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Section 3b: How to measure and “quick sketch” a curvy spine.

 

Drawing the scoliotic spine:  I use a quick drawing to record and understand what my client presents, in addition to photographs, observation or videos of walking, etc. Ask for X-rays and/or scans of the torso, which are very helpful for “looking inside” the torso, and understanding the lateral curves, the rotation of the spine, and the overall nature of the puzzle you hope to help your client solve. Begin with touching the spine, listening with your fingers to the direction the spinous process is pointing. (See drawing 1 of a single vertebra) 

In a regular spine (and start with lots of regular spines if you are new to this) you will feel the spinous process pointing towards you, posteriorly. In a curvy spine, you will notice the spinous process spiraling R or L, and sometimes the spinous process disappears under the paravertebral muscles column in places. Or you may more easily measure the rotation palpating the transverse processes. Place your fingers on either side of the spine and notice. Is your R finger closer to you? That would indicate the spine is rotated R at that point—think rotation of the vertebrae on a horizontal plane. (More on measuring rotation and notating same in Part 2 of this series.)
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Here’s how I draw my "quick sketch" of the spine with the client standing:
Don’t be intimidated if you don’t have drawing skills. It’s really just making a quick map of what you feel and measure.

Back View, standing behind the person: (See drawing 2)

1. I draw one vertical line and 2 horizontal lines, and mark the intersection of the top 2 lines as C7 vertebra, which is usually easy to locate as it protrudes at the base of neck.

2. I then measure off of their C7 point for the C1 base of skull point. Is it to the R or L of C7? Can you trace a curve between the 2 points? Is the head titled to one side?

3. I measure off of C7 again toward the lumbar vertebra that’s at the waist. Is it L or R of C7?

4. I keep a finger on C7 and take another finger down 4 vertebrae or so and mark another point. Is this vertebra to the L or R of the C7? I continue down the spine in this manner, I draw the points on my chart, palpate the spine again, and connect the points on my drawing into curves. On the drawing you’ll see I have marked 7 points total. You might choose less points with a less complicated spine.

I mark the level of shoulders (both the high and low point of scapulae, as sometimes they are different) and top of hips on my chart.

 

 

Viewing from the side: (See drawing 3) You are looking for the RL / GL reflexes presenting from this view.

1. Based on another vertical line, I mark the head position. Is it forward of center? (RL), or is the chin pushed back towards the neck? (GL reflex) Note the angle of the neck.

2. What is the position (rotation) of head, the rib cage and pelvis? In other words, if they were 3 spheres (or ovals), which way are they tipped? Are they tilted anteriorly or posteriorly? Quick lines can record your findings.

3. I add to both of these views indicators of tension (single repeated lines) and/or pain (cross hatch lines) or you can color code it. I might sense these details with my palpation, the client may tell me when I ask, or both. 

I know that sounds like a lot of measurements, but if you practice, you can get efficient at this and get a big picture rapidly. I like how my interaction with their spine in this way, both touching and sketching, helps me get an “inside view.”  (I’ll address palpating the scoliotic spine in other positions in future articles.)

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In my scoliosis weekend workshops, I demonstrate the above quick spine drawing technique, creating a larger than life size torso drawing for each of the group 1 participants, from which we collectively create strategies for their curves during the course of the weekend. We also focus on celebrating our bodies, our curves, contradicting the negative body image issues that often come with scoliosis. The workshop offers a creative learning laboratory for students with scoliosis, somatic movement teachers, and practitioners. For more on the next “Somatic Solutions for Uneven Posture, Scoliosis, and Chronic Pain” workshop, offered in Portland OR, April 12, 13, 2019 (with an addition mentoring day 3 for practitioners) click:  https://lauramgates.com/portland-details .

Continue reading in Section 4: Zig Zag Shoulders.