Adam's Forward Bend Test: Step-by-Step Guide to Screening for Scoliosis

The Adam's Forward Bend Test is probably the most well-known postural test in the world, mainly because it's the one used in school scoliosis screenings. It's extremely quick, needs no equipment, and although it looks simple, it can tell you a lot if you know how to read it.

If you work with kids or teenagers, or just want a first-pass filter for spinal asymmetries with any client, this test belongs in your basic assessment battery.

What does the Adam's test measure?

The test looks for asymmetries in the back when bending the trunk forward, specifically the appearance of a rib hump (a "bump" on one side of the back), which is one of the most characteristic signs of structural scoliosis.

Unlike a functional scoliotic posture (which corrects itself on flexion), structural scoliosis maintains or accentuates the asymmetry in flexion.

What you'll need

• Nothing essential
• Optional: a scoliometer (Bunnell inclinometer) to quantify the hump angle in degrees, rather than relying on a simple "I see it / I don't see it"

Step-by-step protocol

1. The person stands barefoot, feet together, knees extended
2. Ask them to bend the trunk forward slowly, arms hanging with palms together, until the back is roughly horizontal
3. Position yourself behind (or in front, whichever you prefer) and observe the back at eye level, looking for:

- Asymmetry in rib height (rib hump) — most common in the thoracic region - Asymmetry in the lumbar region - Asymmetry in shoulder or scapula height before bending

1. If using a scoliometer, place it over the area of greatest prominence and record the angle in degrees

Common mistakes

• Bending too quickly (not enough time to observe properly)
• Not checking from more than one angle
• Mistaking a muscular asymmetry (from dominance or a one-sided sport) for a structural one

How to interpret the result

Result	Interpretation
No visible asymmetry	Negative — no signs of structural scoliosis on this test
Mild asymmetry, scoliometer < 5-7°	Monitor, re-test at future assessments
Clear asymmetry, scoliometer > 7°	Refer for medical evaluation with X-ray to confirm and measure the Cobb angle

Important: the Adam's test is a screening tool, not a diagnostic one. A positive result doesn't confirm scoliosis, but it does justify referring to a specialist for imaging.

How it relates to other tests

The Adam's test fits well within a broader postural assessment. If you spot a hump, it's worth following up with:

• Comprehensive postural analysis with plumb line — to check for other associated compensations (shoulders, pelvis)
• Pelvic tilt test — spinal asymmetries are often accompanied by pelvic imbalances

Track it and follow up

If you work with growing adolescents, periodic follow-up is key: a mild asymmetry today can progress significantly within months during a growth spurt. In Movalytics you can log the Adam's test result (with or without scoliometer degrees) at every assessment and automatically see how it evolves, without having to dig through past records.

FAQ

Does the Adam's test hurt? No, it's completely painless. It only requires bending the trunk forward. At what age does it make sense to do it? It's commonly used in school screenings from around age 10-11, coinciding with the onset of growth spurts, when the risk of scoliosis progression is highest. Does a negative result rule out scoliosis forever? No. Scoliosis can appear or progress during growth, so it's worth repeating the screening periodically in adolescents.