Is all Physical Therapy the same for Scoliosis?

In 2015, I decided to open my own practice in Lehi Utah to make specialized treatment in scoliosis more accessible. Until then, scoliosis specific exercise treatment wasn’t available within 250 miles.

Since then, I have been asked many times what the difference is, and if all Physical Therapists treat scoliosis. Being a scoliosis specialist, I am probably a bit biased to the methods we use to treat scoliosis, but in this blog post I wanted to share why specialized treatment is necessary in many cases.

First of all, lets look at how we, as Physical Therapists, are trained in school to work with scoliosis. Over the last 15 years, I have had 34 PT students in my clinic. I have asked them what their scoliosis specific education and instruction has been in class, and most of the time the answer is less than an hour of instruction. This instruction goes over the anatomy of scoliosis, how to test for it, and then for most programs, 15 minutes on how to treat it.

This education on treatment usually looks at a very simplistic way of treating scoliosis with strengthening the convex side and stretching the concave side. There are multiple problems with this approach, but that will be discussed later.

Compare that to training I received to be a Schroth Certified Therapist. For that certification, I spent 80 hours over 10 days learning anatomy, treatment, physiology, treatment protocols, and multidisciplinary treatments. Then, we were tested on what we had learned.

And that was just the first level of certification. I then returned to the Barcelona Scoliosis Physical Therapy School to spend the same amount of time on learning about adult and juvenile scoliosis treatment. This was also followed by a test and practical exam.

This is also just training in one method of scoliosis treatment. There are many other methods with similar training.

Now, I am not saying this to toot by own horn, but rather to compare the amount of education someone specialized in scoliosis has compared to a regular PT.

Think of any specialist in the medical field, or many other fields for that matter. They are specialized because they have had more training in treating a specific population. Specialization for scoliosis treatment is no different.

This brings me to the reason why I decided to write this blog post.

Over the last 7 years, I have struggled with a couple of insurances not covering scoliosis specific exercise at my clinic because “any Physical Therapist can treat scoliosis”….or….they “have Physical Therapists in the area who are specialized in it”.

Upon hearing that there were more PTs specialized in scoliosis in my same area, I called them up only to find out they have no specific training in scoliosis specific treatment.

This is frustrating to me, but even more frustrating to patients who are expecting their insurance to do what is best for them.

The idea that ANY Physical Therapist can treat scoliosis is an interesting one. Yes, all PTs have scoliosis in their scope of practice. We all should know what it is, and CAN we treat it? Well, yes. But, SHOULD we ALL treat it? Now, that is debatable.

Most of the time, when someone goes in for treatment to someone not trained in scoliosis specific exercise, they are treated with core strengthening, stretching the concave side, and strengthening the convex side.

If someone has back pain, and a mild curve, and they are not at risk of progression, then, sure, this could be an adequate treatment to reduce the back pain. In my opinion though, this is not treating scoliosis, this is treating back pain.

To treat the scoliosis, we must understand it at a deeper level and treat all its many sides. This is the beauty of scoliosis specific training. We know how to treat the 3-dimensional nature of the scoliosis. Not just the convex and concave issues, but the rotations and the sagittal profile as well.

If someone has back pain that is consistent with the scoliosis, or they are still growing and have a high risk of progression, or they are having degenerative changes later in life causing progression of the curve, then they should be treated specific to their curve.

A recent study looked at the effectiveness of therapy for scoliosis provided by a general Physical Therapist compared to treatment for scoliosis provided by a Physical Therapist trained in scoliosis specific exercise. The difference was significant.

The group treated by the PT specialized in scoliosis saw no progression of the curve (with some seeing a reduction), and the group treated by a general PT had their curves increase. This is a significant finding and shows general PT has no effect on progression of the curve, while specialized PT DOES effect the progression.

Before I got certified in scoliosis treatment, I remember seeing some patients with scoliosis. To be honest, at that time, I really didn’t know what to do with them. Sometimes they had less pain and sometimes the pain didn’t respond. But I do remember feeling like I wasn’t really affecting the curve. I just didn’t know what to do.

And that was after I had been an orthopedic specialist for 7 years! Without specialized training in scoliosis, I didn’t get the outcomes I now see on a daily basis.

So, my suggestion is…if you are looking for treatment of scoliosis, look for someone specialized in it. This means looking for a certified Schroth Therapist, or someone trained in one of the other schools of scoliosis treatment. (SEAS Approach, Lyon, etc)

This is not to say that other PTs can’t help you with your back pain, however. I am a firm believer in Physical Therapy, and it can work miracles.

But….if you are looking to treat the curve specifically, make sure you see someone who knows how to treat the curve specifically.

If you are looking for more information on scoliosis specific treatment, make a comment! You could also email me directly at david@aligntherapyutah.com.

Thanks for reading, and the best of luck with treatment of your spine!

David Butler, Physical Therapist

David Butler PT DPT
AUTHOR

David Butler

Align Therapy

"We help people with scoliosis and spine problems avoid surgery, reduce pain, and improve posture even if you have been told to wait and see if it gets worse."
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