As described in this post, we went to Spinal Dynamics to learn Schroth (and some SEAS) therapy, last year. So, what is Schroth, and what does it do?
Before continuing, since I get into some detail about therapy methodology, I need to reemphasize I have no medical training of any kind, much less any Schroth certifications. I’m sharing share an introductory overview from a layman’s perspective, to help others who are interested in Schroth learn more about it. Please see a licensed Schroth therapist for practical application and make no medical decisions based upon information herein.
My sources of info?
- I read and recommend “Three-Dimensional-Treatment for Scoliosis.” This is not a clear and concise “how to” book.” After walking you through a lot of technical and conceptual info, it does walk you through several Schroth exercises. Unfortunately, the correct application of Schroth is very specific to the degree, location, and direction of curves and rotation of the particular patient’s spine.
- We took our girls to see Dr. Peter Arndt, DPT, at Spinal Dynamics in Wisconsin for one week, 30 hours, of Schroth and SEAS therapy. (though, any inaccuracies in my understanding or recollections should not reflect poorly on him)
- Online research (Gotta love the net!)
Schroth in a nutshell, as I see it: Learn to achieve and recognize (i.e. “feel”, a.k.a. proprioception) the proper elongated, straightened, and de-rotated position for your spine and hold it while breathing, engaging your torso muscles, and performing other activities. In so doing, you strengthen and activate weak muscles in the target position.
In practice, Schroth is based on certain key principles such as:
- Adjusting pelvis and shoulders to achieve a capital “I” position (i.e. pelvis and shoulders level and in alignment)
- Elongation (a subtle stretching of the spine to help straighten… basically, standing up tall)
- Counter rotation (e.g. a typical S curve comes with a rib hump on the upper right back, this is rotated forward)
- Controlled Respiration
In our training, the pelvic adjustments included:
- A slight tilt forward (to 1 o’clock)
- Raising the tail up, to achieve proper lumbar lordosis if to flat
- Shifting right or left, depending on the curve, to achieve proper side to side alignment.
- Pelvic counter rotation (going counter to whatever the lumbar rotation is with the scoliosis)
More about the counter rotation…
The aim during the counter rotation movements is to correct the rotation caused by the scoliosis. An S curve, for example, has two convexities and two corresponding prominences (e.g. the places where the back “sticks out” such as the thoracic area, known as the rib hump.) The following image shows a top down view of the Thoracic region of an atypical S curve (thoracic convexity on the patient’s left). The red arrows (added to this image by me) indicate how, during Schroth, the patient attempts to engage the torso muscles (and breath) to counter rotate the spine, reducing the prominence of the rib hump. Meanwhile, the reverse is attempted in the lumbar region (where the prominence is on the opposite side), through pelvic positioning.
The Respiration component…
After all the above, upon achieving the most straight and de-rotated position attainable, the patient performs breathing exercises. The inhalation is the final stage of de-rotation as the patient attempts to direct the breath (breathing motion) into the areas opposite the prominences. Schroth refers to this as Rotational Angular Breathing (RAB). Then exhalation is what I would classify as isometric, resistive breathing. The exhale is resisted through pursing of the lips, or other such methods, which can create a hissing sound and aid the patient in creating that isometric tension to help engage all the muscles. This is repeated several times per position.
The above steps are performed in various positions including supine, side-lying, sitting, and standing. Mirrors are used to help look for and achieve proper alignment.
In addition to the strengthening of muscles that may atrophy as part of scoliosis, I believe Schroth and SEAS are, in part, about self-bracing. Personally, I have only minor scoliosis but had an injury leaving me with a couple degenerated lumbar discs. To improve my health, I’ve learned to continuously self-brace. Simply put, I’m aware of (proprioception as they refer to it in Schroth) my body’s position and I built the habit of holding my torso muscles slightly engaged at nearly all times to keep myself in a good and well-supported posture.
Through practice of Schroth and SEAS, our daughters are, in effect, learning to self-brace, with all the benefits that come from bracing only without brace related atrophy. Ideally, this becomes habitual for them like it has for me and it will continue to benefit them throughout their lives.
A common criticism levied against Schroth is that it is aimed at addressing only the cosmetic appearance of scoliosis (e.g. reducing the visible rib hump). I believe this criticism misunderstands the role of the
“visible” in Schroth. In my opinion, the visible aspects are only tools in achieving the aims. An aim, for example, is to de-rotate the spine. A visible cue, for seeing if this is being accomplished, is the reduction of the visible rib hump.
Oh yeah, a quick bit about SEAS….
While I’m sure there’s more to it, given the training we received, I saw SEAS as more practical application of the above principles while performing activities. This, I think, helps train the person to be able to habitually hold corrective positions while engaging in day-to-day activities. Examples include rising from sitting to standing and back, or tossing a ball, all while holding corrective positions.
About Spinal Dynamics of WI
I can’t provide any comparisons with other clinics but everyone we encountered at Spinal Dynamics seemed friendly, knowledgeable, experienced, and professional and I think they were worth the trip from Cincinnati to Wisconsin.
I still view all exercises and therapy as complimentary to bracing as recommended by our doctor. Our girls wear Rigo Cheneau style braces (which are complimentary to Schroth) about 21 hours per day and perform daily stretching and exercises of which Schroth is a part… but not all. I hope to cover more on the variety of exercises we use, in later posts.
My Standard Disclaimer: I am not, in any way, medically trained and you should seek professional medical advice before making any decisions based on information found here.