I can still be Juvenile!

I am really loving my Osteopathic medicine education. Not only do we learn what the Allopathic folks (M.D.s) get to but we also learn some great hands-on techniques that only add to our bags of tricks when treating patients. For those of you who still don't know what an Osteopathic Physician is in the United States I refer you to the wonderful wikipedia!
http://en.wikipedia.org/wiki/Osteopathic_medicine

Osteopathic medicine is not for all doctors, but it works well with my personality, philosophies, and goals. Besides, why not add in a little holistic, hands-on care when the drugs seem to be filled with issues of late.

See:
http://www.sciam.com/article.cfm?id=expensive-sugar-pills-wor
I mean 80% pain relief with sugar pills? Only the expensive ones? Does America even know what pain is anymore?! Shows how people seem to think that today's pills have all the answers.

See:
http://news.bbc.co.uk/2/hi/health/7263494.stm
yummy...pills! They make me feel better! Or do they?

See:
http://www.usatoday.com/news/health/2004-10-12-vioxx-cover_x.htm
Ummm. Sometimes the pills just kill you!


Don't get me wrong. I understand the value of drugs in Medicine and will likely spend more time prescribing them than doing manipulations, but there is something to be said for actually touching your patient and maintaining a sense of simplicity in practice when warrented.

Anyhow...enough seriousness. The actual objective of this post was to point out some of the hilarious manipulations and treatments I have come across in my first year of school. They bring out the immature teenager in all of us during lab time.

"Hey man! You better be quiet or I am going to give you the obturator!"
"Hey Mike, I have not gotten to practice the ischial tube spread in a while, do you mind bending over?"


While we learn several modalities in our first year, including HVLA (high velocity low amplitude/ "cracking"), muscle energy, soft tissue, and balance ligamentous tension, the common culprit is a treatment called "Counterstrain".

In all fairness, this treatment is a pretty amazing accumulation of knowledge and works quite well. Counterstain works to address somatic dysfunctions that result in "tenderpoints", most commonly found in muscle bellies or muscle attachments. The physician first identifies the point and then positions the patient to maximally relieve the discomfort. The physician holds the patient in the maximally relaxed position and then slowly returns the passive patient to a neutral body position. The physiological basis for this is quite interesting, however I will not address that here. (See Figure 1. below)





















This maneuvering puts both the patient and physician into some pretty awkward and funny positions. Hands also end up in interesting places. You get to know your classmates well.


SOME OF THE BEST...

Figure 2. My favorite. The obturator. The obturator internus is a small muscle under your gluteal muscles that helps you laterally rotate your hip. Sometimes it gets sore. Treatment: Well, look for yourself.





Figure 3. The Anterior Upper Thoracic Tenderpoints. Aka, the Boob grab.

Figure 4. The Adductor Treatment. Aka: the testicular flick.

Figure 5. The infraorbital tenderpoint. AKA: the smother.

Figure 6. Not counterstain but a great Tx regardless. The ischial spread.

So rest easy. Know that for every ache, sore, and dysfunction you have, we Osteopathic physicians have a treatment.

By the way, anyone want to volunteer to be a practice patient...?

Still trying to figure out how I would not get sued when working in a ER using these particular techniques.