What is scoliosis?
Scoliosis – Greek for ‘crooked’ – is a orthopaedic condition wherein the spine demonstrates abnormal curvature that is evident in 3-dimensional space. The spine deviates side-to-side from centre, and straightens from a side view. A scoliotic spine also twists within the curves, visible through the protrusion of one’s hips, rib cage, collar bones, or shoulders.
Scoliosis has a number of sub-types that may develop at varying moments across the lifespan. However, 80% of all scoliosis cases are considered of an unknown cause with onset in one’s adolescent years – a diagnosis referred to as ‘idiopathic scoliosis‘. When scoliosis develops later in adulthood following the asymmetric degeneration of the spine, this is known as ‘degenerative scoliosis’.
As scoliosis progresses, permanent deformation of the vertebrae can occur, and the spine can become ‘fixed’ in abnormal curvature. Over time, other symptoms such as pain, difficulty breathing, osteoarthritis, depression, anxiety, decreased self-esteem, and a decreased health-related quality of life can become more apparent.
Scoliosis is often first identified through visual or manual assessment of the spine. Physicians may include an assessment of the spine as part of their annual check-up for childhood and adolescent patients, as this is when symptoms are likely to first appear. Others will notice asymmetries in their own body such as in their ribs and hips, or have scoliosis diagnosed later in life as they pursue treatment for back pain or uneven posture.
The severity of scoliosis is often measured by the degree of one’s curvature. This curvature is most accurately measured using full spinal x-rays, which will give your care provider an in-depth portrait of your unique body and alignment. More severe cases of scoliosis may prompt a referral to a spinal surgeon. Other more mild or intermediate cases are best managed through bracing, and scoliosis-specific physiotherapy care like the Schroth Method.
While scoliosis should be diagnosed by your healthcare provider, some quick signs or symptoms to watch for in yourself or your children are:
A visible ‘S’ or ‘C’ shape in the spine that can increase or become more visible with a forward bend in the spine (toe-touch)
One side of the back that appears to protrude more than the other
One shoulder blade that protrudes more than the other
One side of the ribs that protrudes more than the other
Back pain that tends to be one-sided
Not sure whether you or a loved one is living with scoliosis?
Our team of physiotherapists can help you identify and appropriately manage your back pain!
Scoliosis Treatment Methods
Appropriate treatment approaches for idiopathic and degenerative scoliosis will be determined based on the degree of curve in one’s spine, whether or not the individual is still growing, any known comorbidities (arthritis, degenerative disc disease), and the degree to which the scoliosis causes undesirable symptoms like pain or decreased self-esteem in daily life.
The most appropriate treatment approach should be determined by your healthcare team (which may include your family physician, your physiotherapist, and even an orthopaedic surgeon). Spinal x-rays are an important variable in making informed decisions on a case-by-case basis.
Common treatment approaches for scoliosis include:
Observation: Observation is the first step to an active approach to managing scoliosis. This includes regular clinical evaluations ranging from 3-12 months in frequency. This is typically recommended for those in their prepubescent years and with minimal curves. The goal of this approach is to monitor curvature changes during one’s growing years, and to identify the need for further interventions if necessary.
Physiotherapy with the Schroth Method: Physiotherapy itself can help scoliosis patients better mange scoliosis through strengthening, stretching, and postural exercises. However, the Schroth Method is considered an industry ‘best practice’ for the non-surgical treatment of scoliosis, and can be administered only by trained professionals. This exercise-based treatment method is shown to improve scoliosis outcomes, help individuals avoid the need for surgery, and offer improved posture, comfort, and function at various ages and stages of curvature.
Craven SPORT services’ Adrienne Stinson is Saskatchewan’s only provider of the Schroth Method at this time – see below for full program details!
Bracing: Depending on a child/adolescent’s growth and severity of curve, bracing can be used to slow or stop the progression of one’s curvature. Braces are worn daily for the remainder of the individual’s growth. While bracing cannot correct or reverse an existing curve, it can prevent further worsening.
Surgery: When an individual’s curve is more severe, it is reasonable to expect that it will continue to worsen across their lifespan and has the potential to introduce additional health risks such as breathing difficulties. In these cases, spinal fusion surgery may be considered, wherein vertebrae that are curved are fused, healing into a single straight bone. This procedure can prevent further curvature as the individual continues to grow. Scoliosis patients who are outside of their growth window may later in life consider additional surgical options for balancing the spine and relieving nerve pressure.
What to expect with the Schroth Method
Benefits of the Schroth Method
Schroth 3D Scoliosis Therapy was founded in Germany in 1921, and is an exercise-based method of
treatment that has been show to help:
Reduce the need for surgery
Decelerate or prevent further curvature progression
Promote trunk symmetry and improve cosmetic appearance
Improve postural awareness and control of postural changes
Increase chest/ribcage mobility and respiratory function
Stabilize spinal corrections in all three dimensions
Support bracing (when needed)
Scoliosis-specific exercises like the Schroth Method have been shown to improve scoliosis outcomes when used on their own, or when done in combination with bracing. When scoliosis is detected early enough, the Schroth Method may attempt and succeed at restoring a level of normal postural alignment.
For those later in life, the Schroth Method aims to improve posture, function, and pain.
What to expect in your scoliosis treatment program
The Schroth Method involves a series of individually-tailored postural variations and exercises completed in combination with targeted breathing techniques. The goal of this treatment program is to apply these variations in a home-based exercise program, and to apply them in everyday activities.
Motivation, compliance, and commitment of the individual receiving Schroth Therapy is required to see long-term success and postural changes. Depending on the type of scoliosis and the individual’s point of skeletal maturity, treatment could be months, years, or ongoing.
When an individual books their initial Schroth Method assessment, they will be required to book an additional set of follow-up appointments to ensure the proper management of each individual’s therapy.
Getting started with your scoliosis treatment
New clients will be scheduled for an initial assessment, and seven follow-up appointments – all one-hour in length – over the course of an intensive 6 week period. All current Schroth Method appointments are scheduled with physiotherapist Adrienne Stinson on Wednesdays and Thursdays.
Following the completion of the 6-week program, clients will establish an ongoing follow-up plan based on the individual’s progress, goals, and availability.
Your initial assessment will include:
A thorough review of your spinal x-rays and any relevant medical information prior to your visit
A physical assessment including photographs and spinal mobility
An understanding of the individual’s scoliosis
Appointment cost: $190.00
Follow-up appointments will include:
An individualized therapy plan that includes exercises, positioning, breathing techniques, and postural corrections
Passive and active mobilizations
Brace management (when appropriate)
Follow-up photography to track progression
Appointment cost: $145.00
X-rays: All new clients of the Schroth Method will be required to send a recent set of spinal x-rays (weight bearing, full spine PA and lateral views are required). These x-rays must be received a minimum of 3 days prior to the initial assessment. Clients can complete these x-rays at an authorized lab in Saskatchewan, then complete the ‘release of information consent form’ with Craven SPORT services to allow our team to access your imaging reports online. If your x-rays were completed at a chiropractic clinic or outside of the province, a physical copy of the x-rays will need to be emailed or faxed to CSS. Whenever possible, we ask for x-rays that have been completed within the past three months. These steps will be reviewed at your time of booking.
Appointment location: All Schroth Therapy appointments with Adrienne Stinson take place at the CSS Training Centre. Please note that the Training Centre is one block south of the CSS Clinic, at #10-632 1st Avenue North.
Appropriate attire: Visual access to the spine is an important component of Schroth Therapy. Male clients will be asked to remove their shirts during therapy, and female clients asked to arrive in either a sports-bra or bathing suit top that allows for access to the spine. Please note that racer-back tops like THESE are not appropriate attire, as they cover the spine.