Scoliosis Physical Therapy for Stronger, Straighter Spines

Scoliosis Physical Therapy for Stronger, Straighter Spines

If your child has scoliosis, chances are you’ve already discussed many treatment options with a pediatric spine specialist. The specialist may have recommended a “wait and see” approach to determine whether your child’s curve gets worse or stays the same. You may have learned about braces and casts to keep the spine straight, and you’ve likely researched surgeries that can correct the condition. One option you may not have considered is scoliosis physical therapy. 

This specialized form of physical therapy allows kids and their families to be actively involved in their treatment by addressing muscle and posture issues that can develop due to scoliosis. 

How Physical Therapy Helps Kids With Scoliosis 

Scoliosis is an abnormal curvature of the spine. In children with the condition, the spine may twist or be shaped like a C or an S rather than straight. You might notice your that your child has uneven hips or shoulders, but the condition does not always cause symptoms. When it does, children may complain of back pain, difficulty breathing and shoulder pain. 

With scoliosis physical therapy, children work with specially trained therapists to learn scoliosis-specific exercises that correct posture and retrain muscles. These programs help slow or prevent the progression of a spinal curve and may counteract the effects a curved spine can have on the body. Physical therapy can also reduce pain and improve breathing.

Exercises your child learns may focus on improving:

·       Functional movement, so your child can go about their daily activities

·       Range of motion, as kids with scoliosis may have limited mobility 

·       Strength in the muscles surrounding the spine, hips, shoulders, head and lower body

The Schroth Method 

There are a few different scoliosis physical therapy programs that have been developed. At Scottish Rite for Children, several of our physical therapists have completed specialized training in one type, known as the Schroth method. 

Physical therapists use this method to teach children exercises and breathing techniques that strengthen muscles throughout their bodies. The intent is to improve their posture and ability to perform typical daily activities, such as sitting, standing, lying down and walking. 

During these sessions, physical therapists often have children stand in front of mirrors so they can see how scoliosis affects their posture and movement. The therapist asks the child to breathe in specific patterns or tighten his or her muscles to elongate and stabilize the spine. Sessions can last 45 to 60 minutes, and children can continue the exercises at home between sessions.

Schroth exercises help treat another spine condition many adolescents develop — kyphosis. This spinal disorder happens when a curve causes rounding in the upper back. 

Planning a Physical Therapy Program for Your Child 

Many websites offer exercise tips for people with scoliosis, but working with a dedicated physical therapist helps ensure your child performs exercises specific to their needs.

Before the sessions begin, your child will have an evaluation with a pediatric spine specialist, who can determine the type of scoliosis your child has and the magnitude of the spinal curve. 

The physical therapist uses this information to determine which exercises your child needs and teaches him or her the correct way to do each exercise. As your child improves, the therapist will adapt the program to ensure your child gets the most benefit.

The amount of time your child needs scoliosis physical therapy depends on his or her diagnosis. Even after your child completes the recommended number of sessions, the therapist may provide instructions for a home exercise program to relieve symptoms and prevent the spinal curve from worsening.

Combining the Schroth Method With Traditional Physical Therapy

Traditional physical therapy focuses on the side-to-side curve of the spine. Schroth exercises address this issue from a three-dimensional perspective, straightening the spine from back to front and side to side and correcting spinal twisting. 

For this reason, a scoliosis specialist may combine traditional physical therapy with the Schroth method as they work with your child. 

Scoliosis Care Beyond Physical Therapy 

Some children do well with physical therapy alone. Typically, however, a child will have physical therapy along with wearing a scoliosis brace. 

For some kids, more care is needed. Children with spinal curves greater than 50 degrees often require surgery. Children whose curves have worsened despite wearing a brace may need surgery as well. 

Still, children who need surgery may benefit from a scoliosis physical therapy program. Physical therapy can help regain movement and muscle strength as they recover.

Like any form of exercise, physical therapy has many benefits. While it can’t cure or “fix” your child’s curve, physical therapy strengthens your child’s muscles and helps him or her better manage scoliosis, which can make a big difference in everyday life. 

The scoliosis team at Scottish Rite for Children has years of experience treating children with varying degrees of scoliosis. For more information about physical therapy for scoliosis, schedule an appointment to discuss scoliosis care. 

What’s in an ACL Injury Prevention Program?

What’s in an ACL Injury Prevention Program?

In a study conducted by members of Scottish Rite’s sports medicine research team, we have found that one in five parents are not aware of injury prevention programs that can reduce the risk of anterior cruciate ligament (ACL) injuries. This is alarming because studies show that these injuries can take an athlete out of sports for at least nine to 12 months and increase the risk of a second injury and knee problems as an adult. Many say they would participate in these programs if they knew how. Here are three elements of day-to-day training that align with sport-related injury prevention and can be implemented individually or as a team.

    1. Wake Up Your Brain and Muscle Connection

    This step is called muscle activation and is focused on waking up small but very important muscles that maintain core stability during activity. From planks to squats, controlled movements that engage specific abdominal, spinal, shoulder and hip muscles are a key to a safe start for practice or competition. This step is rooted in principles of neuromuscular coordination, and with repetition, it is believed to improve stability and reduce injury risk during activities.

    1. Warm Up Your Muscles

    Now that your brain and muscles are talking, you need to get the blood flowing into those muscles and move them through their full range of motion. Athletes are familiar with dynamic warm-up exercises like soldier walks and knee hugs, and learning ways to maximize these exercises can help improve the effectiveness and reduce the time needed for the warm-up. Make sure you’re warm before you take off at full speed or make large movements with force like jumping, throwing a long distance or kicking a ball.

    Physical therapist Jessica Penshorn has put together a great easy to follow program for basketball players that combines mobility, activation and dynamic warm-up. Watch the short video, or read a summary of the program and download a handout here.

    1. Wind-down

    After the training or competition session is over, abruptly stopping can leave muscles confused and angry. Post-activity recovery strategies like foam rolling, contrast baths and gentle stretching can reduce the onset of muscle soreness and setting the body up for a quick turnaround to activity the next day.
    Email bridgeprogram@tsrh.org to sign up for our Athlete Development program for group training sessions that use all of these strategies to build solid foundations and strength, power and speed for high performance.

    1. Warm Up Your Muscles

    Now that your brain and muscles are talking, you need to get the blood flowing into those muscles and move them through their full range of motion. Athletes are familiar with dynamic warm-up exercises like soldier walks and knee hugs, and learning ways to maximize these exercises can help improve the effectiveness and reduce the time needed for the warm-up. Make sure you’re warm before you take off at full speed or make large movements with force like jumping, throwing a long distance or kicking a ball.

    If you want to learn more about injury prevention programs for your young athlete, check out these resources:

    *Sparagana, P., Selee, B., Ellis, H., Ellington, M., Beck, J., Carsen, S., Crepeau, A., Cruz, A., Heyworth, B., Mayer, S., Niu, E., Patel, N., Pennock, A., VandenBerg, C., Vanderhave, K., Williams, B., & Stinson, Z. (2023). Parental Awareness and Attitudes Towards ACL Injury Prevention Programs in Youth Athletes: Original Research. Journal of the Pediatric Orthopaedic Society of North America5(4).

    Ankle-Foot Orthosis Devices: A Guide for Parents

    Ankle-Foot Orthosis Devices: A Guide for Parents

    Health conditions that limit your child’s ability to walk, run, play and just be a kid can take a lot of fun out of childhood. An ankle-foot orthosis could be the solution your child needs, particularly if he or she has muscle or joint problems in the legs, ankles or feet. These specialized orthotics can help relieve uncomfortable symptoms, allowing children to return to their daily activities. 

    What Is an Ankle-Foot Orthosis?

    Ankle-foot orthoses (AFOs), sometimes called AFO braces, are devices designed to support and improve the function of your child’s foot and ankle. Pediatric orthopedic specialists often prescribe them to children with conditions that cause joint instability, irregular walking patterns and muscle weakness or stiffness. 

    Your child might need an AFO if he or she has: 

    ·       Deformities of the foot or ankle

    ·       Fractures

    ·       Neuromuscular disorders, such as cerebral palsy, muscular dystrophy and spina bifida

    ·       Peripheral nerve injuries 

    ·       Spinal cord injuries

    AFOs can also treat ankle instability caused by cerebral palsy and other neuromuscular disorders, congenital abnormalities and injuries. A child with ankle instability may have a hard time maintaining balance, walking or playing. An AFO provides stability, improves gait patterns and prevents additional complications associated with ankle instability.

    Three Primary Types of AFOs

    Typically made from lightweight and durable materials, such as plastic or carbon fiber, an AFO holds your child’s foot and ankle in the proper position. They can be custom made to fit your child to ensure a secure fit.

    Many people confuse orthotics with prosthetics, but they are not the same. A prosthetic device replaces a missing limb, whereas orthoses and orthotic devices, like AFOs, support and correct musculoskeletal problems.

    There are many types of AFOs, which can range from very rigid to more flexible. The right device for your child will depend on his or her condition and the location of the issue. In general, AFOs fall into these categories: 

    ·       Solid AFOs: These provide maximum support and allow for very little movement of the ankle or foot. They often benefit children with neuromuscular conditions that cause severe muscle tightness.

    ·       Flexible AFOs: Designed to give kids more movement in the foot and ankle, these AFOs allow for a more natural walking motion and give kids more freedom to play while still supporting the muscles and joints.

    ·       Dynamic AFOs: These orthotics have spring-like mechanisms to assist with push-off during walking, which can be helpful for children with muscle weakness.

    If your child has severe muscle weakness, joint instability or paralysis, he or she may need a knee ankle foot orthosis (KAFO). While most AFO braces come up to a child’s calf, KAFO braces extend from the ankle to the knee or even higher.

    On the other hand, children with mild to moderate foot and ankle conditions, such as hypermobility or pronation (inward rolling of the foot), may need only a supramalleolar orthosis (SMO). SMO braces reach an area just above the ankle called the supramalleolar region, offering foot and ankle support without limiting a child’s overall mobility.

    Life With an AFO Brace 

    You can take some steps to help ensure your child’s AFO works as well as it should, no matter what type they have. Make sure your child:

    ·       Always wears shoes. Properly fitting shoes with good support will keep your child comfortable and prevent slips and falls while wearing the orthosis.

    ·       Always wears socks under the AFO. Socks can protect your child’s skin from moisture, blisters and irritation caused by the device.

    ·       Follows instructions for wearing the AFO. Your specialist will show you how to put the device on correctly and adjust the buckles and ankle straps. He or she will also let you know how long your child should wear the device. If your child seems resistant, have him or her start with wearing it only a few minutes a day, gradually working up to the recommended length of wear.

    ·       Wash your child’s foot every day. You’ll not only keep his or her skin clean, but you can also look for bruising, redness and other signs the orthosis is causing discomfort.

    Does your child need an ankle-foot orthosis? Our Orthotics & Prosthetics department craft state-of-the-art, custom-made orthoses in house. To learn how we can help your child, call 214-559-7440.

    Get to Know our Staff: Matt Messer, Administration

    Get to Know our Staff: Matt Messer, Administration

    What is your job title/your role at Scottish Rite for Children? 
    I am an administrative resident. My role is to learn about health care administration through projects and working with leaders to complete my master’s degree.

    What do you do on a daily basis or what sort of duties do you have at work?
    I work on projects, attend meetings and participate in rotations.

    What was your first job? What path did you take to get here or what led you to Scottish Rite? How long have you worked here?
    My first job was working as a lifeguard. I attended Trinity University, which led me to complete my residency at Scottish Rite.

    What do you enjoy most about Scottish Rite?
    I enjoy the mission the most! It is such an incredible mission that everyone works toward, which is really special and something you don’t find everywhere.

    Tell us something about your job that others might not already know?
    I am working toward my master’s degree, which will be completed after I finish my residency!

    Where is the most interesting place you’ve been?
    Copenhagen.

    What is your favorite game or sport to watch and play?
    As a graduate of the University of Alabama, it would have to be Alabama football – roll tide!

    If you could go back in time, what year would you travel to?
    1980

    What’s one fun fact about yourself?
    Fun fact: I love running on the Katy Trail!

    Is Your Young Athlete Having Orthopedic Surgery? Five Suggestions to Prepare your Pantry for Recovery

    Is Your Young Athlete Having Orthopedic Surgery? Five Suggestions to Prepare your Pantry for Recovery

    Following surgery, the body experiences increased energy demands due to inflammation and tissue healing. Some patients may eat less due to reduced activity, an increased need for sleep and the use of medications. Not eating enough, when nutrition needs are highest, can prolong recovery time and cause muscle loss.

    For young athletes planning to return to sports, the demands can go beyond the early phase of surgery recovery. After knee surgeries to reconstruct ligaments, such as the anterior cruciate ligament (ACL) or after extensive activity restrictions for healing of osteochondritis dissecans (OCD), these nutrition tips should be used throughout physical therapy and return to sports training. These phases can last months and have high energy demands.

    Certified sports dietitian Taylor Morrison, M.S., R.D.N., CSSD, L.D., says, “Athletes have unique needs when there are healthy, but these needs change and continue to be unique as they are recovering from significant surgeries.” Morrison cares for young athletes in Scottish Rite’s sports medicine clinic and teaches principles of healing and muscle recovery that can help an athlete well beyond their care.

    Morrison offers these nutrition guidelines to help preserve and promote muscle health and support recovery in all phases:

    Eat regular meals and snacks to maintain energy levels and promote wound healing immediately after surgery. Eat a meal or a snack every three to four hours and around physical therapy sessions.

    Include quality protein to help with tissue repair and wound healing. Include foods rich in leucine, an amino acid that helps build and repair muscle, such as chicken, milk, yogurt, eggs and cheese, at each meal and some snacks and especially after physical therapy sessions.

    Include quality carbohydrates to provide energy. Carbs keeps protein available for healing and fiber, which can help with normal digestive function. Carbohydrates with fiber include whole grains, fruits and starchy vegetables. Other carbohydrates include milk and yogurt.

    Include healthy fats that are high in omega 3s to fight long-term inflammation. Healthy fats with Omega 3s include salmon and tuna. Other healthy fats include avocado, nuts, seeds, peanut butter, almond butter and vegetable oil.

    Include a bedtime snack that contains casein to support muscle protein synthesis throughout the night. Casein is a slow-to-digest protein found in milk, yogurt and cottage cheese.
    When you head to the store to stock up on recovery-friendly foods to have on hand, take this list with you for ideas.

    • Eggs
    • Greek yogurt
    • Protein bars
    • Peanut Butter, Almond Butter, SunButter®
    • Starkist® Tuna packs + crackers
    • String Cheese
    • Balanced nutritional supplements such as Boost®, Pediasure®, Carnation Breakfast Essentials®, Kate Farms® or Orgain®

    Nutrition after surgery is important for all patients to preserve muscle and provide the increased energy and nutrients the body needs to heal. Some patients will need a specific nutrition plan due to additional medical conditions. If you would like help with an after-surgery nutrition plan, ask your care team about a certified sports dietitian consult.

    To learn more from Morrison, visit the sports nutrition page on our website.