"Integrating posture into movement"

Scoliosis Care

Structural scoliosis is a sideways curve of the spine, often beginning just before puberty.  It is possible for an individual to have a single or multiple curves, thus the descriptions of a “C” or an “S”. Signs include uneven shoulders, excessively straight back, limited forward bending, protruding shoulder blades, asymmetrical waist or hips, and rotation of the trunk with bending.

The younger a child is when scoliosis appears, the risk of curve progression is greater, due to the amount of growth remaining. Early diagnosis and treatment intervention are essential. With appropriate therapy and possibly bracing, curve progression may be slowed, prevented, and possibly reduced. It is not possible to predict or guarantee treatment outcomes in adolescents.

Adult onset scoliosis can result from an undiagnosed adolescent scoliosis progressing with age or by degenerative changes. While curves diagnosed in adults are usually smaller, they can be accompanied by significant symptoms. Curve reduction is not possible because growth is complete. However, significant reduction of pain, improved posture and increase in activity levels are possible.

Structural scoliosis is an asymmetrical growth of the vertebrae from side to side AND front to back. This causes a 3- dimensional distortion of the spine resulting in abnormal spinal movement and stiffness of the spine in the regions of the curve. The initiating cause is unknown, but it is not related to poor posture or carrying heavy loads. Once a curve develops the force of gravity creates a vicious cycle of asymmetrical loading that can cause the curve to progress over time.

Typically there is a gradual backward rounding of the spine between the shoulder blades. Hyperkyphosis, also called Scheuermann’s Kyphosis, is when that rounding becomes exaggerated and prevents standing upright.  Occasionally the rounding occurs lower in the spine and appears as poor posture in sitting. Hyperkyphosis is caused by a one – dimensional asymmetric growth of the vertebrae with the front being narrower. This creates the appearance of a wedge shaped vertebrae when viewed on x-ray. As with scoliosis, the initiating cause is unknown but usually starts during puberty and is more common in boys. While uncommon, hyperkyphosis and scoliosis can occur simultaneously. We have seen many cases of undiagnosed hyperkyphosis.

The Schroth Method is a 3-dimensional curve specific exercise program.  Employed for decades in Europe with good results, it has recently been introduced to the US. This form of therapy takes time, commitment, and a willingness to learn and adopt new postural and movement patterns.  Prior to therapy, x-rays are needed to evaluate the curve pattern and in adults rule out spinal instability.  This is a key component of treatment to see and understand the curve pattern and is crucial in developing a customized exercise program. Treatment begins by recognizing the posture that scoliosis creates followed by learning asymmetrical exercises to create and sustain a corrected posture. The goal is to maintain the “new normal” corrected posture during everyday activities. Our scoliosis clients feel hopeful and empowered in the ability to do something to improve their situation. 

  • Knowledge of anatomy and biomechanical effects of scoliosis on the spine
  • Understanding of how posture and movement effect curve progression 
  • Improvement in posture and body image 
  • Reduced pain
  • Optimize the potential for curve reduction in children
  • Prevent curve progression and spinal degeneration
  • Improved energy and endurance for daily activities
  • Improved respiratory function

"Spinal mobility through lengthening."

Structural Integration

Structural integration is a type of bodywork originally created by Ida Rolf that focuses on the fascia of the body.  Students of her technique are called Rolfers.  One of the early Rolfer’s, Joseph Heller expanded on her work by adding a psychosocial component to address how a person’s emotional state and body structure are interconnected, as well as movement to maintain and support the work. His approach is called Hellerwork.  Similarly Tom Myers, also a Rolfer, created the Anatomy Trains System. Through his research and writing he has identified and documented the anatomy and global connection of the fascial system and developed the Anatomy Trains education program. Both approaches are designed to improve postural alignment by treating the fascial system multi-dimensionally from head to toe.  

Fascia is a web-like fabric that weaves throughout the body, but the primary focus of structural integration is on the fascia that relates to muscle. This myofascia divides the muscle fibers into bundles, groups them into larger segments, and wraps them like a package. All these fibers join together and create the tendons that connect the muscles to the skeleton, and interface with sheets of fascia between the muscles and with the fascial leotard of the body. This web provides the structure necessary to support and move the body. Recent evidence shows that fascia also provides feedback to the nervous system and transportation of fluid and nutrition throughout the body. The fascial system can become restricted in response to trauma, repetitive movements, poor posture, or surgery making movement difficult, increasing the possibility of pain and dysfunction.  Through hands-on work, structural integration addresses these restrictions to create the freedom for easier movement and better postural alignment.

Other Physical Therapy Services

  • Headaches
  • Spinal pain/strain
  • Facet joint dysfunction/arthritis
  • Disc dysfunction
  • Sciatica
  • Stenosis
  • SI joint pain
  • Shoulder pain, impingement, bursitis, tendonitis, rotator cuff tears, frozen shoulder
  • Thoracic outlet/ nerve entrapment
  • Elbow tendonitis
  • Carpal tunnel syndrome
  • Hip bursitis/impingement 
  • Knee pain/strain, arthritis, patellar joint dysfunction
  • Total joint replacement rehabilitation
  • Ankle sprains, Achilles tendonitis
  • Plantar fasciitis, foot pain, Morton’s neuroma, bunions
  • Myofascial pain syndrome/fibromyalgia
  • Hypermobility or Ehlers Danlos Syndrome

In addition to our specialized scoliosis treatment, we have years of experience in treatment of a variety of orthopedic problems resulting from injuries, accidents, overuse, poor posture and post-surgical rehab. In addition to the structural integration approach we utilize the following techniques in our personalized treatment plans.

Joint Mobilization/Muscle Energy Techniques

A manual therapy technique for improving joint mobility through therapist-assisted movements or guided muscle contractions.

Posture and Body Awareness

The development of personal recognition of how one holds and uses their body throughout the day both at rest and during activities.  Knowledge of what is, gives freedom to choose what can be.

Functional Movement Re-Education 

Optimization of the body’s capabilities by learning ways to move as effortlessly as possible to improve endurance, reduce repetitive strain, and maintain independence through all the seasons of life. 

Therapeutic Exercise 

Instruction in a personalized exercise plan tailored to the specific needs of each patient to restore flexibility, provide stability, promote new ways to move and improve respiratory patterns.  We blend Yoga and Feldenkrais movements with traditional forms of stretching and strengthening and are happy to review any exercise routine you are currently performing.