If you have scoliosis, you probably know the feeling of one side of your back being tighter than the other. Maybe it’s always the same spot around your ribs, your waist or your lower back. And when something feels tight, the obvious thing to do is stretch it, right?
I get asked this a lot: “Which side should I stretch?”
Unfortunately, with scoliosis, the answer isn't quite as simple as stretching the side that feels tight and strengthening the side that feels weak.
In fact, a muscle that feels tight isn't necessarily a muscle that is short. And sometimes, continually stretching that tight area isn't what your body needs at all.
So let's look at what might actually be going on.
Why do muscles feel tight with scoliosis?
First of all, muscle imbalances aren't unique to scoliosis. We all have them.
We carry our bags on one side, cross the same leg, sit in our favourite position and generally use our bodies slightly differently from one side to the other.
With scoliosis, we have another layer to consider because the spine itself has a different shape.
You may have heard of the concave and convex sides of a scoliosis curve. The concave side is the inside of the curve and the convex side is the outside.
Traditionally, you might hear something along the lines of:
Concave = short and tight, so stretch it.
Convex = long and weak, so strengthen it.
But then you might hear exactly the opposite:
Concave = weak, so strengthen it.
Convex = strong and tight, so stretch it.
So which one is it?
It may seem logical that we should work with the two sides differently — and sometimes that can be helpful.
Research does show differences in the muscles on the concave and convex sides, but that still doesn't give us a simple rule about which side every person should stretch or strengthen.
Unfortunately, our bodies aren't quite that simple.
A tight muscle isn't necessarily a short muscle
This is probably the most important thing I want you to take away from this article.
Feeling tight does not necessarily mean that a muscle is physically shortened and needs to be stretched.
A muscle can feel tight because it has been working hard. It might be helping to stabilise an area, responding to the position of your spine and ribcage, or simply doing more than you realise throughout the day.
Think about how your shoulders might feel after carrying a heavy bag for a long time. They can feel incredibly tight afterwards. That doesn't necessarily mean those muscles need to be made longer. They may simply be tired and overworked.
Something similar can happen around a scoliosis curve.
This is one reason why you may stretch a particular area, feel lovely afterwards... and then find that the tightness comes straight back again.
The stretching may have temporarily changed the sensation without addressing why that area was feeling tight in the first place.
Scoliosis is three-dimensional
Another reason we can't simply decide what to stretch or strengthen based on the concave and convex sides is because scoliosis isn't just a sideways curve.
There is also rotation.
Your vertebrae rotate, which affects the position of your ribcage and the muscles around it. Your pelvis may also be involved, and your body adapts in three dimensions.
So when we look at you from behind and say that one side looks longer and the other shorter, we're only seeing part of the picture.
What's happening at the front of your body?
What's happening around your ribs?
How is your pelvis positioned?
And how are you actually using those muscles when you move?
This is why I am very cautious about giving people simple rules based purely on which side of their scoliosis curve is convex or concave.
Should you stretch or strengthen tight muscles with scoliosis?
My answer is usually: probably some of both.
Stretching isn't bad for scoliosis. I use stretching and mobility work in my own practice and with my students all the time.
But stretching and mobility aren't exactly the same thing.
You can move an area through its comfortable range without holding it in a long, passive stretch. Sometimes that kind of active movement is much more useful than trying to force more flexibility.
I don't think the answer to every tight muscle is to keep stretching it.
Sometimes that tight area might benefit from gentle movement or a supported stretch. Sometimes it might need strengthening. And quite often we want to work on both mobility and strength.
The important thing is to notice what actually happens afterwards.
If you stretch an area and it feels better for five minutes but then tightens up again, that's useful information.
Rather than thinking, “I obviously need to stretch more,” you could ask:
Does this area actually need more support?
Start with gentle movement
If you're having one of those days when your back feels particularly tight or uncomfortable, I often wouldn't start with a big stretch.
Try moving first.
Gentle pelvic movements, moving your spine within a comfortable range, breathing into your ribcage or using a supported restorative position may be enough to help some of that tension settle.
You don't need to force your body into a bigger range of movement to make a difference.
Sometimes simply moving an area gently and giving it a little attention can change how it feels.
Then add strength
This is the part that often gets missed.
If we want our bodies to cope well with everyday life, we need strength.
That doesn't just mean strengthening your “weak side”. We want the muscles around your spine, pelvis, hips and shoulders to be able to support you and work together.
And we want strength through different ranges of movement.
Pilates can be really useful here because we can slow things down and pay attention to how we're moving. Traditional strength training can be incredibly valuable too.
The goal isn't to make both sides of your body perfectly symmetrical.
With scoliosis, that's probably not a very useful goal anyway.
We're trying to create a body that is strong, mobile and able to adapt.
What about passive stretching?
There is nothing inherently wrong with passive stretching.
It can feel lovely. I enjoy it too!
And regular stretching can improve flexibility and range of movement.
But if most of your practice consists of trying to stretch away every bit of tightness, I'd encourage you to look at how much strengthening you're doing as well.
This is particularly important if you're naturally very flexible or hypermobile. If you already have plenty of range of movement, creating even more range may not be what you need. Building strength and control within the range you already have may be much more useful.
Again, this doesn't mean never stretch.
It means we need to stop assuming that tightness automatically means you need more flexibility.
What if one side keeps feeling tight?
This is where I want you to become a little bit curious about your own body.
Rather than immediately trying to get rid of the sensation, notice when it happens.
Is it worse after sitting?
Does it appear after you've been walking for a long time?
Does it change after strengthening?
Does gentle movement help?
Does stretching help for an hour, or only for a few minutes?
Is it actually painful, or does it simply feel different from the other side?
These little observations can tell you much more than a general rule about what someone with your particular curve “should” stretch.
And remember that you are not only your scoliosis.
Age, strength, previous injuries, joint mobility, osteoporosis, arthritis, hypermobility and many other things can affect what your body needs.
Should I stretch the concave side of my scoliosis?
Not necessarily.
There may be situations where creating more space or mobility on the concave side feels helpful, but I wouldn't use “concave = stretch” as a rule.
The same applies to strengthening the convex side.
How you work with the two sides depends on your individual curve, your movement, your strength and what else is going on in your body.
Is stretching bad for scoliosis?
No.
Stretching can absolutely be part of a healthy movement practice when you have scoliosis.
The problem is not stretching itself. It's assuming that every area that feels tight needs to be stretched — or that stretching alone will solve the problem.
Why does my back feel tight again after stretching?
There can be lots of reasons.
If an area is working particularly hard to support you, stretching may temporarily make it feel more comfortable without changing the reason it was getting tired in the first place.
That's why combining mobility with strength and regular movement is often more helpful than continually chasing the feeling of tightness.
Stretch or strengthen? Don't get too caught up in choosing one
I know it would be much easier if I could give you a list:
Stretch this side.
Strengthen that side.
Problem solved.
But that's not really how scoliosis works.
Your body is three-dimensional, your curve is individual and the sensation of tightness doesn't tell us everything about what a muscle needs.
So rather than constantly asking, “Which side should I stretch?”, start paying attention to how your body responds to different types of movement.
Use stretching when it feels helpful.
Keep moving.
And don't forget about strength.
Over time, the goal isn't to create a perfectly symmetrical body. It's to build a body that feels supported, stays mobile and is strong enough for the things you want to do.
Want some guidance with your scoliosis practice?
Inside SHINE, my online yoga and Pilates membership for people with scoliosis, we combine mobility, strength, breathing and relaxation rather than focusing on one “correct” way to exercise with scoliosis.
The aim is to help you understand your own body and build a regular practice that supports you over the long term.
Further Reading and Research
If you would like to explore some of the research behind this topic, here are a few useful studies:
Paraspinal muscle characteristics in adolescent idiopathic scoliosis – systematic review (2023)
This review looks at differences in the muscles on the concave and convex sides of scoliosis curves, including muscle activity, volume and composition. The authors found differences between the two sides, but the quality of the evidence was generally low to very low. It's also important to remember that this research focuses on adolescents with idiopathic scoliosis, so we can't necessarily apply the findings directly to adults with scoliosis.
Link: https://www.thespinejournalonline.com/article/S1529-9430%2823%2903502-7/fulltext
Long-term static stretching and muscle stiffness – systematic review and meta-analysis (2023)
This review found that regular static stretching over several weeks can reduce muscle stiffness. This is a useful reminder that stretching itself isn't the problem — the question is whether stretching is what a particular area of your body actually needs.
Link: https://pubmed.ncbi.nlm.nih.gov/37231582/
Muscle architecture adaptations to static stretching – systematic review and meta-analysis (2023)
This research looks at what actually happens to muscles with regular static stretching. It found small increases in muscle fascicle length, with greater changes seen when higher stretching volumes and intensities were used. The studies were carried out in healthy participants rather than people with scoliosis, so the findings shouldn't be applied directly to scoliosis.
Link: https://pubmed.ncbi.nlm.nih.gov/37318696/
A note about the research
Much of the research into muscle asymmetry and exercise in scoliosis has been carried out in adolescents with idiopathic scoliosis. There is still much less research specifically looking at adults with longstanding scoliosis, so simple rules about which muscles adults with scoliosis should stretch or strengthen should be treated with caution.
