I am an osteopath. Have been since 2006, after getting a First in a Bachelor of Science, a Diploma of Osteopathy and a Diploma of Naturopathy at the British College of Osteopathic Medicine, University of Westminster, London.
I worked in an established practice outside of Paris with Guillaume Carteau (also a ‘BCNO’ or BCOM graduate, based at the 8 rue des sablons, a pedestrian road in Fontainebleau) and set my own practice in the lively neighbourhood of Bastille for 2 years after graduating. I closed my practice when I left for my travels and since have been working at the CEESO, a school of osteopathy in Paris. My interest in manual therapy in general and its application to modern day Western medicine made me research other types of medicine in different countries of the world. Now I want to discover them for myself. But not before explaining exactly what it is I do…
Osteopathy is “that science which consists of the knowledge of the structure and functions of the human mechanism, by which nature under the scientific treatment peculiar to osteopathic practice in harmonious accord with its own mechanical principles, may recover from displacements, disorganizations, derangements, and consequent disease and regain its normal equilibrium of form and function in health and strength” according to Andrew Taylor Still, the founder of Osteopathy, in his autobiography in 1908.
The problem with AT Still is that it is not always easy understanding exactly what he means… which makes it so difficult today to actually know what he did at the time. Let me announce the four main principles of osteopathy (as described in Foundations of Osteopathic Medicine, 2nd Edition), and I’ll explain each one in 21st Century terms. This is my understanding, so any comments gracefully received.
– The body is a unit; the person is a unit of body, mind, and spirit.
We are each made up of separate parts (e.g. cells, muscles, the gastro-intestinal system, the right leg, nerves…) and each of these parts is connected to all the other parts. On top of that, the person (you, me…) is made of of seperate part which are also linked together and interact with each other. Implicitely, the above statement signifies that every single part of the body influences the body itself, the mind and spirits; and reciprocally.
– The body is capable of self-regulation, self-healing, and health maintenance.
Those who studied biology will remember the complex feedback mechanisms that exist in the body. May they be hormonal, neurological, mechanical… we are made so we don’t explode (except in Heroes, but that doesn’t actually really exist). For example, if we run, use our muscles, our hearts will beat faster, our breathing will increase, blood will be pumped around the body faster, and our body will adapt to the situation.
Same happens after eating, when our body digests, or during menstrual cycles, when hormonal levels depend on a number of chemical influences.
All these natural mechanisms, that are used everyday, regulate the body without us knowing anything about it!
– Structure and function are reciprocally inter-related.
This is my personal favourite. A good way to illustrate this, is the astronaut. When the astronaut is in space, its bones aren’t subjected to gravity: the function of the bones is only to hold the framework together, and not to resist to gravity anymore. As the function changes, the structure will too: the bone will start breaking down, become weaker. When astronauts come back to Earth and gravity, they have developed brittle bones (osteoporosis). Since their bone’s function changed, so did their structure.
The function of something defines its structure, and its structure define the function. Let’s make it even easier: take a plastic bowl, food safe and with lots of tiny holes in it… the holes make it a strainer. If it didn’t have them, it would be just a regular bowl… Its structure dictates is usage, i.e. its function.
– Rational treatment is based upon an understanding of the basic principles of the body unity, self-regulation, and the interrelationship of structure and function.
Well that just sums up everything else. And yes, that is different to medicine as we know it, because the body is classically divided up into lots of pieces, which are then treated by different doctors. When have you ever seen a gastro-enterologist ask a rhumatologist for its opinion on the spine (where the nerves from the viscera come from), or an orthopaedic surgeon teaming up with a psychologist on a fracture?
Typically, doctors refer to their patients as “the kidney in exam 2” or “the 45-year-old lung”; but rarely consider other body parts, or even the fact that a actual person may be attached to the diseased organ!
Back to osteopathy. A few more basic principles. of classic osteopathy principles, again found in Foundations For Osteopathic Medicine, 2nd Ed.
1. Health is a natural state of harmony
2. The human body is a perfect machine created for health and activity
3. A healthy state exists as long as there is normal flow of body fluids and nerve activity.
4. Disease is an effect of underlying, often multifactorial causes.
5. Illness is often caused by mechanical impediments to normal flow of body fluids and nerve activity.
6. Environmental, social, mental and behavioural factors contribute to the aetiology of disease and illness.
7. The human body provides all the chemicals necessary for the needs of its tissues and organs.
8. Removal of mechanical impediments allows optimal body fluid flow, nerve function, and restoration of health.
9. Environmental, cultural, social, mental, and behavioural factors need to be addressed as part of any management plan.
10. Any management plan should realistically meet the needs of the individual patients.
This is what makes osteopathy “holistic“: not only does it consider the body as a whole, but the person as a whole too (mind, body, spirit); and then the treatment a person will receive will depend on so many factors, that is why osteopathy is so difficult to explain. There is never one single appropriate treatment for one single condition, symptom or disease.
I used to get so frustrated when studying, I can remember asking one of my tutors: “what exactly should I do to treat a sprained ankle?” … He looked confused and amused… “Well, how old is your patient? and what does this person do? Do they have a job? Do they have children? Which side is it on? and What…” I couldn’t bear it, and interrupted their flow of question: “but it’s just an ankle! twisted it on a curb yesterday, what is the treatment??”
Was it slight anger, or just impatience is my tutor’s voice when he answered: ” But it’s not just an ankle. It never is. It’s a person. A person! with their history, their apprehension, and their ankle. The treatment lies in what they need and want.”
And that did it for me. Is it because I’m insanely curious, or like asking questions? Is it because I love to blurb all day with strangers? But I loved the idea of treating a person, not an ankle. And that same day, the God of osteopathy heard me, when in the College’s clinic I treated two patients, both whom had sprained their ankle within the last week, and both I treated very differently. On one of them, I didn’t even touch the affected ankle!
So what exactly can osteopathic treatment be? Well, first, a good osteopathic diagnosis must be made, taking into considerations all the principles bullet-pointed above. And then treatment.
This will take into account all the different aspects of the person, the presenting complaint (e.g. a sprained ankle) and the general history of that person.
This generally includes manual therapy: soft tissue techniques, joint mobilisation, muscle energy techniques, strain-counterstrain, manipulation/high velocity low amplitude thrust… as well as lifestyle advice, nutritional advice, exercices (specific or general), and even spiritual advice. Oh yes, I said it. The taboo of Western Culture, as spirituality is all too often linked to religion, even though it doesn’t have to be.
Osteopathic treatment is about finding balance, so the body can repare itself, and the person can return to the normal state that is health.
“Doctors look for disease, osteopaths seek health”