Updated on August 23, 2017
Continuing my series this June that highlights different scoliosis alternative therapies, I interviewed Lise Stolz, MPT, DSc, PMA®-CPT, Schroth Barcelona Scoliosis Therapist, and Polestar Pilates Educator. Many of you have expressed curiosity about the Schroth Method, and Pilates has helped many scoliotics feel relief, so I was very excited to interview Lise, and thankful for the time she took to talk with me. Enjoy!
What is your story? How did you come to work with scoliosis patients?
My interest in scoliosis reached its peak about 12 years ago but there was a lack of continuing education courses about scoliosis for physical therapists. The current approach was simply to treat scoliosis like a rotational imbalance and use rotation and side bending exercises and stretches to help reduce the asymmetries. I had heard of the Schroth method and researched and found the only courses offered in the US, through the Barcelona Scoliosis Physical Therapy School (BSPTS). When I learned of the commitment—both time and financial—I initially decided I did not see enough scoliosis patients to justify the cost. But my curiosity for this specialized knowledge got the best of me and I took the Level 1 10-day course in Steven’s Point Wisconsin followed by the 6-day level 2 course a year later, where I was required to present a case study. I was impressed with the information I learned about scoliosis and was surprised at how well patients responded to the Schroth Method. I immediately began to see more scoliosis patients who were searching for alternative therapies online and found that I practiced the Schroth method. Now my practice is about 60% scoliosis patients.
How long have you been in practice? 23 years.
What is the Schroth Method, and why does it work? The Schroth method was founded by Katharina Schroth in Germany in 1921 and developed futher by her daughter Christa Lehnert-Schroth in the 70s. Katharina Schroth had scoliosis herself and used the image of a collapsed ball to represent her scoliosis concavity. She imagined breathing into this ball and used internal movements to expand and de-collapse the concavity. She called it orthopedic breathing, which now is now called rotational angular breathing.
Her daughter Christa Lehnert Schroth wrote the book “Three-Dimensional Treatment for Scoliosis,” which describes the method and contains pictures of patients she and her mother worked with in Germany. The book is notorious for its complexity and many of the exercise positions are not used today. The Schroth method focuses on elongation and expansion to counteract the force of gravity which constantly forces compression on the spine and scoliosis concavities. The patient with scoliosis is taught to understand their specific scoliosis curve pattern and use specific exercises and breath to make active postural corrections to the spine and rib cage. The neuromuscular activity is a concentric force on the convex side of the curve and eccentric contraction on the concave side.
The goal is improved posture with a more centered alignment, resulting in less compressive force on the spine. Corrective exercises are performed in a neutral position of the spine for the most effective expansion. Scoliosis consists of both inter-vertebral torsion (rotation of one vertebra relative to another) and intra-vertebral torsion (an internal rotational distortion within each vertebra), most notable at the apical vertebra (apex of the curve). This distortion contributes to less movement at the apex of the curve ,and more at the transition points of the curve. Schroth scoliosis-specific exercise has the affect of stabilizing the transition points, where movement occurs too much, and expanding the concavity at the apex of the curve.
How do you blend Pilates with Schroth to help your scoliosis patients? Once a patient understands their curve type, is independent with their specific Schroth exercises, and can maintain a better posture with daily activities, then they can apply this posture to any exercise or activity they like. However, caution should be taken with exercises and activities that tend to increase curve compression such as end range motion in any plane (extreme twisting, side bending extension and flexion). Pilates exercises can easily be modified to minimize these positions. Since Pilates exercises emphasize similar principles to the Schroth method such as breathing, alignment, and axial elongation, they can easily support the scoliosis corrective postural positions.
However, many sports activities such as dance and gymnastics involve many compressive positions. That is why each person must be evaluated for the risk that their chosen activity will bring to their scoliosis. Considerations for age, curve type, activity frequency, and muscle imbalances must be taken. Everyone with scoliosis should be free to enjoy activities that provide quality of life and should be educated about scoliosis spine mechanics and progression, to help them make an informed decision about which activity might be best for them.
Why Pilates for scoliosis? Why not yoga, dance, or other “whole body” workout method? Adaptations for the person with scoliosis can also be applied to yoga and other activities. It is worth repeating that those activities that provide quality of life such as dance, swimming, tennis, etc. may be continued (subject to a full evaluation to determine individual appropriateness) as long as risks associated with compressive movements are understood and axial elongation is practiced at all times during these activities.
Who is a good candidate for this treatment? Who is not a good candidate for this treatment? Most people with idiopathic scoliosis can benefit from Schroth therapy; however, the method requires attention and discipline. Those who may not be good candidates are children under the age of 9 or those with cognitive impairments.
What’s the biggest success you’ve had to date with a scoliosis patient? Every adolescent is a big success if they reach bone maturity without progressing to surgery. I also consider every adult with pain who can mitigate pain through Schroth therapy a great success.
Are you available to work with long-distance patients (Skype, etc.)? All patients must be seen in clinic for this treatment. It is a “hands-on” technique that provides tactile proprioceptive feedback to facilitate opening of concavities through. Once this neuromuscular re-patterning is learned, it can easily be duplicated at home. Some patients have traveled and stayed a week at a time for intensive training, and returned to advance the exercises when they are ready.
For people who are interested, where can they find you? Are you offering any special classes or other services/products you’d like to promote here?