Scoliosis Services: What to expect

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Highly specialized scoliosis care combining Schroth method 3D scoliosis curve specific exercises and manual therapy (hands on massage based techniques such as myofascial release and joint mobilizations). 

The goal is to address restrictions potentially holding you into your curve pattern,  retrain muscles, and create forces applied to the spine over time. 

 Stretches and strengthening can be catered to you to help balance imbalances.

If you are wondering if you or a child in your family has scoliosis, let's take a quick look! 

Most scoliosis is genetic, therefore if you have family members with scoliosis, it wouldn't hurt to do a screen.  We will offer a complimentary  15 minute screen using a scoliometer for an objective reading that can translate to a plan, based on cut off numbers.  

Early intervention is key, so let's keep close tabs on maintaining healthy spines and push towards a prevention model of care instead of a crisis management model. 

Time frames of increased growth can be time frames of increased risk of scoliosis progression. The focus of this treatment is empowering the child and in some instances, the family, to help the child manage their condition via a Schroth based home exercise program in order to alter the course of their condition during growth. Growth is a great opportunity for change and now is the time to make change for the long term.  The Schroth method is a way to try to remain as conservative as possible. When curves are caught small and treatment is started early, the goal can be to prevent the need for scoliosis bracing and keep curves small. When curves are more moderate, the goal is to combat the curve and enhance the effects of the bracing process. Often bracing acts as a retainer trying to prevent curve worsening and Schroth can have a stronger effect when treatments are combined and add strengthening to prevent postural weakening and train muscles for life during and beyond bracing. Ulimately, good management of scoliosis during growth is aimed at preventing the need for scoliosis surgery and avoiding long term consequences like pain, cosmetic postural issues,  altered mechanics. These consequences can lead to repetitive injuries and wear and tear of joints over time, and altered breathing mechanics affecting muscle restrictions and efficiency. 

Typically, a phone call consult will determine what your child's needs look like globally, answer your questions, and set up a comprehensive evaluation. Please remember to bring a copy of your child's x-rays, as this will be assessed as well as clinical parameters related to scoliosis in order to come to a Schroth classification needed to build your indivdidual Schroth home exercise program. 

Sessions are typically once a week to get through the initial learning curve of the Schorth method. Once your child seems to be gaining a level of mastery to start doing the more basic level of exercises at home, visits can be decreased in frequency to add progressions and to monitor progress to make any adjustments along the way.  Gain a sense of peace of mind that someone is watching the objective scoliosis measures more than once every 6 months; reassessments typically take place once a month to track progress. Sessions are typically one-on-one for 1 hour with Dr. Sarah Rivard. If you have a longer commute to the clinic and wish to have longer visits to decrease the number of visits, this can be arranged for your driving convenience as well.  

These evaluations are often tailored to solving a problem brought forth by the patient, a persistent pain, a dissatisfaction in posture, a functional challenge limiting them from achieving an activity or life participation, or a desire to avoid future complications and achieve more muscular balance.  A full orthopedic assessment as well as a Schroth scoliosis classification evaluation is completed and objective measures are tracked over time to monitor progress towards the goals.  Bring the most recent scoliosis x-ray you have. 

The transition into adulthood can sometimes be a challenging one. Learn good habits for life and address any issues that seem to be popping up to prevent them from becoming bigger issues later. 

Pregnancy can be a time frame in life when curve progression is possible due to changes in weight carrying, liagment laxity, hormone changes, etc. If you want to prevent curve progression in this time frame and maximize spinal stability, Schroth scoliosis specific exercises can help and positions can be modified to keep them safe for pregnancy precautions. If you are struggling post partum with back pain or regaining a sense of stability and want to help your back get back to a healthy, balanced, stable state, Schroth could help. The SI joint (the junction between the spine and the pelvis) can be particularly vulnerable during this time frame and Dr. Sarah Rivard are certified to treat this joint as well as the scoliosis. Scoliosis can create significant challenges in addressing this joint.

Adults with pain that is persistent: Persistent pain may be back pain, shoulder pain, SI joint, knee pain, headaches, etc. We can even assess to see if it could be related to altered mechanics from scoliosis. Scoliosis is truly a whole body condition, afterall, we are all connected head to toe. The body should be seen as a whole and how each component may affect another. Often, we can get to the root of the problem and fast track you to the results you have been striving for, but seemed out of grasp. 

Adult Onset Degenerative Scoliosis: Those that did not have scoliosis as a child or young adult might develop scoliosis later in life, possibly related to menapausal hormone changes, decreasing bone density, or of unknown origin. If scoliosis starts later in life we can still try to stop curve progression and improve your empowerment over your curve. Dr. Sarah Rivard has taken coursework in the Meek's Method for managing bone density associated with osteopenia/osteoporsis and can address bone density to more effectively treat the scoliosis condition at any age. 

Session frequency is  based on severity of symptoms (how much is it affecting you), your work/life schedule, financial considerations, and we will work together to determine what is best for you. Learn Schroth exercises of which will become a life management skill to take with you for years after and utilize as needed.  Obtain individualized self body maintainance tips and tricks to that will encourage empowerment and provide you with the resources to manage your needs. Learning Schroth exercises does have a learning curve; though you can manage the frequency to set your pace through this learning curve. We also include some manual therapy as needed and this can fast track pain relief and we can do more based on your needs. 

Those that have had surgery can still be helped with therapy. You have a whole new way to move through life and you should learn how to optimize this. Improved breathing patterns and efficient use of the diaphragm during breathing can be important, particularly if you previously had a very large curve and especially early on post surgery recovery.  Addressing scar tissue restrictions can be important to feeling better and moving better. Shoulder mobility, SI joint stability, all other joints should be looked at and protected from future issues. If one curve was fused leaving an additional curve unfused, you can still learn Schroth exercises to help protect that remaining curve from any progression. 

Session frequency depends on how recent the surgery was and what is needed at that time. 

Whether you are a child, teen, or an adult, if you want to learn Schroth exercises and scoliosis management tools but are not local, no problem! We can discuss needs on a phone consult and set up an intensive or mini-intensive session that suits your needs. 

We can provide you with a list of local hotels and even unique local places to visit while you are here, so you can make a mini vacation out of your trip as well! Stay one night and have two days of therapy, or stay a couple and do less in each day, or accomplish even more during your stay. Young children with more limited attention spans, or adults wanting to avoid overdoing it may consider a morning and afternoon session of 1.5 hours each  (for 3 hours a day) or even visit for a couple of days to go home with a Schroth home exercise program. We can discuss and make a stay perfect for you and your goals. 

Come into the clinic for the first visit to meet Dr. Sarah Rivard and become familiarized with the supplies that you will need at home for your home program. Once set up at home, if you are a designated distance from the clinic,  we can use your supplies and the tools that we will come equipped with, and work from your home, if we feel this will be a good plan. This is maximal convenience, though spaces may be limited.  During COVID this was a friendly option for those not wanting to enter the clinic environment and could stay at home and handle their own equipment in the comforts of their home and could even opt to be treated on an outdoor screened porch where open-air interactions are safest. 

This is generally reserved for those who have attended enough therapy visits to understand Schroth and are simply looking for guidance on fine-tuning, progression,  and clarifying questions. We can even offer feedback and support to your technique with the home exercise program. This is great for out of town patients who want some extra support without having to make the drive repeated times. Generally, learning Schroth from the initial sessions via telehealth can be difficult, as it is best learned hands-on. However, extenuating circumstances may make telehealth your best option; we can discuss doing all sessions via telehealth on an as needed basis.