In a true scoliosis the shoulder girdle will be obviously lower on one side than the other. The best observation point to this reference are the clavicles. If they are slanting, but in line with each other it is due to a scoliosis. If only one side is inclined, it can be from other factors like carrying a bag, some former trauma, etc. The ribs will be fixed open where there is convexity of the curvature, that is where the gibbus will be noticed. The ribs are closer together on the concave side. You should notice the scapula being pulled medially by the rhomboids. As the scapula is sliding laterally on the convex side, the serratus anterior and the muscles between the arm will shorten. There will also be a compensatory pattern in the cervical vertebrae at the AO joint with a notable compression.
I think its important to realize there are some degrees of scoliosis and age factors that will only allow a client to feel more comfortable from our work. Once the bones have changed their structure due to the forces paced upon them over long periods of time, there is only so much that we can do.
So the question begs, what can we accomplish as therapists? First of all it depends on the degree of the pattern. It’s a core issue and we must never lose sight of this fact, nor the need to integrate our work throughout the body. There is value to working with the client lying down, sitting and standing as well.
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