Scoliosis Explained
At Spine & Sports Centre, we’re committed to learning from the latest research and techniques so we can deliver the most advanced care to our patients. Our entire team, including chiropractors, physiotherapists, podiatrists, and Pilates instructors, participated in a professional development session focused on scoliosis assessment and management.
Led by Lisa Zorzi from the Perth Scoliosis Clinic, the session deepened our understanding of scoliosis as a three-dimensional spinal condition, affecting not just posture, but also breathing, muscular symmetry, and long-term function.
The presentation on Spinal Biomechanics and Scoliosis Management explored scoliosis from every angle – literally. This wasn’t just about understanding the curve you see on an X-ray; it was about how the spine, muscles, growth, and even breathing patterns all interact to create (and manage) this complex condition.
Here’s what we took away – and what it means for anyone living with scoliosis, or caring for someone who is.
What Is Scoliosis?
Mild, moderate, and severe scoliosis curves, each spine highlighted with arcs.
Scoliosis is more than just a “crooked spine.” It’s a three-dimensional deformity – meaning the spine curves sideways, rotates, and flattens in certain sections all at once.
Imagine twisting and bending a garden hose: not only does it curve, but it also creates kinks and twists. That’s similar to what happens in scoliosis, particularly in the thoracic spine, where vertebrae wedge and rotate. This can lead to the hallmark rib hump and the illusion of a flat upper back or “false lordosis.”
Scoliosis affects around 3–5% of children, and females are up to eight times more likely to have curves that progress to a level needing treatment. The biggest risk window is during rapid growth spurts – typically two years before and after a girl’s first period – when the spine lengthens quickly and curves can worsen almost overnight.
Why This Matters
Scoliosis isn’t just a postural quirk – it’s a condition that can affect comfort, confidence, and long-term health. Left unchecked, curves can progress and lead to pain, breathing issues, and joint strain later in life.
Most scoliosis cases (80–85%) are idiopathic – meaning there’s no single clear cause. But we know what fuels progression: rapid growth combined with asymmetrical loading. This “Stokes vicious cycle” means that once a curve starts, uneven forces create uneven growth, which then makes the curve worse.
That’s why early detection and accurate assessment are so important. Our updated assessment approach now looks beyond a single Cobb angle number on an X-ray. We consider:
Growth markers (Risser grading, Sanders hand scoring)
Family history (is there a genetic component?)
Lifestyle and goals (sport, daily activities, personal priorities)
By seeing the “whole picture,” we can design plans that respect the science of scoliosis and the lives of the people who have it.
How We Treat Scoliosis
Illustration of a scoliosis patient wearing a corrective brace with a clinician providing guidance, set against a textured beige background.
The golden rule we learned? Stability over mobility.
In scoliosis, some spinal muscles are already overworked while others are weak and underused. Stretching or mobilising the “tight side” might feel good temporarily but can actually destabilise the system. Instead, we focus on elongation and stability – building support so the spine can handle daily life.
Treatment depends on curve severity and age:
Mild curves (<25°) – monitored with targeted exercises (often scoliosis-specific physiotherapy).
Moderate curves (25–50°) – usually combine exercises and bracing.
Severe curves (>50°) – bracing for surgical preparation, followed by rehab to stabilise the fusion.
Bracing plays a critical role in halting progression and, in many cases, reducing the curve by 30–50%. Western Australia has a unique bracing program – involving a designer, manufacturer, and specialist fitter – creating braces customised to each patient’s spine and goals.
We also learned about the importance of thoracic flexion and breathing techniques. Something as simple as learning to “breathe into the rib cage” can relieve pain, improve posture, and support the brace’s corrective forces.
For adults, treatment looks different. Curves under 30° are often managed in the community with strength and stability programs, while larger curves – or those causing pain – may need more structured intervention. Restoring natural lordosis in adults can reduce compensations like pelvic tilt and knee bending, improving movement and comfort.
Common Myths We Can Put to Rest
The training also cleared up a few misconceptions that float around about scoliosis:
Swimming doesn’t “fix” scoliosis (and in some cases may increase instability).
Heavy backpacks don’t cause curves.
Poor posture isn’t to blame.
Scoliosis isn’t something you can slouch your way into – it’s a structural condition that needs a structured, evidence-based approach.
The Bigger Picture
The take-home message from this course is simple: scoliosis care is about stopping progression, supporting the spine, and giving patients confidence.
Whether it’s a teen wearing a brace 23 hours a day, or an adult wanting to stay strong and mobile, scoliosis management is about more than just the curve – it’s about quality of life.
And at Spine & Sports Centre, we’re bringing these new insights, tools, and techniques straight into the clinic – so our patients benefit from the most up-to-date, stability-focused care available.
