Scoliosis is a sideways curvature of the spine affecting approximately 2-3% of the population. While some cases are mild and require only monitoring, others benefit significantly from physiotherapy and exercise-based treatment. At M.O. Therapy in Markham, we help patients with scoliosis manage their condition and reduce symptoms through evidence-based approaches.
Understanding Scoliosis
What Is Scoliosis?
Scoliosis is defined as a lateral (sideways) curvature of the spine measuring 10 degrees or greater on X-ray (Cobb angle). The spine also typically rotates, creating a three-dimensional deformity.
Key Features:
- Sideways curvature (10+ degrees)
- Spinal rotation
- May involve thoracic, lumbar, or both
- Can be C-shaped or S-shaped
- May be structural or functional
Types of Scoliosis
Idiopathic Scoliosis (80-85%): No known cause, classified by age of onset:
- Infantile (0-3 years)
- Juvenile (4-10 years)
- Adolescent (10-18 years) - most common
- Adult (after skeletal maturity)
Congenital Scoliosis:
- Present at birth
- Due to vertebral malformation
- May progress rapidly
- Often requires surgical evaluation
Neuromuscular Scoliosis:
- Associated with neurological conditions
- Cerebral palsy, muscular dystrophy
- Often more severe
- Complex management
Degenerative Scoliosis:
- Develops in adulthood
- Due to disc and joint degeneration
- More common in older adults
- Associated with stenosis
Curve Classification
By Location:
- Thoracic (upper back)
- Lumbar (lower back)
- Thoracolumbar (mid-back)
- Double curves (most common in AIS)
By Severity:
- Mild: 10-25 degrees
- Moderate: 25-40 degrees
- Severe: Greater than 40 degrees
Signs and Symptoms
Physical Signs
Visible Changes:
- Uneven shoulders
- One shoulder blade more prominent
- Uneven waist
- One hip higher than other
- Head not centered over pelvis
- Rib hump when bending forward
Adam's Forward Bend Test:
- Person bends forward at waist
- Observer looks for asymmetry
- Rib hump or lumbar prominence
- Screening tool for scoliosis
Symptoms
Many Cases:
- No symptoms (especially mild curves)
- Discovered incidentally
- May have minor postural complaints
When Symptoms Occur:
- Back pain (more common in adults)
- Muscle fatigue
- Postural discomfort
- Headaches (if cervical involvement)
- Difficulty standing straight
Severe Cases:
- Respiratory limitation (severe thoracic curves)
- Significant pain
- Functional limitations
- Cosmetic concerns
Diagnosis and Assessment
Clinical Examination
History:
- Age of onset
- Progression concerns
- Family history
- Pain and function
- Previous treatment
Physical Exam:
- Postural assessment
- Adam's forward bend test
- Leg length measurement
- Neurological screening
- Flexibility assessment
Imaging
X-Ray:
- Standing full-spine views
- Cobb angle measurement
- Skeletal maturity assessment
- Curve pattern identification
MRI:
- If neurological symptoms
- Atypical presentation
- Left thoracic curves
- Rapidly progressing curves
Risser Sign:
- Assesses skeletal maturity
- Important for predicting progression
- Guides treatment decisions
Treatment Options
Observation
Indications:
- Mild curves (10-25 degrees)
- Skeletally mature patients
- Non-progressing curves
Monitoring:
- Regular clinical assessment
- Periodic X-rays
- Every 4-6 months during growth
- Less frequent after maturity
Physiotherapy and Exercise
Scoliosis-Specific Exercise (SSE): Evidence supports specialized exercise programs for scoliosis management:
Schroth Method:
- German-developed approach
- Three-dimensional correction
- Specific breathing techniques
- Postural awareness
- Curve-specific exercises
SEAS (Scientific Exercise Approach to Scoliosis):
- Italian method
- Active self-correction
- Functional integration
- Home exercise program
- Less intensive than Schroth
Goals of Exercise Therapy:
- Improve postural awareness
- Strengthen muscles on concave side
- Stretch muscles on convex side
- Improve breathing mechanics
- Reduce pain
- Slow or halt progression (in growing patients)
Bracing
Indications:
- Growing patients (Risser 0-2)
- Curves 25-45 degrees
- Documented progression
- Significant growth remaining
Types:
- Boston brace (most common)
- Charleston bending brace
- Rigo-Cheneau brace
- Various custom designs
Effectiveness:
- Can prevent progression
- Most effective with compliance
- Typically worn 16-23 hours/day
- Combined with exercise therapy
Surgery
Indications:
- Curves greater than 45-50 degrees
- Progressive curves despite bracing
- Curves causing symptoms
- Cosmetic concerns
Procedures:
- Spinal fusion with instrumentation
- Growth-friendly surgery (young children)
- Various approaches depending on curve
Exercise Program for Scoliosis
Assessment-Based Exercise
Exercise prescription should be individualized based on:
- Curve type and location
- Curve magnitude
- Symptoms
- Age and activity level
- Goals
General Principles
Asymmetric Strengthening:
- Strengthen muscles on concave side
- Focus on rotational control
- Address specific curve pattern
Core Stability:
- Deep stabilizer activation
- Neutral spine awareness
- Breathing coordination
Flexibility:
- Stretch shortened muscles
- Improve spinal mobility
- Address rib cage restriction
Sample Exercises
Postural Awareness:
- Mirror work for self-correction
- Body positioning practice
- Overcorrection exercises
- Sustained positioning
Core Exercises:
- Side planks (modified for curve)
- Bird dogs
- Dead bugs
- Breathing exercises
Strengthening:
- Rows (asymmetric as needed)
- Lat exercises
- Scapular stability work
- Hip strengthening
Flexibility:
- Rotation stretches
- Side bending
- Chest opening
- Hip flexor stretches
Breathing Exercises
Rotational Breathing:
- Expand restricted rib cage areas
- Promote symmetry
- Integral to Schroth method
- Regular practice important
Living with Scoliosis
Activity Recommendations
Exercise:
- Most activities are safe and encouraged
- Swimming often recommended
- Yoga and Pilates can be helpful
- Strength training beneficial
- Avoid prolonged static postures
Sports:
- Most sports are acceptable
- No specific restrictions for mild-moderate curves
- Consider individual circumstances
- Stay active and fit
Daily Life
Posture Awareness:
- Frequent position changes
- Ergonomic workspace setup
- Avoid prolonged sitting
- Sleep comfort (positioning, mattress)
Emotional Support:
- Body image concerns (especially adolescents)
- Support groups available
- Counseling if needed
- Education reduces anxiety
Adult Scoliosis Considerations
Degenerative Changes
Adults with scoliosis may experience:
- Progression of existing curves
- Development of new curves
- Associated stenosis
- Disc degeneration
- Increased pain with age
Adult Treatment Goals
- Pain management
- Maintain function
- Prevent progression
- Improve quality of life
- Avoid surgery if possible
Exercise Benefits for Adults
- Reduce pain
- Maintain mobility
- Improve strength
- Better function
- Slower degeneration
Treatment at M.O. Therapy
Physiotherapy
Our physiotherapists provide:
Assessment:
- Comprehensive evaluation
- Postural analysis
- Movement assessment
- Treatment planning
Treatment:
- Scoliosis-specific exercises
- Manual therapy
- Postural education
- Home program development
Massage Therapy
Our RMTs help with:
- Muscle tension relief
- Pain management
- Improved flexibility
- Relaxation
Chiropractic Care
Chiropractic treatment may include:
- Spinal assessment
- Mobility improvement
- Soft tissue therapy
- Exercise recommendations
Frequently Asked Questions
Can exercise cure scoliosis? Exercise cannot cure scoliosis (eliminate the curve entirely), but it can help manage symptoms, potentially slow progression in growing patients, and improve function and quality of life.
Will my scoliosis get worse? Progression risk depends on many factors including age, skeletal maturity, curve magnitude, and type. Some curves remain stable, while others progress. Regular monitoring and appropriate treatment help manage this risk.
Is it safe to exercise with scoliosis? Yes, exercise is generally safe and beneficial for people with scoliosis. Specific exercise programs designed for scoliosis can be particularly helpful. Very few activities need to be avoided.
At what age does scoliosis stop progressing? Scoliosis progression typically slows significantly after skeletal maturity (around 14-16 for girls, 16-18 for boys). However, larger curves may continue to progress slowly in adulthood.
Book Your Assessment
If you have scoliosis and want to develop an effective management program, M.O. Therapy in Markham can help. Our team provides personalized assessment and treatment.
Call (905) 201-5827 or book online for your assessment. We offer direct billing and same-day appointments.