Exercise for Scoliosis

More and more people are incorporating exercise for scoliosis into their lives. To be effective, exercise should be according to curve pattern and incorporate Schroth rotational breathing.

For years, most orthopedic surgeons claimed that exercise won’t help improve scoliosis. This belief is still fairly common among surgeons. In general, this is true when that statement is taken at face value and refers to general exercise. Doing jumping jacks or going for a run isn’t going to do a thing to help a kid with progressive scoliosis.

To the best of our knowledge, there are no scientific studies which state that exercise can be harmful to those with scoliosis. However, some types of general exercise have proven problematic for scoliosis patients. Among them are regular long distance running, certain yoga positions and gymnastics, to name a few. One recent study also suggests that swimming could be harmful (1). Another cites dancers as having a higher prevalence of scoliosis (2).

With that said, patients need to consult scoliosis exercise experts for advice on specific exercises or activities. Education regarding body mechanics and movement is important. Certain types of exercises and movements may actually exacerbate a curvature.

Exercise specific to curve pattern can be beneficial  when performed regularly and according to Schroth method principles. Currently, there is evidence in support of Schroth exercise (3 – 5), and even more for the newer Schroth Best Practice® (6 – 12). These methods are now being used successfully, internationally.

Consult a Schroth certified practitioner to learn about the right and wrong way to exercise, and how to effectively manage scoliosis. A certified Schroth practitioner knows which exercises could be potentially harmful and teach you why they are harmful. They will also classify the curve pattern and instruct in Schroth exercise and breathing protocols needed to halt, or perhaps even improve curvature.

Why exercise for scoliosis?

Exercise for scoliosis is all about striving for spinal balance and stability. Generally, in patients with scoliosis, muscles on the side of the concavity are shortened and muscles on the side of the convexity are lengthened or stretched. Scoliosis-specific exercises are designed to help the individual performing them create stability.  This happens when the supporting muscles are engaged. In doing so, the goal is to counteract ‘the vicious cycle‘ to hopefully halt or reduce scoliosis.

Postural modifications are important!

Postural rehabilitation is critical component of a scoliosis exercise program since postural correction can be incorporated through the day and during activities.  Postural rehabilitation is validated by Level 1 evidence (13) and many studies point to the fact that posture influences scoliosis (14 – 21).

Which method should you chose?

With a quick scan on the internet,  it’s no wonder parents are confused about scoliosis exercise methods. The Schroth method has the longest track record –it’s been around since the 1920s, although it wasn’t in the US until about a decade ago. It’s hard to argue with a technique that’s been in existence for nearly 100 years. In the last decade it has expanded internationally, under the leadership of Dr. Hans-Rudolf Weiss, as Schroth Best Practice® (SBP). There are an increasing number of studies to support SBP and it is the one exercise method for scoliosis that has the most evidence based research to support it (see below).

When comparing scoliosis exercise approaches, there are numerous factors to consider. Not all scoliosis exercise approaches are created equally in terms of effectiveness or ease of use.

First, the principles behind the varying correction methods are different. When there are published results for various methods, it is impossible to make direct comparisons due to differences in study populations in terms of demographics and severity. When it comes to comparing techniques, ease of performing daily exercise in terms of time commitment and/or equipment required should be considered. One advantage of Schroth Best Practice® is that it uses minimal equipment so exercise is easier to perform anytime, anywhere. When complicated equipment is required it adds to cost and reduces the ability to practice anywhere which in turn decreases the likelihood of compliance.

1. Zaina F, Donzelli S, Lusini M, Minnella S, Negrini S. Swimming and Spinal Deformities: A Cross-Sectional Study. J Pediatr 2015;166:163-7.

2. Longworth B, Fary R, Hopper D. Prevalence and predictors of adolescent idiopathic scoliosis in adolescent ballet dancers. Arch. Phys. Med. Rehabil. 2014;95:1725– 30.

3. Otman S, Kose N, Yakut Y: The efficacy of Schroth s 3-dimensional exercise therapy in the treatment of adolescent idiopathic scoliosis in Turkey. Saudi Medical Journal 2005; 26: 1429–1435.

4. Weiss HR. The effect of an exercise program on VC and rib mobility in patients with IS. Spine. 1991;16:88 93.

5. Schreiber S, Parent EC, Moez EK, et al. The effect of Schroth exercises added to the standard of care on the quality of life and muscle endurance in adolescents with idiopathic scoliosis—an assessor and statistician blinded randomized controlled trial: “SOSORT 2015 Award Winner.” Scoliosis. 2015;10:24. dos:10.1186s13013-015-0048-5.

6. Weiss HR, Seibel S. Scoliosis short-term rehabilitation (SSTR) —a pilot investigation. The Internet Journal of Rehabilitation 2010;1(1).

7. Weiss HR, Hollaender M, Klein R. ADL based scoliosis rehabilitation—the key to an improvement of time efficiency? Stud Health Technol Inform. 2006;123:594–598.

8. Weiss HR, Klein R. Improving excellence in scoliosis rehabilitation: a controlled study of matched pairs. Pediatr Rehabil. 2006;9:3. 190–200 Jul/Sep.

9. Borysov M, Borysov A. Scoliosis short-term rehabilitation (SSTR) according to ‘Best Practice’ standards –are the results repeatable? Scoliosis. 2012 Jan 17;7(1):1.7.

10. Pugacheva, N. Corrective exercises in multimodality therapy of idiopathic scoliosis in children – analysis of six weeks efficiency – pilot study. Stud Health Technol Inform. 2012; 176:365-371.

11. Lee SG. Improvement of curvature and deformity in a sample of patients with Idiopathic Scoliosis with specific exercises. OA Musculoskeletal Medicine. 2014; Mar 12;2(1):6.

12. Moramarco M, Fadzan M, Moramarco K, Heller A, Righter S. The Influence of Short-Term Scoliosis Specific Exercise Rehabilitation on Pulmonary Function in Patients with AIS. Curr Pediatr Rev. 2015 Nov 17. [Epub ahead of print].

13. Monticone M, Ambosini E, Cazzaniga D, Rocca B. Active self-correction and task-oriented exercises reduce spinal deformity and improve quality of life in subjects with mild adolescent idiopathic scoliosis. Results of a randomized controlled trial. Eur Spine J. 2014 Feb 28.

14. Gram MC, Hasan Z. The spinal curve in standing and sitting postures in children in idiopathic scoliosis. Spine 1999; 24(2): 169-177.

15. Drzał-Grabiec J, Snela S, Rykała J, Podgórska J and Rachwal M. Effects of the sitting position on the body posture of children aged 11 to 13 years. Work 51 (2015) 855–862; 855 DOI 10.3233/WOR-141901.

16. Choi JH, Oh EG, Lee HJ (2011). Comparisons of Postural Habits, Body Image, and Peer Attachment for Adolescents with Idiopathic Scoliosis and Healthy Adolescents. Journal of Korean Academy of Child Health Nursing 2011;17(3) 167-173.

17. Bettany-Saltikov J, Stamp MJ. Carrying a rucksack on either shoulder or the back, does it matter? Load induced functional scoliosis in “normal” young subjects. Dangerfield PH eds. Research into Spinal Deformities 6 IOS Press 2008 pp. 221-224.

18. O’ Shea C, Bettany-Saltikov JA, Warren JG. Effect of same-sided and cross-body load carriage on 3D back shape in young adults. In Uyttendaele D, Dangerfield PH eds. Research into Spinal Deformities 5. IOS Press 2006 pp. 159-163.

19. Chow DHK, Kwok MLY, Cheng JCY, Lao MLM, Holmes AD, Au-Yang A, Yao FYD, Wong MS. The effect of backpack weight on the standing posture and balance of schoolgirls with adolescent idiopathic scoliosis and normal controls. Gait & Posture 24 (2006) 173–181.

20. Chow DHK, Hin CKF, Ou D, Lai A. Carry-over effects of backpack carriage on trunk posture and repositioning ability. International Journal of Industrial Ergonomics 41 (2011) 530e535.

21. Sahli S, Rebai H, Ghroubi S,Yahia A, Guermazi M, Elleuch MH. The effects of backpack load and carrying method on the balance of adolescent idiopathic scoliosis subjects. The Spine Journal 13 (2013) 1835–1842.

Additional suggested reading:

“The Use of exercises in the treatment of scoliosis: and evidenced-based critical review of the literature.”