脊柱侧弯评估别只看站姿：走起来，身体的策略才藏不住

Part 2 of the ABCD’s of Scoliosis

Assessment does not stop when the client begins to move.

In fact, gait often reveals patterns that are much harder to see in a static posture.

I asked my client, Summer to simply walk back and forth while I observed her natural movement strategy. I did not want her to “fix” anything. I wanted to see how her body organizes itself when she is not consciously correcting.

The first place I looked was the feet.

Summer demonstrated a relatively heavy heel strike. In her body, this connects with the lordotic posturing that is part of her natural alignment pattern.

From there, I followed the relationship upward.

Her rib cage was translating forward. The ASIS landmarks of the pelvis were also moving forward, while the pubic bone was positioned farther back. Together, these findings suggested an anteriorly organized posture that would become even clearer when we moved into her static postural evaluation.

This is one of the reasons I value gait analysis so much in scoliosis work.

The feet tell us something about the pelvis.

The pelvis tells us something about the spine.

The rib cage tells us something about rotation and balance.

And the way all of those pieces interact while walking gives us information that a photograph or static posture alone cannot provide.

Rather than viewing a heavy heel strike or forward rib cage as an isolated “problem,” I see each finding as part of a larger movement strategy.

The question becomes:

What is the body doing to keep itself upright, moving forward, and feeling stable?

That question guides the rest of the session.

Once I understand Summer’s strategy in gait, I can begin to choose CoreAlign movements that give her new information through the feet, pelvis, rib cage, and center—without simply asking her to force herself into a position that looks straighter.

B — Breathing: Creating Space From the Inside Out

Once the assessment gave us a clearer picture of Summer’s habitual organization, we moved to the Balanced Body CoreAlign® to begin the B of the ABCDs: Breathing.

We started facing the ladder with the carts locked and no resistance. Summer placed her feet over the raised “speed bumps,” with her heels contacting the back side of the platform and her hands lightly holding the ladder.

Before adding movement, I wanted her to establish a relationship with the stopper behind her.

The purpose was simple: feel the back of the body.

By maintaining pressure backward into the stoppers, Summer could begin loading the posterior chain and accessing what I describe as the deep longitudinal lines. Rather than immediately asking her to correct her scoliosis, I first wanted her nervous system to recognize where “back” was in space.

Giving the Body a Map

I placed my hands on two areas: her pelvis and rib cage.

At the pelvis, I used the posterior superior iliac spines—the PSIS—as clear bony landmarks. At the upper trunk, I contacted the area around the inferior angles of the shoulder blades.

These landmarks gave Summer something tangible to relate to.

As she rose over the speed bumps onto her toes, I asked her to continue pressing backward into the stopper. My hands provided directional feedback through the bones, helping her recognize the relationship between her pelvis, rib cage, and posterior chain.

Summer has been doing this work with me for a long time, so something interesting happened immediately.

She started to de-rotate herself.

That might sound like exactly what I wanted—but at this stage, I actually asked her not to correct.

“Stay in your rotation.”

Why?

Because before we change a pattern, we need to feel it.

When Summer allowed herself to remain in her natural rotation, it became noticeably more difficult for her to maintain equal contact with the stopper. That difficulty was valuable information. It allowed both of us to experience how her scoliosis influences the way she loads the body during movement.

This is where Assessment begins to flow naturally into Breathing.

Breathing Into Contact

With my hands still providing feedback at the pelvis and rib cage, I asked Summer to inhale into the points I was touching.

Rather than thinking only about filling the lungs, she was breathing directionally.

On the inhale, she expanded backward into my hands while maintaining the connection through her heels and the stopper.

On the exhale, she rose over the speed bumps as I gradually released my contact.

That release is important.

My hands can give the body information, but I do not want the client to become dependent on my hands.

Ultimately, Summer needs to recognize what is happening inside her own body while she is moving.

We repeated the pattern:

Inhale—expand into the posterior rib cage and pelvis.

Exhale—rise into the movement while maintaining the organization we had established.

Now the breath was doing more than accompanying the exercise.

It was helping create the exercise.

From My Hands to Her Own Feedback

The next step was to replace some of my tactile feedback with a loop positioned around Summer’s upper rib cage, passing beneath the shoulder blades.

The loop became an external reference point.

Instead of breathing into my hands, Summer could now breathe into the resistance of the loop.

I asked her to inhale and expand the rib cage backward and outward into it.

Then, as she moved forward against the pull of the CoreAlign resistance, she exhaled and allowed the ribs to gather.

Inhale—open and expand.

Exhale—organize and move.

This progression is important in scoliosis work.

First, I provide the feedback.

Then a prop provides the feedback.

Eventually, the client develops the awareness to provide that feedback for themselves.

For someone with a rotational spinal pattern, breathing becomes an extraordinary internal tool. We are not simply asking for “more air.” We are using respiration to explore portions of the rib cage that may be compressed, rotated, or less available.

Breath allows us to begin creating space from the inside out.

And once Summer can perceive that expansion, we can begin asking the next question:

Can she maintain that new sense of space while finding her center?

C — Centering: Teaching the Body Where Center Is

After establishing the breath pattern, we moved into the C of the ABCDs: Centering.

For me, centering is not simply telling someone to “engage the core” or asking them to stand in a textbook version of neutral.

With scoliosis, center has to be discovered in relationship to the individual body.

Summer’s assessment had already shown us two important things: she carries a degree of lordosis, and her rotational pattern is more dominant through the pelvis than through the rib cage. Those findings determined how I approached the next phase of the CoreAlign work.

Let the Assessment Guide the Cue

We began again with tactile feedback.

I placed my hands at Summer’s PSIS so I could feel the movement of the pelvis and sacral region as she shifted backward into her heels. I also used contact around the inferior angles of the scapulae to help orient the posterior rib cage.

She inhaled as she moved back.

She exhaled as she rolled forward over the speed bumps toward her toes.

At first, the loop was positioned higher around the rib cage. But as Summer moved forward, something important became apparent.

On the inhale, she could access the posterior expansion beautifully. But as soon as she moved forward over the speed bumps, she dropped back into her familiar lordotic pattern.

That observation changed the exercise.

This is exactly why assessment cannot be separated from intervention.

I did not simply tell Summer to try harder to keep the loop in place. Instead, I changed the location of the feedback.

Because her primary challenge in this moment was lower—through the lumbar region and pelvis—I moved the loop down.

Now the resistance was positioned closer to the area where she needed the information.

Instead of asking the upper rib cage to solve a problem happening lower in the system, we brought the feedback directly to the region that needed it.

Staying With the Back Body

With the loop now lower, I continued to use the PSIS as a tactile landmark.

On the inhale, Summer pressed backward and expanded into the loop.

On the exhale, she moved forward over the speed bumps while trying to maintain that posterior relationship.

Inhale—fill the loop.

Exhale—stay with the loop.

That second part was much more difficult.

And that difficulty was useful.

Summer’s habitual strategy was to move forward by increasing the lordotic organization of the spine. The challenge was to move forward without abandoning the posterior support we had just established.

This is where centering became more than a position.

It became a relationship between front and back.

Introducing the Front of the Center

Once Summer could recognize the posterior landmarks, I added tactile feedback to the front of the body.

Using two fingers just below the navel, I directed gently inward and upward.

The intention was not to flatten or brace the abdomen. I wanted to give her a sense of lift through the center so that the rib cage could organize upward rather than simply translating forward.

At the same time, I maintained contact at the PSIS.

This created two reference points:

the pelvis moving back, and the center lifting in and up.

Now we repeated the movement.

Inhale—connect with the PSIS and expand into the loop.

Exhale—move forward while maintaining the relationship between the posterior pelvis and the lifted center.

The movement became noticeably more challenging.

That was exactly what I wanted.

Not because harder is inherently better, but because Summer could no longer rely as easily on her familiar strategy.

She had to find another way.

Center Is Not Always Where the Body Wants to Go

The next progression introduced the CoreAlign handles.

Now we were connecting a proximal landmark—the inferior angle of the scapula—to a more distal point at the hand.

This gave us another way to explore how organization at the center influences the extremities.

Because I know Summer’s body well, I can anticipate where she naturally wants to rotate.

Her body has a preferred pathway.

My job is not to fight that pathway, but to help her recognize it and then offer another option.

Using the PSIS as my posterior control point and the tactile cue just below the navel, I gently guided Summer toward what we had established as her centered position.

I often describe this simply as:

“I’m teaching her body where center is.”

That phrase is important.

I am not claiming that there is one universal center every person with scoliosis should achieve.

I am helping Summer identify a more organized position relative to her own habitual rotation.

Once she is placed there, the work becomes more demanding because she is no longer relying entirely on the pattern her nervous system knows best.

That is where learning happens.

All ideas and assertions expressed in The CORE are those of the individual contributors, offered to spark conversation, enrich understanding/inspire growth and share diverse perspectives within our community. They may not necessarily reflect the views of Balanced Body®.

Angelie Melzer

Angelie Melzer  CEO, TEAM Pilates® and Ascend Mentoring, a Balanced Body Educator, NCPT®, licensed GYROTONIC® and GYROKINESIS® practitioner, and internationally recognized presenter. A second-generation instructor in the Romana lineage, she is renowned for her expertise in scoliosis and chronic pain. For more information on the ASCEND SCOLIOSIS MENTOR PROGRAM.