| LA JOLLA CHIROPRACTIC HEALTH CENTER |
| LA JOLLA CHIROPRACTIC HEALTH CENTER |
Does Osteopathic Manipulation Still Exist? And If So, Should It?
By Donald M. Petersen Jr., BS, HCD(hc), FICC(h)
A recent study published in the Journal of the American Osteopathic Association (JAOA) (1) provides
interesting insight into the current status of osteopathic manipulative treatment or osteopathic manipulative
medicine.
The paper describes a "free, community-based osteopathic manipulative medicine student clinic" at the
West Virginia School of Osteopathic Medicine in Lewisburg. As an introduction, the authors admit that after
"pharmacology was added to the osteopathic curriculum in 1913" their curriculum was more like that of
Western medicine.
According to the authors of the study, the rationale for the clinic was "that by providing students with
supervised and successful experiences in Osteopathic Manipulative Medicine with community patients -
rather than simply diagnosing and treating one another, as is the traditional practice in osteopathic medical
school - students would be more likely to continue to practice Osteopathic Manipulative Medicine during
their residency training and, eventually, in clinical practice." The program "provided students with 26 hours
of supervised experience in osteopathic palpatory diagnosis and osteopathic manipulative treatment"
(emphasis added).
The first comment one would be quick to make is that "26 hours" is not nearly enough clinic time to develop
any level of skill in any type of manual procedure. They couldn't even hope to be second-rate physical
therapists. Indeed, doctors of chiropractic enjoy more than 1,400 clinic hours, in addition to almost
2,000 hours of clinical sciences. (2)
But the real revelation comes in what osteopathic manipulative treatment or osteopathic manipulative
medicine really is. According to the Web site of the American Osteopathic Association, Osteopathic
Manipulative Treatment includes a number of common techniques (3):
Thrust: Moving a restricted joint in the direction it is resisting.
Muscle Energy: Manipulative treatment in which the patient's muscles are actively used on request
Ignoring the differences in philosophy, terms and techniques for the moment, it is clear that the majority of
Osteopathic Manipulative Medical techniques don't include anything close to a chiropractic adjustment.
The JAOA study actually confirms this by reporting that "[m]yofascial release (27.87%) and muscle energy
(16.08%) were the two OMM techniques most commonly used in patient treatment" at the student clinic.
Once again, we see confusion where none belongs. Rather than admit that the majority of Osteopathic
manual techniques are related to those of physical therapists, the osteopaths still want to position
themselves as an alternative to chiropractic. But what they can't get away from is that most osteopaths don't
hold expertise in Osteopathic Manipulation and don't claim to.
In reviewing the DOs listed on American Osteopathic Association Web site, one can't help but notice that
the majority don't list Osteopathic Manipulation as their "Primary Specialty." Most position themselves as
"Family Practice," "Internal Medicine" or something else. When reviewing a listing of DOs in California, I
noted that only four (2%) of the first 200 listed Osteopathic Manipulation as their primary
specialty.
So, the next time someone tells you they have seen an osteopath or received "osteopathic manipulation,"
you should inform them that there is really no comparison to chiropractic. First of all, only a percentage of
DOs have the training and experience required to be competent in manual therapy. And second, based
upon this most recent paper, it is unlikely the person would have received a form of care that would be even
remotely related to a chiropractic adjustment.
Perhaps one day the DOs will stop the pretense and admit that they have essentially lost their heritage and
are largely just medical doctors with exposure to some physical therapy techniques.
References:
1. Steele KM, Baker HH, Boxwell GF, Steel-Killeen S. Community-based osteopathic manipulative
medicine student clinic: changes in curriculum and student confidence levels. J Am Osteopath Assoc 2005;
105:503-513.
2. Chiropractic in the United States: Training, Practice, and Research. AHCPR Publication No. 98-
N002, December 1997. www.chiroweb.com/archives/ahcpr/uschiros.htm.
3. American Osteopathic Association Web site, "OMT Terms Defined." www.osteopathic.org/index.cfm?
PageID=ost_omtterm.
By Donald M. Petersen Jr., BS, HCD(hc), FICC(h)
A recent study published in the Journal of the American Osteopathic Association (JAOA) (1) provides
interesting insight into the current status of osteopathic manipulative treatment or osteopathic manipulative
medicine.
The paper describes a "free, community-based osteopathic manipulative medicine student clinic" at the
West Virginia School of Osteopathic Medicine in Lewisburg. As an introduction, the authors admit that after
"pharmacology was added to the osteopathic curriculum in 1913" their curriculum was more like that of
Western medicine.
According to the authors of the study, the rationale for the clinic was "that by providing students with
supervised and successful experiences in Osteopathic Manipulative Medicine with community patients -
rather than simply diagnosing and treating one another, as is the traditional practice in osteopathic medical
school - students would be more likely to continue to practice Osteopathic Manipulative Medicine during
their residency training and, eventually, in clinical practice." The program "provided students with 26 hours
of supervised experience in osteopathic palpatory diagnosis and osteopathic manipulative treatment"
(emphasis added).
The first comment one would be quick to make is that "26 hours" is not nearly enough clinic time to develop
any level of skill in any type of manual procedure. They couldn't even hope to be second-rate physical
therapists. Indeed, doctors of chiropractic enjoy more than 1,400 clinic hours, in addition to almost
2,000 hours of clinical sciences. (2)
But the real revelation comes in what osteopathic manipulative treatment or osteopathic manipulative
medicine really is. According to the Web site of the American Osteopathic Association, Osteopathic
Manipulative Treatment includes a number of common techniques (3):
Thrust: Moving a restricted joint in the direction it is resisting.
Muscle Energy: Manipulative treatment in which the patient's muscles are actively used on request
- from a precisely controlled position, in a specific direction, and against a distinctly executed
counterforce.
- a period of time, then is assisted by the physician to slowly return to a neutral position.
- to reduce the barrier and improve motion.
- release patterned soft tissue and joint-related restrictions.
Ignoring the differences in philosophy, terms and techniques for the moment, it is clear that the majority of
Osteopathic Manipulative Medical techniques don't include anything close to a chiropractic adjustment.
The JAOA study actually confirms this by reporting that "[m]yofascial release (27.87%) and muscle energy
(16.08%) were the two OMM techniques most commonly used in patient treatment" at the student clinic.
Once again, we see confusion where none belongs. Rather than admit that the majority of Osteopathic
manual techniques are related to those of physical therapists, the osteopaths still want to position
themselves as an alternative to chiropractic. But what they can't get away from is that most osteopaths don't
hold expertise in Osteopathic Manipulation and don't claim to.
In reviewing the DOs listed on American Osteopathic Association Web site, one can't help but notice that
the majority don't list Osteopathic Manipulation as their "Primary Specialty." Most position themselves as
"Family Practice," "Internal Medicine" or something else. When reviewing a listing of DOs in California, I
noted that only four (2%) of the first 200 listed Osteopathic Manipulation as their primary
specialty.
So, the next time someone tells you they have seen an osteopath or received "osteopathic manipulation,"
you should inform them that there is really no comparison to chiropractic. First of all, only a percentage of
DOs have the training and experience required to be competent in manual therapy. And second, based
upon this most recent paper, it is unlikely the person would have received a form of care that would be even
remotely related to a chiropractic adjustment.
Perhaps one day the DOs will stop the pretense and admit that they have essentially lost their heritage and
are largely just medical doctors with exposure to some physical therapy techniques.
References:
1. Steele KM, Baker HH, Boxwell GF, Steel-Killeen S. Community-based osteopathic manipulative
medicine student clinic: changes in curriculum and student confidence levels. J Am Osteopath Assoc 2005;
105:503-513.
2. Chiropractic in the United States: Training, Practice, and Research. AHCPR Publication No. 98-
N002, December 1997. www.chiroweb.com/archives/ahcpr/uschiros.htm.
3. American Osteopathic Association Web site, "OMT Terms Defined." www.osteopathic.org/index.cfm?
PageID=ost_omtterm.
Doctor Michael Ackerman helps patients to understand and release the emotional stress patterns underlying their
physical problems and disease. Dr. Michael Ackerman has been in practice as a chiropractor in La Jolla,
California, for 11 years of his 23 years in practice. Being a La Jolla Chiropractor has been extremely rewarding for
Dr. Michael Ackerman, and he is unique among the chiropractic doctors in La Jolla in that he has worked with
professional athletic teams, such as the New Orleans Saints, the Delta Festival Ballet Company, as well as
collegiate and amateur athletes from most sports backgrounds. Dr. Michael Ackerman enjoys practicing as a
chiropractor by the sea in such a beautiful town as La Jolla, California, but he also does healing consultations by
phone with people from all over the country.
physical problems and disease. Dr. Michael Ackerman has been in practice as a chiropractor in La Jolla,
California, for 11 years of his 23 years in practice. Being a La Jolla Chiropractor has been extremely rewarding for
Dr. Michael Ackerman, and he is unique among the chiropractic doctors in La Jolla in that he has worked with
professional athletic teams, such as the New Orleans Saints, the Delta Festival Ballet Company, as well as
collegiate and amateur athletes from most sports backgrounds. Dr. Michael Ackerman enjoys practicing as a
chiropractor by the sea in such a beautiful town as La Jolla, California, but he also does healing consultations by
phone with people from all over the country.