Schroth is a specific treatment and exercise approach for scoliosis. Just like any exercise program, it takes commitment, and the proper guidance from qualified professionals, to get the best results. We work together with the patient and their team of carers, including family, doctors, and specialists, to achieve the most holistic approach.
Our clinic is specially designed to incorporate, and not isolate, Schroth physiotherapy patients so they feel comfortable and at ease during treatment. All our Schroth patients receive an individualised approach and a specially designed treatment plan which includes exercise.
SEAS is another method incorporated into treatments for many patients. SEAS stands for the Scientific Exercise Approach to Scoliosis, and is taught and certified through ISICO (Istituto Scientifico Italiano Colonna Vertebrale), which is based in Milan Italy. SEAS is an ‘approach’, where patients are taught exercises to help them manage their posture. Exercises are individualised to each patient.
Our aim is to empower our patients with the skills, knowledge and physical strength to better manage their posture whilst living with scoliosis.
What is scoliosis?
Scoliosis is a term used to describe any abnormal, sideways curvature of the spine, often in a three-dimensional manner. It is not a disease and not a precise diagnosis either. The changes that occur in a person with scoliosis can be both cosmetic and physical, and in severe cases, there can be significant health problems. However, in many cases people with Scoliosis can live a very healthy life, especially when their Scoliosis is properly managed with the right care team around them.
There are different types of scoliosis, but at Schroth Scoliosis Physiotherapy Clinic we mainly treat Idiopathic Scoliosis in adults and children. However, we can treat other types if required.
If you are unsure whether your child has scoliosis, please read the article 5 Signs your child might have scoliosis for further information.
How is scoliosis typically managed?
In Australia, when a child is diagnosed with scoliosis the typical plan of action is this:
- Wait and see what happens.
- If it progresses, the patient is recommended a brace.
- If it progresses further, the patient is usually recommended surgery.
There is definitely a need for bracing and surgery in some cases, however, therapy is not often mentioned as a tool in Australia. This typical approach is frustrating for patients and their families, and there is often much confusion about what is best.
It is this confusion and frustration, and lack of knowledge around appropriate physical therapy, that motivated our Director, Rosemary Marchese, to acquire her Schroth certification under the Barcelona School of Physical Therapy in New York. She has also trained in the SEAS method (SEAS stands for the Scientific Exercise Approach to Scoliosis) and is currently undertaking the World Masters in the Principles and Practice of Scoliosis Conservative Management, which is conducted online through ISICO in Milan Italy.
What is the Schroth Method for treating scoliosis?
The Schroth Method is a nonsurgical, physical therapy approach to managing scoliosis. It uses exercises that are tailored specifically for each patient, with the intention of returning the curved spine to a more natural position.
Schroth therapy can play an integral role in minimising the risk of progression and the need for surgery; as well as improving lung and digestive function, independence with daily activities, musculoskeletal symmetry and balance.
The scoliosis specific exercises are based on the original works of Katharina Schroth, and have been further developed and taught by the Barcelona Scoliosis Physical Therapy School (BSPTS) under the guidance of Dr. Manuel Rigo.The BSPTS is a recognised method for the treatment of Scoliosis by the International group Society of Scoliosis Orthopedic Rehabilitation Treatment (SOSORT).
It is essential that scoliosis patients are aware of the benefits of The Schroth Method and that this type of therapy can only be delivered by Physiotherapists that have passed certification examinations and extensive specialised training – this is not your ordinary back care!
The importance of exercise
Exercises have been shown to have a positive effect on decreasing the progression of curves, improving posture, improving lung and organ function, and for pain management.
The Schroth specific exercises use the following principles of correction.
- Self-elongation from a neutral stable pelvis.
- The ability to recognise the different shapes of each side of the back and how to produce forces to decrease this difference.
- Corrective breathing to expand the areas of the spine that are compressed due to the Scoliosis.
- Stabilisation and strengthening in the corrected posture, which carries over to daily activities.
The changes in the spine achieved by the exercises depend on various physical factors including: Cobb angle; amount of rotation; amount of soft tissue tightness; and degenerative changes in the discs or the joints of the back.
When can my child begin Schroth treatment?
A good time to begin Schroth treatment is during adolescence because of the increased risk of curve progression during that time. It also ensures the level of maturity required to oncentrate and follow directions as the exercises are taught. If the child is younger they are appropriate for a modified version of the program.
What happens during treatment?
In your first appointment, Rosemary will review all X-ray or EOS films, perform a musculoskeletal evaluation and provide a suggested plan of action. If you, or your child, requires Schroth, or other, scoliosis treatment, Rose will create an exercise program and therapy plan that is specific to the circumstance and curve pattern. These exercises will be practised in the clinic to ensure they are learned correctly and you are comfortable practising them on your own. Then a home exercise program will be developed, including photographs and often a video, to assist with the carryover of all the corrections and exercises.
Does this mean my child won’t need a brace?
Not necessarily. The treatment plan for all cases is individualised and we will liaise with other health professionals and the family as required.
Can adults do Schroth?
Yes, adults can do Schroth. Adults tend to have more pain than children, even if the adult curve size is small. Degenerative changes, a long-standing history of scoliosis and a multitude of other factors can all contribute to the pain. Schroth therapy is often combined with traditional Physiotherapy techniques to ensure that pain management is addressed. We aim to strengthen the entire body, not just the spine.
What improvements can I expect from Schroth therapy?
We aim to equip patients with exercises that are specifically designed to improve their posture with scoliosis. Schroth therapy, if done intensively and appropriately, may be able to achieve one or more of the following improvements.
– Reduce the size of the curve (even a slight improvement is a great outcome)
– Maintain the curve to minimise progression risk
– Slow down an aggressively progressing curve
– Improve posture
– Improve breathing capacity
– Work well in conjunction with bracing, when and if bracing is required
– Prepare a patient for impending surgery
– Strengthen a patient in a post-operative situation
What are the benefits of Schroth before and after surgery?
Schroth techniques can be used as a way of preparing the body to be in the best position possible before surgery. It can also be an excellent part of the rehabilitation process. It is important to remember that there is no cure and patients will still have scoliosis after surgery. Surgery improves the position of the spine; while Schroth retrains your muscles and improves posture.
What results have we achieved?
Incredible results are happening every day. The best results come from the most committed patients and those that realise Schroth therapy is about learning the tools that will equip them to manage their scoliosis for life. The ultimate goal for all our patients is to avoid surgery, where possible. However, it is sometimes necessary and in those cases we aim to get the patients as physically prepared as possible.
How many sessions are needed?
Rosemary will recommend an individual treatment plan for each patient based on daily home exercises plus regular treatment sessions in the clinic. However, we do take into account the busy lives of patients, as well as finances, and distance required to travel to our clinic. The length of treatment is dependent on each patient but it is important to remember that exercises are intended to become a part of daily life.
At Schroth Scoliosis Physiotherapy Clinic we understand that managing scoliosis, especially in adolescence, can be a delicate and difficult time. With this in mind, we now have an on-site family psychologist to provide counselling to patients, and their family members if required, to support them during this time. Please phone the clinic on (02) 8914 0508 for more information.
We are are passionate about providing you with the best possible treatment for scoliosis. For more information about our Schroth scoliosis therapy, or to book an appointment, contact the clinic today on (02) 8914 0508. Alternatively you can book online.
We look forward to working with you to create the best possible outcomes for you and your child.
For further information on the effectiveness of physiotherapy and scoliosis specific exercise programs read these articles:
- Schreiber S, Parent EC, Moez EK, et al. The effect of Schroth exercises added to the standard of care on the quality of life and muscle endurance in adolescents with idiopathic scoliosis-an assessor and statistician blinded randomized controlled trial: “SOSORT 2015 Award Winner”. Scoliosis. 2015;10:24.
- Kuru T, Yeldan İ, Dereli EE, Özdinçler AR, Dikici F, Çolak İ. The efficacy of three-dimensional Schroth exercises in adolescent idiopathic scoliosis: A randomised controlled clinical trial. Clin Rehabil. 2015
- Monticone, M, Ambrosini, E, Cazzaniga, D, Rocca, B, Ferrante, S. Active self-correction and task-oriented exercises reduce spinal deformity and improve quality of life in subjects with mild adolescent idiopathic scoliosis. Results of a randomised controlled trial. European Spine Journal Eur Spine J. 2014:1204–1214.
- Schreiber, Sanja; Parent EC,; Mez EK, et al. Schroth Physiotherapeutic Scoliosis-Specific Exercises Added to the Standard of Care Lead to Better Cobb Angle Outcomes in Adolescents with Idiopathic Scoliosis – an Assessor and Statistician Blinded Randomized Control Trial. PLoS ONE 11 (12): e0168746. doi: 10.1371/journal. Pone.0168746
- Scoliosis Research Society (SRS) Statement on Physiotherapy Scoliosis Specific Exercises: https://www.srs.org/about-srs/quality-and-safety/position-statements/srs-statement-on- physiotherapy-scoliosis-specific-exercises