Functional Scoliosis

Functional scoliosis: A structurally normal spine that appears to have a lateral curve (scoliosis). Nonstructural scoliosis involves a temporary change of spinal curvature.

This can be caused by injury, bad posture a leg length discrepancy and by many other causes.  Hair dressers and servers are some common professions, that often present with a functional scolisis; as a result of the common postures of working in those professions.    

There will be length strength in balances in the muscles.  By strengthening the lengthened muscles, minimizing poor posture and massaging and stretching the shortened muscles, it is possible to correct the imbalances.  

Orthopedic Test

Adam’s test.

Purpose: To find out whether the spinal curvature is functional or structural.

Procedure:

  • Patient is standing
  • Observe the location and movement of the patient’s spine and curvature
  • Ask patient to laterally bend their trunk on both sides slowly, then flex their trunk slowly

Positive Signs:

Functional Scoliosis: if the curvature fixes itself (reverses) as the patient laterally bends towards the convex side

Functional Scoliosis: if the curvature and rib humping reverse as the patient bends forward

Structural Scoliosis: the curvature does not correct itself as the patient laterally bends towards the convex side, and the curvature remains

Structural Scoliosis: if the curvature and rib humping remains the same as the patient bends forward

Scoliosis Short Leg

Purpose: to see if patient has an uneven leg length that is causing functional scoliosis

Procedure:

  • Patient is standing
  • Observe the patient’s Bilateral Iliac Crests and Acromioclavicular joints levels, and see if there is tilting and scoliosis.
  • Place a thin book under the shorter leg

Positive Sign: the scoliosis curve reverses and neutralizes after the book was placed under the side with the shorter leg.

Scoliosis Small Hemipelvis

Testing for: Functional scoliosis due to the presence of a small hemipelvis . Hemipelvis* – one side of the pelvis.

Procedure:

  • Patient is seated
  • Observe the patient’s Bilateral Iliac Crests and Acromioclavicular joints levels, and see if there is tilting and scoliosis.
  • Place a thin book under the lower (smaller) pelvis side.

Positive Sign: the scoliosis curve reverses and neutralizes after the book was placed under the side with the lower pelvis.

Supine to Sit Test

Testing for: Functional leg length discrepancy

Procedure:

  • Patient is supine and knees are extended
  • Therapist compares the levels of both malleoli
  • Patient sits up while therapist takes a note of the malleoli levels

Positive Sign:

  • Anterior Hip bone Rotation: One leg is longer when patient is supine, then shorter when patient is stting up
  • Posterior Hip bone rotation: One leg is shorter when patient is supine, then longer when patient is sitting up

SI joint motion or Gillet’s Test

Testing for: Mobility of the Sacroiliac joint

Procedure:

  • Patient is standing, may hold on to something for stability
  • Therapist is behind the patient. Therapist palpates the PSIS of the patient’s affected side with their thumb
  • Therapist places their other thumb on the S2 process of the patient’s sacrum
  • Patient flexes the hip and knee of the affected side, raising their knee as high as they can, while standing on the unaffected side.

Positive Sign: SI joint hypomobility if the thumb on the affected side moves superiorly instead of inferiorly as the knee lifts

True Tibia and Femur Length Test:

Testing for:
The tibia and femur lengths

Procedure:

  • Patient is prone
  • Patient’s knees and hips flexed , with the plantar surfaces of their feet on the table
  • Their medial malleoli even and knees together

To compare the lengths:
Tibia: Therapist stands at the foot of the table to compare the heights of the patient’s tibial plateaus to look for the shorter tibia
Femur: Then therapist stands at the side of the table to compare the positions of the patellas looking for the shorter femur.