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.
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.
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.
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!