Teens

Scoliosis in Teens

Adolescent Idiopathic Scoliosis affects 3% of all teens, and is diagnosed between the ages of 11-18 years old, and the progression can be accelerated by the pre-pubertal growth spurt. As the teen’s skeleton is still growing, there is a higher risk of progression during this growth phase and therefore it’s more urgent to seek treatment as soon as your child is diagnosed with scoliosis.

Idiopathic Scoliosis may present as:

• uneven shoulders
• a shoulder blade that appears to stick out
• uneven waist or hips
• a ‘bump’ on the back when the child bends forward

If you suspect your teen has scoliosis, bring him/her to your family doctor for a proper assessment. Your doctor may request an X-Ray to confirm if a spinal curve is present.

If your child receives a positive diagnosis of scoliosis, it is important to seek conservative treatment early to try to prevent progression of the curve. The ScoliClinic physical therapists can help you navigate the system to determine which treatments are most appropriate for your child.

What causes scoliosis in teenagers?

In Adolescent Idiopathic Scoliosis, the exact cause of the scoliosis is unknown. Some teens with scoliosis have a family history of scoliosis, while others do not. Some are very physically active while others lead a more sedentary lifestyle. Furthermore, it is not yet clear which factors (biological, genetic, hormonal, mechanical, etc) contribute to curve progression.

Even though the scientific world doesn’t yet know the exact factors that trigger the onset of idiopathic scoliosis, researchers do have a clearer understanding of how the curve progresses from a biomechanical perspective. Asymmetrical growth and loading in the spinal column during growth spurts contribute to wedging of the vertebrae. This wedging typically occurs from the side view and the back view, and the 3-dimensional change in vertebral shape lead to shifting and rotation of the spine.

There are many effective treatments for idiopathic scoliosis that range from physiotherapy, to bracing, to surgery depending on the curve(s).

How can you tell if your teen has scoliosis?

Scoliosis in teenagers may present as:

• uneven shoulders
• a shoulder blade that appears to stick out
• uneven waist or hips
• a ‘bump’ on the back when the child bends forward
• the appearance of a tilted head or head not appearing centered on body
• ribs that look to be sticking out in the front/back
• body leaning over to one side

If you suspect your child has scoliosis, book a screening appointment at The ScoliClinic where your therapist will take baseline measurements. Alternately, you can bring your teen to a family doctor; they may request an X-Ray to confirm if a spinal curve is present.

What should you do if your teen has scoliosis?

If your teen receives a positive diagnosis of scoliosis, it is important to seek conservative treatment early to try to prevent progression of the curve. The ScoliClinic physiotherapists can help you navigate the system to determine which treatments are most appropriate for your child.

The phase with the highest risk of curve progression happens while the child is still growing; although this may be a time of risk, it’s also a window of opportunity.

While your teen is still growing, there is still a chance to influence the shape of the growing vertebrae. Therefore, bring your teen for an assessment with a scoliosis-trained physiotherapist who can gather baseline measurements to track progress, and prescribe a detailed and individualized home exercise program that is specific to your teen’s spinal curvature and other needs.

During these appointments, your therapist can discuss the options for bracing and surgery, and can help advocate for referrals to any required specialists.
In Canada, the waitlist to see a spine specialist may be several months to a year long; therefore it’s important to get started on a conservative (non-operative) treatment plan to take action while you wait for further referrals.

As the scoliosis journey can be a taxing one for you, your teen, and your family, you may consider seeking emotional support through this process as well. Through Facebook groups, forums, counselling, and connection, your family can approach your teen’s scoliosis treatment in a multi-dimensional approach. Hear from Hannah, one of our teen clients, about her experience and challenges with scoliosis.

When you book with a therapist at The ScoliClinic, you can ask about the options to connect with other teens and families on the scoliosis journey. We’d be happy to share those options with you!

What types of treatment are available for teenagers with scoliosis?

The types of treatment recommended for teenagers with scoliosis highly depends on many factors including, but not limited to:

• age
• amount of skeletal growth remaining
• number of curves
• size of curves
• location of curves in the spine
• how fast the curve may be changing
• presence of symptoms such as pain or discomfort
• presence of other neurological signs

Typically, treatment for adolescent idiopathic scoliosis consists of a combination of monitoring, scoliosis-specific exercise, bracing, or surgery.

How is Schroth Physiotherapy used in treatment for adolescent idiopathic scoliosis?

Scoliosis-specific Physiotherapy such as the Schroth Method may be helpful to improve posture, address pain, and prevent progression of the curve.

Schroth Method exercises are different than normal Physiotherapy exercises because they take into account your spinal curve measurements from your teen’s X-Rays (if available) and various other scoliosis-related measurements (scoliometer, inclinometer, lung volume, plumb line, and more) to determine exactly which exercises would be best to support their spinal curve.

These exercises acknowledge the muscle imbalances created by scoliosis and work towards more symmetrical muscle function, while respecting the skeletal changes that are occurring in the spine. Your teen will learn how to find a more neutral postural alignment in various positions against gravity (lying on your back, on your side, sitting, standing, etc) so they can incorporate these new strategies into their daily activities, sports, and gym workouts.

Since Schroth exercises are complex, it often takes 8-10 sessions in a 1:1 setting with your scoliosis-trained Physiotherapist to learn a variety of postural alignment exercises. The learning occurs faster if your teen is engaged in their home exercise program. Don’t worry, your therapist will discuss how to make these home exercises most feasible for your teen.

Over a series of periodic follow-ups, The ScoliClinic therapists will monitor and track your teens progress until their skeleton has finished growing. Our team often refers to scoliosis treatment for teenagers as a marathon, not a sprint.

If this feels daunting for you or your teen, we encourage you to share your concerns at your appointment. Our therapists have worked with many families on similar journeys and understand the social and emotional aspects of this condition. We want to support your family in a multi-dimensional way through guidance and emotional encouragement.