The Impact of Competitive Asymmetric Sports on the Development of Idiopathic Scoliosis in Young Athletes: A Literature Review
DOI:
https://doi.org/10.12775/QS.2025.48.67058Keywords
adolescent idiopathic scoliosis, adolescents, asymmetric sports, scoliosis progression, ballet, Gymnastics, volleyball, basketball, tennis, footballAbstract
This review examines how participation in competitive asymmetric sports influences the development and progression of adolescent idiopathic scoliosis (AIS). Studies show that sports involving repetitive unilateral movements, such as gymnastics, ballet, tennis, volleyball, basketball, and football are associated with higher AIS prevalence and increased muscle and postural asymmetries. The highest rates, reaching 30–35%, occur in ballet dancers and gymnasts. Factors such as early training initiation, high training intensity, hypermobility, low skeletal maturity, and rapid growth further elevate risk. While asymmetric sports may promote curve progression, regular recreational physical activity demonstrates a protective effect, reducing both progression and the need for bracing. The review emphasizes the importance of monitoring posture, adjusting training loads, and implementing compensatory exercises in young athletes engaged in asymmetric disciplines.
References
[1] Zale CL, McIntosh AL. Adolescent Idiopathic Scoliosis for Pediatric Providers. Pediatr Ann. 2022 Sep;51(9):e364-e369. doi: 10.3928/19382359-20220724-01.
[2] Negrini A, Donzelli S, Vanossi M, Poggio M, Cordani C, Zaina F, Negrini S. Sports participation reduces the progression of idiopathic scoliosis and the need for bracing. An observational study of 511 adolescents with Risser 0-2 maturation stage. Eur J Phys Rehabil Med. 2023 Apr;59(2):222-227. doi: 10.23736/S1973-9087.23.07489-0.
[3] Mousavi L, Seidi F, Minoonejad H, Nikouei F. Prevalence of idiopathic scoliosis in athletes: a systematic review and meta-analysis. BMJ Open Sport Exerc Med. 2022 Aug 5;8(3):e001312. doi: 10.1136/bmjsem-2022-001312.
[4] Kenanidis E, Potoupnis ME, Papavasiliou KA, Sayegh FE, Kapetanos GA. Adolescent idiopathic scoliosis and exercising: is there truly a liaison? Spine (Phila Pa 1976). 2008 Sep 15;33(20):2160-5. doi: 10.1097/BRS.0b013e31817d6db3.
[5] Lambert B, Haghshenas V, Bondar K, Hirase T, Aflatooni J, Harris J, McCulloch P, Saifi C. Increased Prevalence of Scoliosis in Female Professional Ballet Performers. J Bone Joint Surg Am. 2025 Jun 4;107(11):1227-1234. doi: 10.2106/JBJS.24.00670.
[6] Komang-Agung IS, Dwi-Purnomo SB, Susilowati A. Prevalence Rate of Adolescent Idiopathic Scoliosis: Results of School-based Screening in Surabaya, Indonesia. Malays Orthop J. 2017 Nov;11(3):17-22. doi: 10.5704/MOJ.1711.011.
[7] Modi H, Srinivasalu S, Smehta S, Yang JH, Song HR, Suh SW. Muscle imbalance in volleyball players initiates scoliosis in immature spines: a screening analysis. Asian Spine J. 2008 Jun;2(1):38-43. doi: 10.4184/asj.2008.2.1.38.
[8] Burckhardt P, Wynn E, Krieg MA, Bagutti C, Faouzi M. The effects of nutrition, puberty and dancing on bone density in adolescent ballet dancers. J Dance Med Sci. 2011 Jun;15(2):51-60. PMID: 21703093.
[9] Newman M, Hannink E, Barker KL. Associations Between Physical Activity and Adolescent Idiopathic Scoliosis: A Systematic Review and Meta-analysis. Arch Phys Med Rehabil. 2023 Aug;104(8):1314-1330. doi: 10.1016/j.apmr.2023.01.01.
[10] Theodorou E, Grivas TB, Hadjicharalambous M. The Influence of the Dominant Leg in Body Asymmetries in Children and Adolescent Male Soccer Players. Pediatr Rep. 2024 Aug 8;16(3):684-695. doi: 10.3390/pediatric16030058.
[11] Heshmati S, Ghahraman Tabrizi K, Daneshjoo A, Hosseini E, Bahiraei S, Sahebozamani M, Konrad A, Behm DG. Effects of Asymmetric and Symmetric Sport Load on Upper and Lower Extremity Strength and Balance: A Comparison Between the Dominant and Non-Dominant Side in Adolescent Female Athletes. Sports (Basel). 2025 Mar 14;13(3):89. doi: 10.3390/sports13030089.
[12] García-García O, Molina-Cárdenas Á, Álvarez-Yates T, Iglesias-Caamaño M, Serrano-Gómez V. Individualized Analysis of Lateral Asymmetry Using Hip-Knee Angular Measures in Soccer Players: A New Methodological Perspective of Assessment for Lower Limb Asymmetry. Int J Environ Res Public Health. 2022 Apr 13;19(8):4672. doi: 10.3390/ijerph19084672.
[13] Hadzic V, Sattler T, Veselko M, Markovic G, Dervisevic E. Strength asymmetry of the shoulders in elite volleyball players. J Athl Train. 2014 May-Jun;49(3):338-44. doi: 10.4085/1062-6050-49.2.05.
[14] Grabara M. Comparison of posture among adolescent male volleyball players and non-athletes. Biol Sport. 2015 Mar;32(1):79-85. doi: 10.5604/20831862.1127286.
[15] Modi H, Srinivasalu S, Smehta S, Yang JH, Song HR, Suh SW. Muscle imbalance in volleyball players initiates scoliosis in immature spines: a screening analysis. Asian Spine J. 2008 Jun;2(1):38-43. doi: 10.4184/asj.2008.2.1.38.
[16] de Carvalho Borges SC, Mendonça CR, Ferreira Silva RM, De Vitta A, Noll M. Prevalence and Risk Factors of Musculoskeletal Disorders in Basketball Players: Systematic Review and Meta-Analysis. Healthcare (Basel). 2023 Apr 21;11(8):1190. doi: 10.3390/healthcare11081190.
[17] Dimeglio A, Canavese F. The immature spine: growth and idiopathic scoliosis. Ann Transl Med. 2020 Jan;8(2):22. doi: 10.21037/atm.2019.11.134.
[18] Garret J, Cuinet T; ReSurg; Guillard V, Montalvan B. Shoulder range of motion in competitive tennis players: systematic review and meta-analysis. JSES Int. 2024 Feb 22;8(3):551-569. doi: 10.1016/j.jseint.2024.01.017.
[19] Rogowski I, Ducher G, Brosseau O, Hautier C. Asymmetry in volume between dominant and nondominant upper limbs in young tennis players. Pediatr Exerc Sci. 2008 Aug;20(3):263-72. doi: 10.1123/pes.20.3.263.
[20] Johansson F, Gabbett T, Svedmark P, Skillgate E. External Training Load and the Association With Back Pain in Competitive Adolescent Tennis Players: Results From the SMASH Cohort Study. Sports Health. 2022 Jan-Feb;14(1):111-118. doi: 10.1177/19417381211051636.
[21] Meyer C, Cammarata E, Haumont T, Deviterne D, Gauchard GC, Leheup B, Lascombes P, Perrin PP. Why do idiopathic scoliosis patients participate more in gymnastics? Scand J Med Sci Sports. 2006 Aug;16(4):231-6. doi: 10.1111/j.1600-0838.2005.00482.x.
[22] Trexler ET, Smith-Ryan AE, Roelofs EJ, Hirsch KR. Body Composition, Muscle Quality and Scoliosis in Female Collegiate Gymnasts: A Pilot Study. Int J Sports Med. 2015 Nov;36(13):1087-92. doi: 10.1055/s-0035-1555781.
[23] Ylikoski M. Growth and progression of adolescent idiopathic scoliosis in girls. J Pediatr Orthop B. 2005 Sep;14(5):320-4. doi: 10.1097/01202412-200509000-00002.
[24] Coplan JA. Ballet dancer's turnout and its relationship to self-reported injury. J Orthop Sports Phys Ther. 2002 Nov;32(11):579-84. doi: 10.2519/jospt.2002.32.11.579
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2025 Paulina Jakubowska, Mikołaj Szaryński, Martyna Jakubowska, Kamila Prokopczyk, Antoni Wasilczuk, Michał Józef Peszt, Julia Matuszewska, Martyna Poręba, Kacper Poręba, Rafał Rusiłowicz, Aleksandra Lewandowska-Mackiewicz

This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
Stats
Number of views and downloads: 8
Number of citations: 0