Scoliosis is a medical condition that is characterised by changes in the shape and position of the spine. It causes wedging of the vertebrae and discs, where one side is broader and the other is narrower. The clinical diagnosis of scoliosis is a lateral curvature with a Cobb angle of more than 10 degrees. Currently, there is no fix for scoliosis, but this does not mean it will control your life!
What causes Scoliosis and who does it affect?
There are specific conditions that cause scoliosis such as Cerebral Palsy, Marfan syndrome and Syringomyelia which encompasses 20% of all diagnoses. The other 80% are unknown or “idiopathic”. This means there is no definitive cause of the condition.
Scoliosis can affect both children and adults. It’s typically seen in children during a period of accelerated growth around the ages of 11-12yrs in females and 13-14yrs in males.
How do you diagnose scoliosis?
Initially, a qualified practitioner may observe an individual standing or moving posture (Adam’s test), which is a good tool for suspicion of scoliosis. But by itself cannot be used to provide a definitive answer for diagnosing scoliosis.
To provide a definitive answer, the spine must be X-ray. The Cobb angle is then measure from the X-ray. The Cobb angle formed between the 2 vertebrae that are most tilted/curved. Diagnosis is positive if the angle is greater than 10 degrees (Negrini et al. 2018).
But it should be reported that there are some general thresholds to follow regarding the development of the curvature:
- A curve less than 10 degrees is not scoliosis
- A curve less than 30 degrees will most likely remain stable throughout your life
- If the curve of your spine progresses above 30 degrees, there is an increased risk of progression
- If your spine curvature is greater than 50 degrees, it is almost certain that scoliosis curves will progress (Negrini et al. 2018)
Does Scoliosis cause back pain?
Firstly, the Scoliosis Research Society has stated “People with scoliosis get back pain at the same rate as their peers without scoliosis” and adults “with curves less than 30 degrees have the same risks for back pain as people without scoliosis.”
This means if you have back pain with scoliosis, other factors may contribute to this pain. This includes social life, work, psychological and lifestyle factors. Knowing these factors can influence your perceived pain, it provides evidence if you have back pain with scoliosis it does mean you need to address the degree of your curve but instead address one or two of the other factors which you can control. An example of this includes improving your sleep, re-engaging in physical activity you enjoy, and taking time to decrease your stress. You would be surprised how much impact improvement these aspects can be on your function and pain.
What is the role of exercise for low to moderate severity scoliosis?
Firstly, it is safe to exercise! exercise is an incredible method of maintaining a healthy spine and flexibility. To support this the international Society of Scoliosis Orthopaedic and Rehabilitation treatment states “patients with scoliosis to remain active in sports activities, especially since participation does not seem to affect the occurrence or degree of scoliosis”.
But, if you were to research on the web “scoliosis specific exercises”, you will come across multiple exercise options such as back strengthening, posture exercises, spine stretch etc.
Though these exercises may help improve your strength, functional capacity, and symptoms relief. The research suggests that there is no specific exercise that will reduce your “Cobb angle” or prevent the progression of the curve (Tolo and Herring 2020).
There is research comparing specific scoliosis exercises to general exercises for the management of scoliosis. From the research, it was shown that there was no difference in functional and subjective measurements comparing different types of exercises that are classed as “Specific” to scoliosis or “General” (Yagaci et al. 2018)
This means exercise selection should not focus on improving the curvature of the spine but improve functional capacity and aligning with your goals. To support this the international Society of Scoliosis Orthopaedic and Rehabilitation treatment states “patients with scoliosis to remain active in sports activities, especially since participation does not seem to affect the occurrence or degree of scoliosis”. This means there are no limits to the type of exercise you can do. Therefore, you can swim, run, cycle, and do resistance training or do Pilates. The key is to find something that you find enjoyable, which will result in long term success.
If you are still unsure and need examples, many athletes in our society have been diagnosed with scoliosis and are performing at a high level in their sport. Australia’s very own swimmer Jessica Ashwood was a silver medallist in the 2016 Rio Olympics. To further highlight how scoliosis isn’t as bad as you think, Usain Bolt (the fastest person on earth) has scoliosis and has attributed his training to help him manage his condition. If you are still unsure Lamar Grant a world-record-holding weightlifter deadlifted 237kg with scoliosis.
The most important aspect of treating scoliosis is the patient should be individually and there is no “one size fits approach”. No exercise activity should be avoided, and it’s recommended to remain physically active and feel confident and safe doing so, knowing it won’t make your curve worse.
- Negrini S, Donzelli S, Aulisa AG, Czaprowski D, Schreiber S, de Mauroy JC, Diers H, Grivas TB, Knott P, Kotwicki T, Lebel A, Marti C, Maruyama T, O’Brien J, Price N, Parent E, Rigo M, Romano M, Stikeleather L, Wynne J, Zaina F. 2016 SOSORT guidelines: Orthopaedic and rehabilitation treatment of idiopathic scoliosis during growth. Scoliosis Spinal Disord. 2018 Jan 10;13:3. DOI: 10.1186/s13013-017-0145-8. PMID: 29435499; PMCID: PMC5795289.
- Tolo VT, Herring JA. Scoliosis-specific exercises: A state of the Art Review. Spine Deform. 2020 Apr;8(2):149-155. DOI: 10.1007/s43390-020-00036-1. Epub 2020 Feb 24. PMID: 32096136.
- Yagci G, Yakut Y. Core stabilization exercises versus scoliosis-specific exercises in moderate idiopathic scoliosis treatment. Prosthet Orthot Int. 2019 Jun;43(3):301-308. DOI: 10.1177/0309364618820144. Epub 2019 Jan 10. PMID: 30628526.