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Pilates for scoliosis by Bruna Ximenes

Writer's picture: Julia BarrosoJulia Barroso

Who here does Pilates for scoliosis? I do it 3 times a week! Today, I have a very special guest here to talk about the importance of this activity for those with the condition.


Bruna Ximenes is a physiotherapist, acupuncture specialist, and Pilates instructor with 14 years of experience. We met when I still lived in Rio de Janeiro, and she used to give me Pilates classes – that was quite some time ago!


Pilates for scoliosis: In your opinion, what is the importance of Pilates for scoliosis patients?


I believe the main point is to bring awareness about posture, proprioception (the ability to perceive the location of one's body in space), awareness of movement limitations, and how to reduce compensations through self-correction. What I mean is that, through increased body awareness, the patient can more clearly perceive the mechanical restrictions that scoliosis may be causing and the adaptations the body may be creating to compensate for these limitations.

In scoliosis patients, we notice that some muscles become shortened and contracted, while others become stretched. In a portion of patients, this muscular imbalance can lead to pain, especially when the patient cannot perceive and promote self-corrections to alleviate these overloads. Based on this idea, through Pilates exercises, we can improve spine mobility, lengthen the shortened muscles, thereby relaxing the stretched ones, and strengthen the deeper muscles known as spine stabilizers. Additionally, there's an overall gain in mobility, flexibility, and strength. Another very important aspect is the respiratory work. Postural deviation can lead to difficulty in lung expansion, so conscious respiratory exercises aimed at optimizing lung ventilation are crucial.


Do you recall any special cases of scoliosis patients you've treated?


Some, including yours, which was a surgical case with significant movement restrictions but extreme functionality. I remember a case of a pregnant woman with a severe degree of scoliosis who had surgical indications but chose not to undergo surgery. She didn't have any scoliosis-related pain, despite having a significant structural trunk deformity, but she started experiencing limitations in movement due to the progression of her pregnancy and fatigue from reduced lung expansion. It was a very interesting case to follow in Pilates to provide more respiratory comfort, muscle relaxation, and body adjustments within the context of the typical changes during pregnancy.

What are the main areas of the body that should be strengthened for scoliosis patients?


Overall strengthening is important, but when it comes to postural support, we need to emphasize the deep stabilizing muscles, the abdominal muscles, and the complex known in Pilates as the Powerhouse, which provides all the support for the trunk and spine.


At what age is Pilates recommended (considering children and adolescents with scoliosis)?


I believe that working with children should be specialized and will depend largely on the child's maturity. In general, from the age of 7 or 8, it's possible to start some interesting work.


Can a patient who wears a brace for scoliosis correction do Pilates?


Absolutely. The brace somewhat takes on the role of muscles. Therefore, it's very important that even patients who wear a brace perform mobility, stretching, and strengthening exercises to ensure that the corrections are maintained after the brace is removed. This includes work on proprioception and postural self-correction.


Does Pilates help with pre and post-spine surgery? In what ways?


Absolutely. It's important for the patient to go into surgery with the highest degree of mobility possible, along with all the respiratory work that is also part of Pilates principles. It can be very beneficial in both pre and post-surgery phases. Specifically thinking about the post-surgery phase, the structures will be reorganized and fixed during surgery, so the work on muscle relaxation, stability, internalization of the new posture/body position, and strengthening will be crucial post-surgery. In the post-surgery phase, we also identify possible mobility restrictions due to the fixations and assess how to handle them as functionally as possible in daily life.


Pilates for scoliosis

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