Schroth Method and Pilates are two different but complementary methods of treating Scoliosis. Together, they are effective in Scoliosis management.
What is Scoliosis?
Scoliosis is a condition in which the spine curves abnormally. There are 3 different types of Scoliosis, neuromuscular, congenital, or idiopathic (meaning the cause is unknown). Mild idiopathic scoliosis is the most common type of Scoliosis. It can be caused by a number of factors including genetics, poor posture, or muscle imbalances.
A curve can be to the side (sideways) or to the front or back (twisted) and it often appears in adolescence, through puberty. It occurs more in girls than in boys.
It may be noticed by one hip being higher than the other, one shoulder more prominent, uneven shoulders or waist, or a prominence on one side of the back when bending forward. Mild curves may develop and go unnoticed as there is no pain at all. More severe curves can have complications such as breathing problems and back problems.
What Are the Treatments Available for Scoliosis?
There are a number of treatments available for scoliosis, including bracing, surgery, physiotherapy and exercise. Exercise is sometimes overlooked in the management of scoliosis but should be an integral part of the management of scoliosis due to it being non invasive, inexpensive, safe, accessible and effective. Exercise helps to improve strength, flexibility, and balance.
There are two main types of exercise that are effective in the treatment of scoliosis: the Schroth method and Pilates.
Schroth method was developed in the early 1900s by Katharina Schroth. It focuses on correcting the underlying muscular imbalances that may be contributing to the scoliosis and uses individualised exercises with the goal of de-rotating, elongating and stabilising the spine in a three-dimensional plane.
Pilates is a system of exercises developed by Joseph Pilates, also in the early 1900s. Pilates exercises focus on the development of inner core strength, flexibility, and balance to decrease pain and improve mobility.
How can Therapeutic Pilates and Schroth Method treat Scoliosis?
Both Pilates and Schroth method focus on the key elements of spinal elongation and stabilisation.
Emphasis is put on correct alignment first, and secondly strength, resulting in better overall symmetry and stabilisation of the curve. Together, the unique combination of Schroth Method and Pilates take on an individualised approach to treating scoliosis focusing on straightening, centralising, and de-rotating the spine. The combination of these two methods improve scoliosis by;
- Correcting posture: Reduces the curve.
- Increasing strength: Make the muscles that support the spine stronger.
- Increasing flexibility: Improve range of motion and reduce pain.
- Improved quality of life: Reduces pain, increases confidence.
- Improved balance: More symmetrical, less likely to have falls.
Schroth method and Pilates both also take on corrective breathing techniques, mindful breathing, and body awareness. The Schroth method uses a special breathing technique called rotational angular breathing. The idea is to rotate the spine with breathing to help reshape the rib cage and surrounding soft tissue.
Schroth method and Pilates teach mind-body awareness, and improve the mind-body connection. Having a strong mind-body connection allows the individual to be more aware of how they carry themselves through day to day activities. This enhances posture and stability of the curve. When you have scoliosis, it is very important to be aware of how you carry out day to day tasks, as it can be easy to slouch into your curve and cause the scoliosis to progress further or worsen as you are if you are not aware of how you hold your body.
The strengthened mind-body connection from Schroth Method and Pilates helps to:
- Lengthen shortened muscles
- Strengthen weak muscles
- Reduces pain
- Improve functionality
Adolescent vs Adult:
The treatment of adolescent scoliosis and adult scoliosis differs slightly as the goal for adolescence is to slow down the progression of the curve, and create a strong set of muscles to hold the spine upright. For adults, the focus is to release tight muscles and joints, as well as prevent wear and tear on the joints. Both adolescents and adults can benefit from the combined treatment of Schroth method and Pilates.
From the Literature:
One study, published in the Journal of Medical Science in 2020, found that combining Schroth method and Pilates is more effective in the treatment of scoliosis than either method used alone. In this study, 69 teenagers aged from 10 to 17 years were followed over a 24 week period. They all had cobb angles from 10 – 45 degrees. Participants were given exercises using the Schroth method and Pilates to be performed for 2 hours per week over the 24 weeks. Their angle of trunk rotation (ATR), chest expansion, trunk flexion, and quality of life (QoL) were all measured by a physiotherapist.
The results showed that the combined exercises significantly improved the cobb angle and also provided benefits on ATR, chest expansion, and trunk flexion in adolescents with mild and moderate idiopathic scoliosis. Their quality of life was assessed by a questionnaire assessing function, pain, self image, mental health and satisfaction, of which, all components improved after the 24 weeks.
Another study, published in the journal “The Spine Journal” in 2014, found that adults with scoliosis who participated in a combination of Schroth Method and Pilates exercises for 12 weeks had a significant improvement in their quality of life compared to adults who participated in a control program.
This treatment is all encompassing and offers a non-invasive and safe method of improving posture, balance, strength and flexibility. It can help to reduce pain, and slow the progression of curves, improving confidence and quality of life. Therefore, this method should be considered at the forefront when treating patients with scoliosis.
FAQs about Scoliosis:
What are the signs and symptoms of Scoliosis?
- Uneven shoulders.
- One shoulder blade that appears more prominent than the other.
- Uneven waist.
- One hip higher than the other.
- One side of the rib cage jutting forward.
- A prominence on one side of the back when bending forward.
Healthhub.sg says that Scoliosis in schoolchildren is commonly detected during screening in schools by nurses who observe for asymmetry of the trunk when the child bends forward (known as Adam’s forward-bending test).
How is Scoliosis diagnosed?
Scoliosis is typically diagnosed through a physical examination from a healthcare professional. The exam may include a test called the Adam’s Forward Bend Test. They will also assess your posture and range of motion. X-rays, MRIs, or CT scans may also be ordered to get a more detailed view of the spinal curvature, aiding in diagnosis.
From the x-ray, doctors can measure the cobb angle, a measurement of the degree of side-to-side spinal curvature, describing the distance from straight. It is considered to be scoliosis if the cobb angle is more than 10 degrees.
What happens if I don’t treat scoliosis?
Mild cases may not need treatment. For moderate and severe cases, without treatment, the curve will more than likely progress. This can cause further deformity and may also have increased pain, resulting in physical activities becoming harder. Early detection and appropriate treatment can help prevent further progression of scoliosis and minimise the risk of complications.
Does untreated scoliosis get worse?
Though some curves do not progress over time, most scoliosis curves do worsen over time. This is especially true for adolescence, when growth is rapid and the body is still growing and developing. The progression of scoliosis varies from person to person. The severity of scoliosis rarely worsens after adulthood. However, some adults may face pain, reduced lung function and difficulty in certain daily functions, among other issues.
Early diagnosis and decision to seek treatment are essential for managing scoliosis. Untreated, curves can worsen, increasing pain and may impact your mental health, and ability to participate in physical activities.
Can I still live a normal life with Scoliosis?
Yes, individuals with scoliosis can have normal, happy and active lives with treatment and support. Most people with mild to moderate scoliosis do not experience significant limitations in their daily activities. You may require some extra doctor visits, physiotherapy or wearing of a brace, but you can still participate in a majority of sports and activities. In some cases, scoliosis can cause physical discomfort, affect mobility, and impact self-esteem. If you are struggling, support groups can help where you can talk with other people who also have scoliosis. These are available for children and teens, and their parents.
Should I be worried if I have Scoliosis?
Receiving a diagnosis of scoliosis can understandably cause worry and concern. It is great that you are aware of your condition and therefore can start taking steps to improve and manage it. It is rare that scoliosis causes severe immobility and pain. Most people diagnosed with scoliosis can live relatively unrestricted, normal lives. Very few individuals with scoliosis experience health complications such as respiratory issues, or chronic pain.
We recommend working 1:1 with a specialised Schroth therapist who can provide the guidance and reassurance you need to navigate your condition.
Can scoliosis be cured?
While there is no known cure for scoliosis, appropriate treatment can help manage the condition and prevent it from getting worse. In some cases, surgery can improve the curvature of the spine, but it is not always necessary. Other treatments include bracing and physiotherapy. Choice of treatment is determined by factors including, curvature, age, and likelihood of further progression. Early intervention is a key element in minimising the effects of scoliosis on your daily life.
What should I avoid?
While scoliosis does not necessarily require lifestyle restrictions, there are certain activities that individuals with scoliosis may want to avoid, including;
- Heavy lifting or carrying objects that strain the back
- Participating in high-impact or contact sports that may put excessive stress on the spine
- Engaging in activities that involve deep backbends or extreme spinal positions
- Maintaining poor posture, such as slouching or hunching
Can scoliosis be fixed naturally?
While there is no natural remedy or cure for scoliosis, the combination of Schroth method therapy and Pilates has been shown to improve quality of life for those with scoliosis! These combined methods improve posture, balance, strength and flexibility. It can help to reduce pain, and slow the progression of curves, improving confidence and quality of life.
Can Pilates exercises help Scoliosis?
Pilates is well known for developing body awareness and deep core muscles to support trunk stabilisation. While it is difficult to fully reverse the spinal curvature with Pilates exercise, a targeted program can help to release tight areas of your spine, improve body awareness and alignment and strengthen the intrinsic muscles that support and control your spine.
Especially when Pilates exercises are used in combination with Schroth Method principles, we aim to even out muscle imbalances and to develop the inner muscles of the rib cage in order to change the shape of the upper trunk and to correct any spinal abnormalities. In adults, this aids movement and pain relief whilst in adolescents, more progress in terms of slowing down the progression or reversing the spinal curvature can be achieved.
Fun fact: Did you know that Usain Bolt – world record Jamaican sprinter has scoliosis!