Using the concept of a plumb line falling down the length of your body while intersecting through the middle. Look at the standing body from several perspectives: Anterior (front), posterior (back), and lateral (side on). Each view will offer different pieces of information that when compiled provides a 3D understanding of any presenting scoliosis.
What to look for:
- Is the head central over the body
- Are the shoulders level or asymmetrical (one resting higher or lower than the other)?
- Is there a prominence (excessive showing) of the Scapula (shoulder blade) on one side more than the other?
- Is there a difference in the distance between the arms and the elbows at the waist?
- Does one side of the pelvis (hips) ‘stick out’ on one side more than the other (Waist asymmetry)?
- Is the pelvis tilted up higher on one side more than the other (Hip Hike)?
- Does the lower back have an excessive curve (Lumbar Lordosis)?
The Adams Forward Bend Test
An essential part of the examination process is to observe the back during movement. This determines if the spine straightens out or if rotation and changes at the rib cage is identifiable.
- This test requires two (2) people, yourself and the ‘observer’.
- Stand with your feet slightly apart, with the ‘observer’ standing behind you.
- When in position forward bend at the hips to 90 degrees (your body should be parallel with the ground), with arms hanging loosely down by your side?
- Have the ‘observer’ watch for any changes on either side of the lower, middle, and upper back. Note any asymmetries, prominences, or bulges that may appear more on one side than the other of the ribs cage, scapula (shoulder blades) and/or muscles running on either side of the spine.
- If changes are evident, the ‘observer’ will notice a posterior rib hump on the side opposite from the curve (convex side).
- In the Lumbar spine (lower back) where there is no rib attachment, prominence or bulging of the muscles that run along side the spine may be evident on the side of the convexity.
Seeking advice with an accredited health care provider who has training and experience in the assessment of Scoliosis should be the first step. While literature may begin the inquiry process, it is the guidance and expertise of your health care provider that will inform, guide, and identify the need for any treatment and management of the condition, if required.
Periodical assessment to see if there has been any progression of the curvature. This again can be done in conjunction with your health care provider who is in a position to watch any changes and/or progression of the Scoliosis.
If deemed necessary, braces may be used with children and juveniles when the curve is between 25 to 40 degrees, and the skeleton has yet to fully mature. The goal is to stop or slow progression of curve until bone maturity. The brace is usualy worn for up to 23 hours per day. There is no substantial evidence to support the minimum time required to wear the brace.
The main surgical procedure is correction, stabilisation, and fusion of the curve. Fusion is the joining of two or more vertebrae. Surgery is suggested when the curve progresses to 50 degree or more. The goal of surgery is to diminish the scoliotic curve, then maintain the correction during the period required for healing. To stabilise the spine implants or ‘rods’ are used.