The body is capable of self-regulation, self healing , and health maintenance.
Structure and function are reciprocally interrelated.
Rational treatment is based upon an understanding of the basic principles of body unit, self-regulation, and interrelationship of structure and function.
Tenderness (or Sensitivity),
Restricted Motion (or ROM),
Tissue Texture Change
increased muscle tension
fibrous reaction (from long term limited movement)
In this way, reduction of muscle hypertonicity also reduces neural stress reflexes to the organ.
Abnormal activity in neural circuits is a fundamental of osteopathic practice.
A pool of neurons (one or more segments of the spinal cord) in a sub-threshold state that less afferent stimulation is required to trigger the discharge of impulse.
Abnormal sensory impulses from the higher centers, viscera and from the soma(muscle spindles, golgi tendon ..)
History: Memory of an injury, recent . MORE TENDER
Pain: Acute sharp, severe
Skin: Warm, moist, acute red reflex, inflamed (vascular and chemical changes) (tissue texture changes)
Mobility: range not always restricted but sluggish.
Musculature: Muscle hypertonia
Tissues: Boggy, edematous congested soft tissue (Tissue texture changes)
Visceral : somatovisceral effects are minimal .
History: Long-standing impairment
Pain: Dull ache burning
Skin: cool, dry decrease sweating, scaly, pale itchy, blemished skin, thin pigmentation change ( tissue texture changes)
Mobility: Limited ROM due to chronic compensation, contracture or development of fibrosis
Musculature: contracture but decreased tone that feels mushy flaccid, fibrotic & ropy.
Tissues: chronic congestion doughy, (poor lymphatic pump)
Visceral: somatovisceral effects are common.
Sympathetic response causes vasoconstriction.
However, this response is overridden by local biochemical responses, overpowered by braykinins so a local vasodilitation, leading to warmth and redness.
Indicates either acute S/D in that segmental area, or S/D secondary to visceral dysfunction innervating that segment.
The restrictive barrier is a result of somatic dysfunction.
2. Restriction of Motion
i.e.. in the direction of the restrictive barrier
“going toward or up against the barrier”
3. The direction in which motion is freer.
The direction the vertebra with a somatic dysfunction will move into .
i.e.. less restricted.
“going away from the restrictive barrier”
This is our naming convention
palpation of each vertebrae to look for rotation
TYPE I: When motion is introduced into the spine from a neutral position sidebending preceeds rotation, with rotation occuring to the side opposite sidebending.
Two or more segments involved
scalenes (from anterior of C vertebrae)
When sidebending is introduced into a region of the spine in a non-neutral position, rotation of one segment must preceed sidebending. Rotation and sidebending occur to the same side.
Type II dysfunction
Occur as a result of trauma/abrupt twisting
Should be treated before Type I somatic
Found at apex or extremes of Type I curves at
transitional areas or by themselves .
Apex is the mid point of the curve.
Often traumatic in origin.
Non-neutral spine : active or passive flexion
or extension will change the position of the
Example: T 4 E RXSX
T 4 E Rr Sr
When motion occurs in any one plane within a joint or region, motion in all other planes of that joint will be influenced.
Example: If a vertebral unit was flexed, its range of sidebending and rotation would be reduced.
Let us do this!