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’.
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