I was recently at the World Congress of Low Back Pain in Antwerp (October 2019).  Many of the luminaries were there and it was exceptionally thought provoking.  I was disappointed that there were only a few presentations on scoliosis, however one of the presenters was Dr. Michele Romano from the highly respected SEAS (Scientific Exercise Adolescent Scoliosis) group out of Italy.  His topic was whether assymetrical sports cause scoliosis

Do Sports cause Scoliosis?

Dr. Michele Romano, past president SOSORT has published several excellent research studies on scoliosis and adolescents. The quality of his research has resulted in inclusion by the Cochrane Systematic Review on exercise and scoliosis

Should you play tennis?

In Antwerp Dr. Romano presented on the effect of  tennis on growing girls spines. Despite theories that assymmetrical sports, such as tennis, cause scoliosis he concluded that there is no proof that tennis is a factor.

In addition he looked at the risk for low back pain and concluded that there is a mild risk[1] for increased low back pain in tennis players but generally it is neither severe nor long lasting.

Although his study did not look at competitive tennis, we only have to look at how many of our athletes are taking time off for their back pain to know that back pain is common in this group.  In fact, research confirms that in  general, elite athetes are more at risk  for scoliosis if they start at an early age.

Take home message – stay active and play tennis recreationally.  Work carefully with a spinal therapist if you plan to take your tennis to a higher level or if you are experiencing pain.

Should you swim?

can physiotherapy help swimmers shoulder?

A while ago one of my clients told me that she was considering giving up swimming as someone had told her  that there was a relationship between swimming and scoliosis.  She liked to swim and worked out regularly.

This information was new to me and my review of the literature supported there was some correlation with swimmers having more likelihood of scoliosis.  However in view of Dr. Romano ‘s research it seemed odd that the asymmetrical sport of tennis has less of a relationship with scoliosis than the more symmetrical sport of swimming.

Looking more closely at the literature it becomes clearer that the articles are observing an increased relationship of scoliosis in swimmers however unlike Dr. Romano’s study, they did not look at the exposure to swimming at the time the spine was growing.  In other words they did not check to see if a previously straight spine curved from swimming.  In fact one researcher suggests the problem is not the  sport but rather relates it to early exposure to chlorinated swimming pools.  Their theory is that the main concern is if the child begins to swim in a chlorinated pool during the first year of life.

Take home message – More research needs to be done on the relationship of swimming to scoliosis.  In the meantime if you enjoy swimming there is little to no research to say you shouldn’t participate, particularly if you are over the age of 1.

hamstring stretch - part of physiotherapy

Will participating in sports make my scoliosis worse?

Many of my clients are concerned that some sports may make their scoliosis worse.  This concern is covered in another systematic review which looks at sports and scoliosis.  It reviewed the literature to determine whether there is research to support limiting participation in sports.  It concluded that the reasearch was inadquate to restrict patients with scoliois from participation in physical activities.

Dr. Claire Johnson was one of the lead authors and I had the fortune of meeting her in Antwerp.  Here are the 5 main points:

  1. “brace-treated and surgically treated scoliosis patients have demonstrated that they can physically participate in sports activities at the same level as controls”
  2. “nonsurgically treated patients are encouraged to participate in sports and physical activity, and scoliosis is not a contraindication to participation in most sports”
  3. “brace-treated scoliosis patients are encouraged to exercise with their brace on; however, exercise may also be done outside of the brace”
  4. “physical activity may commence after surgery for scoliosis; however, there is no high-quality evidence guiding return to sport activity”
  5. “the potential association between elite-level competition in particular sports at an early age and an increased prevalence of scoliosis has been reported”

Take away message – that there is no evidence to support that sporting or physical activity is harmful to scoliosis patients.  It does however conclude that there is some support for an increased risk for scoliosis in elite level activities which are started at an early age and that we don’t know enough about post-surgical return to sport.  .

Evidence Based Resources for Scoliosis

There are many myths on what should and should not be done in the treatment of scoliosis.  The research and clinical community has been working to reduce these myths and remove the stigma of scoliosis.  If you require more information consider these websites Scoliosis Research Society, SOSORT or Curvy Girls.

Contact us

Maureen Dwight has worked with Adult scoliosis and post-surgical scoliosis for over 30 years.  She has worked with children and adolescents applying Physiotherapeutic Scoliosis Specific Exercises (PSSE) and principles for conservative and post-operative care  since 2012. Her treatment is centred around finding individualized solutions that are based on best evidence practices.  She is a certified Scoliologic practitioner and has studied with Dr. Rudolf Weiss (Katerina Schroth’s grandson). If you have any questions about treatment please contact her at mdwight@orthophysio.com or book an appointment at 416-925-4687.

Next Up

I will be continuing my series of articles on the war on low back pain however next up will be another summary from the Low Back Pain Congress in Antwerp on exercise recommendations for adults with scoliosis.

[1] Risk for frequent or persistent LBP in teenage control group 6%, 8% in teenage tennis group.