Physiotherapy in Toronto for Mid Back

Curvature of the spine called scoliosis can occur with no known cause. When older children and teens are affected, it's called adolescent idiopathic scoliosis (AIS). Despite our many advances in medicine, science, and technology, we still don't know what causes AIS.

In this study, researchers from Greece explore the possibility that competitive sports activities might be a causative agent. The highly repetitive nature of athletics combined with exercise-related stress on the spine could be a risk factor for this condition. It's possible that in undeveloped children and teens, the immature musculoskeletal system can't handle the physical stress.

They conducted an observational study of over 2,000 adolescents (boys and girls). Everyone filled out a survey with information about themselves: their age, gender, daily activities, family history of AIS, and so on. Based on the answers to the questions, each child was put into a group according to his or her activity level. The two groups were labeled athletes and nonathletes.

Athletes were defined as those children who played a sport on a regular basis for at least two years before the study. They trained for at least 10 hours each week and were members of an athletic organization (club or association). Nonathletes did not practice or play in any sport. They could play games for recreation and still be included. Anyone who did not meet the criteria for one of these two groups was excluded from the study.

Then each child was examined by three orthopedic surgeons. The surgeons did not know which group the child was in. Posture, leg length, and general health were assessed. A special forward bending test called Adam's test was used to screen for any curvature of the spine. Anyone with suspicious signs of scoliosis was sent for X-rays.

There were 99 cases of confirmed scoliosis (defined as a curve measured on X-ray as 10 degrees or more). There were an equal number of children diagnosed with AIS in both groups.

Hours of practice among the athletes averaged about 12 hours each week for boys and 13 hours for girls. Girls were more likely to be involved in gymnastics. The most popular sport with boys was soccer. Otherwise, there were no differences between the two groups.

Height, weight, and activity level did not appear to be linked with the onset of AIS. Being right-handed versus left-handed or strongly dominant with uneven load on the spine did not seem to make a difference in risk for developing AIS.

The authors conclude there probably isn't a relationship between exercise and the onset of AIS. Previous studies reporting an increased number of athletes with AIS and linked it with delay in maturation and positive family history. One study concluded that activities that involve all the joints and muscles may be protective against scoliosis. The possibility of a genetic factor has been raised but could not be confirmed by this study.

Reference: Eustathios Kenanidis, MD, et al. Adolescent Idiopathic Scoliosis and Exercising. Is There Truly a Liaison? In Spine. September 15, 2008. Vol. 33. No. 20. Pp. 2160-2165.