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The Pattern

"It is commonly noted that patients are notoriously asymmetric in the functional behavior of their musculoskeletal systems.

The universal pattern consists of a cluster of findings, including a pronated right foot, an anteriorly rotated right innominate, a posteriorly rotated left innominate, a right inferior pube, a left superior pube, a left on left forward sacral torsion, a lower thoracic scoliosis convex to the right and a left lumbar scoliosis, an anterior and inferior right shoulder girdle, and a left cervical scoliosis."

In reference to the chronically recurrent low back pain syndrome:

"Victims of this problem present with chronic recurrent disabling back pain with minimal radiation to the lower extremity below the buttock. They find it difficult to stand for any period of time as the back pain progressively increases while standing without being mobile.

The structural diagnostic findings in this population usually consist of the problem on the left side with the left pube being superior, the left sacrum being anteriorly nutated, the left innominate posterior, an L5 with extended, rotated, and sidebent (ERS) dysfunction to the left with tight erector spinae muscles and weak abdominals."

Principles of Manual Medicine, 2nd edition, 1996, Philip E. Greenman, D.O., F.A.A.O.,
Professor of Biomechanics, College of Osteopathic Medicine, Michigan State University.

"About 75% to 85% of all scoliosis develops without any known cause in otherwise normal, healthy children and progresses with skeletal growth. Infantile scoliosis develops between ages 0 to 3 and occurs more often in boys than girls.

Juvenile scolioses occurs between ages four to nine and is seen more often in girls than in boys. Adolescent scoliosis is the most common type of idiopathic scoliosis and develops most often in young girls from age 10 to the end of skeletal growth (about 15 or 16). The major curve in idiopathic scoliosis is usually a right thoracic curve occurring between T-4 and T-12. Most curves are convex to the right in the thoracic area and to the left in the lumbar area.

There are four major curve patterns: Thoracic 90% right convexity. Average 6 vertebrae. Apex T8, T9. Upper end vertebrae T5, T6. Lower end vertebrae T11, T12. Lumbar 70% left convexity. Average five vertebrae. Apex L1, L2. Upper end vertebrae T11, T12. Lower end vertebrae L3, L4. Thoracolumbar 80% right convexity. Average six to eight vertebrae. Apex T11, T12. Upper end vertebrae T6, T7. Lower end vertebrae L1, L2. Double 90% right thoracic convexity, left lumbar convexity. Thoracic component. Average five vertebrae. Apex T7. Upper T5, T6. Lower T10. Lumbar component. Average five vertebrae. Apex L2. Upper T11. Lower L4. There may be asymmetry in the hips, pelvis, and lower extremities."

Stewart L. Weinstein MD, Dept of Orthopaedic Surgery, University of Iowa Hospitals and Clinics Childrens’ Virtual Hospital.

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