Title: Functional Scoliosis in a Professional Bodybuilder and Firefighter
Name: Christopher Jones
Primary Presenters: Christopher Jones
College of Health Sciences
Masters
Faculty Sponsor(s): Hayley Ericksen

Background: This level 3 case study involves an undiagnosed functional scoliosis in a professional bodybuilder and fire fighter. The length of time this condition was present is unknown but the literature suggests functional scoliosis typically begins in adolescence. Functional scoliosis is a spinal curvature resulting from poor posture, leg length discrepancies, and muscle imbalances. Structural scoliosis is permanent because the patient is born with the condition, therefore exercise will not correct the curvature.

Patient: A 38-year-old male firefighter, 18-year captain, complained of right shoulder pain that was continuously getting worse. He has been professional bodybuilding for 20-years, has great body awareness and notices miniscule changes in his body. He explained the feeling of being “unset” in his shoulder when performing a bench press, meaning he felt instability when completing the lift. The patient performed a physical adjustment of his right shoulder before doing any lifts which involved rolling his shoulders backward and forward until he found the position he was comfortable with before lifting. There was no mechanism for his condition, but upon inspection of the patient, the right pec minor was noticeably less toned compared to the left. Posteriorly, the right erector spinae muscles were much less developed compared to the left. Functionally, when the patient performed a high plank an obvious right-facing spinal curvature was revealed. The initial diagnosis of the patient was functional scoliosis.

Intervention or Treatment: Initially, the AT corrected the patient’s leg length discrepancy with the isometric stick exercise. The patient was also prescribed exercises to strengthen the right and lengthen the left erector spinae musculature. In week three, the patient performed a high plank with Russian electrical stimulation with the goal of re-educating his right scapular stabilizers and erector spinae muscles, while also activating the core. After a week of positive results, the sets and reps of his exercises progressed and the patient was instructed to perform the exercises at home. Week 4, the patient was re-evaluated and continued the prescribed exercise program. In week 5, exercise difficulty was increased in anticipation of his bodybuilding competition the following week. In the final meeting with the patient, the AT gave him exercises to maintain his corrected spinal curvature, and muscle tone.

Outcomes or other Comparisons: The patient successfully corrected his spinal curvature within six weeks, and he noted that his body had never felt better. He no longer complained of instability in his right shoulder, and you could visibly see the equal tone in his pec minor and erector spinae muscles bilaterally. The patient no longer needs to reset his shoulders before doing a bench press. He noted feeling the congruency between both sides in his posture and activities of daily living. This case suggests there is evidence that exercise to treat functional scoliosis can be effective.

Conclusions: Based on this case study, functional scoliosis can be corrected with a specific rehabilitation program. For a firefighter and professional body builder, functional scoliosis is not something you would expect to encounter due to his exceptional physical shape, and extremely defined posterior musculature. This case shows that functional scoliosis can occur in all populations no matter what the individual does for a living, and ATs need to conduct a thorough inspection to avoid missing unlikely conditions.
Clinical Bottom Line: Overall, this case exemplifies the effectiveness of a specific treatment program for functional scoliosis, and shows how this condition can be present in those with extreme body awareness and in strong physical shape. There needs to be more research done to further support these findings, but this case is strong evidence that corrective exercise can improve functional scoliosis. Word Count: 600

https://sites.uwm.edu/healthresearchsymposium-2022/files/formidable/2/References-720f54.pdf