What is the Barrier Concept?

Figure 3.

Scoliosis is named for its convex side; it can be idiopathic, which is most common, congenital, or gradually acquired if there is a problem such as a shortened limb. Surgery is reserved for curvatures greater than 50 degrees because it can compromise the patient’s cardiorespiratory function. Functional curvatures can be corrected with things like a heel lift. This cannot help in structural curvatures. Things like HVLA, muscle energy, and FPR can help to address specific segments.

With regard to the ribs, there are three major types. The true ribs are ribs one through seven. These are fully attached anteriorly to the sternum. The false ribs are ribs eight through ten, which are not attached to the sternum but are attached to costal cartilage anteriorly. Ribs eleven and twelve are called floating ribs, because they have only a posterior attachment to the spine and no anterior attachment.

There are three possible rib motions. The upper ribs are involved in pump handle motion, in which the anterior parts of the ribs will move upward during inspiration with the goal of increasing the AP diameter of the thorax. The lower ribs are involved in