If someone who has never experienced an osteopathic treatment hears the word ‘osteopath’ the most common response I hear is ‘osteopath…oh thats something to do with the bones right?’. To be fair, ‘osteopathy’ probably isn’t the best word for describing what we do. While ‘osteo’ does mean bone, osteopathy is a lot more than that.
It originated in the late 1800’s with influence from traditional manual therapies involving ‘bone setting’ or manipulation of the joints. The pioneer of osteopathy – Dr Andrew Taylor Still, knew that what was happening under his hands was more than manipulating the bones. He had a great respect and knowledge of the other systems of the body, not just musculoskeletal, but of the arteries, the lymphatic system, the nervous system, the fascia and much more. He coined the term ‘osteopathy’ in 1874 and the name has stuck ever since. So, if osteopathy isn’t just about the bones, how does an osteopath treat you?
Fast forward 140 years to present day, techniques have been refined, developed and researched to give patients the best possible treatment. Osteopathy has adopted evidence based medicine but uses the principles taught from its origins to give a holistic approach to treating the patient. Not all treatments have conclusive evidence of efficacy yet that is changing over time. Where evidence is lacking, the osteopathic philosophy and principles focus on knowledge of anatomy, physiology, biomechanics and more, which helps guide the osteopath to form a treatment plan.
No two osteopaths will treat exactly the same, yet there will be some common techniques and approaches they may use. Dr Still rarely taught techniques to students of osteopathy, instead encouraging them to use their knowledge of anatomy, physiology and more anatomy to guide their treatments. Osteopathy is more than a bunch of techniques, but understanding some of these techniques will help you have an idea about how an osteopath may treat you, why they use them and how they can help. The different techniques used should complement each other and other approaches may be used at different treatment sessions.
High Velocity Thrusts (HVT/HVLA), joint manipulation
An HVT is a short quick manipulation that can be used in some cases to free up joints that may be causing pain and restriction. Although this technique can be applied to most joints, it’s most commonly used on the spine. It’s often associated with an audible ‘pop’ or ‘crack’ sound as the joint releases but this isn’t required for the technique to be successful.
Joint articulation or joint mobilisation aims to restore range and quality of movement in a joint by gently taking it through its full range of movement. Often applied in slow and rhythmical manner to allow the patient to relax the surrounding muscles.
Soft tissue techniques
This is very very broad heading as the majority of the techniques osteopaths use will have some effect on the soft tissues which include the muscles, fascia, tendons or ligaments. This may include specific massage, active and passive stretching techniques, to restore muscle function, length and strength.
This could be considered a soft tissue technique as every organ is surrounded by connective tissue, and the aim on a basic level is to work with this connective tissue to restore the mobility of the organ.
Our breathing muscle; the diaphragm, moves and massages our internal organs several thousand times a day. Poor posture or stress can affect the quality of this movement and restrictions may lead onto back pain or visceral conditions such as IBS among other symptoms. Visceral manipulation can also help reduce the effect of scar tissue after abdominal surgeries such as C-sections or appendix removals.
A very gentle approach that is safe to use in nearly all cases. How it works exactly and what cases it’s best for helping with will be debated and researched for many years.
How it is applied is generally with contact on the head, back, sacrum or sometimes other areas of the body with gentle movement or pressure, often not even felt by the patient. The aim is to restore the balance of the body’s rhythms, fluid dynamics or fascial system. Sometimes it takes a small change to make a big effect. Because of the very gentle nature of this technique it’s safe to use on babies, the elderly or those who prefer a more subtle treatment.
Exercise and lifestyle advice
An osteopath may identify weakened or shortened muscles during the assessment and treatment. Exercises and stretches are often given as part of the treatment plan to restore balance and strength. Lifestyle advice may include things such as assessing your workplace ergonomics to improve your posture, and sometimes nutritional or other advice may be given depending on the osteopaths areas of interest or expertise.
This article barely touches on the wide range of treatments that osteopaths can provide, but hopefully gives you an idea of some of the options available. Osteopathy is more than a bunch of techniques thrown together but the range of techniques we use allows us to help the patient with different options and approaches to suit their needs.