Lateral Curvature Of The Spine. Part 1.

LATERAL CURVATURE OF THE SPINE. Part 1.
There are few affections in which the movement treatment has met with more signal success than in this. The aim should be to invigorate and develop the weakened and pathologically changed muscles of the convex side so as to restore the natural equilibrium of the two sides. There are but four known and acknowledged methods of developing muscles locally - viz., massage, movements, electricity and hydropathy. As the two latter do not come within the province of this manual we shall only describe the two first mentioned. The main things to remember in treating lateral curvature of the spine are:
1. To elongate the spine by suspension.
2. To raise the lower shoulder.
3. To counteract rotation of the vertebrae.
4. Massage to stimulate the muscles.
5. Selected movements in carefully selected positions.

Massage of the back is very useful in most all cases of scoliosis, and the operator should pay special attention to the convex side, particularly in the early stages of the affection. The treatment should be applied also to the glutei - the gluteus maximus in particular. Pinching is a very valuable manipulation, and when the patient becomes used to the massage apply it firmly, so as to reach the deeper layers of muscles. In older cases, it sometimes becomes necessary to treat also the muscles of the concave side, which from disuse have become atrophied. When the primary curve is high up, the cervical region should be faithfully attended to. Patients will often complain if too much pressure is used over the extreme convexity of the compensation curve - "the abrupt lower bend," as some patients style it. We give here a list of the various Swedish movements used in the treatment of lateral curvature, and the intelligent operator who has been properlytrained will experience no difficulty in selecting those which will prove the most beneficial to the individual case in question.

1. St. Bending to the (Convex) Side. - The patient stands with hands clasped on the back of the head. The operator places one hand on the highest point of the curvature and the other on the opposite hip, the patient bending slowly about ten times. It may also be used as a single active movement.
2. St. Bending to the (Convex) Side. - Same movement as 1, only the patient places the arm corresponding to the lower shoulder-blade over his head as demonstrated in Fig. 110, the other hand on hip. Single active or duplicated active, in the latter case the operator placing his hands as in 1.
3. St. Rotation of the Arms. - The patient should stand as erect as possible with arms at sides ; he should carry his arms slowly forward and upward, then backward and downward. A very useful respiratory exercise, besides acting strongly upon the muscles of the shoulders.
4. S. Separating and Closing of the Arms. - Described on page 84. It acts strongly upon the muscles of the chest, but also upon those of the upper part of the back. Kellgren says that if this exercise is performed with one arm at a time, correction of the rotation in lateral curvatures of the spine is produced.

5. St. Flexion and Extension of the Arms. - This movement is described on page 82.
6. St. Raising of the Arms. - The patient is standing with thighs supported; the arms are extended outward and raised upward by the patient, while the operator resists, grasping the wrists. If one shoulder-blade is much lower than the other, work only with the corresponding arm.
7. St. Raising of the Arms. - This movement is the same as No. 6, only it is single active; that is, the patient performs it himself. He should raise his arms from the sides to above his head with a deep inhalation, afterward lower them slowly to original position, and exhale while doing so.
8. St. Bending of the Body Forward and Backward. - (See Fig. 77.) The patient should place his hands on his hips or clasp them on the back of his head. Another form of this exercise is performed in the following way: The patient stands with his limbs separated and his arms stretched straight up; he should bend slowly forward until the tips of the fingers touch the floor (see Fig. 78).
9. L. Extension of the Back. - The patient is lying with legs on couch, the trunk extending; the operator supports the feet; the patient bends his body upward as far as possible. This is a very effective movement and must be given with care. At first it is safest to have some one to aid in holding the patient. He may place his hands on his hips, or clasp them on the back of the head; after he grows stronger he may keep them extended straight forward parallel with the ears.

10. L. on the Side, Bending the Trunk. The patient is lying with legs on couch and trunk extended in side position, the convex side up and the feet supported. The bending should be performed slowly.
11. S. Raising of the Body. - The patient sitting on a stool or a turned chair with hands on back of head, bends forward, the operator resisting him when he resumes the original position. The lower shoulder may be raised up, as the operator has perfect control of the trunk by his firm grasp of the back.
12. St. Raising of the Body. - The patient, standing with thighs supported against a couch or table and hands clasped on the back of the head, bends forward as far as possible. The operator, standing behind and supporting the feet with his turned foot, places one hand on each side of the spine. The patient raises his body while the operator resists.
13. L. Raising of the Body.
14. St. Turning of the Body. - The patient stands with feet closed and hands back of head. He turns from side to side with or without the operator's resistance.