When combined with scoliosis-specific rehabilitation such as Schroth therapy, strength training becomes a powerful tool to improve stability, reduce pain, and slow degenerative changes.
Adult scoliosis is often misunderstood as a static condition — something that stops changing once growth ends. In reality, many adults who have scoliosis during adolescence experience curve progression, or they could experience a de-novo case of scoliosis. This is often accompanied by increasing pain and functional limitations over time. The cause of spinal curve progression is multi-factorial but in general it is closely tied to degeneration of spinal discs, joints, hormonal changes and bone density.
Why Does Strength Training Matter for Adults with Scoliosis?
In adults, as spinal discs lose hydration, they lose height and facet joints wear unevenly, the spine becomes less stable. This instability increases asymmetric loading, which can accelerate curve progression and pain.
Strength training helps counteract this process by:
- Improving active spinal support through stronger core and postural muscles
- Reducing mechanical stress on degenerating discs and joints. You can think of the muscles as a truss system holding the spine in good alignment
- Enhancing postural endurance and movement efficiency
Bone Density, Menopause, and Scoliosis Curve Progression in Women
One of the most important — and often overlooked — risk factors for scoliosis progression in adulthood is bone density loss, particularly in women after menopause. As estrogen levels decline, women experience accelerated bone loss, increasing the risk of osteopenia and osteoporosis. Reduced bone density weakens the vertebrae and compromises the spine’s ability to resist asymmetric forces. This increases the potential for
- Vertebral wedging – which is the change in shape of the vertebrae based on asymmetric loading
- Disc degeneration
- Spinal instability
- Curve progression and risk of compression fractures.
Weight-bearing and resistance exercises have been proven to be one of the most effective and evidenced based remedies for increasing bone density.
The LIFTMOR randomized controlled trial demonstrated that supervised, high-intensity resistance and impact training performed at approximately 80–85% of one-repetition maximum significantly improved lumbar spine bone mineral density in postmenopausal women with low bone mass, while also being safe and well tolerated under closely supervised clinical conditions. It is a great resource – click here to review
What Type of Strength Training Is Best For Adults With Scoliosis?
Strength training for scoliosis is not a generic gym program. It must be individualized, targeted, and aligned with each person’s curve pattern and functional needs.
Key areas of focus include:
- Deep Core Stabilizers (transverse abdominis, multifidus, pelvic floor)
- Paraspinal Strengthening, these are the muscles that span the length of our back and help keep us upright
- Hip and Glute Strength, which play a major role in pelvic and spinal alignment and play an equally critical role in our day-to-day functional movements
- Postural Endurance, enabling sustained upright alignment during daily activities
The goal is to improve stability, control, and load distribution across the spine with progressive loading. Importantly your program may not look like what you typically see in the weight room of a gym given the specifics of your spine.
How to Strength Train Safely with Scoliosis?
Given the three-dimensional nature of scoliosis, strength training must be approached carefully and under the guidance of a qualified therapist that has a deep understanding of your individual curve and how to achieve the best postural correction to enable safe loading and to understand where to begin with loading and how to progress.
It is a very gradual process. First you achieve your specific correction, you build the endurance in that correction and from there you can lift while maintaining the correction. This is important to avoid uncontrolled spinal compression, excessive rotation, or poorly guided loading that increases the asymmetry or overloads vulnerable spinal segments.
Why Schroth Therapy Should Be Part of the Strength Training Plan
Schroth therapy is a scoliosis-specific rehabilitation approach that addresses the three-dimensional nature of spinal curves through targeted exercises, specific muscle activation, corrective breathing, and postural education.
Importantly, Schroth teaches the necessary alignment and neuromuscular control needed to perform the strength training exercises safely. When combined with strength training, Schroth principles ensure that strengthening reinforces corrected alignment, rather than strengthening faulty movement patterns. This combination is especially powerful in adults, where the goal is curve stabilization, symptom reduction, and functional longevity.
When Should Strength Training Begin?
Strength training should begin as early as possible, not only once pain appears. On average we reach maximum bone density by 30 years of age. Prior to that junction in time, we want to fortify the bones as much as possible. Similarly, after that point we want to continue to preventatively strengthen our bones to counteract the ensuing age-related declines. Menopause for women is another critical milestone that we must prepare for by building strength and bone mass again in preparation for steeper declines once estrogen levels drop.
Early intervention helps:
- Reduce the likelihood of rapid curve progression
- Build muscular resilience before degeneration accelerates
- Provide a foundation and endurance for correct posture that makes it easier maintain as tissues age
Takeaway: It Is Never Too Early or Too Late To Be Proactive About Your Spine Health.
For adults with scoliosis — especially women navigating post-menopausal bone loss — Postural training and strength training are the cornerstone of care. When guided by a therapist trained in scoliosis and Schroth therapy, they offer a safe, effective way to:
- Slow degenerative progression
- Reduce pain
- Improve posture and confidence
- Support long-term spinal health
At The Move PT, I love working with all these details in mind on a 1:1 basis. I start with Schroth Therapy and then carry the Schroth principles into strength training which combines use of Pilates for core stabilization and then weights for hypertrophy and bone building that is customized for what your body needs to find its best and strongest alignment.
I would love to hear from you. If you have scoliosis and wondering how to get started send me a note here to set up a call.
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