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
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
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.
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