Scoliosis

Schroth, Pre-hab and Rehab, Postural Screening

A scoliosis is a three-dimensional change in the shape of the spine. The vertebrae rotate, laterally deviate and extend. There can be one curve or there can be multiple curves. Generally, there is one major curve and the secondary curves form as a compensation to keep the body upright. There are different types of scoliosis: idiopathic, congenital, neuromuscular and degenerative. Adolescent idiopathic scoliosis is the most common type and it is the type of scoliosis we treat most often. Idiopathic simply means there is no known cause. At McGowan Physio we are trained in Schroth. Niamh has completed training in ISST and both Niamh and Garett are currently undergoing training through BSPTS.

The Schroth Method

The Schroth method is named after Katherina Schroth. Katherina had moderate scoliosis and wore a steel brace. She wished to be proactive with her care and so created a sequence of exercise that incorporates breathing techniques.

The Schroth method is a 3-dimensional form of corrective exercise incorporating breathing work and postural control to attempt to reduce unbalanced loading of the spine. The method is a sequence of exercises tailored to each individual depending on their spinal imbalances. The Schroth method is often used to slow down the progression of a scoliosis and in some cases it can decrease the degree of the curve. It is also used in spines that are fully developed with an aim to decrease any potential pain and imbalance that may have developed over the years. Schroth can also be used both pre and post op. As a form of pre-habilitation it will prepare your body ahead of surgery so that you are as fit, strong and flexible as possible and so that the nervous system is prepared for the new position you will be in post-operatively.

Specialist Assessment

The correct assessment of each individual’s spine is a crucial part of The Schroth method. It allows for correct classification of the curve type so that the individual exercises can be tailored to each person. Schroth is a form of Physiotherapeutic Scoliosis Specific Exercise. It is a three dimensional form of corrective exercise incorporating breath work and postural control to attempt to reduce asymmetric loading of the spine. Following an initial assessment, the physiotherapist will teach the individual their exercises using a combination of tactile and verbal cues. This means that they use their hands to guide the movement as well as using their words to help instruct you how to move.

The Exercises

The exercises are often isometric. This means a contraction of the muscles held in a stationary position. The physiotherapist will position you in a way that creates optimal length in your spine and then you strengthen your muscles to encourage your body to maintain that position. By repeating the same movements over and over again you not only create strength but you teach your body the correct way to move. This is known as proprioception. A huge part of the method is breathing and breathe control. Breathing is vital for core control and having a strong core helps to create a stable pelvis and support for the spine. Deep breathing to the flat zones in the lungs also helps to expand the rib cage which helps to derogate the twist in the spine.

At McGowan Physio we also offer strength based exercise programmes specifically targeted at patients preparing for scoliosis surgery as well as those completing their post-op rehab. It is important to have a full assessment done by a Scoliosis Specialist Physiotherapist prior to using the method.

We were referred to Spinal Specialist Physiotherapist Niamh McGowan
in July 2020 and can honestly say that we would not have been able to navigate our scoliosis journeys without her.

Patricia & Briain Kelly

Schroth Goals

Spinal correction
in 3D

Improved chest mobility
and respiratory function

Postural awareness
and postural changes

Cosmetic
improvements

Support for brace
treatment

At McGowan physio we also offer scoliosis and kyphosis screening as well as postural assessment.

Bracing & Scoliosis Specific Exercise

We work closely with Ciarnaid Hayes from Orthotic Solutions. Orthotic Solutions is paired with Ortholutions in Germany. They make Rigo-System-Cheneau braces. The braces are unique and are made specifically for each individual based on the information gathered from photos, x-rays and Ciarnaid’s measurements. The brace is checked regularly as the individual is growing to ensure any adjustments needed are made.

From the research we know that the best conservative approach is to use the brace along with completion of Physiotherapeutic Scoliosis Specific Exercise (PSSE - Schroth method).

RSC brace for scoliosis and brace education book

Watch Niamh explain what scoliosis is

In the video we can see Iarla’s scoliosis. Iarla has a double curve. He has a curve in his mid back (thoracic spine) and in his lower back (lumbar spine). This is often referred to as an “S” type scoliosis. It is important to check teenager’s backs to look out for imbalances as Niamh explains in the video. Things that are commonly noticed are a shoulder that is higher than the other, a shoulder blade that sticks out, a hip that is higher than the other or a hip that sits out to the side more than expected.

Thanks again to Iarla for being our scoliosis model.