Scoliosis isn’t a simple condition. It causes the spine to curve unnaturally and rotate, and because many cases are progressive, it can increase over time. Scoliosis can be highly treatable, but it does require scoliosis-specific treatment that, in many cases, includes scoliosis-specific exercise plans.
Scoliosis-specific exercises are targeted and customized around a patient’s curve type, severity, posture, risk of curve progression, and more. Because scoliosis exercises are designed by a scoliosis specialist to impact the curve, they have corrective potential. General physical therapy offers general benefits to overall health, but doesn’t specifically target scoliosis.
Educating patients on the different types of treatment available helps them make informed treatment choices, and scoliosis-specific rehabilitative exercise and general physical therapy are very different things.
Scoliosis-Specific Exercise
Exercise was once questioned as an effective scoliosis treatment option, but we’ve since learned that when exercise is targeted and specific to scoliosis, it supports corrective potential.
Scoliosis-specific exercise plans like the Schroth method and SEAS (Scientific Exercise Approach to Scoliosis) are well-established, evidence-based, and increase the potential of nonsurgical scoliosis treatment.
Although no treatment outcome can be guaranteed, particularly when scoliosis is diagnosed and treated early, scoliosis-specific exercise has more corrective potential.
The Schroth Method
The Schroth method is a widely-used scoliosis-specific physical therapy program that impacts scoliosis by restoring muscle strength and balance, teaching therapeutic breathing patterns and postural awareness.
The goal of Schroth exercises is to improve the spine’s position through elongating, de-rotating, and stabilizing the spine, and further improving its support and stability through targeting the spine’s surrounding muscles.
Strong and balanced muscles are needed to support a strong and balanced spine.
The Schroth method teaches patients to breathe into the concave side of their curve; rotational angular breathing involves intention; it directs air into certain areas of the rib cage to help de-rotate and realign the spine. Combining targeted inhalation, rib expansion, and de-rotation, while teaching patients to engage certain muscles when exhaling, trains the muscles to maintain the spine and trunk’s straighter position.
Patients are taught breathing techniques and scoliosis-specific exercise in front of a mirror to encourage body and postural awareness. It’s amazing how powerful awareness is when it comes to posture. Teaching patients how to recognize poor postural habits and correct them is not just important during scoliosis treatment, but also supports long-term spinal health.
The Schroth method is a long-term treatment option, but the length and intensity of treatment will vary based on individual patient assessment. In typical cases, sessions can last 45 minutes to an hour and may need to be performed consistently for five months or more. When patients are able, the program is continued at home.
Scoliosis-specific physical therapy involves education – patients who fully understand their curve can better understand its effects, contributing factors, and treatment needs.
SEAS
The Scientific Exercises Approach to Scoliosis is also highly specialized. It uses self-correction techniques, without the use of equipment, so once learned, patients can continue the exercises at home.
The main focus of SEAS is to improve the spine’s stability and the power of targeted exercise to strengthen the connection between the brain and the body’s new posture. There is a lot that goes into scoliosis-specific physical therapy, including retraining neuromotor function.
If a healthier body position (posture) is achieved, this better supports the spine’s improved position. Postural health and spinal health are closely linked.
Each case is unique, but SEAS can involve 45- to 90-minute sessions recommended two to three times a week with at-home sessions for 20 minutes a day. Sessions initially take place in-clinic but as progress is made, patients can also perform the program at home.
SEAS is not as long-term as the Schroth method and offers more flexibility in terms of duration of treatment and session length, so SEAS better supports compliance, and considering the main age group affected by scoliosis are adolescents, compliance is an outcome-shaping factor.
If treatment recommendations aren’t followed precisely as prescribed, their efficacy is limited.
Now that we’ve discussed the two main scoliosis-specific physical therapy approaches, let’s move on to the limitations of general physical therapy as a scoliosis treatment option.
Limitations of General Physical Therapy
A general practitioner can treat a patient with scoliosis, but that’s not the same as treating the scoliosis itself, and the same understanding can be applied to the difference between general physical therapy and scoliosis-specific exercises.
General physical therapy can help make overall improvements to a patient’s muscle health and posture, but if it’s not crafted by a scoliosis clinician and shaped around the specifics of a patient’s curve type, severity, and posture, the benefits are general, and not scoliosis-specific.
For example, general physical therapy uses stretches, exercise, and daily activity training to improve mobility, pain, and function, but doesn’t focus on a specific injury or issue, like scoliosis.
General physical therapy can help increase a patient’s overall flexibility, which may help with pain relief, but this doesn’t stretch or elongate the curve, so other than general pain relief and mobility improvement, it’s not going to impact the structural nature of a scoliosis curve.
Improving a patient’s general flexibility and pain are valuable outcomes, but improving symptoms isn’t the same as addressing their underlying cause: the spine’s unnatural position. For long-term sustainable symptom relief, the scoliosis itself needs to be impacted, and because it’s 3-dimensional, it needs to be impacted on every level.
General physical therapy doesn’t include scoliosis-specific breathing techniques, which allow patients to work on muscle symmetry and support internally, while specific exercise is working towards the same goal from the outside.
While postural improvement is within the scope of general exercise, it’s not shaped around the individual characteristics of a scoliosis patient’s posture, symptoms, and curve needs.
When patients are comprehensively assessed, their full treatment needs can be understood, and in some cases, when scoliosis-specific exercise is combined with additional nonsurgical treatment options, its efficacy increases.
Nonsurgical Scoliosis Treatment Options
There was a time when the dominant scoliosis treatment choice was spinal fusion surgery, but in many cases, surgical treatment may be unnecessary, and not always the best choice for long-term spinal health.
Each case of scoliosis is unique, and factors that shape a patient’s treatment outcome include patient age, risk of curve progression, scoliosis type, severity, curve pattern, and the timing of treatment.
Because many cases of scoliosis are progressive, a proactive treatment response can mean starting treatment while the curve is small and flexible and most likely to respond well.
Knowing the early signs of scoliosis can help with early detection, and for parents and caregivers, looking for postural changes is a good place to start (uneven shoulders and hips), and in adults, changes to posture occur, but pain is often the more noticeable symptom.
If a certain amount of progression has occurred before the start of treatment, a broader treatment plan may be necessary to impact the curve.
In cases of small flexible curves, a personalized scoliosis-specific exercise plan alone may be enough to impact the scoliosis, but for stiffer larger curves, evidence suggests the addition of corrective bracing increases the potential efficacy of scoliosis-specific exercise.
Scoliosis-specific chiropractic care, known as Chiropractic BioPhysics®, can also play a role as all treatment modalities work towards a common goal: improving the spine’s position, balance, and stability.
Because scoliosis affects all ages and varies so widely from patient to patient, a customized treatment approach is necessary to ensure all the elements of a patient’s curve, and the factors that may be contributing to its onset/progression, are addressed.
Conclusion
Scoliosis-specific exercises are designed to address the specific issue of scoliosis. Scoliosis-specific exercise approaches such as the Schroth method and SEAS are tailored to address all the factors that shape a person’s curve from breathing to posture and muscle strength and balance.
General physical therapy is limited in its corrective potential because it’s not scoliosis-specific. The benefits of general physical therapy for scoliosis patients may include general improvement to flexibility, posture, and pain, but when it comes to impacting the curve for long-term symptom relief, the spine’s unnatural lateral curve and rotation need to be addressed.
A scoliosis curve isn’t driven by one thing; it has structural elements in the spine’s unnatural curve and twist, but poor muscle health may also contribute, along with chronic poor posture and age-related changes to bone and spinal health.
The multifactorial nature of scoliosis may be more responsive to an integrative treatment approach that combines the potential of scoliosis-specific exercise with corrective bracing and/or scoliosis-specific chiropractic care, when appropriate.
Here at the Scoliosis Reduction Center®, I educate patients on all treatment options available so they can make informed treatment choices, and with proper guidance, the best course of treatment can be determined.
