At my Physical Therapy Clinic in Lehi, Utah, we have been seeing clients for scoliosis specific exercise for the past 7 years. During that time, we have been trying to change the perception that nothing can be done for scoliosis.
Sure, scoliosis has been “treated” for a long time in the United States, but proactively treating it using scoliosis specific exercise is fairly new to our repertoire. It wasn’t till around 2005 that we even really had practitioners in the Schroth Method in this country.
Prior to that, and sadly even today, the “wait and see” approach is the most common method of treating scoliosis.
This is how that treatment approach works.
A child comes into the doctor’s office for a well check. During the well check, the child is told to bend forward and a slight difference is noticed in the rib height on one side. This triggers the doctor to order an x-ray which then reveals the child has scoliosis.
At this point, the doctor usually says, “Well, let’s do another x-ray in 6 months and see if it has gotten worse.” Thus, the wait and see approach begins!
When 6 months goes by, another x-ray is taken. If the curve has gotten worse, the conversation then goes something like this, “Well, it looks like the curve got worse. Let’s do another x-ray in 6 months and see if it gets more worse. If it does, then we may need to start bracing.” A continuation of the same approach.
As another example (one I see all the time): Consider a man in his 60’s who goes into his appointment with a spine surgeon. The surgeon takes an x-ray, finds scoliosis, and suggests, “Well, when it is bad enough where you are ready for surgery, give me a call.” (A variation on the “wait and see” approach, but basically the same)
The main problem with this approach? It is TOTAL lack of treatment, unless it progresses to needing a brace or surgery.
Why are we still treating scoliosis in this way, especially when there is a significantly BETTER option than just waiting.
Scoliosis specific exercise is fairly new to the US, but it has been done for many decades…well, almost a century…in Europe. There are 5 methods of treating scoliosis out of Europe, and even some being developed in China and other countries.
You may be wondering if these are hokey pokey treatments that are “alternative” treatments like snake oil. This is far from the truth!
For example, look at the Schroth Method. This method has been around for 100 years, and a quick PubMed search returns 96 articles. Sure, all of these are not of the highest quality, but there are many that are randomized controlled trials supporting the use of this method.
The SEAS Approach from Italy has also been studied, with 19 results on PubMed.
(Going more in depth on the research behind these approaches to scoliosis treatment is beyond the scope of this blog post, but I would refer you to our Scoliosis Research page to see a breakdown of some of these articles.)
In my visits with scoliosis surgeons, pediatricians, orthotists, and many others, I hear the concern of not having enough “supporting research” to show it is effective. They are still on the fence whether or not exercise in the form of scoliosis specific treatment is actually effective and worthwhile for their patients.
I do have to say that for the most part, this comes from a position of protecting their patients from treatments which are not effective and could delay more mainstream intervention.
Recent studies have shown exercise, and even general Physical Therapy, has NO EFFECT on reducing curve progression. This much is very clear, and may be looked at as proof we can’t affect the curve with exercise.
BUT!….that is not considering scoliosis specific exercise from someone trained in one of the schools of scoliosis treatment. When that is taken into consideration, the research absolutely supports the use of SCOLIOSIS SPECIFIC EXERCISE to halt or reduce progression of the curve.
Let me reiterate…..Exercise and general Physical Therapy, DOES NOT affect the curve, BUT, Scoliosis Specific Exercise DOES!
That is a very important distinction. I feel like many medical providers in the US feel like all Physical Therapy is the same. The PT clinic down the street can treat scoliosis the same as anyone else, and since that doesn’t seem to work, then all of Physical Therapy doesn’t work for it.
This is definitely a flawed way of thinking. That is like saying all MD’s treat heart problems equally well. If you have a heart attack, you don’t need to see a cardiologist, because your general practice doctor treats it the same.
Well, I don’t know about you, but if I have a heart attack, I would be going to the specialist…the cardiologist. Why? Because you will get more specific and better treatment. That is what they do and they are good at it!
The same goes for specialists in Physical Therapy. Most PT’s get 15 minutes of instruction during school on what scoliosis is and how to treat it. On the other hand, those trained in scoliosis specific treatment have hours upon hours of training and much more experience.
Really, the bottom line is, YES scoliosis can be treated effectively using exercise! But, it has to be the right kind of exercise.
Over the past 7 years that I have been treating scoliosis, I have seen some amazing results. I have seen patients avoid surgery, reduce pain, and even reduce the size of their curve. I have seen kids and adults learn how to take control of their scoliosis and not just be at the mercy of it.
Of course, this depends on a lot of factors, and we don’t see the same results with everyone, but why not do SOMETHING instead of NOTHING?
If you do nothing, then the scoliosis will do what it will. That might be progression of the curve to bracing or surgery, or who knows….maybe it wouldn’t have progressed anyway.
If you do something about it, like scoliosis specific exercise, then you are more likely to stop it from getting worse and improving the future.
Besides, there is no real downside of treating scoliosis conservatively. Sure, you might be stronger, have better body awareness, and better posture. But who really wants that!
It really is time we change the way we treat scoliosis in this country. The old way of “wait and see” is not the best for our patients, and it shouldn’t be the standard of care. There is a better way, and it is much more accessible than it once was.
Take the reins and start controlling YOUR scoliosis instead of waiting to see if it controls you. I can’t guarantee you will see amazing results, but if you never try, I can guarantee you WON’T get amazing results.
Thanks for reading! Comment with any questions or thoughts you have. If you are looking for specific treatment for scoliosis, check out our option for a Free Consultation. You won’t regret it!
David Butler, Physical Therapist