Scoliosis Blog

Since my return from Wisconsin things have been very busy. I took a few sets of x rays with me to Wisconsin to review with Dr Rigo and have commenced treatment with these patients.

I would like to think that they are all doing very well but this sort of terminology is fraught with danger as “doing very well” encourages an expectation of improvement of Cobb angle where this is, in my mind, not the direct aim of the Schroth method.

It is important to recognise that the Scoliotic curve is a 3 Dimensional curve and that the Cobb angle measures only the lateral deviation of the spine. It does not indicate the rotation of the spine (which can be indicative of the magnitude of the rib hump), nor the saggital profile of the spine. This means that 2 people with the same Cobb angle can have totally different scoliotic curves and rib hump sizes. Therefore it is possible to encourage a better scoliotic curve without a measurable difference in Cobb angle.

The aim of the Schroth method is to teach the patient an alternate posture by gradually de constructing the existing scoliotic curve. It is possible and we have observed in our patients that the lateral translations can be centred and that the rib hump and lumbar prominences can be derotated and the collapsed areas of the thorax and lumbar region can be de-collapsed during the exercises. Whether or not this alternate “corrected” posture can be maintained in the long term depends on the patient. However, even intermittent unloading of the scoliotic torsion during the daily exercises is beneficial to the patient.

Each Schroth based scoliotic centre seems to have its own treatment protocol and we are currently refining ours. It seems that the best outcomes are achieved when we can see our patients more frequently and for longer periods in the initial stages. There is an initial steep learning curve for the patients to recognise what we are trying to achieve, to then internalise the process and then perform the movements and then perform them correctly.

I am tending to lean towards a treatment protocol we devised for an out of town visitor of 5 days of consecutive visits of between 2 and 3 hours. We were able to get through a great deal of work and this formed a very solid foundation to the program. We are seeing the same benefits when local patients attend treatment more regularly in the initial stages.

In order to perform Schroth exercise the patient will require a few props and devices. These items will be listed in the FAQ section.