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Is scoliosis harmed by high-impact sports?

Periodically, ISICO launches the “Concorsetto,” an initiative in the form of a competition in which patients share their experience with wearing a brace, demonstrating that they can do almost anything: horse riding, dancing, rhythmic gymnastics, skating, and much more. This proves that sports and scoliosis are not incompatible.

But what about high-impact sports? Can they make scoliosis worse?

When it comes to scoliosis, one of the most common questions we receive from parents and coaches concerns sports that involve impacts on the spine (shocks, falls, landings from jumps…). Activities such as horse riding, long jump, high jump, and running often raise concerns.

In the common imagination, it is believed that repeated shocks may generate compressive and torsional forces on the spine, worsening the scoliotic curve. In reality, the spine, thanks to its sagittal plane curves, joints, and tendon structures, has a highly efficient system for “absorbing” impacts and withstanding intense forces without negative effects on its three-dimensional structure.

A recent study of ours has shown that the more sports young people engage in, the lower the likelihood of scoliosis worsening and the greater the chances of improvement with physiotherapy treatment [source 1]. It is no coincidence that mild scoliosis is successfully treated with specific exercises aimed at improving posture and triggering corrective reactions in the curves—an effect similar to that of sports, albeit in a less specific and more global manner.

So, is there anything that can actually worsen scoliosis?

According to the available data, an asymmetrical load on the vertebrae promotes uneven spinal growth in individuals already predisposed to developing scoliosis, contributing to its progression in children and adolescents. This is known as Stokes’ vicious cycle.

What should be done, then?

It is essential to counteract these factors using the tools available. Combined with specific treatments such as physiotherapy exercises and/or a brace, sporthelps develop reflexive corrective automatisms, integrating them into daily life. All sports are suitable in these cases, but every case of scoliosis is unique. Since sport reduces the risk of curve progression, it is advisable to encourage young people to choose an activity they enjoy and are motivated to practise consistently.

Even asymmetrical activities, such as tennis, should not be demonised; in fact, they can be a valuable ally in preventing and managing scoliosis. Often, it is enough to combine them with targeted exercises that strengthen the spinal muscle groups under strain.

Sport and the brace: Can physical activity be practised while wearing a brace?

A recent study confirms that those who wear a brace and engage in sport more frequently achieve better results. Moreover, an ISICO study has shown that wearing a brace does not hinder physical activity.

We just remind you that, in case of doubt, it is important to consult your specialist doctor.

In conclusion

Sport should be experienced as a moment of relaxation and recharge. The impacts on the spine that are inevitable when practising sports should not be a cause for concern, as they do not worsen scoliosis. The brace should not excessively restrict the patient’s movement and freedom but should support them in counteracting spinal deformity.

With the guidance of a scoliosis specialist, each patient can find the best way to manage physical activity—whether with or without a brace—because the confidence and psychological well-being derived from engaging in sport are fundamental to the success of the therapy.

Physical activity in adults with scoliosis: what and how much?

Before we start talking about scoliosis and physical activity in adults, a few background considerations are called for.

It is important to remember that every patient has a unique history. Even though different patients can present similar scoliosis features, it should not be assumed that the same kind of physical exercise will suit all of them.  

It is also necessary to bear in mind certain thresholds of curvature: scoliosis curves measuring less than 25°-30°, especially if treated in adolescence, are extremely unlikely to worsen over time. Conversely, curves that exceed 45°-50° must be monitored, through specialist check-ups, throughout adulthood.

Then there is the “pain” factor. Scoliosis is not necessarily associated with pain. Nevertheless, pain is a factor that needs to be taken into account when choosing what physical activity or sport to do. As a rule, any kind of movement that does not worsen pain, or that alleviates it, can be considered a great help.

Exercise, in a general sense, helps to relieve pain, improve functionality and improve quality of life: and these are the real objectives. A healthy back, which does not necessarily mean a straight back, is one that is capable of withstanding the stresses of everyday life.
Furthermore, when you have scoliosis, it is especially important to train the muscles that support the spine, so as to stabilise it.

It is important that we distinguish clearly between sport and self-correction exercises i.e. active movements designed to lead to better positioning of the spine in the three planes of space, which the patient performs independently.
These exercises, prescribed specifically for scoliosis, with the aim of stabilising the condition, serve a therapeutic purpose. On the other hand, there is no sport or general physical activity of any kind that can be said to “treat” scoliosis.

It is also necessary to beware of certain old “beliefs” regarding scoliosis and sport. In the past, it has been claimed that certain sporting activities can “treat” or vice versa exacerbate scoliosis.

In reality, however, the literature contains no reliable data showing that certain sports activities might be harmful for adults with scoliosis.
The only question mark concerns activities (e.g. belly dancing) that demand considerable flexibility and mobility of the spine, since these could destabilise it and lead to a worsening of the condition.
To date, there are no sports that are specifically prohibited or recommended. Indeed, contrary to what some believe, swimming and Pilates cannot be guaranteed to be beneficial, while running and tennis do not need to be considered risky activities.
In adulthood, any sport, providing it is started gradually, practiced regularly, enjoyed and performed within your own limits, can only be good for you.

In conclusion, it is worth underlining that adults with scoliosis can and MUST do some form of physical activity, at least 2-3 times a week, choosing from the various disciplines. Those whose scoliosis causes them pain must make sure their chosen activity respects this limitation.