Scoliosis - Is It As Bad As You Think It Is?
"I was told that I need to avoid certain movements because I have scoliosis and need to protect my back".
You don't even need to be a physio to have heard some version of this statement when talking to the general population. Over the years I've had different clients tell me their scoliosis prevents them from doing all sorts of activities and I think I've often been surprised by how misinformed people are about scoliosis. That's not their fault - possibly more the result of poor communication from previous health practitioners.
What is Scoliosis?
At the most basic definition of the term, scoliosis is a sideways bend in the spine, giving an "S" shape in most of the people that have it - which is around 2-3% of the population. Most of these cases are identified during the teenage years, when growth spurts tend to cause uneven forces on the spine. It's important to understand that there is a spectrum of the severity of scoliosis though! Some cases are pretty mild, while some are more severe.
Unfortunately, the diagnosis of scoliosis has often been used to explain any level of curvature in the spine, no matter how small (or even non-existent). For scoliosis to have an impact on pain in somebody, I usually would expect to see a fairly noticeable curve in the back before blaming it!
How Can You Work Out If You Have Scoliosis?
One of the most reliable ways to determine scoliosis, and the severity of it, is simply by bending forwards and looking at the uneven nature of the back. In people with scoliosis you will notice a height difference as the back is bent forwards. This is the most effective way to determine the severity clinically, but X-Rays are great at determining the exact position of the bones as well. Most physios would be able to help determine if more investigations are required, if the severity seems quite severe.
What Are The Treatments For Scoliosis?
In severe cases, surgery is the best option in order to surgically straighten the spine - this sounds quite extreme, but my understanding is actually that the surgical techniques used these days are really quite safe, and effective.
Joint mobilising techniques and muscle work can be used alongside muscle strengthening in order to try and reduce the side-effects of having a bent spine (such as pain), and helping to change the forces that are on the spine... I feel like I would be a bit neglectful though if I didn't say this:
***No amount of joint mobilising/clicking/cracking will cause the spine's scoliosis to right itself - its just not possible to change the rotation of the spine in that way***
A great website for further information on scoliosis is linked below:
Here is a little extract from one section:
"AIS [adolescent idiopathic scoliosis] patients soon become conversant with the ‘angle’ of their curves. This is called the Cobb angle and is measured on the x-ray. The only treatments which are effective in the management of AIS are bracing and surgery. The lay press abounds with claims for success with naturopathy, chiropractic manipulations, exercise programs (physiotherapy), electrical stimulation and so on. None of these supposed treatments can withstand critical analysis. The criterion for success of a given treatment is to produce accurate measurements of the Cobb angle before and after a treatment program and this the above-cited ‘therapies’ cannot do."
...They sound pretty confident don't they?
So Is Scoliosis A Reason To Stop Playing Sport?
It never seemed to hold back this guy...
Usain Bolt is certainly not one of the people you would have expected to pop up in this conversation, but have a look at the picture below:
A fairly obvious scoliosis never slowed him down (yes, pun intentional)! Bolt has spoken about how he uses stretches and strengthening to reduce soreness from his scoliosis:
"If I keep my core and back strong, the scoliosis doesn't really bother me"
Don't see scoliosis as a diagnosis that automatically rules you out of activities that you love! You may need some guiding from a physio (for example), but you may be surprised at what you body is able to tolerate if you exercise smart.