June 14 2017

Muscle Imbalances and Scoliosis – by Karena Thek  author of Scolio-Pilates

Scoliosis is a beautiful study in how muscles adapt to the situation they are given. But it’s fair to ask questions of this adaptation … Are the adapted muscles strong? Are they weak? Or are there some of each? Or maybe they aren’t strong or weak? Maybe they are perfectly suited to the job at hand – supporting the vertebral changes of scoliosis.


Weak and Strong Muscles of Scoliosis?

The muscles of scoliosis can’t accurately be referred to as weak or strong if they are all supporting the spine just as they should be, given the shape of the spine they are supporting. The more severe the scoliosis, the more the muscles will change to conform; not just to the shape but also in ways that make everyday living with scoliosis possible. If they didn’t, even the slightest scoliosis would create pain as muscles and nerves and connective tissue would become impinged – which sometimes does occur, but more on that in another article.


How do the muscles conform?

Due to the shape of the scoliosis, some muscles are long as they are given more space to “live” in and some are short because they are given less space to “live” in.   The table below describes one of many thing that occur to change the function of individual muscles in someone with scoliosis:


What’s going on? Which muscles are long or short?
Long Muscles Their attachments are farther away than their physiological normal position It’s not safe to categorize muscles this way, as some fibers of every muscle could be long and some could be short. It depends on where the specific attachments are.
Short Muscles Their attachments are closer together than their physiological normal position.


The “Strong” muscles.

If a muscle is given less space, it is basically folding in on itself – a contraction of sorts. It is not performing the function of a contraction the way we think of it –  performing a function to move joints or to stabilize. The fibers of the muscle have crossed their filaments (myosin and actin) but they aren’t crossed as a result of muscle contraction, they are crossed due to crowding. The crowding looks, and may feel like, a contraction upon palpation.  However, this “contraction” is there whether you are performing a postural function (standing) or a non-postural function (sleeping). So, if the muscle is always “living short” is it functionally contracting? No, it appears it is not. It is just maintaining a functional holding pattern to conform to the scoliosis pattern.

The Weak Muscles.

For the “weak” muscles, well, they aren’t actually weak, these are muscles that are “living long”. These muscles are living in a shape that is much longer than is physiologically normal. So, the filaments that form the cross-bridges of contraction are farther away from each other than they should be. And when you try to contract the muscle? Well, sometimes the fibers just can’t reach each other, so the cross-bridges can’t form. So, the muscles appear weak because they’re not contracting. But remember, it’s part of the support of scoliosis, so it is performing its job perfectly. But what if we don’t want to hold the scoliosis, what if we are trying to move away from the scoliosis?  Hm.


Enter Elongation

Elongation returns the muscles to a more physiological norm. Once closer to their norm, the muscles that are living short are not as short and more filaments become available for creating the cross bridges of contraction.

Your muscles that are “living long”?  With elongation, they become shorter as the spine moves towards a more neutral shape. Now, when you ask for a contraction, the filaments that form the cross-bridges can finally reach other. All this with just elongation. Easy.

You can see how elongation can help everyone who has not just scoliosis changes but also slight changes to the spine that include rotation, flexion, extension or side-bending. Move them to their more physiological norm and now the muscles can function in a way they were intended.


Advanced Elongation and Scolio-Pilates

Advanced elongation happens after your initial elongation correction – in the form of continuing to move the spine more and more towards neutral, after your initial elongation correction. In Scolio-Pilates, we do this with 3-dimensional correction. You are probably already doing some sort of 3-dimensional correction yourself – either for yourself or for your clients. It’s impossible to be an effective Pilates Instructor without addressing all planes of motion. You wouldn’t set someone up for leg presses on the reformer so they were perfect in the coronal plane but allow their transverse plane to go all willy-nilly on the carriage, right? It’s the same with Scolio-Pilates. We use a standard set of rules as a jumping off point to make changes towards neutral. And once in neutral? Everything becomes much more possible.

I’m always available for questions.

KarenaThekKarena Thek is a Pilates Instructor with a passion for managing pathologies in the Pilates setting as well as disseminating information for those who are ready to change. Her work has led her to author OsteoPilates, Increase Bone Density, Reduce Fracture Risk, Look and Feel Great! (2003) and Scolio-Pilates, Exercise for Scoliosis, A Pro-Active Guide (2011). In addition to her books, she has numerous webinars and free YouTube videos on the topics that she teaches. Karena is the host of a women’s health talk radio show, Alive & Well Radio on AM1220 KHTS. You can listen live from anywhere on the planet at She previously hosted Pilates for Healthy Bodies on PBS (2009-2011). And when she’s not teaching, writing or thinking about Pilates? You can find her on Facebook and Twitter posting pics of daily adventures with her partner John and their furry little child, Gus T. Basset Hound. Learn more at