A Conservative Treatment Approach to Combat the Progressive Nature of the Condition
For far too long, individuals and their family members have expressed the feelings of helplessness, like “there is nothing that can be done” and are forced to adapt a “wait and see” approach as the only model of care after a loved one is diagnosed with scoliosis. This condition can present at any point in development, but onset typically occurs during the adolescent years, when growth and skeletal maturity are really starting to progress. Physical therapy over the years has not been considered as a “primary treatment option” for patients diagnosed with scoliosis, however evidence is being developed and global techniques which have been around for decades are being studied and introduced more frequently now more than ever. This is resulting in at least “options” for patients and their families as a means to combat this condition. Instead of “wait and see”, the mantra is shifting to “try and see”. The Schroth Method is one of these options that could be beneficial for you or a loved one who has been diagnosed with scoliosis.
The Schroth method is a cognitive & sensory-motor 3-dimensional approach to treating the scoliotic spine through trunk elongation and rotational breathing strategies to improve trunk and spinal imbalances. The goal is to strengthen and develop the inner muscles of the rib cage and torso in order to influence the shape of the unique spinal curve pattern of each individual patient, while also maximizing the patient’s postural awareness. This technique has been used in Europe for decades; however, only recently began growing in popularity in the United States.
There is growing evidence to support the need of incorporating scoliosis specific exercise techniques, or this “try and see approach”, to provide alternative options for patients and families who are not exactly sure what the future looks like or what to expect in regards to the “severity and progression of the curve”. The Scoliosis Research Society advocates that the goal of conservative treatment should be to “reduce the risk of a curve progressing to a point where surgery is indicated”1. It also acknowledges that recent evidence studying patients with mild scoliosis of 10-20 degrees revealed that scoliosis specific exercises may prevent curve progressions to further levels of deformity resulting in additional medical management, such as surgery.1,2
What are the Goals of Treatment?
- Correction of the scoliotic posture
- Stabilize the spine and arrest the curve progression
- Improve self-image
- Improve function
- Improve pain
- Improve respiration and lung function
- Improve confidence and empowerment over scoliosis
Who would benefit from the Schroth Method?
Although onset typically occurs in adolescence, patients of ALL AGES can benefit from this method of treatment. The exact strategy and approach is dictated by the unique curve patterns as well as levels of skeletal maturity; however The Schroth Method can be beneficial for patients in all stages of scoliosis. This includes patients who have not yet begun bracing, patient who are currently being braced, as well as pre-operative or post-operative treatment when surgery is indicated.
In addition, research on the Schroth Method and similar treatment strategies is also developing to evaluate the benefits and effectiveness on postural related spinal deformities for people of all ages.
What are the exercises like?
During each session, you will be guided through specific exercises designed for you based on the curve pattern, curve severity, age, overall health, and other factors. Your certified Schroth Therapist will provide extensive verbal and tactile cuing throughout each exercise to facilitate curve correction through appropriate muscle activation, spinal positioning and breathing patterns.
Team Approach is Essential:
Proper management of the scoliotic spine requires a successful multi-disciplinary team approach between the treating Physician, Schroth Therapist, Orthotist (when bracing is required), and family members. Our certified Schroth Therapists understand these relationships are essential and work closely with these health care providers in order to provide seamless care for the patients to achieve optimal outcomes.
Dr. Nate Steltz PT, DPT
Certified Schroth Therapist
- Screening for the Early Detection for Idiopathic Scoliosis in Adolescents
- Monticone M, Ambrosini E, Cazzaniga D, Rocca B, Ferrante S: Active self-correction and task-oriented exercises reduce spinal deformity and improve quality of life in subjects with mild adolescent idiopathic scoliosis. Results of a randomised controlled trial. Eur Spine J (2014) 23:1204–1214