According to the National Health Service (NHS), UK; “in 80% of cases the cause of scoliosis is often not identified.” This is known as idiopathic scoliosis. That is 8 out of 10 cases.
One online resource says; “Scoliosis is a condition in which the spine bends to the side abnormally; either to the right or left. The curvature can be moderate to severe. Any part of the spine can be bent in scoliosis; but the most common regions are the chest area, thoracic scoliosis, or the lower part of the back, lumbar scoliosis.”
While these explanations may be useful for layperson to identify someone with scoliosis it doesn’t unfortunately say much about how this condition forms and what can be done about it.
Guy Voyer explains; the mechanical origin of scoliosis lies within the rotation of the vertebrae. Due to the orientation of articular surfaces of the vertebral joints, when the vertebra rotates both on the intervertebral disc and the facet/zygapophyseal joint, side bending occurs in the spine. If the rotation is not corrected, the side bending is there to stay. That is the mechanics of scoliosis.
In many cases people with scoliosis develop two curves. The first one is the primary curve, and then a secondary curve, which is often the curve of compensation. This often occurs because of our instinct to maintain our eyes level with the horizon.
If our aim is to correct the scoliosis, we need to focus on correcting the rotation. We need to consider the alignment of the pelvis and how the sacrum sits between the two ilia. Often times, the patient needs a very precise structural correction of the rotation of the vertebrae. To maintain the correction and to further improve the alignment of the spine, spinal ELDOA needs to be practiced for the segments of where the beginning, the middle and the apex of each curve is.
When you’re performing the ELDOA, you’re targeting a specific spinal segment to “decoapt”, “decompress” or in other words separate the vertebrae. When you increase the space between the vertebrae, you’re not only “elongating” the ligament, the tendon, and the fibers of the annulus fibrosis but also help normalize the tension between these structures.
Designed by Dr Voyer himself, the ELDOA utilize myofascial tension to create a center of “separating forces” around a primary lesion. This myofascial tension solicits postural normalization resulting in numerous benefits, such as improved joint mechanics, increased blood flow, reduced pressure and re-hydration of the intervertebral disc, optimised muscle tone, awareness and proprioception and improved metabolic and hormonal balance. The by-product of this is often less pain, better posture, and an increased sense of well-being.
Once learned, each ELDOA exercise takes a minute to perform, meaning if you have a simple curve, in 3 minutes a day you can continuously improve your scoliosis. If you have a double curve, in 5 minutes a day you can improve and eventually correct it.
In what time frame you can expect to correct a scoliosis? Dr Voyer suggests it will largely depend on the degree of curve, the age of the person, and the degree of congenital component, if there is any.
In his experience you can completely correct the scoliotic spine of the growing child and adolescent while the adult person could only expect an approximate 50% correction, which is approximately the functional part of the scoliosis.
If not corrected in time, the long-term consequences of scoliosis can include pain, osteoarthritis, functional limitation of the viscera affecting;
-the lungs due to the modification of the shape of the thoracic cage,
-the heart due to the retraction of the pericardium,
-the liver, the pancreas and the spleen via their connection wit the diaphragm and so on.
Although the practice of ELDOA is a very unique and effective way of treating scoliosis, yet it is not a quick fix. Its benefits are often felt immediately it still needs to be practiced over months and sometimes years to make structural changes.
But if that’s what it takes to avoid the negative consequences that scoliosis can bring about, if one can comprehend what these consequences mean to a somebody’s health and quality of life…. I’m sure one will willingly take an extra few minutes a day to practice ELDOA.
Created by Dr Voyer himself, the ELDOA utilizes myofascial stretching to put tension around a primary lesion making it the center of “separating forces.” Dr Voyer briefly explained the mechanical aspects and importance of correctly treating a bladder infection and the role of ELDOA in this process. Acute cystitis or bladder infection is an infection that affects the lower part of the urinary tract. If not treated properly it can cause pyelonephritis or kidney infection, which can be life threatening; therefore, it must be taken very seriously. Generally in medicine, urinary tract infections are treated with antibiotics. Since resistance to many of the antibiotics used to treat this condition is increasing, sometimes a longer course or intravenous antibiotics are needed. Because bladder infection often come back, it is very important to treat the underlying cause as well as take preventive steps.
"Misalignment of the pelvis can also be the cause of bladder infection due to the consequent changes in the tension of soft tissue structures between the bladder and the bony parts of the pelvis", Guy VOYER DO explains. When one ilium is more anterior or "outflare", while the other one is more posterior or "inflare", the torsion created increases the tension on the bladder mainly via the median and lateral pubovesical ligaments, which connect the vesical neck to the pelvis near pubic symphisis. This torsion can make it difficult for the vesical neck to open making it impossible to fully empty the bladder, which sets the stage for further infections and complications.
To treat this problem, the lesions of the sacroiliac joint and pubic symphisis need to be corrected with a good osteopathic treatment.
In order to maintain the correction following the treatment, the patient needs to practice specific ELDOA exercises for the pubic symphisis and the sacroiliac joints.
Now this is where it gets a bit tricky. Within each sacroiliac joint there are 5 micro joints. These micro joints are called "apex of the lesser arm, base of the lesser arm, isthmus, apex of the greater arm and base of the greater arm".
These micro-joints allow 22 principle axes of micro-movement within the sacroiliac joint. One needs to understand and master these movements to know which specific ELDOA exercise to apply in order to maintain the pubic symphisis and sacroiliac joints in balance and to correct the bladder infection. This is the topic of the ELDOA Certification Level 4.
The key to osteopathic methodology is the mastery of anatomy
It is of course essential to consider any osteopathic treatment according to the principle of globality; this is why one must possess the subtlety of the analytic in order to understand the synthesis; in this sense, the treatment of one of the many myofascial chains of the lower limb passes through the normalization of each of the links constituting this chain.
The fasciae of the foot are numerous and complex and are all in interrelation as you can see in the table below, where only the main fasciae are represented.
Fascia laciniatum is one of the number of retinaculum of the internal face of the foot.
There is a fundamental role that consists in terminating a tunnel in which you will pass through the arteries, the veins and the internal planters (who seems logical), but also the external arteries, veins and nerves planters.
Position of the patient:
The patient is in decubitus; the lower limb to be treated is totally relaxed, therefore, in slight external rotation of the hip in the majority of the cases.
Placement of the osteopath:
He is standing facing the patient.
His cephalic hand is placed in forceps anterior to the 2 malleoli to stabilize the hind foot. Its caudal hand is such that its thenar eminence is placed up to the malleolar root of ligamentum laciniatum and empamps the calcaneus by respecting the oblique path down and back of said laciniatum.
After listening to the intrinsic respiration of the ligament, the osteopath induces by a lemniscatory movement the normalization of the rhythm of this ligament.
1 - Mechanical standardization
The cephalic hand serves as a fixed point and the caudal hand becomes mobile.
In order to create a lemniscatory movement, the osteopath alternates the tensioning of the different ends of the ligament, without forgetting to have an overall contact of the whole surface of the thenar eminence, to have a component of intra-fibrillar lateral expansion.
This mechanical work only makes sense if there are no subtalar or tibio-talar or tibio-calcaneal lesions (of course, these local lesions may be the cause of other primary lesions at a distance).
2 - Fluidic Normalization
It is carried out in the direction of the fibers, so as to stimulate the harmony of the histological gel / soil rhythm characteristic of any fascial tissue to which the ligamentum laciniatum belongs.
Listening to this ligamentum laciniatum will normalize the alternating and regular rhythm of this fascia's breathing by creating delays between its expansion and its reduction.
The ligamentum laciniatum is certainly an orthopedic structure whose quality intervenes as well on the stability as on the mobility of the leg and the foot; but it is especially, as we have seen previously, a sheath for the vessels and the medial and lateral nerves of the foot.
Any Osteopath respecting the rule of A.T.Still "the role of artery is supreme", must consider the treatment of ligamentum laciniatum.
It is obvious that wanting to treat any lesion at the level of the forefoot (Morton's disease, algo-neurodystrophy, fascites, plantar paresthesia, peripheral vascular consequences of diabetes, etc.) without allowing freedom of conduction neurological and vascular drainage, so without releasing the ligamentum laciniatum does not make sense from an osteopathic point of view.
It has been absolutely amazing to connect with a number of great trainers and therapists in professional sport through ELDOA. These professionals are always looking for tools to get better results to take performance to the next level. I’ve had the privilege to learn about how they do what they do while they learned about ELDOA.
ELDOA is an amazing mobility, recovery, rehabilitation and performance enhancement tool for not just the professional athlete.
A very busy and productive 3 days with Head of Strength and Conditioning and Physiotherapy of England National Rugby.
It was a privilege to spend time with the Strength and Conditioning Team of the Pittsburgh Penguins introducing them the intricacies of ELDOA.
A very productive day spent with the Strength and Conditioning Team of Harlequin FC on MyoFascial Stretching and ELDOA.
The body consists of 70% intra- and extracellular water.
This water allows the mobility and movement of many vectors, provided that the latter is itself mobile.
The movement of the fluid associated with unorganized connective tissue has an anteroposterior, transverse, oblique, lemniscatory direction.
This fluid is found in "bags" called peritoneum, when it is abdominal viscera, pleura, when it comes to the lungs, "pericardium" when it comes to the heart and so on. The general term is "fascia".
The most important of the many fasciae of the small pelvis seems to be the pre-fascial fascia, because it is related to all uro-vesical and genital organs, and with the remainder of the embryological aorta (medial sacral artery), the parallel veins and above all the connection of the 2 terminal sympathetic branches with Walter's ganglion.
1 - Volumetric treatment
You should listen to intra pelvic motility and follow it until you feel a point of balance.
This work must be maintained in the same direction, until feeling a resistance, even a small rebound, which we will associate immediately in the direction of the return.
This work continues until a relative density is perceived without any extrinsic movement, but a point of equilibrium meaning that normalization is achieved.
It may be that we do not reach this point of equilibrium, because an intrinsic lesion (visceral or other) disrupts this fluid movement. Of course, this diagnostic information will be immediately taken into account and processed before resuming volumetric normalization.
2 - Intrinsic standardization
The motility of the presacral fascia must be independent of the intrinsic mobility of the sacrum.
For this purpose, the cephalic hand should be placed on the sacrum caudally, thenar and hypothenar on the sulcus and the III towards the coccyx; this hand listens to the motility of the presacral fascia.
The caudal hand is placed above the cephalic hand, the fingers towards the occiput; this hand will have the responsibility to normalize the mobility of the sacrum.
It is true that it is not easy to follow with the caudal hand the mechanical breathing and with the cephalic hand the MRP. The rhythms being close but different, the osteopath can induce the exaggeration of this difference by slowing down one or other of the movements to create a delay and normalize the motility of the presacral fascia.
The rhythms must be normalized until they are different but regular to justify their autonomy, their relationship but especially the non-existence of any links of type adhesions or others.
This volumetric treatment, of course, is either in phase with an overall volumetric work of the thorax, abdomen, neck, etc., or in combination with a more local treatment at the level of the small pelvis according to each patient.
It is essential to eliminate any adhesions between the sacroiliac movements and the presacral fascia. Indeed, it would be inappropriate to correct a sacroiliac joint in the context of a classic orthopedic problem (lumbago or other) while at the same time the structural manipulation would create an intra pelvic lesion (uterine torso, bladder, ovarian, etc.) because of the new tension created by this intimely manipulation, on this fascial lesion.