When I was in sixth grade, our school nurse mentioned to my schoolteacher mom that my scoliosis screen was a bit suspicious. I was 12, and the image of scoliosis depicted in movies was pretty unkind. I visualized a very nerdy girl with glasses, mouth gear AND a metal brace from hip to head worn over an unfashionable shirt.
But managing my scoliosis was actually a straightforward combination of bracing and frequent doctor‘s visits. I wore a simple spine corset for about five years during my growth period, which was hidden discreetly under my clothes and prevented aggressive progression of my curve. Every six months or so, I missed a few hours of school for checkups — which included McDonald’s for lunch on the way back to class. Not to mention, my diagnosis made for some stellar science projects. Not so bad, right? Now, I’m a mom of two girls, a marathon runner and a physical therapist.
If, like me, you were diagnosed with scoliosis as a kid or were diagnosed later in life as an adult, let me put your mind at ease: Scoliosis can be well managed as you age; and you too can live a healthy, active lifestyle.
What is scoliosis?
The normal curves of the neck and low back are called “lordotic” and describe the typical, front-to-back, sway at those portions of our spine — and are why our bottoms stick out a bit. Scoliosis describes a measurable curvature of the spine in the side-to-side direction (an “S-curve” — see picture below).
Most scoliosis cases are “idiopathic,” meaning the curvature developed without a known underlying cause. Idiopathic scoliosis occurring during growth and development may not be diagnosed until adolescence or even adulthood. Adults can also be diagnosed with scoliosis caused by advancing wear and tear changes in the spinal joints, bones and discs called degenerative scoliosis.
Your doctor can monitor you closely and measure any worsening of the scoliosis curvature on X-rays. A younger individual who is still growing will need more frequent-visits and, possibly, a pediatric spine specialist who can ensure that they are measured thoroughly throughout periods of growth and development. In addition, a knowledgeable physical therapist is key, and starting physical therapy (PT) early on if symptoms arise can be very helpful at any age.
What issues can scoliosis cause?
Again, scoliosis simply describes a variation of your spine’s curvature. With this, the muscles in your back can get a little fussy as one side of the back musculature lengthens and the other shortens to adapt to the spine. This imbalance can lead to discomfort and, sometimes, shifts in posture. Because of the curvature, individuals may have a loss in overall height, uneven alignment of the pelvis and shoulders, or leg length differences.
For example, although my curvature was well controlled with bracing during my growth period, my right shoulder remains a bit higher than my left. I also have a little extra love handle on my left side (ugh!), which makes me mad, but it does not create pain or decrease my spine function. More recently, I’ve noticed that I need to do a lot more stretching to keep my tight side from becoming uncomfortable and have started to wear a small heel lift in my running shoes just on one side. Of course, as a physical therapist, I knew to make these adjustments.
Rarely, scoliosis that is progressing aggressively can lead to pain in the spine and difficulty breathing in children and adults. If scoliosis is detected during a child’s growth period, bracing may be considered to avoid excessive curvature progression. The corsets are individualized, discreet, and made specific to the child’s body in order to best treat their specific curve progression. By the time the body has reached full development, bracing is no longer necessary, so full-grown adults get to skip this part! Occasionally, with very aggressive cases of scoliosis, surgery utilizing long rods in the spine is considered. This procedure is the last resort, however, so breathe easy!
What can I do to manage scoliosis as I age?
Move! I know we medical professionals are constantly barking up this tree, but activity is the typical prescription to keep our spine functioning, especially as we get older. Regular exercise for strength and mobility of the trunk, shoulders and hips can allow our bodies to remain balanced. This is essential in individuals with scoliosis as the side-to-side curvature can create muscle imbalance. Low-impact, moderate intensity aerobic exercise also is essential as it helps to improve cardiovascular and muscular endurance.
The general recommendations are:
- Strength and flexibility exercises 2 to 3 times a week.
- At least 150 minutes a week of moderate intensity cardiovascular exercise.
So, if you walk, bike, dance or jog five days a week for 30 minutes (moderate pace) and do strength training twice, you meet the standard!
For scoliosis-specific exercises, seek out a physical therapist. Physical therapy is a great place to start a safe exercise program that caters to your individual needs. Physical therapists work with individuals of all ages at all stages of injury and diagnosis. Whether you have had scoliosis for quite some time or are newly diagnosed, a physical therapist can give you the exercise tools to keep you moving and functioning at your best.
Adults diagnosed with scoliosis can take a breath. As scary as the terms “idiopathic” and “scoliosis” may sound (and look on X-rays!), you should know that there are resources available to help you maintain a healthy spine.
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