Structural vs. Functional Scoliosis

To understand what I mean by “your scoliotic habit” it’s useful to start by talking about the terms structural and functional in relation to scoliosis.

Structural and Functional are classifications that are used to explain whether a person’s scoliosis can straighten when they perform a side bend motion that is in the same direction as their curve. For instance, if a person has a right thoracic scoliotic curve then a side bend to the right should straighten their curve. If their spine straightens then they are diagnosed with a functional scoliosis. If their spine does not straighten then they are diagnosed with a structural scoliosis.

The importance of the two classifications is that they are used as predictive terms to describe whether there is or is not the possibility for improvement in a person’s scoliosis. A person’s  scoliosis is assessed as functional, then it is assumed that there is some possibility of improvement, whereas if a person’s scoliosis is assessed as structural, then it is assumed there is no possibility for improvement.

The weakness of this form of diagnosis is that people who perform side bending exercises over several weeks tend to demonstrate more ability to straighten their spine in side bending than people who have done no exercises. This reveals that the diagnosis of a structural scoliosis is not particularly precise.

It seems more likely that people with a moderate or severe scoliosis have some ability to straighten their spine, but cannot straighten their spine completely.

The question then becomes: how much of your scoliosis is structural and will never be corrected, and how much of your scoliosis is functional and can be corrected through appropriate non-surgical methods?

The answer that I give myself and all of my clients is: There’s no need to make assumptions. Let’s work hard and find out what’s possible.

Recognizing your scoliotic habit

Over many years, my study of movement and posture methods has confirmed my observation that all of us with scoliosis have some aspect of our scoliosis that is functional, and that this functional part of our scoliosis is a kind of postural habit. Many years ago, with the help of my teachers, I realized that I used to move in a way that expressed and exaggerated my scoliotic curve pattern.

I noticed that when I would sit in a chair I would slightly side bend to the left in my thoracic torso – a movement that matches my thoracic curve to the right, as there is a concave space in my left thoracic torso. As my awareness became clearer I noticed that my habit of compressing and side bending in my left thoracic area would actually happen in almost all movements that I was doing: standing up from a chair, talking on the phone, picking an object off the floor, brushing my teeth, and playing racket sports like squash and tennis.  When I work with my clients I find the same habits exist in them as well.

All of us with scoliosis, to a lesser or greater degree, are exaggerating our scoliotic shape with our habits of posture and movement.

How to resist your scoliotic habit

I’m sure I’m not the first person to make the observation that you can’t fix a problem if you’re not aware of it. The first step in resisting your scoliotic habit is becoming aware of it. A helpful tool for this is a full-length mirror. Identifying and resisting your scoliotic habit is a challenge that requires accuracy and patience. We all want to get results as quickly as possible, but I find that going too quickly can lead to mistakes. The first thing I have students do is sit on a chair in front of a full-length mirror and take enough time to learn about themselves and their posture before trying to make corrections. This process of observation allows us to take our time and make accurate adjustments.

Once my client has taken the time to observe themselves in their usual sitting position then I introduce simple movements for them to do. These movements include leaning forward, leaning backward, standing up and sitting down. Even these simple movements provide a great deal of information in how we either sink into or resist our scoliotic habit.