Osteopathic Manipulation, OM®
Red flags and counterfeit clinical presentations
Structure and function
Neural transmission and positional movement issues
The cervical spine
Vertebrobasilar Insufficiency (VBI)
The Upper Limb
A different approach to impingement
Optimising neural outcome
Lumbar spine and pelvis
Spinal and pelvic mechanics
Assessment considerations for the pelvis
Sacroiliac Joint (SIJ) Tests
Iliosacral vs sacroilial lesions
The Lower Limb
Patellofemoral Joint pain
Flexion Distraction Therapy
Dr William Garner Sutherland, D.O. (1873–1954) was an American
Osteopathic physician and important figure in Osteopathy.
Dr Sutherland was the first Osteopathic physician to conceptualize
the Cranial Approach and teach it systematically.
Dr Sutherland acknowledged that Dr Andrew Taylor Still, DO was the
developer of all Osteopathy, including the Cranial Approach.
The Cranial Approach can be seen performed extensively in the illustrations of the
Book “Osteopathy Illustrated” published in 1899 by Dr. Andrew
P. Davis, MD, DO, DC, who was a student of Dr. Still in his
first Course of Osteopathy in 1892.
Dr Sutherland was the first person to claim to feel a rhythmic shape
change in the bones of the cranium. He later applied this movement
to all body tissues and this movement is the agent of change in
dysfunctional tissues. He later named this motion the body's
Manipulation, OM® Course
Osteopathic Manipulation, OM®
Dates: September / October
- South America: Belo Horizonte, Recife Brazil & Concepcion,
- Caribbean: Punta Cana, Dominican Republic
Dates: January / February
Course Fees: £3,000
Scientific Study Hours:
3. Clinical Training Hours:
150 Lessons (à 45 min.) during 20 days
The course runs 5 days with 1 day off, for each 5 days
Training, 1 Day Off
5 Days Training, 1 Day Off
5 Days Training, 1 Day Off
5 Days Training, End of Course
The manipulation of the various parts of the body of the person who
is afflicted with pain or disease, so as to liberate any and all
undue press-ure, such as over-contracture of muscles, pressure on a
nerve or blood-vessel which, interfering with the normal
Glossary Terminology definition: impaired or altered function of
related components of the somatic (body framework) system: skeletal,
arthroidal and myofascial structures and related vascular, lymphatic
The positional and
motion aspects of somatic dysfunction are best described using at
least one of three parameters:
1. The position of a
body part as determined by palpation and reference to its adjacent
2. The direction in which motion is freer, and
3. The direction in which motion is restricted.
The diagnosis of somatic dysfunction is made by determining the
presence of one or more findings, known as T.A.R.T. (Tenderness,
Asymmetry, Restriction of Motion and Tissue Abnormality).
Osteopathic manipulative treatment includes thrust (active
correction), muscle energy, high velocity-low amplitude,
articulation, counterstrain, myofascial release,
and visceral and craniosacral techniques.
The chosen treatment
will vary depending on patient’s age and clinical condition. Somatic
dysfunction in one region can create compensatory somatic
dysfunction in other regions. Osteopathic manipulative treatment can
also be used to treat the somatic component of visceral disease and
any organ system.
This component can
manifest as changes in the skeletal, arthrodial and myofascial
tissues. Normalizing musculoskeletal activity (relaxing tense
muscles, etc.) can normalize outflows through sympathetic or
parasympathetic autonomic nervous systems to visceral systems,
resulting in more normal visceral and any organ system function.
Osteopathic Manipulation Treatment when necessary is performed by a
qualified professional, in patients whose
history and physical examination indicate the presence of somatic
dysfunction of one or more regions.
Acute Somatic Dysfunction: Immediate or short-term impairment
or altered function of related components of the somatic (body
framework) system. Characterized in early stages by vasodilation,
edema, tenderness, pain, and tissue contraction. Diagnosed by
history and palpatory assessment of tenderness, asymmetry of motion
and relative position,
restriction of motion and tissue texture change.
Chronic Somatic Dysfunction: Impairment or altered function
of related components of the somatic (body framework) system. It is
characterized by tenderness, itching, fibro
sis, paresthesias and tissue contraction.
Dysfunctional segmental behaviour where a single vertebra and an
adjacent rib respond to the same regional motion tests with
identical asymmetric behaviours (rather than opposing behaviours).
This suggests visceral reflex inputs.
somatic dysfunction that maintains a total pattern of dysfunction.
The initial or first somatic dysfunction to appear temporally.
Somatic dysfunction arising either from mechanical or
neurophysiologic response subsequent to or as a consequence of other
Somatic Dysfunction: Impaired or altered function of related
components of the somatic (body framework) system: skeletal,
arthrodial and myofascial structures, and their related vascular,
lymphatic, and neural elements. Somatic dysfunction is treatable
using osteopathic manipulative treatment. The positional and motion
aspects of somatic dysfunction are best described using at least one
of three parameters:
1). The position of a body part as determined by palpation and
referenced to its adjacent defined structure,
2). The directions in which motion is freer, and
3). The directions in which motion is restricted.
Somatogenic: That which is produced by activity, reaction and
change originating in the musculoskeletal system.
Type I Somatic Dysfunction: A group curve of thoracic and/or
lumbar vertebrae in which the freedoms of motion are in neutral with
side bending and rotation in opposite directions with maximum
rotation at the apex (rotation occurs toward the convexity of the
Type II Somatic Dysfunction: Thoracic or lumbar somatic
dysfunction of a single vertebral unit in which the vertebra is
significantly flexed or extended with side bending and rotation in
the same direction (rotation occurs into the concavity of the
Various forms of manipulative therapy — including massage, spinal
adjustments and many others — have been practiced all over the world
for over millenia. Certain historical references point to the fact
that manipulative therapies aimed at correcting musculoskeletal and
spinal abnormalities were used in Europe as far back as the year 400
According to a publication in the Journal of Manual and Manipulative
Therapy, Hippocrates himself described his own spinal manipulative
techniques for treating conditions, including scoliosis, naturally.
of Manipulative Therapy) (The
Female Bone Setter) (Anglesey
Hippocrates believed that the use of gravity — along with basic
tools and equipment like straps, wheels, ladders and axles — could
be used to impart enough pressure on the skeletal system to help
realign body parts contributing to dysfunction. Hippocrates and
other physicians who followed in his footsteps also recommended
practicing exercises after adjustment, along with building strength
in weak areas, standing and walking more.
Even today many modern massage techniques (such as Swedish, deep
tissue or Thai massage) and spinal manipulation manoeuvres draw on
knowledge and traditions dating back centuries. Manipulative healers
from countries such as Greece, Japan, China, Thailand, India and
others have contributed a large body of research and expertise to
the entire field of Osteopathic Manipulation.
The Founder Of
Dr Andrew Taylor
Still, D.O. - Was the son of a Methodist Pastor and
country physician, Andrew become exposed to; diseases such as cholera, smallpox, and meningitis that
often wiped out entire families.
At an early age Still became
aware of the lack of knowledge of the cause and treatment of
these devastating diseases. He recognized the tragic toll of
such ignorance, and decided there must be a better way.
Still had long been aware of the appalling degree of medical
ignorance which existed at that time, it was a tragedy in his
own life that propelled him toward a search for answers and the
development of osteopathic medicine.
In 1874 Missouri was ravaged by an epidemic, one now identified
as viral meningitis. Dr. Still lost three children that spring.
Although a physician he had no way to cure them - no way to help
them. Still's loss sent him on a personal and professional
search for the truth.
He was driven to understand why some
people became sick, and others remained healthy.
The doctor grew
to reject the prevailing medical practices of frequent
amputation and the overuse of drugs. He called his new system of
medicine "osteopathy" (osteon is Greek for bone), because it was
based on anatomy. Still developed his methods of diagnosis and
treatment by relying on the belief that the human being should
be treated as a unit.
A person cannot get sick in one area of his body without having
other areas affected. All body systems operate in unison.
Through experimentation and clinical observation, Still
developed the art of osteopathic treatment, applied directly to
the musculoskeletal system. In addition, he eliminated many
toxic drugs from his practice.
Dr. Still was eager to present
his new ideas and methods of treatment to the medical community.
He selected Baker University in Baldwin, Kansas as the place for
his presentation, a school Still and his family had helped
found. The University refused him.
Turned down by his peers, but determined he was right, Dr. Still
settled in Kirksville, Missouri and began practicing the
osteopathic medicine he had developed. His reputation spread,
and soon people from all over the United States were travelling
to Kirksville for his treatments. As his fame increased, so did
the attacks by his former medical colleagues.
Still was called a "crank," "faker," and a man who had lost all
reason. He was scorned by most, but not all. An increasing
number of doctors were drawn to Still and his methods.
the first formal classes in the teaching of osteopathic medicine
met in Kirksville, later to become the American School of
Osteopathy. A.T. Still 1828-1917
The Foresight and Vision of Dr Andrew Taylor
Was the first to
identify the human immune system and develop a system for
stimulating it naturally.
Was the first to welcome women and minorities into medical
Predicted that western type of medicine would have a major drug
addiction problem within the century if physicians did not stop
over-prescribing addictive drugs.
Warned that women were far too often the victims of needless
Believed that physicians should study prevention as well as
Believed that disease in one body part affects all other parts.
Essential competencies for
Osteopathic Manipulation Practice
Strong foundation in
the study of Osteopathic Manipulation its History, Philosophy and Approach
an understanding of the basic
sciences within the context of the philosophy of Osteopathy
and the five models of structure-function.
Including the role of vascular, neurological, lymphatic and
biomechanical factors in the maintenance of normal and adaptive
biochemical, cellular and gross anatomical functions in states
of health and disease;
ability to form an appropriate
differential diagnosis and treatment plan;
an understanding of the
mechanisms of action of manual therapeutic interventions and
the biochemical, cellular and gross anatomical response to
ability to appraise any deemed
valid scientific literature (taking care to discard nonsense and
garbage litterature) critically and incorporate
relevant information into clinical practice;
competency in the palpatory
and clinical skills necessary to diagnose dysfunction in the
aforementioned systems and tissues of the body, with an
emphasis on osteopathic diagnosis;
competency in a broad range of
skills of Osteopathic Manipulation;
an understanding of the
biomechanics of the human body including, but not limited
to, the articular, fascial, muscular and fluid systems of
the extremities, spine, head, pelvis, abdomen and torso;
Competent expertise in the diagnosis and
Osteopathic Manipulation of neuromusculoskeletal disorders;
thorough knowledge of the
indications for, and contraindications to, Osteopathic
Osteopathic Practice Standards: Safety and quality in practice
Training Curriculum for
History and philosophy
of Health and its natural progression and
understanding upon the Osteopathic concept and
practice; Gross and
functional anatomy, including basic embryology, neuroanatomy and visceral anatomy;
bacteriology - Microbiome, fundamental biochemistry,
fundamental cellular physiology; Materia Medica
Physiology with special
emphasis on the neuroendocrine immune network, the autonomic
nervous system, the arterial, lymphatic and venous systems
and the musculoskeletal system;
biomechanics and kinetics.
Understanding of other Therapeutic Methods and application
within the scope of practice such as Hydropathy and how come
same complement Osteopathy and vice versa.
models of health and disease; safety and ethics; basic pathology and
pathophysiology of the nervous, musculoskeletal,
psychiatric, cardiovascular, pulmonary, gastrointestinal,
reproductive, genitor-urinary, immunological, endocrine and
otolaryngology systems; basic orthopaedic diagnosis; basic radiology;
Nutrition; basic emergency care.
physical and clinical
examination; osteopathic diagnosis and
differential diagnosis of the nervous, musculoskeletal, cardiovascular, pulmonary, gastrointestinal,
endocrine, genitor-urinary, immunological, reproductive and
otolaryngology systems; general synthesis of basic
laboratory and imaging data; clinical problem-solving and
reasoning; understanding of relevant
research and its integration into practice; communication and
interviewing; clinical documentation; basic life-support and
Osteopathic diagnosis; osteopathic techniques,
including direct techniques such as thrust, articulatory,
muscle energy and general osteopathic techniques; indirect techniques, including
functional techniques and counterstrain; balancing techniques, such as
balanced ligamentous tension and ligamentous articulatory
strain; combined techniques, including
myofascial/fascial release, Still technique, osteopathy in
the cranial field, involuntary mechanism and visceral
techniques; reflex-based techniques, such
as Chapman’s reflexes, trigger points and neuromuscular
techniques; fluid-based techniques, such
as lymphatic pump techniques.