Osteopathy

[Christopher M]

Does anyone have any experience with osteopathy? I mean specifically the 'manipulative' therapy stuff, and not just DOs practicing general medicine. I am wondering how it compares to physiotherapy, chiropractic, and things like rolfing, thai massage, etc.

Just looking for general insights here, anything would be appreciated. Thanks.

[stricker]

i saw one briefly cos the 1st session was free.

i wasnt convinced it did anything for me other than scare me ****less when they tried cracking different bits of my back, some of which just didnt want to know.

i then spent a couple of weeks doing more yoga/bodyflow/mobility work especially for my upper back and neck, got a foam roller and a tennis ball and when i went back there wasnt any more cracking to do...

ive since spoken to an ex-physio ex-osteopath who now does some more subtle work (cranial etc) for professional athletes, but i havent investiaged that yet.

i guess the thing to do is give it a go or two, i was told by other people that the first session is mainly diagnostic then the second they actually do something, so may be worth going a few times before deciding its useless hahaha

[cjurakpt]

Does anyone have any experience with osteopathy? I mean specifically the 'manipulative' therapy stuff, and not just DOs practicing general medicine. I am wondering how it compares to physiotherapy, chiropractic, and things like rolfing, thai massage, etc.

Just looking for general insights here, anything would be appreciated. Thanks.

My experience with ostepathy has fairly extensive, in a variety of contexts. To follow is my personal take on the issue, based on thies experience.

UNOFFICAL HISTORY / DESCRIPTION OF OSTEOPATHY
Osteopathy was first created by Andrew Taylor Still in the late 1800's. Still was the son of a Methodist preacher / faith healer and he had been a surgeon in the Union army during the Civil War (although his actual quallifications as an MD are not 100% clear) and his eventual contribution to the field of medicine combined both experiences. After he supposedly had a visionary experience that illuminated the practice in total to him, he described, practiced and taught a system of manual medicine that he felt was capable of better curing disease than the standard medicine of the time (which included things like opium and mercury (calomel) as part of theavailable remedies). it should be noted that he was not alone, as the times were rife with many types of healing approaches, including naturopathy, homeopathy, chiropractic (Palmer, the first chiropracter, a greengocer by trade, spent time studying with Still). Still's approach consisted of manipulatiion, as well as a lot of oscillatory technique used to "pump" the system (activating lymphatics), although the exact nature of what he did is still somewhatr of a mystery (Still never let his students take notes and he was somewhat inclined to hold back the "good stuff" from most of them - not unlike TCMA!).

Over the next few decades, ostepathy became extremely popular (due to a combination of Still's charismatic nature, as well as the reportedly good results that his approach yielded). Dozen's of schools sprang up around the country, and osteopathy began to become a serious "threat" to the medical establishment. In all likelyhood, it would have continued to grow, except for the continued advancement of allopathic medicine, especially the discovery of things like penicillan. This was a serious blow to the need for osteopathic treament, since, whereas before if someone had an infection, ostepathic treament was better than allopathic (three days of constant lymphatic pumping, probably in combination with natural remedies, was more likely to "push out" an infection than the medicines previously available), once antibiotics were available, they were obviously much more clnically advantageous.

Therefore, well into the middle of the 20th century, osteopathy underwent a transformation. Because they were so numerous, they couldn't be eliminated, so they were "absorbed" into the allopathic model, eventually given the same legal status as MD's, which meant they could practice medicine without restriction, including prescribing medications and performing surgery (actually, surgery was also originally part of Still's original curriculum, which he advocated in the event that manual treatment wasn't sufficient). Because of this "legitimizing", many osteopaths foresook their roots, and became essentially allopathic in their approach, a trend which survives to this day: the vast majority of DO's are no different than MD's (although more and more DO's are going back to their roots, due largely to the interst in "aternative" medicine currently occurring, bolstered by osteopathic manual medicine's ability to effectively address a large number of the chronic issues that allopathic approach is unable to ameliorate). Currently, Osteopathic medical education consists mostly of standard medical practice, with the exception that during the first 2 years, students are taught the basics of manual medicine, including thrust, muscle energy (basically highly specific contract/relax technique), counterstrain (positional relaxation technique) and cranial technique (a more gentle approach, that is based on working with various rhythms and fluids in the body to effect healing) this last technique is a relatively controversial topic, even within the profession, and is not taught at some schools as part of the standard curriculum - in fact, many DO's have publically published opinions against cranial, stating that based on available evidence it has no place as part of a medical curriculum (by contrast, the Cranial Academy - the official teaching arm of cranial osteopathy - unequivocally states that it should only be practiced by physicians, and will only teach the approach to DO's, MD's, and dentists). If a DO wants to specialize in manual medicine, they can do a one year fellowship after med school to become certified specifically in OMM. Also, currently the focus of most manual osteopathic treatment is now limited to musculoskeletal issues, as opposed to addressing organic / visceral disease. There are, of course, some who focus more on the more esoteric types of stuff, like Biodynamic Cranial approach (Jim Jealous, DO), or more energetic like Robert Fulford, DO and Rollin Becker, DO (both decesased, their students carry on the work they articulated).

Keep in mind that this is the case in the US - in Europe, the picture is quite different: in Europe, mostly Britain and France (also in Belgium, Switzerland, Germany, Spain and others), osteopathy has more or less stayed true to its roots - it continued to develop as a system of manual medicine, and has remained separate from the practice of allopathic medicine. As such, it is both theoretically and application-wise more developed and well-thought out than its US counterpart. For example, the British approach to structural manipulation is much more specific and detailed than the US thrust technique; the French have developed the art of misceral osteopathy to a very high level, with techniques specific to each organ, which is something that in the US is not really done at all; of course, by now many manually oriented DO's in the US have had exposure to European approach and have integrated it to varying degrees into their own practice.

In the US, osteopathic manual medicine (OMM) is also done by many PT's - training is available to PT's through Michigan State's osteopathic program (http://www.com.msu.edu/cme/general.html) and includes all areas of OMM; the Jones Institute teaches Counterstrain (http://www.jiscs.com/Article.aspx?a=0) to PT's; the Canadian College of Osteopathy (http://www.osteopathiecollege.com/) is based in Toronto, Montreal and Vancouver and teaches a 5-year, part-time French-based program for PT's (and other licensed professions); the Upledger Institute is the main source for Craniasacral Therapy, an offshoot of classical Cranial Osteopathy (http://www.upledger.com/home.htm), and is taught to anyone who basically shows up for a class (he is considered as persona non gratia by the Cranial Academy (http://www.cranialacademy.org/), the official arm of cranial osteopathic teachings in the US, but it is because of him that most people have had exposure to cranial approach).

As for Rolfing: Ida Rolf was a PhD biochemist who articulated a system of deep tissue massage / fascial relase that is very similar to some osteopathic treament, largely because she spent a lot of time hanging out with osteopaths down in Kirksville, TN (in fact, she was one of the few non-physicians allowed into the classes). Formally known as Structural Integration, "Rolfers' are usually massage therapists who undergo intensive training in the approach (about 3 years, I think) and are certified by the SI organization based in, I think , Colorado. One thing, many people describe Rolfing as intensely painful and rough. From what I understand having read much of Rolf's work, and spoken to several high-level practitioners, this is not the case, if it is done correctly...

Like anything, osteopathy is as effective as it is taught and practiced: some DO's in the US are amazing, some are less than useful; same with those in UK and France, although the training in general is more comprehensive (average US DO gets about 750 hrs. of OMM, whereas in France it can be up to 3,000); in my personal experience, I've had trreatments that were awesome and ones that were just outrightly bad; in practice, I've used Counterstrain, muscle energy and thrust techniques to great effect, but sometimes cranial has been the modality that got someone over the hump (despite the lack of definitive evidence as to its basic mechanisms and clinical efficacy); overall, I have found it to be a great help, and is the primary approach that I use manually.

If you have any more questions, a good resource is this forum, run by Steve Sanet, DO - http://www.ohwi.org/cgi-bin/ultimatebb.cgi - if you have any questions, or are looking for a practitioner, it can be a helpful resource

[Christopher M]

This is good info. Thanks!