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Working with Therapeutic Yoga for Scoliosis and Back Pain - An Interview with Deborah Wolk
Deborah Wolk is the founder of Samamkaya Yoga Back Care & Scoliosis Collective in New York City. Inspired by her own back issues, and her extensive yoga education with teachers like Geeta Iyengar, Genny Kapuler, Donald Moyer, Bobbie Fultz, and Elise Browning Miller, Deborah developed a style of yoga teaching focused on alignment and anatomy for back care and scoliosis. In this interview with YogaU, Deborah discusses how yoga can help with back pain, her experience with yoga and scoliosis, and principles for targeting yoga instruction for those with scoliosis.
YogaUOnline: Deborah, you have worked with yoga for back care for a number of years. How did you come to specialize in this work?
Deborah Wolk: I began as a yoga practitioner, practicing Iyengar, Vinyasa, and Ashtanga. When I switched my style focus, it was because I had some injuries that I was dealing with. My teachers during that time kept focusing on my scoliosis, which up until that point I’d had very little awareness of. Then, when I began teaching in 2000 after a two hundred-hour training, I noticed that everyone I looked at had some asymmetry or some back problem or some alignment issue that they needed to focus on, so that’s where I picked up. As a result, people started coming to me because they had back issues, because they had scoliosis. It gave me an angle to focus on in the beginning, and then it became my style.
YogaUOnline: In your work with students, what are some of the conditions that your students get relief from?
Deborah Wolk: I have students getting relief from a variety of conditions, like the alignment issues of scoliosis, kyphosis, and lordosis. Kyphosis is the spine moving back in space, and lordosis is the spine moving forward in space. I help students with bulging and herniated discs, spondylolisthesis, spondylosis, frozen shoulder, sciatica, radiculopathy, shoulder impingement, hip issues, neck pain, and stenosis. Almost any musculoskeletal issue will find some relief from the practice.
YogaUOnline: That’s very comprehensive. What are some of the general principles you apply to help students with back issues?
Deborah Wolk: For back care specifically, the major issue is finding a neutral spine. The spine has natural curves – the thoracic backwards with kyphosis and the lumbar forward with lordosis. People tend to exaggerate these curves, lack them, or have them in the wrong places in the spine. So, the first thing that we look for is how we can make the spine elongated and neutral. The first principle is how to see that, how to sense that, and how to create that in postures.
The next principle very important for all therapeutics is to break down the poses. Mr. Iyengar used to say, “Break the pose and not the body.” Instead of trying to make a shape like you see in a book, try to create part of a posture that will bring the right action into the part of the spine that is misaligned. If there’s a misalignment, everything is missing.
YogaUOnline: One of your specializations is in yoga for scoliosis. How has your personal experience with scoliosis impacted your teaching?
Deborah Wolk: Unlike most of my students, I did not have a teenage diagnosis. It didn’t come up until later, in my thirties when I fell and went to see a PT. I became interested because it helped me. However, when I started practicing yoga, I started practicing for completely different reasons and not for my scoliosis or for pain. When I started practicing with Alison West and Iyengar teachers, people kept pointing out to me like, “Oh, you have quite a bit of scoliosis and you need to pay attention to this.” It didn’t mean anything to me, but then when I started actually doing something with it, I felt so much better and my practice felt better and I felt exponentially better at my life. My pain started going away and I felt emotionally more uplifted. I felt like my yoga practice was really working for me and so, I started really focusing on it.
That’s when I met Bobbie Fultz and things started to really click. She talked about how the nervous system is distorted with scoliosis and because your joints are at an angle, they’re misaligned with the trunk. Therefore, your nerve pathways are different and you have a different proprioceptive feedback. So people with scoliosis will have a distortion of where they are in space, and that explained why I was falling. That’s why I had coordination problems as a child and as an adult and why yoga is difficult for me. With yoga, I could do everything to one side and nothing to the other side and could not feel why it was happening. Thanks to Bobbie, it made sense to me and then I started really relating to the nervous system aspect of scoliosis.
YogaUOnline: Have you found that yoga provides an effective way for people to work with scoliosis so it doesn’t progress, or possibly even gets better?
Deborah Wolk: Absolutely. The most common thing is that people feel better, their muscular use is more balanced. They have a better sense of where they are in space and they move better. It can depend on the person’s individual chemistry and body. It can depend sometimes on diet and things like that. It can depend on the person’s focus on how strong their practice is. In most cases, when people practice well, they’ll have great results.
YogaUOnline: What are the principles that you use in targeting yoga practice for people with scoliosis?
Deborah Wolk: First thing I teach my students is the difference between the convex and concave side of each curve. In the United States, the model is that people have one C curve or two curves that make an S and it is shown on their lateral plane or an x-ray. But the scoliosis is also rotational, so one curve is turning one way and the other curve is turning the other way.
The side that sticks out is the convex side. So if there’s a rotation, the side that sticks out is kyphotic. That side is going to speak to the person all the time and they’re going to feel pain there. It might be achy, it might be sore all the time. Meanwhile, the other side doesn’t do anything; it’s getting more and more contracted. The muscles are getting shorter but the nerves are deeper to the surface and there’s no sensation there. But as the muscles contract more, this area can spasm.
I teach my students how to differentiate where their curves are and then to differentiate between the convex and the concave. Someone who has a very pronounced scoliosis would know where the convexity is but they may have just shut off the concavity. We have to turn on the nervous system where the concavities are. I have them do something very simple like Adho Mukha Virasana (Child’s Pose) and I place a hand on their concavity or have them stand up against the wall and feel their concavity so they can learn to breathe into that area. Most of us always want to stretch the convexity because it aches but what has to actually open and stretch is the concavity.
From there, you can take that breath into the poses that will help de-rotate you later on. For example, working with complex poses like the standing poses or the twists, which can be very confusing for scoliosis because that rotation is working with another rotation.
YogaUOnline: Is there a particular order for sequencing a yoga practice for scoliosis?
The first step is finding length. Extension with Adho Mukha Svanasana or Dog Pose on the ropes and extending the spine is good. After finding your way through extension, one has to look at how the arms and the legs are connecting to the body. I even look at the people’s fingers because a little asymmetry in the hands could create an effect on the shoulder. Awareness of the asymmetry and patterns is key, so try doing all of your standing poses with the back against the wall so that you can feel where you’re rotating and where you are moving away and moving towards it. Next is de-rotation, which for most people involves de-rotating two areas of the spine. One has to think about where they’re breathing and where they’re moving from. The next step would be inversions that in the beginning are just hanging from ropes upside down or things that are very supported like Viparita Karani instead of doing Sarvangasana just so that you are upside down. The last thing to do is spinal strengthening – creating strength around it (the spine) through alignment while tractioning the spine. That can be followed by abdominal strengthening, lumbar strengthening, and spinal strengthening while in traction. So those are the principles.
YogaUOnline: What advice would you give to people who have back problems or scoliosis and they’re wondering if yoga might help them but are a little bit concerned that they could hurt themselves?
Deborah Wolk: There is a lot of yoga out there and I would advise people to definitely look for the best teacher for them – someone who has many years of experience and who works with therapeutics. If you don’t live in New York and you can’t visit me, then I would recommend going to my website, Samamkayabackcare.com, you will see on the links page a list of teachers all over the country who work with back issues and therapeutic issues of all kinds.