Your child pulls that dreaded letter out of his or her backpack and so the tedious journey begins. You may read: "Our screening indicates your child shows positive signs of Scoliosis. Please follow up with your doctor."
Perhaps you start with your pediatrician, who refers you to an orthopedist. The orthopedist, after inspecting your child's back and measuring spinal rotation with a level-type device called a scoliometer, takes an x-ray. Your child, at this point, is getting annoyed at continually having to bend over with few clothes on. If the curve measures less than 20° you will be probably be told to "do nothing." "wait and see," and return at intervals for further x-rays to check curve progression.
If the curve is greater than 20° a brace most likely will be prescribed. While bracing can be a very important part of scoliosis treatment, certain braces used in the United States are ineffective at best. Others can be difficult for a child's comfort and self esteem. Newer, smaller braces are currently emerging.
In addition, the word "surgery" is usually put out there, warning you that this may be necessary should "doing nothing" or conservative measures fail to be effective.
Here are some facts to consider:
- If your child has not yet reached skeletal maturity and especially if the diagnosis was made before their pubertal growth spurt (menses in females,) there is good chance the curve(s) will worsen. For example, there is a 68 percent chance of progression if a curve measures between 20-30° and the Risser sign (measure of bone maturity as seen on rim of pelvis on x-ray) is 0-1 out of 5. Therefore, "doing nothing" at this stage can actually be detrimental.
- The younger the child at diagnosis, the greater the chance of curve progression.
- The larger the curve, the greater the incidence of progression.
- On the other hand, the earlier the intervention with Schroth method exercises the better the results. Even small curves can respond.
- Scoliosis is not life threatening and research shows that surgery is rarely indicated.
- While curves are measured by amount of side bend (Cobb angle), scoliosis is actually a three dimensional deformity where the spine flattens from front to back, bends sideways and rotates around its axis. Addressing just the lateral bend is not nearly as effective as treating all three dimensions.
Data and evidence, as well as experience, show that a Schroth program is effective in halting curves 90-95 percent, if one is compliant. Schroth method has even been shown to reduce some curves, especially in younger adolescents. It can also increase breathing functions and improve cosmetic appearance. (For published evidence of effectiveness see "Supporting Evidence for Schroth" at scolrx.com.)
Schroth Best Practice™ teaches corrective rotational breathing exercises and postural adjustments for use during daily activities to counteract each person's specific curves. Thus, positive forces are occurring throughout the day. Schroth exercises can be done in conjunction with other treatments your doctor recommends, including bracing. Many U.S. doctors may not be aware of the benefits of a Schroth program as Schroth is more prevalent in Europe. Upon Internet research, one can find parent/patient blogs at scoliosis support group sites, who report discovering Schroth on their own. While grateful for the results they were often aggravated that Schroth was never offered to them as a treatment option.
Schroth methodology was begun by Katharina Schroth in Germany in the 1920's, after she, herself, was diagnosed with scoliosis. She opened a clinic where patients learned the techniques in large classes as inpatients and spent up to several months living at the clinic. Schroth continued to progress, with the assistance of Katharina's daughter, Christa, but many of the exercises required extensive equipment and were complicated to learn. Katharina's grandson, Dr. Hans Rudolf-Weiss, a successful orthopedic surgeon in Germany, has continued to enhance and simplify the program making Schroth Best Practice™ easier to learn and comply with.
The first Certification course in Schroth Best Practice™ was held in April, 2015 in Massachusetts, by Dr. Weiss and Dr. Marc Moramarco, who have been instrumental in bringing this newest version to the U.S.. Freda Nogee, a physical therapist from East Meadow, NY, was one of eleven participants carefully selected from around the world to participate.
This updated program is taught one to one, on an outpatient basis, in 12-21 hours. While the exercises are very specific and nuanced, once learned, only take a few minutes a day to perform. All three dimensions of spinal change are addressed. In the sagittal plane (front to back) one works to restore the spine to a question mark shape (Physiologic). In the frontal plane, the side bend of the spine is addressed (3-D Made Easy) and one learns how to effectively correct postures to help specific curve(s) during routine activities such as standing, walking, sitting, lying and carrying items (ADL). In the transverse plane one is taught to expand the lungs against the rib cage in various positions to help de-rotate and stabilize the vertabrae that have twisted (Power Schroth). That one is continually effecting positive change on their scoliosis, not just at exercise time, is what helps an individual become successful in halting curve progression. The Schroth Best Practice ™ program empowers and gives each person the individualized tools and know how to manage their own curves.
Children and adolescents with scoliosis can sacrifice quality of life to conservative treatment for many years. It is our task then, as parents and practitioners, to offer comfortable approaches with the best possible effects, in the shortest amount of time with the least amount of side effects. Schroth is that approach.
Why wait to see if your child's curve progresses when he or she can proactively help halt or reduce that curve from the start?
Schroth methodology may be 95 years old but the latest version is user friendly and getting excellent results.