Many adults with scoliosis, including those with prior corrective surgery, are curious about the risks and benefits of exercises and sports participation. In our experiences, most adults with scoliosis have never held discussions with medical professionals about these issues. Research based information about therapeutic or recreational exercise for adults with scoliosis is lacking. The advice expressed in this article will therefore reflect experiences described to us by our patients with scoliosis, and our recommendations to these patients.
Exercise patterns of adults with scoliosis vary widely, as they do for the general population. Avoidance of exercise because of fear of causing harm to the spine is fairly common, however, in those with scoliosis, especially following spine surgery. This is certainly understandable. However, exercise or sport participation will have no effect on non-fused spinal curves. Although curves tend to increase by several degrees with advanced age, this appears to be unrelated to activity or exercise levels. For patients with solid spinal fusion, exercise and participation in recreational sports should not harm the fused segments. The segments of the spine not involved with the fusion operation are under some increased stress to make up for the loss of function in the fused segment, but this additional stress is present for all daily activities. Several hours per week of exercise or sports participation should not exert any harmful additional stress into these areas. A note of caution however may be appropriate for some adults with only one or two mobile lumbar vertebrae below their fusion. For these patients, excessive twisting or loading of the spine during sports has often been discouraged as it is theorized that this may accelerate degeneration of the discs at the remaining levels. In general however, adults with scoliosis can engage in exercise and recreational sports without undue risk.
As most of us are aware, regular exercise and sports participation has many health advantages. These include improved cardiovascular heart and lung conditioning, improved strength and flexibility of muscles and joints, and better weight control. Exercise helps prevent osteoporosis in women. Exercise has also been reported to result in an improved sense of well-being. It can relieve or reduce daily stress and most people who exercise regularly find it enjoyable. These advantages of exercise can, and should be enjoyed by adults with scoliosis.
Exercise can be therapeutic for adults with scoliosis who have had spinal fusion. When the mobility of the spine is limited because of the fusion, one can feel somewhat inflexible for normal daily movements such as bending over or reaching for objects. A potential solution to this problem can be found by realizing that most of us adults only use a portion of the potential flexibility in our hip joints. The full mobility of the hip can be developed by daily stretching of the ham-strings, quadriceps, hip flexor and muscles. This increase in hip flexibility can then be substituted for the loss in spine mobility, and make it easier to move in desired directions.
In our practices, we also advise exercise for adults with scoliosis who have developed back pain symptoms. As mentioned above, the stresses on the back during daily activities can be reduced by improving the mobility of the hips. This can lead to a reduction in pain. Improving the strength of the back muscles can also help to reduce pain and improve tolerance for daily activities. This can be accomplished by performing vigorous strengthening exercises at home or in a fitness facility several times per week. Endurance levels can be improved by regular walking, bicycling or other aerobic activities. This frequently results in improved tolerance for shopping, yardwork and other sustained activities. In general, a person with a back which is flexible and strong will feel and function better than if that same back (regardless of whether scoliosis is present) is weak or stiff. Favorable results, in terms of improved functional abilities and reduced back pain, have been reported to us by our patients with scoliosis and back pain. Most have continued their stretching and exercise programs for many years.
NFS expresses sincere appreciation to co-authors James Rainville, MD, and Alexander Wright, MD. Exercise illustrations reprinted by permission of VHI, Inc. These exercises are shown as examples only. We recommend all readers to seek the advice of their physician for activities and exercise programs suitable for their situation.