If your spine curves toward the side and is shaped like a “C” or an “S,” (Fig) you may have scoliosis. Scoliosis is defined as a curvature of the spine of more than 10 degrees combined with a rotation of the vertebrae, the small bones that form the spine and through which the spinal cord passes. The 2 most common locations for this abnormal curvature are the thoracic (upper to mid) and lumbar (lower) spine. The thoracic portion of the spine is made up of 12 vertebrae and the lumbar portion of 5. The signs and symptoms of scoliosis include uneven hips, musculature that is uneven from one side of the body to the other, a rotating spine, back pains, and possibly chest pain. If as an athlete you have scoliosis, you may be wondering which sports you can play without experiencing discomfort or worsening your condition.
How do I know whether I’m at risk?
Most forms of scoliosis (about 65%) are idiopathic, meaning that the cause is unknown, and current research reports that the disease is most likely caused by several factors. While anyone can have idiopathic scoliosis, it is most often seen in children between the ages of 10 and 13; in fact, it is the most common spinal disorder in pre- and early teens. Additionally, studies have shown that females are more susceptible to the condition than males, though no definitive reasons have been found to explain this greater risk. A popular theory is that altered sensitivity to leptin, a hormone involved in the regulation of bone and energy metabolism in children and the initiation of puberty in girls, may result in increased sympathetic nervous system activity and a consequent disorder in skeletal growth, such as asymmetry of the spine. Apart from gender, the most significant factor contributing to scoliosis is genetics. Therefore, if someone in your immediate family, such as parent or sibling, has the condition, you should get checked regularly.
Can I be diagnosed as an adult?
Adults are often diagnosed with either idiopathic or degenerative scoliosis. If you are diagnosed with idiopathic scoliosis as an adult, chances are that the condition began in your adolescent to teenage years. If, on the other hand, as an adult you suffer from degenerative scoliosis, then a degenerating vertebral disc (the cushioning fibrocartilaginous pad between vertebrae) is the cause of the problem. As this disc degenerates, gravity can place too much pressure on one side of it, causing your spine to bend and curve. Your symptoms will depend on the degree of curvature, and may include back pain, shortness of breath with activity, lumbar stenosis (compression of the spinal nerve roots in the lower back), or poor posture.
How will my scoliosis be treated?
Through regular checkups with doctors, a treatment plan can be established for you as a scoliosis sufferer. The type of treatment depends on several factors such as your age or pubertal status, the degree and location of the curvature, gender, and associated symptoms. Once the doctor has assessed all the factors in your case, he or she can determine the best course of treatment. This could consist of getting fitted for a brace and attending physical therapy or could mean having a surgical procedure. A combination of bracing and spinal casting may be prescribed as a way to avoid surgery.
Progressively worsening scoliosis may require surgical intervention. As a very young patient, your options may include the implantation of growing rods as a way to straighten the spine without damaging growing tissues. Using hooks or screws, these rods are attached to the spine, or sometimes to the ribs, both above and below the spinal curvature. For children with early onset scoliosis there are also magnetic growing rods which, once surgically implanted, can be controlled and lengthened remotely as the child grows.
If you are an older teenager or adult, your condition may warrant spinal fusion. This is a surgical procedure to correct problems with the vertebrae and prevent any deformity from worsening. It may also improve the appearance of the spine. The procedure fuses together the painful vertebrae so they heal into a single, solid bone. This usually involves the placement of screws, hooks, and rods. The majority of patients are able to resume their normal activities, including athletics, a few months after spinal surgery.
Which sports can I play?
When you hear that you have a disease of the spine, you may be worried that playing a sport is out of the question. This is not true. Having scoliosis does not dictate whether you can play sports, though it may limit which sports you can play. Sports such as gymnastics, football, and heavy weight lifting that put a great deal of stress on the bones in the lower back are discouraged for athletes with scoliosis. On the other hand, sports which are low-impact, such as swimming and certain types of cycling, are encouraged. Moreover, these sports rely on a strong core. Your core includes not only your abdominal muscles, but also the muscles in your lower back and hips. When these muscles are conditioned and equal in strength, they work together to align and stabilize your spine, creating an anatomical brace. If, however, these core muscles are weak and imbalanced, they cannot support your spine and the result is poor posture. Your physician or physical therapist may prescribe an appropriate stretching and strengthening routine that targets your core to help with your condition. You may also benefit from structured activities such as yoga.
Carrying on with scoliosis
Scoliosis is a curvature of the spine that calls for regular monitoring visits with a spinal specialist or an orthopaedist with spinal expertise. While anyone can have scoliosis, statistics show that it is more prevalent in young females. How your scoliosis is treated and which sports you can participate in will ultimately depend on the severity of your condition. With the proper oversight, care, and attitude, you can carry on an active lifestyle and play a variety of sports despite having scoliosis.
Author: Chelsea Adams, LAT, ATC, and Morgan Carr, MS, LAT, ATC
Reprinted with permission from the Hughston Health Alert, Volume 29, Number 2, Spring 2017.