http://www.massageandbodywork.com/Articles/AprilMay2006/scoliosis.html As a rule, scoliotic curves are named according to the side of the convexity. Thus, in the most commonly seen right thoracic scoliosis, the rib cage will be convex right with an accompanying posterior bulge on the right between the spinal column and scapula. When therapists encounter this knotty protruding rib cage, they usually begin digging on the thin layer of overstretched paravertebral fascia covering the bony ribs, mistakenly believing they are releasing fibrotic muscles. In most instances, this well-intentioned maneuver may actually worsen the condition.
During the formation of a right thoracic scoliosis, the spinal transverse processes side bend left and rotate right, pushing the longissimus and iliocostalis erectors laterally. The weakened serratus posterior superior muscles responsible for binding the erectors close to midline allow the erectors to spread, much like the linea alba often permits rectus abdominis spreading during a mother’s third trimester of birth. When distended, compensations develop as bulging babies and protruding ribs are left with a terribly inadequate support system.
Stretch-weakened muscles, ligaments, and fascia are reciprocally overpowered as hypertonic erectors on the opposite side shorten, forcing the spine to bow. Typically, these myofascial tissues become neurologically inhibited due to joint dysfunction, trauma, overuse syndromes, faulty posture, or paralysis. In Figure 5, right, the therapist’s fingers tonify stretch-weakened erectors and serratus posterior muscles with fast-paced spindle stimulating maneuvers via the dynamic gamma motoneuron system. Extended fingers then hook and reposition the laterally migrated paravertebrals back on top of the bulging ribs. To lengthen the erector spinae muscles on the concave side, the therapist reaches across with extended fingers, digs into the left lamina groove, scoops out the wiry spinalis muscles, and stretches all the erectors laterally. Once some spinal bowing has been removed, additional rib cage flattening can be accomplished by depressing the scapula (see Figure 6, right), lengthening latissimus dorsi (see Figure 7, page 68), releasing the diaphragm and obliques (see Figure 8, page 68), and stretching the inferior end of the transabdominal fascial column (see Figure 9, page 68).
(Note: Radiologists usually allow a gray zone that represents a 5 degree range between each classification.)
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Date: 2009-05-09 03:34 pm (UTC)As a rule, scoliotic curves are named according to the side of the convexity. Thus, in the most commonly seen right thoracic scoliosis, the rib cage will be convex right with an accompanying posterior bulge on the right between the spinal column and scapula. When therapists encounter this knotty protruding rib cage, they usually begin digging on the thin layer of overstretched paravertebral fascia covering the bony ribs, mistakenly believing they are releasing fibrotic muscles. In most instances, this well-intentioned maneuver may actually worsen the condition.
During the formation of a right thoracic scoliosis, the spinal transverse processes side bend left and rotate right, pushing the longissimus and iliocostalis erectors laterally. The weakened serratus posterior superior muscles responsible for binding the erectors close to midline allow the erectors to spread, much like the linea alba often permits rectus abdominis spreading during a mother’s third trimester of birth. When distended, compensations develop as bulging babies and protruding ribs are left with a terribly inadequate support system.
Stretch-weakened muscles, ligaments, and fascia are reciprocally overpowered as hypertonic erectors on the opposite side shorten, forcing the spine to bow. Typically, these myofascial tissues become neurologically inhibited due to joint dysfunction, trauma, overuse syndromes, faulty posture, or paralysis. In Figure 5, right, the therapist’s fingers tonify stretch-weakened erectors and serratus posterior muscles with fast-paced spindle stimulating maneuvers via the dynamic gamma motoneuron system. Extended fingers then hook and reposition the laterally migrated paravertebrals back on top of the bulging ribs. To lengthen the erector spinae muscles on the concave side, the therapist reaches across with extended fingers, digs into the left lamina groove, scoops out the wiry spinalis muscles, and stretches all the erectors laterally. Once some spinal bowing has been removed, additional rib cage flattening can be accomplished by depressing the scapula (see Figure 6, right), lengthening latissimus dorsi (see Figure 7, page 68), releasing the diaphragm and obliques (see Figure 8, page 68), and stretching the inferior end of the transabdominal fascial column (see Figure 9, page 68).
(Note: Radiologists usually allow a gray zone that represents a 5 degree range between each classification.)