Physical Therapy for Scoliosis: More Than Just Strengthening Your Back
Today, we’re talking about physical therapy for scoliosis. Many patients and healthcare providers think that the biggest goal of PT is to strengthen the back muscles, but a comprehensive program offers many other potential benefits.
The most effective way to manage your scoliosis symptoms is to build a treatment plan that incorporates strength, balance, and support for your internal body systems.
Muscle Groups and Physical Therapy for Scoliosis
Scoliosis physical therapy often starts with three goals: elongation, breathing, and strengthening.
Elongation
The most important element of PT exercises is elongation. The goal is to learn how to lift your body and elongate your spine so it’s not in a compressed position all the time. (Think about pulling on both ends of a slinky, stretching the coils so they’re longer and less tightly wound).
Elongation exercises are designed to decompress your spine and the muscles running along the sides of your trunk (torso): lats, pecs, and core muscles. Elongating those areas prepares your body to strengthen the muscles there effectively. Once you’ve learned how to hold yourself in an elongated system, you’re 80% of the way toward effectively managing your scoliosis.
Breathing
After elongation, the next goal of scoliosis physical therapy is to improve breathing. Scoliosis curves make it difficult to breathe naturally in the most beneficial way, so these exercises are designed to help you learn how to breathe better.
For example, elongation exercises lengthen the back and other muscles, which frees up more space in the abdomen and lungs. This makes it easier for your diaphragm muscles to have a full range of motion. Training yourself to breathe properly ensures that you get the maximum amount of benefits from something you do approximately 20,000 times a day.
Most scoliosis patients tend to be chest-breathers. They use some of the extremely small chest and neck muscles to breathe, which often causes neck pain. (For more details, listen to this episode.) It’s far better to use the diaphragmatic muscles to drive inhales and exhales.
Breathing exercises focus first on switching from chest to diaphragmatic breath. The next goal is to learn global breathing, which helps to lengthen and strengthen the diaphragm, lungs, and all the little muscles between the ribs. Breathing this way also helps strengthen the core and pelvic floor muscles.
Strengthening
Once you’ve learned to maintain an elongated position and improve your breathing, the next goal of scoliosis PT is strengthening your body within that elongated position.
There are many options for total-body strengthening, like working with a personal trainer or attending a traditional Pilates class. However, working with a scoliosis therapist is often a better option, because you get the benefit of someone who understands the unique challenges of scoliosis.
A scoliosis specialist can offer props and modifications that make exercises more accessible. Plus, they can design a program to help you strengthen your muscles in a balanced, aligned posture.
For example, when I work with my clients, we start with the feet and ankles, making sure that weight is evenly distributed and both sides of the body are working in a similar way. Next, we move upward to the pelvis, fixing the alignment there and making sure the weight is balanced evenly. Then we focus on the spine.
I find that it’s so much more effective to work from the floor up for alignment and strengthening. Working from the top down is much more difficult, and it can even be painful.
Treating Various Body Systems
Most scolio-PT programs focus on the musculoskeletal system, but scoliosis affects many other parts of the body, so it’s essential to address those areas as well.
Visceral
Not all healthcare professionals or trainers focus on this area of the body, but it’s extremely important. The visceral system is complex and sensitive, so it’s very important to learn which exercises are appropriate. For example, you don’t want to use massage balls on your visceral organs. But breathwork can be extremely beneficial for your visceral system. (For more details about supporting the visceral system, check out The MovementREV.)
Digestive
The digestive system is often overlooked in scoliosis physical therapy, but it shouldn’t be! So many scoliosis patients experience chronic digestive issues, like constipation, IBS, gas, and bloating. And these issues can often contribute to additional back pain! So, ask your specialist or physical therapist how you can address these challenges.
Lymphatic
The lymphatic system is responsible for controlling inflammation in the body, so it’s another area that shouldn’t be ignored. If you aren’t supporting your lymphatic system, blockages can occur, which prevent the lymph from flushing toxins and foreign invaders out of the body.
You can work with a lymphatic specialist if you feel like you need a lot of support and education about this system. But if you’re not quite ready for that yet, a great exercise to start with is dry brushing.
Incorporating PT Exercises Into Your Daily Routine
It can feel overwhelming to look at all these scoliosis exercises and therapy activities and try to figure out how to incorporate them into your schedule. So I’ve got some tips that have helped my clients and me:
Address your lymphatic system in the morning: Spend a bit of time each morning dry brushing.
Follow the right exercise routine: Choose yoga, Pilates, cardio, or strength training activities that you enjoy and that are designed for scoliosis patients.
Incorporate elongation and breathwork into your workout: You can use a pull-up bar for elongation and incorporate Schroth breathwork during your cooldown.
Make it fun: Turn on your favorite playlist or podcast during your exercises so you enjoy the time you’re spending taking care of yourself.
You know your body and your schedule the best, so do what works best for you to get in those critical scoliosis exercises and activities that support your musculoskeletal, visceral, and digestive systems.
Scoliosis Care for Your Whole Body
It’s easy to fixate on your back and your curve when you’re finding ways to manage your scoliosis. But as important as it is to strengthen your back, it’s just as important to work on elongation, breathing, and supporting your visceral, digestive, and lymphatic systems.
It can be very helpful to work with a scoliosis specialist (or a personal trainer who understands scoliosis) to find the exercises that work best for you. Then, figure out how to fold them into your daily routine. Even five minutes of elongation, breathwork, or dry brushing here and there can make a big difference.
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Resources Mentioned
Ahead of the Curve, Episode 23: The Connection Between Breath and Spinal Health
