January 20, 2023

Scoliosis Treatment

We are excited to introduce our newest program for kids and adolescents with idiopathic scoliosis (AIS) and kyphosis. Meredith Mueller at Axis Sports Medicine in Avon is the only practitioner offering Schroth therapy in our mountain communities. With Schroth therapy, Meredith uses exercise to empower and meet the needs of kids and families managing scoliosis, rather than the typical “wait and see” approach.

Now let’s learn about Scoliosis.

What is Scoliosis?

“Scoliosis is a complex 3-D deformity of the spine and trunk which appears in apparently healthy children and can progress in relation to multiple factors during any period of rapid growth, or later in life”.*

*Rigo, Grivas, O’Brien, 2010

Scoliosis usually develops during childhood or adolescence and is more common in girls than boys.  Having a family history of scoliosis is a common risk factor for developing scoliosis.

Scoliosis is most recognizable as a lateral (to the side) curvature of the spine. 

What causes scoliosis?

The cause of scoliosis is unknown in 75-80% of cases and is referred to as idiopathic scoliosis or Adolescent Idiopathic Scoliosis (AIS).  There are additional types of scoliosis include:

  • Congenital: Scoliosis can be caused by congenital abnormalities, such as a birth defect or genetic disorder.
  • Neuromuscular: Scoliosis can be a symptom of neuromuscular conditions, such as cerebral palsy and muscular dystrophy.
  • Degenerative: This is a progressive degeneration of spinal elements leading to spine malalignment.  Happens in adulthood.
  • Non-structural or functional: Apparent asymmetries of the spine can be due to muscular imbalance, not a structural abnormality.

What are the Signs and Symptoms of Scoliosis?

Scoliosis symptoms can vary depending on the severity of the condition.  Mild scoliosis may not cause any symptoms at all. However, as a curve progresses, the following may transpire:

  • Uneven shoulders: The height of the shoulders may not be the same.  One shoulder may appear to hang lower than the other.
  • Uneven waist: One side of the waist may seem higher
  • Postural shift: The shoulders may not sit directly on top of the pelvis
  • Muscle fatigue: Muscle fatigue can occur as the muscles work harder to support the deviation of the spine from neutral
  • Back pain: Back pain or neck pain is not always present with scoliosis but can develop at any time.  Pain experienced can be from a muscle, joint or connective tissue, just as in any other spine issue. 

How is Scoliosis detected?

Scoliosis is often detected during a wellness exam or by a parent, coach, or dance teacher who notices a child’s spine or body has asymmetry.

When viewing the spine from the back, the spine is intended to be straight, but with scoliosis, it curves to the side.  This curve is even more noticeable when bending forward. Due to this phenomenon, the screening test called the “Adams Test” is used by a doctor or physical therapist to help to screen a person for scoliosis.  During this test, the person is asked to bend forward while the observer looks for specific characteristics to indicate a positive test.  Due to the shape of the bones in scoliosis or kyphosis, the curve is more pronounced in this forward-bent position. 

How is Scoliosis Diagnosed?

If the screening test is positive, a scoliosis-specific x-ray is taken.  Several measurements are taken, including a measurement of the cobb angle.  This angle measures the lateral curve (curve to the side).  Any measurement greater than 10* would be considered a scoliosis.

Since scoliosis is often progressive, detecting it early and seeking treatment is important. With treatment, the progression of scoliosis can be slowed and, in some cases, improved with treatment.   

How is scoliosis treated?

The intensity of treatment for scoliosis depends upon several factors, including the severity of the curve and skeletal maturity (how much growth is left to do).  Treatment can be as little as monitoring with an x-ray every six months.  Physical therapy, bracing, and in rare cases, surgery can also be recommended.  Treatment for scoliosis should be multidisciplinary, including a primary care physician, a spine specialist, a physical therapist, and sometimes an orthotist for bracing and a surgeon for surgery. 

What type of Physical Therapy is used for someone’s scoliosis?

Schroth therapy is used for the treatment of scoliosis at Axis Sports Medicine.  Schroth exercises address the postural component of scoliosis. In scoliosis, the bones of the spine have structural asymmetry. The muscles of the body then respond to the asymmetry; some become short, and others become long. When the short muscles are taught to lengthen through positioning and breath, the structural component of the scoliosis is often positively influenced, and curve progression is slowed and even sometimes improved. 

How does Schroth therapy work?  

Schroth PSSE uses four principles to help kids positively influence their curve:  

  1. Posture  
  2. Expansion  
  3. Stability  
  4. Integration  

Various positions (sitting, standing, side-lying, semi-hanging, etc.) are used where the patient makes specific “corrections” to achieve optimal postural alignment. In these positions, utilizing these corrections, the patient is taught to use their breath to expand areas of the spine that need expansion. The breath is subtle enough that the optimal posture can be maintained and further improved. In addition to breathing, the addition of tensioning different muscles can further create expansion and stability to support optimal posture. 

Schroth can also be used in conjunction with other more traditional types of physical therapy, including stretching, strengthening and massage, joint mobilization, and trigger point dry needling.

What should you expect from treatment for scoliosis at Axis? 

We aim to gather information during the first visit to help develop a treatment plan. This will involve taking a comprehensive history, understanding individual goals, taking pictures of posture at various angles, performing a musculoskeletal examination, providing education on scoliosis and on the patient’s individual curve pattern, and evaluating x-rays when provided.  

The follow-up sessions will include the following: ongoing education, exercise execution, home exercise instruction, manual therapy, follow-up pictures, and a review of goals. 

What are the common goals for scoliosis treatment? 

The most common goals of treatment include understanding scoliosis, understanding the patient’s particular curve pattern, improving aesthetics, decreasing pain, improving breathing, coordinating care with various practitioners (primary care, orthopedic specialist, orthotist), and slowing progression. 

When should you be treated?  

We encourage anyone with scoliosis to consider an appointment.  Since scoliosis progresses in childhood, adolescents, and later in life, seeking treatment from any doctor or physical therapist right away is advised.

An initial evaluation will be performed, and a plan will be created based on the evaluation’s findings and the patient’s goals.

Find Hope with Scoliosis with Axis Sports Medicine – Eagle County’s Trusted Physical Therapists

If you or someone you know has scoliosis or wants a consultation to determine if there is scoliosis, please contact Axis Sports Medicine in Avon to schedule an initial evaluation.

Our therapist-owned practice is dedicated to providing individualized care that gets results. We look forward to helping you find hope with scoliosis!