Philosophy Of Osteopathy

What is Osteopathy?

Osteopathy is a non-pharmaceutical “hands-on” approach that encourages the body to heal itself by using the body’s intrinsic forces and corrective mechanisms to achieve homeostasis. Osteopathy views the body as a FUNCTIONAL and HOLISTIC unit.

Practitioners of osteopathy believe that the body knows what is best for itself and that treatments should be aimed to strengthening the body’s own defense mechanisms rather than suppressing symptoms of disease. Osteopathy is derived from the Greek words OSTEON (tissue) and PATHOS (to suffer/to feel). It is essentially literally “feeling the motion of the tissues and the usage of bones”. Osteopathy can be also seen as an “umbrella” of different techniques to encourage self-healing.

History

At the end of the 18^th century, the famous American physician Andrew Taylor Still, DO discovered that he was gifted and able to heal patients with his energetic touch (indirect techniques). He could change their physiology and heal many patients in Missouri and surrounding states. He was close to nature and studied the secrets of nature’s design, so at the end he believed that in nature you can find the answers for healing the body! He realized that the human body was potentially PERFECT in Structure-Form and Function. In his mind, he saw the body as a highly complex machine, what can only function optimally if it was in good alignment and lubricated well. He was smart to see the important direct correlation between the musculo-skeletal system and the function of the rest of the body.

“You begin with anatomy, and you end with anatomy, a knowledge of anatomy is all you want or need”. (A.T. Still, DO. Philosophy of Osteopathy)

The Unity of Function

He concluded that the UNITY of FUNCTION of the body was depended on three major systems, the circulation (fluid dynamics), the neurological system (communication) and fascia (connective tissue). Fascia is seen as the unifying connecting factor as it surrounds blood and lymph vessels, as well lymph nodes, nerves, and the outer layer surrounding organs and bones. Fascia is important in the body for support, lubrication and it acts as a “mechanical brain” through compression and traction forces in the musculo-skeletal system.

These three functional systems organize the body into an “unified” WHOLE! Any inappropriate alteration (trauma) in the structure and fluid dynamics can trigger dysfunctions locally or in other parts of the body. The body attempts to adapt to dysfunctions and continues to compensate until it no longer can do so. At that point, the body will break down resulting in disease/dysfunction in parts or the whole body.

Disease – not at Ease

Disease happens in the body as it is not at ease! The body starts to break down which means different parts of the body are no longer functioning smoothly as a whole, or rhythmically working all together. Neuro communication starts to break down in the tissues, and the flow of fluids (blood, lymph and/or spinal fluids) can be disturbed or diminished (stagnation) in the dysfunctional areas. The lack of “normal” ease leads to abnormal stresses upon the body. These stresses (acute or chronic) often lead to disease in inherently weak areas in the body and it will help it to break down.

What is a definition of a TRAUMA in Osteopathy: A quick pull, compression or shear or a slow/chronic irritation on a blood and lymph vessel, or lymph node, nerve OR fascial tissue/line. (Patricia M. Kortekaas, PT, ANT-c)

Rule of the Artery

Andrew Still, DO was unique in his approach at looking at the body. When the blood and lymph supply flow freely and undisturbed, the tissues in the body are healthy and “at ease”. When there is a trauma to those structures, you get an alteration if the fluid dynamics and tissues start to break down. He realized right from the start that when the body was traumatized (acute or chronic), it will go in a “hierarchy of protection” mode to protect itself and has a chance to survive. The body will protect with muscle spasms around an injured blood or lymph vessels. Muscles need to be “movers” but become “protectors”. He called this the “Rule of the Artery” and that mend that the body will always “protect” around the highest denominator, the blood supply! No healthy blood flow, no healthy tissues!

So, what was his ORDER and What was so different from other medical modalities?

The body protects around the following order:

1. The blood supply, the lymph supply and unifying fascia
2. The nervous system
3. The organs
4. The endocrine system
5. The musculo-skeletal system (“muscles are movers or muscles are protectors”)

In that same order of hierarchy, you also need to address the right order of techniques for the different injuries. Osteopathic manipulation of the vascular, lymphatic and fascial dysfunctions will help restore the freedom in the injured tissues, “normalizes” and “restore” fluid flow, relaxes muscles spasms and enhanced inherent physiological functions.

Form directs Function and Functions directs Form is another unique principle of osteopathic thinking. The architecture (FORM) of the body is not an accidental design, but rather the body is constructed in a certain way because the anatomical structure fulfills a specific FUNCTION. When the normal form is altered, not “at ease”, by acute or chronic stresses on the body, the body’s function (health) will diminish over time, temporarily or permanently.

Example: If a patient visits our clinic with a knee injury, we will look at and treat the entire whole patient, not only the knee! Our body is made of much more than just joints and muscles alone. Our body, our cells are continually engaged in dynamic, rhythmic, pulsating motions inside our body. The circulation of blood, lymph, and cerebral spinal fluid, for example, vary if we are exercising or sitting still, or are healthy versus sick.

Our body doesn’t FUNCTION properly if blood and lymph are not flowing freely and undisturbed. When blood flow is restricted by trauma (physical or emotional), our tissue health diminishes because of lack of oxygen, ischemia, nutrients, and our physiological functions are compromised. Our tissues will twist, tighten, shear, gets inflamed and deform. Dysfunctions begin to develop, and the body starts to slowly decompensate and break down over time.

Diagnosis in Osteopathy

“An osteopath reasons from his knowledge of anatomy! He compares the work of the abnormal body with the normal body”.  (A.T. Still, DO Osteopathy Research and Practice)

If we analyze the word “diagnosis”, we see that “dia” means “through” and “gnosis” means “essential knowing”. In osteopathy, the art of differential diagnosis is both essential and not easy to do. For example, the movements of the lumbo-pelvis area during the gait cycle may seem complex and overwhelming, especially when we are observing an altered gait. So, practitioners use guidelines or rules to help organize the physical examination findings into a useable frame work for treatment, or an osteopathic diagnosis.

There are THREE questions to ask after physical examination is complete, and whose answers will help the practitioner in formulating a diagnosis and treatment plan.

WHERE is the problem? –  WHAT is the problem? –  HOW to resolve the problem?

This is the ART of osteopathy, to be able to master “differential “diagnosing” and work with the answers to these questions. It will help you locate the most restricted and dysfunctional area (“area of greatest restriction”) and determine what problems you have found, and what kind of technique(s) to use to resolve the abnormalities found in the tissues and what sequence to follow!