One of the most common mis-understandings people seem to have about idiopathic scoliosis and scoliosis treatment is that scoliosis is a chronic, progressive condition, but it isn’t necessary unstable and doesn’t come from having weak muscles.  In fact, there doesn’t seem to be anything wrong with the spine itself (other than being crooked), which is probably why scoliosis brace treatment and scoliosis surgery yield such poor short and long-term results, respectively, in most cases.  Whist, that being said, there are activities that scoliosis patients should avoid.  Some of these suggestions are rooted in research supported conclusion, but many haven’t been studied yet, and most are in reality just common sense.  

 “What position should I sleep in?” is a very common question  I get from scoliosis patients and generally speaking the only sleeping position scoliosis patients really need to avoid is “stomach sleeping”.   Sleeping on one’s stomach has multiple negative aspects (including lower and mid back pain), but more importantly for scoliosis patients it forces the normal spine position out of the side view dimension and into the abnormal scoliosis curve.  The take away message is don’t sleep on your stomach; especially if you have scoliosis

There seems to be enough circumstantial evidence/research to conclude that activities that cause a “flattening” or hyper-extension of the mid back may cause progression in scoliosis curves.  This type of motion is often referred to as a “back bend” and it seems to be related to the frequency (# of times) the patient is engaging in the bending, and not how much they bend each time.  Scoliosis patients in gymnastics and ballet classes should be particularly careful, because of the amount of back bends each requires for practice and competition.

A scoliosis spine already causes an abnormal loading of the spine and poor postural habits only serve to increase the abnormal bio-mechanical stress on an already compromised spine.  This is often increased greatly when the patient engages in slumped postures (seated or standing) during computer use, texting, and video game playing.  While no studies have actually been conducted to link these activities to scoliosis progression, it just seems like common sense to me.

Much like the slumped posture creates abnormal loading of the scoliosis spine; Over-loaded backpacks may lead to curve progression in adolescents with idiopathic scoliosis as well.  Most schools will readily provide an extra set of text books, so the student can keep a set at home and at school eliminating the need for transferring the books.  The total weight of the patient’s backpack should not exceed 10% of their body weight as a general rule of thumb.

Sticking with the abnormal loading of the scoliosis spine theme, uneven spinal loading with a back pack (carrying a back pack over one shoulder, instead of both shoulders) causes abnormal loading of the spinal curvature and could cause curve progression.  Again, there is no research to indicate this is a major concern in scoliosis, but I doubt any research has been done on the subject either…..and once again, it just kind of makes sense.

The wide spread advent of huge backyard trampolines has been a blessing for many young and teenage children, but it’s a curse for adolescents with scoliosis.  The compressive nature of the patient’s body weight multiplied by the number of times they bounce up and down in short period of time may lead to a rapid advancement of the spine curvature referred to as “postural collapse”.  Bottom line:  Back yard trampolines may be fun, but it isn’t worth the risk for scoliosis patients.

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