By Shelley James - Osteopath
I am often faced with interesting comments about my profession – loosely based around assumptions that relate to “dealing with bones” or “rolling patients around and making their joints crack”. For me, this cannot be further from the truth and I try hard to not show the despair that I feel when confronted with these comments.
I recall in my first year of training we had to write an essay on what we thought Osteopathy was. Back then it seemed a little magical – that a tutor could understand what we were attempting to do in our practical classes, when we had little idea of the impact a small adjustment on a body could do. The different concepts of tensegrity, pivots and curves, muscle tone and function and everything that occurs in line with these were confusing and felt at odds with each other. The mass of information that is taught is overwhelming but now I know that each and every lecture and subject formed what Osteopathy is over the space of the 4 years training. The question therefore is, how do I turn 4 years of knowledge into a couple of sentences to explain what I do. The need to be concise is very definite, to ensure I don’t bore people. but equally I need to be exact so as not to confuse, come across medically ignorant or even arrogant to that matter!
Where did it all begin?
It all started with Mr A.T. Still, an American born in 1828 who was convinced that the allopathic approach to medicine was not conducive to the body’s need for free flow of blood and “nerve force”. After many challenging years, Still was able to set up a clinic and then a school to teach this new way of hands-on treatment, officially adopting the term Osteopathy in 1885. The pertinent point in treatment is the free flow of fluids (blood and lymph) as well as the unencumbered transmission of nerve conduction which allows self-healing and the most important of all, relief from discomfort.
Osteopathy developed worldwide through the years and in the USA, developed as a quite different approach which incorporated the use of surgeries and drugs in the treatment plans. In the rest of the world, Osteopathy remained an “alternative therapy” which I think was where the reputation of the profession received its most damage.
Osteopaths were only “alternative” because drugs are not used. We now receive very similar training to NHS doctors and must know as much as them about how to diagnose conditions in case we come across something that needs onward referral. Simply put – if your back hurts it may be a simple muscle strain, it could be a kidney infection, it could be worse. If Osteopaths just treated you for back pain and didn’t screen you for anything else our duty of care to you would essentially not exist and we’d be no better than someone from the street just rubbing you with a nice smelling ointment! I do wonder if Osteopaths have been corralled into the category of ‘bone crunchers’ by the simple use of the term Osteo (meaning bone). I am sure Mr Still would not have come up with the term if he knew how it would be misconstrued!
Are there different forms or styles of Osteopathy?
There are many forms of treatment style and none of them are truly unique to Osteopathy. Osteopaths do use of massage, effleurage, stretching (isometric etc) and trigger point work. The use of high velocity, low amplitude thrusts (HVT) are common with Osteopathy but more common with Chiropractic practitioners (these are the movements that make the audible clicking sounds). Then there are the less publicised and very technical treatment styles such as cranial, ligament balance and visceral treatments. Around these types of treatment are other techniques that combine and utilise either intricate or global muscle, organ or joint movement or focus on treatment and static relaxation of tissue.
What can Osteopathy treat?
Osteopathy can focus on any tissue in the body to provide correction and treatment of an issue that hinders recovery from an illness or relieves pain suffered due to dysfunction of any body part.
Wow – in that last long sentence I may have accidentally formulated a simplified answer to the question posed in the blog title. It does not explain everything laid out in this blog but I feel it does get to the basic point.
Finally then – as an Osteopath, what do I do? All of the above but more - focussed on gentle and reciprocal movement by the patients. I feel if we work together during the treatment patients are more likely to understand their bodies and inadvertently work on their posture and body movement more than they would if I treated statically. The bony joint movement of HVT’s are effective and I do use them, however not as a matter of course – every Osteopath is different in their approach to treatment and explaining this is also a challenge. One thing at a time I think, let’s just get the message out there that Osteopathy is so much more than the sum of its name!
What should a patient expect from a treatment session?
All patients are asked to wear loose fitting clothes as my treatment does not require you to undress, although you will be asked to remove your shoes before you get on the couch.
You will be asked about your medical history and any issues that are currently troubling you. It is important that we go through this as it informs the type of techniques used and how they are performed.
Treatment is undertaken and you may be given gentle exercises to do at home which will complement the treatment. Where necessary support will be offered if there is a need for you to visit your GP to ensure you can relay any information accurately.
How many treatment sessions are needed?
I aim to treat the vast majority of my patients in one or two sessions, but there may be instances where a number of follow up treatments are required. You will be informed of any treatment or recovery plan during the first session. If only one treatment is required, this does not mean I will not treat you again - I will happily see my patients as and when they feel the need to visit me. I very much believe in being patient led - people know when their body needs help, often we just have to get better at listening to our bodies!
Shelley James M.Ost
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