Rehabilitation-Preventing Progression

Conservative Scoliosis Treatment

Schroth Method Scoliosis Exercise Treatment can empower you to take back control of your
Idiopathic scoliosis.

Research studies are giving credence to Schroth Method exercises as being an effective conservative treatment for Improving posture, mobility and function; reducing pain and disability; preventing progression and improving quality of life for idiopathic scoliosis patients:

You can trust the Schroth Method

"I can confidently say that my Schroth Program experience has been a life-changer for me. My entire thinking has shifted. I now see my scoliosis in a more positive light, rather than a negative one, driven by anxiety that surgery was my only treatment option.

With the knowledge I have gained together with a Schroth home exercise program - specific to my needs - I have taken back control of my own wellbeing, something I have wanted to do for the past 30 years."

Mary, Adelaide, January 2025

Before reviewing the scientific studies listed below regarding conservative treatment for rehabilitation and prevention of progression in idiopathic scoliosis, an understanding of when idiopathic scoliosis and curve progression first occur will help clarify any misconceptions.

Idiopathic Scoliosis - When in Life does it begin?

Idiopathic scoliosis does occur very early in life and is categorised by age of onset:

Infantile 0-3 years
Juvenile 4-10 years
Adolescent 10 years until skeletal maturity

While idiopathic scoliosis may begin in infancy, childhood, or adolescence, curve progression is possible whenever significant spinal growth remains, with the greatest risk occurring during the adolescent growth spurt. So, until skeletal maturity, while curve size is also a major contributing factor, the progression of idiopatic scoliosis is growth driven. The progression risk though decreases markedly as skeletal maturity is reached.

Unfortunately, in many cases, adolescent idiopathic scoliosis is not detected or diagnosed until curves have already markedly progressed; often curves are not even detected until early adulthood.

So what actually happens after skeletal maturity?

In adulthood:

Smaller curves, those below 30° at maturity often do not progress, and remain stable through adulthood;
Moderate to severe curves (30–50°) though are more likely to progress progress;
Where as Large curves, those greater than 50° will usually progress.

Adult idiopathic scoliosis is a worsening progression of Adolescent idiopathic scoliosis. In cases where idiopathic scoliosis continues to progress in adulthood it can become degenerative, resulting in pain and disability. Degenerative scoliosis mostly affects the lumbar spine, a major symptom of which is always lower back pain.

Idiopathic Scoliosis Progression

So what begins as a small, flexible spinal curve can rapidly evolve due to rapid skeletal growth, especially during the adolescent growth spurt which amplifies asymmetrical loading of the vertebrae, discs, ribs, and surrounding muscles causing:

Initial Imbalance
A disruption in normal spinal growth, muscle balance, or vertebral structure creates a small sideways curvature.

Asymmetrical Loading
The curved spine experiences uneven mechanical forces: greater compression on one side. greater tension on the opposite side.

Unequal Growth
In growing children, the compressed side of the vertebra grows more slowly while the tension side grows more normally. This is explained by the Hueter–Volkmann principle, which states that increased compression inhibits bone growth whereas reduced compression promotes it.

Curve Progression
As the curve increases: vertebrae begin to rotate; ribs rotate with the spine (particularly in thoracic scoliosis); and a rib hump may become visible during forward bending.

Structural Change
Over time: vertebrae become wedge-shaped; ligaments and muscles adapt to the abnormal alignment; and the curve becomes structural (fixed rather than flexible).

Functional Consequences
Depending on severity, scoliosis may cause: uneven shoulders or hips; back pain (more common in adults); reduced spinal mobility (rigidity); only in severe thoracic curves (typically >70–100°), reduced lung capacity and breathing difficulties due to restricted chest expansion.

Preventing Progression

Schroth Method scoliosis-specific exercises, even today, are still not widely acknowledged by the medical profession in general as being effective in the treatment of idiopathic scoliosis.

Nevertheless, despite this somewhat indifference, more and more published scientific scoliosis research studies are giving credence to Schroth Method scoliosis-specific exercises as being effective conservative treatment, significantly contributing to the rehabilitation of idiopathic scoliosis patients.

The following scoliosis research studies highlight the effectiveness of Schroth Method Exercise Treatment in preventing progression:

(1) 2021 - "Effectiveness of the Schroth Method in Treating Idiopathic Scoliosis in Pre-Adolescent, Adolescent and Adult Patients."

The purpose of this study was to determine the effectiveness of the Schroth Method on improving the curvature of the spine, pain ratings, and quality of life in pre-adolescent, post-adolescent, and adult patients.

The results of this study suggest that the Schroth Method can be an effective treatment in improving function and reducing pain and disability in patients diagnosed with scoliosis.

The study supports that conservative treatment that included Schroth Method exercises provided by a Schroth trained physical therapist were effective in treating scoliosis.

Bancuk, Dave; Nutter, Jacob; and Ramos, Jessica, "The Effectiveness of the Schroth Method in Treating Idiopathic Scoliosis in Pre-Adolescent, Adolescent and Adult Patients: A Retrospective Chart Review" (2021). Culminating Experience Projects. 83.

(2) 2016 - "Effects of the Schroth exercise on the Cobb’s angle and vital capacity of patients with idiopathic scoliosis that is an operative indication."

The study investigated the effects of the Schroth exercise therapy in patients with scoliosis as a surgical indication for the improvement of their Cobb’s angle and vital capacity.

The patients in this study all had thoracic curves of 40° which were progressing, putting them at risk of surgery.

Results of the study were statistically significant. Patient's Thoracic Trunk Angle's decreased, and on average their Cobb angles decreased whilst their vital capacity improved.

Kim K-D, Hwangbo P-N. Effects of the Schroth exercise on the Cobb’s angle and vital capacity of patients with idiopathic scoliosis that is an operative indication. Journal of Physical Therapy Science. 2016;28(3):923-926. doi:10.1589/jpts.28.923.

(3) 2017 - "Effectiveness of Schroth exercises during bracing in adolescent idiopathic scoliosis."

The results of a preliminary study showed that Schroth scoliosis specific exercises, when performed during bracing, can further improve curve reduction for idiopathic scoliosis patients with high-risk curves, compared to bracing alone.

Kwan KYH, Cheng ACS, Koh HY, Chiu AYY, Cheung KMC. Effectiveness of Schroth exercises during bracing in adolescent idiopathic scoliosis: results from a preliminary study—SOSORT Award 2017 Winner. Scoliosis and Spinal Disorders. 2017;12:32. doi:10.1186/s13013-017-0139-6.