BY WENDY WINN, PT & FOUNDER OF CUSTOM PERFORMANCE.
Scoliosis and Running
I’ve had scoliosis, a curvature of the spine, much longer than I’ve been a runner. While it’s tempting to focus more on the structural abnormality, scoliosis itself presents with a variety of symptoms. Examining the symptoms themselves is the most important course when you’re dealing with scoliosis in runners.
Structure of Scoliosis
Scoliosis is usually idiopathic, which means of unknown origin, although genetics play a role. When a person has scoliosis, their spine has either a lateral curve (a c-shape) or two lateral curves (an s-shape). In addition to these curves, the spine is also rotated. It appears as though curves develop in adolescence, and essentially stabilize by adulthood. The spine, like everything in the human body, can degrade with age. Previously asymptomatic persons may experience symptoms later in life. Everyone’s curve is different, and the symptoms can vary widely from person to person.
- Joints between vertebrae: Where two vertebrae meet, there are joints on each side. Because of the curvature in the spine, the bones in the joints meet at different angles in people with scoliosis. This can cause joint dysfunction and premature wear on the surfaces. Long-term joint problems are correlated to osteoarthritis and boney spurs.
- Discs: The discs between vertebrae serve to cushion the spine. In scoliosis, the vertebrae are compressed on one side (the concave side), thereby putting pressure on those discs. The opposite side of the compression can put pressure on the disc, causing it to bulge out of that side. Disc bulges can result in pain and nerve irritations, sometimes local, sometimes radiating down the leg.
Nerves: For the same reasons, nerves bordering these discs can be affected by the alignment of the spine. These irritated nerves can cause pain in the back and radiate down the leg.
Muscles: Due to poor alignment, muscles surrounding the spine can be too short or too long, creating tension. This tension can cause pain, spasm, and discomfort.
Spinal and pelvic alignment: Because the spine joins up with the pelvis at its end, both pelvic and hip alignment can be affected. The pelvis can rotate forward or backward on one side, creating the illusion of leg-length discrepancy.
Ribcage and lungs: The thoracic spine is often involved in scoliosis. The thoracic vertebrae attach to the ribs and the decreased motion and stiffness of the joints can lead to decreased lung expansion capabilities.
- Pain: Pain in the lower back and/or down the leg from nerve or disc irritation can be debilitating and make running very difficult. The research on running and scoliosis is shockingly limited, but in general, it is my professional opinion that if running does not increase one’s back pain, there is no reason to limit it. Studies do show that exercise is helpful for pain in the lower back. Of course, if running exacerbates your symptoms, you should rest!
- Limited Range of Motion: The joints in the spine and pelvis may have a restricted range of motion, which may affect running mechanics. Running requires spinal rotation in order to move the legs and arms reciprocally. If trunk rotation is limited, efficiency may decrease and running may feel more difficult.
- Lung capacity: While there are not many studies on this, breathing mechanics may be impaired and this should be considered.
- Weakness: If muscles are too short or too long (because the bones they attach to are curved towards or away from one another), those muscles may be tense or weak. This is called either passive or active insufficiency and just means that they cannot contract as effectively in a shortened or lengthened state.
- Leg length discrepancy: If one side of the pelvis is elevated or rotated, one leg may seem longer than the other. This asymmetry can lead to hip, sacral, and lower back pain, along with many other lower extremity issues.
How do I treat my scoliosis?
- Understand your spine and its curvature. Go see a doctor if you haven’t had imaging in a while, and get to know your curve. It’s part of you!
- Identify mobility restrictions in all planes of motion, including rotation, and work on them daily. Yoga can be great for this!
- Make movement a priority. Don’t sit all day with your spine stiff, move around! Do not give up on any exercise, including running, unless it makes your symptoms worse.
- Schedule a gait analysis to see how your scoliosis is affecting your running.
- Strength your glutes and core to support your spine. This is helpful for reducing lower back pain in general, so everyone should do this!
- Work on your muscles, either with self-massage, a foam roller, or professional massage.
- See a physical therapist to devise a plan to help you live well with your condition.
- Practice pain management, such as acupuncture, to decrease your pain.
Scoliosis can be painful and challenging, but it doesn’t have to mean the end of your running. With vigilance, dedication, and a great plan of care, you’ll be back on the road in no time.