Scoliosis and Physiotherapy

Scoliosis refers to a lateral (sideways) curvature of the spine. A small percentage of the population has some degree of scoliosis. Both adults and children can be affected by scoliosis and the cause is largely unknown. Symptoms of scoliosis vary greatly between individuals and may depend on the type and location of curve, the degree of the lateral curvature as well as the rotation or twist of the spine. Scoliosis may be structural (where the curve is fixed) or non-structural in nature. Structural causes may include one leg being shorter than the other, birth defects, neuromuscular conditions like cerebral palsy or orthopedic conditions like spinal degeneration. Non-structural scoliosis may be the result of an injury or muscle imbalance and the lateral curve or twist of the spine may be temporary.

Persons with scoliosis may or may not experience pain, with the most commonly affected areas being the spine, hips, shoulders and pelvis.

Treatment for Scoliosis

Some cases of scoliosis are asymptomatic and may not require any therapy. For these individuals, X-rays may be indicated to monitor curvature changes over time. For moderate to severe cases, treatment may be required, which can include spinal bracing to help minimize the curve progression, physiotherapy, or surgery in severe cases to fuse the spine with rods in an attempt to minimize long-term health complications.

Physiotherapy for scoliosis starts with a detailed history and physical assessment. Muscle imbalances are identified and spinal alignment examined, as well as the mobility of the spine, pelvis, hips and shoulders. Muscle fatigue and joint stiffness are commonly reported. Breathing patterns should also be assessed especially when the spinal curvature is in the thoracic region where asymmetry of the ribcage may prevent optimal breathing.
A physiotherapy treatment plan is developed based on assessment findings and the client’s personal goals. Therapeutic exercises including stretching, strengthening and breathing exercises are commonly prescribed, monitored and progressed during the course of treatment. Soft tissue release and joint mobilization are often key components of the treatment plan. Physiotherapy goals include managing pain, minimizing joint stiffness and optimizing alignment and breathing patterns. Physiotherapists will also address the client’s functional goals at home, work or on the playing field. Many individuals with scoliosis enjoy very active lifestyles and can participate in competitive sports.

Group in a pilates classNo two cases of scoliosis are identical, so the treatment must be individualized based on the client’s physiotherapy assessment, current level of function and goals. Kelly uses Fascial Stretch Therapy to help increase mobility in areas like the lateral trunk that can become compressed or restricted from scoliosis and Pilates based exercises to try to rebalance the body through awareness, alignment correction and stability exercises.