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Osteopath y

This document provides an overview of osteopathic techniques. It begins by outlining the basics of osteopathic practice including somatic dysfunction, treatment principles, and classification of techniques. It then describes various osteopathic techniques in detail, grouping them into rhythmic techniques involving kneading, stretching, articulation, and others. It also covers thrust techniques which apply force rapidly to manipulate joints. Thrust techniques are further divided into categories involving different amounts of leverage and momentum. The document provides examples and explanations of how each technique is performed and its intended physiological effects.

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Manuel Damil
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66 views26 pages

Osteopath y

This document provides an overview of osteopathic techniques. It begins by outlining the basics of osteopathic practice including somatic dysfunction, treatment principles, and classification of techniques. It then describes various osteopathic techniques in detail, grouping them into rhythmic techniques involving kneading, stretching, articulation, and others. It also covers thrust techniques which apply force rapidly to manipulate joints. Thrust techniques are further divided into categories involving different amounts of leverage and momentum. The document provides examples and explanations of how each technique is performed and its intended physiological effects.

Uploaded by

Manuel Damil
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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Osteopathy

The basics of practice


Joo Moita

The basics of practice


Somatic dysfunction
Treatment principles
Classification of osteopathic techniques

Treatment principles
Osteopathic technique Osteopathic treatment
There is no such thing as osteopathic technique since the repertoire can be endless

Nevertheless, techniques are classified and analyzed, by covering the basic


principles of technical approach for teaching purposes
Manipulative methods regardless of the discipline of the practitioner,
should be totally guided by the raw material that we work with: the human
body!

The technique relies on the method based on the Osteopathic diagnosis

Osteopathic diagnosis - the method of differentiation between a


mechanically well adapted human structure which is capable of
functioning normally in its environment , and a structure unable to
adapt itself to its environmental demands because of internal disease
or disorder, poorly body mechanics and/or misuse of the structure. It
will determine if the osteopathic treatment is considered appropriate.

Classification of osteopathic techniques (BSO system)


Organized into three main categories based on the application of
forces:
Rhythmic techniques
Thrust techniques
Low velocity stress techniques
Functional technique

Rhythmic Techniques
Can be classified as repetitive procedures where the control of the
rhythm plays the essential part
Forces are applied and released in graduated fashion

They fall into eight groups:


1. Kneading; 2. Stretching; 3. Articulation; 4. Rhythmic traction; 5. Springing; 6.
Inhibition; 7. Vibration; 8. Effleurage

1. Kneading
Slow rhythmical movement combined with pressure
Applied to: skin, fascia, muscle
Control variables: speed and pressure depth

Normal speed rhythm: 10 - 15 cycles per minute ( stimulatory effect,


up to 36 cycles/min)

1.1. Speed and pressure


Slow stroking with maintained touch: slowly adapting tactile receptors
and parasympathetic stimulation (general inhibition through skin

desensitization)
Firm deep pressure: activates tactile receptors and muscle proprioceptors
Enhance muscle response

Brief, light pressure: rapidly adapting tactile receptors and sympathetic

stimulation
Excitatory response on muscle contraction

2. Stretching
Slow rhythmic technique
Applied to: muscle attachments; fascia; ligaments; membrane
Control variable: amplitude, speed and time (intensity)
Short amplitude stretching (i.e. intra-articular of a spinal segment)
Longer amplitude stretching (i.e. extrinsic structures of the joint)

2.1. Prolonged stretch


Receptor: muscle spindle endings and golgi tendon organ
Stimulus: maintained stretch in a lengthened range

Response: dampens muscle contraction

2.2. Quick stretch


Receptor: muscle spindle endings, detecting length and velocity
changes.
Stimulus: quick stretch or tapping over muscle belly or tendon
Response: activates agonist to contract
Reciprocal innervation effect will inhibit the antagonist; activates synergists.
Response is temporary; can add resistance to augment response; not
appropriate to use in muscles where increased muscle tone limits function.

3. Articulation
Old osteopathic terminology for: repetitive passive joint motion
Control variable: range of motion (ROM)
End movement emphasis: enhances tissues reactivity as they are moved at
different rates

Best applied to joints with large ROM (i.e. shoulder; hip joint)

4. Rhythmic traction
Objective: to separate and release joint surfaces producing gentle stretch

of inter and peri-articular structures


Stimulates joint receptors

Control variable: speed


Handling: should be performed slowly and monitoring the tissues response

Often performed after thrust techniques and articulatory techniques


Takes advantage of synovial fluid change after the separation of the joint surfaces
(refractory period of relative hypermobility)

5. Springing
Repetitive pressure of graduated nature sometimes combined with
very short leverages
Control variable: speed and pressure

Handling: slow rhythmical pressure and release


Sometimes used as a diagnostic technique for assessing tenderness,

resistance and reactivity

6. Inhibition
Consists in applying pressure for a fairly long period, being slowly and
deeply brought into play and then slowly and gradually released.

Control variable: pressure depth


Handling: applied over small areas where the inhibitory effect is considered

necessary; can be combined with positional techniques


Is designed to produce relaxation, improvement in local circulation and
reduction in facilitation of afferent impulse response

7. Vibration
Rapid oscillatory pressure or movement
Applied superficially at a fairy fast rate

8. Effleurage
Borrowed from the massage
Drainage effect on the lymphatic channels
Promotes circulatory response

Thrust techniques
Rapid application of force
They are usually applied parallel or at right angles to the plane of the

articulation and in the direction against the barrier of joint fixation


Joint must be positioned in the most favourable position

Thrust techniques do not necessarily have to be carried out at the limit at


of a range of motion

Thrust techniques comprise five broad sub-divisions:

Thrust techniques sub-divisions


1. Combined leverage and thrust
2. Combined leverage and thrust using momentum
3. Minimal leverage

4. Non-leverage thrust
5. Non-leverage thrust using momentum

1. Combined leverage and thrust


Thrust applied at or near to the point of lesion
Static fulcrum created by pressure or fixation

a) Thrust at the lesion point (i.e. typical cervical thrust; sidebending


with reverse rotation)
b) Thrust at the extremity of the lever arm (i.e. supine mid-dorsal)

c) Combination thrust: lesion point and extremity of the lever arm

2. Combined leverage and thrust using momentum


Sub-division of the previous combined leverage and thrust
A build-up of momentum in the primary leverage direction is used
Particularly useful for heavily built patients and very rigid areas

It is a more dynamic technique but has the danger of losing control of


the amplitude and be potentially traumatic through overlocking

3. Minimal leverage
It uses the general principles of a combination of leverages and then a
thrust, but whereas in the standard method the leverage is

deliberately employed to supplement the thrust, in the minimal


leverage it is kept to an absolute minimum
Combined leverages are used only as a way of placing the segment in
an available position and in a maximum relaxation attitude
Contact point accessible for thrust
Neutral tension positioning

3.1. Minimal leverage


The accent is on the thrust
Very high velocity

Applied when torsion or other tension in the tissues is not possible


i.e. acute disc prolapse

Is the most delicate thrust technique and the and the most difficult to
master
Highly accurate tension sense needed

It has the benefits of far less trauma and after-treatment reaction


Separation of joint surfaces can be achieved with very small degrees of capsular
stretch and stress on the surrounding tissues

4. Non-leverage thrust
Directed to bony landmarks such as spinous process without the use
of a leverage
Preliminary pressure in a particular direction substitutes for a
leverage and minimises the eventual amplitude of the thrust
It uses compression for extending the length of the lever arm
It is performed with very high speed or very high force

Speed is preferable

5. Non-leverage thrust using momentum


The same as the previous technique whereas the momentum effect is
produced by applying and releasing the contact point pressure several
times until a state of relaxation is sensed

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