Three Models of Osteopathy
When you go see an osteopathic doctor, if they use their hands to treat you, you might be surprised to find that each one works quite differently. Why does one doctor carefully measure your leg lengths and tug on your extremities, while another seems to sit silently barely moving? What drives the different approaches?
While there is only one philosophy of osteopathic medicine, but each doctor trained in it uses different techniques and skills to treat you. These techniques generally fall into one of three models: the biomechanical model, the functional model and the biodynamic model 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. Study the anatomy and biomechanics of the human form and you will be able to put the body back to normal. This not only restores structure but normal structure of the musculoskeletal system allows flow of essential nutrients to the rest of the body which in turn allows for self-regulation of healing mechanisms to function more effectively. 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 downside to the biomechanical model is that it assumes there is only one correct position for any part of the human form. The reality is we are complex organisms and our understanding of what the perfect structure is is limited by the reductionist model and our inability to grasp the function of the whole.
The biomechanical model seeks to return structure to normal. But a basic principle of osteopathic medicine is that the physician should seek cause. It might be easy to say that a strained ligament is cause by a fall or twist of the ankle, but in most illness the cause is not as directly discerned. Take for example a headache. We have many triggers – such as being dehydrated, or getting too much sun, or stress. But the habitual position of the bones of the neck, tension in the muscles of the neck, or genetic factors are likely involved as well. What’s the biomechanical approach to headache then? The biomechanical osteopath will fix the bones and muscles of the neck. The focus will not be on preventing further headaches by learning about triggers, finding better nutrition, adopting a meditation practice.
The Wisdom of the Design
The biomechanical model assumes the knowledge of the physician is greater than the capacity of the body, and even than that of natural laws. The idea is that the physician understands natural law, in this case structure, well enough to manage them. However, even in the field of anatomy scientists are continually making new discoveries about how the body is designed. We will never know everything about the human form. The result, when using the biomechanical model, is that sometimes there are treatment reactions such as pain, worsening of symptoms, or new symptoms.
Fighting Healing Forces
There are many reasons a condition can become chronic. Most commonly it is due to life circumstances – repeated use of a keyboard or driving long distances, for example. However, sometimes it is a side effects of using the biomechanical model. If a part of the body is “out of place” and the biomechancial osteopath “puts it back,” it may feel better short term. However, sometimes this out of place structure is in fact supporting the whole person from a worse condition or even just keeping another part of the structure functioning. The healing forces of the body will return the part that was “out” to this position, resulting in a fight of sorts between the healing forces and the osteopathic doctor.
Seeking cause, and trying to understand the whole are two key features of the biodynamic model which dramatically decrease the chronicity of conditions and the risk of side effects.