Gian Stavin
After many years of working in SEO, I’ve seen algorithm updates, trends, and best practices come and go. But one lesson that’s never been clearer than it is today is this: topical authority matters more than ever—especially for health-related keywords. I learned this the hard way when a client’s website that I managed started losing its ranking for its main keyword: “scoliosis.”
At first, the website performed exceptionally well. The content was laser-focused, high quality, and tackled every aspect of scoliosis. But as time went on, the strategy shifted. I began publishing other health-related content—well-optimized, keyword-targeted, and aligned with SEO fundamentals. However, despite all this, the site’s scoliosis rankings began to gradually decline.
This drop wasn’t due to a penalty or poor technical SEO. Everything was in place: clean architecture, fast loading speeds, optimized on-page elements, and even quality backlinks. What I eventually discovered was a hard but valuable truth: by branching too far away from the core topic, I had inadvertently weakened the site’s topical relevance, and Google responded accordingly.
The Early Success: A Strong Topical Focus
Initially, my entire content strategy revolved around scoliosis. I created clusters of content that covered everything—types of scoliosis, treatment methods, patient experiences, bracing, posture correction, and so on. The results were impressive. The site ranked on page one for high-volume terms like:
- “What is scoliosis?”
- “Scoliosis symptoms in adults”
- “Scoliosis brace for teenagers”
Organic traffic steadily grew, backlinks came in from niche health forums, and engagement metrics were solid. At the time, I was confident the strategy was working—and it was.
But then I started broadening the site’s scope. Articles about other orthopedic conditions like “ankle sprain,” “bursitis,” and even general wellness topics like “sleeping positions for better posture” were added to diversify traffic and capture more long-tail keywords.
The content was well-written and followed all on-page SEO practices. But not long after this expansion, I noticed a worrying trend in Google Search Console: impressions and clicks for scoliosis-related queries were declining.
Diagnosing the Drop: Topical Dilution
I knew I needed to figure out why. I ruled out technical issues, manual penalties, and site performance problems. Then, I looked at the site from Google’s perspective—not just page by page, but as a whole.
That’s when I recognized the issue: topical dilution.
By adding a growing number of non-scoliosis articles—even if they were still health-related—I had inadvertently weakened the site’s topical identity. Google was no longer as confident that the site was an expert in scoliosis, especially compared to other sites that maintained tighter topical boundaries.
This aligns with Google’s broader direction: rewarding topical authority. In the health space, especially, Google wants to send users to websites that demonstrate deep expertise, not just surface-level content across many categories.
In hindsight, it made perfect sense. I had diluted the brand’s clarity in Google’s eyes. The site was once seen as “the scoliosis resource.” But now, it looked more like a general health blog.
The Turning Point: Refocusing on Topical SEO
Once I identified the cause, I set out to repair the damage and restore the site’s authority on scoliosis. Here’s the strategy I followed, step by step.
1. Rebuilding the Topical Core
I started by producing a large volume of fresh scoliosis content. I didn’t just target high-volume keywords; I aimed for comprehensiveness. I wanted Google to understand that scoliosis wasn’t just a category—it was the site’s core identity.
Here are just a few of the topics I covered:
- Early signs of scoliosis in children
- Scoliosis and athletic performance
- Coping with scoliosis as an adult
- Different types of scoliosis curves explained
- Real stories from scoliosis patients
This was not a quick fix—it was a long-term content investment. I approached it like building a knowledge base, not just a blog.
I also made sure to use a topic cluster structure: creating detailed subpages that linked back to authoritative pillar pages on scoliosis. This gave Google a clear hierarchy and semantic relationship between topics.
2. Organizing Content into Silos
The next move was to audit the existing content. I categorized articles into topical groups and physically separated scoliosis content from everything else. This meant:
- Grouping scoliosis pages under /scoliosis/
- Segmenting general health content under a different section of the URL structure
I also tightened internal linking. Previously, scoliosis articles sometimes linked to unrelated health topics. I revised this by keeping internal links mostly within the scoliosis silo, so link equity and context signals stayed focused.
For larger volumes of general content, I considered using a subdomain (like health.example.com), though in this particular case, I chose to keep it on the same domain but clearly separated structurally and contextually.
3. Updating and Expanding Existing Scoliosis Content
Some of the older scoliosis pages were outdated or underperforming. Rather than letting them stagnate, I refreshed them with:
- Updated stats and references
- New expert quotes and insights
- More visuals and videos
- FAQs and schema markup
- Related internal links
I also ensured every scoliosis article was fully optimized not just for the main keyword, but for supporting entities and variations: “idiopathic scoliosis,” “thoracic curve,” “scoliosis X-rays,” etc.
The goal was to show Google that the site didn’t just have scoliosis content—it had the best scoliosis content.
4. Pruning or Repositioning Unrelated Content
I didn’t rush to delete all the non-scoliosis articles, but I did evaluate them carefully. Some were thin or outdated and weren’t bringing in meaningful traffic—those were either removed or redirected.
For the higher-quality but unrelated articles, I asked:
- Can this be revised to tie into scoliosis somehow?
- Is it pulling in backlinks or traffic that benefits the domain?
- Is it diluting topical focus too much?
In cases where the answer was yes to dilution and no to value, I either noindexed the content or prepared to move it off-site eventually.
5. Monitoring Recovery Through Data
Over the following weeks and months, I monitored several key indicators using Google Search Console and Semrush:
- Impressions and rankings for scoliosis-related terms
- Crawl activity on scoliosis sections
- Backlink acquisition on refreshed pages
- Engagement metrics like bounce rate and time on page
Recovery wasn’t instant, but it was steady. As more scoliosis content was published and restructured, rankings began to improve. Google started crawling scoliosis pages more frequently, and impressions for “scoliosis” and related terms gradually climbed back up.
But, Why Big Brands Still Win the Top Spots—Even Without a Singular Focus
Despite refocusing the site and seeing gradual recovery, a question kept nagging at me: Why are top spots for “scoliosis” still dominated by large hospitals or media giants—even though their content isn’t exclusively about scoliosis?
After digging deeper, the answer became clear. These sites benefit from massive domain authority, institutional trust, and high EEAT (Experience, Expertise, Authoritativeness, and Trustworthiness). When a hospital like Mayo Clinic or a platform like Healthline publishes a scoliosis article, Google already trusts the source implicitly. That trust outweighs even the most focused topical strategy on a smaller niche site.
It’s not just about how many scoliosis articles a site has. These big players have decades-old pages, loads of backlinks from reputable health sites and academic sources, and content often written or reviewed by licensed medical professionals. Even if they cover a wide range of topics, everything stays within the health vertical, which maintains thematic consistency. Google sees them as holistic medical resources—not as diluted.
For smaller or niche sites like the one I manage, this means the bar is simply higher. I can’t rely on brand equity alone; I have to overdeliver on topical depth, ensure expert-backed or experience-based content, and build a network of backlinks from scoliosis communities, forums, or rehab clinics. Competing with giants may not mean outranking them on the head term, but it does mean dominating the long-tail, serving real user needs, and building a brand that earns trust over time.
Final Takeaways: What I Learned
This experience taught me that modern SEO is not just about optimizing pages—it’s about creating a cohesive, authoritative presence on a specific topic. Especially in sensitive categories like health, topical depth and consistency play a massive role in search visibility.
Here are some key takeaways I’ll carry into every project moving forward:
- Topical focus matters more than keyword density
- It’s better to go deep in one niche than shallow in ten
- Internal structure and siloing influence how Google sees your site
- Content pruning is sometimes necessary to protect core authority
- Recovery is possible, but it takes consistent effort and time
Looking Ahead: Committing to Topical Authority
I’ve now recommitted to the idea that if a site is going to rank well long-term, it must own its topic completely. That doesn’t mean never branching out, but it does mean being intentional about how content is structured, linked, and balanced.
For my client’s scoliosis site, the renewed focus is paying off. Rankings are climbing back, engagement is stronger, and the site once again appears to be seen as a go-to authority on scoliosis.
If there’s one thing I would emphasize to any SEO professional today, it’s this: the clearer a site is about what it stands for, the better it will perform. Google rewards focus, depth, and clarity—and it always will.