The “7 Schools Of Scoliosis”

March 19, 2019

If you want to know about the options that are out there for you and your scoliosis you have come to the right place.

You are not alone in seeking a non-invasive approach, which can be especially difficult if you live in North America. The reason being is that the North American approach to scoliosis is the“wait and see approach”.  As you wait your scoliosis will probably get worse, so it becomes self-fulfilling because once a scoliosis gets bad enough the only options are bracing and surgery. The reason most physicians in North America think that it’s  no use trying to use exercises for scoliosis is that they have not been exposed to any other ways of thinking.

Luckily other countries do think differently and there are different options for you out there.

Let me show you

In 2016 an article appeared in the Journal Scoliosis and Spinal Disorders that aimed to shed some light on how an exercise based approach to scoliosis may help and who is doing it.

They listed 7 major approaches or schools that share a common set of principles outlined by  the Society of Scoliosis Orthopedic Rehabilitation and Treatment (SOSORT).

Let’s look at the schools

I’m going to have a look at each of the approaches to see what, if anything, is unique about them, where in the world they  are and how you can access them.  Where possible I have provided links, but not all the schools have direct website, or display costs.

You might be wondering why I would be writing about these other approaches to scoliosis  when I am trying to promote my own approach.  Well, I think it is important to be informed.  I think that dealing with a scoliosis is a personal thing and some ways or methods of doing it will suit different people better than others.  Some people may want to travel and spend time in specialist clinics.  Others may like the convenience of an online approach, that’s not my decision, it’s yours, and it’s easier to make that decision when you have all the information.

What are the similarities?

The first thing to know about these 7 schools is that, along with the Scoliosis Correction Protocol™, they have the following things in common:

1) They use a 3-dimension approach to self-correction. This is something I’m very passionate about. The spinal joints move in all three planes, therefore any attempt to correct the way they move must be done in 3 planes.

2) They all train activities of daily living. In other words the exercises try and address common movements so that they are not disconnected from the patients life.

3) They include stabilization of the corrected posture. This means that stretching alone is not enough; exercises are also used to increase strength and endurance in the muscles of the spine.

These schools primarily focus on childhood or Adolescent scoliosis and therefore the scoliosis specific movements are part of a bigger picture of observation, psychological support and intervention and if needed bracing and surgery.

However most of the schools also adapt their programs for adults with scoliosis.

I’m presenting  the schools in the historical order in which they were developed. They include the Lyon approach from France, the Katharina Schroth Asklepios approach from Germany, the Scientific Exercise Approach to Scoliosis (SEAS) from Italy, the Barcelona Scoliosis Physical Therapy School approach (BSPTS) from Spain, the Dobomed approach from Poland, the Side Shift approach from the United Kingdom, and the Functional Individual Therapy of Scoliosis approach (FITS) from Poland.

 

What are the “7 Schools of Scoliosis”?

1.Lyon school of physiotherapy,

The oldest is the Lyon school of physiotherapy, it’s about 200 years old and was one of the first schools to use braces for scoliosis. This legacy continues today and they are mainly known for their braces using exercise as an adjunct.

The treatment protocol of the Lyon method depends on the patient’s age. Juvenile patients (younger than 15 to 17 years) do no stretching. Adolescent patients complete the entire program. With adult patients, the focus is on pain reduction and disc protection. The Lyon school also has a course of exercises that patients can do while in the brace.

If you are treated by a practitioner using the Lyon method you should also have access to mirror therapy which allows you to gain better control of your back and to their specialist breathing equipment that will allow you to strengthen your diaphragm and back muscles.

I couldn’t find a specific centre that specializes in treating patients onsite with this method, so I assume it is delivered via individual therapist who are trained in the Lyon method.

2. Schroth Method (Germany)

Developed by Katharina Schroth in the 1920s the method is taught round the world and in person via their intensive rehabilitative program which is at the Askelpios Katharina Schroth Spinal Deformities Rehabilitation Centre in Germany.

https://www.asklepios.com/bad-sobernheim/patienten/anmeldung/international-patients/

The clinic has a good reputation and apparently has a wait list to get in, no details of cost of a week with them were online though. Presumably the course is delivered on a case by case basis.

The premise of the Schroth method, as outlined by Katharina, is that breathing into the concave side while performing 3D specific exercises is the most effective way to correct a scoliosis. Most of the other 7 schools share this premise in one form or another.

However, one criticism I’ve repeatedly heard about the Schroth method is how complicated it is. This is backed up by a study from Kuru et al that noted that exercises performed in a clinic under supervision significant improvement in Cobb angle, quality of life and trunk rotation, but those who just did the exercises program at home did not have the same success.

There are Schroth trained physiotherapists all over the world and access to them is easier than finding people trained in the other methods. If you are going to seek out a Schroth practitioner make sure you work on mastering your home program because if the only time you do your exercises is when you are in the presence of the therapist it is going to get expensive really quickly, and that’s without factoring in the time it takes to drive to their location….

3. Scientific Exercises Approach to Scoliosis (Italy)

The Scientific Exercise Approach to Scoliosis (acronym SEAS) is as individually tailored conservative treatment for scoliosis based on current research. Therefore, it is always changing. At its core the approach follows the Lyon method but does not use bracing for mild-moderate curves.

The SEAS method focuses on active 3D self-correction of the scoliosis by means of patient education (first) and then developing the patient’s awareness of their deformity. So you have to do the work! The exercises don’t rely on outside aides, no fancy equipment that you have to rent or buy just to be able to do the exercises. The idea is that with awareness both of the deformity and the way to correct it, the patient is empowered to consciously make adjustments to the curve themselves. These adjustments are done in every plane—frontal, sagittal and rotational. They recommend performing the exercises 20mins a day in conjunction with physiotherapy every 3 months for 1.5 hours.

Another very important element of the SEAS method is the “team approach” involving the physician, the physical therapist, the orthopaedist, and the patient’s family. This approach is based on the belief that teamwork produces greater success in treating Adolescents than the work of a single professional. Teamwork improves patient compliance with exercises, leading to an improved outcome. Family counselling, with strong involvement from all family members throughout the treatment course, is also an important aspect of the SEAS treatment plan. You should factor this in if you are considering seeing a SEAS specialist as it really does involve the whole family.

4. Barcelona Scoliosis Physical Therapy School (Spain)

Originally a Schroth Centre, the Barcelona scoliosis physical therapy school is based on the Schroth principles of breathing and 3D treatment and is designed to treat Adolescent Idiopathic Scoliosis, some forms of congenital scoliosis and sagittal plane deformities such as Scheuermann’s disorder, which is essentially a big hump in the thorax without rotation.

The method is patient centred which means that the exercises are part of therapeutic spectrum that includes observation, psychological support, bracing and surgery.

The school has 7 goals for each client.

1) correct the ‘scoliotic posture’ and improve aesthetics,

2) stabilize the spine and arrest the curve progression

3) educate patients and families about the condition and treatment options 4) improve breathing function

5) increase activity, including activities of daily living and functional mobility

6) improve overall self-image and self-esteem

7) decrease pain

Elena Salva, the physiotherapist who founded the approach, taught and certified Schroth practitioners in Spain for 40 years before developing her own approach, so they are very similar but the additional focus on self image and family education differentiate this approach slightly from the Schroth method.

5. The Dobomed Method (Poland)

Originally developed by physiotherapist and physician Professor Krystyna Dobosiewicz, hence Dobomed, it has been practiced in Poland since 1982. This method is used as a stand alone treatment and with bracing. As with the other schools Dobomed utilizes an active 3D correction but focuses on the primary curve. This is similar to the Scoliosis Correction Protocol because once the primary curve begins to change it will influence the other secondary or compensatory curves automatically. They also emphasise increasing the kyphosis of the thoracic spine and lordosis of the lumbar spine. In other words, they are looking to add mobility to the natural arches that already exists in our upper and lower backs.

The exercises start with a person on all fours with a symmetrical positioning of the shoulder and pelvic girdles. This is unique to the Dobomethod, although, again, a similar approach is taken in the Scoliosis Correction Protocol. For equipment they only use mirrors, photographs and video for feedback to help patients learn the movements. The method has some promising research to back it up especially when it comes to patients’ ventilation or breathing abilities after treatment.

6. Side Shift (UK)

Led by Tony Betts, a UK physiotherapist the Side Shift method is built upon the theory that a flexible curve can be stabilized with lateral movements (this contrasts with the Dobomed method which does not use lateral movements).

The method was first used by Dr Min Mehta in 1984 for children with congenital scoliosis. She proposed that the growth of the child could be used as a corrective force to the scoliosis if the child did enough repetitive actions in the opposite direction of the curve while they were growing.   Although the method relies on frontal plane correction it also includes core stabilization of the spine via isometric lower abdominal, gluteal and scapular muscle strengthening exercises. The treatment is guided by different classifications and has different protocols for congenital scoliosis, Adolescent Idiopathic Scoliosis or Adult onset scoliosis.

7. Functional Individual Therapy of Scoliosis aka FITS (Poland)

FITS is a relative new comer compared to the legacy of the Lyon school or the Schroth method. It was created in 2004 by two Polish physiotherapists and essentially includes some new techniques and many of the elements found in the other ‘schools’. It can be used as a stand-alone therapy, in conjunction with bracing, for surgery prep, and for the correction of shoulder and pelvic girdles after surgical intervention.

The method is used for any size of curve and is completely individualized, therefore the process has to be guided by an experienced and specially trained therapist. It can be conducted in private clinics or in 1-2 week camps. Physical therapy is also integral to the program. This approach really does use some innovative ideas when it comes to influencing the muscles, joints, ligaments and bones of the spine. It shows that the founders are constantly thinking of way to improve and build upon the work that has been done by the older schools.

So what now?

Even though these schools all have a slightly different approach they share common goals; each method seeks to treat all aspects of the 3D scoliosis deformity by realigning the spine, rib cage, shoulders and pelvis to ‘normal’ anatomical postures. The evidence supporting the effectiveness of specific scoliosis exercises is growing, with more high quality research studies being published in recent years. The research must continue in order to further study the effectiveness of the various schools and to determine which methods and which exercises are most beneficial for patients.

You’ll notice that none of these methods started in North America, which makes accessing these for Americans difficult.
However there are other smaller, newer methods that could be worth investigating if you are still looking for an in person treatment.

For example:

Clear (USA)

Scoliosis SOS (UK)

Spiral Stabilization (UK, Czech Republic, Korea, China) (I’ve actually collaborated with this group and highly recommend their program).

Yoga for Scoliosis

 

And – my very own Scoliosis Correction Protocol – which is the only one currently in existence that can be completed online, saving you time and money in the process!

Find a link to the referenced paper here:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4973373/

 

 

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Over the last 10 years Ed has been building a YouTube library to help people manage their own pain or movement limitations and increase performance through exercise. He regularly adds videos so be sure to subscribe and visit regularly