Developed in the 1920’s, The Schroth Method has become widely recognized as the most researched and used conservative treatment of those with scoliosis and kyphosis. It was developed in Germany by Katharina Schroth, who found herself dealing with her own scoliosis and finding movements and exercises that improved the look and feel of it.
One-hundred years later The Schroth Method continues to be practiced, with schools teaching it around the world, and practitioners in almost every country. Along with this advancement, we have also seen a huge increase in the research supporting the current techniques inspired by Katharina Schroth.
The Schroth Method helps to improve balance of the spine using breathing techniques and specific exercises directed at the individual scoliosis or kyphosis curve. Learning to use the muscles and lungs to “actively self correct” the spine is essential to reducing pain associated with the curve and limit progression in the future. It has become the standard for treating scoliosis and kyphosis conservatively, and has been shown to stop or limit progression of the curve. Some studies are even showing reductions in the curve as well.
Along with these benefits, we don’t see any specific drawbacks to treatment. Strengthening, breathing, and postural retraining, really have no negative side-effects, and can only improve one’s self image and quality of life.
If you are reading this, you most likely have decided The Schroth Method is right for you, and you may be wondering what your first visit will be like. Having treated thousands of scoliosis and kyphosis patients, hopefully I can shed some light on what to expect on that first visit!
Check out this video showing what to expect on that first visit!
What to Bring and Wear
When talking about this first visit, it is important to discuss what you should bring to this appointment and especially what you should wear. This will ensure you are prepared for that visit and that your therapist has all the necessary information before starting you on exercises.
Here is a list of things I have my patients bring to their first visit:
- Your most recent x-ray: This will be reviewed and measured
- Medication list: If you take multiple medications, make sure to have this.
- Paperwork: This is usually filled out online, but if you need it printed off, that is fine.
- Doctor’s referral: If you have seen a doctor and they referred you, bring it.
- A parent: If you are a minor, please make sure to bring a parent. Better yet, bring both!
- Comfortable clothes: Make sure to wear clothes you are comfortable moving in.
- Sports Bra if Female: To really assess your back, your therapist needs to be able to see your back. Wear a sports bra or something that will allow them to do this.
Initial Assessment
Before you can do specific Schroth exercises, your physical therapist needs to perform an assessment to determine what curve type you have, where your weaknesses are, and what might be tight or need manual therapy. Depending on the severity of your curve, along with your overall health, this can sometimes take half of the time of that first visit.
IMPORTANT! This assessment should not be painful. If you have pain with any of the following, make sure to let your therapist know.
The following is what is normally included in the physical assessment, but there is most likely some variability in how each therapist does their assessment.
- Health and Spine History Review
To understand more about your spine, your therapist will ask you specific questions about your scoliosis, including your family history. They will also discuss your health history, and current aches and pains, to make sure to take into account any health issues you have. - Range of Motion and Strength
Because scoliosis and kyphosis affect the body’s symmetry, an assessment of strength and motion is helpful in guiding treatment. Your therapist might have you bend in different ways to see your back mobility. They will push on you to see your strength, and will most likely test your balance and reflexes. - Palpation of the Spine
To determine your specific spine issue, your therapist will have you lay on your stomach if possible, and then will push on your back. Determining the alignment of your spine is essential and this is done by pushing on each vertebrae lightly. The mobility of your spine is also helpful to know, so they will push on your back and ribs to determine this. If you are having back pain, they will also push on those areas to see where it hurts. - Scoliosis and Postural Measurements
A few measurements will be taken to assess your scoliosis or kyphosis. This can include bending forward while the therapist uses a scoliometer, or standing up straight while they use another device called an inclinometer to measure your kyphosis. They might also take pictures to document your posture at the first visit.
Some offices will use Surface Topography to image the back without using x-ray. - Other Testing
Sometimes, we like to assess other things we find as we go through the examination. This could be things like, lung capacity, shoulder or hip mobility, neck tension and range of motion…and many others. This is very individual and specific to what is found.
Education
After your examination, your therapist will talk to you about what was found. This is an important part of this visit because understanding YOUR curve is essential to being able to do Schroth Method exercises.
The therapist will most likely show you what is going on with a spine model. Make sure to pay attention and, most importantly, make sure to ask questions as they come up. We want you to understand what is going on. It is YOUR back after all!
Making a Plan
The examination and education help you and the therapist understand what is going on, and then they will work with you to develop a plan based on your goals. This is a crucial part of treatment and it needs to be based on what you want out of treatment, not necessarily what the therapist would like to achieve.
This involves deciding how often you are going to attend therapy in the clinic as well as what you are going to do at home. The therapist will discuss what they feel is the best plan, but here are a few things you need to consider during this discussion and plan:
- What are YOUR goals?
Make sure you are working toward things you want to achieve. What brought you in in the first place? Do you want to stop progression, reduce pain, improve posture, get off pills, avoid surgery, etc? Make sure the plan is working toward those things. - Commit to it!
If your therapist tells you they need you to do exercises at home 5 days a week, will you do it? Really consider this and talk to them about your concerns. Don’t commit to something you aren’t willing to do. - Follow Through
After developing the plan with your therapist, make sure to do your best to follow through with it. Motivation is high at this point to do something about your spine, but you may need to strategize what to do when that motivation is lacking. Your therapist can help with this and can give you ideas.
Basic Schroth Exercises
Finally, we get to what you actually came in for! At this point, you should understand what YOUR scoliosis or kyphosis is like, and you have developed a plan to get you to your goals. Now, it is time to learn curve specific exercises.
The therapist will start you off with some basic Schroth Method exercises designed to help you learn body mechanics and improve your awareness of where your spine is. Breathing exercises will be used to improve your lung function so you can use this powerful force in active self correction.
You will most likely use some equipment to perform these exercises, and your therapist will discuss how you can do these exercises at home.
Warning! Some of these exercises may seem very basic and easy, but I assure you, they are crucial to learn. Being able to understand the basics of Schroth will help you do the more advanced exercises better and improve your results, so don’t skip doing these at home.
Don’t leave until you:
- Have clarity on what you are supposed to do at home.
- Know what equipment you will need or have received that equipment.
- Ask all of your questions related to the exercises
Follow Up
You have learned many things about your scoliosis or kyphosis, you have made a plan to meet your goals, and you have learned some exercises to get started on. This is just the start!
Make sure you discuss with your therapist when you are coming back to learn more. Schedule that visit, and even better, schedule out your whole plan of care. Commit to it! The more committed you are to the plan, the better your result will be.
If you notice some aches and pains related to muscles working differently than they have, that is a good thing. If you are noticing pain that is not exercise type pain, make sure to let your therapist know so they can modify things. Remember, this shouldn’t be painful!
Now, with the first visit under your belt, you are ready to really do something about your curve. Take the reins and really work hard at these exercises. You only get out of these exercises what you put into them.
On your next visit, you will review what you did in the first visit, and progress your exercises. This can only happen when you have practiced them and are getting better at them.
I hope this blog post sheds some light on what the first visit looks like with The Schroth Method. It can be a complex method for treating these curves, but it is also the most effective in the current research.
If you are looking for Schroth Method treatment for your scoliosis or kyphosis, click HERE to sign up for a Free Consultation at my clinic where we can talk about how this can help you.
Thanks for reading!
David Butler, Physical Therapist
