Exercise for Scoliosis
(sideway bending deformity of the spine)
I am glad that Scoliosis (sideway bending deformity of the spine) screening test is becoming more popular in Hong Kong. The ill effect of such sideway deviation of spinal alignment is obvious, both medically and aesthetically. Patients should be referred for medical advice. If severe, mechanical or even surgical intervention may be necessary. Structural malalignment of the spine could never be altered by any form of manual therapy but manipulative physiotherapy may help to minimize aggravations due to unnecessary daily physical stress to the 'abnormal' spine. Since the spine is already 'out of place' and its flexibility and stability/strength are disadvantaged, maintaining the best possible spinal posture at all time is therefore very important for such patients. The usual postural, mobility, stretching and strengthening exercises/advice are therefore very useful for the young patients and their parents alike. I find that forward head and back slouching posture is one of the most aggravating factors of worsening scoliosis. The chin in/chest out/stomach in/buttock out posture should therefore be maintained at all time. Since maintaining such posture is very difficult and scoliosis has no pain initially, kids should be repeatedly reminded of the importance of their active role in preventing deterioration of their condition. As scoliosis deteriorates, spinal and chest mobility is often restricted. Gentle spinal mobility, especially in the opposite direction of the deformity, and chest expansion exercises should be given to prevent stiffness. Spine movements around the peak of scoliosis are often stiff with surrounding soft tissue thickening. Manipulative treatment may help initiating the loosening process. Certain muscles are often tight. An intensive stretching exercise program should be given as early as possible to prevent adverse influence of such tightness to the spine. Postural muscles especially the back muscles are often relatively weak. This is worsened by the parents' unnecessary fear of physical activities that might affect their kids' scoliosis. A progressive strengthening/stability exercise program should be encouraged. Although contact sports are not advisable, most sporting activities will promote general fitness and should be encouraged as long as the above mentioned exercises are practiced regularly.