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What is Scoliosis?

Scoliosis is characterized by a side-to-side curvature of the spine. Clinically, this is diagnosed by Cobb’s Angle and is measured by the most tilted vertebrae above and below the apex of the curve. Cobb’s angle is the angle between the intersecting lines drawn perpendicular to the top & bottom vertebrae. An angle of greater than 10 degrees is considered scoliosis.

kinesoilogy scoliosis active rehab

Scoliosis is usually also accompanied by rotation of the vertebral column towards the concavity of the curve.

There are various types of scoliosis including congenital, idiopathic, and neuromuscular. The most common is idiopathic scoliosis, meaning that there is no definite cause, however, it tends to run in families and affect girls more than boys. Additionally, scoliosis can be classified as functional or structural scoliosis. In function scoliosis, the spine is normal but appears to be curved due to underlying issues such as injury, leg length discrepancies, and muscle imbalances. Functional scoliosis can usually be improved by treating the underlying issues. Structural scoliosis is a physical deviation in the spine’s structure and is considered permanent unless the spine receives treatment. In both cases, specific exercises can be a way to delay the progression of scoliosis.

Screening for Functional versus Structural Scoliosis – Adam’s Forward Bend Test

To perform Adam’s Forward Bend Test, the patient bends forward starting at the waist with feet together and knees straight while dangling the arms and palms together. Any imbalances in the mid-back or other deformities along the back could be a sign of scoliosis. Before performing the test, it may be good to look for any hip misalignment and/or leg length discrepancies. In the bent position, if the back assumes asymmetrical form, the scoliosis is considered functional. If there is asymmetry or a rib hump, the scoliosis is considered to be structural.

Picture of functional and structural scoliosis

Findings

This diagram displays a posterior (rear) view of an individual with scoliosis. Let’s assume this is an idiopathic scoliosis (no known cause e.g. no fractures or damage). In the diagram, the individual’s upper back is side-bending to the right. This is typically associated with a rotation in the opposite direction (left rotation of upper back in this case). In contrast, the individual’s lower back is side bending to the left and rotated to the right. The goal is to correct these findings through movement and exercise.

After general strength and conditioning is achieved, specific exercises will focus on lengthening, de-rotating, and strengthing the appropriate areas. The red arrows depict the areas that need to be strengthened as they have been put on “stretched”. Additionally, the blue arrows depict the areas that need to be lengthened or stretched as they have been “compressed”. Lastly, de-rotating means applying rotational movements in the opposite direction of the dysfunction. The purple arrows depict the rotation caused by scoliosis.

General Exercises

Here are some exercises to get you started on your journey. It is recommended to go slow and easy to start, especially if you are feeling pain. Don’t forget to breathe when doing the exercises. Book a session with one of our Kinesiologists for more information!

Start on all fours and lower your buttocks on your heels and reach forward with your arms. Your spine should be rounded at this point. Reach out as far as possible to one side until a stretch is felt on the torso (opposite side). Hold the stretch.

Start on all fours with your back straight, hands under the shoulders and knees under the hips. Let the belly fall toward the floor to arch the back and extend the head at the same time. Then round the back and tuck the chin to the chest. Alternate between these two positions slowly.

Sit on a chair and lean to one side while reaching over your head. Once a stretch is felt along the side of your body, rotate your trunk towards that same side. Hold the stretch for 30 to 60 seconds.

Lie on your side with your knees bent at 90 degrees. You can place a towel under your head for support. Place the bottom hand on the knees and press lightly to make sure they stay on the ground. With the top hand, reach for your ribs and pull gently as you rotate the torso.

Picture of functional and structural scoliosis

Lie on your side with your knees bent at 90 degrees. You can place a towel under your head for support. Place the bottom hand on the knees and press lightly to make sure they stay on the ground. With the top hand, reach for your ribs and pull gently as you rotate the torso.

Standing up, take a dumbbell in the left hand and a theraband (anchored behind you) in your right hand. Press the dumbbell up to the ceiling and at the same time press the theraband forward to rotate the trunk to the left.

Sit down on the Swiss ball and place your feet in front of you. Elongate the trunk, as if somebody was pulling your head up, and avoid raising the shoulders. Maintain this position and rotate the thorax to counterclockwise. Rotate and tilt the shoulders to clockwise. Flex the trunk a little to the left, without losing any of the previous corrections. Repeat and alternate the rotation direction.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

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