Scoliosis Programs

The Scoliosis Programs at Scoliosis 3DC*

•Scoliosis specific exercise instruction for adolescents or adults
•For mild, moderate and severe curves
•For those who want to take a proactive approach to scoliosis management
•Post-surgical instruction, Scheuermann’s kyphosis patients
•Moderate/severe curves: twenty-hour outpatient scoliosis rehabilitation over seven or eight consecutive days
•Mild curves and post-surgical - fewer sessions necessary
•Private sessions

What to Expect When You Become a Patient at Scoliosis 3DC:

Patients (and parents) meet with Dr. Moramarco to review, in detail, the history of the patient’s scoliosis and x-ray films followed by a comprehensive examination based on:
•a complete scoliosis history, age, type of curve, Cobb angle(s), bone maturity, age of puberty, health and family medical history, experience with bracing and/or scoliosis alternatives including anything else that has been done for the scoliosis.
•visual Inspection: observation of curve(s), shoulders, hips, head, pelvis, knees, ankles, feet-from front, back and sides.
•specific tests: range of motion, flexibility, scoliometer measurement, spirometry, chest expansion, palpation, muscle strength and gait analysis.
Each scoliosis patient will receive an anatomy lesson focusing on his/her unique scoliosis. This is central to understanding the Schroth breathing exercises. A patient must be able to internalize the concepts of the Schroth three-dimensional corrections that are the foundation of the scoliosis exercises and rotational breathing technique.
Each patient will receive a scoliosis manual, and a workbook, to document the status of his/her unique scoliosis - past, present and future.
Digital photos are taken to document posture for future comparison.
As determined by an individual’s curve, the patient is instructed in ‘Best Practice’ and Schroth postural corrections, Schroth exercises, Schroth rotational breathing and stabilization
Each patient is instructed in corrections in the sagittal, frontal and transverse planes.
Each patient is instructed in activities of daily living to help maintain postural corrections to reduce the risk of curve progression.
Each patient is provided with a DVD as a helpful resource to refer to when performing the exercises at home.

The programs used in this office are based on years of personal and clinical experience working with scoliosis patients. It is structured on clinical protocols learned directly from Dr. Hans-Rudolf Weiss as outlined in his text, Best Practice*, and also from clinical experience gained in the Schroth Method at the Asklepios Katharina Schroth Clinic in Germany.

Each scoliosis patient’s recommended program will vary according to the risk of curve progression. This determination is based on a variety of factors based on each unique scoliosis including age, gender, Cobb angle, Risser sign, bone age etc.

At Scoliosis 3DC we offer four Basic Programs*:

10-20° Curves - Mild Program

For patients who are skeletally immature and at risk for curve progression, we do not subscribe to the traditional ‘watch and wait’ philosophy regarding scoliosis. We certainly recognize that at this juncture it may be a bit early to initiate an aggressive scoliosis rehabilitation program; however, according to our way of thinking, to ‘observe’ while a scoliotic curve gets worse is a questionable practice. Our answer to this dilemma is to teach patients the ‘Best Practice’ approach devised by Dr. Hans-Rudolf Weiss, former medical director of the Asklepios Katharina Schroth Clinic in Germany. The postural modifications he has devised for scoliosis patients have been developed as a result of his experience in working with more than 30,000 scoliosis patients over the course of his career. The purpose of these modifications is to halt, and possibly reduce curve progression in adolescents with scoliosis. Statistics show that if a curve’s progression can be halted until growth is complete, the likelihood of curve progression is reduced over time. Of course, we offer no guarantees, but it is our philosophy that learning these techniques and incorporating them consistently into daily life will improve a patient’s odds against scoliotic curve progression.

‘Best Practice’ includes:

Physiologic®-a technique used to mobilize the spine in the sagittal plane

3D Made Easy-instruction in ADL’s (activities of daily living). The patient learns to correct the spine during a variety of dynamic activities. ADL's are practiced to increase patient awareness of posture during daily activities. These are relatively easy to learn, but require compliance and intensive work to become cognizant of the new posture. The primary advantage of daily activities instruction is that, with practice, ADL’s allow the patient to relieve the asymmetric loading of the main scoliotic curve reducing the possibility of scoliotic progression.

Spinal Mobilization-hands on therapy- above, at and below the apex of a curve- providing derotation and deflexion of the spine.

20-30° Curves-Upper Mild to Lower Moderate Program

Our program for patients with curves in this range incorporates everything in our Mild Program, plus introduces Schroth curve-pattern specific scoliosis exercises that are appropriate to each individual’s curve.

The Schroth Method Explained-

What is the Schroth Method, exactly?

The Schroth Method is a non-surgical, conservative treatment program for scoliosis consisting of curve-specific exercises and a proprietary breathing technique. Schroth ‘exercises’ for scoliosis are not what a person thinks of when they typically think of exercise. These scoliosis exercises are used to correct the spine in three dimensions through scoliosis-specific movements accompanied by a special breathing technique developed at the German Schroth Clinic. The purpose is to derotate, deflex, and to correct the spine in the sagital plane while elongating the spine. Consistently working to correct the spine in this manner is the key to successfully incorporating the Schroth method into a scoliosis patient’s life.

Why do we take this approach to scoliosis management? The Schroth Method is unique because it focuses the patient on trying to re-establishing spinal symmetry. In scoliosis, the muscles along the spine become imbalanced on opposite sides. So, a patient must learn to shorten (tighten) the muscles on the convex side of the spine and lengthen the muscles on the concave side of the spine. This requires dedication on the part of both the Schroth clinician and patient. The Schroth Method also incorporates a unique breathing routine for scoliosis patients referred to as ‘rotational breathing’** or ‘rotatory breathing’. Simply stated, the patient is taught to breathe into the concave side of the trunk in order to rotate the ribs allowing them to return to a more ‘normal’ physiological position. Following this ‘inhalation phase’, comes the ‘exhalation’ phase of Schroth known as 3D stabilization. 3D Stabilization helps restore a more stable three-dimensional spinal alignment. This helps a patient experience the feeling of the corrected posture in order to recognize how maintain it. This postural awareness should be used in a patient’s daily activities.

30°+ Curves-Moderate to Severe Curves

This program includes everything in the mild and moderate programs, but also institutes additional Schroth exercises, offering the most comprehensive ‘Best Practice’ and Schroth programs available for patients with scoliosis.

Schroth Post-Surgical Program for Scoliosis

Whether your surgery was a recent event, or years ago, Dr. Moramarco will work with you to help improve mobility and stabilize the spine above and below the fusion. The purpose of our post-surgical program is to help prevent scoliotic progression above and below the fusion, helping with pain and eliminating the need for additional surgery.

* Dr. Moramarco works with all scoliosis patients until they master ‘Best Practice’ and Schroth techniques and are ready to go home and incorporate what they have learned into daily life. He encourages patients to return for check-ups, if a change occurs, or anytime a patient wants to brush-up on - or perfect their Schroth technique.

Coming Soon...You Tube Videos demonstrating Schroth Method Exercises so you can see what Schroth is about.

Finally, a little more on Corrective Breathing...

Corrective rotational breathing is a major component of the Schroth method. The focus is on changing the patient's breathing pattern in order to decrease the risk of scoliotic curve progression. The patient will focus on the expansion of the collapsed concave areas during inspiration. This enhances mobility and promotes an increase in correcting the asymmetrical scoliotic posture. The basis for the use of this technique can be found in an article entitled, "The Effect of an Exercise Program on Vital Capacity and Rib Mobility in Patients with Idiopathic Scoliosis," by Hans-Rudolf Weiss, M.D.