Description of Osteopathic Treatment

What Is Osteopathic Treatment?

Osteopathic treatment is a form of manual medicine first applied by Dr. Still and further developed by the osteopathic profession. It is used by DOs and properly trained MDs to treat structural restrictions (somatic dysfunction) and improve the level of health in their patients.

Osteopathic treatment has gone by various names: Osteopathic Adjustment, Osteopathic Manipulative Therapy, Osteopathic Manual Treatment, Osteopathic Manipulative Treatment, Osteopathic Manual Medicine, etc

The level a treatment takes place on depends on a number of factors, among them, the level of skill, perception and experience of the physician. Some treatments are aimed primary at joints, others at membranes or fluids; still others at even deeper levels.

What makes a certain form of manual medicine osteopathic is not just the technique, but also the way in which it is applied, that is, according to osteopathic philosophy.

How does it work?

Osteopathic treatment works by engaging the innate forces of the body to do the work and preferably, to do it in a fashion in which the body is already trying to treat. By applying seemingly innocuous forces in a very precise manner, the bodies self-treatment can be enhanced to release strains and patterns imprinted on the body from trauma and stresses of life.

Self Treatment Patterns

There have always been a number of methods used to classify osteopathic treatment. The easiest way to understand these approaches is to look at the way in which the body treats itself.
For sake of simplicity, we use a classic model dealing with motion of one bone with respect to another, though it is truly much more complicated than this.

Indirect (Exaggeration of the problem)

In an indirect approach the pathologic position of the disturbed areas is exaggerated until a change occurs.

Direct

In a direct approach the pathologic position of the disturbed areas is reduced or taken directly towards their “normal” position until a change occurs.

Disengagement

Disengaging forces applied to altered anatomy.
In disengagement the disturbed areas are separated and the tension adjusted until a change occur

Opposite Physiological Motion

Forces applied appear opposite to a physiologic approach
In this approach one part is positioned as if an indirect approach and the other as if a direct approach.

Molding

Molding is useful for treating “warped” bones such as the thin bones of the head deformed from physical trauma. The forces essentially remold the shape of the bone.
Other There are a number of other approaches, which affect the body on deeper levels that are very uncommonn or too complex to discuss here.

Involved Forces
The above treatment methods can be applied with different types of forces
High velocity
Low velocity
Muscle energy
Balanced tension
Observation/Augmentation

These can be forces that are applied externally or they can be patient generated forces (the body always treats itself).
Tissue Levels
In addition, an individual treatment approach can be applied to different tissues or different levels of function of the body.
Bones
Connective tissue
Muscles
Ligaments
Membranes
Organs
Fluid
Potency
Embryologic matrix
Energetic

Treatment Techniques

Commonly used treatment techniques are as follows:
HVLA
Direct
Indirect

High velocity low amplitude treatment uses forces quickly applied to a discrete area. This is familiar to many people as thrusting or “popping”technique. This is most commonly performed as a direct technique.

Muscle Energy--Muscle energy uses the force of patients voluntarily directed muscle contractions to treat. It is usually direct, but can be an indirect approach.

Counterstrain -uses tender points (discrete tender areas that are caused by structural problems) to locate a problem and the body is positioned in such a fashion to relieve then tenderness at this point and held until the body fixes it. It is a form of indirect technique.

Fascial and Myofascial Release-Fascial release is a very old osteopathic technique, which can use direct or indirect forces to treat fascial restrictions.

Balanced Tension-This technique balances the tension of or across a givem level to set up a condition where the body is less affected by the pathology and can treat itself. Can be applied to all connective tissues. most commonly it a applied to ligaments, membranes, and articulations.

Fluid -This balances the tension on the level of the fluid, which can develop physiologic restrictions. Remember the fluid contains electrolytes and proteins, which alter the characteristics of a fluid.

Potency-This balances the tension on the level of the potency, a level deeper than the cerebrospinal fluid.

Lateral Fluctuation-This sets up a wave in the fluid that fluctuates back and forth from one side of the body to another until it reduces in magnitude and sets up a change in the body.

CV4/EV4A CV4 is a technique that brings the fluid towards the midline of the body to institute a change. An EV4 brings about a change by allowing the fluid to go away from the midline and towards the periphery. They are useful under different circumstances

Observation-It would not seem that observing something would have any effect on it, but when a trained practitioner observes the body in the correct manner and at the proper level, he/she can augment the self-healing forces allowing the body to fix itself.

Percussion-The use of percussion was pioneered by Robert Fulford, DO and developed over many years of practice. This involves using a Foredom percussor over precise areas of the body at just the right speed (and correct length of time) to help the body treat itself.

Biodynamics is an approach put together by James, Jealous DO using the later writings of the founder of Cranial Osteopathy, W. G. Sutherland, DO.

Embryologic matrix technique is another new approach based on the ideas of W.G. Sutherland, DO and principles of embryology. It utilizes the matrix of embryologic development of the body (which the body uses to treat itself) to augment self-corrective forces.

Other There are numerous other approaches that were not mentioned, but most fall in the categories already mentioned.

All this being said, it is a misnomer to think that there are discrete structural “lesions” or problems in the body. Any problem anywhere in the body affects the whole and is a whole body problem. That is, the body is structurally one unit and becomes dysfunctional as a whole unit, not individual parts. As such, treatment is approached with this idea in mind and the treatment technique must be appropriately applied.

Reflexology

From the authors of Reflexology, Health at Your Fingertips
Reflexions: The Journal of Reflexology Research Project
Barbara and Kevin Kunz, editors
Volume 25, Number 2, January 2004
Reflexology Paths around the World

"In nearly every village in Taiwan they have built special paths of pebbles and every morning at 3 or 4 o'clock, people walk barefoot around the pebble path for a half hour before they go to work. Hundreds, even thousands do this. It has become a way of life. I think this is very important. We eat three times a day for our health. For me it is like praying or meditation, I need it for my bodily health and I think every body needs it." (Father Josef Eugster, (British) Reflexions , March 1995, pp. 16-17.)

Call it stone stepping or cobblestone-mat walking. Or, call it walking on a Reflexology Path or a Barefoot Path. By any name, it's the tradition of walking on a surface specifically designed to pursue health. Reports of associated health benefits typically are based on word-of-mouth - until now. The Chinese tradition of "stone stepping" has been undergone controlled testing at the Oregon Research Institute. Scientists found that the older adult participants "experienced significant improvements in mental and physical well-being." In addition the study found the activity to be an answer to the quest for a "simple, convenient, and readily accessible exercise programs that will reduce health problems and improve quality of life of the aging population."
To the bare-footed reflexology path users around the world, the proof is in what they've been doing for years. The bare-footed exercise is grounded in the traditions of its location. Special paths have been built in parks, spas, condominium complexes and country clubs across Asia. In Germany and Austria, one embarks on a hike through nature with bare feet making contact with specially selected surfaces. Ideas of "acupoints" in Asia and "reflexzonmassage" in Germany tie the walking to the health of the whole body.

History

In Asia, the history of the reflexology path begins with cobblestone paths. Cobblestone was the common building material for paths and roads. One elderly Japanese remembers villagers volunteering their time to repair the roads near the village. The availability of these surfaces for transportation probably lead informally to the tradition of walking on them for health.
Kunz and Kunz currently speculate that the recent interest and building boom in cobblestone paths in Asia is a further impact of the work of one man, Father Josef Eugster. Thanks to the work of this Swiss Jesuit priest who heads a parish in Taiwan attention was rekindled in ancient Chinese foot working traditions some twenty- five years ago. Since that time foot work has spread throughout Asia. All across Asia, in China, Malaysia, Taiwan, Hong Kong, Japan, and Singapore, the impact has reverberated. Reflexology practitioners have set up shop. Singapore's Chinatown is known for its reflexology clinics. Singapore malls include reflexology businesses. Japanese tourists travel to Taiwan to experience the work of that country's reflexology practitioners. A Japanese woman who operates a chain of reflexology parlors in Japan is noted to be one of Japan's leading taxpayers. Research is conducted by Chinese medical doctors and reflexology is a common therapy in the Chinese medical system.

In Germany and Austria, attention has been paid to the feet throughout history. Both water and pressure applied to the feet are traditionally seen to impact the whole body. One traditional practice, kneippen, popularized by Pastor Sebastian Kneipp in the 1800's, consists of "wading" on wet grass or in shallow water to stimulate the internal organs, strengthen the immune system, and help the body to heal itself. "Reflezonmassage" began in the early 1900's simultaneously with the development of zone therapy in the US. The practices were both further refined to the application of pressure techniques to the feet to impact specific parts of the body.

Today, some call the Barefoot Path " do-it-yourself" reflexology. In the tradition of Kneipp, walkers on the Barefoot Path might have access to "kneippen," a walk through water with rocks.
American reflexologists first became aware of Asian interest in walking on varied surfaces for health purposes following presentations at the Rwo Shr Health '90 Worldwide Conference Tokyo in July 1990. (The organization is named for Father Josef. Rwo Shr is Mandarin Chinese for Josef.) Participants Barbara and Kevin Kunz became interested and, over the years, have written about the ideas surrounding the presentations. The 1990 presentations were: "Healthy Stroll Path" at a Shiseido factory in Japan, a scientific study of walking on a beaded mat, and a moving personal account of the benefits of walking on a varied surface by the 80 year-old Mr. Keichi.

Differences and Similarities

The similarities between Asian and European traditions and paths are striking:
(1) Traditions of doing something actively to impact one's health
(2) Traditions of doing something to one part of the body to impact the whole body
(3) Traditions of doing something to specific parts of the feet to impact specific parts of the body (4) Doing something natural to improve one's health
(5) Use of materials found commonly in one's surroundings to construct paths
(6) Building paths in public areas
(7) Use of the paths as an inducement to entice potential visitors or customers.


The differences are striking as well:
(1) The size of the path system - compact in Asia and sprawling in Europe. Think 75 m. in Asia and 3500 m. in Europe
(2) The surface underfoot - cobblestone in Asia and mud, logs, stone, moss and more in Europe(3) Stone placement - embedded in concrete in Asia and loose on the ground in Europe
(4) The sensory experience - varied surface in Asia with the addition of balance opportunities in Europe. (Interestingly, Asian traditions also include takefumi, stepping on bamboo as well as tai chi with its practice of balance.) ©Kunz and Kunz 2004
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