Latest / Scoliosis with Dr. Chris Gubbels / How to Check Your Child for Scoliosis at Home (A Specialist Shows You Step by Step)

Transcript

How to Check Your Child for Scoliosis at Home (A Specialist Shows You Step by Step) · Scoliosis with Dr. Chris Gubbels

• 0:00
  SPEAKER_00: Most parents who find out that their kid has scoliosis had already noticed something was off weeks or even months earlier.
• 0:06
  SPEAKER_00: They just didn't know exactly what they were looking at.
• 0:09
  SPEAKER_00: And by the time they got checked, it had already progressed beyond the point where it was the most easy to treat.
• 0:14
  SPEAKER_00: You see, your pediatrician may have looked at your child's back on the last visit for a few seconds.
• 0:18
  SPEAKER_00: Maybe they said it was fine, or maybe they said there was a small curve there, but it wasn't really a concern, and we could just watch and wait.
• 0:24
  SPEAKER_00: And you left wondering, what exactly does watch and wait mean?
• 0:28
  SPEAKER_00: What am I supposed to watch and wait for?
• 0:30
  SPEAKER_00: Or how do I know if it's actually getting worse?
• 0:33
  SPEAKER_00: And then really, what should I do if I actually notice something getting worse?
• 0:37
  SPEAKER_00: I've worked with over 6,000 patients over the last 18 years, and the parents that catch the curves early and get the most effective treatment always do something that the pediatrician likely never told them to do.
• 0:48
  SPEAKER_00: You see, there's one thing that you could check at home that most parents are completely unaware of, and they've never been told to actually look for this.
• 0:55
  SPEAKER_00: And this is one sign that may not be at first very obvious, but it's the thing that will most accurately tell you if the scoliosis is there or if it's not, and if the curve is getting worse.
• 1:06
  SPEAKER_00: So in the next few minutes, I'm going to show you exactly how to check your child for scoliosis at home, what to look for, and what these findings actually mean.
• 1:14
  SPEAKER_00: And if you notice something there, what your next step should be.
• 1:18
  SPEAKER_00: So point one is what is the standard way to check your child for scoliosis at home?
• 1:22
  SPEAKER_00: Now, first off, most parents probably never check their child for scoliosis and they just assume someone else is doing that.
• 1:28
  SPEAKER_00: And they likely never really think about it unless they have severe scoliosis themselves.
• 1:32
  SPEAKER_00: Now, if they do check their child for scoliosis, it's probably something very basic, like looking at their child from behind and seeing if they notice any major obvious asymmetries or possibly looking to see if one shoulder appears higher than the other.
• 1:45
  SPEAKER_00: Now, the reality is that may not be a lot different than the check that was possibly done at their pediatrician.
• 1:50
  SPEAKER_00: So a parent likely assumes, hey, if that's all I see down at the doctor's office, that's probably all I need to do.
• 1:55
  SPEAKER_00: There's maybe nothing else to look for.
• 1:57
  SPEAKER_00: The reality is a clean standing scoliosis check doesn't mean the spine is necessarily clear from scoliosis.
• 2:04
  SPEAKER_00: Now, the reason standing checks don't work is that scoliosis is a three-dimensional spine deformity.
• 2:09
  SPEAKER_00: See, the spine both laterally bends and it twists and it rotates.
• 2:13
  SPEAKER_00: And that rotation is what creates the most obvious and most accurate sign of scoliosis.
• 2:19
  SPEAKER_00: And it's picked up using something known as the Ford Adams bending test.
• 2:22
  SPEAKER_00: Now, the Ford Adams bending test is something that's taught in medical school, chiropractic school, probably physical therapy schools, but in all healthcare professions, it is one of the standard screening assessments that's taught to check for scoliosis.
• 2:34
  SPEAKER_00: It's really quick to do.
• 2:36
  SPEAKER_00: You can do it as part of your home assessment.
• 2:38
  SPEAKER_00: When you do it accurately at home, it moves you away from this vague, unsure or uncertain if they if your child has scoliosis to a more confident, accurate assessment, knowing if they have the most common or most prominent sign of scoliosis.
• 2:51
  SPEAKER_00: I'm Dr.
• 2:51
  SPEAKER_00: Chris Goobels.
• 2:52
  SPEAKER_00: I specialize in the non-surgical treatment of scoliosis with hyperkyphosis.
• 2:56
  SPEAKER_00: And what I see happens when this test gets done wrong or completely skipped is parents come in after watching their child's progress for months and months, and they had no idea that it was there or it was possibly getting worse.
• 3:07
  SPEAKER_00: One, because no one's ever told them or they've never been taught what to look for, and possibly the healthcare providers they went to weren't doing an accurate assessment and they weren't looking for this themselves.
• 3:16
  SPEAKER_00: So let me show you exactly how to do the Adams forward bending test step by step so you can do it right from your own home.
• 3:23
  SPEAKER_00: So my second point in this video is exactly how to do the forward Adams bending test right from your own home.
• 3:29
  SPEAKER_00: Now, first of all, this may not be done in your pediatricians' checkups because those are generally pretty brief and pretty quick and they may not have the time to do this really accurately.
• 3:37
  SPEAKER_00: And when you do it, how you do it and how you look at the spine is maybe the most important thing.
• 3:41
  SPEAKER_00: For example, if you're just looking at your child, looking down at them as they bend over, you're gonna miss the most important thing.
• 3:48
  SPEAKER_00: You have to get down and you have to look at their spine level or parallel to their spine so you can most accurately detect any subtle bumps or humping in their mid back or their low back.
• 4:00
  SPEAKER_00: So the angle and how you view it is one of the most important things.
• 4:03
  SPEAKER_00: Because the humping in their back, whether that's a hump in their rib cage or their lumbar spine, is evidence that the spine is twisting and rotating, and it's the most accurate test that there's actually scoliosis there.
• 4:14
  SPEAKER_00: So how do you do this accurately?
• 4:16
  SPEAKER_00: Well, first of all, you have your child put their hands together like they're praying, and they should extend their arms straight out in front of them.
• 4:22
  SPEAKER_00: Then you want them to bend over at their waistline, not their knees, keep their knees straight, bend over at the waistline.
• 4:28
  SPEAKER_00: Now, you don't want to bend too far, you want to bend over so your body's at about a 90 degree angle or so the spine is parallel to the ground.
• 4:36
  SPEAKER_00: Then you want to get behind your child, don't look down at them, not viewing from the side.
• 4:40
  SPEAKER_00: You want to crouch behind them, you want to squat down, and you want to make sure you're looking at them at the angle or the level of their flat back.
• 4:48
  SPEAKER_00: And what you're looking for is any visible humping in the rib cage or in the lumbar spine.
• 4:54
  SPEAKER_00: Now it's possible if your child has scoliosis, they may not be very flexible because with your spine twists and rotates, you lose the normal mobility in the spine.
• 5:04
  SPEAKER_00: So if they have trouble or difficulty bending over to at least 90 degrees, you're gonna have to get even lower so you can have a better angle when viewing their spine, especially their lower spine.
• 5:16
  SPEAKER_00: So why does this test really matter?
• 5:18
  SPEAKER_00: Because when you do it properly, you move away from guessing to actively observing.
• 5:22
  SPEAKER_00: It's one of the most accurate tests to know there's actual signs of scoliosis.
• 5:26
  SPEAKER_00: Now, it's not enough to diagnose someone for scoliosis, but it's enough to know that there are signs of scoliosis, so you can do more detailed evaluation like x-rays, and x-rays are the gold standard to actually determine if scoliosis is or isn't present.
• 5:41
  SPEAKER_00: So, how it typically goes is you do the screening like the Ford Addispin test.
• 5:45
  SPEAKER_00: If you see signs that indicate scoliosis may be present, then you do an X-ray to rule in or rule out scoliosis.
• 5:52
  SPEAKER_00: Now, if you're finding this content for helpful, be sure to subscribe below and hit that bell icon so you're notified every week when we release new content on scoliosis, going over how to detect scoliosis, latest treatment trends, and what the research is saying about the most affected non-surgical scoliosis treatments.
• 6:10
  SPEAKER_00: So you're at home and you're doing these scoliosis screening tests.
• 6:13
  SPEAKER_00: How do you know if what you're looking at is significant, if further action is actually warranted?
• 6:18
  SPEAKER_00: First of all, I understand parents are not healthcare professionals.
• 6:21
  SPEAKER_00: They may be uncertain or question what they're actually looking at, or if what they're seeing is actually a true sign.
• 6:27
  SPEAKER_00: So here's one thing do the test more than once.
• 6:29
  SPEAKER_00: Do it a couple days back to back, or do it over a couple times and look to see are you seeing the same thing over and over?
• 6:36
  SPEAKER_00: If you're seeing the same thing repeatedly, that's a good sign that there's actually something there and you're not just seeing something, or it's not just how your child is standing or how they're bending.
• 6:44
  SPEAKER_00: The other thing is, you know, are you seeing more than one of the signs of scoliosis?
• 6:48
  SPEAKER_00: The forward Adams bend test is just one.
• 6:50
  SPEAKER_00: And we're gonna go over several different things that we look for when doing scoliosis screenings.
• 6:55
  SPEAKER_00: And when you're seeing more than one of these, that's enough to know that there's likely something there.
• 6:59
  SPEAKER_00: And a further testing or a more thorough evaluation is definitely warranted at that point.
• 7:04
  SPEAKER_00: Now, there is another tool that can be used and should be used if you really want to get the most accurate testing at home.
• 7:11
  SPEAKER_00: It's a tool called the Scoulimeter.
• 7:13
  SPEAKER_00: And a SCOLIMER is a test that's specifically designed to be used when doing the forward admin spinning test, and it measures the amount of actual rotation in the spine.
• 7:22
  SPEAKER_00: We use it in our office every day.
• 7:24
  SPEAKER_00: We use it on the initial and routine evaluations because that's the way we can easily assess how much rotation is there in the spine, and it's a way to evaluate the scoliosis severity beyond just the measure of the cob angle or the curved degree angle on an X-ray.
• 7:38
  SPEAKER_00: So squad units are pretty cheap.
• 7:40
  SPEAKER_00: You can give them on Amazon for probably$20,$30.
• 7:42
  SPEAKER_00: And how you do this test is they come as a little notch in it, and you just hold it and you run it down your child's spine while they're bending over in the Ford Adams test with their hands together, and you'll see a little bead on there, and that bead will move if there's rotation in the spine because it does rotation, it'll be unlevel.
• 8:00
  SPEAKER_00: Now, generally in the thoracic spine, if there is like six to seven degrees of rotation, that's considered a positive signing.
• 8:08
  SPEAKER_00: There's enough rotation there telling you yes, there's likely scoliosis.
• 8:12
  SPEAKER_00: X-rays are warranted for more detailed or more thorough evaluation.
• 8:16
  SPEAKER_00: In the lumbar or spine, if there's four or five degrees of rotation, that's a positive sign, and that's enough to tell you yes, there's likely scoliosis.
• 8:25
  SPEAKER_00: We need to do x-rays to do further assessments.
• 8:27
  SPEAKER_00: Now, the reason why the numbers are typically bigger in the thoracic spine is in the thoracic spine, you have the rib cage, and as you have the rib cage, when the spine rotates, that creates a bigger or more significant hump.
• 8:39
  SPEAKER_00: You don't have the rib cage in the lumbar spine, and so you typically don't get as much humping.
• 8:45
  SPEAKER_00: Also, if they have an anatomical short leg, meaning one leg is shorter than the other and the pelvis tilts, that kind of hides the scoliosis, and so it can even blunt or decrease the amount of humping is there.
• 8:58
  SPEAKER_00: Point four, finding something is only half the evaluation.
• 9:02
  SPEAKER_00: A positive screening is not a diagnostic test, it's only the starting gun.
• 9:06
  SPEAKER_00: But also remember, people that get the best outcomes are also the ones that take action early and they get treatments early on while the curves are still small.
• 9:15
  SPEAKER_00: So if you suspect something is there, stop waiting to see if it's progressing or if you notice it getting worse.
• 9:20
  SPEAKER_00: Or if you've been to your pediatrician and you're told that it's not a big concern to just watch and wait, stop waiting and go out and see what can actively be done while the curve is still small before it gets more severe.
• 9:32
  SPEAKER_00: So here's what you should actually do.
• 9:33
  SPEAKER_00: One, you need to go to a true scoliosis specialist.
• 9:36
  SPEAKER_00: You want to make sure you ask for full spine standing x-rays viewed from the front or back and the side.
• 9:42
  SPEAKER_00: Full spine x-rays are much better than sectionals because it also tells you if your body is out of balance and that's more accurate because although you can stitch sectional x-rays together, the patient can move, it's just not quite as clean and not as accurate.
• 9:56
  SPEAKER_00: Also, make sure your provider measures how much rotation is in the spine, not just the size of the cob angle.
• 10:02
  SPEAKER_00: And another thing you want to make sure they do is tell you how much skeletal growth they have remaining or what their current level of skeletal maturity is and how that actually equates or what that actually means for your child's scoliosis, the risk of the progression, and what treatments are gonna be most appropriate.
• 10:19
  SPEAKER_00: You see, here's the thing a 20-degree curve and a 10-year-old who hasn't even hit puberty yet is a completely different scoliosis than a 20-degree curve and a 16-year-old who's almost done growing.
• 10:30
  SPEAKER_00: Point five, I'm gonna show you how to do a systematic step-by-ab complete scoliosis screening right from your own home.
• 10:36
  SPEAKER_00: And remember, this is important because there are no scoliosis screening programs in the United States anymore.
• 10:41
  SPEAKER_00: They're not done in schools, and your pediatrician may not also be doing these.
• 10:45
  SPEAKER_00: So if no one else is gonna be looking for scoliosis, you need to take it on your own to make sure your child is properly checked.
• 10:51
  SPEAKER_00: So I want you to start by doing the Ford Adam spinning test.
• 10:55
  SPEAKER_00: So to start, you're gonna have your child put their hands together like they're praying, they're gonna extend their arms straight, they're gonna bend over at the waist, have their arms hang straight down.
• 11:03
  SPEAKER_00: You're gonna get behind them, you're gonna crouch down, and you're gonna look level or horizontal with their spine.
• 11:09
  SPEAKER_00: You're looking to see if there's any humping in the thoracic spine or in the lumbar spine.
• 11:15
  SPEAKER_00: And you can also go order one of those scoli meters.
• 11:17
  SPEAKER_00: And if you have a scoli meter, you're gonna run that along their spine and measure any degrees of rotation.
• 11:24
  SPEAKER_00: Now, as you go through this, mark down each test or each screening as you go.
• 11:29
  SPEAKER_00: Make sure you write down exactly what you're seeing.
• 11:32
  SPEAKER_00: After you do the forward adding spin test, have them stand up.
• 11:35
  SPEAKER_00: Look at them from behind.
• 11:36
  SPEAKER_00: First thing I want you to look and check does one shoulder appear higher than the other?
• 11:41
  SPEAKER_00: Are the shoulders unlevel?
• 11:43
  SPEAKER_00: If so, write that down.
• 11:45
  SPEAKER_00: Then I want you to look at their shoulder blades or their scapulas.
• 11:48
  SPEAKER_00: Does one stick out further than the other?
• 11:50
  SPEAKER_00: What's known as scapular winging?
• 11:52
  SPEAKER_00: Is scapular winging present, which is a sign of scoliosis?
• 11:56
  SPEAKER_00: Next, look from behind and look at their waistline.
• 12:00
  SPEAKER_00: Do they have that normal hourglass shape with their waistline?
• 12:03
  SPEAKER_00: Do both sides of their waistline look even, or does one look indented and one look flat?
• 12:09
  SPEAKER_00: If you see them looking asymmetrical, write that down.
• 12:12
  SPEAKER_00: Look at their pant line.
• 12:13
  SPEAKER_00: Does their belt line slope or dip on one side?
• 12:16
  SPEAKER_00: Meaning, does their hips or pelvis look uneven, which is a sign of having an anatomical short leg or one leg being shorter than the other?
• 12:25
  SPEAKER_00: Then, do you notice any obvious or visible scholotic curves just looking at their back from behind?
• 12:32
  SPEAKER_00: In the last test, with their arms hanging by their side, does the space between their arm and their torso even on both sides?
• 12:39
  SPEAKER_00: Or does the spine seed shift it to one side?
• 12:42
  SPEAKER_00: You notice a bigger gap on one side while the other side is pinned to the arm.
• 12:47
  SPEAKER_00: Now, as you go through these, write all these down.
• 12:49
  SPEAKER_00: And if you see any of these obvious signs of scoliosis, and especially if you see more than one of them, then it's time to get your child scheduled with a scoliosis specialist for a more detailed evaluation.
• 13:01
  SPEAKER_00: Here's my final thought.
• 13:02
  SPEAKER_00: That home screening you just did, look, it is not a diagnostic tool, it's a directional tool.
• 13:08
  SPEAKER_00: It tells you whether or not there may or may not be scoliosis present.
• 13:11
  SPEAKER_00: And if you sense or things or see signs of scolios being present, then you know your next steps.
• 13:16
  SPEAKER_00: Seek out and get your child a detailed scoliosis evaluation by a true scoliosis specialist.
• 13:21
  SPEAKER_00: And if you don't see anything there and your child is still growing, check them again in six months.
• 13:26
  SPEAKER_00: Just remember this the window where scoliosis is the easiest to treat is also the window where it's the most difficult and most challenging to pick up because it's when the curves are small, when the scoliosis is just beginning.
• 13:39
  SPEAKER_00: So if you see anything at all, even though it may seem small or minuscule, take action and get further evaluation by true scoliosis specialists.
• 13:47
  SPEAKER_00: Now, if your child already has a scoliosis diagnosis or the pediatrician mentioned, someone like maybe just needing to watch it and see if it gets worse.
• 13:56
  SPEAKER_00: This video linked right here is going to be really important for you.
• 13:59
  SPEAKER_00: It covers the really specific physical signs that indicate a curve is already present and that it's actually getting worse.
• 14:06
  SPEAKER_00: So if that's you, be sure to watch this next video.
• 14:08
  SPEAKER_00: There'll be a link in the description and at the end of this video.
• 14:12
  SPEAKER_00: I'll see you there.