Idiopathic Scoliosis (IS) is a 3-dimensional spinal deformity resulting in twisting or rotation of the spine into an “S” or a “C” curve. While other forms of scoliosis exist, IS is the most common and results from an unknown cause. It is primarily diagnosed in apparently healthy adolescents and teens and is more often found in girls than boys.
Adult Idiopathic Scoliosis exists, but is likely the result of adolescent idiopathic scoliosis (AIS) that went undiagnosed and progressed in adulthood. Any curvature of the spine greater than 10 degrees is considered scoliosis and should be treated to prevent the curve from worsening. Severe scoliosis can cause back pain, problems with the lungs and heart, and spinal arthritis if not addressed.
If your child was recently diagnosed with scoliosis, you may have a lot of questions about what to do next. What is the best course of action to help your child improve without severely interrupting their childhood? Your doctor may have even recommended waiting to see if their condition worsens before taking action, but that can feel discouraging.
In addition to traditional treatment methods, there are a number of alternative therapies that aim to treat scoliosis. While alternative therapies such as yoga, massage, and acupuncture may help reduce pain from scoliosis, the Schroth Method is one of the only alternative treatments for scoliosis that has shown to help stop the progression of the spinal curve.
Below, we will compare the traditional method of treating scoliosis with the Schroth Method.
Traditional Scoliosis Treatment Methods
Traditional treatment methods for scoliosis include three basic options. Most doctors recommend observation first to determine the extent of curvature. Depending on the severity of the scoliosis, bracing or surgery may be recommended next to stabilize and straighten the spine.
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Watch and wait
When a child is first diagnosed with scoliosis, the degree of the spinal curve, the developmental age of the child, and the rate at which the curve is progressing are all taken into account.
Less than a 20-degree curve is considered mild; if the child is done growing, the chances of the curve progressing are minimal. If the curve is less than 20 degrees but the child is early in their physical development, or if the curve is 20-40 degrees, the likelihood of the curve getting worse is much higher. Also, if the curve is greater than 50 degrees, it is likely to continue to worsen yearly, even after the child reaches spinal maturity.
The first recommended step for most patients in traditional scoliosis treatment is to take X-ray imaging every 6 months to observe if and how rapidly the curvature of the spine is progressing. Essentially, unless the scoliosis is very severe to begin with, you need to wait for it to worsen before determining any further treatment.
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Brace
Bracing is recommended to stabilize and potentially assist in straightening the spine if your child’s spinal curve has worsened, or if they are still early in spinal development. Bracing is recommended when the curvature is at 25 degrees or more and the child is still growing. There are many different types of braces, ranging from a soft brace made of elastic bands and velcro, to a variety of hard plastic braces. The brace should be fitted, by a thoroughly experienced orthotist,to the patient’s specific spinal curve and what type of support is needed.
However, some braces have been shown to be more effective than others, and often need to be worn about 18 hours per day in order to make a difference.
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Surgery
If the curve of the spine continues to worsen even after bracing, or if the degree of curve is severe enough to begin with, surgery may be recommended. Surgery may be considered when the curvature is greater than 50 degrees. There are a few different surgical procedures used, ranging from implanting metal rods along the spine, tethering the spine with screws and cords that straighten when tightened, or even removing portions of the ribs or spine.
Surgery is invasive and may require multiple procedures. Additionally, the patient will need recovery time and may have limited spinal mobility afterward, so it is often reserved for severe cases of scoliosis.
The (Surgery-Free) Schroth Method
The Schroth Method is a physical therapy approach for treating Scoliosis that strengthens and elongates muscles in the back, core, and torso to help stabilize the spine and correct postural alignment. The patient is guided through various positions that place the trunk and pelvis in a 3D correction first. Then the patient is guided on performing specific breathing, postural, strengthening, and stretching exercises aimed to amend imbalances of the spine.
How does it work?
Depending on the location and degree of curvature in the spine, a certified Schroth Method therapist will guide the patient through 60-90 minutes of exercises that the patient can then practice on their own 3-5 days a week depending on the age of the patient and where they are in their growth
Exercises involve Rotational Angular Breathing, a practice of breathing into the ribcage in various positions, as well as stretching and strengthening to achieve muscular symmetry. These exercises may be done lying down on the back, sidelying, on hands and knees, seated, and in standing using various therapy props. The therapy props assist in placing the patient’s trunk and pelvis in the most optimal position based on the patient’s curve prior to the start of the rotational breathing.
This method is proactive and non-invasive and can be done in conjunction with bracing or other treatment and pain management methods if desired. In fact, using the Schroth Method in conjunction with bracing can help prevent atrophy and further muscular imbalances that may result from wearing a brace.
How Does Schroth Therapy Compare to Traditional Methods?
Preventative vs. Corrective
Unlike in the traditional method of observing first, the Schroth Method takes action immediately to address Scoliosis in the child and prevent the curve from worsening. The traditional method allows the spinal curve time to progress before taking corrective action to straighten it. Using the Schroth method is a more proactive approach in treating the curvature versus having to be reactive after the curve has progressed.
It’s much harder to correct the spinal curve non-invasively once the patient has reached skeletal maturity. Therefore, the sooner you can act to treat the curve, the better. Schroth therapy can begin as soon as the patient is diagnosed, and studies have shown its effectiveness in preventing the spine from curving further.
Non-invasive and Empowering
A Scoliosis diagnosis can feel discouraging if the prognosis is to wait and see, then potentially wear a brace through your adolescent years, or have spinal surgery. The movement exercises offered in Schroth therapy, on the other hand, can help the patient to feel empowered that they can do something daily to improve their condition.
Additionally, the goal for most, who use the Schroth method, is to avoid surgery. Some patients may even be able to successfully avoid needing a brace if the curve is caught and treated early enough. While regularly practicing the Schroth exercises is a daily commitment for the patient and their family, it may be significantly less intrusive on their formative childhood years than wearing a brace daily or recovering from surgery.
Effectiveness
Surgery can be effective in correcting the curve of the spine, but often isn’t needed unless the spinal curve is severe: greater than 50 degrees or rapidly getting worse. However, it is an invasive treatment option that will likely restrict the mobility of the spine and may require multiple procedures as the child develops and grows, as well as physical therapy for recovery and pain management.
Bracing may prevent the curve of the spine from worsening for patients with a 20-50 degree curve and is most effective while the child is growing. However, the traditional method of waiting and observing before taking action may be doing a disservice. Studies have shown that even part-time bracing for milder curves early on can help prevent the need for full-time bracing or surgery, more so than simply observing.
Braces can straighten the spine while being regularly used, but the curve will often return once the spine stops growing and the brace is no longer worn. As long as the curve is less than 30 degrees after spinal maturity, it’s considered less concerning because it’s not likely to progress, though may still cause pain in adulthood.
Additionally, it’s important to use the right type of brace and ensure the child is wearing it for the recommended amount of time. Some braces have been shown to be ineffective at preventing the progression of the spinal curve.
The Schroth method is a gentle and effective treatment to strengthen musculature, increase range of motion, improve rotation of the spine and trunk and reduce pain. While Schroth exercises do not aim to correct the spinal curve, they have been effective in preventing the curve from worsening as well as reducing the degree of the curvature.
Schroth Therapy is most effective in patients with a mild curve (less than 25 degrees), especially when the patient is early in spinal development. The earlier treatment can begin, the better.
However, studies have shown that using Schroth therapy in conjunction with bracing for patients with a moderate to severe spinal curve (30-50 degrees) actually improved the spinal condition or prevented the curve from worsening to the point of needing surgery. Additionally, adult patients with Scoliosis may benefit from Schroth exercises as well to help improve posture, reduce pain, and improve general quality of life.
Find a Schroth Method Therapist You Can Trust at Advanced Care Physical Therapy
If your child has been diagnosed with Juvenille or Adolescent Idiopathic Scoliosis, the sooner you can take action, the better. It is important that you find a certified Schroth Physical Therapist to ensure the best possible outcomes for treating scoliosis.
At Advanced Care Physical Therapy, we specialize in treating Idiopathic Scoliosis in children and adults using the Schroth Method.
Julie Reinstein PT, MS, Cert. VRS, BSPTS Scoliosis Therapist, Schroth Method C2/SEAS C2 is Co-Owner of Advanced Care Physical Therapy and has been practicing in outpatient PT for 29 years. Julie is certified in the Principles of Schroth from the Barcelona Scoliosis Physical Therapy School as well as the Scientific Exercise Approach to Scoliosis (SEAS). She is very passionate about helping her patients achieve both a more balanced spine, as well as an improved quality of life.
Schedule an appointment with us today if you or your child has been diagnosed with Idiopathic Scoliosis and are looking for a non-invasive and empowering treatment plan!
