Posture Insights

The Adams forward bend test is a simple screening method that can help with scoliosis diagnosis and help in developing a treatment plan. The exam is named after the English physician William Adams. As part of an examination, a doctor or chiropractor will look for an abnormal side-to-side bend in the spine.

Scoliosis Diagnosis

• The Adams forward-bend test can help determine if there are indicators for scoliosis.
• It is not an official diagnosis, but the results can be used as a starting point.
• The test is done with school-age children between 10 and 18 to detect adolescent idiopathic scoliosis or AIS.
• A positive test is a noticeable asymmetry in the ribs with a forward bend.
• It can detect scoliosis in any part of the spine, especially in the thoracic middle and upper back.
• The test is not only for kids; scoliosis can develop at any age, so it is also effective for adults.

Adams Forward Bend Test

The test is quick, easy, and painless.

• The examiner will check to see if anything is uneven when standing straight,
• Then the patient will be asked to bend forward.
• The patient is asked to stand with their legs together, facing away from the examiner.
• Then patients bend forward from the waist, with arms hanging vertically downward.
• The examiner uses a scoliometer-like level to detect asymmetries within the spine.
• Deviations are called the Cobb angle.

The Adams test will reveal signs of scoliosis and/or other potential deformities like:

• Uneven shoulders
• Uneven hips
• Lack of symmetry between the vertebrae or the shoulder blades.
• The head does not line up with a rib hump or the pelvis.

Detection of Other Spinal Issues

The test can also be used to find spinal curvature issues and conditions like:

• Kyphosis or hunchback, where the upper back is bent forward.
• Scheuermann's disease is a form of kyphosis where the thoracic vertebrae can grow unevenly during a growth spurt and cause the vertebrae to develop into a wedge-like shape.
• Congenital spine conditions that cause an abnormal curve of the spine.

Confirmation

The Adams test by itself is not enough to confirm scoliosis.

• A standing X-ray with Cobb angle measurements above 10 degrees is required for diagnosing scoliosis.
• The Cobb angle determines which vertebrae are tilted the most.
• The higher the angle, the more severe the condition and the more probable it will produce symptoms.
• Computed tomography or CT and magnetic resonance imaging or MRI scans can also be used.

Forward Bend Test 

General Disclaimer *

The information herein is not intended to replace a one-on-one relationship with a qualified healthcare professional or licensed physician and is not medical advice. We encourage you to make your own healthcare decisions based on your research and partnership with a qualified healthcare professional. Our information scope is limited to chiropractic, musculoskeletal, physical medicines, wellness, sensitive health issues, functional medicine articles, topics, and discussions. We provide and present clinical collaboration with specialists from a wide array of disciplines. Each specialist is governed by their professional scope of practice and their jurisdiction of licensure. We use functional health & wellness protocols to treat and support care for the injuries or disorders of the musculoskeletal system. Our videos, posts, topics, subjects, and insights cover clinical matters, issues, and topics that relate to and directly or indirectly support our clinical scope of practice.* Our office has reasonably attempted to provide supportive citations and identified the relevant research study or studies supporting our posts. We provide copies of supporting research studies available to regulatory boards and the public upon request.

We understand that we cover matters that require an additional explanation of how it may assist in a particular care plan or treatment protocol; therefore, to further discuss the subject matter above, please feel free to ask Dr. Alex Jimenez or contact us at 915-850-0900.

Dr. Alex Jimenez DC, MSACP, CCST, IFMCP*, CIFM*, ATN*

email: coach@elpasofunctionalmedicine.com

Licensed in: Texas & New Mexico*

References

Glavaš, Josipa et al. "The role of school medicine in the early detection and management of adolescent idiopathic scoliosis." Wiener klinische Wochenschrift, 1–9. 4 Oct. 2022, doi:10.1007/s00508-022-02092-1

Grossman, T W et al. "An evaluation of the Adams forward bend test and the scoliometer in a scoliosis school screening setting." Journal of pediatric orthopedics vol. 15,4 (1995): 535-8. doi:10.1097/01241398-199507000-00025

Letts, M et al. "Computerized ultrasonic digitization in the measurement of spinal curvature." Spine vol. 13,10 (1988): 1106-10. doi:10.1097/00007632-198810000-00009

Senkoylu, Alpaslan, et al. "A simple method for assessing rotational flexibility in adolescent idiopathic scoliosis: modified Adam's forward bending test." Spine deformity vol. 9,2 (2021): 333-339. doi:10.1007/s43390-020-00221-2

Practicing improper/unhealthy postures throughout the day can severely fatigue the mind and body. Children's postural health is vital to their overall health and energy levels to perform tasks, school work, and play. An unhealthy posture causes the body to lose its ability to dissipate forces evenly and correctly. Symptoms like soreness, pain, tightness, and irritability can begin to present, which is the body's way of letting the individual know something is off. When the body is in proper alignment, the spine disperses body weight correctly and efficiently. Chiropractic adjustments can effectively counter the unhealthy posture effects, and simple postural exercises can strengthen the body, increasing healthy posture habits.

Children's Posture Health

Healthy posture is more than simply sitting and standing up straight. It is how the body is positioned, meaning the head, spine, and shoulders, and how it moves unconsciously like a walking gait. An uneven gait or awkward body position can indicate a problem and cause long-term consequences to a child's health.

Challenges

Kids and children are constantly hunched, slumped, and slouched over device screens. This constant awkward positioning adds weight to the spine, increasing the pressure, which can cause issues ranging from headaches, mild neck pain, low back pain, and sciatica. Severe health effects from poor posture include:

• Shoulder problems.
• Chronic pain.
• Nerve damage.
• Difficulty breathing from prolonged hunching-over.
• Spinal joint degeneration.
• Vertebral compression fractures.

Poor alignment of the muscles begins to restrict postural muscles from relaxing correctly, making the muscles stay stretched or slightly flexed, causing strain and pain. As a child's body grows, practicing unhealthy postures can drive continued awkward positioning, abnormal spine growth, and an increased risk for arthritis later in life.

Chiropractic Adjustments

A chiropractor will check for any imbalances, like a hunched back, one shoulder higher than the other, or a pelvic tilt/shift. Through a series of adjustments, chiropractic releases the muscles, relieves pressure on ligaments, allows the postural muscles to relax and realign to their proper position, prevents further muscle overuse, strain, abnormal joint wear, and helps reduce fatigue by conserving/utilizing energy as the muscles are functioning correctly and efficiently.

Exercises

Simple postural exercises can help maintain children's postural health.

Triangle Stretch

• Standing, spread the legs into an A shape shoulder-width apart.
• Bend and stretch to one side.
• Raise the opposite arm of the side, bending straight above the head, so the bicep touches the ear.

Arm Circles

• Raise the arms above the head.
• Elbows bent at 90 degrees.
• Make small circles forward and backward ten times.

Cobra Pose

• Lay flat on the floor.
• Place hands next to the chest so that they are underneath the shoulders.
• Gently press the chest upward.
• Keeping the legs on the ground.
• Look straight ahead.

They only take a few minutes, but the objective is consistency. Doing the poses for one week won't immediately change unhealthy posture habits. It is developing consistent healthy postural habits that generate improvement. They should be done at least three times weekly to build strength and endurance.

Kids and Chiropractic

General Disclaimer *

The information herein is not intended to replace a one-on-one relationship with a qualified health care professional or licensed physician and is not medical advice. We encourage you to make your own healthcare decisions based on your research and partnership with a qualified healthcare professional. Our information scope is limited to chiropractic, musculoskeletal, physical medicines, wellness, sensitive health issues, functional medicine articles, topics, and discussions. We provide and present clinical collaboration with specialists from a wide array of disciplines. Each specialist is governed by their professional scope of practice and their jurisdiction of licensure. We use functional health & wellness protocols to treat and support care for the injuries or disorders of the musculoskeletal system. Our videos, posts, topics, subjects, and insights cover clinical matters, issues, and topics that relate to and directly or indirectly support our clinical scope of practice.* Our office has reasonably attempted to provide supportive citations and identified the relevant research study or studies supporting our posts. We provide copies of supporting research studies available to regulatory boards and the public upon request.

We understand that we cover matters that require an additional explanation of how it may assist in a particular care plan or treatment protocol; therefore, to further discuss the subject matter above, please feel free to ask Dr. Alex Jimenez or contact us at 915-850-0900.

Dr. Alex Jimenez DC, MSACP, CCST, IFMCP*, CIFM*, ATN*

email: coach@elpasofunctionalmedicine.com

Licensed in: Texas & New Mexico*

References

Achar, Suraj, and Jarrod Yamanaka. "Back Pain in Children and Adolescents." American family physician vol. 102,1 (2020): 19-28.

Baroni, Marina Pegoraro, et al. "Factors associated with scoliosis in schoolchildren: a cross-sectional population-based study." Journal of epidemiology vol. 25,3 (2015): 212-20. doi:10.2188/jea.JE20140061

da Rosa, Bruna Nichele et al. "Back Pain and Body Posture Evaluation Instrument for Children and Adolescents (BackPEI-CA): Expansion, Content Validation, and Reliability." International journal of environmental research and public health vol. 19,3 1398. 27 Jan. 2022, doi:10.3390/ijerph19031398

King, H A. "Back pain in children." Pediatric clinics of North America vol. 31,5 (1984): 1083-95. doi:10.1016/s0031-3955(16)34685-5