Three Models of Osteopathy

The Biomechanical Model

This is the primary model taught in Osteopathic Medical Schools currently.The essential components of this model are; there is a correct position for each structure in the body, and external forces applied with precision can return the body to proper alignment. Using this model one can reason that correct or symmetric structure of the musculoskeletal system allow flow of essential nutrients to the rest of the body which in turn allows for self-regulation of healing mechanisms within the body.  Using traditional gross anatomy and the concepts of levers and pulleys to understand what is correct alignment, the Osteopath applies an external force in either a direct or indirect manner to affect movement of bones and ligaments.  This model is most useful for acute injuries.

The Functional Model

This model is taught in some Osteopathic Medical Schools and in continuing medical education courses. It is often called Functional Technique. The essential premise in this model is that passive motion of any part of the body directed in a precise way will result in a return to normal function of that body part. Interestingly, in this model, the diagnosis and treatment occur simultaneously. Additionally there is very little force applied when using the Functional Model and the forces are almost always in the direction of ease.  The Osteopath uses one hand to listen to the tissues and the other to direct movement of them.  The technique uses Thoracic Respiration as the primary therapeutic force and the end point of a treatment is a neutral state within all the tissues. From this state of neutral, or homogenization, the body can access internal healing therapeutics.

The Biodynamic Model

The Biodynamic Model was developed by James Jealous, D.O. and is rarely taught in Osteopathic Medical Schools. It must be learned through continuing medical education courses or through working with a mentoring physician. The primary therapeutic force in the Biodynamic Model is the Health of the patient or Primary Respiration. Rather than applying an external force, both hands are engaged in an attentive waiting and listening and the motion present in the lesion field is accessed through synchronization with the inhalation phase of Primary Respiration.  While these concepts, and the treatments, are subtle and always gentle, the results tend to be profound.

There are three tenets in the Biodynamic Model:

• First the treatment must be a movement towards treating the Whole.
• Second the Health of the patient is greater than the wisdom of the physician.
• Third, the embryonic forces of growth and development are present and palpable in the adult and are working as forces of regeneration and healing.

Most Osteopathic treatments in the Biodynamic Model involve reaching a neutral and balancing the autonomic nervous system. Because of its critical role in health and disease, balancing the autonomic nervous system allows optimization of innate forces of healing.

"We … begin with the feeling of Dynamic Stillness, which is omnipresent. Thus we start with perceiving the whole, which cannot be described. During the entire therapeutic process the Osteopath gives up the need to know exactly what happens. The Osteopath does not see any dysfunctions, {or} … problems….. The Osteopath stays with this Dynamic Stillness and even though transmutations and changes will take place in the patient as a whole, there is no augmentation, no interface with the motion. The Osteopath connects with this dynamic stillness."—James Jealous D.O. 2000.