Scoliosis is corrected by regularly performing a series of exercises that restore the natural position of the spine and correct breathing. The system developed by Katharina Schroth allows even patients with advanced cases of curvature to get their spinal column in order.

Creator health-improving gymnastics I tested every movement on myself. Suffering from a lateral curvature, she created gymnastics complex to adjust it. The technique turned out to be effective, and in 1921, Schroth gymnastics was already actively used in a specialized clinic for the treatment of scoliosis. Today, these simple and effective breathing exercises help patients around the world.

About gymnastics

Katharina Schroth researched human body and concluded that because of the air inside it is like a ball. Air pressure can return correct form, agility and vigor even in the most advanced cases. Thus, scoliosis is treated by restoring proper breathing.

Regular performance of Schroth exercises gives the following effect:

1. The uniform distribution of oxygen is restored. The lungs are straightened, the narrowing is corrected chest.
2. The back muscles become stronger and more resilient. Chronic pain caused by instability of the vertebrae recedes.
3. Displacements and subluxations of individual vertebrae are corrected. The spinal column returns to its natural shape.
4. Torso deformity is corrected in all three planes. The foundation is laid for the development of a strong muscle corset in the future.
5. Conscious regulation of breathing is learned. Proper breathing is the best prevention of exacerbation of back curvatures.

The basis of treatment according to the Katharina Schroth method is the elimination of the stereotype of incomplete breathing that occurs due to tightness of the chest. As you inhale, you need to make sure that the lungs become wider and strive to fill the volume of the chest, moving forward and outward. Moreover, for each patient the point of application of maximum pushing efforts is different.

Before the start of the first training, the sinking zones of the chest are determined and the direction of correction is established. It is due to individual approach the treatment is so effective.

Contraindications

Breathing exercises are available to both children and adults. It does not require preliminary physical preparation and does not overtire the patient. However, there are groups of diseases that prevent the fulfillment of these loads:

1. Acute forms of infectious diseases.
2. Any chronic heart disease.
3. Heart blockades.
4. Respiratory failure.
5. Problems with blood supply to the brain and heart muscle.
6. Oncological pathologies.
7. Intellectual disorders.

There are also temporary conditions that prevent you from exercising. If you feel unwell, then refrain from training and undergo proper treatment first. You can return to exercise later and catch up on lost time.

The following ailments require immediate cessation of gymnastic procedures and medical intervention:

1. Vascular crises.
2. Heart rate instability.
3. Exacerbations of any chronic diseases.
4. Exacerbation of back curvatures.

Before starting therapeutic exercises, consult your doctor.

Exercises

Katharina Schroth has developed a flexible course of exercises that can be adjusted to suit various shapes scoliosis. Breathing exercises are carried out individually, since each patient performs the exercises in his own way, depending on the defect. At the same time, breathing is carefully monitored. Mobility in some areas is limited by bags of rice. Other areas are raised due to the fact that special pads are placed under them.

During the treatment process, the map of the correction process may change significantly. Don’t quit classes with an instructor, don’t completely switch to doing exercises at home. You will not be able to recognize the transition point when it is necessary to change course, and the exercises will have only a partial effect. It is even possible to internalize an incorrect breathing pattern, which can lead to aggravation of existing problems.

For any diagnosis, the complex will consist of the following elements.

Exercise 1

Passive straightening. The optimal body position and application of respiratory efforts are developed so that scoliosis is corrected with only one breathing effect.

The patient is placed on the massage table in a certain way, then some parts of the chest are pressed down on him with soft weights, while others, on the contrary, are lifted. Sometimes the patient may be asked to spend some time in this position to get used to it.

In the later stages of recovery, it becomes natural for the patient and is used exclusively as a starting position for other exercises.

Exercise 2

Trunk stretching, also known as autoelongation, is when the patient, through his own efforts, strives to widen the spaces between the ribs and increase the volume of the chest during inhalation.

At the command “stretch out,” you should either begin to smoothly pull your head as far away from your shoulders as possible, or begin to pull your pelvis back. The direction of stretching is determined individually and depends on the individual characteristics of the course of scoliosis. The instructor should help the patient by performing stimulating movements along spinal column towards the pulling side.

This exercise allows you to take a correct breath, using areas that usually do not participate in the respiratory process due to scoliosis.

Exercise 3

Inhale through curved zones in a direction selected individually. At the command “inhale,” the patient begins to smoothly draw in air, pushing the sinking ribs outward, sideways and upward, following the movement of the instructor’s hands. Exercises are performed only after preliminary warming up, since otherwise it is difficult to feel whether the muscles are tense or tense. The movement of the zones is additionally controlled by hands and viewed in the mirror.

Exercise 4

Active correction. A force load that corresponds to the curvature is selected (for example, traction or emphasis) and performed with a long exhalation. When doing the exercise, you should tense the muscles of the convex side of the costal arches. Thanks to this, the muscles of the rib bulge are maximally worked out and stretched.

To start exercising, you first need to get rid of excess air in the lungs, then slowly continue to exhale, as if drawing in the muscles of the rib zones. Stimulate muscle contractions with your hands to quickly learn how to tense correctly. The correction is carried out due to the stretching and tension of the muscles characteristic of deep exhalation.

The subsequent inhalation is also important because it straightens the crooked areas. It should be as free as possible. After inhaling, the patient repeats the prescribed physical exercise from 24 to 30 times.

It is very important to monitor the correct execution of all movements and breathing throughout the entire workout. There should be mirrors around the massage table. They show how the chest rises when breathing, which muscles are more tense, whether the exercises have a positive effect and whether the body position is approaching a healthy one.

One of the criteria for the success of the session is a temporary change in the patient’s height. The difference between “before” and “after” can be up to two centimeters.

Katharina Schroth's gymnastics is carried out with an instructor, since it is important to ensure that the exercises are performed correctly as early as possible. Classes using the Schroth method are always preceded by detailed explanation what specific type of scoliosis the patient has and which areas will be corrected. Without this information, it will be difficult to understand how to do some of the movements. If you are not given clarification, ask for it yourself. If your request is denied, change your instructor.

Some useful tips:

1. Mutual respect and trust between patient and instructor is the key to successful completion of the course. Only a professional can track changes in the patient’s body and promptly correct the program if necessary.
2. It is best if you see the full clinical picture, so try to choose an instructor with whom you can work long and fruitfully.
3. Since Schroth treatment involves deep diaphragmatic breathing, try to breathe consciously during each session. Lead the direction of the process; it should proceed as if from the bottom up.
4. Monitor muscle tension by counting the “checkpoints” passed to yourself.
5. When inhaling, the lumbar fold first tenses, then the main force falls on the sunken chest areas. The end of the inhalation occurs in the front of the chest.
6. Smoothly draw air into your lungs, and then release it even more slowly. Exhale through your mouth for as long as you have the strength and patience. The lips should be semi-clenched, as this creates resistance and ensures maximum active muscle work.

Practice Schroth breathing not only in the massage room when doing exercises. Try to breathe correctly as often as possible, because it is through regular effort that the crooked areas straighten out and the body returns to normal.

Scoliosis (Greek “scolios” - crooked) is a persistent lateral deviation of the spine from the normal straightened position.

About 5-7 percent of the population suffers from scoliosis - from a minimal degree (many do not even know it) to severe forms with the formation of a large hump, unequal hips and a host of health problems caused by scoliosis. Only in 14 percent of cases can a cause be identified, such as: an accident, rickets, mild or spastic paralysis or congenital bone defects, differences in leg length, genetic diseases and much more. In approximately 86% of all cases, the cause of the curvature is unknown. These scolioses are called idiopathic (which in Greek means “unknown cause”). This type of scoliosis occurs in girls about 5 times more often than in boys.

This disease has long been called “a doctor’s mystery” and “orthopedic cancer.” Scoliosis is classified as a growth deformity. The most unpleasant characteristic of any scoliosis is its steadily progressive course.

Of one hundred patients with initial symptoms of scoliosis, only one third will have progressive deformity. Of this number, only one third will experience rapid progression (up to 15º per year) and the deformation will reach levels of up to 35º - 40º in the frontal plane. And finally, only one third of last date In patients, the course of scoliosis will be aggressive when the scoliotic curve increases by more than 30º per year and often reaches 80º - 120º according to Cobb. Scoliosis itself, i.e. purely lateral curvature of the spine - curvature in the frontal plane - practically does not occur. Changes occur in all three planes: in the sagittal plane - lordosis, “flattening” of physiological thoracic kyphosis with increased physiological lumbar lordosis. In horizontal pathological rotation (rotation of the vertebra around its axis). The progression of scoliosis leads to secondary deformation of the chest and pelvis, dysfunction of the lungs, heart and pelvic organs, and the development of early degenerative changes.

Conservative treatment of scoliosis

Bloodless (conservative) effective treatment scoliosis in European practice is currently a combination of specialized anti-scoliosis gymnastics according to Schroth and corset therapy according to the Chenot principle. Under positive conditions - a high-quality corset with a strong primary correction of the arch on an x-ray in the corset, very good motivation of the patient to wear the corset and daily performance of specialized gymnastics, in some cases in adolescence, complete correction can be achieved only with the help of bloodless conservative treatment.

Operation

Initial (initial) indications for surgery vary depending on age and the effectiveness of available brace treatment and lie between 45 and 70 degrees Cobb, if all available conservative treatment options have been exhausted and have not brought sufficient success. ABOUT
IEC "Promotion" conducts group and individual sessions according to the method of K. Schroth, in which our specialists teach not only children, but also their parents. As a result, patients receive a tool with which they can successfully fight this serious disease.

Katharina Schroth's technique

The main goal of exercise therapy according to K. Schroth’s method is to stop the progressive curvature of the spine with scoliosis, as well as reduce the angle of deformation, correct muscle imbalance, and remove external cosmetic defects.

The Schroth method uses breathing, derotational (aimed at reversing the rotation of the vertebrae), isometric, and other exercises to strengthen and eliminate muscle asymmetry in scoliosis.

A system of exercises for the treatment of scoliosis was developed in the 1920s by Katharina Schroth (1894-1985). Further development The system was continued by her daughter Christa Lehnert-Schroth. In the 1960s, the Schroth method became a standard set of exercises in the non-surgical treatment of scoliosis in Germany.

K. Schroth’s technique helps patients:

• stop the development of scoliosis, stabilize and maintain the achieved correction results;
• decrease pain syndrome;
• correct the deformity and stabilize the correct position of the body in three planes;
• remove cosmetic defects;
• restore proper breathing;
• increase self-esteem by changing the patient’s psychological and social status;
• avoid surgery.

The Schroth therapy technique pays great attention to the conscious correction of posture, not only during exercise, but also throughout the day. During classes, each patient learns what he must do in order to recover, how to control the position of the body so that the correct posture of the spine becomes habitual.

Spinal deformation is why exercises are also selected individually. With scoliosis, each person is individual, the Schroth Method gives the patient knowledge and tools in the form of exercises that will help control healthy postures and posture throughout life.

Correction of the sagittal profile

“Flat back” is one of the main problems in the treatment of patients with idiopathic scoliosis. Based on this, one of the main tasks when selecting and performing exercises is to create a physiological sagittal profile. All exercises are based on the same basic principle: to create or maintain lumbar lordosis, as well as increase thoracic kyphosis, which will stop the progression.

Exercises according to Schroth in the initial positions of standing, sitting, lying down, and walking are performed while maintaining the physiological curves of the spine, which in the process of repeated repetition leads to the consolidation of postural reflexes.

Asymmetrical correction of the torso

It is carried out in the frontal and horizontal planes. The main goal is to teach the patient to achieve body position correction independently using the strength of the trunk muscles. Exercises are selected strictly individually depending on the type of scoliotic deformity. Required component Each exercise is asymmetrical, local, rotational breathing according to Schroth, which promotes correction.

Stabilization of the achieved correction is carried out through isometric tension of the trunk muscles during the exhalation phase, which has an active lengthening effect on shortened muscles and activates “overstretched” muscles.

Maintaining body position in space

Patients are trained to take correction postures, in the initial position standing, lying, sitting, and walking. This is important point to change the scoliotic stereotype to a physiological one.

By the end of treatment, the patient will learn to take the correct positions regardless of the presence of a doctor or the presence of a mirror, as well as maintain body position throughout the day.

Unfortunately, many orthopedists in Kaliningrad have not heard anything about the Schroth method, and in the old fashioned way they prescribe exercise therapy, massage, physiotherapy, or only corsetry. We are not opponents of all these methods, but we are ready to give you a modern and reliable way scoliosis treatment.

The Katharina Schroth Clinic is located in Germany. There are also certified centers in St. Petersburg. First, let's look at the history of the creation of this clinic. It all started when Katharina Schroth, according to her daughter, was diagnosed with scoliosis. Therefore, she tested all the gymnastics on herself, and before teaching her patients proper breathing and exercise techniques, she mastered it all herself. From the surviving photographs it can be concluded that she did not have major scoliosis, but from the photographs of her patients the results are visible. She took on patients with severe curvature and worked with them. The results were captured in the photo. She has also written and published extensively about treatments for scoliosis.
Under the current chief physician, H.-R. For Weisse, her son, the material and technical base was significantly modernized, the equipment for performing exercises was modernized, but the exercises themselves remained, for the most part, the same. Currently, he is developing theory and practice, believing that the combination of these two methods is the optimal tactic for preventing the progression of scoliosis.

The basis of Katharina Schroth’s gymnastics is proper breathing

The main thing in Schrot gymnastics is breathing. Its essence is as follows: in order to achieve the desired effect from the exercises, you need to learn to breathe correctly and eradicate the type of breathing that has developed during curvature. To put it bluntly, with scoliosis the chest participates in breathing asymmetrically. This is due to the rotation of the spine and the corresponding displacement of the chest (to the side and back on the convex side, forward and inward on the concavity side).

Thus, the intercostal spaces on the concavity side are reduced, and on the opposite side they are increased, so with each inhalation, an increasing volume of air enters the lungs from the convex side, and less and less from the concave side. This is one of the reasons for the appearance of a rib hump and retraction of the ribs on the opposite side.

Therefore, Katharina Schroth developed corrective asymmetrical breathing, which is directed in the direction opposite to the curvature, that is, inhalation is done through the sinking zones of the chest. The exact location of these zones depends on the type of curvature, its degree, and the level of the apex of the scoliotic curve. During exercises, corrective bags are placed on the side of the convexity and muscle roll, which limit the volume of inhaled air on this side.

How to breathe correctly with scoliosis?

Many will immediately ask the question: how can you consciously inhale with only one half of your lungs? The answer here is simple - it all depends on the training time. Since the intercostal muscles, which belong to the striated muscles, like the muscles of the legs and arms, are responsible for the movement of the ribs, it is quite possible to regulate breathing to certain limits. Both adults and children learn this. Breathing exercises are conducted individually at the Schroth Center. The person lies down on his stomach, at which time the doctor does a light massage of the sinking area so that the patient focuses the owl's attention on it and remembers where it is located. Then the doctor tells you to inhale with this particular part and raise your palm, then he holds your palm up and when you inhale, you need to touch it. The sequence of inhalation training is directed from bottom to top: first of all, close attention is paid to the lumbar fold, then to the sinking zone of the chest, and finally to the upper part of the chest. The last method of breathing is carried out while sitting facing the doctor.
The exhalation should be long and through semi-clenched lips to increase the resistance to exhalation and train the intercostal muscles. The doctor can press on the convex parts when exhaling, stimulating the muscles in this area, tightening these muscles and reducing the distance between the ribs on the convex side. With this type of breathing, the patient understands which zones should be used when inhaling and which when exhaling.

Main aspects of Schroth therapy

Gymnastics according to the Katharina Schroth method

A necessary aspect of treatment according to the Schroth method is a detailed explanation to the patient of what kind of scoliosis he has, how many arches there are, where the convexity and recession zones are located. Knowing this gives a complete idea of ​​where the muscles need to be trained and where to relax. This is the second criterion for success.
All exercises in Katarnia Schroth gymnastics are performed with this type of breathing. The exercises here are mainly static; they provide different loads on different muscles depending on the type of curvature. Their main goal is not the formation of a muscle corset, but the so-called “reduced” effect on the body in all three planes. The Schroth exercise complex contains the following exercises:

1. Correct body position when performing the exercise. This already helps to correct the arc of curvature and work better with the muscles.
2. Stretching the torso in order to develop proper breathing and make it easier to inhale with the concave part. Such exercises help increase the distance between the ribs in the sinking part.
3. Inhalation should be carried out in the sequence described above. In this case, the patient observes the movement of the ribs in the mirror and corrects inaccuracies.
4. All active exercises are aimed at contracting the stretched intercostal muscles of the convex part and are performed during exhalation.

After studying all the exercises, the patient performs them himself 24-30 times, controlling himself. For this purpose, the gymnasium is completely equipped with mirrors, with the exception of the floor. Since a lot of effort is put into mastering exercises and breathing, you need to drink a large number of water.

How often is rehabilitation using the Schroth method needed?

After completing the rehabilitation course, you cannot stop exercising. You need to practice every day, only then will there be an effect. In general, initially, according to Katharina Schroth’s method, the course lasted 3 months, with classes every day 3 times for 1.5 hours. Now the duration of the course has been reduced. It is recommended to undergo such rehabilitation once a year for children and once every 2-3 years for adults.

In the end, it should be noted that Short Therapy is not a cure for scoliosis once and for all. These exercises should be performed continuously, even if the progression of the disease has stopped. Its goal is to combat the disease.

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It is used in rehabilitation centers due to the fact that it optimally combines strength, breathing and recovery exercises.

Its creator, Katharina Schroth, tested the effectiveness of her method on herself. She suffered from a lateral curvature of the spine, and to get rid of it she developed a gymnastics complex. Schroth gymnastics received official recognition in Germany in 1921, when the first clinic for the treatment of scoliosis was opened, which used Schroth breathing exercises.

Basic principles of therapeutic gymnastics Schroth

At the core effective complex treatment of scoliosis lies in the idea of ​​the creator of the method that the body of a sick person resembles a ball in functionality. When pressure is applied to it, it levels out. This principle forms the basis of the exercise therapy complex.

The method is based on proper breathing. It is he who plays the leading role in eliminating the incorrect breathing pattern that has developed as a result of the displacement internal organs with scoliosis.

Rotation of the spine (twisting along the vertical axis) during deformation of the spinal column also causes instability of the vertebrae, so any careless movement causes pain in a person. To prevent it, Katarina’s treatment complex includes exercises to increase the strength endurance of the back muscle corset.

With lateral displacement in thoracic region of the spine, a narrowing of the intercostal spaces on the affected side can be seen. As a result, the lungs on the narrowing side of the chest receive less oxygen. They cannot fully deal with it. Without breathing training, such a pathology cannot be eliminated.

Vertebral displacement is eliminated unique system breathing exercises, which were developed by the daughter of Katharina Schroth Lenard. She is a physiotherapist by training. Over the course of many years of practice, Lenard Schroth was able to perfectly perfect his technique for eliminating vertebral subluxations, which are always observed with frontal deformation of the vertebral axis.

Before training, an explanatory conversation is held with the patient. He must understand the essence of the disease and its anatomical features in order to realize the value of the measures taken.

At the initial stage, the patient learns the basics of proper breathing in combination with static exercises. The simplest lesson using Katarina’s method consists of the following steps:

1. Studying and consolidating the correct body position to eliminate the pathological stereotype of body position;
2. Stretching the back muscles through breathing to increase the distance between the ribs in the chest;
3. Training the frequency and depth of inhalations and exhalations to adjust the width of the intercostal spaces;
4. Active exercises to strengthen the tone of the intercostal muscles during exhalation.

After preliminary classes, a person with an instructor, the patient performs the exercises independently 30 times daily. At the same time, he needs to constantly monitor the condition of his back using mirrors.

The training is based on asymmetrical breathing. Its essence lies in the consistent development of weak pulmonary areas by strengthening the intercostal muscles. During classes, to prevent pain, sandbags are placed under the convex side of the chest, and special cushions are placed under the spinal column.

When performing gymnastics, the body spends great amount energy, so a person should drink large volumes of fluid.

On average, the course lasts about 3 months, and then the technique involves the use of rehabilitation procedures. They are performed in adults 2-3 times a year, and in children – once annually.

Exist mandatory rules, which should be performed by a patient who treats scoliosis using the Katarina method:

• Repeated repetitions of exercises lead to the consolidation of permanent muscle reflexes, so it is very important to initially correctly stage the movements and breathing;
• Breathing exercises are first performed while lying on your stomach. In this case, first the doctor massages the sinking area of ​​the chest. While inhaling, the patient should touch his chest to the palm of the doctor’s hand located above the upper back. Thus, the depth of inspiration is fixed;
• Exhalation is carried out through semi-clenched lips, which allows you to actively train the intercostal muscles;
• Gymnastics aimed at stretching the intercostal spaces are performed while exhaling;
• To strengthen the reflexes developed during the day, about 30 repetitions of each exercise are recommended;
• During training, you should drink at least 1 liter of water.

There are also contraindications to the use of Schroth gymnastics:

1. For infectious diseases breathing exercises enhances the intensity and severity of the process;
2. Active physical movements are contraindicated in tumor diseases, since increased blood supply can lead to the spread of tumor cells to other tissues and organs;
3. For heart diseases physiotherapy is developed individually by a doctor. In some types of cardiac pathology it is contraindicated (angina pectoris, myocardial infarction);
4. Severe bone osteoporosis (loss of calcium salts) and spastic paralysis disrupt the functioning of the musculoskeletal system.

In conclusion, we note that Katharina Schroth’s breathing exercises for scoliosis are not a panacea for the disease. Its main purpose is to teach a person to effectively resist pathology.

When the patient learns to take the correct position and breathe evenly and evenly, he will subconsciously counteract the pathological curvature of the spine throughout the day. The method is best used in combination with other methods of treating frontal curvature of the spinal column to increase the effectiveness of therapy.

Gymnastics by Katharina Schroth for scoliosis is used in rehabilitation centers due to the fact that it optimally combines strength, breathing and rehabilitation exercises.

Its creator is Katharina Schroth I tested the effectiveness of my method on myself. She suffered from a lateral curvature of the spine, and to get rid of it she developed a gymnastics complex. Schroth gymnastics received official recognition in Germany in 1921. when the first clinic for the treatment of scoliosis was opened, in which Schroth breathing exercises were used.

Katharina Schroth

Basic principles of gymnastics:

The effective complex for the treatment of scoliosis is based on the idea of ​​the creator of the method that the body of a sick person resembles a ball in functionality. When pressure is applied to it, it levels out. This principle forms the basis of the exercise therapy complex.

The method is based on proper breathing. It is he who plays the leading role in eliminating the incorrect breathing pattern that has developed as a result of the displacement of internal organs during scoliosis.

With lateral displacement in the thoracic spine, a narrowing of the intercostal spaces on the affected side can be observed. As a result, the lungs on the narrowing side of the chest receive less oxygen. They cannot fully deal with it. Without breathing training, such pathology cannot be eliminated.

Rotation of the spine (twisting along the vertical axis) during deformation of the spinal column also causes instability of the vertebrae, so any careless movement causes pain in a person. To prevent it, Katarina’s treatment complex includes exercises to increase the strength endurance of the back muscle corset.

Displacement of the vertebrae is eliminated by a unique system of breathing exercises, which were developed by the daughter of Katharina Schroth Lenard. She is a physiotherapist by training. Over the course of many years of practice, Lenard Schroth was able to perfectly perfect his technique for eliminating vertebral subluxations, which are always observed with frontal deformation of the vertebral axis.

The cornerstone of the method is Schroth breathing. Its meaning is that for the corrective effect of the exercises, it is necessary to teach the patient to breathe correctly while performing them, contrary to the formed scoliotic stereotype of respiratory movements of the chest. The fact is that with scoliosis, the chest participates in breathing asymmetrically.

Rotation of the spine leads to a change in the position of the ribs: the ribs attached to it from the convex side of the arch come out (in side and back), and the ribs attached to the opposite concave side of the arch go inward (forward and from the side to the middle), sink, and the intercostal spaces on this side narrow. The chest has a suction effect in relation to the lungs: there is negative pressure in the pleural cavity. Therefore, when inhaling, the lungs follow the expanding chest, filling its volume and repeating its shape.

With scoliosis, inhalation occurs to a greater extent from the convex side of the arch than from the opposite side. With each respiratory excursion (movement), the situation gradually worsens: the intercostal spaces on the convex side of the arch widen, the intercostal muscles stretch, and the concave side inhales less and less. That is, respiratory movements occur in the same direction as the rotation of the spine, and aggravate it. This is how the rib bulge, the gibbus, is formed. The rate of its formation depends on the rate of progression of scoliosis; with a rapid increase in the arcs of curvature and rotation of the vertebrae, the displacement of the ribs is sharper and breathing is more and more asymmetrical.

Therefore, precisely due to breathing, the most noticeable manifestation of spinal rotation is the rotation of the chest: gibbus and contralateral (on the opposite side) retraction of the ribs. This is when viewed from behind. In front, the picture is the opposite: the ribs that form the gibbus at the back go away, sink, and on the opposite side move forward (the so-called anterior gibbus).

Of course, all people breathe from birth without thinking. The same goes for people with scoliosis. K. Schroth developed corrective asymmetric breathing, opposite to scoliotic breathing. In this case, the patient must consciously inhale through the sinking areas of the chest.

In the most common type of scoliosis with the thoracic and lumbar curves, these zones are located:

Posteriorly, on the concave side of the lumbar arch (lower ribs and waist on this side)
Posteriorly, on the concave side of the thoracic arch (approximately level with the angle of the scapula)
In front, on the side of the sternum where the thoracic arch is directed, under the collarbone.

The exact location and severity of these zones depends on the level of the apex of each arch in each individual patient and is noted on the diagram in a special booklet that is given to him. All directions of correction and the position of small corrective bags - pads (with rice), which are placed during lying exercises on the opposite (convex) side under the protruding ribs and muscle ridges - are also marked there to limit inhalation into these zones.

At first glance, it is not clear how you can consciously inhale on one side and not inhale on the other. But, if we remember that the intercostal muscles, which are responsible for the movements of the ribs during breathing, are the same skeletal striated muscles controlled by consciousness (in contrast to the smooth muscles of the internal organs, which act independently of our consciousness) as the muscles of the limbs, for example who obey our commands, it doesn’t sound so strange anymore.

Up to certain limits, voluntary regulation of breathing is possible. And this is actually real, both children and adults master it.

Breathing therapy classes go like this. They are individual. Before this, the patient already knows what type of scoliosis he has, they explained to him where the zones on his body are and marked on the diagram the sinking places that he must learn to inhale.

The patient lies on his stomach on a soft massage table with a hole for the face so as not to twist his neck and breathe freely. The instructor gives a light tonic massage to the sinking area so that the patient concentrates and remembers its location.

Then the instructor asks you to inhale in this exact place and thus raise his hand, after each attempt re-stimulating the memorization of this zone with a massage. The patient tries to raise the instructor's hand with his breath, then reach and touch his slightly raised palm while inhaling.

Since the correct type of breathing is diaphragmatic, the sequence of inhalation is through the sinking zones from bottom to top, i.e.: at the beginning of inhalation, the patient concentrates on the lumbar fold (opposite to the lumbar ridge), then inhales through the sinking thoracic zone (opposite to the rib bulge). The last part of the inhalation is concentrated on the chest in front; inhalation through this zone is trained while sitting, facing the instructor.

Exhalation according to Schroth should be long, the longer the better, and noisy, made through semi-compressed lips, thus increasing the resistance to exhalation, and, therefore, the work of the muscles, especially the intercostal muscles, which have high proprioceptive sensitivity (i.e., reflex strengthening of muscle contraction when it is stretched).

During exhalation, the instructor presses strongly on the convex sides: thereby encouraging the patient to exhale as much air as possible from there, strain the muscles of this area as much as possible, tighten the stretched intercostal muscles, and reduce the widened intercostal spaces. That is, the exhalation is not passive, but active, with great tension in the muscles of the convex side of the arch. Thus, the patient remembers and gets used to “which place” to inhale and which to exhale.

The skill is trained and monitored every day by everyone, both individually and in a group. In my impression, it is the ability and practiced skill of inhaling through sinking zones and asymmetric breathing that to the greatest extent determines the corrective effect of Schroth therapy.
All exercises according to Schroth are performed only under the condition of such breathing.
The exercises are mainly static, giving an isometric load on the muscles. Since the muscles in scoliosis also work asymmetrically, on one side of the arch they are overstretched, on the other they are tightened and shortened, the point of the exercises is not in training or creating a general “muscle corset”, which with scoliosis is unlikely to be symmetrical, but in a targeted corrective, realigning action on deformation of the torso in three planes (frontal, i.e., lateral, sagittal, i.e., anteroposterior and horizontal).

The main components of the exercises are:

Passive correction. That is, a starting position has been developed for performing the exercise, which in itself provides a partial correction of arches and deformities, or provides the opportunity for the most effective muscular effort for the purpose of their correction.

Autoelongation, i.e., self-lengthening, stretching of the torso. This component is necessary in order to most effectively inhale through the sinking zones, increasing the intercostal spaces due to stretching, stretching the tightened muscles of the concave side of the arch. The instructor gives the command “stretch out” and stimulates by moving his hand along the spine in the direction of stretching. It is carried out by pulling the head from the shoulders, or pulling the pelvis back (depending on the exercise) in the corrected position.

Inhale according to Schroth with sinking zones in the previously indicated sequence. The instructor gives the command “inhale” and touches the sinking places in the required sequence, the patient “follows” his hands, inhaling. The patient knows that with the correct corrective inhalation, the sinking ribs should move outward (backward), to the side and upward; he controls this in the mirror and checks it with his own hands.

Active correction. Performing the muscular effort specified by a specific exercise (traction, emphasis, etc.) during a long exhalation (see above) with tension in the muscles of the convex side of the arches. The exercises are designed to work and shorten pulled muscles zones of costal prominence. The instructor gives the command “exhale”, then immediately “pull in”, stimulating with his hand the contraction of the muscles in the desired zones or reminding the direction of the correction.

Thus, all muscular efforts to perform the exercise occur only on exhalation, maximally maintaining the achieved correction due to traction, straightening of the sinking zones during inspiration and direct muscle tension. Then the exercises are repeated independently 24-30 times.

The exercises and breathing are controlled by mirrors, they are in front, behind, on top (on the ceiling), i.e. the patient must see how he breathes, what muscles he strains, and how much he achieves alignment during each exercise. Since breathing is forced and the effort is significant, you need to drink a lot and open the windows. Height is measured before and after the lesson; the difference may be 1-2 cm.