Hi, my name is Amanda…I’m an Electrician.- By Amanda Maier, RMT, Osteopathy (In Study)

Some of you looking into Osteopathic treatment are unsure of what it is or even how it really works…even people currently receiving regular Osteopathic treatment have trouble understanding what it’s all about…and I can honestly say, as an Osteopathic student currently in training, some days I can’t even explain it well to my patients.  I once had a teacher who got so tired of explaining her job to people that she just started telling everyone she was a plumber.  No one asks her about her work anymore.

 My definition of Osteopathy is continuously evolving as I delve further into my training and as new concepts are taught.  So it was pretty funny to find a group of fresh third year graduates standing around after the exam last week joking about how it still takes us an hour to explain what it is we do.  And there’s a reason Osteopathic students have trouble articulating our role in healthcare…here is how our founder, Dr. Andrew Taylor Still, defined Osteopathy:

‘That science which consists of such exact, exhaustive, and verifiable knowledge of the structure and function of the human mechanism, anatomical, physiological and psychological, including the chemistry and physics of its known elements, as has made discoverable certain organic laws and remedial resources, within the body itself, by which nature under the scientific treatment peculiar to osteopathic practice, apart from all ordinary methods of extraneous, artificial, or medicinal stimulation, and in harmonious accord with its own mechanical principles, molecular activities, and metabolic processes, may recover from displacements, disorganizations, derangements, and consequent disease, and regained its normal equilibrium of form and function in health and strength.‘         -AT Still

Sure, try breaking that down to someone in less then 5 minutes.  No pressure.

So it became my mission after three years of studying this unique form of health care that I might learn how to define it in layman’s terms so as to be able to define what I do to friends, family, patients, and other professionals.  There have been some light bulb moments in these past few years that have helped greatly in clarifying what Osteopathy is.

Amanda’s Unofficial Guide to Understanding Osteopathy:

#1 Treat the Patient, not the Diagnosis

So many times people come into our clinics with a laundry list of diagnoses and labels they have collected over the years from other health care professionals.  Instead of being John Doe who comes in with sciatic symptoms and headaches, you’ve become Mr. Hypertension-Diabetes-Hip Replacement.  You are no longer being treated as a unique individual but as a list of ‘issues’.  You will now be stuffed through the cookie-cutter mold that the last ten Hypertensive-Diabetes-Hip Replacement people have been.  When you don’t come out the other end ‘fixed’, your health care team will furrow their brows and scratch their heads.  Odd. 

Osteopathy is different.

A difficult concept to learn as an Osteopath is to break the lens we’ve previously been trained to look through (which seeks out labels and disease diagnosis in order to give us clues to a patient’s past and current health status), and to assess the patient as an individual.  It is easy to spot disease, or what we label as ‘unhealthy’.  It takes skill to seek out health and to emphasize its expression.  This concept did not come easily to me in my first few years of training…it just seemed to bounce off of me time and again, without sticking.  I intellectually knew what it meant, but it didn’t make sense until I had a light bulb moment while dealing with a patient’s forarm cyst.  I was seeing the actual cyst as the problem and treating it locally when what I needed to do was clear the pathway of nerves and blood vessels up the arm and into the neck to ensure proper drainage and blood supply of the arm itself.  The cyst was not the problem…it was the symptom.  Ho-ly paradigm shift Batman.  The concept stuck.

 In Osteopathy, we dig for the root cause of dis-ease, for what started this entire cascading process of health deterioration, which may or may not be found in close proximity to our patient’s symptoms. Although our patients might have existing diagnoses, we try not to confine them to the ‘box’ traditional medicine dictates they belong in.  We consider their unique situation with all of its implications, past and present.  We try to get a big picture look at how each person is living.   We believe that a problem anywhere equates to a problem everywhere.  We ask ourselves how each tissue is living, how it would like to be living, and what is keeping it from living well.  Dr. Still suggested that our title of D.O. really stands for ‘Dig On’.  Which leads me to my next point:

#2 Think Global

The foot bone’s connected to the...hip bone!...Wait…What??

Like with life in general, when we widen our perspective and expand our ways of thinking, we allow for many more possibilities to be considered.  We shed a little more light onto the situation so that we may better identify the underlying issue.  So when a patient walks (rather, limps) through the door complaining of knee pain, we must consider not only the knee and it’s surrounding tissues, but the neighboring ankle and hip, the pelvis, the spine, and the cranium.  In short, we must assess the entire body and all its systems.  No small feat. 

An Osteopath considers the relationship between everything in the body…is your knee going to be happy if the hip on the same side has been out of alignment for six months?  What about if you’ve had a bad ankle sprain?  Probably not.  The symptoms are rarely where the problem is and so the Osteopath goes gently digging and prodding into the rest of the body to get the full story.  Hips don’t lie.  Neither does the rest of the system…we are trained to recognize health as well as the absence of it.  Our orthopedic testing and palpation usually gives us the real scoop if we take the time to listen to what the tissues have to say.  So the next time your Osteopath is standing quite still with their hands on you for what seems like an eternity…give them some patience.  They’re having a conversation with you on a very deep level.

#3:  We make ‘Suggestions’ to the Body

I love this modality of healthcare because it so darn respectful of the patient.  Osteopathy is the Canadian in the room.  It has also been compared to a ‘dance’ between practitioner and patient.  It is a give and take relationship between the two, geared toward improving the health and vitality of the patient.

During treatment, when we come across tissue in distress, we quietly listen to what the body is asking for and simply (albeit, literally), provide a helping hand.  We very gently but very specifically offer and apply techniques that the body is asking for. The patient does the rest.  We work to give the patient favorable conditions under which to heal, and the patient does the rest of the work.  We believe in auto regulation of the body and we work to engage the self-healing mechanism we all inherently possess.  In bodywork, if you have to fight against the system to get a technique completed, it is likely going to be rejected and possibly further damage tissue.  In Osteopathy, there is much reverence and respect for the patient and we simply determine what will help and then in most cases, make suggestions to the system.  This is a smart way of treating, as the body will never accept therapy that would further harm it.  Safe for practitioner as well as patient!

Interesting Tidbit:

Dr. Still got into a bit of hot water with the law back in the day, as he was thought to be ‘emulating’ the one and only Jesus Christ due to the gentle manner of treatment he provided.  These days, science has provided a backbone to the art that is Osteopathic treatment and helped dispel the mysticism around it.

#4  Find it, Fix it, Leave it Alone

Osteopaths are always joking about how lazy they are.  They like to think that life should be lived in ease and that often times, less is more.  In regards, to the therapy they provide, they are usually right.  Osteopathy differs from other modalities in that we treat certain structures very specifically and then let the body rest so that it may integrate the new changes globally.  We need to give the patient time to get used to the new changes while giving their system a chance for everyone to get on the same page.  Like in weight training, the rest and recovery component of therapy is vital to a proper integration.   We often find on re-assessment that many secondary issues have taken care of themselves between the appointments.  Remove the cause and you remove the compensation!

There is so much more to say on the topic of Osteopathic treatment…this article doesn’t do it justice, but hopefully it has helped answer some questions about the more general points.  The Cape Bretoner in me was informally chatting with an Engineering friend this week on the topic.  I was attempting to concisely define what I do for a living  (engineers are thus far the only people I’ve found that naturally understand the concepts behind our work).  This is how I broke it down:

“Osteopathic treatment is all about figuring out if you have a problem with not having enough juice in the system, or if the system itself is all jammed up…You know when you get a fuse blowout in the house and bunch of stuff stops working?  Then you go down to the fuse box and try to figure out if it was an electrical issue or just a faulty fuse??  Well, that’s sort of what I do.  Except to the body’. 

Light bulb moment.

-Amanda Maier, RMT, Osteopath (In Study)

The Thoracic Diaphragm By Amanda Maier, RMT, (Osteopathy in study)

The thoracic diaphragm is a parachute-shaped muscle that divides the chest cavity from the abdominal cavity in our torso.  It attaches along the tip of the breastbone, lower ribs and low back vertebrae by several strong tendons.  The thoracic diaphragm is considered one of the most important muscles in the body because it is responsible for most of our breathing.  On inhalation the diaphragm contracts and lowers, giving our lungs room to inflate while on exhalation, the lungs deflate.  We do this roughly 20, 000 times per day. 

            Not only is the thoracic diaphragm responsible for keeping us alive by allowing us to breath but it also acts as a pressure regulator within the body and makes the body more adaptable to physical stressors.  Too much pressure built up in the body can contribute to muscle strain headaches, and even low back pain.

We have important blood vessels as well as our esophagus running through our diaphragm.  The muscles serves to protect and stabilize these tubes and makes sure blood can get into and out of the heart.  Not only does the diaphragm protect the esophagus and large blood vessels, but as we breathe, this constantly moving muscle acts to massage these structures which encourages better circulation and digestion.  The fibrous sac holding our heart is actually fused directly into the top of our diaphragm so our heart is massaged and moved each time we breathe as well!

Looking at our digestive system, the diaphragm is in direct contact with our liver and has an effect here as well.  Extra tension on the muscle can result in unwanted stress on some of our organs.  In addition, too much tension in this muscle can pull at its attachments, namely the breastbone, ribs and low back, and create tension and pain in these areas.  Proper movement of the ribs and spine can be compromised because of a diaphragm under too much tension.  Clinically speaking, we often find a thoracic diaphragm under tension when we see people suffering from low back pain or in those who have suffered a low back hernia (‘slipped disc’).

Similarly, we often treat people complaining of headaches with associated neck and shoulder pain.  Often times in these patients we find a diaphragm under tension that isn’t moving as well as it should be.  A free diaphragm will allow us to breathe properly.  When this muscle isn’t moving well, the small accessory muscles in the neck and shoulders have to work harder to elevate our ribs so our lungs can fill with air.  These muscles weren’t designed to do most of our breathing and soon we develop tension and knots in the neck and shoulders, leading to pain and headaches.  Related symptoms can even include numbness and altered sensation in the arms and fingers due to the tight neck muscles compressing important nerves.  If we don’t identify the root of the problem, we end up treating these painful muscles only to find the problem comes back.  In this case, treating the neck and shoulders is only addressing the symptom.  We need to properly assess and treat the thoracic diaphragm to have lasting results.

Although the body has several other diaphragms, the thoracic diaphragm is the most important one.  Without it we couldn’t survive.  It serves such an important function that when its health is compromised the whole body feels the effects!  It is important to consider its impact on the rest of our body and its systems and should be maintained to ensure our overall health.

Amanda Maier, RMT, DOMP (In Study)

It's the little things.....By Carl York, RMT (Osteopathy Thesis Writer)

Small changes lead to BIG improvement

It seems spare time is a rare commodity now a days.  If you are like me, you run the gauntlet between work, maintaining your home, the kids’ school, soccer practice, hockey practice… and on and on.  Then in the midst of this, terrible people like myself, have the nerve to ask you to find the “time” to look after your own health!

SO… I’ve decided to make this blog entry of about some simple recommendations that you can easily incorporate without eating up too much of that precious little free time that you have each day.  Most people want to do the right things to keep them healthy.  It just becomes difficult to KEEP doing these things!  The following are general recommendations that I suggest to patients all the time, regardless of their reasons for coming to see me. 

In osteopathy, we study that we are a functional unit.  Anything that you can do to help any part of you (or your life) will positively affect all other parts.  The French mathematician, physicist, and philosopher Blaise Pascal is quoted as saying “Little things console us because little things afflict us.”  Most people who I see in my practice have injuries/problems that are the result of little things accumulating over time, until their body can no longer accommodate.  We often begin treatment by addressing one area of tension, which affects another area of tension, which is related to another area of dysfunction… and so on.  Each bit of function we give the body back improves the overall function and lessens the burden of any remaining dysfunction.  Homecare is the same!  There is no perfect exercise for you if it is an exercise that you don’t do.  Initially, the best advise if you want to maximize the results of your treatments with us, or generally do something positive for your health/condition, is to incorporate one (or two) of the “little things below”.  Once that one thing becomes routine, try one more.

“The little things…”

1.      DRINK… and not caffeine or sugary drinks.  Water.  But be realistic.  If you currently drink zero glasses a day, don’t start by trying to drink 8.  Start by increasing your intake by an extra glass or two a day for a week or two.  This will allow your body to adapt to the fact that you are giving it more water.  For the first few days you will pee more.  Stay with it and once your body adapts, I promise the problem will disappear.

2.      SLEEP… we have no problem telling our kids that they have to get enough sleep while we stay up until midnight watching American Idol and The Biggest Loser!  If you are suffering from an inflammatory condition one of the most important things you can do is get enough sleep so that your body has time to heal.  Research indicates that people who get fewer than 6 hours per night of sleep have higher blood levels of inflammatory proteins.

3.      EXERCISE… I recently read a great line in a textbook written by Laurie Hartman, DO that I agree whole-heartedly with, and often share with my patients.  He says he “prefers exercise to exercises”.  I think this is great advise given that many people come to me every day looking for what “exercise” they should do or what “exercise” they should stop doing.  For the vast majority of people, particularly those with chronic insidious onset complaints, just getting out and adding some amount of mild to moderate activity in your day is far better than any one exercise or type of exercise alone.  Walking for example, is something almost everyone can safely incorporate into their daily routine regardless of your physical condition and receive health benefit from.  According to an article published in the Harvard Health News walking can strengthen bones, strengthen the cardiovascular system, and perhaps most importantly clear a cluttered mind.  Not to mention a little fresh air and shot of the sunshine vitamin.

4.      EAT… I mean eat differently, in most cases.  There few things that you can do to “shoot yourself in the foot” more when coming for treatment than continually eat foods that are perpetuating a cycle of inflammation in your body.  The food (and drink) you put into your body is all that your body has to fuel your activities for the day.  It is also all your body has to begin to rebuild and heal injured tissues.  A consultation with our Naturopathic Doctor, Dr. Colin Huska, ND, is a good way to find out if specific foods are creating a problem for you (or of course if there are certain foods that you should be eating but are not).  This is obviously more of an “involved” item than a simple change for you to implement.  However like everything else you can start simple like decreasing (or eliminating;)) the amount of refined or process foods you eat!

5.      BREATHE… Diaphragmatic breathing is a simple “exercise”, or routine you can practice before going to sleep every night.  Amanda Crewe, RMT has written a great article for this website (which will be published soon in this blog section) on the thoracic diaphragm.  But briefly, the diaphragm is our primary muscle used for breathing.  It is a muscle that when not working well recruits help from all the upper back, chest, and neck muscles that are so frequently areas of complaint for our patients, and when overused in breathing, lead to the prototypical shoulders in the ears posture so commonly seen.  Diaphragmatic breathing is something we are born doing naturally but un-learn later in life from slouched postures, abdominal inflammation and pressure imbalances, and stress.  Diaphragmatic breathing exercises can be Googled or one will be posted on this site in the near future.  Conceptually they are easy to do.  Practically they take some practice, so be patient.  Proper functioning of the diaphragm is related to normal muscle tone of the mid back, neck and shoulders, proper digestion, proper functioning of all abdominal organs, normal expansion of the chest and lungs, the relaxation of the nervous system, to mention just a few.  I have said many times that if I were only allowed to treat one anatomical structure, regardless of the complaint, I would undoubtedly choose the diaphragm.  

As the year goes on I will expand upon some of these thoughts, as well as add others, so please check back regularly.  I challenge you (especially if you are a current patient of mine) to try to incorporate one of the above simple changes.  I promise if you can pick something simple and do it until it becomes routine it will be of more benefit to you than any workout tape or fad diet you’ve resolved to try this year!

Carl.