View Full Version : Impact of Pilates

09-21-2003, 12:46 PM
A local therapist that specializes in Pilates has said that she attended training where a woman with a fairly severe spine curvature was able to use Pilates to straighten her posture significantly. The therapist said the woman with scoliosis showed her normal curvature. Then she bent over, and began to straighten up, focusing on specific muscle groups that one learns to identify in Pilates. Although not perfectly straight, she was able to substantially improve her posture.

I do trust this therapist because she has been highly effective in treating other back problems I have had. I just wonder what others that are professionals in this field think about Pilates and its ability to help people with my condition. I do have a curve of 30+ degrees, and have had scoliosis since childhood. I am now 58.

I'm looking for healthy things I can do now to keep the curve from advancing. Thank you for sharing your insights.

09-22-2003, 12:08 AM
A few thoughts...

First, it's important not to confuse "posture" with a true spinal curvature. I don't doubt that Pilates--or for that matter yoga or resistance training--could improve most people's posture by strengthening muscles in the back and abdomen, and by improving flexibility in joints. But scoliosis is not a problem with muscles or joints. Poor posture is an effect, not a cause, of scoliosis.

Second, what is your current curve measurement? If you are 58 are your curve is not much more than 30 degrees, you're probably fine. Scoliosis surgery is rarely done on curves below 50 degrees. Your curve may be progressing at a snail's pace, in which case it would be hard to justify surgery.

There's no way to stop a curve from progressing, other than surgery. The best thing you can do now--if you haven't already--is consult an orthopedist trained in treating scoliosis to assess your current curvature and rate of progression.


09-22-2003, 03:24 PM
I have good and bad about Pilates. I have a tape at home, which I have not yet used. I pulled a muscle in my hip this year and am just now getting back to normal. My curvature was at about 70%, I had surgery in 1967 and my curvature is about 39% now. I have had some discomfort in the last couple of years and had wondered if Pilates would help. I have been swimming and found that has helped.

I think I might give Pilates a try, althought very gingerly.

Joe O'Brien
09-23-2003, 02:27 PM
Dear Netgoddess:

I have not used Pilates myself, but my 21 year old daughter who has a similar curve magnitude as yours, and also a 60 degree kyphosis, uses it and is pleased with the results. She also runs and does several hundred abdominal crunches every day!

As a healthy active 58 year old with a 30 degree curve there is little expectation of any significant progression for you. Certainly staying active and using various reasonable excercise methods such as Pilates etc is considered to be generally beneficial to your overall health.

What it may, or may not, do for your spine is debatable. According to several studies, such as those of Ian Stokes, scoliosis progression is considered to be attributable to asymmetric loading of the spine. If various methods such as Pilates can alter asymmetric loading then perhaps we can influence potential curve progression. Of course this influence may be either positive or negative so we should be cautious about what we do. If you are interested in an depth look at the question of excercise and scoliosis I would recommend you read 'Scoliosis and the Human Spine" by Martha Hawes, PHD.

Anecdotedly some patients have reported reducing their curve magnitude as well as feeling better because of various excercises. Depending upon your flexibility, you may find that your 30 degree curve is actually considerably less if you took your xray while lying down and removing the force of gravity. This supine xray indicates the magnitude of your bony deformation. The range of flexibility between your standing and supine xray is the range that can generally be altered with fusion, the force of a brace, or perhaps in some cases with other non operative means.
Obviously this possibility needs to be scientifically validated, but whether or not we can stop progression or reduce the curve by five or ten degrees does not obviate the benefits of excercise or the desire to feel healthy and do the things we want to do.

As a closing thought, 85% of scoliosis is classified as idiopathic which by definition means we do not know the cause. It is still unclear what role genetics, proprioception, nutrition, cellular development, or any one component of the neuromusculoskeletal system plays in the development and progression of this spinal deformity. It is clear however that an abnormal curvature does not only affect the spine but may consequently impact all of the various elements surrounding it such as discs, joints, ligaments, nerves, muscles, lungs etc. Ultimately it is about the whole person and we should be taking a whole person approach for proper care.

09-23-2003, 04:34 PM
:) Thank you so very much for writing such a thoughtful reply to my request. I appreciate so much your advice, as well as all of the other excellent responses above.

My local orthopedist told me that it would degenerate 1 degree a year and gave me a very poor outlook. On the other hand, my brother, who is also an orthopedist in another state, tells me to live a healthy active life--that scoliosis does not need to diminish the quality of my life at all.

I am able to do all of the physical activites that I want to do, but have concerns if it has 20 degrees more curve in 20 years, I am rather frightened and upset about that future picture. My mother had scoliosis, and as she reached her 80s, she did have a significant curve that was quite noticeable while she wore clothing (some was osteoporosis, too) and as she walked. She was always in pain from her back. If I can prevent that future for myself, that is my goal.

I have been very pleased with the responses I have had to this posting on this website. If anyone is doing research on it, I want to know who they are, and possibly be a participant in various studies to help others stay healthy and active. If you know of any, besides the doctor that wrote the book (that I will buy), I would appreciate your help.

Karen Ocker
10-01-2003, 06:58 PM
I am 63 and had an anterior/posterior revision for 80deg scoliosis in 2002. In 1956 (age 14, I had an uninstrumented fusion T-4 to L-1, a year in bed, in casts, for a 100deg curve. ) Over the 40 plus years since that procedure my "solid" fusion progressed to the 80 deg curve, with breathing impairment necessitating last year's revision. The 4 years before the revision I did Pilates with a personal trainer. It helped the muscle fatigue and improved my stamina and posture but it did not stop the progression. I am again doing Pilates, modified with my surgeon's permission, which strengthens the muscles in the fused area not otherwise exercised. I personally love this particular discpline even during my recovery period from the revision.

09-28-2005, 08:25 PM
Hi! I also had a fusion without hardware, not for correction as much as to stop the progression. My cervical vertabrae were already fused from birth so all that could be done was to continue the fusion in hopes of stopping the progression of the curve in the thoracic area. Can you tell me how you deal with the uneven muscles on either side of your spine? I find that I have to be very careful not to injure them. What have you tried? Yoga?

09-29-2005, 06:15 PM
Dealing with uneven muscles on either side of the spine as well as the fusion and instrumentation is definitely a challenge. I have not found yoga or pilates classes to be effective for me, because there are too many moves or positions which I can't do or are afraid to do. Instead, I have found that working with a trainer at my local gym has been most effective. My trainer has developed a customized program for me which has built core strength and has improved my balance on the left side of my body. Even though the left side of my body is weaker than the right side, I always use the same amount of resistance on each side. As a result, each side of my body has learned to work together to become stronger and more balanced. I have been working out for about 4 years and find that it has helped improve my self image. I have no intention of quitting; the results are too gratifying.