Scoliosis is defined as lateral curvature of the spine (Foundations of Athletic Training). Often rotational deformity is present, together with the lateral deformity, and the severity of the deformity can range from mild to severe. Scoliosis is usually seen in the thoracic (middle) or lumbar (lower) spine, or both, and appears either as a ‘C’ or ‘S’ shape.
Scoliosis can be structural, which means that both the curvature and rotation are present even with forward and lateral bending, or non-structural (functional), where both the curvature and rotation are flexible and disappear with corrective movements.
Structural scoliosis is usually caused by congenital abnormalities or certain neuromuscular diseases, such as cerebral palsy and muscular dystrophy. Non-structural, or functional, scoliosis is generally caused by a problem elsewhere in the body, such as a leg length discrepancy or muscle spasm. But 70-90% of all cases are idiopathic, that is, of unknown cause. Idiopathic scoliosis can be seen at any age, but is most commonly diagnosed between the ages of 10 and 13 years, and is more prevalent in females. Degenerative scoliosis is more likely to develop in adults, where degeneration in the spine and surrounding musculature can result in abnormal curvature.
Mild cases of scoliosis are generally asymptomatic, as there is minimal deformity. Such cases can, therefore, be treated with appropriate stretching and strengthening exercises. In moderate to severe cases in children who are still developing, it is important to monitor and re-assess the condition on a regular basis. In these cases, the use of a brace is usually necessary to manage the scoliosis and prevent further curvature and rotation. In severe cases that cause pain and deformity, surgery to straighten the spine may become necessary. If a severe scoliosis is left untreated, the rotation places too much pressure on the lungs, resulting in an individual struggling to breathe.
Structural scoliosis is usually more difficult to treat and requires external assistance, such as a brace. Functional scoliosis, on the other hand, is usually easier to treat, as the contributing factors can usually be treated. A leg length discrepancy can be fixed by a podiatrist with an appropriate orthotic or heel lift. A physiotherapist can release muscle spasms. A Biokineticist should be consulted to assess what functional aspects may be contributing to the scoliosis, so that appropriate stretching and strengthening exercises can then be prescribed to manage the scoliosis and prevent further deterioration.
Foundations of Athletic Training: Prevention, Assessment, and Management