Soccer Player Wins the Long Game of Scoliosis Treatment

The date of Dec. 6 is branded on Macy Lehrer’s mind as the day she got her life back. It was the day the teenager took off her back brace for good, after wearing it for nearly three years to correct scoliosis, a curvature in her spine.

“Wearing a brace for that long had its challenges, but if I had to choose again, I would do it just the same,” says Macy.

Macy is sharing her scoliosis care story to inspire other girls who are diagnosed with scoliosis as preteens. She wants them to know that they will make it through. Her advice is to “just keep going week to week and focus on something you love to do, letting it carry you to the other side.”

Scoliosis diagnosis

“During Macy’s sixth-grade well check, her pediatrician noticed some asymmetry when Macy leaned forward. The x-ray showed more curvature in her spine than we thought,” says Christine Boyd, MD, Macy’s mom, who is the medical director of the Sports Medicine Program at Stanford Medicine Children’s Health. Her specialty isn’t scoliosis, so when it came to Macy’s care, she was a supportive mom, not a doctor.

Scoliosis is a condition in which an individual’s spine curves from side to side so that it looks more like an S or a C than a straight line. It is often diagnosed in early puberty. Left untreated, it can cause increasing pain and deformity, potentially damaging the heart and lungs.

Scoliosis is most common in girls ages 10 to 16. Macy got her brace right before starting seventh grade, a painful time for girls to carry the emotional burden of being different, with the brace as a constant reminder.

Scoliosis treatment options at Stanford Medicine Children’s Health

The Pediatric Spine Center at Stanford Medicine Children’s Health takes a multidisciplinary approach to treating scoliosis and serves as a one-stop shop for scoliosis treatment.

“We are a comprehensive team of doctors, nurses, physical therapists, imaging specialists, and an orthotist who makes custom braces on site based on the curvature of each child’s unique spine,” says James Policy, MD, a scoliosis specialist at Stanford.

When it comes to scoliosis treatment, Dr. Policy says that children with mild scoliosis, who have less than a 25-degree curvature, are often simply watched and checked as they grow, and when their skeleton is done growing without any further curvature, they need no further treatment. Yet Macy’s scoliosis fell into the moderate category, between 25- and 45-degree curvature.

“Our course of treatment for moderate curves is having the adolescent wear a brace and receive a special type of physical therapy to improve strength, mobility and posture,” Dr. Policy says.

When the curve is more than 45 degrees, scoliosis is considered severe, and spinal fusion surgery is often recommended. Stanford Children’s also offers a new surgical procedure for severe scoliosis called spinal tethering.

Macy and her mom were hoping to avoid surgery, so they were glad she could be treated with a brace. “Think of a brace as a stake that you place to help a tree grow in the direction you want it to grow. The brace pushes the top and bottom of the S curve of the spine, holding the spine straighter and encouraging it to grow that way,” Dr. Policy says.

While scoliosis affects only 1% of the population, Stanford Children’s sees a large number of adolescents with scoliosis due to its advanced offerings and comprehensive approach. It’s not unusual for Dr. Policy to see 20 children and teens with scoliosis in a day.

Playing soccer throughout scoliosis treatment

The main motivator for Macy to stick with the brace rather than consider back surgery was maintaining her full mobility so she could play soccer.

“We take a conservative approach to care because spinal fusion surgery permanently takes away motion in the part of the spine where the curve occurs. It can mean that adolescents can’t go back to playing certain sports, which can have a big impact on their lives,” Dr. Policy says. “With that said, our outcomes for spine surgery are very good.”

To be effective at correcting the curve of the spine, the brace must be worn 18 hours a day—that means every minute except those spent showering, changing, or playing sports. At first, playing soccer during treatment felt doable for Macy, yet as time progressed, it got harder.

“I wasn’t using all of my muscles because of the brace, so I got weaker and weaker. And I had back pain while playing,” Macy says.

She was falling behind her teammates. Along with the pain, she would lose her breath easily. On top of all that, she went through a growth spurt, which made her even weaker. Yet she never gave up.

“I felt a little ridiculous. I felt like a burden to my team. I was way down there trying to catch up, and they were way up here. But I told myself to just keep going. I’m proud of myself for making it through,” Macy adds.

Scoliosis in sports isn’t like having an injury that everyone knows about. After you’ve been wearing a brace for so long, teammates forget that you are carrying an extra burden and might assume that you are just falling behind.

“It can be challenging for athletes to play sports with a brace. Over time, they can lose flexibility and strength of their core muscles because their body is kept in a stiff and rigid position in the brace. The short period of times that athletes are out of their brace to play sports can make it really tough to feel their best,” says Charlie Lee, PT, DPT, one of Macy’s physical therapists at Stanford.

Straight talk on what it’s like to wear a back brace

Wearing a brace wasn’t a challenge only for her soccer success—it also demanded day-to-day perseverance. Macy doesn’t play down what it’s like to live with a brace.

“A lot of little things ate at me,” she says.

There were the bruises and pain she’d get from where the brace pressed on her body while she slept. And she had to limit her wardrobe to specific clothes that fit over the brace. Plus, she couldn’t eat what she wanted because the brace caused heartburn. Despite all of this, she kept her eye on the prize—a body with full mobility and flexibility.

Her tenacity and persistence paid off. It earned her a spot on the soccer team at the Massachusetts Institute of Technology (MIT) for fall 2023.

“It can take every bit of parental capital to get kids to wear a brace, but Macy was amazing from the start. She wore her brace and simply persevered and went on with life,” Dr. Policy says.

Staying on track with Schroth physical therapy and EOS spinal scans

Stanford Children’s is one of a few centers in the Bay Area to offer the Schroth method of physical therapy—an innovative approach that has been shown to improve strength, posture symmetry, and quality of life while reducing the degree of the scoliosis curve.

“Schroth exercises are individualized to each person’s curve. They help them do what the brace is doing using their own muscles,” says Dorothy Fung, PT, DPT, one of Macy’s physical therapists at Stanford.

During Schroth, adolescents learn exercises to support a straight spine, which they do in the clinic and at home. Macy was a rock star at doing her exercises. Fung also helped Macy keep her torso in a good position for playing soccer.

“Unless their scoliosis is very severe, teenagers can do almost anything they want. I’ve helped gymnasts, ballerinas, competitive cheerleaders, and elite soccer players like Macy continue their sports during scoliosis treatment,” Fung says. “Macy’s the cream of the crop. Not many become collegiate athletes.”

Macy and her mom also appreciated the EOS low-dose imaging system, which scans the entire body using one-50th of the radiation of a single x-ray. Adolescents with scoliosis often need frequent imaging to check for changes in their spine, so the benefit adds up.

Celebrating her back brace coming off with Nutella and whipped cream

Shortly after the start of her freshman year in high school, Macy heard Dr. Policy say the words she longed for: You no longer need the brace. After nearly three years of wearing it, the last six months at night only, she was free to move, dress, eat, and play as she wanted. And the first thing she wanted to do was eat a breakfast of pancakes with Nutella and whipped cream.

“It was certainly a happy moment to see the joy on Macy’s face when I told her she no longer needed the brace,” Dr. Policy says.

Six months after getting her brace off, an x-ray showed that Macy’s spinal curve was stable and she did not need surgery.

Even though Macy acknowledges that life with a brace is hard, she sees a silver lining—appreciating the small pleasures of life.

“The brace took away little joys that I took for granted. Now, I notice the soft seat of the car, appreciate the fun of spinning in office chairs, and the ease of rolling over when I’m sleeping. If it weren’t for the brace, I wouldn’t appreciate all of these little things,” Macy says.

Of course, a healthy, straight back without surgery is the best reward for Macy’s perseverance. She didn’t let her time wearing a back brace get in the way of her dreams—earning a spot on MIT’s soccer team and a seat in the classrooms of the prestigious university, where she will study computer science, economics, and data science. “It was a rough couple of years, but I’m off to an amazing future, and I want to give hope to others that they can do the same,” Macy says.