Case Study
Scoliosis – My Guide to Spinal Awareness
Disclaimer: I am not a trained Iyengar teacher, nor trained in therapy using Iyengar yoga techniques, nor a trained researcher, nor from the medical profession. This is a simple documentation of my journey. I do not know what worked, what didn’t; what worked with a delayed effect, or what worked as part of the cumulative effect of all that was done. I have documented every little detail that I could recall so that those who are wiser than me in this beautiful amalgam of science and art that we have termed as Iyengar Yoga, may figure out what was appropriate and worked to correct the scoliosis. I hope it inspires others on their yoga journey. I would like to categorically state that everyone’s therapy requirements are different, each body and mind responds differently, and hence, the practices followed by me may or may not be beneficial to another person with scoliosis. It is essential that a teacher of Iyengar yoga, trained in therapy techniques, be consulted for any therapy requirement.
Sometime in 2005-06, I had a fall which resulted in a slipped disc in the sacro-iliac region. At the time, I just continued my daily activities, albeit gingerly, until the pain stopped. I did not bother with an x-ray, or any kind of medical advice. In 2007, I started learning Iyengar yoga, not for any medical reason – simply as a means to keep fit.
Over the years, I would periodically have slipped disc episodes, which I would manage with the help of my Iyengar yoga teacher. In the early days itself, Sir had pointed out certain imbalances in my body – the left leg, the right shin, the right neck etc. etc. – all of which were attributed to the damage I had done to my body with running and wearing high heeled footwear on polished stone floors.
So it was that I decided to put in focused effort on rectifying the scoliosis.
When I started studying my body, specifically focusing on the scoliosis, I realized it was possibly one problem manifesting in multiple ways. If I looked at my pelvis in the mirror in tādāsana, the right pelvic corner went in (caved in) on the side while the left jutted out (convex). In non-symmetrical lateral movement āsana such as trikońāsana, the right pelvis could not open at all, and the left had limited movement. The left hamstring was significantly shorter than the right. There was a “catch” in the left side of the sacro-iliac spine, that made itself intensely apparent in seated forward extensions such as pasćimothānāsana, extending from the spine through the buttock to the back of the thigh. There was a palpable “bump” on the left side of the spine in the sacro iliac region. The left groin was much tighter than the right in uppaviśtakońāsana. The body weight tended to be more on the outside edge of the left heel rather than the center. The right shoulder blade refused to move in during sternum lifts such as in gomukhāsana arm movements or śirśāsana. The effect of this on the right collar bone shortened the right side of the neck, due to which my head tended to turn slightly towards the right and up in repose, rather than facing dead center. The list was endless, but as I feel now – it all came down to the spinal imbalance in the sacro-iliac region.
I had never taken an x-ray of the pelvis, and now I was under the spell of studying the body with the eye of the mind. As far as I could make out, the fall on my right hip had pushed the right iliac bone in and slightly towards the anterior body. This in turn had pushed the left iliac bone to the left (out) and rotated its inner portion slightly, probably twisting the top of it towards the posterior body and the lower end towards the anterior body, though I could not be certain. And of course, the spinal disc had slipped in that region.
All these insights came to me gradually, over the months of intensified practice and resultant pain. My initial therapy was limited to what I term as my daily morning padmāsana preparatory āsana practice. Releasing the lower back with gradual forward extensions in a crude version of kūrmāsana, followed by adho mukha baddhakońāsana. Moving onto jānuśirśāsana and krounćāsana to release the hamstrings. Then focusing on pelvic and groin opening by moving one foot at a time to touch the forehead, chin, sternum before taking it into ardha padmāsana position. Gradually, as the hips and groins started achieving some mobility, I could take the foot higher and over the head, until I could take the foot into ekpāda śirśāsana position.
Video : Morning "Padmāsana Preparatory" Sequence
Some months later, showing off my prowess to my teacher through email, I spoke of my efforts to address the scoliosis. He advised me to introduce utitha hasta pādānguśtāsana 1 (forward) and utitha hasta pādānguśtāsana 2 (lateral) to the regimen. He also mentioned that there was nothing like rope śirśāsana to address this issue. At this stage however, I had not installed the wall rings for rope śirśāsana. So, I introduced utitha hasta pādānguśtāsana 1 and 2, resting my raised heel on the back of the chair, and then gradually increasing the height, as well as the duration of the posture. Months of this, and I could sense no impact. Meanwhile, another teacher of Iyengar yoga visited me and strongly advised me to install the wall rings, further adding that rope śirśāsana, done with the legs straight, would help in establishing pelvic alignment.
Finally, I gave up my concerns for the cleanliness of the wall and had the wall rings installed. Now, in addition to the daily morning “padmāsana preparation” regimen which had gone to the extent of including ekpāda śirśāsana by then, I developed a daily evening practice of ūrdhva prasāritta pādāsana, suptapādānguśtāsana 1 and 2, utitha hasta pādānguśtāsana 1 and 2 on the ropes and in the doorway, ending with straight leg rope śirśāsana and finally sarvāngāsana. I would use a stopwatch to maintain each leg lift for 5 mins at a time, repeating each side twice. So, 20 mins each of suptapādānguśtāsana 1 and 2, utitha hasta pādānguśtāsana 1 and 2 on the ropes. Doorway utitha hasta pādānguśtāsana 1 and 2 was brief, as my hamstrings had not yet released adequately enough for me to maintain that for 5 mins. Rope śirśāsana gradually increased from 5 mins to 15 and 20 mins, with commensurate time spent in sarvāngāsana. Of course, I could not always spend this length of time. So often one or the other āsana would be omitted
Somewhere during this period, while trying to move a large flowerpot around, my disc again slipped. The pain was relatively mild, and I knew how to take care of it myself, but I informed my teacher so that he would not query my gingerly movements during online classes. His immediate response was that the disc had slipped because of ekpāda śirśāsana practice. I recognized that the spine was in a state of flux due to all the āsana practice that was focused on it, but Guruji’s words, oft quoted to us by our teachers rang in my ears – “If śirśāsana gave you neck pain, go into śirśāsana to understand how to remove your neck pain”. And as Prashantji often says “all of you who are past your prime, don’t let the āsana slip away as you age”.
With both these exhortations ringing in my ears, I continued all āsana practice while the slipped disc episode was on, with the attention now on keeping the buttocks balanced in every āsana. Immediately, the extent to which the leg moved in āsana like ekpāda śirśāsana reduced, but I could intuitively recognize that what was happening now was more correct and did not stress the spine. Despite the pain of the slipped disc, with the spine balanced, I could continue all the āsana that now constituted my morning “padmāsana preparation” practice with deeper learning. Another instance of how an injury had acted as an inner guide to better understanding!
Then Prashantji started online classes and he mentioned that while āsana in general needed to be maintained for some duration, when an āsana was being done for remedial purposes, repeats were more beneficial. Immediately, I gave up my 5 min regimentation and started holding the postures for shorter durations and increasing the number of repeats. Almost immediately, I felt release happening much more readily and every subsequent repeat released the body further and further. This became quite an “aha!” moment. And it enabled me to regularly include all the aforementioned āsana in my 1 – 1.5-hour evening practice.
Every new discovery would be eagerly shared with a couple of my teachers, who would generously view the videos or read my long messages and give me tips on how to further improve on what I was doing. These interactions played their own role in deepening my understanding of what was happening within the body.
One morning, releasing the leg from ekpāda śirśāsana, I found the back of the knee very well established
In one of Prashantji’s prāńāyāma sessions, he was educating us on the beneficial effects of silent sound forms (tattva kriya, prańa kriya) and he mentioned that rather than counting in English or the vernacular, which had no prāńic benefit, one should use the first letter of each number (in any language) and convert it into a prāṇa kriya. So rather than एक, दो, तीन (ek, do, teen) etc. one could use ए, दे, ते (e, de, te) etc. Rather than one, two, three etc., one could use ओ टो थो (o, toe, thoe) etc. Immediately, I changed the counting style during my eye exercises, or any other time that I needed to count. Now it has become a reflex. I’ve developed my own style and 1-10 are now counted as अ, ब, त, च, प, स, श, अ, न, ध (a, ba, ta, ća, pa, sa, śa, a, na, dha)!
With all this focused attention, I had developed intense spinal awareness. So it was that when standing with any degree of attention, I could make out the spinal imbalance. Reflexively, I would tuck the tailbone in, lift the kneecaps and lower abdominal organs and feel the lift in my sternum and inward movement in the dorsal spine. Initially, my inner knees would not touch. Daily practice gradually made the knees touch, and the effort shifted to making the calves come in contact. This brought awareness to the weight on the right heel not being centered – so centering the weight on the right heel got added to the “to-do” list.
Week by week, I could feel ligaments and tendons deep inside the backs of my knees, thighs and buttocks releasing. Initially, there would be a “click” kind of sensation as I wilfully released it. Within days, the release would happen without too much effort, and then without any effort. I must mention that during these months of intense effort and release of deep-seated muscles, ligaments, and tendons, I went through intense pain in my legs, back and pelvic regions. The pain kept shifting, reassuring me that different parts of the lower body were getting extended. However, there were many nights when the pain in the pelvic area refused to allow me to fall asleep; and when I did fall asleep, any shift in position brought me to full wakefulness due to the stiffness that had set in.
Mornings were a different story – I would find my body, especially the legs and lower spine stretching voluptuously, repeatedly, even before I came to full wakefulness. My teacher told me this was the cellular memory setting into the cells, so I was happy to enjoy these stretches as evidence that things were progressing in the right direction.
The shifts in the pelvic and spinal skeleton system also impacted the knees. Where earlier, I had attained the proficiency to sit in padmāsanā for 20-30 mins, now I could barely sit for 5 mins before the left knee started paining. I understood that as the pelvis and leg rotated, a different part of the knee was being asked to extend for padmāsanā. This section of the knee having been unaccustomed to the extension, was now protesting. I kept at it and gradually, over months of daily padmāsanā and prāńāyāma practice, again worked up to 30 – 40 mins of padmāsanā
It was interesting that as the hamstrings extended and the pelvis and groin opened, the excessive lordosis in my lumbar back reduced. The tailbone moved in, and the lower abdominal organs lifted. I could feel the space in the lower abdomen. When I sat in padmāsana, I could feel the lift in my lower flanks and abdominal area. One day, as I sat in padmāsana, I felt the impulse to extend my flank to the side. As I did so, I felt intense extension in the flank, extending all the way to the buttock bone and back of the thigh. Prashantji would say my inner Guru was prompting me, because I do not recall having ever seen this sideways extension being done in padmāsana by anyone. I could feel it working on the sacroiliac spine, and so yet another aspect got added to the “padmāsana preparation” sequence.
The cumulative effect of all the practice resulted in far-reaching lower abdominal extension, which had its own impact on my digestion. An Ayurveda I had consulted many years ago had told me that good digestion and absorption were evidenced by stools that came out as a single banana. Two years of treatment and dietary experimentation under her certainly put right the perennial sinus problem for which I had consulted her. But the single banana output was a goal beyond my reach.
Now, with the intestinal space created through the spinal extension, I could feel as if crimped sections of my intestine were releasing, and this had a positive effect on my digestion. Acidity and bloating became a thing of the past. A flat stomach became a goal within reach – not for reasons of vanity alone (well, a little bit for that as well), but as evidence that the excessive spinal lordosis was correcting itself and lower pelvic organs like the urinary bladder were lifting.
The extension of the lower abdominal space is also having its impact on the prāńāyāma practice. Now, the ability to sense and manipulate the breath in the internal domain is often effortless and even playful. No longer are recovery breaths required and it is only the pressing demands of the “business of life” that requires me to cease the prāńāyāma practice (and sometimes, the fatigue in the knees from long duration padmāsanā)
As of August 2021, the scoliosis is reduced to maybe 10% or 20% of its original severity. I can rotate the left leg in the socket while in śirśāsana, though it is yet to happen on its own. I can feel the pull on the right side of the body, which means the right flank is still slightly shorter than the left – it takes some effort to keep the flanks the same length, but the effort is minimal and therefore sustainable.
Earlier, when instructed to use the fingers to part the buttock cheeks was given, I would go through the motions, but could feel that the right buttock was not budging, even if I used my fingers directly on the bare skin. Now, with some effort, the right buttock cheek moves away from the spine and the urine flow which used to angle towards the right, has started straightening, indicating that imbalances in the internal body have started to correct. A straight flow of urine, even when bladder pressure is low, is my diagnostic tool to know when the internal body has adjusted correctly!
My sole exposure to Geetaji was the annual Yoganuśāsanam held every year from 2014-2018. Sometimes, she would single out someone who she had spotted as having a body imbalance. She would make the person walk and comment how one buttock was swinging freely, but the other one was not. I would wonder at it – I could see the imbalance in the other person, but I could not feel my buttocks, either of them, swinging when I walked. I figured that either it was happening, and I was not sensitive enough; or that I was too thin for my buttocks to swing. As the groins and hips are freed up, today, I can feel my buttocks move side to side as I walk, and I recall how our shāstrā describe a womanly woman – one who walks like an elephant!
Now it feels like the universe is conspiring to rectify my scoliosis. Every āsana affects the spine and works to correct the distortion. Rope adhomukhaśvānāsana, with the feet halfway up the wall followed by rope adhomukhavīrāsana on the wall released something low down in the sacro-iliac spine. I distinctly felt something (calcium deposits?) crack on the left side of the sacro iliac spine. Trikońāsana with the rope at the hip and the lower arm extended over the backrest of the chair again had the sensation of the distortion being addressed. Kapotāsana with the bolster on the chair worked intensely on the sacro iliac spine.
At some point, sethubandha sarvāngāsana on a single block started giving rise to a pain in the right anterior iliac bone and right pelvic corner. I realized the twist in the iliac was probably getting addressed. I started staying longer in that posture. Earlier, in śavāsana flat on the floor, I could not feel the backs of my thighs or knees touching the floor. As the hamstrings extended and the lumbar lordosis reduced, I could feel that the two buttocks were not touching equally. Gradually, after staying in block sethubandha sarvāngāsana for an extended duration, both buttocks and backs of knees started touching the floor, though there is still some pain from extension in the right frontal pelvic corner. Matsyāsana has been added to the morning “padmāsana preparation” sequence to address this. The pain that started on the right periphery has gradually shifted closer to the center and is currently on the right side of the spine. I know, that when it moves to the center, it will disappear. Even as I completed writing this account, one of my teachers showed me how to get spinal traction in shavāsana, using the belt and the bottom rings. This looks like it might deliver the coup de grace on the scoliosis, as just a couple of days of this practice is yielding palpable correction to the minimal imbalance that remains
The experience is not without its share of scares. As the left leg starts to rotate in its socket, there are times when walking, the leg buckles at the root with a sharp twinge. At such times, I just freeze momentarily, and then slowly take a cautious step forward. Within a step or two, the pain goes, and I know it is just the leg telling me that it is yet unstable, yet in the process of completing the rotation to the correct position.
As things improve in the lower half of the spine, my attention has moved to the top half. My teachers had noticed it from the early years, and now I gradually developed the sensitivity to notice that my right shoulder was not carrying its fair share of load in śirśāsana. I found shoulder work done in the doorway to be more effective than ropework 1. Possibly because with the ropes, I could not make out when the two wrists were not at the same level. Pushing the sides of the doorframe apart with my palms at shoulder level, squeezing the shoulder blades together as I took a half step forward, I could feel the stiffness in the left scapula. When doing gomukhāsana with the right arm lower, I felt stiffness in the right scapula. While both scapulae had opened significantly more than at the start of lockdown, there is still an imbalance in the shoulders that needed to be put right. The weight on the right foot is still not quite in the center of the heel. And so, the journey continues, each day yielding yet another discovery, contributing to the sense of wonder that keeps us forever young!
Acknowledgment: I would like to express my deep indebtedness and gratitude to all my Bandra Iyengar yoga teachers- in alphabetical order, Shri Jawahar Bangera, Shri Siddharth Bangera and Ratna Kaji - who knowingly and unknowingly, helped me (and continue to help me) on this fascinating journey of the discovery of the self.
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