What is Scoliosis?
Scoliosis is a sideways curvature of the spine that typically develops during childhood or adolescence, although it can also occur in adulthood. Instead of a straight line down the back, the spine curves into an “S” or “C” shape. It can range from very mild (barely noticeable) to more severe cases that impact posture, movement, and sometimes breathing.
Who Gets Scoliosis and Why Does It Happen?
There are different types of scoliosis, including:
- Idiopathic scoliosis – most common, especially in adolescents, and the cause is unknown.
- Congenital scoliosis – caused by spinal abnormalities present at birth.
- Neuromuscular scoliosis – linked to conditions like cerebral palsy or muscular dystrophy.
- Degenerative scoliosis – develops in adulthood due to ageing, arthritis, or disc degeneration.
How common is it?
Scoliosis affects around 2-3% of the population, which means millions worldwide. Most cases are mild and don’t require surgery but may benefit from targeted movement and strengthening to manage symptoms and posture.
Understanding Scoliosis in More Detail
It involves:
- Lateral curvature (sideways bend)
- Vertebral rotation (twisting of the spine)
- Changes in sagittal alignment (flattening or exaggeration of the natural curves)
It’s often assessed using the Cobb angle, which measures the degree of curvature.
- Mild scoliosis: 10-20 degrees
- Moderate: 20-40 degrees
- Severe: Over 40 degrees
Common symptoms in degenerative scoliosis:
- Lower back pain (chronic or activity related)
- Muscle fatigue and tightness (particularly on one side)
- Uneven hips or shoulders
- Reduced mobility and balance
- Sciatica-like nerve symptoms (in more advanced cases)
- Be cautious with loaded or weighted spinal movements (e.g. overhead pressing, fast-paced flexion/rotation).
- Include functional balance work – scoliosis + ageing increases fall risk.
Can Scoliosis Get Worse with Arthritis or Ageing?
Yes – scoliosis can progress over time.
This is known as Degenerative or Adult-Onset Scoliosis
This form typically appears after age 40-50 and is linked to age-related spinal changes, particularly:
- Facet joint osteoarthritis (wear and tear of the small joints of the spine)
- Degenerative disc disease (thinning, bulging or herniated discs)
- Osteoporosis (leading to vertebral compression fractures)
As the spine weakens and changes, the curvature can worsen, especially if combined with muscle imbalances and poor postural habits.
Exercises to Avoid or Modify:
People with scoliosis may need to avoid or adapt the following:
- Strong spinal rotation or twisting (e.g. seated twists) – especially if asymmetrical or unsupported.
- Loaded side flexion – like side bends with resistance or overextension.
- Unilateral exercises that overemphasise one side – unless they’re specifically tailored to address imbalances.
- Any movement that causes pain or discomfort – always regress or offer an alternative.
What Fitness Professionals Should Know LI Key Considerations in Older Adults with Scoliosis and Arthritis:
- Prioritise spinal stability over flexibility.
- Encourage neutral spine alignment – avoid extremes of flexion or extension.
- Focus on core strengthening, glute activation, and thoracic mobility.
How Can Fitness Pilates Help?
Fitness Pilates is a fantastic tool to support people with scoliosis. The focus on posture, core control, breath, and mobility makes it ideal for managing discomfort, improving alignment, and supporting spinal health.
Li Beneficial Fitness Pilates Exercises:
- Pelvic tilts (supine or standing) – to build awareness and control of pelvic alignment.
- Bridge variations – strengthening glutes and core, with emphasis on symmetry.
- Four-point kneeling exercises (e.g. bird-dog) – great for balance and spinal stability.
- Spinal mobility sequences (e.g. catcow, roll downs) – encouraging safe, mindful movement.
- Breathing work and lateral expansion – supports better ribcage mobility and alignment.
