Scoliosis exercises: Improve your alignment!

Looking for some great Scoliosis exercises? This blog post will go through the exact exercises to help you to straighten your spine!


What is Scoliosis?

Scoliosis refers to the lateral curvature that occurs in the thoracic and/or lumbar spine.

Additionally – there is influence from the position of the ribs and rotation of the spine. (… which will be covered in another blog post)

Characteristics of Scoliosis

scoliosis
[Blausen.com staff (2014). “Medical gallery of Blausen Medical 2014“. WikiJournal of Medicine 1 (2). DOI:10.15347/wjm/2014.010 ]

  • Head tilt
  • Uneven shoulder height
  • Uneven nipple height
  • Rotated torso (Rotoscoliosis)
  • Rib hump
  • Compressed ribs (+/- breathing issues)
  • Uneven arm gap
  • Uneven muscle bulk
  • Asymmetrical abdominals
  • Hip hike (Lateral pelvic tilt)
  • Leg length discrepancy

Area affected:


Image: Scoliosis treatment centre

a) Thoracic

b) Thoracolumbar

d) Lumbar

d) Thoracic and Lumbar


Note: With the presence of 2 (… or more) curves, there is a primary and a compensatory curve(s).

The compensatory curve is the attempt of the body to maintain an upright posture as a response to the primary curve.


 

Types of Scoliosis

1. Structural Scoliosis is determined by your genetics and/or as a result of fused joints.

If you have had your Scoliosis for a long period of time and the joints have fused together, then there is a smaller likelihood of significantly impacting the shape of your spine by performing the Scoliosis exercises.

2. Functional Scoliosis is determined by how your body habitually holds itself up as it attempts to maintain an up right posture against gravity.

It is able to be changed and/or improved. (⬅ Read this sentence again. This means  that there’s a good chance that the Scoliosis exercises will help you!)

 

“Which type of Scoliosis do I have?”

Forward bend test


Image: Medline Plus

 

Instructions

  • Position 1:
    • Stand with your feet together.
    • Keep knees completely straight.
    • Take note of the severity of your Scoliosis.
  • Position 2:
    • Bend forwards at the waist until your torso is horizontal.
  • (Get someone to take a photo of your torso so that you can compare the 2 different positions)

Results:

  • Nil change to alignment ➡ Structural Scoliosis.
  • Partial or full correction of alignment ➡ Functional Scoliosis.

(Note: Another method is to laterally flex away from the side of the concave curve. If the curve  partially/completely reverses, then you have a Functional Scoliosis.)

What are the causes?

The habitual positions that you adopt on a daily basis can often lead to Scoliosis.

The spine becomes so accustomed to using certain muscles in a certain position, that over time – you are now “hard wired” to hold this abnormal posture.

For example:

  • Playing sport with dominant arm only
  • Work requirements
  • Asymmetrical sitting posture
  • Always carrying bag on one side
  • Incorrect technique at gym
  • Always sleeping on one side

 

Why is it an issue?

Scoliosis in the spine can bias the body to a particular position of asymmetry. (An asymmetry that may be the root cause of any pain!)

It limits the accessibility to the full range of movement of the spine in which posture and movement requires.

The body functions more efficiently and effortless with better alignment.

How can you move properly if you do not start from a good position?

(… Also aesthetics – Let’s be honest. Do we want to have a crooked spine?)

 

 

How to determine if you have Scoliosis (… and the severity of it!):

XRay analysis:

Getting a Xray scan is going to be the easiest and most accurate method.

If your doctor is happy to refer you and you’re not opposed to the radiation involved with the scan, then go for it!

(… just make sure they include the full body in a standing position!)

I recommend getting a EOS scan which I believe has 7-9 times LESS radiation than the standard Xray.

 

How to analyse your Scoliosis on the XRay:

(By comparing your Xrays over time, it serves as a great way to keep track of how your alignment is progressing with the Scoliosis exercises!)

1. Your alignment vs The ideal alignment [Red line]

  • Draw a vertical line that is the mid point between the 2 hip joints.

This shows how much the alignment of your spine deviates from the ideal mid line.

2. Pelvic tilt [Orange line]

  • Draw a line between the waist heights.

This shows if your pelvis is level or tilted.

3. Leg length discrepancy [Yellow line]

  • Draw a line between the top of the hip bones.

This shows if your legs are standing at the same vertical height.

4. Identify the Convexity and Concavity curves

This shows you the exact location of your Scoliosis.

5. Determine the Cobb’s angle

This determines the severity of the Scoliosis.

  • Locate the:
    • Apex of the spine and
    • the most tilted vertebra above and below the apex
  • Draw a line that matches the angle of these 2 vertebra.
  • Add perpendicular lines.
  • The point where these 2 lines intersect creates the Cobb’s angle.
  • Measure the angle.

RESULTS:

  • <10 degrees: Relatively “normal”/minor
  • 10-20 degrees: Moderate
  • 20-40 degrees: Moderate/severe
  • >45 degrees: Severe

 

** The following Scoliosis exercises are best suited for those who have a curve of <20 degrees.

** The exercises will still help for those who have a curve of >20 degrees, however, other factors such as spinal rotation and rib position will likely need to be addressed as well. (.. which is a bit more complex!)

 

 

Exercises for Scoliosis


Please note:

  • The following Scoliosis exercises serve as a starting point when addressing the curvature of your spine.
  • For best results for your specific presentation – perform these exercises in conjunction with seeing a health professional.
  • There are NO short cuts in improving your Scoliosis. It takes time.

 

 

Read this BEFORE you start:

Address your pelvis!

“You can’t build a great building on a weak foundation”

As the position of the pelvis has a significant influence on the orientation of the entire spine, it is vital that this structure is in a neutral position when addressing your Scoliosis.

 

1. Lateral pelvic tilt:

This is the asymmetric positioning of the pelvis which creates uneven waist heights.

To address this issue: Check out this post: How to fix a Lateral pelvic tilt.

 

2. Leg length discrepancy:

Asymmetries between the length of your legs can lead to a lateral pelvic tilt.

How to measure:

  • Lie on your back.
  • Measure the distance from the ASIS to the Medial Malleolus.
  • Do both sides.
  • Results: If these lengths are significantly different between the legs, then you may have a leg length discrepancy.

Alternatively – you can get a CT scan to measure it.

To address this issueIf you have a true leg length discrepancy, consider getting inserts in your shoe to address the height difference.

 

 

3. Rotated pelvis

This is where the pelvis is twisted and facing more towards one side.

To address this issue: Check out this post: How to fix a Rotated pelvis.

 

 

… Now that the pelvis is level, let’s get on with the Scoliosis exercises!

Scoliosis Exercises:

Table of contents:

  1. Releases
  2. Stretches
  3. Strengthening
  4. Corrections
  5. Progressions
  6. Asymmetrical positions
  7. Addressing other areas
  8. Common questions
  9. Conclusion

1. Releases

It is important to know WHERE your concave curve is located.

For simplicity sake – release the muscles which fall within the shaded area of the concavity.

These muscles will tend to be tight and/or over active.

 


Possible muscles to target

For the correct placement of the massage ball, use Google Images to locate the muscle you are trying to target.

Thoracic region:

  • Paraspinal muscles
  • Intercostal
  • Upper latissimus dorsi
  • Serratus posterior inferior
  • Serratus anterior

Lumbar region:

  • Paraspinal muscles
  • Quadratus Lumborum
  • Psoas
  • Obliques
  • Thoracolumbar fascia

a) Ball releases

Instructions:

  • Place the target muscle on the side of your concavity on top of a ball.
  • Apply your body weight on top of the ball.
  • Make sure to cover the whole concavity.
  • Continue for 1-2 minutes.
  • Note: Do NOT roll directly onto your rib cage! Instead, do this…

 

b) Intercostals

Instructions:

  • Place a finger in the gap between the ribs on the side of the concavity.
  • Apply a firm pressure as you trace around the ribs.
  • Continue for 1 minute per rib level.

 

 

 

2. Stretches

Stretching addresses the tight muscles that are holding the spine into a particular pattern of Scoliosis.


Image: AO Foundation

It is very important to know the exact location of the apex of the curvature of your spine.

This will dictate how and where you will perform these stretches.

Aim to FEEL the stretch in the region of the concavity at the level of the apex.

Hold each stretch for at least 10 minutes (… go longer if you can).

 

 

For Thoracic Scoliosis:

a) Sexy pose

  • Area targeted: Side of rib cage

scoliosis exercises

Instructions:

  • Lie down with the side of concavity towards the ground.
  • Prop your upper body onto your forearm. (see above)
  • Whilst keeping your waist pinned down to the ground, push your torso up right.
  • Aim to feel a stretch on the side of your rib cage.
  • Take a deep breath into the area where you feel the stretch.
    • (Push your ribs and belly out as much as you can!)

Note: The angle of your torso whilst performing this stretch should be dictated by the area of the thoracic region you are targeting.

  • Upper thoracic region: The torso will be less up right
  • Lower thoracic region: The torso will be more up right

b) Side stretch with flexion

  • Area targeted: Side of spine

Instructions:

  • Remain seated.
  • Curve your upper back region forwards.
    • Aim to curve your spine at the level of the apex.
  • Side bend the spine away from the side of concavity.
    • Try to isolate this movement to the apex region.
  • Pull your head towards the armpit that is on the opposite side of the concavity.
  • Aim to feel a stretch on the side of your spine.
  • Take a deep breath into the area where you feel the stretch.

For Lumbar Scoliosis:

Side tilt 

Instructions:

  • From a standing position, cross the leg on the same side of your concavity behind the other leg.
  • Place your hand on the outer hip opposite to the side of the concavity.
  • Push your hip towards the side of concavity.
    • Make sure that you do not rotate your pelvis.
  • Reach up/over with the arm on the side of the concavity.
  • Aim to feel a stretch on the sides of your mid torso.
  • To get the most out of the stretch, try placing your body at slightly different angles.
  • To progress: Hold onto a stationary object with the over reaching arm and allow your body to hang off this arm.

 

For more stretches like this, check out this post: How to stretch the Quadratus lumborum.

 

Thoracic or Lumbar Scoliosis:

Stretches using equipment:

You can use a variety of equipment to help you stretch. These include:

  • Foam roller
  • Gym ball
  • Yoga wheel
  • Rolled up towel

Which one to use? Pick the equipment with the appropriate width that you can comfortably feel the stretch.

Instructions:

  • Lie on top of the equipment of your choice with the side of convexity on the lower side.
    • The foam roller should be on the same level of the apex.
  • Reach over head with the upper arm.
  • Aim to feel a stretch on the upper side (concavity).
  • Take deep breaths in this position.
    • The aim of breathing is to increase the stretch.

 

 

3. Strengthening


To perform the following Scoliosis exercises, you will need to learn how to “bow the spine”.

“Bowing” is the movement of a specific part of the spine (… as opposed to moving the whole spine) which allows for certain areas to be stretched or strengthened.

The aim is to move the spine so that the apex of your curve is shifted towards the opposite direction.

(Don’t worry if you can’t get it straight away…It takes a bit of practice!)


 

For Thoracic Scoliosis:

Translations

Instructions:

  • Sit on the floor in the position as shown above.
  • Place the hand on the same side of the thoracic concavity onto the floor.
    • Keep your arm completely locked straight.
  • Sink your weight into your hand.
    • Keep the shoulder relaxed. It should naturally shrug up as you do this.
  • Bow the apex of your curve towards the side of concavity.
  • Aim to feel a:
    • stretch into the concavity
    • muscle contraction on the side of convexity
  • Hold 10 seconds.
  • Repeat 10 times.

… Do you have at tight thoracic spine? Check out this post: 17 exercises to improve your thoracic spine.

 

 

For Lumbar Scoliosis:

Leg drop/Arm reach

  • Stand on the edge of a step with the leg on the opposite side of the lumbar concavity.
  • Keep this leg slightly bent and stationary throughout the exercise.
  • Perform these movements together:
    • Reach down towards the floor with your other foot
    • Reach your hand up/over your head.
  • Bow the apex of your curve towards the side of concavity.
  • Aim to feel a:
    • stretch into the concavity
    • muscle contraction on the side of convexity
  • Hold for 3 seconds.
  • Repeat 20 times.

 

 

4. Corrections

After investing some time with the above Scoliosis exercises, you should notice that your spine is not as restricted as it was before.

A malleable spine will enable you to perform the following corrective exercises more effectively.

 


Key points:

  • Perform these exercises whilst using a mirror as to provide visual feedback of your posture.
  • Move as far as the body will allow you to without causing significant distortions to the rest of your alignment.
  • Remember – our immediate goal here is to reduce the degree of curvature (… even if it is a small amount) and not to eliminate it completely.
    • You are aiming for your best possible correction for your current level of ability.
  • If you are having difficulty with the corrections, focus more time and effort on the Releases/Stretches/Strengthening exercises.

 

[Video coming soon]

Instructions:

  • Remain seated. Keep equal weight distribution between your buttocks.
  • Remain elongated throughout the spine.
    • Imagine your head is being lengthened towards the sky.
  • Locate the apex of the convex curve.
  • Bow the apex back into place as far as you can achieve without causing major distortions to the rest of your spinal alignment.
  • Reset your position (whilst holding correction):
    • Perform a gentle circle motion of your head and shoulder.
    • Lift your buttock off the chair one side at a time.
  • Take slow and deep breaths in this corrected position for 5 minutes.
  • Use a mirror to help you guide your correction.
    • Pay attention to the spinal curve, shoulder height, level of the head etc.
    • SEE the correction. But more importantly – FEEL the correction.

Addressing multiple curves:

  • Target your correction to a single area first.
  • Whilst maintaining this correction, proceed to address the other curve.
  • Reset your head, shoulder and pelvis position.
  • As you become more confident with the exercise, you can perform the corrections for the different areas at the same time.

 

 

5. Progressions:

Aim: To maintain your best possible correction whilst performing the following Scoliosis exercises.


Initially – it is very likely that you will need you rely on visual feedback (ie. using a mirror/video) to help you maintain the proper correction.

As your postural awareness improves with practice, aim to perform your correction by “feel”.


1. Challenge correction with Limb movement

a) Single arm lift

Whilst sitting or standing, lift your arm above your head. Alternate sides.

b) Single leg lift

Whilst standing, lift your knee up to hip level. Alternate sides.

c) Sit to stand

From a sitting position, stand up right. Repeat.

d) Hinge

Instructions:

  • Whilst in the standing position, gently engage your core muscles.
  • Bend forwards at the HIPS. Keep knees slightly bent.
  • As you bend forwards, sit your hips backwards as you lean you forwards.
  • Make sure that you maintain the torso alignment throughout movement.
  • Do NOT bend your lower back.
  • Hinge as far as you can until you can feel your hamstring start to stretch.
  • Resume starting position.

e) Bird/Dog

 

2. Challenge with Spinal movement

a) Torso rotation

Instructions:

  • Whilst sitting, rotate your torso as far as you can to one side.
  • Repeat on the other.
  • Make sure that your pelvis does not move.

b) Segmentation

Instructions:

  • Whilst standing, wrap your arms around an exercise ball as much as you can. (see above)
    • Try to get your fingers tips to touch.
  • Perform your correction.
  • Starting from the neck: Proceed to round your spine down one vertebra at a time.
  • The goal here is to emphasize the rounding over the areas where your Scoliosis is located.
  • From here, reverse your movements back to the beginning.
  • Repeat 20 times.

 

c) Walking

d) Any movement you like

All this means is that you should perform your correction whilst doing any activity that is important to you!

 

6. Asymmetrical positions

There is absolutely no point in performing all of these exercises if you continue to place your body in the position which has lead to your Scoliosis in the first place!

 

a) Side sleeping

Solution: Support your body with pillows as to maintain a straight spine.

(See post: Best sleeping posture)

 

b) Sitting tilted to one side

Solution: Ensure that you have equal weight distribution between your buttocks. Do not slouch to one side.

 

c) Carrying bag on one shoulder

Solution: Use a bag that straps over both shoulders.

 

d) Leaning on one side

Solution: Ensure that you have equal weight distribution between your feet. Do not hitch your hips!

 

 

7. Addressing other areas:

Addressing other areas of postural dysfunctions may help the Scoliosis exercises (as mentioned above) be even more effective.

 

1. Thoracic Kyphosis

➡  Check out this post: Exercises for Hunched back posture.

 

2. Flat back posture

➡  Check out this post: How to fix Flat back posture.

 

3. Hyperlordosis

➡  Check out this post: How to fix Lumbar hyperlordosis.

 

4. Anterior pelvic tilt

➡  Check out this post: How to fix Anterior pelvic tilt.

 

5. Posterior pelvic tilt

➡  Check out this post: How to fix Posterior pelvic tilt.

 

 

 

 

 


8. … Any questions?


1. How long will it take to fix?

If you’ve been through the comments in my other blog posts regarding fixing your posture, you will already know that I find this question VERY HARD to answer. (especially if I’ve never seen you in person)

The short answer – it depends!

Every one is different.

Instead – Focus on: Doing the exercises. Being consistent.  And celebrate the small wins!… You’ll get there 🙂

 

2. Will these Scoliosis exercises give me a PERFECT straight spine?

No – No spine is perfectly straight…

However- the exercises will certainly help you attain and maintain a better spinal alignment as compared to what you have now.

 

3. What about a Scoliosis brace?

Wearing an external brace may help prevent or slow down the progression of Scoliosis.

 

4. Does everyone have it?

It is important to note that almost EVERYONE has some degree of Scoliosis (Ranging from minor to major).

Its presence is not always problematic in the short term.

 

 


9. Conclusion:

  • Scoliosis involves the abnormal sideways curves of the spine and presents differently from person to person.
  • The Scoliosis exercises are designed to be most effective for curves that are <20 degrees.
  • The Releases, Stretches and Strengthening sections are designed to give the opportunity for change to occur in the alignment of the spine.
  • The Corrections are designed to engage the muscles responsible for bringing the spine into a better alignment.
  • The Progressions will help challenge your ability to maintain the correction.
  • For best results – use these Scoliosis exercises in conjunction with seeing a Physical therapist.

 

 

So… What’s your Cobb’s angle? I’m curious!

Let me know in the comments section down below!

I’d love to hear from you!

 

About

I am a physiotherapist who has personally experienced the pain as a result of bad posture. I would like to offer you some of the solutions that I and my patients have greatly benefited from.

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2 thoughts on “Scoliosis exercises: Improve your alignment!

  1. Hey Mark
    Another awesome post your work here is one of a kind I only wish we could clone you and other therapists were half as knowledgeable as you
    Just a quick one on the leg length
    If it’s functional what amount of difference would u suggest before adding a lift ? Mine is around a 1cm when doing the measurements you suggested it’s only on the same side as my lateral tilt

    Cheers
    Romana

    1. Hi Romana,

      If your leg is Functionally short, then there should be no need for a heel lift. This is because once you balance out your muscles, there should be no difference in your leg length.

      If your legs are structurally unequal, then you might need a heel lift. I usually suggest to see how far the exercises will take you before considering a heel lift.

      Anything more than 20mm is quite a lot and may require it.

      Mark

      PS. thank you for being the FIRST to comment on this page. I appreciate it 🙂

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