What is Scoliosis?
Scoliosis is a medical condition where your spine is curved from side to side. The spine-shape of a person with typical scoliosis may look more like an “S” than a straight line. Approximately 2% of the population will have a scoliotic curvature in their spine, and about 10% of these are severe.
Scoliosis terminology is according to where the apex of the curvature of the spine occurs. Most commonly, these curves happen in the thoracic (mid-back) and thoracolumbar (junction between the thoracic and lumbar) areas of the spine. Scoliosis does not frequently occur in the neck.
Early adolescence, specifically between 11 and 14 years of age is the ideal time to screen your spine for scoliosis. Scoliosis can progress during adulthood if not treated during youth. Therefore, being checked and treated at any stage can significantly improve your comfort, muscular strength and mobility.
What Causes Scoliosis?
Several types of scoliosis exist:
Structural (Idiopathic) scoliosis has genetic roots. A family history of scoliosis, particularly along the female side, can increase your likelihood of having it by up to 20%. Idiopathic scoliosis usually develops in early adolescence between the ages of 11-14, with a higher incidence occurring in females than males (10:1). Progression of scoliosis is also more common in females than males. If left undiagnosed and untreated in adolescence, the curvature of the spine can progress.
Functional scoliosis can develop in adulthood, often in response to an injury or repetitive practice of asymmetrical activities (i.e. tennis, golf swing, etc.). It is a curvature of the spine that has formed from overuse of muscles on one side and underuse of muscles on the reciprocal side. Since it is muscular based, it can reverse with appropriate treatment and exercise.
Pathology-related scoliosis can arise in people with a neuromuscular disease. Examples include muscular dystrophy or response to a severe injury to the spinal cord such as quadriplegia.
What are the Symptoms of Scoliosis?
Physical signs in children after the age of 8 that parents should suspect is scoliosis:
- Uneven hips
- Uneven shoulders
- The one-shoulder blade being more prominent than the other.
- Listing (bending) to one side
- Pain around the areas above imbalanced areas.
Contrary to common belief, scoliosis does not result from poor posture. However, it can progress to a more severe curve as a result of an inferior position of weak spinal muscles.
How is Scoliosis Diagnosed?
Checking for scoliosis usually is undertaken during a routine clinical examination by your physiotherapist or doctor.
Your physiotherapist will examine your spine, shoulders, rib cage, pelvis, legs and feet for abnormalities and asymmetry. If they suspect significant scoliosis, they will arrange for X-rays to confirm your cobb angle – or severity of scoliosis.
Significant curvature in the spine detected in adolescence will require a review from an orthopaedic spine specialist. Please seek the advice of your doctor or back physiotherapist.
PHASE I – Pain Alleviation
While not all scoliosis sufferers experience pain or discomfort, a percentage do. In these patients, the provision of pain relief does assist with patient compliance with corrective or prevention exercises.
Pain relief can result from a variety of techniques:
- electrotherapy modalities (ultrasound, TENs),
- release of tight muscles, and
- supportive postural taping.
In this phase, your physiotherapist may also introduce gentle exercises to maintain mobility in your spine as well as enhance your posture while your pain settles.
PHASE II – Rectifying Imbalances (Strengthening and Stretching!)
As your pain and inflammation settle, your physiotherapist will turn their attention to optimising the strength and flexibility of your muscles on either side of scoliosis. They will also include adjacent areas such as the hip and shoulder region that may impact upon your spinal alignment.
The main treatment aims will include restoring normal spine range of motion, muscle length and resting tension, muscle strength, endurance and core stability.
Taping techniques may assist until adequate strength and flexibility in the targeted muscles has been achieved.
PHASE III – Restoring Full Function
This scoliosis treatment phase gears towards ensuring that you resume most of your normal daily activities. Activities, including sports and recreational activities without re-aggravation of your symptoms.
Depending on your chosen work, sport or activities of daily living, your physiotherapist will aim to restore your function to allow you to return to your desired activities safely.
Everyone has different demands for their body that will determine what specific treatment goals you need to achieve. For some, it may be only to walk around the block. Others may wish to run a marathon. Your physiotherapist will tailor your back rehabilitation to help you achieve your own functional goals.
PHASE IV – Preventing a Recurrence
Since scoliosis in many cases is a permanent structural change in the skeleton, ongoing self-management is paramount to preventing re-exacerbation of your symptoms. Self-management will include a routine of a few critical exercises to maintain optimal strength, flexibility, core stability and postural support. Your physiotherapist will assist you in identifying which are the best exercises to continue in the long-term.
In addition to your muscle control, your physiotherapist will assess your hip biomechanics. If you would benefit from any exercises for adjacent muscles or some foot orthotics to address to correct for biomechanical faults, you will be p[rescribed relevant activities. Some scoliosis results from an unequal leg length, which your therapist may treat with a heel raise, shoe rise or a built-up foot orthotic.
Rectifying these deficits and learning self-management techniques is key to maintaining function and ongoing participation in your daily and sporting activities. Your physiotherapist will guide you.
What Results Can You Expect?
If you have mild to moderate scoliosis, you can expect a full return to regular daily, sporting and recreational activities. Your return to function is more promising when your diagnosis and treatment commences early.
Individuals with more moderate to severe scoliosis curvatures may need to wear an orthopaedic brace to halt curve progression. In some severe cases during adolescence, surgery is indicated. Both of these latter two pathways are overseen by an orthopaedic specialist who may require monitoring the progress of the curve with routine X-rays.
Please seek the advice of your trusted scoliosis physiotherapist or spinal surgeon to determine your best scoliosis treatment.
- Scheuermann's Disease
- Spinal Stenosis
- Rib Stress Fracture
Nerve-related / Referred Pain
What is Physiotherapy Treatment?
Physiotherapists help people affected by illness, injury or disability through exercise, manual joint therapy, soft tissue techniques education and advice. Physiotherapists maintain physical health, help patients to manage pain and prevent disease for people of all ages. Physiotherapists help to encourage pain-relief, injury recovery, enabling people to stay playing a sport, working or performing activities of daily living while assisting them to remain functionally independent.
There is a multitude of different physiotherapy treatment approaches.
Acute & Sub-Acute Injury Management
Hands-On Physiotherapy Techniques
Your physiotherapist's training includes hands-on physiotherapy techniques such as:
- Joint Mobilisation (gentle joint gliding techniques)
- Joint Manipulation
- Physiotherapy Instrument Mobilisation (PIM)
- Minimal Energy Techniques (METs)
- Soft Tissue Techniques
Your physiotherapist has skilled training. Physiotherapy techniques have expanded over the past few decades. They have researched, upskilled and educated themselves in a spectrum of allied health skills. These skills include techniques shared with other healthcare practitioners. Professions include exercise physiologists, remedial massage therapists, osteopaths, acupuncturists, kinesiologists, chiropractors and occupational therapists, just to name a few.
Your physiotherapist is a highly skilled professional who utilises strapping and taping techniques to prevent and assist injuries or pain relief and function.
Alternatively, your physiotherapist may recommend a supportive brace.
Acupuncture and Dry Needling
Many physiotherapists have acquired additional training in the field of acupuncture and dry needling to assist pain relief and muscle function.
Physiotherapists have been trained in the use of exercise therapy to strengthen your muscles and improve your function. Physiotherapy exercises use evidence-based protocols where possible as an effective way that you can solve or prevent pain and injury. Your physiotherapist is highly-skilled in the prescription of the "best exercises" for you and the most appropriate "exercise dose" for you depending on your rehabilitation status. Your physiotherapist will incorporate essential components of pilates, yoga and exercise physiology to provide you with the best result. They may even use Real-Time Ultrasound Physiotherapy so that you can watch your muscles contract on a screen as you correctly retrain them.
- Muscle Stretching
- Core Exercises
- Strengthening Exercises
- Balance Exercises
- Proprioception Exercises
- Real-Time Ultrasound Physiotherapy
- Swiss Ball Exercises
Biomechanical assessment, observation and diagnostic skills are paramount to the best treatment. Your physiotherapist is a highly skilled health professional. They possess superb diagnostic skills to detect and ultimately avoid musculoskeletal and sports injuries. Poor technique or posture is one of the most common sources of a repeat injury.
Aquatic water exercises are an effective method to provide low bodyweight exercises.
Sports physio requires an extra level of knowledge and physiotherapy skill to assist injury recovery, prevent injury and improve performance. For the best advice, consult a Sports Physiotherapist.
Women's Health Physiotherapy is a particular interest group of therapies.
Not only can your physiotherapist assist you in sport, but they can also help you at work. Ergonomics looks at the best postures and workstation set up for your body at work or home. Whether it be lifting technique improvement, education programs or workstation setups, your physiotherapist can help you.
Plus Much More
Your physiotherapist is a highly skilled body mechanic. A physiotherapist has particular interests in certain injuries or specific conditions. For advice regarding your individual problem, please contact your PhysioWorks team.
Youth Spinal Pain
Teenager Neck & Back PainTeenagers can be particularly vulnerable to back pain, mainly due to a combination of high flexibility and low muscle strength and posture control. The competitive athlete and most individuals who exercise regularly or maintain a level of fitness and core stability control are less prone to spine injury and problems due to the strength and flexibility of supporting structures. Your physiotherapist can assist the resolution of any deficits in this area. Luckily, issues involving the lower lumbar spine are rare in athletes and account for less than 10% of sports-related injuries. Injuries do occur in contact sports and with repetitive strain sports. Sports such as gymnastics, cricket fast bowlers, and tennis have a higher incidence of associated lumbar spine problems related to repetitive twisting and hyper-bending motions. Spondylolisthesis is a significant concern and needs to be appropriately treated by a physiotherapist with a particular interest in these type of injuries. Luckily, most injuries are minor, self-limited, and respond quickly to physiotherapy treatment.
Common Adolescent Spinal Injuries
Lower Back (Lumbar Spine)
Midback (Thoracic Spine)
Neck (Cervical Spine)
PelvisCommon Youth & Teenager Sports Injuries Common Youth Leg Injuries Common Youth Arm Injuries
Back & Neck Pain Prevention TipsHere's some very useful advice to help you prevent back pain and enjoy life to the maximum.
PostureI'm afraid that your mother was right. If you slouch you'll end up with problems. Just one of those problems is back pain. You'll find other problems elsewhere on this website. Think "Grow Tall". Imagine that you have a string screwed onto the back the back of your head, just above your hairline. Then think that someone is dragging you up off the chair you are sitting on. Hold this "grow tall" position for 10 seconds and repeat every half hour. As well as greatly reducing your chances of back pain you'll note that your chest has lifted, shoulders are relaxed, chin is tucked in, head is level and stomach muscles have contracted. Not bad for such a simple exercise. This posture can be repeated in sitting, standing, sleeping, walking or running. Try it and physio will work for you too!
LiftingThe best method to avoid back pain from lifting is delegation. If this isn't an option for you, try the following:
- Use a back support to lift loads over 15 to 20kg.
- Bend at the hips and knees with your feet shoulder-width apart.
- Firmly grip the load and hold it close to your body.
- Think "grow tall" to tighten your stomach muscles and look upwards to straighten your back.
- Stand using your strong thigh and buttock muscles to lift.
- Once upright, turn by using your feet. Avoid twisting your back.