Scoliosis Physical Therapy Case Study
The patient is a 23 y/o female diagnosed with scoliosis at age 15 and a history of mild to moderate low back pain. At the time of her initial diagnosis, she was prescribed a back brace at night for about a year. When the patient came to Pivotal, she was experiencing a flare-up of low back pain that was beginning to adversely affect her daily life. She was waking up with low back pain which lingered throughout the day. As an art student, not only did she paint large canvasses on the floor which required bending and reaching. In addition, she also worked as a waitress carrying heavy plates, and upon arriving at home she couldn’t get comfortable on her couch.
This patient wanted to wake up in the morning, sit on her couch and pursue her art pain-free. In addition, she wanted to learn ideal body mechanics and positioning in order to not worsen her scoliotic curves in the future.
The patient was found to have a poor habitual sitting posture. She was slouching and as a result of her scoliosis, leaning to her left side. The evaluation revealed her scoliotic curve: Primary L thoracolumbar curve with compensatory R thoracic curve. Muscle strength testing revealed the significant weakness of her core muscles including all of her abdominals and trunk extensors. Upon functional movement tests, such as squatting, lunging, reaching and transferring from sitting to stand she demonstrated poor body mechanics exaggerating her scoliotic curves.
This patient is very motivated and therefore an ideal candidate for the SEAS Method.
After evaluating this patient, it was clear that she would benefit from a combination of methods to address her scoliosis and pain. I initiated treatment teaching her to optimize the breathing pattern in sitting using manual and verbal cues. We changed her sitting posture to a more upright position to allow her to breathe more fully into her lower ribcage. I then started addressing her scoliotic curves using the SEAS Method. Mirror feedback was used for the patient to see how she habitually sat into her curves further accentuating them. I used my hands to facilitate minimizing her curves while the patient used her breath. With practice and time, the patient learned to self correct her posture, achieving a more upright and neutral spine. At this time, she was ready to be challenged by adding exercises and movements in different body positions while maintaining self-correction. In addition, I started incorporating Pilates exercises based on the SCHROTH Method to help further strengthen her core. She learned modifications for the exercises to ensure optimal curve correction.
This patient was pain-free when she woke up in the morning while sitting on her couch (in her corrected position) and while performing all of her activities. She understood her scoliotic curves, which allowed her to make better decisions with body mechanics and positioning. The combination of the SEAS Method and Pilates (based on the Schroth Method) resulted in excellent results of pain-free function and a safe exercise regimen. She enjoyed Pilates during her rehabilitation and decided to continue with it to further strengthen her core and support her spine.