Have the Olympics gotten you and your family all fired up about winter sports? We here at the Spine Hospital at the Neurological Institute of New York have sure enjoyed the games, and since Olympians are usually set on their path when still children, we would like to share with you some good news about children, sports and one of their most common spinal conditions—scoliosis. In fact, our pediatric neurosurgeon, Dr. Richard Anderson, says he gets asked by parents all year long whether kids with scoliosis are allowed to play sports.
The short answer to this question, says Dr. Anderson, is “yes.”
The long answer is that scoliosis is a disease in which prognosis and treatment of children can be radically different because it comes in different levels of severity and has many different causes. This doesn’t mean all kids with scoliosis should stay away from active involvement in sports, but it is a good idea to first see a doctor for advice. Very often, you’ll find the doctor even recommends playing sports.
Scoliosis is a general term for a spine that is abnormally twisted and bent from side to side. The diagnosis is made by a doctor, often using X-rays to measure the degree of the curve. In some cases a doctor may further evaluate the condition using MRI or CT scans. Depending on severity, you may notice the following signs in children with scoliosis: One shoulder appears higher than the other; the head looks off center to the body; the hips look uneven; or the shoulder blades aren’t even.
Most cases of scoliosis occur in kids (mostly girls) aged 10 to 15 and have no clear underlying cause. When mild, scoliosis usually doesn’t have an impact on quality of life, and it may even go unnoticed by the screening commonly done in schools.
When the side-to-side curves are between 20 and 50 degrees (measured by X-ray) the scoliosis is considered moderate, and a doctor may recommend bracing. According to the National Scoliosis Foundation, an estimated 30,000 children with scoliosis are fitted with a brace each year. Physical therapy is also often prescribed. Rami Said, DPT, a senior physical therapist at the Spine Hospital, says, “We encourage these kids to be active in sports, and we get them ready by teaching them how to strengthen and stretch their core. In most cases, the benefits of sports far outweigh any potential risks. In fact, learning how to manage asymmetries in their bodies caused by scoliosis really prepares them for the rigors of most sports.”
When any of the side to side curves of scoliosis is greater than 50 degrees, the condition is considered severe. The spinal deformity can become so bad that it causes great discomfort and loss of functional movement like walking. It may even press on the lungs or other organs.
When curves are greater than 50 degrees, progressing rapidly, or causing symptoms like those mentioned above, pediatric neurosurgeons such as Dr. Anderson often recommend surgery to straighten and stabilize the spine. Scoliosis surgery in children is usually done with adjustable metal rods to allow for spinal growth. After a full recovery from surgery, these children are most often encouraged to exercise, but their level of athletic participation, especially contact sports, may be limited if their surgeon feels it is necessary. For the most part, however, scoliosis does not progress to the point of surgery. While an estimated 7 million people (both kids and adults) in the United States have scoliosis, only about 38,000 have undergone spinal surgery.
Most people with scoliosis lead normal, pain-free lives, and for most kids, Dr. Anderson recommends no restrictions on activity–that includes sports and even chasing an Olympic dream. Is it realistic for someone with scoliosis to make it to that level? According to ESPN there are two athletes with scoliosis, one is a runner and one is a swimmer, who made it to the last Olympics, and it is entirely possible there are more. They may even be competing right now.