Motion: The Key to diagnosis and treatment
“We know life only by the motion of material bodies…The processes of life must be kept in motion.” ~ Dr. A. T. Still
Osteopathic Philosophy understands that the natural motion within the body's structure has a relationship to the body’s ability to function. Our main goal is to restore normal motion within the body, and therefore restore normal function. We recognize and work with several types of motion in the body, and have many ways of interfacing with tissues with our hands. Some of these forms of motion were discovered within the osteopathic profession.
For the body to function well, all the structures of the body must move “as Nature ordered.” In osteopathic medical school, we study medical anatomy and physiology in detail, along with many other topics, such as pathology, biochemistry, etc. In addition to the basics, we understand from a medical point of view how all the intricate parts of our bodies are constructed and work to do the job they are meant to do (function). We are trained to understand how each part of the body must move naturally in order to have ideal function. The interrelationships in the body (which are many!) all become a part of the incredibly intricate understanding of the life and ongoing connecting functions that go on inside our bodies. This includes relationships not only from head to toe, but inside out and between systems (e.g. nerve and artery interactions with organ functions, etc.). When we put our hands on patients, we develop a fine ability to feel these things, and, combined with our medical knowledge, learn to “sense” or “read” how your body is working, and where things may not be moving or working as well as they could.
Osteopathic Treatment restores motion, improves vitality, and brings about a higher state of function. Because the focus is on health and the individual, rather than only on the disease, patients with virtually any condition may benefit.
Dr. Still understood that the human body is composed of many parts, but they are intimately related as a functional whole, and that the body has self-regulatory and self-healing mechanisms that can be used to help people get well.
The many types of motion in the body include the obvious movements we can control (such as our muscles and bones moving in our necks, backs, arms and legs), some involuntary movements such as the heart beating, blood and lymphatic fluids moving and circulating, respiratory breathing (voluntary and involuntary) involving lungs moving air as they expand and contract with the diaphragm and ribs moving, and some more subtle internal movements that we may not be aware of, but which are nevertheless necessary for health to be maintained. Dr. Sutherland, an osteopathic physician, discovered a very important form of motion called primary respiration, which exists in every cell and tissue of the body, and is key to good function and health. See section on “Cranial Osteopathy” for more details on this. We are trained to feel and work with all these types of motion.
Osteopathy recognizes that good motion of all cells and tissues is necessary for good function.
There are many ways that Dr. Spector uses her hands to treat the body. Osteopathy includes various methods of interacting with the body tissues. Some methods are experienced by the patient as more “physical”, where body parts are actively moved, such as high velocity/low amplitude (commonly experienced as cracking or popping), muscle energy (a mild form of contraction and stretching) and visceral manipulation. Other methods are more subtle, where internal mechanisms are utilized and the outer body does not have to be moved very much, such as cranial osteopathy, biodynamics of cranial osteopathy, myofascial release and percussion machine treatment. All forms of osteopathic manipulative medicine apply the same principles and are focused on achieving the same results.
Dr. Spector always individualizes her osteopathic treatments by what each patient and their tissues need and may use a variety of osteopathic approaches. However, cranial osteopathy is a large focus of her treatments and these methods are particularly subtle and gentle, yet extremely effective.
Philosophical Foundations of Osteopathy
Although osteopathy employs the practice of manual medicine, it is not just a set of techniques. It is a philosophy and a science based on the application of sound principles. These principles, although initially conceived during the late nineteenth century by Dr. Andrew Taylor Still, the founder of osteopathy, have been consistently validated by scientific research (see http://cranialacademy.org/research/ ).
The philosophy and science of osteopathy is based upon the following four principles:
1. Structure and Function are interrelated.
From the smallest cell to the largest bone, all of anatomy is alive and in constant dynamic, rhythmic motion. Blood flows, lymphatics drain and cerebral spinal fluid fluctuates. The heart beats and the ribcage expands and contracts with each respiration. Each and every organ gently moves as it functions. Each and every structure has its own inherent rhythmic activity. This is the living anatomy that osteopathic physicians feel with their hands. When this motion becomes impaired, the tissues will not function as they were intended. As a result of this altered motion, symptoms develop, and disease may even occur. Dr. Still described this process in the following way, “Disease is the result of anatomical abnormalities followed by physiologic discord.”
For example, taking a deep breath may be difficult if the ribs, diaphragm or parts of the spine do not move well. When breathing is impaired, lymphatic drainage (necessary for clearing congestion and inflammation) will also be impaired. This may lead to the development of asthma or respiratory infections.
A dramatic example of how well osteopathic physicians understand the importance of the structure and function relationship is the influenza epidemic of 1917-1918. Approximately 30,000,000 people died worldwide. In the U.S., osteopathic physicians treated their patients with osteopathic manipulation and were quite successful in decreasing mortality from the disease. In fact, while hospitals run by MD’s reported a 30 to 40 percent mortality rate, osteopathic hospitals reported a mortality rate of less than one percent.
2. The Body is a Single Dynamic Unit of Function
There are many unifying systems within the body. The circulatory system supplies blood to every tissue and organ. The nervous system connects and integrates all of the body’s functions. A third unifying system is comprised of a connective tissue matrix called fascia. The fascia is a continuous sheath of living tissue that connects the body front to back, head to toe. It surrounds every muscle, organ, nerve and blood vessel. A primary function of this fascial system is to support, lubricate and transport electrical signals and cells, including immune cells, to other parts of the body. Thus, the circulatory system, the nervous system and the fascia all help to organize the body into a unified continuous whole. No single part exists independent of the whole. When even a small part of the body does not function optimally, the entire person is affected.
Consider the circulatory system. Dr. Still stated, “The rule of artery and vein is universal in all living beings, and the osteopath must know that and abide by its rulings, or he will not succeed as a healer.” Dr. Still used these words to describe the essential need for optimal fluid exchange. When blood and other fluids flow freely, the tissues can perform their physiologic functions without interference. When injury or disease occurs, the result can be a twisting or compression of all tissues, including the circulatory system. The blood and fluid flow becomes obstructed and areas of the body may become under-nourished and vulnerable. This effect may be a significant factor in causing disease. It is similar to trying to water a garden with a kinked hose. The water will not flow properly and the garden will not receive its proper nutrition.
Understanding this concept of functional unity allows osteopathic physicians to diagnose and treat their patients as a functional whole. This explains why an osteopathic physician may treat an area that is fairly distant from the area of pain or injury.
3. The Body Possesses Self-Regulatory and Self-Healing Mechanisms
The human body is always working to maintain a state of balanced function. For example, blood pressure, blood sugar and the heart rate are actively kept within a normal range. When there is a laceration or tear in the tissues, a physician can assist by cleaning the wound and bringing the edges together, but healing occurs by the action of inherent forces and processes within the body.
Dr. Still stated, “All the remedies necessary to health exist in the human body.” He understood that within the tissues, there is an inherent wisdom, a wise all-knowing restorative force, an intelligence within every cell that keeps the body well. When a state of discord arises, this healing force acts to restore functional balance and harmony. Sometimes the body’s self-healing forces can be impaired or impeded by disease or structural imbalance. The osteopathic physician is trained to augment these intrinsic mechanisms to help the body to better and more quickly heal itself.
4. Rational Treatment is Based on Applying These Principles
Osteopathic treatment applies these principles with a sound and thorough knowledge of anatomy and physiology. An osteopathic medical approach to treatment typically integrates osteopathic manipulation to restore structural freedom in the tissues, enhance fluid flow throughout the body, and creates the optimal setting for healing to occur.