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​What is Scoliosis?
You may have heard that Princess Eugenie, Yo-Yo Ma, Usain Bolt or Martha Hunt -to name just a few- have scoliosis, but what is it? 

​Scoliosis is a curvature of the spine in a C or S-shape, the spine can also rotate. Broadly speaking, all cases of scoliosis can be placed in one of two categories: functional or structural. 

​Functional scoliosis is the appearance of a curved spine but it is caused by another condition, such as different leg lengths.

In structural scoliosis, as the name suggests, the structure of the spine is actually altered. There is often no clear underlying cause for this type of scoliosis leading it to be labelled idiopathic (unknown). 

Some kinds of scoliosis are present from birth, and others develop in childhood, adolescence or as we age.

​Some people have a lot of pain, some have occasional pain, and some have none. 
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​Although there are similarities, no two experiences are the same.​
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​Treatments depend upon the type of scoliosis and its severity. Often, a wait-and-watch approach can be taken when degree of curvature is low. Although, in Juvenile and Adolescent Idiopathic Scoliosis (AIS) things can change quickly due to the rapid rate of growth at these times. 

​Bracing may be offered, not to correct the spine but to prevent curve growth. There are several types of brace, they are often worn both day and night. My daughter wore hers for 20 hours a day, for two years. This bought her some time and allowed her to complete her growth before surgery. (She’s an absolute hero and I’m incredibly proud of how she’s managed things so far.)

There are several kinds of surgeries: Vertebral body tethering (VBT) is fairly new and not currently offered on the NHS because its long-term efficacy is unknown. In the US, where it is more commonly offered there are reports of repeated surgeries due to instrumentation failure. The benefit of this technique is that it aims to preserve flexibility. It works best on smaller curves and on adolescents who are yet to have their major growth spurt. ​

​Growing rods are typically used on younger patients. Traditional growth rods require spinal fusion after growth is completed. The use of magnetic growth rods is relatively new, and it has been developed to improve the traditional growing rod procedures. It normally requires no follow-up surgery after initial implantation surgery.

​Another option is growth-guided devices, here the spine is left to grow on its own after the initial procedure. As the child grows, the spine elongates along the rod. The device is removed at the end of growth.

​Spinal fusion uses metal implants, rods and bone grafts to fuse as few segments of the spine as possible. These implants and rods are used to hold the spine in place until it can fuse itself. Over a period of about 12 months, the bone graft fuses (grows together) with the existing bone in the spine and forms a solid column of bone in that area. The instrumentation is no longer needed at this point but is usually left in place. This is the tried-and-tested surgery usually offered by the NHS.

Adolescent Idiopathic Scoliosis (AIS) is the most common type of scoliosis.
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​Of course, there is always the option to do nothing. However, when the curve reaches a greater degree -normally around the 50-degree mark- there is an increased likelihood of the curvature continuing to grow, even if the patient has completed growth. Year-on-year this often compounds, along with becoming uncomfortable it could become dangerous as there is a potential risk to organs such as the lungs and heart. This is uncommon, and seen in cases with a degree of curvature normally over 100-degrees (a few are affected when over 70-degrees). In the right care a patient shouldn’t reach this stage. Our family is grateful to have a wonderful team supporting us all as we head into the next stage, spinal fusion. Understandably, my daughter has some trepidation about the procedure but is keen to get it done. Luckily, it’s only her thoracic spine that will require fusion as the lumbar spinal curve has been determined to be compensatory. The majority of her flexibility will be preserved—phew! 
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​Progression can be very swift, especially with Adolescent Idiopathic Scoliosis (AIS) as it coincides with the growth spurt. Naturally, teens become more private with their bodies and caregivers see their shape less under baggie-hoodies and layers. Summer is often the time a parent or carer notices something doesn’t look quite ‘right’. In my daughter’s case it was the start of summer and I noticed something different when we were swimming on holiday.

Above is a very simple forward-bend test you can do at home, and markers show you what to look for. You could do this check on your teen monthly or quarterly.

​If something looks ‘off’, see your GP. Early intervention is recommended. Most cases remain mild and a wait-and-watch approach is appropriate, some cases require bracing, and a small percentage go on to require surgery.

​Whether it’s a wait-and-watch approach, bracing or surgery, all benefit from muscle-strengthening, not to correct or halt progression but to prevent or lessen pain by strengthening and retraining muscles. I use a number of techniques and tools including; balls; yoga bricks; Pilates; yoga postures (āsanas); and breathing practices (prāṇāyāma), depending on the client's need and preference. Being consistent with exercise is important; when so much feels out of control this is an area where ownership can be claimed – improvements in strength and self-confidence make it all worthwhile. I always say, “do what you can do, the rest isn’t up to you”.

So that's an overview of what scoliosis is and some treatments available. To get a better picture of the lived-experience search #scoliwarriors or #scoliosiswarriors (especially on Instagram) to read personal stories of people at all ages and stages -- they're so inspiring and full of support for the community.
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This was going to be a piece summarising some of my FAQs and some top-tips for newbies. Instead, I’m afraid I’ve gone to the heart of things.
​(FAQs are here if that’s what you’re looking for, loads of good info for beginners.)
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​Starting where you are now is the right place to start. You do not need to look a certain way, shape, size, colour, or sex. As you are now is perfect. You are ready to begin, the fact you are reading this probably means your journey has already begun. How long it will take, well…read on.

​Yoga is more than the postures. Yoga comes from the Sanskrit word ‘yuj’, which means ‘to yoke’. (Yoking was a practice used to connect and harness two animals. They would be ‘yoked’ together, typically at their necks, to then be able to perform tasks, such as ploughing a field.) To yoke is to create a union, and this is typically how we hear yoga defined today, a union of ‘the self’ with the ‘true-self’. Ultimately, it’s a piercing of illusion or peeling back of layers, the word ‘yoga’ in and of itself is already a paradox. The true essence of yoga is uniting two things that were never actually separate to begin with. It is just the illusion of separation that we need to remove.
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​Through asana we build strength in the body, promote health and remove tension and energetic blocks. We use the breath here to ensure we aren’t straining and our mind focuses on our breath, balance and openness. This is a type of moving meditation – if your mind wanders, you’ll lose the thread of your breath, or your balance, or go too deep, or not deeply enough, into the pose. Pranayama, along with other benefits, gives our mind a single focus, which again, is a kind of meditation. A specific meditation part of the class may also be offered, which also trains the mind.
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Alongside physical and physiological benefits these techniques also help us psychologically as (when practiced correctly) they share the quality of stilling the mind – bringing peace.

​It’s good and it keeps unfolding for your benefit.
For many beginners the novel experience of this balance, internal stillness or unity – even if only briefly glimpsed on the mat – is what captivates them. Interpreted as a sense of well-being it feels familiar and is often described as ‘home’. Most would say that this is what initially brings them ‘back to the mat’. 

​We should remember:​
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​The elements within our practice are our tools for this goal.* (Don’t worry, there’s joy along the way.) If we reach a constant state of stillness and steadiness of mind we can dispense with the tools, for we’ve reached freedom, enlightenment, achieved stability in pure awareness, which is understood by some as Samadhi. 

​There are many styles of yoga and I would encourage you to do your research, be open, and give it a try, see which style and teacher you gel with. A good teacher will always be able to give modifications and extensions for poses and be open to your questions. Use your brain, maybe don’t hit an Ashtanga level 2 or hot yoga class if you’ve mainly been ‘yoked’ with your couch during lockdown. There’s no shame in being a beginner, in fact, I still love taking a beginners classes as much as I enjoy teaching them (that’s my jam), it’s an inward journey after all. Find a teacher that supports you in your practice and your ‘going-in’.
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The tips I share below are aimed at getting us out of the fight-flight-freeze response (stress cycle), which many of us are in a lot of the time, and returning to rest-and-digest (relaxation) by accessing the parasympathetic nervous system. We will do this through stimulation of the vagus nerve (stay with me…).
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​The vagus nerve branches out from the brain stem to the inner ear, throat, diaphragm, lungs, heart and abdominal organs. Although we cannot consciously control our heart, kidneys or small intestine, we can control the muscles of respiration (breathing) and the muscles of the larynx (that open and close the vocal cords and control the pitch of sound). To facilitate the parasympathetic response in the body (and stimulate the vagus nerve), we need to exert influence over those two main areas, namely breath and sound. ​
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If chanting isn’t already part of your practice and seems a little out there, don’t worry, I have a few options for you; firstly, you could chant OM, instructions below; or softly hum your favourite song, this is perfectly acceptable and may be the most accessible option for you; or practice Bhrāmarī prāṇāyāma (bee breath), instructions below. Give these three options a try and see which sits best with you. If you laugh along the way, that’s an added bonus.

1. How to chant Om: (Om syllable by syllable—a-ā-u-ū-m-(ng)-(silence).)
   With eyes closed take a deep inhale, as you exhale to sound the first two syllables, open the mouth wide (a-ā-). Pursing lips together helps stretch out the next two syllables (u-ū-). Place the tip of your tongue on the roof your mouth to sound the last two syllables (m-ng). Let the silence within you settle before inhaling again. Repeat for a minute or so, noticing the vibrations in your throat and skull. Keeping your eyes closed, return to your normal breathing. Notice if anything has changed.
2. ​To practice Bhrāmarī prāṇāyāma (Bee Breath) you lengthen the exhalation and make a long one-tone M sound, this is usually calming.

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​The difference in pace is not mysterious: it has to do with novelty. The more our days are filled with new, unpredictable and challenging experiences, the longer they will feel. And, conversely, the more one day is exactly like another, the faster it will pass by in an evanescent blur. Childhood ends up feeling so long because it is the cauldron of novelty; because its most ordinary days are packed with extraordinary discoveries and sensations: these can be as apparently minor yet as significant as the first time we explore the zip on a cardigan or hold our nose under water, the first time we look at the sun through the cotton of a beach towel or dig our fingers into the putty holding a window in its frame. Dense as it is with stimuli, the first decade might as well be a thousand years long.

​By middle age, things can be counted upon to have grown a lot more familiar. We may have flown around the world a few times. We no longer get excited by the idea of eating a pineapple, owning a car or flipping a lightswitch. We know about relationships, earning money and telling others what do. And as a result, time runs away from us without mercy.

One solution often suggested at this point is that we should put all our efforts into discovering fresh sources of novelty. We can’t just continue to live our small predictable and therefore ‘swift’ lives in a single narrow domain; we need to become explorers and adventurers. We must go to Machu Picchu or Angkor Wat, Astana or Montevideo, we need to find a way to swim with dolphins or order a thirteen course meal at a world-famous restaurant in downtown Lima. That will finally slow down the cruel gallop of time.

But this is to labour under an unfair, expensive and ultimately impractical notion of novelty. We may by middle age certainly have seen a great many things in our neighborhoods, but we are – fortunately for us – unlikely to have properly noticed most of them. We have probably taken a few cursory glances at the miracles of existence that lie to hand and assumed, quite unjustly, that we know all there is to know about them. We’ve imagined we understand the city we live in, the people we interact with and, more or less, the point of it all.

But of course we have barely scratched the surface. We have grown bored of a world we haven’t begun to study properly. And that, among other things, is why time is racing by.

The pioneers at making life feel longer in the way that counts are not dieticians, but artists. At its best, art is a tool that reminds us of how little we have fathomed and noticed. It re-introduces us to ordinary things and reopens our eyes to a latent beauty and interest in precisely those areas we had ceased to bother with. It helps us to recover some of the manic sensitivity we had as newborns. Here is Cezanne, looking closely at apples, as if he had never seen one before and nudging us to do likewise:

Here is Van Gogh, mesmerised by some oranges:

​Here is Albrecht Durer, looking – as only children usually do – very closely at a clod of earth:

We don’t need to make art in order to learn the most valuable lesson of artists, which is about noticing properly, living with our eyes open – and thereby, along the way, savouring time. Without any intention to create something that could be put in a gallery, we could – as part of a goal of living more deliberately – take a walk in an unfamiliar part of town, ask an old friend about a side of their life we’d never dared to probe at, lie on our back in the garden and look up at the stars or hold our partner in a way we never tried before. It takes a rabid lack of imagination to think we have to go to Machu Picchu to find something new.
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In Fyodor Dostoevsky’s novel The Idiot, a prisoner has suddenly been condemned to death and been told he has only a few minutes left to live. ‘What if I were not to die!,’ he exclaims. ‘What if life were given back to me – what infinity!… I’d turn a whole minute into an age…’ Faced with losing his life, the poor wretch recognises that every minute could be turned into aeons of time, with sufficient imagination and appreciation.

It is sensible enough to try to live longer lives. But we are working with a false notion of what long really means. We might live to be a thousand years old and still complain that it had all rushed by too fast. We should be aiming to lead lives that feel long because we have managed to imbue them with the right sort of open-hearted appreciation and unsnobbish receptivity, the kind that five-year-olds know naturally how to bring to bear. We need to pause and look at one another’s faces, study the evening sky, wonder at the eddies and colours of the river and dare to ask the kind of questions that open our souls. We don’t need to add years; we need to densify the time we have left by ensuring that every day is lived consciously – and we can do this via a manoeuvre as simple as it is momentous: by starting to notice all that we have as yet only seen.