A Physical Therapist with Scoliosis
I was about 10 years old when I first started to experience back pain. My mother was very concerned since many women on her side of the family had scoliosis. At that time, my mother worked at a skilled nursing facility. A physical therapist co-worker examined my back and confirmed that I did in fact have scoliosis. I went to a physician who was a scoliosis specialist and learned that my scoliosis was not severe enough for surgery and I would have to just wait and see how it goes. He did not refer to me to physical therapy nor give me any specific exercises to do. My back pain would persist, and my curvature worsened over several years. My life changed when I chose physical therapy as my profession and I soon discovered Pilates. Needless to say physical therapy and Pilates-based exercises have helped me significantly reduce my back pain and postural abnormalities related to scoliosis. As a physical therapist with scoliosis, it makes me very happy to help others do the same.
So, what is scoliosis?
Scoliosis is an abnormal lateral (side to side) curvature of the spine. There are several indications that you may have scoliosis. Signs of scoliosis include having one shoulder higher than the other, one hip higher than the other, and/or a rib hump/protrusion on one side. Our physical therapy practice, Synergy Health and Wellness, has treated many patients with idiopathic scoliosis and degenerative scoliosis.
“Idiopathic scoliosis” usually presents itself in early adolescence during periods of growth and is defined by a curve > 10 degrees. Idiopathic scoliosis is thought to be caused by a combination of asymmetrical skeletal growth, muscular imbalances, and impaired communication within the nervous system (your brain and spinal cord). Idiopathic scoliosis is characterized by a wedged or abnormal shaped vertebra (the 24 bones that stack together to form the mobile portion of the spine).
“Adult onset scoliosis” or “degenerative scoliosis” develops slowly over time and is related to uneven degeneration of joints and discs between vertebrae and is worsened by poor postural/core strength and stabilization. The degenerative scoliosis (adult- onset) patient is extremely common in our practice, usually older adults that have a degenerative spine diagnosis (degenerative disc disease, spine arthritis, degenerative joint disease, and osteoporosis). Patients we would classify as having degenerative scoliosis likely had mild scoliosis (idiopathic scoliosis) earlier in life. Frequently, the scoliosis was not identified but as the person aged, the scoliotic curvature worsened and became more bothersome.
There are many other types of scoliosis including congenital scoliosis and neuromuscular scoliosis. Congenital scoliosis is caused by abnormalities of vertebral development while in utero. Neuromuscular scoliosis develops in the presence of a neuromuscular disease such as cerebral palsy, muscular dystrophy and spina Bifida. These disorders lead to the body being unable to maintain normal alignment, which facilitates the development of scoliosis.
Consequences of having scoliosis include back pain, pinched nerves or sciatica, a progressive decline in postural alignment, and hip/knee/ankle pain. In later stages of scoliosis, patients may experience decreased balance due to changes in center of gravity related to postural changes, reduced lung and cardiac function, and impaired gastrointestinal function. Gastrointestinal issues often arise due to compression and tightening of abdominal structures.
I can confidently say whether you are going the conservative route, wearing a brace, or if you have decided to have surgery, physical therapy plays an important role in the treatment of scoliosis. Scoliosis cannot be cured or eliminated by physical therapy. Physical therapy treatments focus on building up the muscle strength around the spine (often referred to as your “core”) and training patients in good postural and lifestyle habits that can prevent/limit progression of the curve.
Our therapists at Synergy Health and Wellness utilize the following basic concepts when treating a patient with scoliosis:
- Attain and maintain a neutral spine posture during daily activities
- Develop an exercise program that emphasizes neutral spine exercises.
- Train a client with scoliosis to learn the safest body mechanics during movements.
- Instruct clients in modifications to activities necessary for daily life.
I encourage any person with any type or severity of scoliosis to seek an educated physical therapist for guidance in managing this common issue. Please contact our office for more information at 561-741-1876.
Dr. Lydia Picard earned her doctoral degree in Physical Therapy from the University of Central Florida in 2014. While at the University of Central Florida she pursued coursework in neurology and manual therapy while also working at the UCF Wellness center as a trainer for physically disabled college students. She recently completed her training in the Polestar Pilates method for rehabilitation. Her recent work experience includes working in a sub-acute inpatient facility with an emphasis on post-hospital rehabilitation for patients following joint replacement, stroke, and other medically complex conditions.