Adolescent idiopathic scoliosis is a condition that affects children between the age of 10 and young adulthood and is described by the presence of an abnormal curve of the spine to the right or the left in the shape of an S or a C. Adolescent idiopathic scoliosis is by far the most common type of scoliosis and as many as 4 percent of all children between 9 and 14 years old have detectable scoliosis.
Adolescents with adolescent idiopathic scoliosis are generally healthy. Most are completely active, despite the curvature in the spine. Girls, or young women, are at higher risk than boys, or young men, with 60 to 80 percent of all cases occurring in females. Adolescent idiopathic scoliosis is regularly seen by the pediatrician or primary care physician, or during a school screening at the beginning of puberty or during a growth spurt. Adolescent idiopathic scoliosis is also the type of scoliosis with the best chance of not developing a worsening curve, which is why treatment usually begins with observation only.
The appropriate treatment for adolescent idiopathic scoliosis depend mostly on the severity of the spinal curvature and the physical maturity of the patient. Each children grow at different rates and experience growth spurts at different ages, the age of the patient is not as important as the child’s bone age.
The majority of children or adolescents will have mild curves (10-25 degrees) when adolescent idiopathic scoliosis is first diagnosed, and will therefore be treated with observation only in most cases. This means that the child will be seen regularly by a Pediatric Orthopaedic Surgeon, who will monitor the the curve with several standing x-rays over time. The spinal curves of most children do not progress, and no further treatment is needed. However, if the curve becomes more severe, the patient may require bracing treatment. The main goal of bracing is to begin treatment before the spinal growth period is completed.
The Schroth method is a conservative exercise approach to the management of scoliosis, kyphosis, and other spinal conditions. This specialized treatment for scoliosis is a form of physiotherapeutic scoliosis specific exercises, which are exercises founded in principles of self-elongation and specific muscle contraction individualized based on the shape of each patient’s trunk. The physical therapists with Schroth Certification Course have a solid foundation in understanding the biomechanics of scoliosis in order to best optimize the health of each patient’s spine and movement system.
This therapeutic method was created by Katharina Schroth, she began using a mirror and the image of a balloon to use her breath and the muscles of her trunk to address her own scoliosis. Her success in addressing her own posture prompted her to then pursue an education in physiotherapy and begin treating patients. Her family has carried on her legacy, and now Schroth is being practiced throughout the world.
The philosophy of this therapeutic method considers the whole person, and not simply a painful body part. The Schroth Physical Therapists take a history, and perform an exam that investigates the patient’s posture, function, movement patterns, breathing patterns, and muscle performance, as well as tissue tone. A plan of care is developed based on goals set by the patient and the physical therapist together and individualized to the patient’s needs.
The Schroth physical therapy exercises place a strong emphasis increasing the patient’s awareness of his body and the postures and movements that the patient routinely perform, as well as teaching the patient how to optimize his postural muscles to achieve a more neutral position that the patient can incorporate into sustained positions as well as movements and then integrate this new awareness into the patient’s daily and recreational activities. The patient and the physical therapist may utilize mirrors, hands-on guidance, as well as external props to facilitate the patient’s most optimal posture. The total duration of a Schoth physical therapy program will vary based on patient individual needs, but usually averages 10-15 total sessions.