YAY!!!!  Its July.

Winter is here and we have had to ensure that the heating is on in the studio.

Quite a few patients who are now on school holidays have returned for their follow up reviews after commencing therapy between November and February.  Some have done well, some have stayed the same but none appear to have regressed (curve progression). It does however appear that those who have done the best have been most compliant in their exercise program. It also appears that, over time, small unwanted compensations creep into the exercise positions and that these reviews are important to keep things on track.

Last week I had the pleasure of working with a very special young man from Melbourne who did very well during his sessions.  He and his mother commented during his post session debrief that it would be beneficial to get some kind of idea about Schroth and the treatment regime we use before attending the first treatment session.

So.... here goes..

Schroth therapy aims to replace the existing scoliotic posture with a new posture that reduces and hopefully counteracts the scoliotic progressing forces. Lior Neuhause once stated that "if you can understand the curve, you can treat the curve". Therefore , the first part of the treatment protocol involves a comprehensive deconstruction of the components of the scoliotic curve and then a workshop period where the patient gets to "understand and internalise" their existing curve profile.  This involves x-ray analysis, physical measurements and discussion.

Katarina Schroth called her technique 3 Dimensional treatment of scoliosis. We then apply the 3 dimensional correction protocol to the patients current existing curve profile. The Schroth technique is applied through a systematic series of postural corrections which are dependent on the curve profile.  Over the course of the following week the systematic corrections are taught in a variety of starting positions. Once these postural corrections have been achieved then the patient is ready to commence specialised schorth breathing called Right Angled Breathing (RAB), which is an essential component of Schroth. The aim of the breathing is to expand the collapsed areas of the thorax and flank as well as to counter-rotate the chest wall and floating ribs in the abdomen. 

Once we have achieved corrected posture, performing RAB we teach the patient activation exercises to strengthen the muscles that are required to maintian the new corrected posture.

to be continued

It seems a bit repititous to say that "another month has gone by" but its true.  We continue to stride along creating a healing environment to address postural and scoliotic issues.

I stayed up quite late a few nights ago to write this blog but somehow deleted the completed page before saving it.  It was a good lesson... always save and backup.

When we were building the clinic, our builder; Blair, reported that the studio would make a great party venue for a ballet party. My daughter Gabrielle turned 7 last week and she requested a gymnastics party.  Both Shana-Lee and myself are gymnastics coaches and a gymnastics party she had.  It was wonderful seeing 21 little girls MOVING in the studio we created.

This month I received Martha Hawes updated book called Scoliosis and the human spine.  I also received Nancy Schommer's book Stopping Scoliosis as well as David Wolpert's book Scoliosis surgery.  The are all available through the American scoliosis assoc. here

Although not unexpected, it seems that the majority of the patients I am seeing have curve profiles around 40 degrees plus. They are all self referred or word of mouth referrals...Therefore.. these patients are probably in the group of probably or possibly heading towards surgery and as a last resort are willing to try physio because they have nothing else to lose.  Reading the latter 2 books explains why there is such a reluctance to use physio as an option in idiopathic scoliosis treatment but reading the first book (Hawes) also provides fascinating reading of why it should be explored.  I somehow don't seem to mind being classed as "you have nothing to lose by doing Schroth therapy" but I do have concerns when the argument claims "you have nothing to gain by doing schroth therapy".

Dr Rigo, on our intitial day of training, stressed that Schroth therapy is only one aspect of treatment and that we work in conjunction with all the other treatment providers. Martha Hawes is quite scathing in her thoughts regarding the "wait and see" approach to scoliotic curves.  I don't agree with all her comments but there seems to be some logic in this.  You might have nothing to lose by doing Schroth therapy and you might have something to gain (even if its only "muscular postural improvement and treatment of the parents psyche") but you definitly have nothing to gain by doing nothing.

We have been seeing quite a few adults over the last month.  They differ from the adolescent patient in that their primary complaint is one of pain.  It is important to note that the pain is NOT related to curve profile or whether they have had surgery or not.  ie. a patient with a small curve might reports a great deal of pain whereas one with a large curve will not.  Interestingly, idiopathic scoliosis in the adolescent is characterised by NO PAIN (although some authors disagree with this statement).

The treatment of the adult scoliotic is intersting as it might not be the curve that is causing their pain.  They may, like 80 of the general population be suffering from "normal" musculoskeletal back pain.  However they may not be... If my new patient reports in the history that they have, with limited success,  already been treated with appropriate phyio, chiro or osteo.. etc. Then I have tended to commence treatment using Schroth based therapy.  Results have been very positive..  quite a few of my patients are saying that when they do their exercises and adopt a better posture then it assists to resolve their pain.  The goal is now to get them to maintain their corrected postures for great periods of the day.

Another month is flying by.

We have been in the clinic for almost a month. The reception desk arrived last week and the wall bars were installed today. It remains very exciting. Yesterday, Danielle Salomon came on board to join myself and Shana-Lee as a physio.  She will be gradually increasing her time in the clinic over the next few weeks and I am really looking forward to working with her.

The studio is finally looking the way I envisaged.  I had a new 14 year old patient today who was referred with acute knee pain and according to her mother "by the way, she has been told that she has scoliosis".  The knee condition whilst significant is under control but the scoliosis which is VERY real needs to be investigated and managed.  It is comforting to know that we now have a dedicated space to deal with these cases and that patients can feel reassured that we can provide excellent therapy in the correct environment.

We will be taking some photo's over the next week or two and I will upload them to the site.

At the end of the last months blog I wrote about the Canberra marathon. Thankfully as well as unfortunately its over.  I managed to beat my previous marathon best (10 years ago) by almost an hour.  Its amazing to recognise that during the massively busy period of setting up and moving clinics I was still able to train reasonably hard.  I am now able to put more time into the clinic but miss the time on the road which I suspect my mind uses as "stress relief".  Although I think its a good idea to stay out of political debate I think Tony Abbot's physical training regime is a GOOD THING.  I wish I could complete an Ironman whilst being very busy and think he is an incredible athlete having only trained 10 hours per week.

This week is the SOSORT conference in Montreal.  Unfortunately I cannot make it there as there is much to do in the clinic. Quite a few of the Schroth therapists from around the world will be there.  I was lucky this week to have a chat to Lou-Anne Rivett who is a South African trained Schroth physio.  We had a very interesting chat about her approach to scoliotic curves and we will continue to work together.  She has been treating a patient for the last few years who has recently moved to Sydney. Lou-Anne was telling me that she was dreading "schlepping" on a plane from Johannesburg. I think that its much further from Sydney. This year  I will look foward to the conference book and next year I hope to be at the conference in Barcelona.

If you do read this blog......   please send me an email with some of your scoliosis stories.

Goal for the month...  get to meet some Scoliosis surgeons!!

It is hard to believe how quickly time has flown this year.

This past week has been a momentous, or to use a word from Kill Bill (the movie)- Gargantuan step in the life of postural physiotherapy.

We have finally moved into our new space. I know.... its been very hush hush. I have been practicing out of a 15sqm room in  a doctors surgery for the last 10 years and since returning from Wisconsin realised that to work in postural and scoliosis therapy I would need more space. Admittedly I have been looking for the right space for a few years but nothing ever worked out - till now.

The space started off as part of the garage of the Meriton serviced  apartment block which was converted into office suites by Meriton. It was an empty shell when I first saw it, but with the help of Agi Sterling architect and Blair and Alex of Mammoth builders, we moved in on Monday.  There are of course the standard teething problems such as the reception desk not being ready on time and the 10 station wall bars not being ready on time (hopefully both will be installed in the next week or two).

The initial aim is to continue the existing "practice" of postural physiotherapy.  The thursday morning "osteoporosis" class had its first session in the space. It was great!! finally the class could, using the surround mirrors,  see what I have been trying to tell them for years.  We will be adding another osteoporosis class on Tuesdays.

Although it started off as the "osteoporosis class" its more of what I call an intuitive journey through movement.  We will also be adding some classes aimed at total hip and total knee recepient patients as well as people with chronic shoulder pain.

Finally!!!!  when we get up to speed, we will be adding specialist posture and scoliosis classes.

Speaking to Blair a few days ago..  when we were really rushing aound doing a milliion things at once he asked what I have been doing in my spare time.. well- training for the Canberra Marathon on the 2nd of May.  Once that is out of the way I will be able to devote more time to the blog.