Allison was surprised to see a teenage boy entering the building where the offices for scoliosis therapy are located. She was taking her daughter, Heather, to check on the progress of her scoliosis Cobb curve since her daughter was under the care of the center and wearing a brace for several months. Allison was under the illusion that only girls suffered from scoliosis and boys did not have this problem and now she just learned something new about scoliosis, that it can affect boys too.

Statistics vary, but about 75% of the cases of idiopathic scoliosis are girls and is noticed around eleven to twelve years of age depending on puberty arrival. While it is true that girls are definitely in the majority when it comes to scoliosis, boys do get it but usually at a later age since their puberty begins later. An average of three to four percent of teenagers will require treatment for juvenile scoliosis and this condition must be caught early to be effectively treated.

While girls reach puberty fast, boys are much slower, and this is the reason why scoliosis in girls is generally more severe. Scoliosis occurs when the growth of the vertebrae in the back become wedged which causes curvature of the spine and places uneven load on the vertebrae which leads to further uneven growth of the spine. Tension on the spinal cord develops as the person bends.

Until recently boys wore looser clothing than girls making it more difficult to notice if the boy had any back curvature issues. Adding to that was the fact that scoliosis screening in schools does not always include the boys and the curvature forms much slower and parents may miss the signs of scoliosis. There is a greater range of years that a boy’s scoliosis can be diagnosed because many boys grow into their late teens as opposed to the girls whose growth is completed in a much shorter time span. Yet there are many cases where boys do have curves that require either bracing or surgery.

It is prudent that teenage males be screened at school or least at their regular doctor visit. The average age for guys is between thirteen and fourteen but if the individual is a late bloomer meaning late beginning puberty, the guy should be checked during his teen years until growing is complete. Although it is not always true, if the guy has a sibling or parent with scoliosis the chances due increase for him.

The proper way to inspect if the posture of the guy is correct is by doing a three-step check.  

1) Check if the shoulders are even and the head centered.

2) Check if the opposite sides of the body are even.

3) Check the back muscles while the boy bends forward and see if there is a large difference in the opposite sides of the body. (By the way, make sure the guy removes his shirt.)

Here are two real-life case scenarios of scoliosis in teen males. Names have been changed to respect patients’ privacy.

Case #1: Clark Stephenson, 16, Cobb Rating: 55 Degrees

Clark’s parents had no idea that he was suffering from scoliosis even though there were some indicators that something was not right with his back. For example, he did complain about his back hurting, and he had his last checkup eighteen months previously because of Covid. Prior to that crazy time his parents were always on top of his checkups. The Covid period was the time that Clark experienced a big growth spurt and at the latest checkup when his doctor checked his spine, she became alarmed and sent him for X-rays. The checkup was on Friday and the X-rays were done that same day. By Monday morning Clark’s mom’s phone was ringing off the hook but she could not answer right away since she was at work. The doctor had already made Clark an appointment at a specialist causing his mom to freak out with worry. What could possibly be such an emergency? Mom felt so guilty when she saw the X-rays and felt it was her fault since, she missed one checkup and Clark had complained about his back and she had not taken it seriously.

Of course, Clark’s mom was not to blame. COVID-19 basically closed off doctors to their patients except for emergencies and Clark’s back pain was not that intense for his mom to advise him to see his doctor. Most children could postpone a doctor checkup for half a year with little consequences, but the problem with boys’ scoliosis is that it is not expected like girls. Also, it is also slower to develop and in some instances is not that severe when caught. However, this unfortunately was not the case with Clark since by the time his curvature was caught, he was not a candidate for bracing since he was too old and almost finished growing.

Therefore, the only way to correct Clark’s scoliosis was with surgery, even though the surgeon that they consulted advised physical therapy for scoliosis and a return visit in four months. Clark took the PT seriously, but his back pain was getting worse, and he was finding it quite difficult to sit or stand for long periods. In only four months Clark’s curve had increased from 49-50 degrees to 54-55 degrees and the doctor advised surgery.

Clark’s surgery sounded complicated with not only the shaving of some of his vertebrae and putting in steel rods, but they used the ground up bone powder for bone grafting. When the rods were screwed to his vertebrae the vertebrae themselves were grafted together. All this fusing would get the back straighter but unfortunately Clark would lose mobility of his spine.

Clark’s operation was called a success, his back is straighter, the back pain gone, and he is now able to sit for long periods of time. Clark’s height also increased by an inch which was good since he was in the lower height percentile for his age before the surgery. The only disadvantage is the mobility of his back for bending and other activities. His surgery was mandatory only because his scoliosis was not caught fast enough and if it would have been caught earlier a brace would have helped him.

Case #2: Amada Hurley’s son, 15, Cobb Rating: N/A

Scoliosis has been in Amanda’s family for generations but like Clark’s mom, Amanda was in shock when the doctor informed her that her son suffered from scoliosis. At the conclusion of her son’s annual checkup the doctor called her into the room, “See that, ”asked the doctor, “your son’s ribs are slightly higher on the right side of his back than on the left.”

Amanda was terrified because as a child she experienced spinal fusion surgery that took over eight hours after bracing did not solve the scoliosis. Her surgery was like Clark’s with the rods, fusion, and bone grafting. Post-surgery found Amanda in the hospital for a week and flat on the couch for six more weeks! This was not going to happen to her son, no way. Amanda’s brace that she wore prior to surgery was extremely uncomfortable and she has terrible memories of wearing it and on top of that she still required extensive surgery.

Today’s braces are much more comfortable but the trauma of Amanda’s experience with bracing and surgery made her very determined that her son would suffer with neither. Medicine has come a long way in the thirty years since those horrid times and Amanda was determined to discover a more comfortable option for her teenage son. “If people can straighten their teeth with plastic instead of metal (Invisalign) then there should be some similar type of bracing for crooked spines”.

The Whisper is so new that only forty patients have tried it. It was invented at a startup company called Green Sun Medical which it describes on its website, “a revolution in bracing technology”. With this type of open frame brace, patients can touch their toes while wearing it and there’s less area to cause pinching a chafing of the skin. Since it is made of hoops and rings, air can circulate around them. Adjustments can be made regularly during follow-up visits and since the components are modular and can be changed as necessary.

Final Words

It is most important that boys just as girls be checked often for symptoms of scoliosis. Although boys mature at a slower rate than girls and begin puberty later, they still can develop severe scoliosis. Many times, boys’ symptoms go unnoticed or ignored because the incidence is much less in males than females. As we can learn from the above cases, the severity can be enough to warrant surgery when the scoliosis is not diagnosed early enough.

The mother in the second scenario was so traumatized by her own scoliosis thirty years before that she would not allow her son to be fitted with today’s braces. All she could think about was the anguish and suffering that she went through wearing a metal brace. We hope the new whisper brace does the trick for Amanda’s son, but she failed to check out the present types of scoliosis braces that are available today at respected scoliosis centers. So, yes, Allison, teen guys do get scoliosis.

Horses are unique animals and they each have their own personality. So too, the novice and experienced horseback riders and it is so vital that each horse is paired with the right rider so that both can complement each other and understand each other. To those who have no experience in equine therapy or equine sports, this may sound redundant as each animal in our universe has a specific personality. Yet, a horse has a uniqueness that cannot be duplicated with any other animal. Yes, dogs are loyal, and cats are cuddly, but horses offer the rider a special experience especially if they become friendly on a longtime basis with the horse.

Whatever the reason may be, for a preteen, teenager, or an adult the sport of horseback riding is unparalleled. The first-time rider may base their first experience with the unpleasant smell that follows the rider and his horse instead of looking ahead and enjoying the view and the building of trust with this animal. After a few rides you will be surprised at the satisfaction that you will recognize as you build a relationship with the horse of choice.

As you watch a typical rider, you will notice how straight their back is aligned as they trot slowly. As the horse speeds up the bumps and jumpy feeling begin to take hold and for most people this confirms that they are on their way to become a horseback rider. However, for some people with back issues such as scoliosis, horseback riding can be problematic. Scoliosis sufferers who love the sport will not want to give it up, yet they are looking for relief from the limitations that scoliosis can give to their enjoyment. Here are some examples of folks of different ages and different abnormalities all associated with some type of scoliosis and if they overcame their individual obstacles to stay in the saddle.

1) A twenty-three-year-old female horse trainer called a scoliosis therapy clinic asking if they could fit her with a special brace that she could use while riding her horse. This young woman complained that as she rode, and her speed increased her back leaned to one side giving her a lot of pain. In fact, not only did her back lean to one side but her whole body seemed to be off center.

For a horseback rider to wear a hard scoliosis brace would be quite challenging for the simple reason that the brace is supposed to support your back or whatever part of your body needs improvement and a rider must be flexible. There are some over the counter soft braces that are available for riders who have minor worries such as back pain and back support. This trainer was advised to first bring a copy of a recent x-ray to the scoliosis therapy clinic if it deems necessary, she will be given a prescription for a brace. It is possible that one of the braces that they will recommend could be worn while riding but her case will have to be assessed individually since each case is unique. At her age, she was advised that the brace could prevent the increase of her scoliosis, but it would doubtfully decrease her curve by many degrees. Therefore, it is imperative for parents to ask their pediatrician to check out their child’s back before puberty. Many long-haired girl’s backs are covered by their hair and the disability can be camouflaged. Most scoliosis braces are worn for most of the day between 18 and 23 hours. The period when the brace is removed could possibly be the time to ride, this all depends on the age and the condition of the patient.

2) Thirteen-year-old Lily Capone was diagnosed at birth with Marfan syndrome, a genetic disorder characterized by the child growing unusually tall along with other physical liabilities such as nearsightedness, heart valve and vessels abnormalities and chronic pain. Despite her limitations she has gone on to compete in the 3’6” horseback riding competition.

By the age of thirteen, Lily’s scoliosis had gotten much worse than it was earlier in her life. The S shape curve of her spine was so extreme that it was beginning to crush one of her lungs. Lilly was adamant that she did not want to stop riding, but it was explained to her that without surgery her rib cage and inevitably her internal organs would be affected.

A person with Marfan syndrome grows at such a fast rate that the spine cannot keep up with it. In addition, Lily was experiencing pain in the upper right side of her back with one of her ribs protruding. Although Lily continued riding, she was in such pain that as soon as she would get off the horse, she would demand Motrin.

Ultimately in a case such as Lily’s bracing was not the answer and in 2019 Lily had surgery with two titanium rods and thirty-eight screws and bolts attached to her back. She gained two unneeded inches and had to learn to ride without slouching her shoulders. The relaxed look of a typical rider was not in the cards for Lily, but she learned to compensate since she had such a love of riding. Two years later Lily experienced a setback and was back in the hospital for heart surgery because of her Marfan syndrome but after two weeks she was back in the saddle. With all her challenges and setbacks, Lily’s doctors support her riding schedule; in fact riding has even helped her foot problem of pigeon toes.

3) Horse racer, Rosie Twickenham has scoliosis which afflicted her with so much pain and discomfort that it threatened to take her out of the saddle permanently. Horse racing places much pressure on the rider’s lower spine due to the fact that a jockey must lean forward, and the high speed picks up the jockey swiftly and places her right back in the saddle repeatedly during the race. Rosie was advised by a physical therapist when evaluated that it was imperative for her to undergo massive physical therapy if she wanted to continue jockeying. Her therapist was very much in favor of her continuing her passion despite her scoliosis, explaining to Rosie that it was essential to maintain a strong core through proper exercise. She was also advised to pay very close attention to the position of her hips so that the weight is distributed evenly across her pelvis during riding.

Many scoliosis patients suffer from having one hip higher than the other and sometimes blame the horse for going towards one side until the correct diagnosis is made. Exercises that strengthen the muscles around the spine are quite beneficial for a rider, especially one who races. Although Rosie found the treatments extremely strenuous in the end, she was able to compete in the race of her dreams.

Practical Advice For Riders

The advice for horseback riders who have scoliosis and other spinal issues is not to give up on their dream but instead pay attention to balance training. When a rider is aware of exactly how their limbs are directed and becomes aware of exactly what their body’s position is in the saddle, the probability of serious injuries will lessen. When the entire body works in union, the knees, ankles, shoulders and hips the reaction time of foreseeing any obstacles increases and so the likelihood of harm decreases.

Final Words

Horseback riding has many different purposes for an equestrian enthusiast. Riding is fun and some health professionals recommend it for promoting good posture and this holds true for recreational riding. Horseback riding has been proven to be therapeutic for teens who have suffered trauma such as abuse, drug addiction and physical injury. Horses have a unique nature of relating to people especially if that person has a similar personality. A smart instructor or therapist will know how to pair each person with the right horse. Horse racing puts additional pain on the jockey because of the position that he or she postures while increasing speed during racing. A recreational rider can maintain a slower stance and keep their back straight, but a jockey must bend to increase speed.

A horse can sense when a rider is not straight in the saddle and tilting to one side. This can confuse the horse and make him go the wrong way. Horses are highly sensitive and are responsive to even the smallest shifts in a rider’s balance. For instance, a rider who unconsciously twists to one side, weighting one side more than the other, can cause her horse to tilt its head or to gallop unevenly in a straight line. The rider who depends too much on the inside rein for equilibrium may feel his or her horse becoming stiff. Many times, the rider will give preference to the horse’s wellbeing which holds back the success of a rider in both their progression as a rider and their physical health. Sports are an essential part of an adolescent’s life. With the right physical therapy and/or bracing they should be able to continue their favorite sport, in this case horseback riding.

There are experts who recognize that professions such as gymnastics and dancing can exacerbate idiopathic scoliosis. These wonderful athletic abilities are passions of young girls who upon reaching ages close to puberty are diagnosed with scoliosis. Should this medical condition stop these young girls from pursuing their dreams?

Imagine when a young girl is at a routine checkup with her doctor, and she finds out that she has scoliosis. By asking the simple question, “roll down and touch your toes’ ‘, a girl’s life can be altered forever. Don’t panic! This diagnosis does not have to be the shattering of a dream of a young girl with her heart set on being a dancer.

Would a professional baseball star stop playing because his orthopedist tells him that if he keeps playing his injuries will worsen? Does a boxer leave the ring when he gets hurt? Although dancing might indeed take its toll on a young girl’s body, no one can ask her to give up her desire.

Normally, the spine, the ribs and the pelvis will look mostly level and balanced with one another, however, if a dancer has scoliosis, he or she may have one shoulder higher than the other or look tilted to one side. Each case of scoliosis is unique and each one presents its own challenge. Let’s look at two passionate dancers and how they dealt with their scoliosis diagnosis at such critical times in their budding dancing careers.

“Bent But Not Broken”

The phrase above is the clarion call of a wonderful and talented dancer who was diagnosed with idiopathic scoliosis at age thirteen just as she started her high school journey. Paige Fraser learned that she suffered from scoliosis at a routine checkup when the doctor asked her to bend down so he could examine her back. He immediately sent her for an X-ray which confirmed his unfortunate diagnosis. He showed Paige the x-ray and explained to her that her spine was curved like an S. She left the doctor’s office scared, frustrated and angry since she had no prior warning, no symptoms, and no discomfort.

Paige’s mom saw her talent and when she was ten years old her mom enrolled her in a ballet school. At that time, this Bronx, New York native simply enjoyed dancing but as she excelled at her practice and lessons she realized this is something that she would like to dedicate her future to. Her mom enrolled her in the Performing Arts High School in New York City and Paige began to take her dancing seriously.

In ninth grade Paige was diagnosed with scoliosis and was forced to learn exactly how her body functioned under pressure, specifically her spine. The first specialist she went to, informed her that she needed spinal surgery. He also let her know in no uncertain terms that she would have metal rods inserted into her back and she would no longer be able to bend normally. This did not jive with her dancing talent because dancers have specific movements, and the rods would limit those actions. However, Paige’s parents would not accept this diagnosis sitting down and they asked around for other options. They were recommended to a chiropractor who fitted Paige with two braces, one for day and one for sleeping.

Paige has been dancing since she began to walk. One of her teachers noticed her talent and cast her as Clara in The Nutcracker when she was ten years old. In fact, her teacher in the school dance department suffered with severe scoliosis herself and since she herself had a severe curvature she was very helpful to Paige as she was getting used to her scoliosis diagnosis.

Scoliosis did limit the amount of turns that Paige could do at one time. It was not scientifically possible for her to do more than two or the most three turns. Paige had to work much harder than a normal dancer to achieve positions that her peers took for granted.

There was no stopping Paige no matter how difficult it was for her to dance while bracing and therapy. After completing high school, Paige was accepted at the Ailey School of Dance in addition to her attendance at Fordham University. After being accepted at the Ailey dance tour company she toured worldwide while dancing up a storm professionally.

Paige attained great success in professional dancing in spite of being treated for scoliosis. She was accepted full time at the Visceral Dance Center of Chicago, won the Princess Grace Dance Award in 2017 and ultimately won a role in the touring company of the Broadway hit, The Lion King after failing more than five auditions in previous years.

During a Zoom interview, Paige admits that her scoliosis is a challenge in her dancing career. The moves that a dancer with scoliosis must perform are often anti-scoliosis moves. For example, dancers must, “square off the hips” and ribcage and this is difficult for someone with her condition.

As a youngster Paige was trained in ballet dancing. As she got older her career branched out to Broadway and even Jazz. With Jazz, the dancer must roll up and roll down very quickly. She was quite concerned that she did not have the same mobility as the other dancers. There are some scoliosis sufferers who have one leg shorter than the other and it is difficult to get the feet to align properly. Because of her scoliosis, Paige is very sensitive to other dancers with various disabilities, whether physical or mentally challenged and she started a dance school in 2017 which is a virtual school that is free.

Leah Roddenberry

When Leah was in eighth grade her mom noticed that her right shoulder blade was strangely sticking out. This was right before Leah was scheduled to go to dance class and she was dressed in her leotard which showed every curve clearly and precisely. It was peculiar since Leah had already been evaluated for scoliosis in sixth grade and no problem was detected. She was told after an x-ray that she had a slight 20-degree curvature. Her doctor, Dr. Neustadt, a scoliosis specialist at All Children’s Hospital in St. Pete, recommended that she be fitted with a hard brace to wear to sleep. Even though the brace was uncomfortable Leah was determined and wore it every night. However, this therapy did not solve her scoliosis and not only was it getting worse, but she began having pain in her back. A noticeable hump was appearing on the right side of her back and since this therapy was not helping her doctor prescribed spinal fusion surgery.

When Leah asked her doctor if she would be able to dance after surgery, he could not give an affirmative answer. Imagine Leah’s concerns which she articulated to her doctor. Leah has been dancing since she was three years old, and her passion has only increased. The doctor theorized that Leah would need rods in her back and that would mean losing the flexibility of bending at will. Leah was so shattered and at that moment she truly believed that her dancing career was over.

G-d fortunately had different plans. After the surgery Dr Neustadt came to tell Leah the good news. Since her spine was very flexible, he did not have to fuse the entire spine. It took many months of practice, blood, sweat and tears and Leah went on to become Miss Florida in 2021 and competed in the Miss America Pageant. She performed a most difficult jazz dance in the competition with this song playing as she danced, “Don’t Stop Me Now”

How Do Dancers Such as Paige Overcome Such Great Obstacles?

As one of our dancers said, there are always obstacles in life to overcome. Sometimes they are obstacles that are outwardly noticeable and sometimes they are obstacles of the heart and soul. We don’t choose our obstacles, but we choose how to handle them. As a famous person noted, ‘Be a victim or be a victor”. That choice is in the realm of your reality.

All the dancers shared that strength of their family and acknowledging their scoliosis publicly were important catalysts in their successes. Leah remarked, “I started embracing my scar and surgery not as a weakness, but as my strength. I was motivated to push past my roadblock and pursue my passion for dance.”

Paige believed from the time of her diagnosis that it was crucial for her to tell people about her struggle,” I couldn’t be quiet if I wanted to be a dancer.” She also had to put aside any negative thoughts and only think about success. Through physical therapy Paige was able to stabilize her spine and has only occasional stiffness. Every dancer has pain so why should Paige and other dancers with scoliosis stop? These feminine heroes are role models for their younger contemporaries who are sometimes discouraged from following a dream if it becomes difficult. You may be a writer with writer’s block, a nurse with difficult patients, a worker with a tough boss, each challenge is unique.

Whoever you are and whatever roadblocks you are facing you can be successful if you have family who believe in you, you believe in yourself and your right to see your passion through. Also remember that it is so important to talk your problems over with someone who can commensurate with you. Paige was fortunate that when she was faced with adversity, she had a dance teacher who was also experiencing scoliosis. It might not be so easy to find the right person to confide in but keep trying and you will win.