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Understanding Scoliosis in the Growing Athlete

Scoliosis in child or adolescent athletes represents a real challenge at the intersection of sports medicine, pediatric orthopedics, and manual approaches such as osteopathy. This spinal static disorder, often mistakenly considered benign or purely cosmetic, can have profound repercussions on the young person’s athletic performance, growth, and overall well-being.

Definition and clinical criteria

Scoliosis is defined as a three-dimensional deviation of the spine , combining lateral tilt, vertebral rotation and, often, a disturbance of the sagittal curvature (kyphosis or lordosis). Unlike the scoliotic attitude, which is reducible and postural, structural scoliosis is non-reducible and involves deformation of the vertebral bodies and rotation of the spine.

It is usually detected by a forward lean test (Adams test) revealing trunk asymmetry, rib or lumbar hump, or a more prominent hip. In athletes, these signs may be subtle, masked by developed musculature, or compensated for by effective but energy-consuming postural adaptations.

Typologies: idiopathic, congenital or secondary

There are several types of scoliosis:

  • Idiopathic scoliosis : the most common (80 to 90% of cases), it generally appears between the ages of 10 and 16, without any identifiable cause. It affects girls more and can progress rapidly during pubertal growth spurts.
  • Congenital scoliosis : linked to a spinal malformation from birth, it is rarer but often more complex.
  • Secondary scoliosis : resulting from a neuromuscular disease (such as muscular dystrophy), an inequality in the length of the lower limbs, or a rheumatological pathology.

In young athletes, idiopathic scoliosis is the most common , but it is crucial not to neglect scoliosis secondary to functional or real inequality of the lower limbs, pelvic imbalance or unilateral repetitive constraint linked to the sport practiced (e.g.: tennis, fencing, classical dance).

Growth and spinal vulnerability

Adolescence is a pivotal period during which bone growth is rapid, but often out of sync with muscle and neuromotor maturation. This disharmony creates a breeding ground for postural imbalances . The spine, in full elevation, is particularly sensitive to asymmetric mechanical stresses.

In the growing athlete, increased stress on the muscle and fascial chains, especially if it is unilateral or poorly balanced, can promote the onset or worsening of scoliosis. Respiratory mechanics , often neglected, also plays a key role: thoracic scoliosis disrupts costal and diaphragmatic play, impacting ventilation and recovery from exertion.

Why are athletes at risk?

Contrary to popular belief, sport is not in itself responsible for scoliosis , but certain disciplines can exacerbate a pre-existing condition or create compensatory postural adaptations. For example:

  • In classical dance , the search for absolute verticality and the position in external rotation can aggravate latent scoliosis.
  • In artistic gymnastics , the extreme amplitudes of flexion-extension and the asymmetry of movements favor unilateral constraints.
  • In racket sports or throwing , the dominance of one arm and repetitive movements accentuate the twisting of the trunk.

Furthermore, ligament hypermobility, common in some young athletes, can facilitate a loss of spinal segmental stability, making the spine more vulnerable to deformations.

Early detection is essential

The detection of scoliosis in a child athlete should never be trivialized. A rigorous postural assessment , including static and dynamic observation, an analysis of joint ranges of motion and a comprehensive osteopathic examination, allows for early detection of warning signs.

The osteopath, through his or her detailed approach to the entire body, is well placed to identify early functional imbalances and, if necessary, direct the patient to specialized monitoring in pediatric orthopedics or corrective physiotherapy.

Clinical signs not to be neglected

Scoliosis in young athletes often develops in deceptive silence . The absence of pain does not equate to the absence of dysfunction. Many young athletes develop compensatory mechanisms that temporarily mask structural imbalances, delaying diagnosis. However, subtle clinical signs can—and should—alert osteopaths, parents, or coaches.

Visible postural asymmetries

One of the first observable signs is body asymmetry , easily spotted by visual examination:

  • One shoulder higher than the other ,
  • A more prominent or “protruding” shoulder blade ,
  • A more hollowed-out size on one side ,
  • A more prominent hip .

These asymmetries are accentuated during the forward lean test : the child, standing with feet together, leans forward with arms dangling. A hump (muscular or rib protrusion) on one side of the back is the typical sign of structured scoliosis, revealing vertebral rotation.

Localized muscle or joint pain

If the scoliosis is still mild, pain is not systematic. However, some young athletes report:

  • Unilateral back or lumbar pain , after exercise or at the end of the day,
  • Asymmetrical muscle fatigue during exercises involving the trunk,
  • Recurring tension or contractures in the paravertebral muscles, quadratus lumborum or trapezius muscles.

These pains are sometimes trivialized, attributed to a “false movement” or to sports overload. However, when they are recurrent, unilateral and always located in the same place , they should be a warning.

Subtle alteration of athletic performance

In a motivated young athlete, any decrease in performance is experienced with frustration. Scoliosis can cause:

  • Loss of balance or difficulty staying centered during a technical movement (jump, rotation, reception),
  • A decrease in coordination between the upper and lower body ,
  • Increased respiratory effort , especially in cases of thoracic deviation which disrupts lung volume,
  • Parasitic muscular compensations which generate excessive energy expenditure.

These changes, although often imperceptible to the untrained eye, are sometimes felt intuitively by the child or their trainer: “He no longer holds his axis”, “He forces on the left side”, “He seems less fluid in his movements”.

Associated signs in other areas of the body

Scoliosis, as a three-dimensional disorganization of the trunk, spares no functional chain . Distant signs may reveal a bodily adaptation linked to a spinal deviation:

  • Knee, hip or ankle pain related to poor load distribution,
  • Inequality of apparent length of the lower limbs ,
  • Asymmetrical plantar support or proprioception disorders,
  • Minor digestive or respiratory problems (in thoracolumbar scoliosis).

These manifestations, often taken in isolation, may seem unrelated to each other. This is where the global osteopathic reading takes on its full meaning, by reconnecting the symptoms to a central cause .

Postural disorders in static and dynamic situations

Observation in static position is not enough. It is essential to examine posture in movement :

  • When walking, an asymmetrical swing of the pelvis or arms may appear.
  • When running, a foot that turns outwards, a hip that “drags” or instability of the trunk can betray an overall imbalance.
  • When sitting, some children always sit in the same twist, or shift their weight onto a single seat bone.

These habits, if they are constant, reflect adaptive motor patterns that the child is often not aware of reproducing.

Importance of early detection and osteopathic perspective

Detecting these signs as soon as they appear allows for early treatment , limiting the progression of scoliosis and its impact on musculoskeletal development. The osteopath, with his keen sense of palpation and his fine reading of posture, can:

  • Identify areas of tension and mobility restriction related to the diversion,
  • Observe the compensatory strategies put in place by the body,
  • Educate young patients to recognize their asymmetries and adopt more balanced habits.

Finally, it can play a key role in directing towards a medical diagnosis , in collaboration with health professionals, if the curvature appears to exceed functional thresholds.

Possible causes: genetics, posture and overload

Scoliosis in young athletes is never a matter of chance. It results from a tangle of factors , where genetic inheritance, mechanical constraints, neuromotor development and postural habits intertwine. Understanding this complexity is essential to implement appropriate management, but also to prevent the worsening of the deformity at the critical age of growth.

Genetic predisposition: an often neglected hereditary trait

In cases of idiopathic scoliosis , which represent the majority of situations in adolescents, no single cause has been identified. However, recent studies highlight the importance of genetics :

  • A family history of scoliosis is found in approximately 30% of cases.
  • Certain genes involved in bone growth, hormonal regulation or connective tissue integrity appear to play a role.

This predisposition does not mean that scoliosis is inevitable, but it suggests a fragility of the vertebral system during periods of rapid growth, which mechanical or environmental factors can exacerbate.

Rapid growth and body disharmony

Adolescence is marked by a disjointed development between bone structures and soft tissues. Bones grow rapidly, while muscles, fascia, and neuromotor systems don’t always have time to adapt. This disharmony leads to:

  • A loss of segmental stability , particularly at the spinal level,
  • A temporary reorganization of motor patterns ,
  • An increased risk of postural imbalances , especially if the child is sedentary or subject to repetitive physical constraints.

In young athletes, this phase of rapid growth can be particularly delicate if it coincides with an intensification of training or competitions.

Mechanical overload: between repetition and asymmetry

Some sports place intense and sometimes unilateral demands on the body. This asymmetrical overload becomes problematic when repeated on an immature skeleton . Here are some typical examples:

  • Tennis, badminton, baseball : predominance of one upper limb, frequent rotation of the trunk,
  • Classical dance, gymnastics : search for extreme amplitudes, constraints on the lumbar spine and the pelvic girdle,
  • Martial arts, rowing, fencing : accentuated lateral dominance, imbalances between muscle chains,
  • Endurance sports (running, cycling): risk of poor alignment with a pre-existing postural pattern.

When a technical gesture is repeated hundreds of times with a distorted body axis , even slightly, this can accentuate a latent curvature and create a vicious cycle of mechanical aggravation .

Postural and environmental factors

Beyond sport, the adolescent’s daily lifestyle can influence the development of scoliosis:

  • Carrying heavy, ill-fitting backpacks ,
  • Prolonged sitting positions, often twisting or asymmetrically bending (screen, telephone),
  • Poor sleep hygiene or unsuitable mattress,
  • Postural stress linked to an unergonomic environment (school desk, chair, etc.).

These factors may seem trivial, but in a rapidly growing individual they exert a chronic influence on overall posture .

Lower limb length inequalities

Another common cause of compensatory scoliosis is an anatomical (or functional) inequality of the lower limbs:

  • Even minimal (8 to 10 mm), it can cause a tilting of the pelvis , lumbar and then thoracic misalignment.
  • The child develops adaptive scoliosis , often reversible if the cause is identified and treated (insoles, rehabilitation, osteopathic treatment of the pelvis and ascending chains).

The osteopath plays a valuable role here in distinguishing true bone inequality from functional inequality linked to muscular, fascial or visceral tension.

Neuromuscular or proprioceptive disorders

Although rarer, some scoliosis can be linked to:

  • Neuromuscular disorders (dystrophy, cerebral palsy, spina bifida),
  • A proprioceptive deficit , preventing the young person from having a precise perception of their verticality,
  • Alterations in body schema linked to developmental disorders or early trauma.

These situations require multidisciplinary support , but osteopathy can find its place as an integrative approach.

Often multifactorial causality

In the majority of young athletes, scoliosis does not have a single identifiable cause , but results from a combination of factors. A genetic predisposition is associated with rapid growth, on top of which are grafted:

  • A sports mechanical overload,
  • Unsuitable postures for everyday life,
  • Undetected muscular or proprioceptive imbalances.

The challenge is therefore to decipher the postural history of each child , to understand the aggravating factors, and to act on the ground, lifestyle habits, and compensations.

Impacts on sports practice and quality of life

Scoliosis, when it affects a young athlete, is not simply a structural problem of the spine. It subtly—sometimes brutally—changes the way the body perceives itself, balances itself, and moves in space. Far beyond the morphological aspect, its repercussions extend to athletic performance , body confidence , chronic fatigue , and, in some cases, the adolescent’s emotional health . Support must therefore be considered in a global and individualized vision .

Disruption of biomechanics and body axis

A deviated spine disrupts the alignment of body segments. This loss of physiological verticality leads to:

  • Uneven distribution of loads between the lower limbs,
  • An imbalance of the muscle chains , with compensatory hypertrophy on one side and weakening on the other,
  • An alteration of the center of gravity , modifying support and stability.

Concretely, this translates into:

  • Less fluid technical gestures (e.g.: reduced trunk rotation, unbalanced reception),
  • Energy-consuming motor adaptations (e.g., excessive use of lumbar muscles or trunk stabilizers),
  • Faster fatigue during sustained efforts.

In athletes undergoing postural development, these disturbances can weaken performance and even generate chronic microtraumas (tendinitis, lower back pain, joint instability).

Breathing and endurance disorders

When scoliosis involves the thoracic spine , it directly affects ventilatory mechanics . Spinal rotation alters the play of the ribs and limits lung expansion:

  • One hemithorax becomes less mobile , reducing inspiratory volume,
  • The diaphragm functions asymmetrically , impacting the depth and efficiency of breathing,
  • Recovery capacity after exercise decreases , particularly in endurance sports.

Result: even a young person in good physical condition may complain of dyspnea on exertion, unusual shortness of breath , or a drop in performance with no apparent explanation.

Chronic pain and discomfort during exercise

Although often silent at rest, scoliosis manifests itself through:

  • Lower back or chest pain after intense training ,
  • Asymmetrical muscle sensitivity ( trapezius, paravertebral, quadratus lumborum),
  • Joint stiffness that sets in gradually, especially at the end of the day or upon waking.

These pains can become a barrier to investment in sports practice , especially when they are not taken seriously by those around them or are trivialized as “normal aches and pains”. The risk is that the child internalizes their discomfort , reduces their efforts or compensates with harmful motor patterns.

Psychological impact and body image

Adolescence is a crucial period for identity building . The body becomes a medium for expression, self-esteem, and social integration. In this context, scoliosis can lead to:

  • A feeling of embarrassment or difference from others,
  • Shame related to posture or back asymmetry ,
  • Withdrawal or a drop in motivation to continue exercising, particularly if an orthopedic brace is prescribed.

Young girls, in particular, may be sensitive to the visible deformation or perception of a “crooked” back, which can influence their psychological posture, their clothing, and even their desire to show off.

School and daily impact

Away from the sports field, scoliosis can also affect daily life:

  • Difficulty sitting for long periods in class , with the need to change position frequently,
  • Back pain during homework or exams ,
  • Chronic fatigue and loss of concentration , linked to less efficient breathing or persistent discomfort.

These signs do not always correlate with the radiological severity of the scoliosis. Even a moderate deviation can have a major functional impact if it disrupts overall balance.

When should you worry?

It is essential to act before the onset of chronic pain or loss of desire to move . There are warning signs:

  • A sudden drop in performance without explanation,
  • Unusual fatigue after moderate exertion,
  • Pain that systematically returns in the same area,
  • A change in posture or coordination.

In these cases, an osteopathic and multidisciplinary assessment allows us to take stock, objectify the imbalances, and propose a global action plan to prevent scoliosis from becoming a lasting obstacle to the child’s development.

The role of the osteopath in detection and monitoring

In the journey of a young athlete suffering from scoliosis, the osteopath occupies a strategic position: postural reference point, attentive observer of body dynamics , he can detect the first signs of imbalance and accompany the child in an evolutionary follow-up respectful of his growth. His approach does not replace that of the doctor or the orthopedist, but it is a valuable complement , based on listening to the body, the globality, and prevention.

A detailed and comprehensive postural assessment

The osteopath’s primary role is to identify bodily imbalances early, often before pain sets in or a formal diagnosis of scoliosis is made.

Its assessment is distinguished by:

  • A static observation (shoulder, pelvis, scapulas, vertebral axis),
  • A dynamic analysis (walking, running, flexion, extension, rotation),
  • A subtle palpation of tissue tensions, joint fixations, and remote compensations (pelvis, skull, feet).

He thus perceives the bodily spiral in its entirety , and can identify compensatory patterns which often escape a purely radiological evaluation.

Identify key areas of fixation or release

Scoliosis is not just a visible curvature: it is expressed in living tissue by areas of osteoarticular fixation , muscular hypertonia or, conversely, areas of hypomobility or neuromotor inhibition .

The osteopath is looking in particular for:

  • Asymmetry of tension in the pelvis or sacroiliac joints,
  • A restriction of mobility in the cervical-dorsal or lumbosacral junction ,
  • A diaphragmatic imbalance , which influences posture and breathing,
  • Areas of congestion or fascial compression , particularly in the thorax.

These bodily support points are as many locks or levers to slow down or accompany the development of scoliosis.

Create a bond of trust with the child and his family

Osteopathic monitoring is part of a relationship of trust , which values the child’s words, their sensations, their bodily experience. Far from an anxiety-inducing medical discourse, the osteopath adopts a reassuring and participatory posture:

  • He explains the imbalances without dramatizing,
  • It involves the child in postural awareness ,
  • It enhances the adaptive capacities of the growing body.

This connection is fundamental to promoting compliance with advice, strengthening body esteem, and maintaining motivation in sport.

Monitoring adjusted to the pace of growth

Osteopathic care is not fixed: it adapts to growth phases and key periods of sporting activity . For example:

  • During growth peaks , consultations can be brought closer together to support temporary imbalances.
  • Before an intensive training course or a competition , a session allows you to release tension and optimize body mechanics.
  • In times of fatigue or pain , targeted rebalancing can prevent chronicity.

The osteopath acts here as a long-term postural guide , capable of anticipating imbalances rather than suffering them.

Act in synergy with other professionals

Scoliosis, especially when it becomes structured, requires a multidisciplinary approach. Osteopaths never work alone, but in close collaboration with :

  • The attending physician or pediatrician, to make the diagnosis and monitor the radiographic progress,
  • The orthopedist , in case of need for a corset or surgical advice,
  • The physiotherapist , for specific work on the musculature and postural chains,
  • The sports coach , to adapt training and avoid harmful asymmetrical movements.

This collective approach strengthens the consistency of monitoring and allows for personalized interventions based on the child’s stage of development.

A preventive, educational and therapeutic role

Finally, the role of the osteopath goes beyond the immediate therapeutic framework. He also becomes a postural educator , capable of:

  • Make the child aware of bodily signals (fatigue, tension, breathing difficulties),
  • Offer simple self-awareness exercises (standing, sitting, moving),
  • Advise parents on equipment (shoes, backpack, bedding) or on habits to correct.

Through its holistic vision, it gives children back the power to inhabit their body with more balance, security and fluidity.

Osteopathic Approach: Restoring Dynamic Balance

In the management of scoliosis in young athletes, the osteopathic approach does not aim to mechanically straighten the spine, but to restore the dynamic harmony of the body . It is based on a detailed understanding of biomechanical, fascial and neuromotor imbalances, and is part of a comprehensive approach , respectful of the child’s growth rate and adaptation capacities.

Act on spinal mobility and compensations

The osteopath works primarily on areas of loss of mobility which disrupt spinal dynamics:

  • The cervico-dorsal and lumbosacral hinges , often fixed in compensation for the main curvature,
  • Transient segments that experience torsional or shear stresses,
  • The costovertebral joints , whose mobility directly influences trunk rotation and breathing.

The techniques are gentle, non-invasive, and age-appropriate :

  • Rhythmic joint mobilizations , to restore joint play,
  • Gentle decompressions , particularly in the closure zones (concavity of the curvature),
  • Deep tissue work , to release asymmetrical myofascial tension.

The goal is not to “correct” scoliosis by force, but to restore freedom to key areas , allowing the body to reorganize its balance.

Restart diaphragmatic and respiratory dynamics

In thoracic scoliosis, the diaphragm is often asymmetrical : one hemicupola is compressed or restricted, disrupting respiratory mechanics and overall posture.

The osteopath will:

  • Work on the costal and lumbar insertions of the diaphragm , to release tension,
  • Release the attachments of the mediastinum and thoracic fascia , to promote expansion of the thorax,
  • Stimulate respiratory proprioception , by helping the patient become aware of their asymmetrical breathing.

This work is essential for improving endurance, recovery from exertion , and the ability of the trunk to adapt to sporting constraints.

Rebalance the ascending and descending chains

Scoliosis is part of a global postural chain , which connects the feet to the skull, passing through the pelvis, the spine and the shoulder girdles. Osteopathic treatment therefore includes:

  • Work on plantar supports , to correct imbalances under load (e.g.: supination of one foot, collapse of the internal arch),
  • Rebalancing the pelvis , the fundamental pivot point of posture,
  • The release of cervical tension , particularly on the C0–C1–C2 hinge, often involved in compensatory scoliosis.

By intervening on these areas remotely, the osteopath not only treats the spine , but restores coherence to the bodily adaptations put in place by the child.

Support proprioception and body schema

Scoliosis alters the body’s spatial perception . The child may be unaware that they are standing crooked, compensate without realizing it, or develop a blurred body image.

Osteopathy, by combining therapeutic touch and verbal guidance , helps to:

  • Strengthen fine proprioception , by highlighting the asymmetries felt,
  • Reintegrate forgotten areas , often located in the concavity of the curvature,
  • Support the central axis , developing a more balanced perception of the center of gravity.

This subtle work is valuable for restoring coherence to movement , improving gestural efficiency, and preventing exhausting compensations.

Adapt techniques to age and sporting discipline

The osteopath adjusts his techniques according to:

  • The child’s biological and pubertal age ,
  • The nature of the sport practiced (symmetrical, asymmetrical, impact, rotation, etc.),
  • The frequency and intensity of training ,
  • The presence or absence of an orthopedic corset , which can modify breathing, proprioception and thoracic flexibility.

For example, a young dancer will need precise work on pelvic symmetry and the vertical axis , while a tennis player will benefit more from balancing the high-low, right-left cross chains .

Frequency and objectives of monitoring

The frequency of sessions depends on the progression of scoliosis, the level of physical activity and key periods of growth. In general:

  • 1 session every 2 to 3 months for prevention in children at risk,
  • 1 monthly or bi-monthly session during phases of rapid growth or pain,
  • Close monitoring in the event of orthopedic treatment (corset, intensive rehabilitation).

The osteopath always sets clear functional objectives : better mobility, freer breathing, reduced pain, improved posture or sports coordination.

Multidisciplinary care and prevention

Managing scoliosis in young athletes cannot be reduced to a single approach. It requires synergy between different health professionals , but also active involvement of the child and their family. The osteopath, in this context, plays an integrative role, capable of reading the body’s signals and facilitating communication between disciplines. Prevention, meanwhile, remains the key to limiting the progression of the curvature and preserving the adolescent’s sporting and functional potential.

When and why collaborate?

Even moderate progressive scoliosis can have lasting repercussions if it is not monitored in a concerted manner . Teamwork allows:

  • An accurate and up-to-date diagnosis , particularly via X-rays and the Cobb angle,
  • Additional support , where each participant acts within their field of expertise,
  • Better therapeutic compliance , thanks to consistent communication with the child and parents.

The professionals to be included in this collaboration are:

  • The attending physician or pediatrician , for initial screening, coordination of examinations and overall monitoring,
  • The orthopedist , in the event of structural curvature requiring a corset or close monitoring,
  • The physiotherapist , for active work on the musculature, posture, proprioception and functional gain,
  • The podiatrist , if an inequality in leg length or a deviation of the plantar supports is identified,
  • The osteopath , to regulate overall tensions, restore mobility, and promote postural adaptation.

In some cases, a psychologist can also be useful in supporting adolescents who are having difficulty with their body or their postural difference.

The role of each in complementarity

  • The orthopedist’s mission is to assess the severity of the curvature (angular measurement, flexibility, evolution), and to prescribe an orthopedic corset if necessary . The objective is to slow down the worsening during growth spurts.
  • The physiotherapist offers active work based on specific postural exercises , often inspired by the Schroth or Mézières methods, aimed at strengthening the deep muscles, correcting symmetry and stimulating proprioception.
  • The osteopath intervenes by releasing areas of tension , supporting adaptations, and working away from the curvature (skull, feet, pelvis, diaphragm).
  • The sports coach can, thanks to appropriate advice, adjust training to avoid risky movements or movements that overuse an asymmetrical chain.

This plurality of approaches allows for comprehensive, personalized and progressive care , which respects both the uniqueness of each scoliosis and the specific needs of the child.

Primary prevention: identifying weak signals

Prevention begins even before pain appears. Certain warning signs should be:

  • A constantly asymmetrical posture when sitting,
  • Difficulty maintaining balance or standing up,
  • One-sided fatigue after exercise,
  • Recurring tensions always located in the same place.

A regular osteopathic examination during growth, particularly in the case of family history or intense sporting activity, allows early imbalances to be detected and prevented from becoming established.

Secondary prevention: limiting the worsening

In a child diagnosed with early scoliosis, preventive measures aim to:

  • Slow down angular evolution while maintaining good overall mobility,
  • Avoid secondary imbalances (lameness, lumbar or cervical compensation),
  • Preserve respiratory function and endurance,
  • Maintaining pleasure and safety in sports practice .

The role of the osteopath is central here: by balancing tensions, he helps the body to remain flexible and functional , despite the deviation. He also acts as a movement teacher , making the child aware of his posture and his bodily sensations.

Tertiary prevention: preserving quality of life

In young people whose scoliosis is already established and medically monitored, the objective is to avoid functional deterioration and psychological suffering . The osteopath supports this approach by:

  • Relieving secondary pain (articular, visceral, muscular),
  • Restoring a more integrated and less fragmented body image ,
  • Encouragement of adapted mobility, without fear of movement .

In the long term, good tertiary prevention allows the adolescent to build a healthy relationship with his body , to remain active, and to prevent scoliosis from becoming a limitation in his adult life.

Practical advice for young athletes and their parents

Supporting a young athlete with scoliosis means helping them feel supported without being limited , and preserving their pleasure in moving while respecting their body balance. Far beyond treatment, it is daily actions, discipline choices, postural habits and the messages transmitted to the child that determine their ability to evolve positively with their curvature. This section offers concrete advice, aimed at both parents and young people, to optimize monitoring, autonomy and body confidence.

Choose suitable sports activities, without giving up movement

Contrary to popular belief, scoliosis does not prohibit you from participating in sports . On the contrary, staying active is essential for:

  • Maintain harmonious musculature,
  • Stimulate coordination and proprioception,
  • Strengthen body esteem.

However, some adjustments are necessary. It is best to:

  • Promote symmetrical sports , such as swimming (backstroke, crawl), athletics (running, jumping), climbing or cross-country skiing,
  • Avoid (or closely supervise) very asymmetrical or high unilateral impact disciplines (tennis, fencing, baseball, competitive gymnastics),
  • Alternate dominant movements (e.g., change the hand carrying the bag, vary the sides in dance or yoga),
  • Integrate postural strengthening and mobility practices , such as Pilates, adapted yoga, or simple proprioceptive exercises.

The important thing is to observe whether the sport practiced accentuates pain, asymmetries, or unilateral fatigue. In this case, an adjustment is necessary, in consultation with the osteopath and the coach.

Adopting daily ergonomics that respect posture

The daily environment plays a central role in the development or worsening of scoliosis:

  • The backpack : always worn on both shoulders, well adjusted at the height of the shoulder blades, and never too heavy (10% of body weight maximum).
  • Sitting posture : both feet flat, hips aligned with knees, back supported. Avoid slouching or leaning to one side.
  • The screen : placed at eye level, so as not to create prolonged flexion of the neck or twisting of the trunk.
  • Bed and pillow : a firm but comfortable mattress, a pillow that respects the head-neck-shoulder axis. Avoid twisting positions while sleeping.

These seemingly trivial details have a cumulative daily impact that can influence spinal statics, especially during periods of growth.

Establish a home exercise routine

A child with scoliosis can benefit greatly from simple, regular exercises incorporated into their daily routine:

  • Targeted asymmetric stretches , to open the concavity of the curvature,
  • Strengthening the core , particularly the deep muscles (core strengthening, bridges, side plank),
  • Conscious diaphragmatic breathing , to balance thoracic volumes,
  • Work on balance , on an unstable cushion or with closed eyes.

The osteopath or physiotherapist can suggest a personalized routine, taking into account the shape of the scoliosis, the child’s activity level and preferences.

Promoting speech and listening to the body

One of the pillars of prevention and support lies in the child’s ability to identify their bodily feelings :

  • Identify areas of unusual tension or pain,
  • Feeling an asymmetry in gesture or posture,
  • Knowing how to tell when an exercise or piece of equipment is becoming uncomfortable.

Encouraging this bodily listening, without judgment or dramatization, allows the child to take responsibility without feeling guilty . It is also a way of restoring the connection to a body sometimes perceived as “deviant” or “unsuitable.”

Involve the family in a supportive and positive way

It’s not a parent’s role to constantly monitor or correct their child’s posture. This can create pressure, even shame. Conversely, an attitude of encouragement, availability, and trust fosters calm support.

Some attitudes to favor:

  • Recognize the efforts made, even modest ones,
  • Avoid negative comments about appearance or gait,
  • Incorporate exercises into a family routine (e.g., everyone does a minute of breathing or stretching after meals),
  • Talk with teachers or coaches to adjust expectations and avoid over-solicitation.

Supporting autonomy and motivation

As the adolescent grows, it is important to give him tools that he can use :

  • Understanding the impact of your daily actions,
  • Identify the warning signs that warrant a consultation,
  • Make appointments yourself (with support),
  • Develop a positive vision of your body in movement.

Osteopathy, as a gentle, non-invasive approach based on fine perception, is a valuable ally in this progressive empowerment, linked to sport, health and personal development.

What current research tells us

The field of adolescent idiopathic scoliosis (AIS) is constantly evolving. Contemporary research is refining our understanding of the mechanisms of onset , the evolution of curvatures , the effectiveness of conservative treatments , as well as the role of complementary approaches , including osteopathy. This section provides an up-to-date look at the available scientific data, while highlighting the limitations and perspectives of research.

An etiology still partially elucidated

Despite advances in genetics and imaging, the exact cause of idiopathic scoliosis remains unknown. Several hypotheses coexist:

  • Genetic and hormonal factors : Mutations related to the regulation of melatonin, bone growth or collagen synthesis have been identified in some cases.
  • Neuromuscular hypothesis : a dysfunction of central postural control or an asymmetry of neuromuscular activity in the paravertebral muscles is considered.
  • Environmental and mechanical factors : rapid growth, prolonged posture or asymmetric loads could play an aggravating role.

Research agrees on a multifactorial vision , which justifies the need for therapeutic approaches that are also plural.

The importance of early detection and longitudinal follow-up

Epidemiological studies show that the progression of scoliosis is strongly linked to the pubertal stage , and therefore to rapid bone growth. Current data emphasize:

  • The role of the Adams test and the measurement of humpback,
  • The need for regular monitoring of the Cobb angle (from 10°),
  • Increased vigilance during Risser stage 0 to 2 , the period of greatest risk of progression.

School screening, still unevenly applied depending on the country, has shown its effectiveness in preventing severe scoliosis requiring orthopedic or surgical treatment.

Orthopedic corsets: efficacy validated, but adherence variables

Meta-analyses, including those from the Scoliosis Research Society , confirm the effectiveness of the corset (brace) in reducing the progression of scoliosis, provided that:

  • The initial angle should be moderate (between 20 and 40°) ,
  • Daily wearing time exceeds 16 hours ,
  • The patient is adolescent and still in the growth phase .

However, the psychological impact of the corset, the drop in compliance , and the secondary respiratory or postural difficulties are significant obstacles, requiring human and complementary care.

Specific rehabilitation: towards individualized approaches

Rehabilitation methods such as Schroth , SEAS (Scientific Exercises Approach to Scoliosis), or the Lyonnaise method have been the subject of recent research, which shows:

  • Improved body awareness and active posture,
  • Stabilization or slight improvement of the curvature in some patients,
  • Reduced pain and improved endurance.

These methods share a common philosophy: the conscious activation of asymmetric postural muscles and active 3D correction. They are now integrated into many treatments in Europe and North America.

And what about osteopathy in all this?

Studies on the effectiveness of osteopathy in the treatment of scoliosis are still few in number , but the preliminary results are encouraging:

  • Some case studies and clinical series report a reduction in pain, an improvement in thoracic and lumbar mobility , and a better quality of life.
  • Pilot trials have shown that osteopathy, in addition to conventional treatment, promotes tissue and respiratory flexibility , and reduces tension secondary to scoliosis.
  • The osteopathic approach is particularly appreciated for its gentleness, its listening and its personalization , important qualities in adolescents.

However, the lack of standardized protocols and randomized controlled trials makes rigorous scientific evaluation difficult. Several journals call for more interdisciplinary studies , involving osteopaths, physiotherapists, and sports medicine physicians.

Research avenues in development

Research continues to explore:

  • Genetic markers of progressive risk ,
  • Automatic detection technologies via 3D imaging or postural sensors,
  • The psychological and social impact of scoliosis in adolescence ,
  • The role of breathing and fascial dynamics , fields where osteopathy could contribute to advancing knowledge.

These avenues highlight the interest of more integrative models , where the body is approached in its functional and relational complexity, and not as a simple structure to be corrected.

Conclusion: Support without stigmatizing

Scoliosis in young athletes should not be seen as inevitable, nor as a simple posture defect to be corrected. It is the expression of a dynamic imbalance in the process of transformation , which involves the body, the environment, emotions, growth, movement… and the way we look at ourselves. For this reason, the therapeutic approach cannot be solely biomechanical. It must also be relational, global, and respectful of the body’s evolving identity.

Restoring confidence in the body in movement

In a society where performance is valued, scoliosis can become a source of anxiety, even shame, for adolescents. It is therefore essential to reposition therapeutic discourse in a dimension of trust :

  • By showing that curvature is not a barrier to sports practice, but an invitation to know yourself better ,
  • By emphasizing that the body, even if deviated, remains capable of adapting, of progressing, of performing differently ,
  • By helping the young person to reconcile his inner image with his physical reality.

The osteopath plays a key role here: by touching with respect, by listening without judgment, he offers the child a space where the body can be felt without being analyzed, experienced without being reduced to a pathology.

Reject the standardization of care trajectories

Every scoliosis is unique. There is no single way to assess it, nor a single method of treating it. Too often, standardized protocols risk reducing the young person to their Cobb angle , neglecting:

  • The flexibility of the curvature ,
  • The body’s adaptive resources ,
  • The subjective reality of the painful or non-painful experience,
  • Young people’s motivation and relationship to sport .

This is why the osteopathic approach is intended to be individualized and evolutionary , linked to the biological, but also emotional and social evolution of the patient. It is integrated into a logic of co-construction of care , where the therapist does not impose, but proposes and adjusts.

Prevention rather than correction at all costs

The major challenges of scoliosis in adolescents lie in prevention:

  • Morphological prevention , by identifying asymmetrical signs or abnormal tensions early,
  • Functional prevention , by guiding sports movements and daily posture,
  • Psycho-corporeal prevention , by supporting the subjective experience of the young person in their growth.

Early detection, active monitoring, listening to bodily signals, and fluid dialogue between professionals and families are all keys to effective action . And when scoliosis progresses despite everything, it remains possible to support it in a logic of potentiation, not limitation.

Provide a caring and supportive therapeutic framework

Adolescence is a vulnerable period, but also an extraordinarily flexible one. What a young person hears, feels, and experiences in their relationship with care will leave a lasting imprint on:

  • His relationship to pain and effort,
  • His connection to the body and to performance,
  • His confidence in the therapeutic process.

This is why the osteopath – through the quality of his presence, his touch, his listening – can contribute to building a positive body memory , anchored in fluidity, breathing and confidence. It is not just about realigning a spine, but about retuning an inner perception, a movement, a vital impulse.

Opening perspectives, not verdicts

Finally, it is important that the conclusion of an article—like that of a therapeutic journey—does not close, but opens. Scoliosis is not defined by its radiological form, but by what it provokes: adaptation, transformation, listening, overcoming. The child is not a curve on an X-ray, but a living body in the making.

Osteopathy, as an art of living, can accompany this development with gentleness, precision and presence , without ever confining, without ever predicting. Just by offering stable support so that the body, at its own pace, finds its axis – whatever it may be.

References

1. Epidemiology and pathophysiology of idiopathic scoliosis

Physical activity, sport and scoliosis

Conservative treatment and orthopedic corsets

  • Weinstein SL, Dolan LA, Wright JG, Dobbs MB.
    Effects of bracing in adolescents with idiopathic scoliosis.
    New England Journal of Medicine. 2013;369(16):1512–21.
    https://doi.org/10.1056/NEJMoa1307337
  • Negrini S, Donzelli S, Aulisa AG, et al.
    2016 SOSORT Guidelines: Orthopaedic and Rehabilitation Treatment of Idiopathic Scoliosis During Growth.
    Scoliosis and Spinal Disorders. 2018;13(1).
    https://doi.org/10.1186/s13013-017-0145-8

Specific rehabilitation and active methods (Schroth, SEAS)

  • Monticone M, Ambrosini E, Cazzaniga D, Rocca B, Ferrante S.
    Active self-correction and task-oriented exercises reduce spinal deformity and improve quality of life in subjects with mild adolescent idiopathic scoliosis.
    Results of a randomised controlled trial. Eur Spine J. 2014;23(6):1204-14.
    https://doi.org/10.1007/s00586-014-3241-y
  • Kuru T, Yeldan İ, Dereli EE, Özdinçler AR, Dikici F, Çolak İ.
    The efficacy of three-dimensional Schroth exercises in adolescent idiopathic scoliosis.
    A randomized controlled clinical trial. Clin Rehabil. 2016;30(2):181–90.
    https://doi.org/10.1177/0269215515575745

Role of osteopathy and global approach

Adolescent psychology and the impact of scoliosis on body image

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