First, let’s define what scoliosis is: scoliosis is a curvature of the spine usually 10 degrees or more diagnosed via x-ray. There are different types of scoliosis including:
– Infantile: scoliosis found in ages 0-3
– Juvenile: found in children ages 4-10
– Adolescent: found in adolescents ages 11-18
– Adult: found in patients older than 18
More than 80% of scoliosis cases are “idiopathic”, meaning the cause is not known. It is most often found in adolescent girls. In the other 20% of cases, scoliosis develops in those diagnosed with other conditions including syndromes or neuromuscular diagnoses such as cerebral palsy. The focus of this blog is on Adolescent Idiopathic Scoliosis or AIS.
What is AIS?
AIS is a curvature of the spine 10 degrees or more that begins in adolescence usually between 10-18 years of age. AIS curves progress during the rapid growth period of the patient. Therefore, adolescence is the optimal time to treat the scoliosis. AIS is a 3-D curvature meaning it results in a curve in all directions: side to side, rotational, and forward-backward. The side-to-side curve is often the most noticeable, but the rotational curve can be seen from the Adam’s forward bend test—it can show a rib prominence on one side. Due to the 3-D nature of scoliosis, all directions of the curve need to be treated for optimal results.
Treatment
There are different treatments based upon the degree of the curvature and the age of the patient. These include observation, bracing, scoliosis-specific exercise or Schroth-based therapy, and potentially surgery with more severe cases.
– Observation: Recommended for curves less than 25-30 degrees, yearly or bi-yearly x-rays
– Bracing: Recommended for curves larger than 25 degrees but smaller than 45-50 degrees in someone who is still growing. Braces range in styles and can be worn during the day, at night, or both.
– Surgery: Recommended for people with curves usually greater than 45 or 50 degrees and who are at high risk of continued worsening even after they are finished growing. Curves that are large can affect body functions, cause difficulty with breathing, and may cause pain.
Schroth Therapy
Scoliosis-specific exercise, or Schroth therapy, is a three-demensional form of treatment for AIS via conservative management. It can be used in conjunction with observation and bracing. The purpose of Schroth-based therapy is to prevent the progression of the curve and therefore decrease the chance of surgery. The Center for Physical Rehabilitation currently has two Schroth-certified Physical Therapists who have advanced training to customize a physical therapy program based on the patient’s age, skeletal maturity, and specific spine curvature.
Due to the nature of curve progression occurring in the rapid growth periods of adolescents, being proactive in treatment to prevent a worsening curve with smaller curves is essential. Schroth-based therapy can be utilized as early as 10-15 degree curvatures. It can also be utilized with larger curves to improve flexibility and muscle balance prior to a planned surgery.
The goals of the Schroth Method are to:
– Make you aware of your posture and self corrections
– Help correct your posture by improving muscle strength and endurance
– Improve breathing quality
– Improve postural appearance
– Decrease joint pain related to muscle imbalance from the spinal curve
– Prevent the progression of the curve
What does Schroth Therapy Look Like?
Your Physical Therapist will assist you with low-impact exercises such as:
– Holding your body in standing, sitting, or lying down positions
– Working with props such as a wall ladder, poles, and exercise bands
– Practicing breathing exercises
– Learning posture correction techniques
Appointments typically begin 1-2 times/week for approximately 45 minutes which will be discussed with your physical therapist after the initial evaluation. Treatment will last 3-6 months as you learn the exercises. After that time period, your PT will discuss when it is appropriate to hold on PT visits for a period of time and continue with home exercises. Commonly, your PT will want to follow up after a couple months to progress exercises or continue to monitor and address the curvature. Schroth therapy is typically utilized over the length of the adolescent period until skeletal maturity (the end of growth).
Additionally, scoliosis-specific exercise or Schroth therapy can be utilized with adults; however, it is less likely to have an effect on the actual degree of the curve. With adults, scoliosis-specific exercises can be used to manage pain and improve flexibility and movement of the spine.
The Schroth Method teaches you how to align your posture naturally, and helps you strengthen the muscles that support your spine, so you can function at your best.
Interested?! Check our our Schroth Therapy page, or give us a call to set up a consultation with one of our Schroth Therapists! 616.954.0950
Resource: Scoliosis Research Society ( SRS), https://www.srs.org/