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F r e e m u s i c d o w n l o a d s f o r C e r t i f i e d m e m b e r s : w w w. a b m p . c o m / g o / c e r t i f i e d c e n t r a l 101 TREATING THE FUNCTIONAL COMPONENT OF A STRUCTURAL SCOLIOSIS When treating a structural scoliotic spine, the therapist uses one arm to grasp and lift the client's torso, and the other palm to gently spring the vertebrae above and below the rigid hump (Image 5). As seen with the Adams test, there will be some available movement above and/or below the twisted vertebrae. Although the mobile vertebral segments appear to be part of the rigid deformity, they have not yet ossified and are simply along for the ride. These are critical areas to target in your treatment plan. Begin myofascial work using extended fingers or forearm to hook and scoop the lumbar and/or thoracic erectors up onto the scoliotic convexity (Image 6). Next, dig extended fingers into the lamina groove on the concave side and push the shortened (guy wire) erectors away from the spine (Image 7). Because scoliosis is a three-dimensional problem, always look for patterns. For example, when observing the standing client from the front, notice how one shoulder is lower than the other. Look for an oblique crossing pattern traversing from the external obliques and pectoral fascia to the contralateral hip. Use any of your favorite myofascial, deep-tissue, or assisted-stretching techniques to bring length to the front line. Scoliotic clients will always present with length-strength muscle imbalances. The resulting asymmetry is thought to affect posture, appearance, pain tolerance, and, in more severe cases, the ability of the lungs to function to their full capacity. In my experience, strategically designed manual, movement, and cognitive-based therapy modalities work beautifully together to help stop a Type 1 group curve from progressing. Notes 1. S. H. Berven and T. Lowe, "The Scoliosis Research Society Classification for Adult Spinal Deformity," Neurosurgery Clinics of North America 18, no. 2 (April 2007): 207–13. 2. Philip Greenman, "Principles of Manual Medicine" class notes, Michigan State College of Osteopathic Medicine (1992). Erik Dalton is the executive director of the Freedom from Pain Institute. Educated in massage, osteopathy, and Rolfing, Dalton has maintained a practice in Oklahoma City, Oklahoma, for more than three decades. For more information, visit www.erikdalton.com. 4 5 7 3 6