Also called: Scheuermann disease; Scheuermann kyphosis; juvenile kyphosis
Exercise strongly helps
Strength
Stretch
A rounded upper back in a teenager that does not straighten when they are told to sit up. Several thoracic vertebrae have wedged during the growth spurt, so the curve is built into the bone - and that test is what separates it from ordinary slouching.
How common: 0.4-8% of adolescents; the most common structural kyphosis in that age group, typically appearing at 10-12 and 2-7 times more often in boys
What it is
Scheuermann's disease is wedging of the front of three or more consecutive thoracic vertebrae during adolescent growth, producing a rigid, structural kyphosis. It is not a posture problem and it does not respond to being told to stand up straight.
That single test - does the curve correct when the teenager actively straightens or lies over a support - is what distinguishes it from postural slouching. A postural curve corrects; a Scheuermann curve does not. It matters, because postural kyphosis responds well to strengthening while this needs monitoring and sometimes bracing during growth.
What it feels like
- A pronounced, rigid rounding of the upper back in a teenager
- Not correctable when asked to stand up straight
- Aching between the shoulder blades, particularly after standing or sitting for long periods
- Tight hamstrings, which are characteristically short in this condition
- Often more concerning to parents than to the teenager, who may have no pain at all
What causes it
Most people have more than one of these at once, and they feed each other. Read the
list looking for the two or three that sound like your week rather than for the one
true answer — the ones that describe you are the ones worth acting on.
- Vertebral wedging during growth
- The front of several adjacent thoracic vertebrae grows less than the back, producing a wedge shape. Once the bone has formed that way the curve is structural.
- Growth plate abnormality
- The condition involves the vertebral growth plates, though why they behave this way is not established. It develops during the adolescent growth spurt and progresses while growth continues.
- Genetics
- It clusters in families, suggesting a strong inherited component. It is more common in boys.
- Rapid growth
- Progression happens during the growth spurt and generally stops at skeletal maturity, which is why the timing of diagnosis determines what can be done about it.
- Tight hamstrings and hip flexors
- Characteristically short in this condition, and they tilt the pelvis in a way that the thoracic curve then compensates for. Addressing them is part of management.
- Weak thoracic extensors
- Not the cause, but a consequence and a modifiable one. Strengthening improves symptoms and function even where the curve itself does not change.
- Heavy loading during growth
- Repeated heavy axial loading during the growth spurt has been suggested as a contributor, though the evidence is not strong enough to be prescriptive about.
- Being told it is slouching
- The most common early experience. Years of being told to sit up straight for a structural condition is demoralising and delays appropriate monitoring.
Who tends to get it
- Adolescents during the growth spurt, more often boys
- Anyone with a family history of the condition
- Teenagers whose rounded back does not correct on active straightening
- Those with a curve identified while significant growth remains, where bracing is an option
- Adolescents with characteristically tight hamstrings alongside the curve
What makes it worse, and what settles it
Makes it worse
- Being repeatedly told to sit up straight, which cannot work and is dispiriting
- Delaying assessment until growth has finished, which closes the bracing window
- Ignoring back pain in an adolescent with a rigid curve
- Heavy loaded spinal flexion during the growth period
- Doing nothing at all, since strengthening improves symptoms regardless of the curve
Settles it
- Getting it properly identified, since the management differs entirely from postural kyphosis
- Thoracic extensor strengthening, which improves symptoms and function
- Hamstring and hip flexor stretching, which addresses the associated tightness
- Bracing where indicated during growth, which can reduce progression
- Staying active, since the condition is compatible with most sport
What actually helps
The short version: Wedging of the front of several thoracic vertebrae during the growth spurt, so the curve is built into the bone rather than held there by habit. It does not straighten when the teenager is told to sit up - and that is the test that separates it from ordinary slouching
Strength work: Back: Spinal Erectors; Back: Traps: Lower; Back: Traps: Middle; Back: Rhomboids; Core; Abs: Transverse Abdominis; Shoulders: Deltoids: Posterior
Stretching: Chest; Back: Mid-Back; Spine; Legs: Hamstrings; Hips: Flexors - tight hamstrings travel with this one and pull the pelvis under
Massage: Back: Upper Back; Chest; Back
Also worth doing: Keep the sport going - loading is good for a growing spine; bracing is a specialist decision made on the curve angle and how much growth is left
What the evidence says: Programs combining thoracic extensor strengthening with chest and hamstring stretching improve both curve angle and symptoms in adolescents. Exercise does not un-wedge a vertebra - it buys posture, strength and comfort around a fixed curve, and a teenager deserves to be told that distinction straight.
The names above are the Targets qFIT tracks —
the Muscle Guide explains what each one does, and
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The qFIT routine for this
Ready-made routineGrowing Bodies (Kids & Teens)
qFIT already has this one built. It runs massage first, then stretching, then
strength — the order that works on a body that is already sore — and every
activity in it carries the reason it is there.
The button below opens your Checklist with this routine already selected, so instead
of your whole list you land on just its Categories, Targets
and Exercises, each with its checkbox, ready to tick as you work through
them.
Have more than one problem? Tick yours under My Problems on
My Profile and your Checklist's Routine list gains
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Get it checked if…
A curve that hurts at night, is progressing quickly, or comes with any leg weakness, numbness or bladder change - image it
And whatever the body part: chest pain or unusual breathlessness on
exertion; a fever alongside the pain; unexplained weight loss; pain that is constant and
unrelated to how you move; new numbness, weakness or loss of bladder or bowel control; or
one calf that is swollen, warm and painful. Any of those, stop and get assessed.
How it usually goes
The curve progresses during growth and generally stabilises at skeletal maturity. Bracing during growth can reduce progression in curves of moderate size; surgery is reserved for severe curves with significant symptoms. Most people with Scheuermann's live normal active lives with a more rounded upper back and manageable symptoms. Strengthening does not straighten the bone and it does reliably improve pain and function, which is worth doing regardless.
Prevalence basis: Adolescent spine screening series
Others the same routine covers
These share the Growing Bodies (Kids & Teens) routine, so the work is the same. If one of them also
sounds like you, that is a reason to expect more from it, not less.
This is general information, not a diagnosis, and it cannot examine you.
If it matches you, use it to ask better questions of a clinician rather than to replace one.