Exercises specific to scoliosis are becoming an increasingly common and favoured treatment of scoliosis. Exercise therapy as per Schroth method for scoliosis is usually recommended by your physician as a first line treatment of scoliosis, sometimes in combination with a brace, or while awaiting surgery. There are many differences of scoliosis specific exercises to traditional exercises. The program design and approach, is determined by the patients age, absence/presence of symptoms, and risk of curve progression, and the quality is determined by the training and experience of the therapist/s.

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What is scoliosis specific exercise?

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The primary goal of scoliosis specific exercise is to influence the "progressive cycle" that occurs with structural postural conditions. The spine is designed to sit with balance: that is, the head on top of shoulders, on top of ribcage, on top of pelvis, hip and ankles. Disturbance in the balance of the system means compensations occur and the body looks at strategies to maintain upright posture in response, this can results in increased loads on certain structures of the spine.

For those growing, that is, the asymmetrical vertebral growth which increased pressures on the inside of the curve, and distraction of the growth plate on the outside of the curve, this creates a cycle of continuing asymmetrical growth and progression of the scoliosis or scheuermann's kyphosis with growth spurts. Offloading the growth plate and opposing these faces encourages more symmetrical vertebral growth and a slowing/prevention of further changes in the scoliosis, and in some cases improvement. For adults, the goals is to prevent further asymmetrical degenerative changes and loss in ligamentous strength that leads to progression of the scoliosis with aging.

Scoliosis specific exercises teach the person to "hold out of their curve",/ and often including exercises that oppose the curve. Once able to maintain this posture, strengthening of the spinal musculature is added. Through the exercises the body is able to return to a more ‘normal’ physiological position and lessen the progressive "cycle", while also improving posture and muscle symmetry by restoring the length-tension relationships of muscles, and offloading structures that may have been overloaded and contributing to pain.

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• PSSE- A comprehensive review of seven major schools,  Scoliosis and Spinal Disorders, volume 11, Article number: 20 (2016)2016 https://scoliosisjournal.biomedcentral.com/articles/10.1186/s13013-016-0076-9

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What is the evidence for each school?

In recent years a lot of new methods of scoliosis specific exercise are being developed, the oldest method "The Schroth Method" has formed the basis of many of these other approaches. Others include SEAS, FITS, Rigo concept, Lyon Method, Side-shift, Scolibalance and in recent years many Schroth variations - each different slightly in their design and approach.

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• “Rehabilitation schools for scoliosis” thematic series: describing the methods and results. Scoliosis 2010, 5:27

https://scoliosisjournal.biomedcentral.com/articles/10.1186/1748-7161-5-27

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What is the “Schroth Method”?

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The Schroth Method is a specialised form of exercise therapy specific to the 3D nature of Scoliosis - considering the flattening of usual curves in sagittal plane, the side bending in the frontal plane, and the rotations in the transverse plane. It was developed by Katerina Schroth, a Physiotherapist in Germany, and is the most widely used and researched method of physical therapy/ exercise in the treatment of Scoliosis with various studies supporting its use. 

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• Three-dimensional treatment for scoliosis. A physiotherapeutic method to improve deformities of the spine. Palo Alto, CA, The Martindale Press 2007

https://scoliosisjournal.biomedcentral.com/articles/10.1186/1748-7161-6-17