The term “scoliosis” derives from the ancient Greek word “skolios” meaning curved or crooked. Scoliosis is described as a sideways curvature of the spine. However, this definition is misleading. Scoliosis represents a 3-dimensional change in the position and shape of the vertebrae. This leads to Poor Structural Alignment that can be identified by:
o Uneven shoulders
o Tilted head
o Clothing may appear uneven
o Rib or lumbar prominences “humps”
o Differences in leg length
o Quickly become out of breath with physical activity
o One foot turned excessively out or in
o Back muscle asymmetry
Scoliosis is the most common spinal disorder in children and adolescents. Prevalence and risk of curve progression is significantly higher in females than males. The adolescent growth spurt is when it is typically first seen. This condition is hereditary. Therefore, it is of utmost importance that children and adolescents whose family members have scoliosis be checked early and on a regular basis. If there is any suspicion of scoliosis, then a screening can be performed by a health professional (certified physical therapist, MD, nurse) who if necessary can then refer you on to a specialist.
Scoliosis is diagnosed by X-ray. A measurement (Cobb Angle) is taken between the two most angled vertebra and if it exceeds 10° then a diagnosis of scoliosis is made. The chances of a small curve progressing into a larger curve is likely and depends on age & most recent degree of the curve. There is no known cure for scoliosis. In determining how likely someone is to progress and how to slow or stop a curve it can be of great help to consult with a scoliosis specialist. Scoliosis has an 8% prevalence in adults over 25 years of age and has been found as high as 68% in adults over 60 years of age. This higher percentage is most likely caused by degenerative changes in the aging spine. Considering the increased risk of progression over time, it is a good idea to intervene as early as possible in the treatment and postural retraining of the spine. Feel free to call for a phone consultation with Dr. Shelton.
Schroth Method Treatment
After speaking with a family who had recently returned from a scoliosis clinic in Europe I was flabbergasted to learn that they start treating patients much earlier than we do in the States. Their system assesses for scoliosis more frequently. Additionally, nurses & doctors know to refer scoliosis patients on for specialized physical therapy care. Here in the United States this method for treating spinal curvatures has only existed for a little over a decade. In Germany & much of Europe it has been the gold standard for nearly a century. This is known as the Schroth Method. A specialized approach is necessary to safely & effectively treat scoliosis. The Schroth method is one of the longest standing and most research validated approaches to scoliosis rehabilitation. There are relatively few certified Schroth practitioners in the US. Dr. Shelton is one of the few physical therapists who have this certification and have been specializing in scoliosis since 2013.
At ALIGN the Schroth Method is used to pursue Specific Goals:
*Slow or Stop Curve Progression
*Improve Upright Posture
*Increase Breath Capacity
*Relieve Pain
*Avoid Surgery (whenever possible)
*Improve Symmetry of the entire Muscular System
*Balance your strength & flexibility
*Decrease Organ Pressure
Here at ALIGN the Schroth method is used to try and reduce or halt a curve from progressing. Schroth treatments can also markedly improve scoliotic posture. Scoliosis Specific Exercises are shown to be helpful in the 10-30° range. In the adolescent population with a curvature of 30° or more it is strongly recommended that appropriate bracing be considered to compliment & maximize the benefits of a Schroth scoliosis program. [Feel free to inquire regarding optimal comfort & effect brace options. alignwnc@gmail.com]
What does a Schroth Treatment at Align look like?
*Breathing Measurements
*Posture Screening (pictures from multiple angles against a posture grid)
*Height Measurements
*Review of X-Rays
*Answering Patient and Parent Questions
*Full Spine and Extremity Evaluation (Identify ROM, flexibility, strength deficits)
Scoliosis Specific Exercises
As with any form of exercise we can influence & shape the human body. This applies to scoliosis specific exercises as they can reshape the body into a new posture.
*Unique Breathing Techniques
Rotational Angular Breathing is used to repositions the ribs which act as levers for moving the spine. Oddly enough one of the most surprisingly helpful things patients learn is how to breath out of & into different portions of their ribcages. When performed correctly this can relieve pain and help train a whole new posture.
*Customized Core Strengthening
Nothing offers more stability for the back than the abdominal muscles. Learn how to isolate different abdominal muscles This helps with spinal straightening!
*3-D Postural Realignment
* Specialized Manual Therapy Techniques
Why should you avoid the traditional “Wait & See” approach?
It is fairly standard to hear “well let’s just wait & see, we can measure the curve again in 6 months.” The problem with this approach is that the curve can increase during that period of time. Sometimes to the point that surgery may be the only other option. Other reasons to introduce safe exercises and posture improvement strategies for adolescents with scoliosis include:
Pain
Disability
Reduced quality of life
Negative body image & self-esteem
Cosmetic deformities
Early fatigue with exercise
Curve progression into adulthood leading to pain and premature spinal wear & tear.
Unfortunately, here in the US it is not yet common knowledge that there is a world renowned non- surgical exercise approach to effectively manage scoliosis and possibly prevent a progression. The Schroth Method has helped thousands of crooked spines for nearly a century. Since many cases of scoliosis do worsen over time it is imperative that treatment begins early. When scoliosis progresses to 30° or more the risk of a curve worsening is much higher!!! Therefore, it is imperative that early education & intervention occur on how to effectively control your posture and safely exercise. For example, learn what not to do in Pilates & Yoga classes or which gym exercises cause pain & problems.
BRACING
3-dimensional scoliosis bracing can be performed by specially trained orthotists. I work with Dr. Luke Stikeleather who has been in the field for over 20 years and has gone to Europe to study the best techniques. He is based out of Fairfax VA.
If after reading this, you still have any questions then please contact me at ALIGN Specialized Body Care.
(alignwnc@gmail.com or 828.891.0085)