Approximately seven million Americans have scoliosis, a spine condition characterized by a curvature in the back. While it is most often diagnosed in children, adults can also develop scoliosis. Either way, you may wonder if it affects running.

Here, two scoliosis experts, Juan C. Rodriguez-Olaverri, M.D., Ph.D., a former runner with scoliosis and the director of pediatric deformity surgery and early onset scoliosis in the NYU Langone Department of Orthopedic Surgery, and Michelle Yang, DPT, C.S.C.S., a physical therapist at the Hospital for Special Surgery, answer questions about scoliosis and how it may affect runners.

What is scoliosis?

Everyone’s spine has normal curves from front to back, says Rodriguez-Olaverri. When you look at someone’s back from behind, most spines also appear straight from side to side. People with scoliosis, however, have spines that curve sideways when viewed from behind. Depending on where the spine curves, it may form an “S” or a “C” shape.

“There are many types of scoliosis,” Rodriguez-Olaverri tells Runner’s World. “You can have scoliosis in the thoracic [upper] spine or in the lumbar [lower] spine, [and] you can get scoliosis when you’re an adolescent or you can get scoliosis as an adult, and there’s scoliosis that needs surgery and scoliosis that doesn’t need surgery.”

In most scoliosis cases, the problem begins to develop for an unknown, or “idiopathic” reason, per the National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS). Idiopathic scoliosis typically occurs in children aged 11 and older, and is more common in girls than boys. However, genetics may play a role in its development. Patients are more likely to have scoliosis if a parent or sibling has it.

More uncommonly, some babies are born with spinal abnormalities that develop before birth (congenital scoliosis). Others, as they get older, develop spinal changes that occur because of neurological or muscular diseases like cerebral palsy, muscular dystrophy (MS), and spinal cord injury, according to the American Association of Neurological Surgeons (AANS).

Sometimes, scoliosis can be so mild that it doesn’t cause symptoms or pain. In other cases, the curve can become so exaggerated that someone may have uneven shoulders (one or both shoulder blades may stick out), one hip appears higher than the other, or one side of the rib cage is higher than the other when bending forward. When scoliosis is severe, a person may have back pain and even difficulty breathing.

Can adults develop scoliosis?

Adults are at risk for developing degenerative scoliosis, which is also known as adult onset scoliosis. It is caused by degeneration of the spine as people age, and is considered completely different from juvenile or adolescent scoliosis. The difference is that an adult is considered “skeletally mature,” and is no longer growing.

Symptoms of degenerative scoliosis are similar to those found in other age-related back problems. You might feel back pain, pins and needles tingling in the leg, or numbness in the buttocks and legs. Finally, someone may feel sharp pain or one side of the spine may stick out a bit more than the other.

How is scoliosis diagnosed?

A doctor performs a physical examination to evaluate posture and check for asymmetries, and will likely order an X-ray to evaluate and measure the curve of the spine. If the curve is greater than 10 degrees, it is likely scoliosis. A curve is considered “significant,” say the experts, if it measures greater than 25 to 30 degrees and “severe” if it exceeds 45 to 50 degrees.

How is scoliosis treated?

Treatment for scoliosis varies depending on the age at diagnosis, the degree of curvature, and whether symptoms are present. The overall treatment goals are to stop or slow the spinal curve from worsening, prevent or decrease pain, improve posture, prevent or manage breathing problems, and boost quality of life.

You may not need treatment if the curve is mild, or if there is minimal concern that it will increase. However, people with scoliosis of any type and degree of curvature can benefit from physical activity. Yang encourages people to see a physical therapist for a top-down assessment to learn which exercises can help improve posture and prevent their scoliosis from progressing.

In addition, your doctor may recommend taking a spinal X-ray every five years—or sooner, if symptoms present—to ensure the curve isn’t worsening.

In general, surgery is only recommended if the spinal curve is greater than 50 degrees, the patient has nerve damage to their legs, and/or is experiencing curve-related bowel or bladder issues.

How does scoliosis affect running?

If you suffered with scoliosis as a teenager you should be able to run without limitations, unless you need future surgery, says Rodriguez-Olaverri. Those with degenerative scoliosis who have lower back pain should not run, he cautions, because that will place additional pressure on the lumbar spine and worsen the pain.

If your spinal curve affects your lungs, running may be less comfortable. Sometimes, the curves can decrease space in the ribcage, which can limit how much air you’re able to inhale with one breath, which is known as vital capacity, Yang says. So, you may find that you get out of breath easily. One major benefit of running, though, is that it forces you to breathe harder, repeatedly, which makes your lungs stronger over time, Yang notes.

Scoliosis may also create issues with running if there are significant asymmetries between the two sides of the body. “Some people with scoliosis actually have leg-length discrepancies, so one leg might be a bit shorter than the other,” Yang says. This asymmetry can put more load on one leg while you run, increasing your risk for injuries like bone stress fractures.

Also, asymmetries between your shoulder heights can affect running posture. Having one shoulder that’s higher than the other can cause you to slouch forward or lean more heavily to one side, Yang says. As you get fatigued, this forward slouch or side-lean can become more exaggerated.

One of the primary goals for people with scoliosis is improving their posture to prevent the spinal curve from worsening. Running with poor posture won’t help you achieve this goal. Yang recommends seeing a physical therapist or orthopedist if you experience pain, discomfort, or have questions about running safely. People with scoliosis benefit from a running form assessment, and the healthcare professional can offer specific exercises and advice to improve posture and form.

Can running improve scoliosis?

Despite the potential risks, running can be helpful for people with scoliosis. “I’m a huge advocate for people with scoliosis participating in any type of physical activity, which includes running,” Yang says. “It allows for symmetrical movement and helps engage your postural muscles overall, as well as keeping your core strong, which is really important” Strong core muscles help support your trunk, taking some of the burden off your spine.

Watching your running form is essential to reaping these benefits. If you can, get a running gait analysis. This way, a running professional can recommend how to improve your form and technique.

Here is a general running form checklist from the experts:

  • Move your arms from the shoulders, not the elbows.
  • Bring your heels toward your buttocks.
  • Gaze directly in front of you; don’t tilt your chin up or down.
  • Pull your shoulder blades back (pretend you’re squeezing a pencil between your shoulder blades).
  • Lean forward slightly from your ankles.

It’s always best to chat with your doctor first, though, before starting a running routine. That’s especially true for those with degenerative scoliosis, because as lumbar disks (spongy pads between the bones that make up the lower portion of the spine) wear down, you may need to do low- or no-impact exercise. “If you have scoliosis in the lumbar spine and your disks are degenerating, you don’t want to keep banging on those disks because they’re going to get worse,” Rodriguez-Olaverri says.

Having your doctor on board is especially important if you have higher-degree curvature. “With the higher-degree curvature, you worry about posture getting worse over time, so that’s a conversation to have with a doctor to make sure they’re doing the proper things to help decrease the curvature in their spine,” Rodriguez-Olaverri says.

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Lauren Bedosky is a freelance health and fitness writer who specializes in covering running and strength training topics. She writes for a variety of national publications, including Runner’s WorldPrevention, Experience Life and Women’s Running.

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