Dr. John Jed Downs,
an osteopathic physician from Madison Manual Medicine discusses the
fundamentals of osteopathic therapy, including general history,
diagnostic techniques and maninpulative techniques used in therapy.
There are a number of terms that get bandied around which are largely
synonymous when it comes to osteopathic manipulative therapy. Other
terms that may be used include osteopathic manual therapy, osteopathic
manipulative medicine, and osteopathic manual medicine. It is a pity
that more people are not familiar with the terms. Osteopathy was
developed in this country in the 1870’s and has been taught continuously
in the US since 1892. It was developed as a complete form of medicine
that was an alternative to the crude surgeries without anesthetics and
the toxic drugs of the day. Current practitioners of osteopathic
treatment techniques consider it a form of complementary or integrative
medicine and do not seek to invalidate medical advancements that
occurred during the past century.
Osteopathic manipulative medicine holds these underlying tenets:
The body is an integrated unit of mind body and spirit.
The body possesses self regulatory mechanisms and has the inherent capacity to defend, repair and remodel itself.
Structure governs function and function governs function
Rational therapy is based on consideration of the previous principles.
Traditional osteopathy as practiced internationally adds an additional tenet:
The rule of the artery is supreme.
This is understood to mean that fluid flow within the body is
critical. Impediments to arterial, venous, lymphatic, spinal fluid and
other flows within the body are impediments to optimal function and
optimal health.
With these truths in mind, the practitioner uses his/her hands to
identify the regions in the body where blockages or restrictions exist
to fluid flow, blockages or restrictions of mechanical movements of the
joints. These blockages may be due to trauma, be it physical, surgical
or emotional, postural habits, ergonomics, repetitive or cumulative
trauma, or birth trauma as either the infant or the mother. These
blockages are referred to as lesions or somatic dysfunctions and can be
found almost anywhere. They may occur as a result of shock waves that
hit distal to a site of injury, for example falling on one’s buttocks
will send a wave up the spinal structures to the neck and skull. They
may be due to shearing forces between tissues during rapid acceleration
or deceleration events between organs or structures of different
densities. Unfortunately, it may not be possible to identify all the
root causes for a symptom complex.
After finding somatic dysfunctions, the practitioner mentally maps
them and prioritizes the dysfunctions, before and during the ongoing
treatment process. The treatment process is controlled by the
practitioner’s hands and body. Depending on the quality of the tissues
in terms of texture, mobility and subtle rhythmic motions, the provider
selects the appropriate technique needed to restore movement and
function to a target region. She/he then observes changes in response to
the initial treatment before continuing on to treat other regions.
Depending on the provider’s assessment and prioritization of the
patient’s body’s needs for improved health and function, she/he may not
end up directly treating the area of pain or region of lost motion.
Osteopathic treatment techniques include treatments that go into the
ease of tissues which allow the body to unwind or untie itself in
relation to dysfunction. Techniques include direct techniques in which
tissues are put on stretch, others in which the nerves and muscles are
hopefully retrained, and yet other techniques that are designed to break
down a restriction, osteoarticular techniques, that may or may not be
associated with popping or cracking.
The examination is comprehensive and looks for impacts of
restrictions on nerves, arteries, lines of gravity, the autonomic
nervous system, and the capacity of the head to express movement
associated with spinal fluid circulation. The spine, ribs, joints of the
extremities, interfaces between organs or the insides of cavities
(chest & abdomen) and joints of the skull may all need to be
examined and treated in the pursuit of better health and improved
function.
