Pilates

 for  Scoliosis  
 
 

 
 
 
 
 
 
 
 
Savannah  Hein  

September  2012  

Oakland  California  January  2012  CCTT  

 
 

  1  
  
  This  paper  attempts  to  explain  how  practicing  in  a  Pilates  regimen  regularly  

can  benefit  someone  suffering  from  a  spinal  condition  known  as  scoliosis.    The  

paper  will  address  this  condition  by  explaining  what  it  is,  and  giving  some  statistics  

about  how  many  people  suffer  from  it.  Lastly,  I  will  design  an  exercise  program  that  

will  include  exercises  from  the  classical  BASI  Pilates  repertory  that  can  benefit  

someone  with  scoliosis.  My  goal  for  the  sample  class  will  be,    (over  time  with  

continued  practice)  to  reduce  pain  caused  from  the  condition,  as  well  as  increase  the  

overall  functionality  of  a  person  suffering  from  this  spinal  condition.    

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 

  2  
  
 
 
 
 
 
 
 
 

Table  of  Contents  

Cover  Page ................................................................................................................................................. 1  

Abstract..................................................................................................................................................................... 2  
Table  of  contents..................................................................................................................................................3  
Anatomical  Description  .......................................................................................................................... 4  
Introduction............................................................................................................................................................ 5  
Body   ......................................................................................................................................................................6-­7  
  Work  out………………………………………………………………………………………………..............8-­‐11  
    Conclusion……………………………………………………………………………………………..12  
      Citations…………………………………………………………………………………….13    
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 

  3  
  
 
 
 
 
 

 
 
According  to  the  Mayo  Clinic,  Scoliosis  is  defined  as,   “a  sideways  curvature  

of  the  spine  that  occurs  most  often  during  the  growth  spurt  just  before  puberty.  

While  scoliosis  can  be  caused  by  conditions  such  as  cerebral  palsy  and  muscular  

dystrophy,  the  cause  of  most  scoliosis  is  unknown.”    As  stated  in  the  quote  above,  

there  are  many  different  reasons  that  a  person  can  develop  scoliosis.    The  severity  of  

  4  
scoliosis  is  widely  varied  and  can  be  very  slight,  or  it  can  be  quite  significant  and  

possibly  disabling.      

Scoliosis  is  a  very  common  ailment,  and  according  to  the  National  Scoliosis  

foundation,  2-­‐3%  of  our  US  population  suffers  from  it.    It  can  be  noted  from  the  

diagrams  above,  that  patients  with  scoliosis  suffer  from  either  an  S    or  reverse  S  

shaped    curve  in  their  spine.  This  curve  can  occur  anywhere  along  the  vertebrae.  

However,  It  is  most  commonly  found  in  the  thoracic  region  of  the  spine.    Both  men  

and  women  have  an  equal  chance  in  developing  scoliosis,  however  the  chances  that  

you  will  have  a  severe  case  of  it  are  much  higher  in  women  than  in  men.    Scoliosis  is  

most  often  diagnosed  when  children  are  at  the  height  of  their  growth  years.    It  is  

quite  common  for  prepubescent  adolescents  to  develop  this  condition.      

The  degree  to  which  scoliosis  affects  a  person’s  daily  life  depends  a  lot  upon  

how  serious  the  curve  in  their  spine  is.    It  can  be  seen  by  looking  at  the  diagrams  

provided  above,  the  more  severe  the  curve,  the  more  areas  of  the  body  it  will  affect.  

If  someone  has  a  severe  curve  in  his  or  her  spine,  not  only  does  it  affect  the  space  

between  vertebrae,  it  affects  the  entire  bone  structure  of  the  individual.    As  a  

scoliosis  patient  ages  and  develops,  the  surrounding  structures  are  developing  

around  this  curve.    The  curve  can  shift  the  height  of  the  hip  bones  (can  result  in  legs  

that  are  two  different  lengths),  it  can  shift  the  height  of  the  scapula,  and  it  can  

severely  tork  the  rib  cage  (can  affect  breathing).    These  are  just  a  few  of  the  many  

  5  
problems  that  someone  with  this  condition  can  suffer  from.    Because  the  spine  is  

thrown  out  of  alignment,  it  in  turn,  throws  much  of  the  appendicular  spine  out  of  

alignment  as  well.  As  one  can  imagine,  this  can  lead  to  lots  of  complications.    Again,  

depending  on  the  severity,  a  scoliosis  patient  can  experience  a  lot  of  pain.    The  curve  

in  their  spine  can  affect  their  ability  to  walk,  reduce  range  of  motion  in  particular  

areas  of  the  body,  and  may  lead  to  complications  in  exercising  in  the  same  way  that  

a  fully  functioning  individual  may.    Depending  on  where  the  curve  in  the  spine  is  

located,  scoliosis  can  also  affect  respiration  because  of  reduced  space  for  one  of  the  

lungs.    

Scoliosis  goes  largely  untreated.  A  lot  of  cases  are  not  severe  enough  to  

where  treatment  is  necessary.  However,  if  it  is  caught  in  time,    (while  the  patient  is  

still  growing)  the  use  of  a  back  brace  may  be  administered  in  order  to  help  

straighten  the  spine  as  the  patient  grows.  After  the  patient  is  finished  growing  and  

the  spine  is  set  in  place  not  a  whole  lot  can  be  done  to  correct  scoliosis  other  than  

surgery.  Although  there  are  not  many  things  that  will  straighten  the  spine  after  

skeletal  maturity  in  a  scoliosis  patient,  there  are  ways  that  they  can  get  relief  from  

the  pain  that  results  from  it.  There  are  also  ways  that  muscles  can  be  developed  to  

help  pull  and  guide  the  bones  into  more  of  a  natural  alignment.  Pilates  is  perfect  for  

doing  this.    

  6  
   The  following  information  is  a  case  study  of  a  client  that  has  Scoliosis.    I  will  

be  sharing  my  thoughts  and  ideas  about  how  practicing  Pilates  has  helped  her  find  

relief  from  pain,  excessive  tightness,  and  help  her  to  get  stronger.    

Marla  Dean  is  40  years  old.    She  was  diagnosed  with  Scoliosis  when  she  was  a  

teenager,  about  14  years  old.    It  was  first  noticed  when  she  was  screened  for  it  at  

school.  At  this  time,  the  curve  in  her  spine  was  mild  and  she  was  told  not  to  worry  

about  it.  The  doctors  told  her  that  she  would  not  need  a  brace  or  any  sort  of  special  

treatment  for  her  case.    However,  her  case  advanced  abnormally  quickly.  By  the  

time  she  was  about  16  the  curve  in  her  spine  was  quite  severe.    At  this  point  her  

doctors  did  not  think  that  a  brace  would  do  anything  to  help  her  curve.  She  was  not  

experiencing  a  whole  lot  of  pain  from  it,  so  surgery  was  not  recommended.      

  Marla’s  scoliosis  is  located  in  the  thoracic  region  of  her  spine  from  about  T6  

to  T12.    The  curve  in  her  spine  veers  off  to  the  right.    The  curve  in  her  spine  has  

pushed  the  right  side  of  her  ribcage  out  and  had  made  the  right  side  of  her  body  

extremely  tight.    She  experiences  a  lot  of  stiffness  along  her  neck,  ribcage,  and  back  

on  that  side  of  her  body.    The  alignment  of  her  hips  has  also  been  altered  somewhat  

from  the  curve  in  her  spine.    

  Marla  experiences  the  most  pain  from  her  condition  when  she  has  been  

sitting  for  long  periods  of  time.    She  begins  to  hold  a  lot  of  tension  in  her  back  and  

neck  and  starts  to  get  stiff  throughout  the  intercostals  in  her  rib  cage.    

  7  
   My  goal  in  designing  a  Pilates  regimen  for  Marla  was  to  help  her  stretch  out  

the  areas  of  her  body  that  were  excessively  tight  because  of  her  condition,  

strengthen  her  hips  and  lower  body,  and  develop  muscles  in  her  upper  body  that  are  

weak  due  to  her  scoliosis.    

  The  following  session  was  developed  around  the  needs  and  limitations  for  

someone  with  scoliosis.    It  is  designed  for  a  client  who  is  on  an  intermediate  level.    

SAMPLE  EXERCISE  PROGRAM  

Warm  Up:  roll-­ups,  spine  twist  supine,  double  leg  stretch,  single  leg  stretch,  

criss-­cross.  The  intermediate  warm  up  can  be  performed  for  someone  with  

scoliosis.  If  the  curve  in  your  client’s  back  is  severe  enough,  sometimes  it  is  helpful  

to  put  a  small  pad  or  a  hand  towel  under  the  side  of  the  back  that  is  not  in  contact  

with  the  mat.  This  will  help  your  client  have  something  tangible  to  roll  down  onto  

while  they  are  on  their  backs.  It  will  help  your  client  with  their  alignment  if  they  can  

feel  a  surface  under  both  sides  of  their  back.    

FOOT  WORK  (ON  CADILAC  OR  TOWER):    One  red  spring  bottom  loaded  with  

safety  strap  on.  Parallel  heels,  Parallel  toes,  Open  V  heels,  Open  V  toes,  Calf  

raises,  Prances,  Single  leg  heels,  Single  leg  toes.      

  For  Marla  I  like  to  do  her  foot  work  on  the  Cadillac  because  she  has  tight  

hamstrings.  It  is  also  easier  for  her  to  control  her  back  when  she  is  lying  down  and  

  8  
her  feet  are  overhead.  We  put  a  small  pad  under  the  lifted  side  of  her  back  and  she  is  

able  to  have  more  balance  between  both  sides  of  her  back.    

Abdominal  Block:  (on  the  Cadillac)  roll  ups  with  roll  up  bar,  mini  roll  ups,  and  

mini  roll  up  oblique.    

I  specifically  choose  all  of  these  exercises  for  Marla  because  of  her  scoliosis.  The  roll  

ups  with  the  roll  up  bar  help  her  get  used  to  rolling  up  and  down  from  the  mat  

evenly  on  both  sides  of  her  spine.  If  necessary,  we  put  a  small  pad  under  the  side  of  

the  back  that  is  lifted  from  the  mat,  due  to  the  scoliosis.  This  helps  her  feel  her  back  

contact  on  the  mat  evenly  on  both  sides.    Mini  roll  ups  are  good  for  her  because  she  

is  able  to  concentrate  on  isolating  her  abdominals  without  her  scoliosis  affecting  her  

work.  In  mini  roll  ups  I  have  Marla  lift  her  spine  off  of  the  mat,  only  to  the  level  of  

the  bottom  of  her  scapulae.  Since  her  curve  begins  lower  down  on  her  spine,  she  is  

able  to  keep  the  curved  part  of  her  spine  on  the  floor.  Mini  roll  ups  with  obliques  

serve  two  purposes  for  her.  One  is  that  we  are  able  to  strengthen  her  obliques,  and  

the  other  is  that  this  exercise  actually  gives  her  a  chance  to  stretch  out  and  rotate  

the  side  of  her  spine    that  is  tight  from  her  condition.    

Hip  work  Block:  (on  the  Cadillac)  Single  Leg  Supine  series:  Frog,  Down  circles,  

Up  circles,  Hip  Extension,  and  Bicycle.      

This  particular  leg  series  is  critical  for  Marla,  or  anyone  with  major  muscular  or  

skeletal  imbalances.  The  beauty  of  this  exercise  is  that  you  can  really  focus  on  each  

  9  
side  of  the  body  individually.  This  becomes  important  for  a  scoliosis  client  because  

their  hips  and  back  can  be  misaligned  from  the  curve.    This  can  make  their  legs  two  

different  lengths,  which  can  be  a  real  problem.  We  always  want  to  make  sure  that  

we  are  building  muscle  evenly  on  both  sides  of  the  body.  If  we  start  with  legs  with  

two  different  lengths  and  try  to  work  both  legs  at  the  same  time,  we  will  be  building  

muscle  unevenly.    Working  the  legs  individually  allows  us  to  work  each  side  and  

really  focus  on  building  muscle  precisely  and  evenly.    

Spinal  articulation:  (on  Reformer)  Bottom  lift  and  Bottom  lift  with  Extension.    

I  specifically  chose  these  exercises  for  our  clients  with  scoliosis  because  some  

of  the  other  spinal  articulation  exercises  can  be  too  intense  for  clients  with  scoliosis.  

Short  spine  and  long  spine  can  be  uncomfortable  for  someone  with  a  severe  spinal  

deviation.  Bottom  lifts  are  also  a  really  great  way  of  finding  where  the  pelvis  is  in  

relation  to  your  own  body.  The  spinal  articulation  of  a  scoliosis  client  will  feel  very  

different  than  that  of  a  client  with  a  back  that  has  a  “natural”  curvature.    Figuring  out  

how  to  up  and  down  the  middle  of  the  back,  when  the  spine  is  not  centered  down  

the  middle  of  the  back  is  both  a  challenge  and  something  that  is  really  crucial  to  

your  client.    

Stretches:    (on  Reformer)  kneeling  lunge  and  side  splits  

Full  Body  Integration  I:  (on  reformer)  Round  back,  flat  back,  reverse  knee  

stretch,  up  stretch  I,  and  long  stretch.    Round  back,  flat  back,  reverse  knee  stretch  

  10  
and  up  stretch,  are  all  wonderful  exercises  for  a  scoliosis  client  because  it  helps  

them  connect  their  back  extensors  to  their  abdominals.    These  exercises  provide  a  

good  way  to  use  the  front  body  and  back  body  simultaneously.  Because  of  spinal  and  

muscular  imbalances,  connecting  the  back  extensors  and  the  core  at  the  same  time  

can  be  hard.  These  exercise  provide  a  great  way  to  practice  this  with  your  scoliosis  

client.      

Arm  Work:  (on  Reformer)  Side  arm  series:  Deltoid  Reach,  Cross  Arm  Pull,  

Triceps,  Arms  Overhead.    

  The  upper  back  and    

Additional  Leg  Work:  (on  Cadillac)  Squats  

  Squats  are  a  good  leg  work  exercise  for  scoliosis  clients  because  it  really  

allows  them  to  work  on  their  posture  as  the  slide  down  into  their  squat.  The  springs  

act  as  an  assist  in  this  exercise  to  help  keep  the  spine  upright  and  erect.  The  back  

extensors  and  abdominals  are  co-­‐contracting  as  the  quadriceps  engage  to  lower  the  

legs  into  a  squat.    

Lateral  Flexion:  (on  Reformer)  Mermaid    

  Mermaid  can  be  a  really  beautiful  exercise  for  your  scoliosis  client.    It  is  a  

wonderful  lateral  flexion  exercise  that  helps  bring  space  into  the  upper  body.  The  

act  of  twisting  helps  stretch  out  tightness  throughout  the  back  and  rib  cage  that  is  a  

result  of  your  client’s  condition.  Be  aware  in  this  exercise  that  there  could  be  

  11  
marked  differences  between  your  clients  two  sides  on  this  exercise.  Because  of  the  

displacement  of  the  spine,  it  will  be  much  easier  for  your  client  to  perform  this  

exercise  on  one  side  than  it  will  be  on  the  other.  Being  careful  to  stretch  both  sides  

of  the  client  but  not  pushing  your  client  to  stretch  intensely  on  the  tight  side  is  

important.    

Back  Extension:  (on  Chair)  Swan  Basic    

  Back  extension  is  important  for  your  scoliosis  clients.  A  lot  of  times  the  

muscles  in  your  scoliosis  client  can  be  very  tight  and  can  look  deceivingly  strong.  

But,  from  personal  experience  working  with  scoliosis  clients,  their  backs  are  often  

very  tight  and  very  weak.    Swan  basic  is  a  great  exercise  for  scoliosis  clients,  because  

they  really  have  to  focus  on  keeping  their  abs  engaged  and  their  pelvis  in  alignment  

while  letting  the  pedal  rise  and  fall.    

  In  conclusion,  bringing  awareness  to  your  scoliosis  clients’  pelvis,  

abdominals,  and  back  extensors  is  critical.  Connecting  throughout  the  body  and  

calling  on  muscle  groups  to  co-­‐contract  will  help  your  client  tremendously.  The  

exercise  plan  for  your  scoliosis  client  does  not  have  to  be  complicated.  As  you  begin  

to  work  with  your  client,  you  will  realize  that  working  on  some  of  the  most  

fundamental  exercises  with  your  client  will  help  improve  their  pain  and  quality  of  

life  the  most.  The  importance  of  careful  observation  and  listening  to  your  client  can’t  

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be  stressed  enough  in  this  case.  Everyone’s  bodies  are  drastically  different  and  as  

Pilates  professionals  you  must  treat  each  case  with  this  in  mind.    

   

"National  Scoliosis  Foundation."  National  Scoliosis  Foundation.  National  Scoliosis  

Foundation,  n.d.  Web.  14  Aug.  2012.  http://www.scoliosis.org/info.php.  

"Scoliosis."  Mayo  Clinic.  Mayo  Foundation  for  Medical  Education  and  Research,  n.d.  

Web.  14  Aug.  2012.  <http://www.mayoclinic.com/health/medical/IM03006>.  

"Musculoskeletal  Radiology."  Scoliosis  â€”  â€”  UW  Radiology.  Department  of  Radiology  

University  of  Washington,  n.d.  Web.  14  Aug.  2012.    

<http://www.rad.washington.edu/academics/academic-­‐sections/msk/teaching-­‐

materials/online-­‐musculoskeletal-­‐radiology-­‐book/scoliosis>.  

"Pilates  Exercises  for  Scoliosis  Straightening."  Pilates  Exercises  for  Scoliosis  

Straightening.  Easyvigour,  n.d.  Web.  14  Aug.  2012.  

<http://www.easyvigour.net.nz/pilates/h_pilatesscoliosis.htm>.  

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