Scoliosis occurs as a permanent lateral deviation of the spine whose main component (cause?) Is the rotation of the vertebral bodies
CAUSES
Genetics
Endocrine: linked to puberty
Postural: vice, attitude, paramorphism
Neurological: neuro-muscular imbalance between the spinal muscles of one side with respect to the other
Morphological alterations of the spinal column:
VICE: posture different from the norm, but still in the initial state; it has a cause which, once removed, determines its disappearance.
Attitude: consolidation of the vice; while removing the cause, the postural attitude different from the norm does not disappear. It is important to bring the subject to the awareness of the result to be obtained.
PARAMORPHISM: morphological alteration that has consolidated at the muscle and tendon level, and requires specific muscle toning gymnastics to recreate the lost balance.
DYSMORPHISM: morphological alteration that also affects the skeletal system: in fact, in these cases, there is a rotation of the vertebral bodies. It cannot be completely corrected either with specific gymnastics or with the use of corsets.
LOCATION:
Lumbar scoliosis
Dorso-lumbar scoliosis
Dorsal scoliosis
Cervico-dorsal scoliosis
Usually there are two curves; the most frequent have right dorsal and left lumbar convexity. If the first has a large radius of curvature, the second is automatically formed to recreate the equilibrium situation.
OBJECTIVE EXAMINATION:
Shoulder alignment
Symmetry of the triangles of the size
Presence of gibbosity at the bending of the bust
Protrusion of one shoulder blade with respect to the other
Alignment of the iliac crests (be careful that it does not depend on an asymmetry of the lower limbs)
CLASSIFICATION BASED ON SEVERITY
Location:
dorsal
back-lumbar
lumbar
Bending angle:
> 45-50 ° surgical treatment
30-45 ° non-operative treatment with the use of torso plus physical activity
25-30 ° physical activity
PURPOSE OF THE PHYSICAL ACTIVITY FOR SCOLIOSIS
Specific physical activity, alone, does not correct a dysmorphism such as scoliosis, but is necessary to prevent worsening, acting on general toning and muscle lengthening to favor the recovery of symmetry.
GENERAL PRINCIPLES OF THE CORRECTIVE TECHNIQUE
Like all physical activities and sciences, corrective gymnastics must also be subject to certain principles.
First principle
Search for the triggering and aggravating causes of the morphological alteration. It is necessary to sensitize parents and children about the causes that determined the alteration in order to be able to implement, through their education, a conscious preventive action.
Second principle
Awareness by the subject of his own bodily aptitude (alteration); only in this way can he be able to correct himself and actively collaborate in everyday life. (use the sensory pathways of sight and touch for this purpose)
Third principle
Promote relaxation and relaxation in order to have precise, effective and well-localized movements. It is important that the subject has an "exact awareness of which muscles are involved in the movement and which ones must be left at rest.
Fourth principle
Unlock the segment and then tone up: perform mobilization exercises first and then tone up, in order to rebalance the muscle groups reactivated with mobilization. In the case of asthenic or hyperlaxis subjects, we only work on toning.
Fifth principle
Overcorrection gymnastics; the movement must always exceed the limit of the normal position. Asthenics and hyperlaxis are still an exception.
Sixth principle
Movement choices to shorten stretched muscles (full contraction and incomplete stretch) and to stretch shortened muscles (incomplete contraction and full stretch); in this way it is possible to correct the muscular imbalance that determines the alteration.
Seventh principle
Few exercises, well chosen and well dosed. Specificity of exercises according to the alteration that the subject presents, dosed according to the actual abilities. The repetition of these exercises is also useful for exercising muscle memory. Negative side: repetitiveness creates situations of boredom.
Eighth principle
Graduate the progression of the exercise, from simple to complex, from mild to intense.
Ninth principle
Go from supine to sitting position, on your knees, until you reach a standing position.It is best to start from a gravitational unloading position, up to the normal standing position.
Tenth principle
Rhythm of movement: neither too slow nor too fast, the ideal is the respiratory rhythm. Too fast movements lose precision, too slow generate a poor blood supply.
However, it is understood that the mobilization exercises are carried out at a faster pace, while the toning exercises are carried out more slowly.
Eleventh principle
Respiratory gymnastics must always intervene in the corrective gymnastics lesson because all the alterations of the trunk involve a "respiratory insufficiency.
Twelfth principle
Periodic control of the boy so as to be able to evaluate the results obtained and to be able to adapt the exercises based on the progress achieved.
