place in Italy
work the back, the girdles, and the spine.
the spine and the torso until the client feels with Janie French and Annie Duggan. She
The use of a mirror helps to reset the
and sees that there is more length and less began Rolfing and Rolf Movement teacher
client’s system, including the way that the
twisting. I shape the client’s shape with training almost twenty years ago and has
brain has unconsciously mapped his/her
my hands so that the person perceives been teaching since 2006. She maintains
physical reality.
the difference between what is familiar a practice in Rimini, Italy and teaches for
I invite my client to do a number of and what is possible and is finally able to the European Rolfing® Association. Her
things: sense position and weight on accept this change in his/her shape. I then website is www.volpones.it.
the sit bones; feel the connection of the
ask the client to put on the corset, feeling
feet to the spine; perceive the length of
the places where it holds rigidly against the
the spine; sense the space in front of the
ribs or pushes against the pelvis or lumbar
spine; use breath to relate the shoulder to
spine. I invite the client to allow the corset’s
the thorax and neck . . . All of this is the
push, to stop resisting, recalling the same
normal bench work that I use with clients
sensation that s/he felt from my hands and
in general, but when there’s a scoliosis
the memory of the moment where s/he
I pay more attention to de-rotating and
accepted a new reality, a changed shape.
untwisting the spine. To achieve this, I

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