Rehab Insights is a weekly blog written by Burke Rehabilitation professionals to offer practical information for patients, families and the community. Its goal is to educate the reader on relevant topics in rehabilitation, general health and wellness.

Somers Outpaitent Clinic Spearheads Scoliosis Treatment

According to the National Scoliosis Foundation, roughly 7 million people in the United States suffer the effects of scoliosis. Burke Rehabilitation Hospital’s outpatient clinic in Somers, New York is at the forefront of providing specialized physical therapy to treat scoliosis, called a Schroth program.

The treatment method was named for Katarina Schroth (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3180431/), who pioneered the approach in Germany in the 1920s.  Its underlying principles are to build muscle symmetry, develop efficient breathing techniques, and create postural awareness. The method was perfected over several decades in Europe, where it is practiced as standard scoliosis treatment.

Although only recently introduced in the United States, more and more American orthopedic surgeons are prescribing it. Jill McDonald is Burke’s first Certified Schroth Therapist, practicing at the Somers location. “We are receiving more and more patient referrals from specialists at NYU, Hospital for Special Surgery, Columbia, and Montefiore Hospital,” she says, “as well as from pediatricians.”

Scoliosis is an abnormal curvature of the spine that resembles a letter “C” or “S” when viewed from the back.  Inside the body the vertebrae are rotated and spaces between them are compressed in some locations and and stretched in others.  This overworks some back muscles, leads to the deterioration of others and can cause breathing difficulties.

Most patients are diagnosed between the ages of 10 and 15, but adults can also be affected.  School nurses and pediatricians frequently detect the condition, during a simple screening where the child bends forward from the waist.  

The severity of scoliosis is determined by the degree of curvature in the spine. Patients with a curve of 20- 25 degrees often wear braces while those with curves exceeding 45 degrees may require surgical intervention.  Not all scoliosis cases require treatment, but the condition can be progressive, so children diagnosed with milder (10-15 degree) curvatures should be carefully monitored, especially during puberty.

“A large part of Schroth therapy focuses on stabilizing the spine to arrest progression,” explains McDonald. This involves activating the muscles to support the spine. It also requires visual feedback, so her patients use a mirrored wall bar to remind them of what proper body position looks like. Some of the exercises include “hanging” from the bar to elongate and stretch the spine, and using traction belts to create as much tension as possible in the body, allowing greater movement to occur.

As one of only a handful of therapists in New York State certified to provide Schroth treatment, McDonald understandably has a very full schedule.  Her patients come to intensive therapy sessions two or three times a week.  In addition, they must practice their exercises at home for 30 minutes, five times a week.

A significant part of her role is to motivate young patients to work hard. “It’s important to make the process fun and engaging,” she says. “One of my many mantras when working with kids is “Relax, don’t collapse!” says McDonald. She stresses that parental support is a major factor in the success of the program, because constant cueing is necessary.

A desired outcome of Schroth therapy is to prevent the need for surgery in the future, especially fusing of the spine. “There’s no way to know if an individual’s scoliosis is progressive, or non-progressive,” says McDonald, “so awareness and early intervention are critical.”

Burke has outpatient clinics throughout Westchester County and the Bronx that treat a variety of illnesses and injuries. Click here to learn more.

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Burke's Rehab Insights blog is intended to provide general information about rehabilitation and other health care topics. It should not take the place of medical care. Burke staff cannot comment on individual medical cases or give medical advice.

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