There are however some causative factors recognized by the osteopathic physician that are responsive to osteopathic manipulative treatment. In order to appreciate them regard this patient as a dynamic unit of function from head to feet and not merely a vertebral column with an unusual curve in it. Examining the standing patient from the back the level of ears, the shoulders, the scapulae or shoulder blades, the crests of the ilia are noted for their symmetry, is one side higher than the other. Next ask the patient to balance on one leg and note how far the pelvis drops on the opposite side. Is the range of motion equal to that when standing on the other leg.
Less motion indicates restriction of physiological motion in the sacroiliac joint.
How far can the patient bend forward toward touching the toes without bending the knees. As the patient uncurls note whether the rib cage is symmetrical on the two sides. A prominence of one side may be the earliest evidence of a scoliosis of the spine. Is there freedom of motion to permit elevation of the straight arms beside the head. Standing behind the seated patient place hands on the front of the chest or the sides of the chest to note whether the ribs move symmetrically.