Scoliosis - What is Menopause doing to my Spine?

Scoliosis is not just a teenage issue. Menopause can also play havoc with our spines. Caroline Freedman, a Personal Trainer and author of The Scoliosis Handbook and Christine Jaureguiberry a yoga teacher who runs Yogaberry, specialising in Yoga for Scoliosis, have seen that scoliosis can be a very common problem for women.

Caroline and Christine both have scoliosis. Caroline has had three scoliosis spinal fusion surgeries and Christine has a moderate idiopathic curvature. They have extensive knowledge and found the combination of load bearing weight exercises and yoga practice is ideal to manage the condition.

What is Scoliosis?

Scoliosis is a sideward curvature of the spine with rotation measured over ten degrees (cobb angle). It can affect any age from before birth (congenital), in young children (early onset), teenagers (adolescent idiopathic) where the scoliosis has developed through puberty/growth and onto adulthood. The curve can change dramatically around the ages of 10-20 years old with adolescent scoliosis comprising 80% of cases.

There are three times in a women’s life when scoliosis is most likely to progress: during adolescence, pregnancy, and menopause. During these 3 times hormone levels change and specifically menopause is associated with the loss of bone density which can contribute to progression of scoliosis.

Scoliosis & Menopause

We often see Scoliosis first detected or progressing in women going through menopause. The hormonal changes that take place during menopause affect the quality, strength, and resistance of women’s bones and joints. ‘Menopause significantly speeds bone loss and increases the risk of osteoporosis. Research indicates that up to 20% of bone loss can happen during these stages and approximately 1 in 10 women over the age of 60 are affected by osteoporosis worldwide’ (Jan 23 2022 endocrine.org)

Caroline says:

“I have seen a number of new personal training clients and also friends complaining of backache where they have not had any previous issues. This is due to in many cases a lack of bone density causing osteoporosis.

Physically the first thing they may notice is pain on one side of their bodies. This is due to the spine twisting and a feeling of the lateral muscles being pulled across the ribcage which over time as the curve progresses can lead to neck ache, headaches and then central and lower back ache. Pain, as we know causes tiredness and coupled with all our hormonal changes, just adds to the feeling of exhaustion.

They may also notice that they do not look as symmetrical, and one shoulder may protrude forward lifting the shoulder blade. This causes clothes to hang differently and often my clients/friends cannot work out why.”

Christine adds:

“from my experience working with yoga students with scoliosis I can say that a big part of my clients that come to me with problems of pain due to their scoliosis are women that have recently gone through menopause.
They usually fall into two categories: women who knew they had scoliosis for a long time and
where the scoliosis got worse during menopause and women who never knew they had scoliosis and were recently diagnosed.
We can of course not say for sure if they had scoliosis before (called Adolescent Idiopathic Scoliosis if it developed during teenage years) and it has never been detected or if they developed it later which is called De Novo Scoliosis or Degenerative Scoliosis."

“Scoliosis can be a debilitating condition, and maximising bone mineral density is important in helping to reduce the risk of scoliosis developing and deteriorating. After the menopause, bones mineral density (BMD) reduces, taking HRT is an important option to prevent BMD reduction which has been confirmed in several large research studies. Other lifestyle options like regular weight-bearing exercise and diet are also important ways to maintain bone health"
Ellis Downes FRCOG
Consultant Obstetrician & Gynaecologist,

'This is an important under appreciated condition that warrants wider discussion and awareness of the psychological impacts that can be associated with it. I have several menopausal patients who have a history of Adolescent Scoliosis, which is an abnormal curvature of the spine. As these women approach perimenopause depending on the extent of the curve, asymmetric loading in conjunction with declining oestrogen levels and lower bone density may impact on intervertebral disc degenerative changes. This could present with symptoms of chronic back pain, reduced mobility, poor sleep quality, feelings of negative body image, affecting self esteem and confidence, sometimes causing social withdrawal, anxiety and depression.'
Dr Suzanne Saideman

MBChB, MRCGP, DFSRH
GP and Menopause
“I’m seeing menopausal women with various bone and muscle problems. The hormonal changes affect blood and bone chemistry.”
A degenerative curve in adults is caused by progressive joint damage to the spinal segments, falling bone density and weakening of muscle. It presents as a C-shaped curve. (Scoliosis
Handbook 2021)

John Rutherford adds
‘Postural deficits and falling exercise levels contribute, as well as hormone deficits and mineral and vitamin deficiencies from reduced stomach absorption. Existing idiopathic scoliosis affects 2% of population.

Degenerative scoliosis can be up to 30%
Also degenerative mainly affects the lumbar spine with minimal curve in the thoracic spine and further, menopause can make an existing idiopathic scoliosis worse’ John Rutherford mcsp dc hcpc

Yoga & Scoliosis

Yoga is a great way to create more balance in the body which is unbalanced due to the nature
of scoliosis which creates both a side bend and rotation of the spine. Breathing exercises are wonderful to open the concave areas that often feel collapsed and lacking kinaesthetic awareness. Here are two of Christine’s favourite yoga poses that can easily be practised at home.

Downward Dog

Downward Dog is a pose that features in most yoga classes and it’s a great one for those with scoliosis! In this pose we have the opportunity to lengthen through the spine to counter the rotation and strengthen the upper body and shoulders at the same time. Top tip: bend your knees slightly if your hamstrings are tight! With scoliosis focus on lengthening the spine rather than straightening the legs.

Tree Pose

Tree Pose is a fantastic way to work on balance (so important also for those who suffer from Osteoporosis) and core strength! With scoliosis we can very often see one side of the hips being higher than the other so I would recommend starting to practice this pose in front of the mirror and working on keeping the pelvis level. This will be harder on one side compared to the other!

Resistance Training & Scoliosis

Proven to increase bone density, here are two of Caroline’s favourite exercises.

Upright Row

The upright row works the traps – the triangular muscle at top of the spine that connects to the deltoids. It’s so important to keep the trapezius muscle toned. It helps to hold your head upright. Clients have reported improved posture, reduced neck aches and headaches.

1. Stand with legs hip-width apart, knees soft, slightly bent, shoulders relaxed.
2. Start with arms down, relaxed, holding the bar with hands thumb-width apart. Leading with
   elbows, slowly raise the bar, hands brushing your body until at upper chest level and elbows are
   higher than hands, elevated above shoulders, making the shape of a V.
3. Do not raise your shoulders
4. Slowly return to start
5. Introduce a weight slowly, starting with 0.5 kg.

Bent-Arm Pullovers

This exercise works your back, rear shoulder muscle, chest and triceps while supporting your back, neck and head.

1. On your back, feet a little wider than hip width, check leg alignment
2. Chin tucked in, relaxed.
3. Suck in abs and push back into the floor with pelvis tilted upwards.
4. Start by clasping hands together into a fist. Progress by adding weights up to max 5 kg.
5. Elbows slightly bent. Start with arms at eyeline, over your chest, then extend them above
   your head, as far as is comfortable. Feel a slight stretch. Do not attempt to bring your arms
   further back to touch the floor behind you as this will make you arch your back.
6. Start with five repetitions with no weight and increase to 5 kg and 20 repetitions x 3 sets.

Caroline Freedman: Personal Trainer and TRX Sports Medicine Suspension Training exercise
professional, is author of The Scoliosis Handbook of Safe and Effective Exercises Pre and Post
Surgery. www.scoliosishandbook.com @scoliosishandbook
Published by: Hammersmith Books www.hammersmithbooks.co.uk
Illustrated by: Dunelm Digital www.dunelmdigital.co.uk
Photos by: Sam Pearce www.square-image.co.uk
‘Images courtesy of Scoliosis Association UK’

Christine Jaureguiberry: Yoga for Scoliosis Teacher at Yogaberry
Website: www.yogaberry.net
YouTube: Yogaberry
Instagram: @yogaberry.scoliosis
Facebook: YogaberryUK