Is Strength Training with SCOLIOSIS safe?

Do you want to know if strength training with scoliosis is safe? You’re probably wondering if there are specific things you need to pay attention to. In this article, I will share my own experience and present the current evidence on this topic.

Types of Scoliosis

Let’s first go over some important facts about scoliosis. There are various types of scoliosis, but adolescent idiopathic scoliosis is by far the most common, accounting for about 75% of cases.

The other types of scoliosis include congenital scoliosis, which develops in the womb and is extremely rare. There is also scoliosis associated with spina bifida, which is also very rare, and neuromuscular scoliosis, which occurs in neuromuscular diseases.

But as mentioned, idiopathic scoliosis, which simply means the cause is unknown, is the most common. Therefore, this article will focus on this type.

How is the extent of scoliosis related to back pain?

The extent of scoliosis cannot be clearly linked to back pain. Of course, you can have pain in the thoracic or lumbar spine with scoliosis, but you can also have it without scoliosis.

Théroux et al. studied over 300 patients with scoliosis and found no correlation between the severity of scoliosis and the intensity of back pain.

What about when your scoliosis is treated with or without a brace? Here too, no significant differences between the groups could be found. Balagué and Pellisé examined this in their study in 2016.

How is the prognosis for scoliosis?

Negrini et al. created a scoliosis guideline and set some thresholds. If your spinal curvature is less than 10 degrees, it cannot even be called scoliosis.

If the curvature is less than 30 degrees, it will most likely remain stable into adulthood and beyond, meaning it will not change significantly. However, if the curvature is over 30 degrees, there is an increased risk that it will worsen.

If the curvature exceeds 50 degrees, it is almost certain that the scoliosis will worsen. If the curvature is less than 30 degrees, which is the case for most people, you don’t need to worry much about it getting worse.

My scoliosis was diagnosed when I was 15 and I had a curve of around 20 degrees. Since sports have always been and still are a great passion of mine, I naturally asked myself, what about training now? Do I need to adjust anything? Do I need to consider anything?

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Strength training with scoliosis – part of the solution or the problem?

As I just mentioned, your scoliosis will most likely not get worse if you have a curvature of less than 30 degrees.

Additionally, as I described above, there is no clear cause for the development of scoliosis. This also applies to unilateral sports such as tennis, table tennis, or similar. Many people worry if they developed scoliosis due to one-sided training and resulting imbalances.

No, that cannot be said. Scoliosis is a multifactorial condition that does not simply arise from tension or imbalances. Multifactorial means it is dependent on many different factors. I can clarify this further in another article, but now let’s focus on strength training.

In terms of training, we can clearly say, and guidelines confirm this, that it is more part of the solution than the problem (Negrini et al. 2016). With strength training, you definitely won’t make your scoliosis worse.

But you might wonder if you are wasting your time with strength training and should instead do scoliosis-specific exercises.

I’ll first share my personal experience. I did Schroth therapy (a specific scoliosis therapy) with a physiotherapist for years. I did my exercises daily for half an hour, and my scoliosis angle didn’t change significantly.

This doesn’t mean that specific scoliosis therapies are ineffective. We now know that posture is very habitual, shaped by your habits.

If you do scoliosis-specific exercises daily, it will likely become a habit, so you constantly correct yourself, even while sitting. This way, you gain better control over your scoliosis because you can activate your muscles to correct the angle.

It’s also pretty cool for your self-image if you are at the beach or pool and feel self-conscious about your back. Being able to activate your muscles, so the scoliosis angle becomes less visible or even disappears is quite normal and beneficial.

Therefore, I would recommend doing this for a certain period so you can correct your scoliosis angle if you want to.

When we look at studies to check if specific scoliosis training is better than just training the trunk muscles, it turns out there is no significant difference.

Sometimes studies show significant results, suggesting scoliosis therapy is better than trunk training in improving the scoliosis angle. However, looking closer, you see that it doesn’t exceed the measurement error of over 5 degrees (Zhou et al. 2021).

I think these are very good news because training the trunk and abdominal muscles shows comparable results to specific scoliosis treatment.

Regarding the load on the spine when carrying something, Li and Chow conducted a very interesting study. They looked at the effect of asymmetrically carrying weight on either the left or right shoulder on the scoliosis curve.

In the study, they found that the scoliosis angle actually decreased. For some people, this only happened when they carried the weight on the side of the largest curvature; for others, it happened on both sides. In any case, the angle did not worsen, which is very good news.

We can use this principle of asymmetrically loading the spine or strengthening the trunk and abdominal muscles in strength training. The trunk muscles are naturally engaged when doing free exercises like squats, deadlifts, bent-over rows, or similar exercises.

We can also use Li and Chow’s principle from the study by asymmetrically loading the spine. For example, you could do suitcase carries or lunges with weight only in one hand, or one-arm rows with rings. There are many different ways to use this principle.

The good news is that you don’t necessarily have to leave anything out in your training but can really explore and do what you enjoy.

By the way, to alleviate your fear that scoliosis will significantly impair your performance, Lamar Gant was the first person in the world to lift five times his body weight. And now I’ll show you a picture of his back.

The likelihood that your scoliosis angle is less than his is relatively high, and yet he was extremely capable.

I think the picture clearly shows that you can do strength training with scoliosis without worrying too much. However, you should still make sure to do targeted strength training with a customized training plan.

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