Scoliosis and scapula

My name is Brigitte and I’m a certified STOTT PILATES instructor and massage therapist in Montreal. I have watched you over many hours while editing the rehab DVD series that you did (I edit from English to French). I find you very knowledgeable, inspiring and motivating and if I could, would love to just spend a few months with you to learn even more (something that right now is not possible but who knows what the future holds!). I’m writing to you because I’d like to have your opinion on someone I’m working with. I realize that you cannot make any diagnosis or give me the absolute answer regarding this client, however perhaps you could shed some light.

I’ve been working with a woman for over a year now, she has spondilolithesis (so she’s obviously quite kyphotic in thoracic and hyperextended in cervical), fused lumbar, with a slight scoliosis, winging right scapula. She has a lot less stability in right shoulder and scapula. I have been focusing on spinal extension and scapular stabilization. I also work her in seated, kneeling and standing positions to encourage recruitment of the spinal and pelvic stabilizers in a neutral position. My one issue that I have is this terribly winging right scapula. I make her do lots of rotator cuff work, I also do lots of protractions against resistance to work her serratus anterior. I work on the cadillac, doing mid, lower and upper trap work, often unilaterally. The upper fibers of her rhomboids and mid traps seem to be firing well. However her mid to lower area of her scapula is always winging at a certain degree, usually when her elbows are bent (ex: when they’re bent and at elbow height, or while side-lying and doing ext. rotations with ball – although this has improved greatly). I make her do certain things and think, wow, her scapula is flush and moving smoothly. Then I make her do something else and it totally pops right off. I’ve been trying to help by placing her against a wall, with elbows bent at 90 degrees, in line with her shoulders. I then get her to do external rotations, bringing her forearms to the wall. She has a much smaller range with her right side and sometimes cringes while attempting this (she has improved but still not to full range).

Is there anything else I could do, it’s just boggling my mind and I really want to help this woman. I know I already have but I’m stumped. I started to think that she has quite a few active trigger points which may be preventing her from getting that full range. Either way, anything insight you could give would be much appreciated. I hope to one day attend one of your workshops, perhaps when you’re a little closer to Montreal!

Thanks so much and have a great day!

Sincerely,
Brigitte

From Brigitte to Pacific NW Pilates