Global Expansion
Global expansion is a lovely concept for working with scoliosis and spinal fusions. I like to envision global expansion with the image of tennis court nets. If you imagine that the spine is the post in the image above, the net represents fascia, muscles, ribs, and a whole lot more. As the net pulls taught from side to side, the post is better supported. Another great image is that of a well-staked tent that stays expanded without collapses.
Scoliosis and Spinal Fusions
With scoliosis, the net (muscles, fascia, ribs, etc) doesn’t always support the spine optimally. With a spinal fusion, the spine (and sometimes ribs) receives a surgical correction but the fascia, muscles, nerves, arteries, and veins, as well as our internal organs don’t and so rotational forces may still act upon the soft tissues and organs. The concept of global expansion helps all of us.Below are images of scoliosis with the changes that happen in the spine, ribs, and a few muscles (erector spinae, latissimus dorsi, and quadratus lumborum). The ribs change shape in that they spread and move back in space on the same side of the curve (convex) and become closer and move forward on the opposite side (concave). And the muscles become different lengths with the same side of the curve overstretched and the opposite side shortened.



If we add the idea of the tennis court net gently pulling from side to side in addition to axial elongation to lengthen upwards, the spine becomes better aligned and stronger.
Sometimes our imagination magically embodies complex concepts with imagery when our left brain struggles to connect concepts with our body. Elephants tugging on nets to help center our spine is my favorite image for global expansion. (Photo courtesy of Hagit Berdishevksy and Lise Stoltze ).

James Blake Discusses Scoliosis in Breaking Back
Speaking of tennis court nets, did you know that the retired professional tennis player James Blake has scoliosis? He received his diagnosis at age thirteen and wore a Boston (armpits to tailbone) 18 hours a day for four years. I really admire and appreciate how candidly he speaks about his scoliosis and bracing in Breaking Back . He talks about the sleeveless t-shirts he wore under the brace, the discomfort and heat during the summer months, and wearing oversized t-shirts so the brace wouldn’t show. Does this sound familiar to anyone? He also addresses how tough it is to wear a brace at a young age, “…the brace made me feel like a bit of a freak, like I had a secret to protect, and I did a pretty good job of concealing it.” Breaking Back at its core is about resilience. James Blake had an amazing career and endured extreme challenges. He suggests that scoliosis is one of the factors that helped develop his resilience. “I witnessed children my own age, and much, much younger, being wheeled in and out of surgery, being fitted for prosthetic limbs, or undergoing physical therapy. It was a powerful experience for a little kid to have. I know that the injured and the handicapped are often scary to children, and can even make adults uncomfortable, but I was fascinated by these children, kids my own age, being wheeled around or straining to lift a weight. Seeing them and their strength made me grateful that my problems were so minor compared to theirs, and I was moved by their determination.”
Glossary
Fascia – densely woven covering of connective tissue that surrounds and holds every muscle, bone, nerve, artery, and vein, as well as all of our internal organs including the heart, lungs, brain, and spinal cord. Fascia is fascinating in that it’s one continuous structure from head to toe 1 .