Many people are sent to general physical therapy for scoliosis and get standard core exercises and stretching. Their pain may improve a little, but the curve keeps progressing because the treatment is not scoliosis specific. In this article, I explain why scoliosis specific exercise like PSSE and the Schroth method matters, the risks of relying only on general PT, and how to choose the right provider so you give your spine (or your child’s spine) the best chance possible.
A Story I See Again And Again
A mom walks into my clinic with her 13-year-old daughter.
Her daughter is quiet, clutching a folder of X-rays. Mom is doing her best to stay strong, but I can see the worry in her eyes.
She tells me the story I have heard so many times.
Their pediatrician noticed the curve at a routine visit and sent them to a specialist. The specialist confirmed scoliosis and said, “Let’s start with Physical Therapy.” That sounded hopeful.
They looked up the nearest clinic, scheduled an appointment, and did exactly what they were told.
For weeks they drove to general PT.
Her daughter did planks, bridges, sit-ups, stretches, and a lot of “core strengthening.” The therapist talked about stretching the concave side of the curve and strengthening the convex side – very old-school thinking.
Her back felt a little better.
But then they went back for follow-up X-rays.
The curve was bigger.
That is usually the moment they start searching online late at night and eventually find scoliosis specific exercise, PSSE, and the Schroth method. Sometimes they find my clinic in time.
Sometimes they do not.
I have also met families who arrive in tears because they just left the surgeon’s office with a surgery date already on the calendar. They did “everything they were told” – including general PT – and still ended up here.
When I hear these stories, it hurts. Not because physical therapy is bad, but because the wrong kind of PT was used for the wrong problem.
Why General PT Often Isn’t Enough For Scoliosis Treatment
I am a physical therapist, so I believe deeply in movement.
But scoliosis is different.
Most general PT is designed for things like:
- Low back pain
- Sprains and strains
- Post-surgical rehab
- Sports injuries
Those are mostly 2D or simple movement problems. Scoliosis is a 3D structural condition.
If you only do general strengthening and stretching, you may:
- Feel a bit stronger
- Improve pain temporarily
- Move more comfortably
But you are not necessarily changing how the spine curves and rotates.
And if we are talking about a growing child or teen, time matters.
Scoliosis Is 3D – Most PT Is 2D
When I explain scoliosis to families, I describe it like this:
You are not just looking at the spine from the front and seeing a C or S shape.
The vertebrae also rotate.
The ribs shift.
One side of the trunk can become fuller, and the other side more hollow.
So scoliosis is not only a side-to-side curve. It is a three-dimensional twist of the spine and ribcage. General PT programs that focus on symmetrical core exercises or “good posture” often ignore that rotation and asymmetry.
That is why the old idea of “stretch the concavity and strengthen the convexity” is usually not enough. It treats scoliosis like a simple side bend, not a complex 3D pattern.
What Research Tells Us About General PT And The Curve
Studies looking at scoliosis treatment suggest that general physical therapy and non-specific exercise have not been shown to consistently change the progression of the curve.
Pain may improve.
Function may improve.
But the curve itself often continues to follow its natural path.
That is what families feel when they say, “She feels a little better, but the X-rays keep getting worse.”
On the other hand, scoliosis specific exercise (often called PSSE) has been developed precisely to influence the curve in all three dimensions. Some research and clinical experience suggest that, especially in growing kids and teens and when combined appropriately with bracing, these exercises can help reduce the risk of progression or even modestly improve the curve in some cases.
Is PSSE a guarantee that surgery will be avoided? No.
But it is a much more targeted tool if the goal is to address the scoliosis itself, not just the symptoms.
What Is Scoliosis Specific Exercise (PSSE)?
PSSE stands for physiotherapeutic scoliosis specific exercises.
That is a long phrase, so here is how I explain it in the clinic:
These are exercises designed only for scoliosis, built around how your spine actually curves and rotates, not generic “strength and stretch” routines.
They are:
- 3D – Working on side bending, rotation, and lengthening.
- Curve-specific – Different patterns for different curve types.
- Posture-focused – Teaching you how to sit, stand, and move in a more corrected position.
- Breath-based – Often using breathing to help open the collapsed side of the rib cage and derotate the spine.
The Schroth method is one of the most widely known forms of scoliosis specific exercise.
How The Schroth Method Is Different From General PT
When we use Schroth-based scoliosis treatment, we do not hand out a generic “scoliosis exercise sheet.”
We start by studying your X-rays, posture, and movement.
Then we:
- Identify your exact curve pattern
- Teach you a specific corrected posture for your spine
- Use targeted muscle activation, self-elongation, and rotational breathing
- Build a home program that fits your life
It is not about doing 100 crunches (which would be not good by the way!).
It is about teaching your body a new, more balanced alignment and training your muscles to support that posture.
Movement is medicine, but for scoliosis, it has to be the right kind of movement.
Why Many People Never Hear About PSSE
One of the most frustrating parts of my work is this:
Even though scoliosis specific exercise exists, many families are never told about it.
We have been working to educate local providers – pediatricians, surgeons, family doctors – about PSSE and the Schroth method. Some are very supportive and send patients early.
Others simply have not been exposed to the research yet, or they are used to doing things a certain way.
In one survey of scoliosis surgeons, only about 22% of scoliosis surgeons reported that they referred patients for scoliosis specific exercises (PSSE).
That means most families will never hear the words “scoliosis specific exercise” from their surgeon.
They just hear “Try Physical Therapy” and assume all PT is the same.
It is not.
The Risk Of “Just Trying General PT First”
I want to be clear: general PT is not harmful in most cases.
The real risk is time.
Especially in kids and teens who are still growing, curves can change quickly.
If you spend 3, 6, or 9 months doing only general PT while the curve keeps progressing, you might miss a critical window to influence the spine with more specific treatment.
That is how some families end up hearing, “The curve is now too big. We should talk about surgery.”
Again, surgery is sometimes the right and necessary choice.
But I never want a family to get there simply because they did not know scoliosis specific exercise was an option earlier.
How To Find The Right Provider For Scoliosis Specific Exercise
If you or your child have scoliosis and have been told to do PT, here are some questions I would encourage you to ask before you start:
- Do you offer scoliosis specific exercise, like PSSE or the Schroth method?
- Have you had specialized training or certification in scoliosis treatment?
- Will my exercises be tailored to my exact curve pattern and X-rays?
- How do you measure progress beyond just pain? (For example, posture photos, trunk shift, rib hump, scoliometer readings, or cooperation with your physician’s imaging plan.)
- How much time is spent on education? You should leave understanding your curve, not just your exercise list.
If the answer is, “We mostly do general core strengthening and stretching,” you may want to keep looking.
At Align Therapy here in Utah, our entire scoliosis program is built around scoliosis specific exercise, PSSE, and the Schroth method. We work with both kids and adults, and everything we do is centered on your unique curve and your goals.
We have also created a scoliosis resource hub at https://aligntherapyutah.com/scoliosis-portal/ to help you start sorting through options and information.
What Working With Us Typically Looks Like
When someone comes to us for scoliosis treatment, we usually follow a simple, step-by-step process.
1. Discovery Visit
This is a low-pressure visit where we:
- Listen to your story
- Look at your posture and movement
- Review any imaging you already have
- Talk through your concerns and goals
It is a chance for you to see if scoliosis specific exercise feels like the right path, and for us to see how we can best help.
2. Detailed Scoliosis Evaluation
If you decide to move forward, we perform a more in-depth assessment:
- Curve pattern and balance
- Flexibility and strength
- Breathing pattern and rib mobility
- How scoliosis is affecting daily life, sport, or work
From there, we build a personalized scoliosis specific exercise plan.
3. Learning Your Curve-Specific Exercises
In your sessions, we teach you:
- How to find your corrected posture
- How to breathe into the collapsed side of your ribcage
- How to activate the right muscles to support the correction
- How to transfer that posture into sitting, standing, and movement
We take photos, give you clear home instructions, and gradually progress your exercises.
4. Ongoing Support And Reassessment
Over time, we reassess posture, function, and, when appropriate, coordinate with your medical team on imaging.
We adjust your program as your body changes and as life changes.
For adults, the focus is often on pain reduction, function, and confidence.
For kids and teens, we are often working alongside your doctor and, if needed, your brace provider to support the best possible long-term outcome.
You Deserve Scoliosis Care That Matches The Problem
If you have been doing general PT and feeling confused about why the curve is still changing, please know this:
You did not do anything wrong.
You followed the plan you were given.
The missing piece is that the plan was not specific enough for a 3D condition like scoliosis.
Scoliosis specific exercise is not magic, and it is not a cure. But in my experience, and in the research we have, it is a far better match for the actual problem than a generic strengthening and stretching program.
You deserve a plan that:
- Respects how unique your spine is
- Addresses the curve in all dimensions
- Builds your confidence, not your fear
- Gives you practical tools you can use every day
If you are ready to explore that kind of approach, we are here to help.
Take The Next Step
You do not have to navigate scoliosis alone.
If you or your child have been told to “try PT,” consider making sure it is truly scoliosis specific exercise with someone who understands PSSE and the Schroth method.
If you are in Utah or would like to talk about whether our approach at Align Therapy is a good fit, we would be happy to meet you.
Schedule a discovery visit to ask questions, see how scoliosis specific treatment works, and start building a clear, personalized plan.
Schedule a discovery visit or call us at 8019800860.
Small, consistent steps create real change. Let’s take the next step together.
This information is for educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Always consult your qualified health provider with any questions you may have about a medical condition.
