Scoliosis and Sport: The Best and Worst Exercises for You
Patients often ask our scoliosis physiotherapist questions about which lifestyle changes they can make to slow the progression of their curve and get the most from bracing treatment. Other patients want to know which activities, habits and exercises to avoid that may exacerbate their curve.
Below are some of the most common questions asked by patients undergoing treatment, with LOC’s Schroth Certified BSc. CSP and HCPC registered physiotherapist Deborah Turnbull here to answer them.
Should you exercise when you have scoliosis?
Yes, definitely! Apart from being good for your general health, exercise and physiotherapy should be an integral part of any non-surgical scoliosis treatment package. Every exercise programme we prescribe at LOC is created uniquely for each individual’s postural compensations and flexibility. There’s no one-size-fits-all approach as each set of exercises is based on each patient’s curve-specific pattern and tolerance.
Which exercises are the best for people with scoliosis?
This entirely depends upon the patient’s age, the issue being addressed (i.e. appearance, pain, curve progression, avoidance of surgery) and tolerance and flexibility of exercise. Schroth method-based exercises can address all these issues. If they are teenagers and going through bracing treatment, Schroth Best Practice exercises are the most effective, but other Schroth-based exercises may help non-braced patients also.
Debs doing exercises with patients at our Scoliosis Open Day.
How can physiotherapy help scoliosis?
Firstly, there’s no evidence that general physiotherapy is any benefit to scoliosis patients.
The specialist physiotherapy techniques we prescribe work in tandem with the over-corrective Gensingen Brace, normalising the posture through static, dynamic and stabilising control. These techniques use gravity to the body’s advantage in gaining and maintaining spinal corrections through over-corrective positions.
These programmes are curve-pattern specific and are individual to the patients’ own postural compensations and flexibility. They are designed to address the patient’s main concerns and increase the length of the muscles, reduce rotational humps and prevent curve progression. For patients with small, immature curves, Schroth-based exercises have been shown to help reduce the deformity, even without bracing.
For patients with larger thoracic scoliosis, rotational breathing can help de-rotate the scoliotic curve and stretch the muscles between the ribs. Patients learn to use rotational breathing to add to three-dimensional corrections and to reduce rib cage deformity.
Activities like rock climbing can be good for scoliosis sufferers as it improves spinal extension.
Do young scoliosis patients need flexibility or stability in their scoliosis physiotherapy programme?
In the juvenile and adolescent age groups hypermobility is much more common than stiffness. A specialist physiotherapist should always advise you on activities relating to your specific needs.
Multiple studies indicate that individuals who are hypermobile, i.e. their joints move beyond the normal range of motion, are more likely to suffer from scoliosis and exhibit a sway back or scoliotic posture. Sometimes increased flexibility can be brought on by over-exercise at a young age which can increase the likelihood of generalized joint hypermobility and scoliosis.
In my experience of over 12 years working as a specialist physiotherapist with scoliosis patients, this young patient group have too much mobility in their joints and generally lack stability. Therefore, it would be good to invest time in sports and exercises that encourage strength conditioning and help to strengthen the stabilizing muscles.
Netball is also a great sport for scoliosis sufferers to partake in as playing regularly can improve extensor strength. Photo by LocalFitness.Au
Which sports are recommended?
The types of sports I tend to recommend are those that improve spinal extension; netball, basketball, rock climbing for example, all increase extensor strength when done regularly (extensors being the muscles that keep us upright against the force of gravity).
Sports and activities that increase flexibility (which might not be prescribed for patients with hypermobile joints) include gymnastics, pilates and yoga. These are especially good for inflexible, stiff adult patients and those over the age of 15. There are benefits in increasing core strength with these activities, but they do not aim at increasing spinal extension and stability.
The brace should be removed during sports, especially contact sports to avoid risk of damage.
Which sports aren’t recommended?
For children, some activities can worsen or aggravate their spinal deformity. Sports to avoid include trampolining, which increases the forces of gravity on a curved spine and can compress it further. Other activities like cycling and rowing are sitting sports, therefore more likely to compress the spine and are not as beneficial as standing, running and extension-based sports.
Trampolining is one of the only sports we advise against for scoliosis sufferers, especially children.
Patients that continue to participate in sports often generally have less progression in their overall condition. At LOC, we feel that if a child loves an activity or sport, they shouldn’t be restricted from enjoying it (with the exception of trampolining). Encouragement and opportunity to participate in extension sports as a child can develop into a healthy active lifestyle choice. Bone health and weight bearing exercises become more important as a person with scoliosis ages.
Is swimming good for scoliosis sufferers?
Swimming is great for rib cage flexibility (if rib cage deformity is an issue) and improves general strength though it involves little weight bearing, so there’s not much benefit to the bones. Technique is important here and it’s best to work with a good swimming instructor initially to avoid poor neck posture. Butterfly stroke may contribute to poor back posture by arching the upper back.
We believe in the capacity of orthotics to intervene in the progression of scoliosis and prevent surgery in later life, that’s why we use the corrective Gensingen Brace by Dr Weiss® and Schroth-based physiotherapy to treat scoliosis patients. A full specialist physiotherapy assessment is carried out with each patient to establish the most appropriate treatment, according to their spinal flexibility, age and the patient's main concerns i.e. whether they want to avoid surgery, help with pain management or simply halt their curve progression and improve their appearance.
In addition to our specialist Scoliosis clinic in our headquarters clinic in Kingston, we have opened a Schroth Best Practice physiotherapy clinic at The Portland Hospital in central London. We also offer small group physiotherapy sessions for adolescent scoliosis patients every other Saturday at our Kingston clinic. You can make an appointment at any clinic by calling 020 8974 9989.