Objective: The patients are frequently referred to swimming for conservative follow-up and treatment of scoliosis. However, there are also studies reporting high scoliosis prevalence in swimmers. The aim of this study is to define the scoliosis incidence in adolescent swimmers and evaluate the effect of swimming on radiological parameters in swimmers with scoliosis. Material and Methods: The medical reports of the swimmers who have applied to sports medicine outpatient clinic in our institution for license renewal were retrospectively reviewed. The swimmers with positive Adam’s forward bending tests determined during physical examination were subjected to radiological evaluation and the whole spine was evaluated with anteroposterior and lateral orthoroentgenograms. The swimmers were demanded to continue swimming and called for follow up 1 year later. The swimmers with scoliosis who continued swimming and applied for follow-up one year later were evaluated radiologically. Results: Six hundred and seventy-nine swimmers were examined. Twenty eight (4.1%) swimmers, [11 male (39%), 17 female (61%); mean age 12.6 (min 10, max 17) years] with positive Adam’s bending test were further evaluated radiologically. These swimmers were called for follow up 1 year later. Seventeen swimmers who continued swimming and applied for follow up were evaluated radiologically. Sagittal and coronal plan parameters of the spine were measured on the first and the second radiographs. These parameters were compared statistically. There was no statistically significant difference among proximal thoracic, main thoracic, main lumbar curves and thoracic kyphosis and lumbar lordosis degrees on the first and the follow-up radiographs of the athletes who continued swimming. Conclusions: Swimming was found to have no effect on spinal sagittal plane parameters in swimmers with scoliosis. Moreover we found that it has not provided any improvement or stability also in the coronal plane deformity after 1 year follow up. According to our results, it may be concluded that swimming is not effective in the conservative treatment of scoliosis.
Amaç: Yüzme skolyozun konservatif takip ve tedavisinde hastaların sıklıkla yönlendirildiği bir spor dalıdır. Bununla birlikte yüzücülerde de skolyoz prevelansını yüksek bildiren çalışmalar mevcuttur. Bu çalışmada yüzücülerde adolesan idiyopatik skolyoz prevalansının saptanması, bu yüzücülerin takip edilerek radyolojik sonuçlarının değerlendirilmesi amaçlanmıştır. Gereç ve Yöntemler: Hastanemiz spor hekimliği polikliniğine lisans yenileme nedeniyle başvuran yüzücülerin verileri geriye dönük olarak tarandı. Fizik muayenede Adam’s öne eğilme testi pozitif olarak saptanan hastalar radyolojik değerlendirmeye tabi tutuldu ve tüm omurga 2 yönlü ortoröntgenogram grafikleri ile değerlendirildi. Skolyoz tespit edilen sporcuların yüzme sporuna devam etmesi istenerek bir yıl sonra kontrole çağrıldı ve radyolojik olarak tekrar değerlendirildi. Bulgular: Altı yüz yetmiş dokuz sporcunun verilerine ulaşıldı. Adam’s öne eğilme testi pozitif tespit edilen 28 (%0.4) hastanın [(11 erkek (%39), 17 kadın (%61); ortalama yaş 12.6 (minimum 10, maximum 17) yıl] tüm omurga 2 yönlü grafikleri değerlendirildi. Bu sporcuların yüzmeye devam etmesi istenerek 1 yıl sonra kontrole çağrıldı. Yüzmeye devam eden ve takipten çıkmayan 17 sporcu radyolojik olarak değerlendirildi. İlk ve takip radyografilerinde omurga sagittal ve koronal plan parametreleri ölçüldü. Bu parametreler istatiksel olarak karşılaştırıldı. İlk çekilen grafiklerinde ölçülen proksimal torasik, ana torasik eğrilik, ana lomber eğrilik ve torasik kifoz dereceleri ile bu parametrelerin takip grafiklerindeki dereceleri arasında istatistiksel olarak anlamlı artış tespit edildi (p
1. Weinstein SL, Dolan LA, Cheng JC, et al. Adolescent idiopathic scoliosis. Lancet. 2008;371:1527–37.
2. Wang WJ, Yeung HY, Chu WC, et al. Top theories for the etiopathogenesis of adolescent idiopathic scoliosis. J Pediatr Orthop. 2011;31 (1):14–27.
3. Omey ML, Micheli LJ, Gerbino 2nd PG. Idiopathic scoliosis and spondylolysis in the female athlete. Tips for treatment. Clin Orthop Relat Res. 2000(372):74-84.
4. Wood KB. Spinal deformity in the adolescent athlete. Clin Sports Med. 2002;21(1):77-92.
5. Baker RJ, Patel D. Lower back pain in the athlete: common conditions and treatment. Prim Care. 2005;32(1):201-29.
6. Sward L. The thoracolumbar spine in young elite athletes. Current concepts on the effects of physical training. Sports Med. 1992;13(5):357-64.
7. Hellstrom M, Jacobsson B, Sward L, et al. Radiologic abnormalities of the thoraco-lumbar spine in athletes. Acta Radiol. 1990;31(2):127-32.
8. Tanchev PI, Dzherov AD, Parushev AD, et al. Scoliosis in rhythmic gymnasts. Spine. 2000; 25(11):1367-72.
9. Konieczny MR, Senyurt H, Krauspe R. Epidemiology of adolescent idiopathic scoliosis. J Child Orthop. 2013; 7(1):3-9.
10. Akçalı Ö. Adölesan İdiopatik Skolyoz. Türk Omurga Derneği Yayınları. 2017; 10: 187.
11. Liljenqvist U, Witt KA, Bullmann V, et al. Recommendations on sport activities for patients with idiopathic scoliosis. Sportverletz Sportschaden. 2006;20(1):36-42
12. Ueno M, Takaso M, Nakazawa T, et al. A 5-year epidemiological study on the prevalence rate of idiopathic scoliosis in Tokyo: school screening of more than 250,000 children. J Orthop Sci. 2011;16(1):1-6.
13. Listernick R. A 14-year-old girl with leg length discrepancy. Pediatr Ann. 2012; 41(4):138-41.
14. Suh SW, Modi HN, Yang JH, et al. Idiopathic scoliosis in Korean schoolchildren: a prospective screening study of over 1 million children. Eur Spine J. 2011; 20(7):1087-94.
15. Maffulli N, Longo UG, Spiezia F, et al. Aetiology and prevention of injuries in elite young athletes. Med Sport Sci. 2011; 56:187-200.
16. Schmid AB, Dyer L, Boni T, et al. Paraspinal muscle activity during symmetrical and asymmetrical weight training in idiopathic scoliosis. J Sport Rehabil. 2010; 19(3):315-27.
17. Kenanidis EI, Potoupnis ME, Papavasiliou KA, et al. Adolescent idiopathic scoliosis in athletes: is there a connection? Phys Sportsmed. 2010;38(2):165-70.
18. Romano M, Minozzi S, Zaina F, et al. Exercises for adolescent idiopathic scoliosis: a Cochrane systematic review. Spine (Phila Pa 1976). 2013;38(14):883-93.
19. Mroczkowski A, Jaskolski E. Effects of aikido exercises on lateral spine curvatures in children. Archives of Budo. 2006;2(4): 31–34.
20. MuntanerMas A, Palou P, Ortega FB, et al. Sports participation and low back pain in schoolchildren. J Back Musculoskelet Rehabil. 2018;31(5):811-819.
21. McMaster M, Lee AJ, Burwell RG. Physical activities of patients with adolescent idiopathic scoliosis (AIS) compared with a control group: implications for etiology and possible prevention. J Bone Joint Surg (Br). 2006; 88(2):225.
22. Becker TJ. Scoliosis in swimmers. Clin Sports Med. 1986;5(1):149–158.
23. Warren MP, Brooks-Gunn J, Hamilton LH, et al. Scoliosis and fractures in young ballet dancers. N EngJ Med. 1986;314:1348-53.
24. Cilli K, Tezeren G, Taş T, et al.School screening for scoliosis in Sivas, Turkey. Acta Orthop Traumatol Turc. 2009; 43(5):426-30.
25. Negrini S, Donzelli S, Gabriele A ,et al.2016 SOSORT guidelines: orthopedic and rehabilitation treatment of idiopathic scoliosis during growth. Scoliosis and Spinal Disorders. 2018; 13:3.
26. Burwell RG, Aujla RK, Grevitt MP, et al.Pathogenesis of adolescent idiopathic scoliosis in girls - a double neuro-osseous theory involving disharmony between two nervous systems, somatic and autonomic expressed in the spine and trunk: possible dependency on sympathetic nervous system and hormones with implications for medical therapy. Scoliosis. 2009; 4:24.
27. Jandric SD. Scoliosis and Sport. Sport Logia. 2015, 11(1), 1–10.
28. Damsgaard R, Bencke J, Matthiesen G, Petersen JH, Müller J. Body proportions, body composition and pubertal development of children in competitive sports. Scand J Med Sci Sports 2001;11:54-60.
29. Bielec G, PeczakGraczyk A, Waade B. Do swimming exercises induce anthropometric changes in adolescents? Issues Compr Pediatr Nurs. 2013;36(1-2), 37– 47.
30. Pizzutillo PD. Spinal considerations in the young athlete. Instr Course Lect. 1993;42:463–472.
31. Zaina F, Donzelli S, Lusini M, et al. Swimming and spinal deformities: a cross-sectional study. J Pediatr. 2015; 166:163-7.