Вы находитесь на странице: 1из 5

Aramos, PTRP, MAEd



I. Introduction
Since the Stone Age, man has recognized the obvious
deformity of curvature of the spine. In the normal spine, the
neck goes into a forward curve (lordosis); the thoracic spine
develops a normal posterior curve (kyphosis); and the lumbar
region then again develops a normal lordosis. A lateral
curvature of the spine is called SCOLIOSI, and its major
deformity is a rotation of the spine and ribs. AN increased
forward curvature, especially in the thoracic regions, is called
In the majority of cases, the etiology of scoliosis is
unknown, an it is therefore called idiopathic scoliosis.
Scolisois is a complicated deformity characterized by
lateral curvature and vertebral rotation. As the disease
progresses, the vertebra and spinous processes in the area of
the major curve rotate toward the concavity of the curve.

The rotating vertebra push the ribs on the convex side

of the curve posteriorly and cause the ribs on the concave side
to crowd together. Scoliosis is often associated with kyphosis
(hunchback) and lordosis (swayback). In addition to rotation,
scoliosis also causes other pathologic changes in the vertebrae
Aramos, PTRP, MAEd

and related structures in the area of the curve. The disc spaces The lumbar major curve is quite common. 65% of
become narrower on the concave side of the curve and wider cases, thee curve is to the left. Lumbar major curves are not
on the convex side. very deforming but become quite rigid and can lead to severe
Idiopathic scoliosis is by far the most common. About arthritic pain in later life and during pregnancy & child
90% of all the idiopathic curves are probably genetic, and thus bearing.
the two terms are used synonymously.
Four distinct curve patterns are found in idiopathic
The right thoracic curve is one of the most common
idiopathic patterns. The curve usually extends from the upper
end or the lower end of the thoracic region.
Although the right thoracic curve is always a major
curve, there are usually smaller curves in the opposite
direction above and below that curve. These curves are
secondary or compensatory, and are usually referred to as
minor curves. A compensatory curve tends to keep the
individual’s head over the pelvis in an effort by the body to
keep the spine in “balance”.
The thoracolumbar curve is a fairly common
Scoliosis is most likely to progress during adult life in
idiopathic curve pattern. It is a longer curve and may be to
patients with a strong genetic “dose” of scoliosis, a curve
either right or left.
pattern that throws the trunk out of balance, or extremely poor
The double major curve consists of two structural
muscle tone, especially in women who have become sedentary
curves of almost equal prominence. They can be either a right
and overweight. An adult with a mild curve of less than 30o is
thoracic – left lumbar curve, as most frequently seen, or a
generally not in danger of progression. Patients with curves
double thoracic curve such as a high right thoracic – lower
greater than 45p to 50p are usually at high risk for curve
left thoracic curve.
increase, especially when the patient nears the menopause and
develops osteoporosis.
Aramos, PTRP, MAEd

II. Clinical Evaluation & Physical Examination Exercises. Exercises are mentioned under treatment only to
be strongly recommended as a sole cure for scoliosis. The best
Following the general examination, a more specific
treatment for scoliosis is early detection and prompt referral for
examination of the deformity is done. This starts with an
complete scoliosis care.
evaluation of trunk alignment, used to gauge balance or
IV. Exercises
displacement of the torso.
The shoulder girdle should be examined for symmetry. While exercise will not cure your condition, it will maintain
Both the scapular prominence as well as the neck shoulder your strength and overall body health. Some helpful forms of low-
angle should be noted. impact exercise are:
Pelvic obliquity must be carefully evaluated as well as
leg length discrepancy. Swimming is an ideal form of exercise for many complaints
that involve the spine as it frees the joints from bearing weight,
allowing the body to stretch and can be done as gently or as vigorously
as your condition allows.

Hydrotherapy is another ideal form of exercise, performed

in water, will relieve pressure, and a warm pool can help soothe
muscle inflammation.

Walking is low impact and has the added benefit of

increasing your overall health. Walking can be done vigorously over
long distances, or casually as an alternative to more intensive exercise.

III. Treatment

School screening. The best treatment for scoliosis is early

detection. Most curves can be treated nonsurgically if detected before
they become too severe.
Aramos, PTRP, MAEd

Specific Exercises
Lie on your back with your arms at your sides. Lift one leg off the
Wall slides to strengthen back, hip, and leg muscles
floor. Hold your leg up for a count of 10 and return it to the floor. Do
the same with the other leg. Repeat five times with each leg. If that is
too difficult, keep one knee bent and the foot flat on the ground while
Wall slides to strengthen back, hip, and leg muscles
raising the leg.
Stand with your back against a wall and feet shoulder-
width apart. Slide down into a crouch with knees bent
Partial sit-up to strengthen stomach muscles
to about 90 degrees. Count to five and slide back up the
wall. Repeat 5 times.

Leg raises to strengthen back and hip muscles.

Lie on your back with knees bent and feet flat on floor. Slowly raise
your head and shoulders off the floor and reach with both hands
toward your knees. Count to 10. Repeat five times.

Back leg swing to strengthen hip and back muscles

Lie on your stomach. Tighten the muscles in one leg and raise
it from the floor. Hold your leg up for a count of 10 and return it to the
floor. Do the same with the other leg. Repeat five times with each leg.
Stand behind a chair with
Leg raises to strengthen stomach and hip muscles your hands on the back of the
chair. Lift one leg back and up
while keeping the knee
straight. Return slowly. Raise
other leg and return. Repeat
five times with each leg.

Exercises to decrease the strain on your back

Aramos, PTRP, MAEd

Back Pain Exercises retrieved May 4, 2006 from

Lie on your back with your http://orthoinfo.aaos.org/fact/printer_page.cfm?topcategory=Sp
knees bent and feet flat on ine&Thread_ID=17
your bed or floor. Raise your
knees toward your chest. Place Keinm, H.A. & Hensinger, R. N. Spinal Deformities Scoliosis &
both hands under your knees Kyphosis. Clinical Symposia, Vol 41, No. 4, 1989
and gently pull your knees as
close to your chest as possible. Some Helpful Exercise retrieved May 4, 2006 from
Do not raise your head. Do not www.scoliosissupport.org.au
straighten your legs as you
lower them. Start with five
repetitions, several times a