Wednesday, 20 May 2015

overview of global bio-mechanics - yet with a precise muscluo-skeletal diagnosis and tissues causing symptoms

A precise diagnosis, in musculo-skeletal terms, of the tissues causing symptoms is essential in good Osteopathy and good physical therapy, and musculo-skeletal medicine.

Further to my last blog, and emphasis on the importance of whole-body bio-mechanics (which is essential for good Osteopathy), and an understanding of the whole of the person, body mind and spirit, as Andrew Still, the founder of Osteopathy put it  -  I should also like to point out, that we also need a good musculo-skeletal diagnosis, good anatomical knowledge, logical clinical reasoning skills, and a precise diagnosis, in terms of the tissues causing symptoms.

These tissues causing the symptoms may not be only local (as physiotherapists often seem to think) but may sometimes (especially in a chronic case) also be (part of) a complex pattern of altered global bio-mechanics.  If this is the case, then in good Osteopathic treatment, we must address the entire pattern of the altered bio-mechanics, i.e. Osteopathic treatment of the whole body, not just perhaps the part that hurts.

Of course, this is not always so, and sometimes things are relatively straightforward, e.g. in a younger person perhaps, or a simple sports injury (but even here, sometime the entire body pattern, and the way a person uses their body has a significant influence).

For example, sometimes a medial collateral ligament strain of the knee, is just that - a medial collateral ligament strain.  Of course, there may be also other factors:  e.g. any muscle imbalance of the legs or pelvis, and/ or pelvic, sacral, or spinal torsion, as these factors can certainly influence the mechanical loading to the knee.

An understanding of, and a treatment plan aimed at also addressing the 'big picture', i.e. these global bio-mechanical influences, if present, can certainly lead to better treatment outcomes and faster recovery time from injury.  They may also even predict an area that might predispose to injury, and in treating this broader imbalance in global bio-mechanics help prevent injury.

For more on this, you might want to see:

And as for Acupuncture, sure an understanding of the whole person is important, and we can give a constitutional treatment, and this can give better results, and promote general health and faster tissue healing.  Yet, even with acupuncture, it is also important sometimes to give specific treatment.  If there is knee pain, for example, then needling around the knee, perhaps both above and below also, is probably important.  Ans if it is, for example, a medial collateral ligament strain, then needling over the medial collateral ligament directly can help promote tissue healing, and collagen regeneration.

For more on this, you might want to see:

Saturday, 9 May 2015

modern osteopathy, acupuncture and integrated healthcare: towards an global understanding of health, not just a analytical reductionist understanding of dis-ease.

There is a Traditional Chinese Medicine and Acupuncture pattern of disharmony described as 'deficiency below and excess above', and any experienced clinician or acupuncturist may recognize this in many chronic diseases (e.g. chronic fatigue, hypertension, diabetes, heart-disease, etc) and in the older person.

There is the concept 'zang-fu' of paired organs in Traditional Chinese Medicine and Acupuncture, and after all, in physiology, this also makes perfect sense: e.g. the relationship of the heart and kidneys in haemodynamics, and regulating blood pressure (as well as rate and force of the heart's contractions and suction) through the kidney's control of water and electrolyte balance.  

The traditional acupuncture concept of the heart-kidney shao-yin axis does of course go way beyond the mechanical and haemodynamic action of these organs, and suggests neuroendocrine effects, altering mood, emotion, and mental states.  For in the traditional acupuncture paradigm, emotions are 'visceral' and organic, and have a physiological basis.  None would argue with this perhaps. 

Even modern osteopathy (e.g. John Pierre Barral) sees the visceral component as highly significant, and the 'tissue memory' (as John Upledger put it) storing 'emotional charge' locked away in the body.  Or as John Littlejohn (who studied with Andew Still, the founder of Osteopathy) said: 'The body is the graveyard of emotion'.  Any experienced clinician has an intuitive grasp of these truths, I would hope.  The early Chinese acupuncturists wrote of this in pre-Christian times, when Aristotle and Hippocrates were leaving some the early written European records.  In traditional acupuncture the specific emotions relating to each organ system were identified, in their integrated body-mind continuum world view. 

For more on this, see: