Osteopathy

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Osteopathy

"Osteopathy is an established, recognised system of diagnosis and treatment that lays its main emphasis on the structural integrity of the body. It is distinctive in the fact that it recognises much of the pain and disability we suffer stems from abnormalities in the function of the body structure as well as damage caused to it by disease. Osteopathy used many of the diagnostic procedures used in conventional medical assessment and diagnosis. Its main strength, however, lies in the unique way the patient is assessed from a mechanical, functional and postural standpoint and the manual methods of treatment applied to suit the needs of the individual patient." (Ostepathic Information Service at www.osteopathy.org.uk)

Many factors can contribute to pain and stiffness - the pain cycle - including:

• Trauma/accidents
• Sports injuries
• Poor occupational posture
• Congenital abnormalities
• Repetitive strain injuries
• Ageing

Future articles on this website will deal separately with each of these factors. This introductory paper will deal with generalities and the ageing process. Our unique and individual approach to osteopathy attempts to understand and address the fundamentals of ageing and its effect on the human body, and to offer a treatment protocol and management which gives long term results. This involves a series of different techniques which aim at breaking the pain cycle, not simply at offering relief. These techniques vary from deep tissue kneading/inhibition to the traditional osteopathic manipulation and cranial osteopathic techniques. The combination of techniques helps to induce a change in the body's pattern from that of an unorganised structure to one of balance and stability at birth. Each individual's human body has a structured pattern of organised tissue particular to it. Assuming that there are no congenital abnormalities, illnesses or birth trauma present the individual displays a harmonious dynamic and healthy musculoskeletal system. We only have to look at young children who innately display good posture and movement. This is an example of a body with a balanced organised tissue pattern.

However, as we get older this pattern can become distorted due to injury, occupational posture and so one. This can result in pain and muscle stiffness, i.e. the pain cycle. Treatment can uncover this harmonious structure by helping to break the pain cycle, thus encouraging the body to return to a more natural and balanced state.

Ageing may result in the degeneration of the body's joints and inter-vertebral discs, with symptoms associated with these degenerative changes generally becoming manifest from the age of 50 onwards. If poor foot mechanics is a contributing factor then these symptoms may present earlier.

The onset of body degeneration can be attributed to the fact that the bony skeleton has a shelf life of 35 to 40 years, as compared to an average life expectancy of 70 years or so in the industrialised world. In theory, this short shelf life is thus explained: Homo sapiens and his predecessors had a life expectancy of roughly 30 to 40 years. With the significant improvements in social conditions and health care in the past 200 years this life expectancy figure has easily doubled. The human skeleton, however, has not been able to fully respond and adapt to the demands now made upon it, hence the onset of skeletal degeneration.

Poor foot mechanics can be accounted for by the fact that, whilst our predecessors, who lived on different types of terrain - rough, angled and soft - and wore non-supportive footwear, were able to maintain effective foot mechanics, this is no longer the case. It is true that in the past 200 years shoe design has provided increased levels of comfort and walking surfaces have improved, with flat and level paved roads. But these two factors, it is believed, have had a detrimental effect on the mechanics of the foot, by removing the stress factors which enhanced the integrity of the various muscles, ligaments and fascia essential to support the inside arch of the foot.

Structural balance in the body begins at the feet, which should offer a reliable and supportive base through which the upper body can relate to the horizontal plane of the earth. Collapse or lowering of the foot arch may result in increased strain and imbalance in the pelvis. This may result in an increased arch in the small of the back, which in turn results in an imbalance in the upper back and neck. All these changes in the basic body structure result in altered structure and function of the soft tissue attached to it, whether musculo-connective or visceral. This dysfunction can produce limited motion, palpable tissue changes, such as congestion, thickening, calcification or asymmetry, thus increasing a person's energy requirements to function effectively. If prolonged and left untreated, this may result in pain and stiffness, the dreaded pain cycle.

Complicating the pattern of disorganisation are the compensations made to satisfy the body's need to have both eyes at a horizontal plane with little regard for any distress which might be created in the area between our eyes and our feet. This may be aggravated further by poor posture, often work related. Treatment protocol must consider the 'symmetry myth', i.e. that some form of body symmetry actually exists! In fact, virtually all of our daily activities, such as preferred positions, work, sport, etc, are asymmetrical. Bone growth is asymmetrical, with feet varying in size, legs varying in length, etc. The skeleton and its mechanical abilities are never perfect, however good effective treatment will enhance its function and break the pain cycle.

Treatment can only begin once a sound, plausible working diagnosis has been established through a complete and thorough case history and full osteopathic examination. The case history should highlight any medical conditions, past and present, including previous musculoskeletal injuries, operations, accidents, family history, current lifestyle, fitness level and occupational hazards. From the outset the patient should have a clear prognosis and advice on management of the complaint. Good effective osteopathic treatment is holistic in its essence in that the whole body should be treated in order to the break the pain cycle and not just simply offer temporary relief. A combination of deep muscle release techniques, osteopathic manipulation techniques and cranial osteopathic techniques are used in various combinations to achieve this. If orthotics are recommended by David Holland (the consultant podiatrist - see separate article on this website) they are incorporated into the treatment plan. We have found that this treatment regime can be used successfully to treat chronic and acute condition in patients of all ages and occupations. The majority of our patients will have had very good treatment previously but will note that this was only maintained for approximately 3-4 months before symptoms would reappear, thus requiring a high rate of 'maintenance treatment'.

Good osteopathic treatment also requires good management, in other words, advice on factors such as a greater awareness of good occupational posture, healthy eating habits and improved levels of fitness. Together these factors will maintain and with time improve your health.

As part of this management, we feel that David Marshall has a lot to offer in terms of diet and fitness. Indeed, for some patients, David Marshall's participation in the treatment protocol has proven essential in order to rebalance and strengthen and appropriate muscle groups.

Sean Durkan BSC Hons Osteopathy

Sean Durkan runs a busy and successful osteopathic clinic at 140, Harley Street, London W1. He can be contacted directly on 07880 746077.