As a clinician who uses natural methods to reduce and stabilize scoliosis the question of effectiveness as it pertains to scoliosis specific exercises is always a concern. The internet is riddled with advice, some good, and some not so good especially when it comes to curing ailments. There are a lot of so-called “experts” giving conflicting advice. Unfortunately this certainly holds true with the diagnosis and treatment of scoliosis especially adolescent idiopathic. I don’t know if it’s just me, but I feel the world has become a bit more hostile when it comes to what healthcare option is best for a certain condition. Scoliosis, because it affects children, comes with plenty of hostility when discussing what is best for a child diagnosed with this spinal deformity.
I remember when the Milwaukee brace was the standard of care for children with crooked spines. This was a rigid cast style brace with metal traction rods that pushed the skull away from the body to traction the spine. Orthotists (specialists in bracing) have since removed the traction component and now use just a plastic cast to force pressure on the spinal curvatures and claim to prevent progression, yet tens of thousands of kids are fused using titanium rods every year, most who were braced prior. Surgery is also a very controversial treatment option for scoliosis patients, mainly because of the magnitude of risk involved in fusing a large portion of a child’s spinal column; having referred scoliosis patients for surgery, I have seen the devastating consequences of this procedure when things do not go well, so it is not without justification.
When it comes to actually reducing curvature of the spine using any treatment option, the first thing that needs to be questioned is the length of time the result from treatment should last. If you perform an exercise designed to reduce your scoliosis, how long will the result from that exercise program last. Tractioning a patient for 5 days, taking an x-ray immediately afterward, and then marveling at the 30% improvement, does not provide evidence to claim that traction is a way to successfully treat scoliosis. The traction produces a temporary improvement but nothing that will last more than a few hours. Exercise is a very broad term that encompasses a wide variety of things. So when patients ask me if there are exercises they should be doing for their scoliosis, I usually respond with, “It depends on what you mean.” Exercises like, Pilates, yoga, cardiovascular, or weight lifting will have no ability to reduce or stabilize a child’s scoliosis. Sure there are few patients that did 5 years of Pilates or yoga and reduced their scoliosis by 5 or 10 degrees, usually adults, but this does not provide evidence that Pilates or yoga permanently reduces scoliosis.
The real issue when it comes to exercise induced changes and scoliosis is in understanding what type of exercise is being performed and to what capacity it can create spinal adaptation. For instance, I can do one directional exercises at the gym or stretch only to the left and it won’t give me scoliosis. I can position myself in a scoliosis type posture consciously and it won’t give me a 30 degree curvature. These types of conscious exercises lack the ability to influence spinal control centers that cause an adaptive response. These exercises can alter global posture and can influence the overall scoliosis measurements by approximately 5 degrees in larger curvatures but really lack the neurological punch necessary to actually reduce a scoliosis by more than a degree or two.
The complexity of spinal adaptation limits my discussion based on the educational background of most readers, not everyone will understand neuroscience and muscle physiology to warrant a scientific discussion. When simplified the spine is made up of layers of muscle that are of different mass and fiber type. The larger the muscle the more leverage it has and can move the body easily when contracted, these muscle groups are largely Type II fibers which are good for voluntary movement and also can be controlled by thought. These muscles have little to do with scoliosis as they are not asymmetrical in composition or function when examined in scoliosis patients. The deeper we get in examining spinal muscle layers we find that muscles get very small and their fiber type switches to Type I which is resistant to fatigue and controls the stability and alignment of the spine in gravity. These intrinsic deep layers are involuntary and controlled for the most part innately through righting reflexes in our anti-gravity mechanism of our brain.
So exercises that activate the intrinsic muscle layers and influence how the brain is programming these muscles will have a significant ability to cause spinal adaptation and alter static alignment of our spine. If I were able to perform an exercise that caused by brain’s anti-gravity system to learn a new alignment pattern it will have a lasting effect as it is involuntary, like our heart beat. This form of scoliosis specific exercise is termed auto response training. The clinician provides a piece of equipment that uses forces which push and pull against your body and hips while you are performing balance exercises usually on an unstable surface. Your body fights to not fall off, and in the process the brain initiates those deep intrinsic muscles to engage at a high level as they are responsible for stabilizing you and creating an alignment pattern that causes balance. If in the process of redistributing weight, your scoliosis gets smaller, than you have now influenced the ability to reduce your curvature in a lasting manner.
So to quickly summarize, exercises which do not engage the anti-gravity system and cause spinal adaptation will be a waste of time, if your goal is to reduce and stabilize your scoliosis.