[Durgical](https://durgical.com/en/) › [DurgiPedia](https://durgical.com/en/durgipedia/) › [Clinical exam](https://durgical.com/en/clinical-exam/) › [Musculoskeletal system](https://durgical.com/en/clinical-exam/#a-musculoskeletal) › Spine examination: the Adams forward-bend test and Schober test [Clinical exam](https://durgical.com/en/clinical-exam/) · [Musculoskeletal system](https://durgical.com/en/clinical-exam/#a-musculoskeletal) # Spine examination: the Adams forward-bend test and Schober test - Maneuver Bending forward reveals the rib hump of scoliosis (Adams), and measuring how much the low-back skin stretches shows whether the lumbar spine is stiff (Schober). Updated 2026-11-01 **See it in 3D:** [L1 vertebra](https://durgical.com/en/anatomy/lumbar-vertebra/) · [L5 vertebra](https://durgical.com/en/anatomy/lumbar-vertebra-spine-and-pelvis-l5/) · [Ribs (back part)](https://durgical.com/en/anatomy/ribs/) · [Sacrum](https://durgical.com/en/anatomy/sacrum/) · [T6 vertebra](https://durgical.com/en/anatomy/t6/) · [T12 vertebra](https://durgical.com/en/anatomy/t12/) ## Key points - Adams: forward bend with the examiner behind; a rib or lumbar hump means vertebral rotation from structural scoliosis. - Scoliosis is confirmed on radiograph with a Cobb angle of 10 degrees or more. - Red flags in scoliosis: a thoracic curve convex to the left, significant pain or a neurological deficit. - Modified Schober: marks 10 cm above and 5 cm below the line of the lumbosacral dimples; an increase under 5 cm on flexion means lumbar stiffness. - Reduced Schober plus inflammatory back pain in a young adult: think of ankylosing spondylitis. ## What it is The spine exam includes standing inspection, palpation, range of motion and two high-yield maneuvers. The Adams test shows the vertebral rotation of scoliosis as a rib or lumbar hump. The Schober test measures lumbar flexion and is classic in ankylosing spondylitis. Both are quick and done with the patient standing. ## The anatomy it tests - In scoliosis the vertebrae shift sideways and rotate; as they rotate they carry the ribs, which form the hump on the convex side. - Bending forward brings the thoracic and lumbar spine horizontal and makes this rotation visible. - Lumbar flexion separates the spinous processes of L1 to L5 above the sacrum; if the joints are fused or inflamed, the skin stretches less. - In ankylosing spondylitis inflammation starts in the sacroiliac joints and climbs the spine; it also limits chest expansion. ## How to do it - Patient standing barefoot with the back exposed; inspect from the front, back and side: shoulders, shoulder blades, iliac crests and curves. - Adams: feet together, knees straight, arms hanging with palms together; ask the patient to bend forward until the back is nearly horizontal. - The examiner stands behind, eyes at back level, and looks for one side of the chest or lower back sitting higher. - Positive Adams: an asymmetric rib or lumbar hump; rotation can be measured with a scoliometer. - Schober: mark the skin on the line joining the lumbosacral dimples, another mark 10 cm above and another 5 cm below. - Ask the patient to bend forward as far as possible with knees straight and measure the distance between the outer marks again. - Normal Schober: the distance grows by 5 cm or more; a smaller increase means limited lumbar flexion. - Finish with palpation of the spinous processes, motion in every plane and the neurological exam of the legs. ## What a positive result means - Rib hump on Adams: structural scoliosis, most often adolescent idiopathic, usually with a thoracic curve convex to the right. - A curve that disappears on bending: postural scoliosis or a leg-length difference, not structural. - Left thoracic curve, significant pain or a neurological deficit: look for a non-idiopathic cause (tumour, syrinx, neuromuscular disease). - Schober under 5 cm: ankylosing spondylitis or another spondyloarthritis; also severe pain or vertebral fusion. - Back pain that improves with exercise, worsens with rest and causes morning stiffness: inflammatory pattern. - Fever, weight loss, a history of cancer, trauma or a neurological deficit with back pain: red flags. ## Usefulness and limits - Adams: common errors are not asking for feet together and knees straight, or looking from too far away. - A leg-length difference can mimic scoliosis: level the pelvis before reading the test. - Schober: a wrong starting mark changes the result; radiographs confirm scoliosis (Cobb) and sacroiliitis. ## Test yourself Think of the answer, then tap the question to see it. ## What finding makes the Adams test positive? An asymmetric rib or lumbar hump on bending forward, from vertebral rotation in structural scoliosis. ## What Cobb angle defines scoliosis? Ten degrees or more on the radiograph. ## How is the modified Schober test done and when is it abnormal? Marks are placed 10 cm above and 5 cm below the line of the lumbosacral dimples; it is abnormal if the distance grows by less than 5 cm on flexion. ## Which type of scoliotic curve calls for a search for a non-idiopathic cause? A thoracic curve convex to the left, especially with significant pain or a neurological deficit. [Add to my cards (4)](https://durgical.app/estudiar/?add=/en/clinical-exam/spine-examination-the-adams-forward-bend-test-and-schober-test/) ## See it in 3D The structures of Durgical's 3D anatomy where it is found. - [L1 vertebra](https://durgical.com/en/anatomy/lumbar-vertebra/) - [L5 vertebra](https://durgical.com/en/anatomy/lumbar-vertebra-spine-and-pelvis-l5/) - [Ribs (back part)](https://durgical.com/en/anatomy/ribs/) - [Sacrum](https://durgical.com/en/anatomy/sacrum/) - [T6 vertebra](https://durgical.com/en/anatomy/t6/) - [T12 vertebra](https://durgical.com/en/anatomy/t12/) ## Related - [Lasègue sign (straight leg raise) and Bragard sign](https://durgical.com/en/clinical-exam/lasegue-sign-and-bragard-sign/) - [FABER (Patrick) and FADIR tests](https://durgical.com/en/clinical-exam/faber-and-fadir-tests/) - [Inspection of gait and posture (orthopedic)](https://durgical.com/en/clinical-exam/inspection-of-gait-and-posture/) - [Chest inspection: shape, expansion, accessory muscles and retractions](https://durgical.com/en/clinical-exam/chest-inspection-shape-expansion-accessory-muscles-and-retractions/) ## Related conditions - [Scoliosis](https://durgical.com/en/conditions/scoliosis/) - [Ankylosing spondylitis](https://durgical.com/en/conditions/ankylosing-spondylitis/) - [Mechanical low back pain](https://durgical.com/en/conditions/mechanical-low-back-pain/) [← All of the clinical exam](https://durgical.com/en/clinical-exam/) Educational content on the clinical exam; it is learned and practised under supervision. It does not replace assessment by a health professional and is not for self-diagnosis. Sources: [Adolescent Idiopathic Scoliosis: Diagnosis and Management](https://www.aafp.org/pubs/afp/issues/2014/0201/p193.html) (American Family Physician (American Academy of Family Physicians), 2014); [Ankylosing spondylitis: MedlinePlus Medical Encyclopedia](https://medlineplus.gov/ency/article/000420.htm) (MedlinePlus, U.S. National Library of Medicine, 2026); [Musculo-Skeletal Examination – Lower Back Exam – Practical Guide to Clinical Medicine](https://sites.ucsd.edu/clinicalmedguide/musculo-skeletal-examination-lower-back-exam/) (UC San Diego School of Medicine, 2026). ## **Spotted a mistake?** We are always improving for the community. Tell us what is wrong and our team will review it. Report a mistake Representative model, for educational purposes only. --- Source: https://durgical.com/en/clinical-exam/spine-examination-the-adams-forward-bend-test-and-schober-test/ License: CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). Cite as: DurgiPedia (durgical.com), https://durgical.com/en/clinical-exam/spine-examination-the-adams-forward-bend-test-and-schober-test/