At its simplest, scoliosis is an abnormal curvature of the spine. It looks like an S shape. There are four common types:
- Right thoracic curve – curve to the right (thoracic) upper back.
- Right thoraco-lumbar curve – curve bends to the right of the thoracic down to the lumbar (lower back).
- Right lumbar curve – curve bends to the right of the lumbar.
- Double major curve – usually a curve to the right at the thoracic and left at the lumbar.
Diagnosis includes bending over to touch the toes and checking to see how symmetrical the spine appears plus X-ray, CT scan and MRI.
Signs of scoliosis as advised by the NHS include:
- A visibly curved spine
- Leaning to one side
- Uneven shoulders
- One shoulder or hip sticking out
Treatment for scoliosis includes wearing a brace to help straighten the spine which can work, depending on the stage of the curvature, or surgery. If the spine develops a severe curve, this can cause pain, while also putting pressure on the heart, lungs and other organs. Physiotherapy, exercise and massage can also alleviate pain before and after surgery.
Starting to exercise again after scoliosis surgery can be daunting for many people. How far do you push your body and how quickly? It is easy to have lost confidence in your ability to judge your body especially if you have been out of action for months.
My guidelines for returning to exercise are based on recovery after scoliosis spinal fusion surgery but the general principles can be applied to anyone who has had fusion surgery, for example damaged discs, or indeed any other condition.
The idea after scoliosis surgery is to build up back muscles gently.
According to the surgeon from my third surgery, the general rule is to lift no more than 5 kilos with free weights.
Starting back to exercise
You should not feel pain during exercise at all. If there is any pain in the joints – back, neck, hips, knees, shoulders, elbows, wrists – stop what you are doing immediately. Gentle muscle pain after two days is normal in, for example, the quads (thighs), glutes (bottom) and abs (stomach). It is not normal not to be able to walk, or to have terrible neck and shoulder pain or to be in agony. If this happens, either the exercise was performed incorrectly or you have overdone it, or that exercise is definitely not for you. Do not over-push yourself at any time after scoliosis surgery. Initially, fatigue sets in quickly, so always make sure there is a rest time when the session is finished. Chill out for at least 30 minutes afterwards.
Always be aware of your posture and body alignment. Head, neck, shoulders, spine, hips, knees, ankles and toes should follow each other. A tip is to look down or check yourself in the mirror. Are your knees pulling together or your toes positioned inwards? Knees should be front facing or slightly outwards and toes positioned between 11am and 1pm OR 10am and 2pm.
With my clients, I operate what I call ‘exercise allergy awareness’
EXERCISE ALLERGY AWARENESS
- Start with one gentle exercise
- Start with low repetitions
- Wait for two to three days
- If you feel no pain at all after two to three days, continue with the first exercise and add a second
- Wait another two to three days
- If you feel no pain at all, add a third exercise to your routine
- Wait another two to three days
- If you feel no pain at all, add a fourth exercise, and so on … If you do feel pain, which at its maximum should be no more than gentle muscle pain, you will now be aware that a particular exercise is to be avoided – just like a food allergy.
Regular exercise will really help to stretch and strengthen the muscles around your spine, keeping them strong. As a result, posture will improve and you will look and feel so much better. It is a case of listening to recommendations from the consultant, physiotherapist and your body as to what may be comfortable to do.
Always consult your GP, consultant or physiotherapist before starting to exercise again.
Blog post written by Caroline Freedman, author of The Scoliosis Handbook, coming soon to Hammersmith Health Books. For more information about Caroline or the book, visit her website: https://www.scoliosishandbook.com/ or follow her on Facebook or Instagram.