Pilates Adaptations for Scoliosis

Have you ever wanted to try Pilates but been told that it’s dangerous for people with scoliosis? Or maybe you went to Pilates class only to find some of the “basic” movements were extremely uncomfortable.

It’s frustrating, especially when you hear about all the potential benefits of Pilates. So what’s the truth? Can you safely practice Pilates if you have scoliosis? Do you need to just suffer through the painful movements?

Yes and no. Yes, you can absolutely practice Pilates in a safe way, even if you have scoliosis. And no, it doesn’t have to be painful or put extra stress on your curve. The key to practicing Pilates when you have scoliosis is to understand how each movement impacts your spine. Once you know that, you can avoid or modify each exercise to make it right for your body and your curve.

Why Are Pilates Adaptations for Scoliosis Important?

Pilates is a fantastic activity for anyone, but it can be especially helpful for scoliosis patients. It allows you to strengthen your whole body through low-impact movements. However, some Pilates movements put extra pressure on your vertebrae and encourage you to lean into your curve, which is generally something you want to avoid. Fortunately, most Pilates exercises are easy to modify so they’re safe and comfortable for your spine.

How to Modify Pilates Poses for Scoliosis

Props can be really helpful when it comes to adapting Pilates moves. I’d recommend wedges and a physio (or “squish”) ball that’s about 9 inches around. 

If you want to see demonstrations of how to adapt these poses, check out my YouTube video here.

Roll Up and Roll Down

In this movement, you would typically start sitting on the floor with your arms straight out in front of you. Then you’d lower yourself down to a lying position “one vertebra at a time.” The forward flexion movement of this exercise can exacerbate the spinal curve, which is uncomfortable and potentially dangerous.

To adapt this movement, sit with the squish ball wedged behind your back and stretch your arms out in front of you. Instead of rolling your spine down onto the floor, just lean back gently onto the ball. You don’t need to go far — just until you feel the abdominal muscles turn on. Then, tighten your core, exhale, and return to sitting upright.

Rolling Like a Ball

In this Pilates exercise, you sit down with your feet floating off the floor. Then, you round your spine, roll backward onto your shoulder blades, and then back up to the initial position. This entire movement can be very uncomfortable when you have scoliosis, and most scoliosis patients will intuitively opt out of this movement in a Pilates class. 

To modify this movement, start sitting up with your spine as neutral as possible, but allow your feet to touch the floor. Then, tip back just far enough to come off your sit bones, bring your feet off the floor, and feel your abs engage. As soon as you reach that point, tip forward again so you can tap your feet on the floor. Continue going back and forth, keeping the core engaged so you never roll all the way back onto your spine.

Mermaid

This Pilates movement involves side-to-side bending, which can be uncomfortable for many scoliosis patients. Even the initial setup, which includes a Z-sit position, can be less than ideal because it requires a significant amount of hip flexibility. 

The best way to benefit from this move if you have scoliosis is to replace the side bending with a gentle lift. Place one hand on the ground, but instead of lifting the other over your head and bending, just reach the other hand straight up and try to lengthen that side of your torso. Focus on elongation, not bending. And if the Z-sit position doesn’t work for you, you can do this same movement just sitting with your legs crossed.

Series of Five

This movement incorporates five mat-based Pilates exercises that are designed to strengthen your abdominal muscles. Often lying flat on your back is uncomfortable if you have scoliosis. A mat helps, but I find that my wedges are even more useful.

Use wedges to give your spine the support it needs when you’re lying on the floor. Without wedges, you will probably rock side to side during the series of exercises simply because of how the movements interact with your curve. That’s uncomfortable, and it can limit core engagement. You can use the wedges on either side of your spine to prevent that rocking motion and make it easier to connect to your core muscles. 

A further modification you can consider is to keep your head down on the ground while you do the series of five movements. Traditionally, you’re supposed to lift your head and shoulders off the ground (like you’re doing a crunch), but that’s very hard on the spine. You can still do the movements with the legs, just keep your head down on the ground.

Swan

Swan pose involves lying flat on your stomach with your hands under the shoulders. Then, you press into the hands and raise your chest and torso upwards, arching your back. (It’s similar to yoga’s cobra pose). 

This movement compresses the lower back, and it can enhance your concavities. To make the pose more comfortable and less intense on the spine, set up the same way, but don’t extend as much. Instead of pushing your shoulders and ribs up enough to straighten the arms all the way, just be a little “mini-swan” and push yourself up a small amount. Focus mostly on creating length in the spine.

Modify Pilates Poses to Build Strength Safely

If you want to make your body stronger and improve your alignment and posture, Pilates is a fantastic option, as long as you protect your curve. Some Pilates movements naturally put more strain on the spine, which is something you should avoid if you have scoliosis. But there’s nothing wrong with modifying the poses so they’re safe, comfortable, and accessible for you.

In honor of Scoliosis Awareness Month, I’m going to be doing a special series on Instragram. Over the next two weeks, I’ll be demonstrating a Pilates “pose of the day” and showing you how to modify it for scoliosis. Follow me over on Instagram to get all the demonstrations!

Want more help and ideas on how to incorporate safe, gentle movement into your daily life, The Scoliosis Movement Bootcamp is for you. I created this self-paced program to help scoliosis patients at any fitness level build strength and mobility at home. With this 6-month program, you’ll get regular emails and other resources to learn more about your curve and incorporate adjustments into your daily routine. At less than $100, this program probably costs less than your last spinal X-ray! Sign up for The Scoliosis Movement Bootcamp here!

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Resources Mentioned

Physio Ball
The Scolio Therapist on Instagram
The Scoliosis Movement Bootcamp