Manual therapy, osteopathy - Causes, symptoms and treatment. MF.
Osteopathy ( from Greek οστεον - "bone" and πάθεια( πάθος) - "disease, disease") is one of the methods of alternative nonmedicamental medicine, which consists in manually influencing the anatomical structures of the body in order to release them from functional blocks and restore circulationfluids to create the optimal motor state of a person leading to an improvement in the quality of his life.
Sections of Osteopathy
Visceral Osteopathy: It deals with the treatment of mechanical disorders in the internal organs of the abdomen, pelvis, chest.
Craniosacral Therapy: A part of the practice of osteopaths concerning the dysfunction of the bones of the brain and facial skull.
Craniosacral therapy is a complex of theories and techniques originally developed by W. Sutherland. It is based on the assertion that the bones of the skull perform microscopic movements occurring in a certain rhythm. It is stated that cranial osteopathy is based on the "primary respiratory mechanism" - the pulsation rate of the cerebrospinal fluid, which can be determined only with the specially developed palpation sensitivity of the physician. Some osteopaths believe that correcting the dysfunction of cranial rhythm impulses by applying the hands to the bones of the skull increases the current of the cerebrospinal fluid to the peripheral nerves, thereby improving metabolic processes. This technique is also proposed for use in the treatment of infants and children.
The "primary respiratory mechanism" is not mentioned in the classical medical literature, and at least one scientific study has not confirmed the possibility of a consistent assessment of this rhythm by different osteopaths. Although there are studies carried out with the help of hardware, confirming the existence of such a rhythm, the possibility of determining and measuring such a rhythm by hands is doubtful, in addition, any connection between the rhythm and health or the degree of the disease is disputed. An extensive systematic analysis of scientific articles conducted by the Office of Health Technology Assessment at the State University of British Columbia, Canada, concluded: "There is evidence of the existence of craniosacral rhythm, pulsations, or" primary breathing, "independent of other measured rhythmsbody, "but it also states that" these and other studies do not provide any scientific evidence that such a craniosacral "rhythm" can be reliably determined by a physician [hands], "and that "The impact of craniosacral rhythm on the health or progress of diseases is absolutely unknown"
Structural Osteopathy: Part of the practice of osteopaths regarding the treatment of bone and joint disorders - this part looks like treatment from manual therapists.
Features and advantages of osteopathy
- Reliable diagnostics
Osteopathy finds and treats the cause of the disease, which may not be where it hurts. - Safe and painless treatment
Osteopathy is safe, as an osteopathic doctor uses techniques that exclude coarse effects, remaining only within the physiological barriers of tissues. - Treatment without surgery
Osteopathy is an alternative to surgery for diseases of the spine, flat feet, cholecystitis, nephrolithiasis, varicose veins, etc. - Substitution or reduction of medication use
Osteopathy is an alternative to hormone therapy for endocrine diseases, antibiotic therapy for respiratory diseases andwith prolonged gynecological inflammatory diseases. - Short-term treatment
The course of treatment in osteopathy is from 4 to 8 sessions with a frequency of one session per week( or two weeks).
Preparation for the first osteopathic session.
First of all, it should be clarified that it is desirable to come to the primary consultation with all the data of previous studies available to you - X-ray images, ultrasound, computer and magnetic resonance imaging, general, biochemical analyzes of blood, urine, etc. By combining information from these sources withinformation from osteopathic manual tests, examination and palpation data, an osteopath will be able to place an expanded clinical( classical neurological) and osteopathic diagnosis,tion. Of course, osteopathic diagnostics is self-sufficient and does not require mandatory instrumental confirmation, but the presence of an additional source of data objectively coinciding with the data obtained by hands, favorably affects the confidence of the osteopath and his patient in the accuracy of the diagnosis. In addition, the presence of changes in the composition of the blood, ultrasound or X-ray images allows them to make a starting point for the subsequent monitoring of the course of osteopathic treatment.
Given that it is advisable to take off your outer clothing at the first session( the osteopathic physician should conduct an examination, analyze the symmetry of the body, change the shape, contours, color, and perform certain manual tests with muscle and fascia tension), wear comfortable underwear orfor women) outdoor swimsuit. The need to examine the entire body, even if you have only local complaints( for example, pain in the head or neck area) is due to the fact that the leading osteopathic damage( root, primary, causal dysfunction) can be at a considerable distance from your discomfort. Thus, skewed pelvic area will affect the position of the skull and cervical vertebrae, and the scar remaining after removal of the appendix may contribute to the displacement of the hip joint and, as a consequence, pain in the right knee.
The beginning of the first osteopathic reception is first of all a conversation. The osteopath discusses in detail with the patient what is bothering him at the moment, how it manifests in the body, when it emerged, how it went on, how often it became aggravated, what treatment was being taken. Do not need to respond with diagnoses. For example, the diagnosis - osteochondrosis of the lumbar spine - will not tell the doctor anything, except, perhaps, the indication of a zone of localization of anxiety in the region of the lower back. It is much more important for him to hear that you are "hurting in the sacrum, more to the right( you can just show by hand), the pain is periodic, occurs after a long sitting behind the wheel, sometimes gives in the right foot on the back surface to the knee, can be accompanied by a feeling of slight numbness inright foot, first appeared 5 years ago after lifting a heavy closet( did repairs), is difficult to treat with analgesics( what) and massage, decreases in a certain position( show in which). "
Such a response brings with it a lot of useful information and already allows the osteopath to assume the presence of certain local changes in the area of ligaments, joints, the disc of the fifth lumbar vertebra, sacrum, pelvic bones. Additional information about the diseases that have been transferred and surgical interventions will also be useful. If the occurrence of complaints was preceded or accompanied by psychoemotional injuries( stresses, severe events in personal life) - it is desirable to touch them and to determine the role of the psychoemotional component in muscle tension, fascia.
The next stage is an inspection.
There are many different testing techniques in osteopathic diagnostics.
These are active tests when an osteopath asks the patient to bend over in different directions, bend, unbend, curl, evaluate with the hands or visually the mobility of the spine, bones, muscle tension.
Passive tests - when the osteopath itself conducts movements in the joints of the patient with complete relaxation and unattachedness, assessing their volume, elasticity, plasticity, etc.
Axial stress tests - when the doctor puts his hand on the patient's head with a slight force on the central axis of the spine, assessing the stability of the bodily system to the external load, its balance, the possibilities for compensation, weaknesses. Sometimes an osteopath asks the patient to inhale or exhale during the test, sometimes - performs an examination in a prone position or with a load along the axis of the legs.
Tensile tests - when an osteopath, in the patient's lying position, draws lightly over the head or legs( sometimes hands) to determine the level of elasticity of the spine, joints, muscles, fascia, to isolate the area of maximal tissue tension-spasm-the probable site of an important osteopathic lesion.
One of the most important options - testing is indirect testing of fascial tensions-spasms( twists) and testing of cranio-sacral rhythm.
An experienced osteopath with good sensitivity can do without amplitude passive and active tests in diagnostics, but it can never do without the test of "fascial tension" and "cranio-sacral rhythm".
What are these tests, how are they conducted?
With regard to the fascial tension test, an osteopath puts its hands on the body in certain diagnostic sites with the selected diagnostic algorithm. He can start with the head, move to the neck, then into the chest, diaphragm, stomach, pelvis, legs, and maybe go up from the legs to the head area. Applying hands, an osteopath, controlling the force of depression, plunges into various levels of body tissues. At first, the skin is passed( as much as possible), then subcutaneous fat, superficial fascia, muscles, deep fascia, periosteum and even bone. Separately, you can create a pressure level to determine the state of deeply lying vessels or nerve trunks. It is not mysticism, it is simply due to different pressures that we exert influence on this or that layer of the body, inducing it to release from this external load. If the tissues are in a healthy state, and the tension inside them( contraction, spasm) is absent - in response to the pressure of the osteopath's hand they will simply move apart and, reaching the elastic limit, gently push out the hand. If somewhere in a number of lying structures there is a defeat, if there is a displacement of the organ, bone or inflammatory focus, fibrosis, the surrounding tissues will aspire to this site, as if to twist on the sheet. Depending on the depth of damage or the nature of the affected tissue( nerve, vessel, bone) - the hand of the osteopath will feel different tensions towards the pathological focus, with different levels of pressure on the body. If from different parts of the body the direction of thrust goes to the same area - that is the main cause of the disease. Such osteopathic diagnostics requires the osteopath a lot of experience and high sensitivity, but it is one of the most reliable sources of information about primary lesions.
Another informative and complex method of diagnosis is the determination of the craniosacral rhythm on the skull and various parts of the body.
Craniosacral rhythm is a phenomenon known to osteopathic science from the 40s of the twentieth century, when the pupil of the founder of osteopathy Andrew Still, Dr. William Sutherland, proved that the seams of the skull in adults are not completely infested, and the skull bones retain micro-mobility throughout the life of a person. Together with this, Sutherland discovered that in the ventricles of the brain with a certain rhythmicity, the intracerebral fluid( liquor) is ejected and absorbed. With each outflow of CSF, the skull is expanded, and the vibrational wave is consistently distributed throughout the body. In this process, not only the dorsal, brain and nerve shells are involved, but also the intercellular fluid. That is why the craniosacral rhythm in the form of a small swing can be recorded from any part of the body. Normally, in response to the discharge of the cerebrospinal fluid and the expansion of the skull, the fascia of the body also unfolds. When absorbing liquor - are compressed. If there is an osteopathic lesion, bone bias or spasm of any tissue in this area, the craniosacral rhythm will be recorded distorted. Its amplitude, the deployment vector, is changing. It is these data that allow an osteopath to suggest the location of a functioning disorder significant for the body. As for the objectivization of such a diagnosis, over the past twenty years, many experiments have been carried out by the official medical science, proving the existence of a craniosacral rhythm. The audio sensors that fixed the pulse wave of the rhythm, and the pressure-stretch sensors gave the same information as the hands of the osteopath. That is why this method of diagnostics is reliable and accurate, despite its non-dramatic nature for an outside observer. In the course of time, when going through osteopathic treatment, many patients learn to determine the craniospheric rhythm on their own and can discuss with the doctor the changes that occur during the session.
After conducting tests and determining the most significant, key areas that require correction, the doctor proceeds to osteopathic treatment.
Osteopathic treatment
As a rule, treatment starts from the position of the patient sitting or lying on the back.
The number of osteopathic techniques is huge, so different sessions for different patients and for different osteopaths can be quite different.
The choice of an osteopath is influenced by:
a) features of the lesion focus, features of the body tissues in the lesion focus( some dysfunctions and dislocations require cautious, slow action, others - rhythmic techniques, in some cases, rapid manipulation or indirect effects through the muscles)B) the presence or absence of concomitant compensatory lesions, injuries, diseases( the presence of injuries, surgical scars and adhesions requires mandatory consideration of their location and additionalc) the age of the patient( small children and elderly patients require special softness of treatment)
d) individual features of the body, the lifestyle of the patient, his preferences( athletes sometimes require more intense exposure, young women - balancing and tactile soft tissue treatment)
e) personal preferences of the osteopath( some osteopaths are oriented mainly to work with the skull and nervous system, others - on the musculo-ligamentous tendon-bone apparatus, the third - on fasciaFourth - on biodynamic techniques, the fifth - on the psycho-somatic component - this does not mean that they will not use other techniques if necessary, however, most of the techniques will carry the imprint of the "favorite" direction).
Uses mainly soft-tissue, fascial,articulatory and biodynamic correction techniques. This means that, by treating, your osteopathic physician will lay hands on various parts of the body, seek relaxation of the underlying tissues, and softly pushes the bones, organs and joints to the physiological "lawful" place. Sometimes the effects will be deeper and more dynamic, with a clear sense of "veins" of muscle tension, but always soft, pleasant, painless. The purpose of fascial methods of osteopathic treatment is to determine the direction of the spasm and by special manual techniques to remove this spasm, returning the tissues, joints, organs to normal position and mobility.
As a medical phenomenon that marks the withdrawal of spasm and the normalization of blood flow, the patient can feel at the hands of the doctor - raspiranie, allocation of strong heat( improvement of blood flow!), Pulsation, softening, "spreading" of muscles, increased local sensitivity, light skin reddening. Also, the treatment will be accompanied by relief of movement in the joints, the disappearance of pain syndrome, severity, discomfort, a general state of tranquility, relaxation, comfort, mild drowsiness.
Conventional correction sites are joints of the spine, hip and shoulder joints, feet, pelvic bones, ribs, bones of the cerebral skull and face, abdominal and thoracic cavity.
If necessary, the osteopath can perform amplitude movements in the joints of the pelvis and spine, using the arms and legs as levers, may ask to strain certain muscles or hold your breath. Some osteopathic techniques will resemble massage movements, some will be accompanied by vibration or light shocks.
Periodically, the osteopath will stop and check the effectiveness of its manipulations, evaluate the symmetry, muscle tone, fascial thrust.
Having completed the necessary correction, the osteopath will leave you to lie down for 3-7 minutes in a relaxed state. This will allow the body systems to perform the necessary adjustment taking into account the treatment performed and can identify additional areas that need correction.
Having corrected the revealed violations, the osteopath waits a few more minutes and, upon receiving satisfactory information from the tests, begins to prepare the patient for recovery.
The fact is that after an osteopathic treatment all the muscles of the body are in deep relaxation, so in no case should you allow a sharp rise and couch. This can disrupt all the work done and even cause a traumatism.
Before you get up, you need to perform several cycles of deep slow breathing, while inhaling the plantar( fingers from oneself) flexing the feet, turning the arms outward( palms to the top) and slight axial extension, exhaling - rear( fingers to yourself) bendingstop, internal rotation of the hands( palms down) and slight compression of the body along the center line. This exercise helps to "wake up" to the muscular and nervous system, to balance the vegetative reactions. After breathing in and out, you need to bend your knees together and raise your arms, holding your elbows in the opposite hand with your hands. We begin to softly swing the arms and legs from side to side, making a twist on the diagonal. Legs go to the left, hands to the right and vice versa. The amplitude of the exercise is not very large, the purpose of the exercises is to restore the tone of the periarticular bags of the spine and large joints of the limbs.
After performing a diagonal spiral wiggle, the patient straightens his arms and legs along the body, turns over on his side and, helping himself with his hands as a "jack", slowly assumes the "sitting on the couch" position.1-2 minutes, you just need to sit, to return the tone to the vessels, redistribute the blood flow.
The patient rises, the osteopathic doctor conducts an evaluation axial test, gives recommendations for the next 2-3 days after the treatment, answers questions, and sets the time for the next visit.
The session is over.
Some recommendations:
After the session, do not rush to immediately get behind the wheel or in public transport. If you use a car - sit for 15 minutes at the wheel, before turning on the ignition, tune into the road. It is necessary to remove the residual influence of internal relaxation after the session, to concentrate. If you come by public transport - take a walk. Near the clinic "Our Doctor" is the park "Tsaritsyno".20-30 minutes in the open air, far from noise, in communicating with trees - will enhance the positive impact of osteopathy on the central nervous system, allow more efficient work out for self-regulation systems of the body.
During 2-3 days after the osteopathy session, it is undesirable to engage in pronounced physical activity( visit fitness clubs, swimming pools, gyms, repair, change the wheels of the car:) , clean up, work in the garden), try to avoid also expressed psychoemotional loads. This is necessary for the body to adjust to the inner ideal, and not under traumatic stresses. The session of osteopathy can be compared to a complete reassembly of your body. Pathological limitations and traction have been removed, but the brain has not yet learned to live in a new quality. You are trying to return to the previous stereotype of movement and in your body there is an invisible and almost imperceptible struggle between the old and the new. Sometimes this struggle can be expressed in the occurrence in different places of local discomfort, even soreness, which disappears for no apparent reason a few minutes after the appearance. These are signs of the self-correction system. If you load the body with exorbitant work from the outside, the result of treatment can not be achieved.
Also during 2-3 days should avoid massage sessions, other bodily-oriented therapeutic effects, taking new( not previously accepted) homeopathic medicines. The osteopathic method of treatment fully utilizes all the possibilities of the internal system of adaptation and when receiving additional impulses( even completely healing with separate application!), The body simply can not stand the dose. There will be a disruption of treatment processes and the effect can be lost.
Given the possibility of excretion of homotoxins from the body when removing local spasms in the bloodstream - after an osteopathic treatment session, it is necessary to increase the intake of clean drinking water( not coffee and tea!) To 1.5-2 liters per day for 1-2 days.
The next treatment session of osteopathy is usually administered in a week or( in acute cases) 3-4 days after the initial session.
In subsequent sessions, the osteopath will ask about progress. Note where the improvement occurred( pain decreased, there was more mobility, sleep improved, etc.).It is desirable to have a personal diary, reflecting the dynamics of health status by days. This will help to correct further treatment.