Adolescent Scoliosis: What Can Parents Actually Do?
When a child is diagnosed with scoliosis, most parents' first reaction is a rush of questions:
Should we start correcting it right away? Does she need a brace? Should we begin physiotherapy? Can exercise or Pilates actually help?
The honest answer is that there is no single "best method" that suits every child with scoliosis.
What matters first is understanding three things: the degree of the spinal curve, how much growth the child still has ahead of them, and whether the curve is showing signs of progression.
This is especially important once girls enter the rapid growth phase of puberty, when the body can change significantly in a short period of time. If scoliosis is identified during this window, the priority is not anxiety — it is timely assessment and consistent monitoring.
If it's mild, does that mean nothing needs to be done?
Not exactly.
For mild, stable curves, doctors will often recommend regular observation first, rather than immediately starting intensive treatment.
If the curve carries a risk of progression, scoliosis-specific physiotherapy — such as the Schroth method — may be introduced. And if the child is still growing rapidly while the curve has already reached a certain degree, bracing can become a very important tool for control.
This is the balance I always come back to: don't over-treat when the situation calls for observation, and don't miss the growth window by insisting on "natural improvement" when a brace is genuinely needed.
As for manual approaches like chiropractic adjustment or manipulation — these may help some children release tension or feel more mobile in the short term, but they currently cannot replace medical follow-up, bracing, or scoliosis-specific exercise in controlling the progression of a structural curve.
So where does Pilates fit in?
In my view, the value of Pilates is not simply to "straighten" a curved spine.
What we are really training is a growing body.
For example:
Whether the feet can bear weight in a stable way
Whether the hips have sufficient mobility and control
Whether the lower-limb alignment is stable
Whether the trunk has enough supporting capacity
Whether the shoulder blades and rib cage can move in coordination
Whether the breath can reach different regions of the rib cage
Whether the child can control her body better when walking, running, jumping, or standing on one leg
These abilities are not the same as "changing the Cobb angle" — but they shape how a child uses her body every single day.
And there is one role of Pilates that is often overlooked, yet deeply important:
Helping a child genuinely understand what "sitting well" and "standing well" actually feel like.
“Sit up straight" — but does she know what that means?
When parents see their child slouching or leaning to one side, they often remind her:
"Sit up straight." "Stand properly." "Chest up."
But here's the problem: does the child actually know what "standing well" feels like?
Many children, when told to "lift the chest," respond by pushing the ribcage forward and arching the lower back.
This is especially significant for children with scoliosis, who may already have rib rotation or a rib cage that protrudes forward on one side. Constantly emphasising "push the chest up" can actually make the ribs protrude further.
So in training, we don't simply tell a child to "lift the chest." We help her genuinely feel what a supported sitting posture is.
Sitting well is not about forcing the back straight
When a child sits on a chair or a mat, we first help her find support through the pelvis.
We let the sitting bones truly receive the body's weight, let the feet find support from the floor, keep the pelvis from tipping too far forward or back, and then allow the rib cage to rest naturally above the pelvis.
From this foundation, we invite the child to imagine the crown of the head gently lengthening upward.
Not holding the breath. Not squeezing the shoulder blades together. Not straining to force the lower back straight.
Instead, in a state of support, the spine is given more length and space.
This is when a child gradually realises: "sitting up straight" is not about muscling the body into place — it's the body becoming taller naturally, once it has found its support.
Standing well works the same way
"Standing properly" is also not about pushing the chest forward.
A truly stable standing posture is built from the ground up:
The soles of the feet make stable contact with the floor
The knees are not locked
The hips, pelvis, and lower limbs share the load together
The rib cage sits relatively stable above the pelvis
The head then lengthens naturally above the trunk
Only then can the body's weight transfer efficiently through the foot, knee, hip, and pelvis down into the ground.
For a child with scoliosis, we further adjust according to her individual curve and body characteristics — rather than asking every child to stand in exactly the same way.
So I prefer to tell a child: not "stand up straighter," but "find better support."
This is why I place so much value on body awareness in children's Pilates
A child might only train for one or two hours a week. But every day, she sits for many hours, walks, attends class, exercises, and carries a school bag.
So the meaningful change isn't just her performing one movement correctly in front of an instructor.
It's that, after a session ends, she begins to notice:
"Am I collapsing to one side right now?" "Are my feet actually grounded?" "Am I pushing my ribs forward again?" "Can I let myself grow taller, instead of straining to lift my chest?"
When these sensations gradually enter a child's daily life, movement training begins to genuinely influence how she uses her body.
A real example: a 10-year-old I currently train
One of the girls I currently work with is exactly this kind of case.
Her curve is not large, so the training has not revolved around "bending the spine back into place."
Instead, I've spent a great deal of time improving her foot stability, single-leg balance, hip control, lower-limb alignment, and trunk and scapular stability — while continually helping her understand what a supported sitting and standing posture feels like.
As her physical capacity and body awareness have gradually improved, her standing posture, scapular control, balance, and overall body stability have all changed noticeably.
A combined approach makes the most sense
For adolescent scoliosis, what I believe in is a combination of approaches, each doing what it does best:
Medical assessment determines the level of risk and guides monitoring
Bracing, when needed, helps control progression during the growth period
Scoliosis-specific physiotherapy (such as the Schroth method) addresses the curve directly
Pilates helps the child build better strength, stability, coordination, and body awareness
These are not competing options. What matters most is choosing the method the child needs most at each stage of her growth.
Because in the end, the goal is not only to make a curve on an X-ray smaller.
It's to help a growing child gradually learn how to sit, how to stand, how to move — and how to use her body better, for life.
Curious whether Prehab Pilates could support your child's movement, posture and body awareness?
WhatsApp to Book a Trial Session
Sessions are conducted in English and Mandarin.