World Osteopathy Day

Manual osteopathy is an allied health profession that is gaining an increasing profile around the world. The Osteopathic International Alliance (OIA) has official relations status with the World Health Organisation. Moreover, manual osteopaths all over the world will get to celebrate World Osteopathy Day on 22nd June, the day that osteopathy was originally founded in 1874 by Dr Andrew Taylor Still.

Why I Chose Manual Osteopathy As A Profession

Manual osteopathy can make a real difference to people and their quality of life. This is because many health conditions and other movement related pain can be effectively treated with manual osteopathy. With varying degrees of success, osteopathic manual treatments can address diverse problems such as asthma, bronchitis, stomach problems, angina pain, sciatica, ear infections, and menstrual problems. In fact, manual osteopathy is highly effective in helping people who suffers from chronic pain. Whatever are their reasons for turning to an osteopath, patients often find that their overall health improves.

An important aspect of manual osteopathy is the philosophy of osteopathic holistic approach in patient care. Manual osteopaths  treat the patient as an individual and not just the injury or condition. Manual osteopaths spend time to know their patients so that they can understand their unique set of circumstances and other factors which may be playing a part in their conditions. Manual osteopaths then use this knowledge to deliver a sound treatment plan in partnership with the patient.

The job prospects for manual osteopathy graduates are impressively high. Manual osteopathy provides students with practical skills which will always be in demand. Many receive job offers before they even graduate, while others choose to set up in business on their own or with fellow graduates. Manual osteopaths have great earning potential and what they can earn is largely dependent on where and how often they want to work, how many patients they want to see, what patients they want to see, and what rates they decide to charge. Besides, qualified manual osteopaths can also practice in countries all over the world, subject to local regulations.

While many manual osteopaths work with a wide variety of patients, some may choose to specialize in a niche market. Specialists in manual osteopathy can focus on work with young patients, elderly people, professional athletes, patients with specific chronic conditions or even animals. The career of an manual osteopath can evolve with time and change direction with their interests.

Manual osteopathy is a noble profession, and  therefore those who pursue it are well respected and valued members of society. Like other healthcare professions, manual osteopaths must be registered with the profession's regulatory body. Manual osteopaths need to undertake regular professional development and comply with professional standards, so that the general public can have confidence in the treatment they provide. 

Conditions That May Benefit From Manual Osteopathy

Many patients seek osteopathic care for aches, pains, strains, sprains, headaches, and other common musculoskeletal problems.

Nonetheless, many health problems can be and have also been successfully addressed with osteopathic manipulation. Studies have shown positive effects with the following conditions:

² Arthritis ² Asthma ² Autism ² Back pain ² Bell's palsy ² Chronic pain ² Degenerative disc and joint disease ² Ear infections ² Epilepsy ² Fibromyalgia ² Headaches ² Head Trauma and Concussions ² Irritable Bowel Syndrome

² Migraines ² Motor vehicle accident injury ² Neck pain ² Pregnancy and childbirth ² Reflux ² Repetitive occupational strains ² Shoulder conditions ² Sports injures ² Tendonitis ² Temporomandibular Disorders ² Physical Trauma ² Postural conditions ² Post surgical conditions

Benefits of Manual Osteopathy

The common benefits of manual osteopathic treatments are:

² Promote deep breathing ² Improve posture ² Improve circulation ² Enhance skin health ² Increase joint mobility ² Induce a calm mind ² Reduce anxiety ² Increase self awareness

² Promote mental alertness ² Increase peace of mind ² Fulfill need for human touch ² Prevent injury ² Acute and chronic pain relief ² Improve sports performance ² Decrease muscle tension ² Decrease muscle spasm

Manual Osteopathy: Cranial Osteopathy

Manual osteopathy in the cranial field was pioneered by William Sutherland (1873 to 1954) and remains one of the more controversial areas of manual osteopathy. Cranial osteopathy is based on the supposition that oscillatory motions of the cranial bones and sacrum exist. It stresses the importance of movement within the 29 bones of the skull; the rhythmic movement of spinal fluid through the brain, central nervous system, and body tissues; and the ability of the sacrum to move in a coordinated manner with everything else. These movements are barely perceptible and are mediated through the tension of the various dural membranes such as the falx cerebri, tentorum cerebelli, and the dura along the entire spinal cord. Their amplitude and rate are thought to provide information about the patient's health and are thought to be influenced by the application of gentle pressure over specific areas of the cranium and sacrum. Cranial osteopathy is also thought to influence parasympathetic tone because the origins of parasympathetic division of the autonomic nervous system are located in the craniosacral regions.

The goals of cranial osteopathy are to normalize nerve function, eliminate circulatory stasis, normalize cerebrospinal fluid fluctuation, release membranous tension, correct cranial articular strains, and modify gross structural patterns. Cranial osteopathy requires special training and should be performed only by certified practitioners. This technique is contraindicated for patients with recent trauma, a lack of biomechanical dysfunction or an aversion to receiving treatment.

Manual Osteopathy: Lymphatic Treatment

Most manual osteopathy treatments have an effect on lymphatic circulation. All lymphatic techniques begin with treatment of somatic dysfunction in areas known as “choke points.” The choke points, when dysfunctional, are areas that can obstruct the flow of lymph between body compartments. Choke points are usually treated with myofascial release techniques assisted by respiration. Once the obstruction is reduced, other lymphatic pump techniques are used to promote fluid movement, such as pectoral traction, postural drainage, effleurage, thoracic expansion, and rhythmic passive dorsiflexion of the feet. The goal is to enhance lymphatic return either by influencing negative intrathoracic pressure or mechanically assisting return of lymph from the lower extremities. As somatic dysfunction resolves, the body’s natural homeostatic mechanisms are restored and lymphatic drainage is naturally enhanced. Lymphatic treatments remove obstructions to lymphatic flow and augment the clearance of lymph and other immune elements from specific congested tissues. Lymphatic techniques are contraindicated in the presence of metastatic cancer, certain infections (e.g., tuberculosis), and hypercoagulable states.

Manual Osteopathy: Myofascial Release (MFR)

Myofascial release (MFR) is a technique that focuses on fascia and the surrounding muscles. It is similar to deep massage, but the hands of the practitioner are not merely slid along the skin surface. The goal is to stretch muscles and fascia to reduce tension. Myofascial techniques can also be adapted to promote venous and lymphatic drainage.

In myofascial release treatment, the manual osteopath applies compression or distraction forces to the area of myofascial strain, using palpatory feedback to guide the strain to resolution. Myofascial release techniques either directly or indirectly engage restrictive barriers depending on the manual osteopath’s perceived response of the fascia to palpation. The effectiveness of myofascial techniques is explained via the concept of tensegrity. A tensegrity structure consists of multiple, non-touching rods balanced by a continuous tension system. If there is problem in one component, the entire structure is affected. Applying this concept to the human body suggests that bones are the rods and the continuous tension system is the myofascial and ligamentous tissues of the body. Therefore, myofascial strain theoretically has influences across the entire body and resolution allows the restoration of a more balanced homeostatic equilibrium.

The use of myofascial release depends on the safe introduction of motion upon dysfunctional tissue. Consequently, myofascial release is contraindicated for patients with open wounds, fractures, recent surgery, deep vein thromboses, an underlying neoplasm, or other internal injuries.

Manual Osteopathy: Counterstrain

Treatment using counterstrain is directed at discrete areas of tender tissue called tender points. Tender points are painful to the touch and they can be found in acute and chronic conditions and may be the primary indicator of somatic dysfunction or appear secondary to another medical cause. Tender points are theorized to arise from an antagonist muscle in a state of “panic,” lengthening in response to a strained and painful agonist muscle.

Counterstrain is an indirect, passive technique in which the patient is positioned away from a restrictive barrier of motion. When performing counterstrain, the manual osteopath places the symptomatic joint in the position of least discomfort while at the same time monitoring the degree of tenderness at a nearby tender point. This position of minimal discomfort is usually a position where the muscle is at its shortest length. The position is held for 90 seconds and the joint is slowly and passively returned to the neutral position. By placing the body into a position of maximal ease and comfort, the somatic dysfunction of the strained muscle should begin to resolve. Treatment is repeated until a 70-percent reduction in tenderness is reported by the patient.

The prolonged contracted state of a muscle causes shortening of both the intrafusal (muscle spindle) and extrafusal fibers. The gamma motor neurons then increase their firing rate to maintain tone in the muscle, and the muscle spindle fibers become hypersensitive. If the hypersensitive muscle is now lengthened too rapidly, a reflex overstimulation of the alpha motor neurons will occur. This sensory input travels to the higher centers of the central nervous system, which may misinterpret this input and respond with excessive gamma motor stimulation, maintaining the spasm. Reshortening the muscle by using counterstrain technique allows the muscle spindle to shorten and resume normal firing. The central nervous system then resets its gamma motor neurons after about 90 seconds. Absolute contraindications for counterstrain occur in patients with fractures or torn tendons in areas of dysfunction.

Manual Osteopathy: Osteoarticular Treatment

Osteoarticular treatment  in manual osteopathy is a set of low-velocity and high-amplitude techniques which involve the application of gentle and repetitive motions on to the joints of the body to restore mobility in a restricted joint. Manual osteopaths use this treatment to reduce muscle spasms around a joint, reduce neurological irritations near a joint, normalize the mobility of a joint, and to eliminate pain and discomfort.  The osteoarticular technique usually involves the gentle movement of 2 joint surfaces. Before treatment, the manual osteopath will carefully place the patient into an optimal position that will reduce the energy and force required to perform the technique. It is not necessary to perform the techniques at the anatomical end range of movement of the joint. Therefore, many patients find that osteoarticular techniques are more comfortable than conventional joint manipulations. The beneficial effects of osteoarticular techniques are proven in clinical trials. The evidence for the effectiveness of osteopathic osteoarticular techniques suggests that the central nervous system is involved in mediating the endogenous pain inhibition system. Osteoarticular treatment is contraindicated in patients with fractures, unstable joints, and recent surgery.

Manual Osteopathy: Muscle Energy Technique (MET)

One cause of somatic dysfunction is postulated to derive from chronically contracted muscles which affect the body’s normal range of movement. Muscle energy is a direct, active treatment with broad applications to any part of the body restricted in motion. In treatment, the manual osteopath engages the restrictive barrier and asks the patient to voluntarily move from a precisely controlled position. The osteopath exerts an equal and opposite force to the patient's active force from a certain position and in a specific direction. During the patient’s effort, the physician provides an isometric counterforce for 3 to 5 seconds and then allows the muscle to relax for 3 to 5 seconds. A new restrictive barrier is then engaged and the process is repeated 2 to 4 times. The result is repeated isometric contractions with passive range of motion through the barrier after each isometric contraction.

The goal of muscle energy technique is to increase joint mobilization and increase the length of contracted muscles. Because no thrusting is done, this procedure has a very low likelihood of producing complications and can be used where HVLA technique is contraindicated. The mechanism of action of muscle energy is thought to be related to the reciprocal inhibition of agonist/antagonist muscles and the Golgi tendon reflex. When a stretch reflex excites one muscle, reciprocal innervation causes simultaneous inhibition of the antagonist muscle. The Golgi tendon organ reflex is an inhibitory reflex that can cause relaxation of a muscle when excessive tension is placed on the Golgi tendon organ through either stretching or contracting the muscle. Muscle energy is contraindicated in patients with low vitality, fractures, unstable joints, and recent surgery.