My Child Was Just Diagnosed With Scoliosis
For some parents this comes as a complete surprise - other times the parents suspected it and initiated the evaluation.
Either way - it is a stressful time with lots of questions and often hard to get answers.
I am discussing AIS - Adolescent Idiopathic Scoliosis.
First of all - what is it?
It's a 3 dimensional change in the shape of the spine and torso in an otherwise healthy child. We don't know why it happens and we do know there is a familial tendency.
The key things your doctor should be looking at are Risser or Saunders score and the degree of the Cobb angle.
Risser score is a measurement of how far along in the growth stage they are by looking at xrays of the pelvis.
Saunders also looks at growth stage but looks at x rays of the hand. It is considered more accurate.
Cobb angle is a measurement of the curve or curves taken on the xray - it's important as a baseline but also to determine if and when a child would benefit from bracing. I should mention that Risser or Saunders score weighs into that decision heavily as well.
If a brace is recommended for your child, it is worth seeking out an orthotist who specializes in three dimensional bracing, since scoliosis is a three dimensional problem!
A Rigo Cheneau style brace is a good place to start.
There are others. Feel free to reach out to me if you find yourself in the situation.
Unfortunately the bracing terminology is not standardized so it's hard to sort through.
At minimum, speak to a few orthotist before you let them fabricate the brace and make sure they have experience with scoliosis and address the three dimensional components.
Even within the same company, ask for the closest thing they have to a scoliosis specialist!
I think one of the hardest things for families is the unknown.
The truth is, we have no idea which children will progress more rapidly, not at all,
or sometimes smaller curves even regress.
So no one can offer a guarantee.
The main goal with adolescents is to limit the progression of the curve until they are done with bone growth. The risk of progression goes way down as they are closer to bone maturity.
Research has shown that bracing, if indicated, and PSSE can be helpful.
PSSE stands for Physiotherapy Scoliosis Specific Exercise.
The Schroth method and the SEAS method are the two most evidence based of those schools.
Some physicians will refer you for specific physical therapy after your diagnosis, but often times the referral will only happen if the family requests it.
The other challenge is whether or not you have a trained physical therapist in your area.
Feel free to ask me how to find a trained PT in your area.
It's important for your child to understand the mechanics of scoliosis and the shape of their particular curve or curves. That's a big part of scoliosis specific exercises and these become tools that they use for the rest of their lives to care for their spine health.
Of course, what and how I would teach a 12 year old is very different than how I would teach a 17 or 20 year old.
But we are still laying the foundation!
Long-term consequences to scoliosis will vary from person to person as well as on the degree of the scoliosis and whether or not surgical intervention is required.
There is no reason they can't live a full and healthy life, carry and bear children, participate in sports etc.
How that manifests will be different depending on the individual.
The more they understand their curves and how to stabilize them as they grow into adulthood, the less likely they are to have secondary joint and pain problems.
And if they do, they will know better how to manage them.
So… :) … in the short term, it is important that your child sees a pediatric scoliosis spine specialist to properly assess their curves, x-rays, bone growth etc. and guide the plan of care.
From there it may be more up to you to seek out a well trained physical therapist to educate and work you and your child.
I should also mention mental health - there are great groups and books offering support for the stress and anxiety that can occur. Search in the group and you will find a few!
Join my Scoliosis Facebook Group to keep in touch and learn more:
https://www.facebook.com/groups/863924137312889
For some parents this comes as a complete surprise - other times the parents suspected it and initiated the evaluation.
Either way - it is a stressful time with lots of questions and often hard to get answers.
I am discussing AIS - Adolescent Idiopathic Scoliosis.
First of all - what is it?
It's a 3 dimensional change in the shape of the spine and torso in an otherwise healthy child. We don't know why it happens and we do know there is a familial tendency.
The key things your doctor should be looking at are Risser or Saunders score and the degree of the Cobb angle.
Risser score is a measurement of how far along in the growth stage they are by looking at xrays of the pelvis.
Saunders also looks at growth stage but looks at x rays of the hand. It is considered more accurate.
Cobb angle is a measurement of the curve or curves taken on the xray - it's important as a baseline but also to determine if and when a child would benefit from bracing. I should mention that Risser or Saunders score weighs into that decision heavily as well.
If a brace is recommended for your child, it is worth seeking out an orthotist who specializes in three dimensional bracing, since scoliosis is a three dimensional problem!
A Rigo Cheneau style brace is a good place to start.
There are others. Feel free to reach out to me if you find yourself in the situation.
Unfortunately the bracing terminology is not standardized so it's hard to sort through.
At minimum, speak to a few orthotist before you let them fabricate the brace and make sure they have experience with scoliosis and address the three dimensional components.
Even within the same company, ask for the closest thing they have to a scoliosis specialist!
I think one of the hardest things for families is the unknown.
The truth is, we have no idea which children will progress more rapidly, not at all,
or sometimes smaller curves even regress.
So no one can offer a guarantee.
The main goal with adolescents is to limit the progression of the curve until they are done with bone growth. The risk of progression goes way down as they are closer to bone maturity.
Research has shown that bracing, if indicated, and PSSE can be helpful.
PSSE stands for Physiotherapy Scoliosis Specific Exercise.
The Schroth method and the SEAS method are the two most evidence based of those schools.
Some physicians will refer you for specific physical therapy after your diagnosis, but often times the referral will only happen if the family requests it.
The other challenge is whether or not you have a trained physical therapist in your area.
Feel free to ask me how to find a trained PT in your area.
It's important for your child to understand the mechanics of scoliosis and the shape of their particular curve or curves. That's a big part of scoliosis specific exercises and these become tools that they use for the rest of their lives to care for their spine health.
Of course, what and how I would teach a 12 year old is very different than how I would teach a 17 or 20 year old.
But we are still laying the foundation!
Long-term consequences to scoliosis will vary from person to person as well as on the degree of the scoliosis and whether or not surgical intervention is required.
There is no reason they can't live a full and healthy life, carry and bear children, participate in sports etc.
How that manifests will be different depending on the individual.
The more they understand their curves and how to stabilize them as they grow into adulthood, the less likely they are to have secondary joint and pain problems.
And if they do, they will know better how to manage them.
So… :) … in the short term, it is important that your child sees a pediatric scoliosis spine specialist to properly assess their curves, x-rays, bone growth etc. and guide the plan of care.
From there it may be more up to you to seek out a well trained physical therapist to educate and work you and your child.
I should also mention mental health - there are great groups and books offering support for the stress and anxiety that can occur. Search in the group and you will find a few!
Join my Scoliosis Facebook Group to keep in touch and learn more:
https://www.facebook.com/groups/863924137312889
