Understanding Scoliosis in Children: A BACK-to-School Guide

As summer ends and the school year approaches, it’s a crucial time for parents to ensure their children are prepared academically and physically. Scoliosis, a condition characterized by an abnormal curvature of the spine, can have a significant impact on a child’s physical and emotional well-being by affecting a child’s growth, which can lead to uneven development and delayed puberty. This is why detecting scoliosis before the school season begins is essential, particularly as they return to the demands of school sports and daily activities. Early intervention can help manage the condition effectively and prevent it from hindering your child’s participation in sports and other school-related activities. In this comprehensive guide, we will explore the causes, treatments, and importance of early intervention for pediatric scoliosis, especially during this critical time of year.

Causes of Scoliosis in Children 

Scoliosis can develop for several reasons, many of which are particularly relevant as children experience growth spurts during the school years: 

• Idiopathic Scoliosis (Unknown Cause): This is the most common form of scoliosis and typically emerges during periods of rapid growth, such as adolescence. The exact cause remains unclear, but it’s believed to be influenced by genetic and environmental factors. Monitoring during growth spurts, especially before and during the school years, is crucial for early detection. 
• Congenital Scoliosis (Present at Birth): This type is present at birth and results from malformations of the vertebrae. While congenital scoliosis can be identified early, it’s important to keep an eye on any changes or progression as your child grows, particularly during school years when physical activity increases. 
• Neuromuscular Scoliosis (Associated Conditions): This form is linked to neurological or muscular conditions such as cerebral palsy or muscular dystrophy. The physical demands of school sports and activities can exacerbate these conditions, making it important for parents and teachers to observe any signs of scoliosis. 
• Genetic Factors and Family History: If scoliosis runs in the family, your child is at a higher risk. Keeping a vigilant eye on your child’s spinal health, especially if there is a family history, is crucial as they engage in various school activities. 

Diagnosis and Screening: The Use of Physical Therapy 

The start of the school year is an ideal time for a comprehensive health checkup, including scoliosis screening. Early detection of scoliosis can significantly influence the management and outcome of the condition, particularly when physical therapy is integrated after diagnosis: 

• Regular Check-Ups and Evaluations can help identify early signs of scoliosis. While initial screenings are often performed by school nurses or pediatricians, if scoliosis is detected, a referral to a physical therapist can ensure a more thorough evaluation. Physical therapists are skilled in assessing posture, spinal alignment, and movement patterns, which can reveal subtle issues that might otherwise go unnoticed. 
• Physical Examination and Testing are commonly used to detect spinal curvature. If your child screens positive for scoliosis, a physical therapist can conduct a detailed musculoskeletal assessment to evaluate the severity of the condition and recommend appropriate interventions. 
• Functional Movement Screenings conducted can assess how scoliosis may be affecting your child’s daily activities and sports performance. Identifying these issues early allows for personalized exercise programs that can address specific needs. 
• Ongoing Monitoring and Exercise Programs provided by physical therapists can help manage mild scoliosis and prevent progression. These programs are tailored to the individual and can be adjusted as your child grows, ensuring their spine remains as healthy as possible during the school year. 

By incorporating physical therapy into your child’s scoliosis screening process before the school year begins, you can take proactive steps to ensure that any spinal issues are managed effectively. This approach helps to minimize the impact of scoliosis on your child’s academic and athletic activities, allowing them to fully participate in school life with confidence. 

Treatment Options for Pediatric Scoliosis 

Once scoliosis is diagnosed, treatment options are tailored to the child’s individual needs, considering the severity of the spinal curve, the child’s age, overall health, and the potential for further progression. The overarching goal is to manage scoliosis in a way that allows the child to maintain an active and fulfilling school life, participating in sports and other activities without hindrance. Below, we explore the various treatment strategies available for scoliosis management. 

Observation and Ongoing Monitoring 

In cases where scoliosis is mild, the primary approach may involve regular observation and monitoring, especially during the school year when growth spurts are common. This method is ideal for children whose spinal curves are not severe enough to require immediate intervention but still need to be closely watched for any signs of progression. 

• Regular Check-Ups: These typically occur every 4-6 months and involve physical exams and X-rays to assess any changes in the spinal curvature. The goal is to detect early signs of progression, allowing for timely intervention if necessary. 
• Parental Vigilance: Parents are encouraged to stay alert to any physical changes, such as uneven shoulders or hips, or changes in posture, that may indicate worsening scoliosis. 
• Physical Activity: Encouraging regular physical activity during this period can help maintain muscle strength and flexibility, which supports overall spinal health. 

Bracing: Providing Support for Active Children 

For children with moderate scoliosis, bracing is often recommended to prevent the curve from worsening, particularly during growth spurts. The purpose of bracing is not to correct the curve but to halt its progression, allowing the child to continue their daily activities with minimal disruption. 

• Types of Braces: The most common braces include the Boston brace, which covers the torso and is typically worn under clothing, and the Rigo-Chêneau brace, a more modern and custom-fitted option that offers better comfort and compliance. Both are designed to be worn for most of the day and night, though the exact duration depends on the child’s individual condition. 
• Impact on Daily Life: While wearing a brace may require some adjustment, most children can continue to engage in school sports and other physical activities. Physical therapists often work with children to ensure the brace is properly fitted and to develop exercises that complement its use, maintaining muscle strength and flexibility. 
• Psychological Considerations: Wearing a brace can be emotionally challenging for children, especially during adolescence. Support from family, friends, and healthcare providers is crucial to help them adapt and maintain a positive outlook. 

Physical Therapy: Building Strength and Flexibility 

Physical therapy is a cornerstone of scoliosis treatment, particularly during the school year when integrating exercise into a child’s routine can be most effective. Through targeted exercises, physical therapy helps to strengthen the muscles that support the spine, improve posture, and enhance flexibility, all of which are crucial for managing scoliosis. 

• Customized Exercise Plans: A physical therapist will develop a personalized exercise regimen tailored to the child’s specific needs, focusing on core stabilization, spinal alignment, and overall body mechanics. These exercises can be easily incorporated into the child’s daily routine, whether at home, during physical education classes, or as part of after-school activities. 
• Posture Training: Physical therapists work with children to improve their posture, teaching them how to maintain proper spinal alignment during various activities, including sitting in class, carrying a backpack, and participating in sports. 
• Pain Management: For children experiencing discomfort due to scoliosis, physical therapy can also include pain relief techniques, such as manual therapy, stretching, and the use of heat or cold therapy to manage symptoms and enhance comfort. 

Each of these treatment options plays a critical role in managing scoliosis and ensuring that children can continue to thrive both academically and physically. With the right combination of monitoring, bracing, physical therapy, and advanced techniques children with scoliosis can lead full and active lives, participating in the sports and activities they love while maintaining their spinal health. 

The Role of Physical Therapy in Scoliosis Management 

Physical therapy plays a crucial role in managing scoliosis, especially during the school year: 

• Improving Posture and Awareness helps your child maintain good form during sports and daily school activities. 
• Strengthening Core and Back Muscles ensures that your child can handle the physical demands of carrying backpacks and participating in sports. 
• Increasing Flexibility and Range of Motion allows your child to move comfortably and confidently, reducing the risk of injury during school activities. 
• Reducing Discomfort and Enhancing Quality of Life can significantly improve your child’s quality of life, enabling them to focus on their studies and enjoy their school year. 

Importance of Early Intervention and Specialized Care 

As the school year approaches, early detection and treatment of scoliosis become even more critical: 

• Growth and Development Impact: Scoliosis can affect a child’s growth, leading to delayed skeletal age, especially in girls with curvatures greater than 20 degrees. The condition can also delay puberty and cause uneven growth, resulting in muscle imbalances. As children grow, the likelihood of curvature progression increases—especially for children under 10. A curvature between 5 and 19 degrees has a 45% chance of progressing, while curves between 20 and 29 degrees have an almost 100% chance of worsening. 
• Early Detection and Treatment: Early detection can prevent curve progression, ensuring that your child can participate fully in school sports and activities without limitations. Timely intervention also helps manage scoliosis-related symptoms such as back pain and mobility limitations, allowing children to maintain an active lifestyle throughout the school year. 
• Multidisciplinary Approach: A multidisciplinary approach involving pediatric orthopedists, physical therapists, and other specialists ensures that your child receives comprehensive care tailored to their needs as they grow and develop. This collaboration becomes especially important when managing the potential effects of scoliosis during school sports and daily activities. 

Twin Boro Has You and Your Family’s Back! 

As your child gears up for the school year, it’s important to remember that their physical health is just as important as their academic success. With the return of school sports and the daily rigors of carrying backpacks, undiagnosed scoliosis can become more apparent and potentially worsen if left unchecked. Early detection and intervention are key to ensuring that your child can fully participate in school activities without discomfort or limitation. If you suspect your child may have scoliosis, seek professional evaluation.  

At Twin Boro Physical Therapy, our team of specialists is here to provide the support and care your child needs, helping them start the school year strong and healthy! Schedule an appointment with us today!