Cranial. Discuss

[DocEspana]

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So the last time someone had commented on a thread with the word 'cranial' in the title was three years ago. I'm sure its been talked about tons since then, but it definitely deserves a new batch of comments because... lordy... is this an interesting topic.

My class just got to its three week crash course on cranial osteopathy. And I'm very into osteopathic techniques as a modality option and diagnostic tool in musculoskeletal and some visceral pathologies. But when they started discussing certain aspects of it I want from 🙂 to 🙄 to 😕 finally to

I've heard a few anecdotes from people who aren't inDOctronates (my name for the people who are all OMT all the time for every last disease known to man) about cranial being useful. But really they are all referring to actually sensing CSF flow at the cranium (in one case) or sacrum (Rest of them). And all had no faith in moving any fused bones. They simply stated that their training in it let them notice when someone had an disease about to present since CSF fluid does tend to pulse to, supposedly, palpable levels in the very early stages of a strong immune response.

An example of a "what the..." moment was the doc explaining to us that the inventor of cranial looked at the skull suture lined, and how they are interdigitated, and though of 1) a hinge like movement and 2) fish gills.

before your brain blows up at the absurdity of those two conclusions, let me explain them and further confuse you. so we were told that the interdigitations allowed for very subtle hinge-like movements. Which seems ridiculous given that we are always told to analyse condyles and ridges and realize that they are there either due to forces or to resist forces. And interdigitation is a design that maximizes friction and minimizes movement in the real world (think about scoring spackle or grout when putting down tiles so that everything sticks together as tightly as possible).

and then this golden gem: "he felt that he had seen the design before in fish gills. Fish gills, which are used for respiration. This brought him to the conclusion that the mobility at these joints must be used to aid respiration"
Firstly: WTF?????
B: it looks nothing like fish gills. at all.
Three: fish gills work passively, there is no actual motion. What people see and wrong assume are gills are the opercula. They have nothing to do with breathing.
IV: how the **** did that train of thought even develop. And how did my school let this poor woman say that same train of thought out loud.


anyway. I know very little about cranial except that I had one of the least inspiring introductions to it ever. but this is an open discussion of cranial. What you think. Crazy explinations you've heard. And the .1mm. Also known as the levels of movement recorded between the cranial bones during cranial osteopathy when super high resolution scans were used to prove that they were indeed moveable.

 

[SmokD]

mmm, My pod leader told us she could feel the rhythm of the water going up the stem of a tomato plant. I mentally checked out at that point.

 

[schussboarder]

Not a big believer in cranial osteo. I found it very disheartening after my lab partner for the day was diagnosed with a completely different diagnosis by three different professors.

Basically I found out the best way to go about this unit was to act confident with your diagnosis. Even if i didn't feel s**t, when the professor would ask my diagnosis I would just respond extremely confidently with a diagnosis and around 90% of the time he would say I was correct.
And the v-spread...are you kidding??? so im supposed to tap on my partners forehead and send pulses of fluid to the other side of his skull which will ultimately release the sutures that im spreading with two fingers of my other hand 👎...if all this stuff can work with such a minimal amount of force, I don't even want to see what happens to my CSF and cranial sutures each time i throw my head into my pillow before bed
While i enjoyed much of the visceral and MSK osteopathy I learned, cranial by far was the worst unit--i don't think i will ever be convinced that it works.

 

[Styria]

Sutherland was looking at the squamous suture above the temporal bone, which is beveled with grooves, not interdigitated. That's where "like the gills of a fish" comes from. Interdigitation is a design element which resists sliding or shearing motion, not hinging.

Whether it assists respiration or not, external rotation of the extremities during flexion is the same thing that happens when you take a deep breath. Incidentally, I had someone induce a still point on me, and when I took a deep breath my temporals externally rotated. I and two others got to palpate that happening before my CRI resumed.

 

[DocEspana]

Sutherland was looking at the squamous suture above the temporal bone, which is beveled with grooves, not interdigitated. That's where "like the gills of a fish" comes from. Interdigitation is a design element which resists sliding or shearing motion, not hinging.

Whether it assists respiration or not, external rotation of the extremities during flexion is the same thing that happens when you take a deep breath. Incidentally, I had someone induce a still point on me, and when I took a deep breath my temporals externally rotated. I and two others got to palpate that happening before my CRI resumed.

we definitely were shown the saggital suture which is most definitely interdigitated. That subtle different still does not at all explain the gills of a fish comment since they *still* look nothing like the squamous suture. At least the opercula looks like the saggital suture.

now with that said, working from a starting point of the squamous suture at least makes a little more sense to me (though not a ton more. but im not neccessarily the target audience for cranial. so grain of salt here, same as i take positive comments with it).

 

[wannabeOBGYN]

For some sad reason, they chose to have Dr. X give our introductory lecture on craniosacral OMT. But in the lecture prior to that, Dr. Y ended his lecture with, "Next week Dr. X will begin cranial! Have a good week, I leave you with this quote: 'Absence of proof is not proof of absence.'" We were all dumbfounded by the fact that he essentially said "Hey guys, we're not sure cranial's real, but try to bear with us for the next six weeks. Later!"

Also, during our first lab session, the Dr. X was talking about feeling the CRI and held her hands out in front of her moving them in and out slightly to show what the movement would be like. This is the interaction that followed:

Dr. X: If you hold your hands out in front of you with your palms facing each other and really focus, you should be able to feel the energy passing between them. I can feel it now.
OMM fellow off to the side: *whispered* I think I saw that in Mortal Kombat!
Dr. Y: *whispered less quietly* Do you think she can knock someone over?
Dr. X: No, Dr. Y, I can't knock someone over, but thanks for asking.

You can guess how seriously most of us took cranial after that...

 

[Styria]

It doesn't help them to start out discussing cranial as anything other than an articulatory mechanism. At my school they talked a lot about the Traube-Herring wave (a cyclic variation in blood pressure) and how the CRI ended up matching up with that with a 2:1 ratio. The new (3rd) edition of Foundations of Osteopathic Medicine has a good chapter on oscillations, with a Fourier transformation showing separate peaks for pulse, respirations, CRI, and the slower 'long tide' and other variations that go on.

One of the OMM fellows studied the Bass skeleton collection and found that fusion of cranial sutures matched up with signs of somatic dysfunction on the same side of the body (such as a unilateral fused sacrum and innominate). This had far more correlation than any suture closure by age. This work was for her forensic anthropology PhD.

There's so much to learn in cranial that it's better to just stick with the mechanism in school. You have enough to do just to learn to palpate it (though my class is doing excellent at it).

V-spread. Try it ten times and see if you'll have felt anything by then. If not, go ask your faculty for help. Kind of like what you're supposed to do if you have trouble with anything else in medical school.

 

[Terpskins99]

As a DO currently in a neurology residency, and as someone that has discussed the topic with several neurosurgeons (both MD and DO)... I've come to the conclusion that the theory behind craniosacral therapy is essentially horse poop.

Once those sutures fuse, you've got a fixed bone. The skull does not move, folks. That sensation you feel on your fingertips? Its your own pulse.

 

[sideways]

As a DO currently in a neurology residency, and as someone that has discussed the topic with several neurosurgeons (both MD and DO)... I've come to the conclusion that the theory behind craniosacral therapy is essentially horse poop.

Once those sutures fuse, you've got a fixed bone. The skull does not move, folks. That sensation you feel on your fingertips? Its your own pulse.

Silence!

 

[MedicinaeDoctor]

is cranial the only modality that is perhaps bunk in OMM?

 

[DocEspana]

is cranial the only modality that is perhaps bunk in OMM?

there are some less common techniques that likely only have extremely limited usage that some people seem to be in love with and probably overly expand the usage of. But I think that, generally speaking, everything in OMM has a pretty valid purpose (Though maybe not as big of a value as sometimes reported) and has pretty good science behind it (since OMT is not the most complex thing, science wise) except for cranial.

 

[vanbamm]

Cranial manipulation is a terrible theory. They don't even teach it in chiropractic school where we learn every kind of manipulation possible- so what does that tell you.

Now moving into evidence based practice- it is going to be ruled out as a possible therapy unless some people really decide to do some research and prove it exists...and works!

 

[wannabeOBGYN]

Cranial manipulation is a terrible theory. They don't even teach it in chiropractic school where we learn every kind of manipulation possible- so what does that tell you.

Now moving into evidence based practice- it is going to be ruled out as a possible therapy unless some people really decide to do some research and prove it exists...and works!

Oh I love this, a chiropractor talking about the validity of medicine.

 

[HealingDoc]

I was also skeptical about cranial, when it was being presented at my school for a few weeks during 1st year. I basically tried to maintain a calm mind, and I tried to sense the CRI but I would usually just feel my own pulse in my hands and I couldn't get past it. For the written test, I just memorized the strain patterns very well and a couple of points regarding the history and I did pretty well. I just decided to put it past me after that, until fall of my 2nd year when we had a new professor on faculty who uses cranial to prescribe proper glasses for his patients- sounds like BS, right?

Our new professor had a brown bag lunch for us about this one day and chose me to come up front to palpate a fellow student's cranium while he held different powered lenses in front of her eyes (I was the last person I thought he would pick because of my skepticism). He would change the lenses and ask her to look through them as I felt for a shift under my index and pinky fingers. So he had my friend look at the first lens, and then asked me the cranial strain pattern in front of about 50 people- yikes! Thinking of the strain patterns I memorized, I decided which one it felt like the most and I told him and the class- got it right first try, and I was completely astonished that I did actually feel a shift. It turns out, the four extra occular recti muscles arise from a short funnel-shaped tendinous ring called the annulus of Zinn, which attaches to the sphenoid bone. So as different lenses were held in front of my friend's eyes, her extra-occular muscles were changing their forces on the eye in order to compensate, and in turn they exhibited different forces on the sphenoid. For the rest of the exercise, I tried to keep telling myself, "if you think you felt it, its there," I was able to get most of the strain patterns right. Unfortunately my friend had a huge headache afterward and felt nauseous, so my professor had to work on her through class time.

The lens activity actually gave me a physiologic and anatomical explanation for the forces I was feeling under my fingers. If the eyes work this way, then one must think that someone who walks around with a short leg for years could have a corresponding strain in the cranium from unequal forces on each side. It doesn't matter if the bones move at the sutures or not- bones can transmit forces, and if those forces are stong enough they can cause strain in the structure of the material. I'm not sure about the CRI or CNS fluctuations, but I do think forces in the bone and stiffness in the dura can be palpable and treated.

So that's my take on it for now- I focus on vectors/distribution of forces and strain in materials as a real, palpable way to approach understanding of cranial.

 

[JaggerPlate]

where we learn every kind of manipulation possible

Apparently you guys haven't gone over the 'foot in mouth' technique yet.

 

[Dr Skeptismo]

...So as different lenses were held in front of my friend's eyes, her extra-occular muscles were changing their forces on the eye in order to compensate, and in turn they exhibited different forces on the sphenoid...

I though the extraoculars were responsible for eye movement, not eye focus. Maybe I'm misinterpreting the purpose of the test, but aren't the ciliary muscles responsible for focusing the eye? And they don't attach to the sphenoid.

Unfortunately my friend had a huge headache afterward and felt nauseous, so my professor had to work on her through class time.

I used to get those same headaches when I'd try on my parents glasses as a kid...

The lens activity actually gave me a physiologic and anatomical explanation for the forces I was feeling under my fingers... I focus on vectors/distribution of forces and strain in materials as a real, palpable way to approach understanding of cranial.

If the extraocular muscles could move the sphenoid (if the sphenoid could move), why the need for the lens test? Using that reasoning, I'd be able to appreciate motion everytime I rolled my eyes.

 

[HealingDoc]

I though the extraoculars were responsible for eye movement, not eye focus. Maybe I'm misinterpreting the purpose of the test, but aren't the ciliary muscles responsible for focusing the eye? And they don't attach to the sphenoid.

Introduction of different powered lenses (in one eye and in both as my professor demonstrated) causes the eyes to accomodate and does involve the cilliary muscles, but convergence also occurs. Convergence involves movement of the eye by the rectus muscles and it happens in effort to maintain single binocular vision. Convergence would be what ultimately causes varying forces on the annulus and then on sphenoid. In neuro, we learned that the actions of accomodation, convergence, and dilation/constriction of the pupil are all under control of the Edinger-Westphal Nucleus in the brain, and thus work together to help the eye focus.

I used to get those same headaches when I'd try on my parents glasses as a kid...

I think our professor would respond to this by asking why you think you got the headache- was it the weight of the frames on your face? Not likely, but it may have been the changes your eyes had to make to adjust to the lenses. Just as any muscle aches when you use it in a way that it is not used to being used, your extraoccular muscles were shifting in ways they were not used to, and also putting strain on your spenoid bone that your head is not used to. Whether its the muscles, your cranium, or both causing the headache, I am not sure. Your vestibular system feeds off of visual input as well, so I am surprised you didn't also feel nauseous when you tried on those glasses.

If the extraocular muscles could move the sphenoid (if the sphenoid could move), why the need for the lens test? Using that reasoning, I'd be able to appreciate motion everytime I rolled my eyes.

I think the lens test is what he uses to determine what lenses ultimately create forces on the spenoid bone that remove any strains which were already there causing problems. He would figure out that prescription and tell his patients to wear glasses at all times for x many weeks- they would come back into the office after that, and he would re-evaluate their vision/ cranial mechanism to determine if they still needed glasses. The glasses function to retrain the patient's "near triad" to operate with no strain to the cranial bones.

 

[st2205]

Cranial manipulation is a terrible theory. They don't even teach it in chiropractic school where we learn every kind of manipulation possible- so what does that tell you.

Every kind of manipulation possible? Really? Counterstrain? Muscle energy? Balanced ligamentous tension? Rolfing? Psychic surgery? Orthopedic surgery? Reiki?

 

[vanbamm]

"every manipulation possible" = we do ALOT of manipulation and techniques. simmer. put the handcuffs away.

 

[Namedmymember]

Why not just run a test? What the hell is the point of arguing about who's anecdotal experience is most valid?

 

[st2205]

"every manipulation possible" = we do ALOT of manipulation and techniques. simmer. put the handcuffs away.

The way I understood it, chiropractic had it's own version of cranial osteopathy. I forget what it was called and maybe perhaps only a few of them do it, but you're the chiropractic student so what would I really know.

I'm curious to know, which other manipulative techniques do chiropractors learn? I really only see them doing HVLA. This is just my personal experience and isn't a criticism since most of what I find highly effective in OMT is HVLA, and is one of the things that brought me in to osteopathic med (being previously familiar with/interested in chiropractic technique).

Do you learn any of the therapies I mentioned? I'm assuming the "every manipulation possible = we do ALOT of manipulation" must equal at least one or two of those.

 

[vanbamm]

The way I understood it, chiropractic had it's own version of cranial osteopathy. I forget what it was called and maybe perhaps only a few of them do it, but you're the chiropractic student so what would I really know.

I'm curious to know, which other manipulative techniques do chiropractors learn? I really only see them doing HVLA. This is just my personal experience and isn't a criticism since most of what I find highly effective in OMT is HVLA, and is one of the things that brought me in to osteopathic med (being previously familiar with/interested in chiropractic technique).

Do you learn any of the therapies I mentioned? I'm assuming the "every manipulation possible = we do ALOT of manipulation" must equal at least one or two of those.

Some practice the cranial-sacral technique, incorporating both ends of CSF flow while trying to establish better function through stabilizing proper structure- that is something we are introduced to, but not something we delve into...palpation of sutures and feeling the CSF is a common part of the occiptal aspect when looking to correct pathology, but we do not learn to mobilize sutures- rather just introduced to the theory and its relationship to the life energy that is throughout the entire body...

To be honest, alot of the adjustments are HVLA, which is to adjust fixations, not hypermobile regions. This goes for every region of the spine, including the sacrum and also the pelvis. Some of the blocking techniques incorporate gravity and do not utilize HVLA, and even more of some of the adjustments are done simply through opening joint spaces through distraction and allowing the structure to return to its position- which you will find happens most of the time on a good tissue pull with proper technique and positioning before even attempting HVLA thrusts...

These are the basics for spinal/occipital/pelvic adjustments...extremity and TMJ manipulation varies but for the most part, it simply involves opening the joint space and placing the said structure back into the correct position...I am not sure what types of techniques OMM incorporates; what does OMM involve?

 

[Ferrismonk]

I tried to read all the replies above, but honestly I couldn't read all of it before my brain tried to exit my skull. 😉

I personally love cranial OMM, but I think people tend to put too much into proposed mechanisms and its wacked-out origins. I can feel the cranial motions and am able to fix a number of problems through cranial techniques. Mostly I use it at home because the hospital culture doesn't lend itself to spending hands-on time with patients (plus OMM is technically a treatment, thus needs attending approval first, thus in never actually gets done). I've relieved countless headaches by releasing the occipito-mastoid suture and the spheno-squamous suture. I've relieved clogged sinuses with dural-sinus techniques and the CV4. I've even relieved constipation by relaxing a compressed jugular foramen (and thus the vagus nerve).

Now does any of this have anything to do with CSF flow or actually moving cranial bones? I'm not sure. But it works and I'll use it.

That being said, I had an OMM professor that had quite a collection of respectable journal articles proving that various tenants of cranial osteopathy were in fact legitimate. I wish I had the list to share, but I know there is literature out there that supports cranial OMM.

 

[SmokD]

Why not just run a test? What the hell is the point of arguing about who's anecdotal experience is most valid?

Because you can't design a valid double blinded study on pretty much anything in OMM. The person preforming the technique will always know whether or not they are administering the actual technique or the "placebo".

If it ain't double blinded, it doesn't exist.

 

[thepoopologist]

I think Cranial is useless. My opinion might change once I try it on someone and it actually works or I try it on someone and they think it works and pay me $500 for it.

 

[toastedcheese]

Because you can't design a valid double blinded study on pretty much anything in OMM. The person preforming the technique will always know whether or not they are administering the actual technique or the "placebo".

If it ain't double blinded, it doesn't exist.

Haha, no tests. What if you took a group of PAs, trained half in cranial and half in something made up but plausible sounding? Just an idea.

Anyway, arguments with chiropractors must be super awkward. How do you say, 'No, no, what you do is bull****, but "[relieving] constipation by relaxing a compressed jugular foramen" is legit' with a straight face?

 

[hawkeye pierce]

Honestly, If it isn't double blind then it doesn't exist? Do you doubt the effectiveness of 90%(made up number) of surgeries due to this? Also, chiropractic is effective and works.

 

[DocEspana]

Honestly, If it isn't double blind then it doesn't exist? Do you doubt the effectiveness of 90%(made up number) of surgeries due to this? Also, chiropractic is effective and works.

I can prob answer for SmokD because I would have made a similar point. The answer to your question is: "I don't doubt those. But people do. And they do so because its not double blind."

Until there is a double blind, some pretentious ******* can, and inevitably will, declare that the research is not completely there yet. I've seen examples of this done to surgical studies (specifically one on a new method of heart valve replacement). And I've definitely seen it applied to even the most clearly obvious and justifiable OMM techniques. Some things, like cranial, i think require an asshat to be picky and demand a double blind. Because the actual mechanics of it are in debate. Some things, like basic OMM or surgical techniques, dont need double blinding because we understand the mechanics, we just want to know if it is more or less effective. But unless it is double blind, someone can make a point that the most rigorous studies have not been accomplished and, no matter how rational or irrational his argument his, he'd be 100% correct to say so.

 

[J-Rad]

If there are distinct and measurable (by the trained expert(s)) phenomena underlying the cranial pathophysiology, then there should be some inter-examiner reliability when two experts are palpating the same patient. This, apparently, is not the case:
http://faculty.une.edu/com/shartman/sram.pdf

Cranial, at least in adults, is religion, and people are hard pressed to give up their religious beliefs, no matter the lack of evidence or sensible-ness behind it.

 

[SmokD]

It's totally different with surgery. With surgery, 1) Find something thats not supposed to be there, 2) Cut that thing out, 3) Verify that said thing is out. Theres really no question about any point of that process.

But yea DocEspana said it right, thats what I meant. The different between Cranial and other OMM/Chiropractic techniques is that with OMM there is a clear problem(somatic dysfunction) that we are trying to address with at the very least a modicum of scientific basis.

Whose to say where the "rhythm" you feel in cranial techniques is coming from the patient, coming from the practitioner's own hands, or coming from the practitioner's own head. Furthermore, who can say without a shadow a doubt that the relief felt by a patient who underwent cranial therapy came from the technique itself. I can't verify this but I am sure there is more scientific evidence supporting the use of meditation and relaxation in medical treatment than in cranial techniques. The fact that the patient can take a 20min nap while the doc is doing cranial is a more reasonable explanation to the "efficacy" of cranial treatments.

Haha, no tests. What if you took a group of PAs, trained half in cranial and half in something made up but plausible sounding? Just an idea.

But then the people trained in cranial will know they are providing a treatment with efficacy and, whether they mean to or not, will display this to the patient. The patient will then be more confident of a positive outcome and therefore the outcome is more likely to be positive. Likewise someone who is trained in something else will unintentionally display that the treatment is a placebo, and the patient will respond to it. At least, thats the reason why in a double blinded study no one who has patient interactions knows who is in the control/experimental group.

 

[JaggerPlate]

Haha, no tests. What if you took a group of PAs, trained half in cranial and half in something made up but plausible sounding? Just an idea.

It's been discussed, but you're bringing in additional variables by teaching a group that doesn't put the time, effort, etc, into OMT from the get go (providing manual medicine isn't the same thing as handing someone a pill), and you're also running the risk of a placebo treatment (especially when it's essentially from a secondary source) having some sort of measurable effect -positive or negative.

There is no doubt that OMT NEEEDDDSS to be researched more efficiently and subject to the same merits of proof that all other types of medical treatment go through, but it really is hard to set up proper trials for manual medicine studies. I took a research course a while back and did my big end project on designing research trials in OMM. It was a pain trying to conceive something close to double blind, to remove a lot of sources of error/variables, measure outcomes, etc, etc. Not an excuse by any means (especially for a modality that's 100s of years old), but just my .02

Anyway, arguments with chiropractors must be super awkward. How do you say, 'No, no, what you do is bull****, but "[relieving] constipation by relaxing a compressed jugular foramen" is legit' with a straight face?

I'd probably say - "show me your unrestricted license to practice medicine and surgery in all 50 states in the union ... OHH, wait - never mind."

Also, chiropractic is effective and works.

This statement seems a bit vague - do you have the studies to back it up? Generally saying 'chiropractic is effective and works' based on anecdotes is just as unscientific as condemning OMM without providing tangible, objective proof. Furthermore, it's absurd to say chiropractic is effective and works when you really don't have inside knowledge of the mechanism of the techniques. HVLA performed by a DO is, from what I've gathered, quite similar to spinal manipulation performed by a DC - although after talking with a few DCs, it seems like this is where they draw the line and where OMM continues expanding into different realms.

If you want to say that some OMM techniques aren't effective, some are, and then make an argument ... that's fine. However, I don't feel like the generalizations are a good idea. The overwhelming majority of OMM is based on sound physiological principles and is effective in a good chunk of patients.

 

[hawkeye pierce]

Jagger,
I should note, I never said omm isn't effective. I will be attending an osteopathic medical school not a chiropractic school. I was simply saying that chiro works. It is a broad statement with lack of double blind placebo controlled research. However, surgery and OMT have the same problems.

 

[vanbamm]

I'd probably say - "show me your unrestricted license to practice medicine and surgery in all 50 states in the union ... OHH, wait - never mind."

DC's assume practice without the use of drugs or surgery. No matter either way- just a few less things in the tool belt.

This statement seems a bit vague - do you have the studies to back it up? Generally saying 'chiropractic is effective and works' based on anecdotes is just as unscientific as condemning OMM without providing tangible, objective proof. Furthermore, it's absurd to say chiropractic is effective and works when you really don't have inside knowledge of the mechanism of the techniques. HVLA performed by a DO is, from what I've gathered, quite similar to spinal manipulation performed by a DC - although after talking with a few DCs, it seems like this is where they draw the line and where OMM continues expanding into different realms.

There are journals you can read to discover these things- www.jmptonline.org, www.chiroandosteo.com to name a few.
HVLA is a common technique, as if flexion-distraction, and actually a little mobilization which is HALV...and it does work (I have inside knowledge of the mechanism of the techniques)🙂

 

[JaggerPlate]

Jagger,
I should note, I said omm isn't effective. I will be attending an osteopathic medical school not a chiropractic school. I was simply saying that chiro works. It is a broad statement with lack of double blind placebo controlled research. However, surgery and OMT have the same problems.

A few things ...

1. If you're attending DO school in the Fall, I would seriously reconsider your attitude toward OMM a bit. If you practice it, study it, and research it, and still think it's unproven, bunk science ... that's fine by me. However, rest assured that OMT is going to comprise a significant amount of your curriculum, and going into it convinced it's junk and ineffective is going to make you hate life.

2. I'm still confused about your logic here: OMT and DC essentially have a large overlap in one technique - HVLA. To my knowledge (I apologize if I'm being a bit vague or broad here), HVLA (or spinal manipulation in general) comprises the majority of DC treatment and a portion of OMM treatment. How then, can you say that all of DC is legit and all of OMM isn't effective or valid when there is an significant overlap in the techniques.

Again, if you want to say HVLA is the only legitimate OMM technique (which is far from the truth), then that's fine, but it's not what you're saying. You're saying that all DC is legit, proven, and effective and all OMM isn't. Additionally, you state that double blind, accepted spinal manipulation studies (pertaining to Chiro manipulation) are out there and make your case. However, like I said before, this makes just as strong of a case for OMM (due to the overlap in spinal manipulation techniques). So which one is it? DC is all valid, OMM is all invalid? Doesn't make sense to me. Is HVLA the only OMM treatment you think works?

3. You still haven't provided any studies/reasons why you think Chiro manipulation works. I'm not saying that it doesn't, nor am I pulling out peer reviewed studies here to support OMM (though I could do so quickly and have in the past), but it sounds like you've forged an opinion here based on anecdotal evidence or a 'gut feeling.' This isn't good science.

 

[JaggerPlate]

DC's assume practice without the use of drugs or surgery. No matter either way- just a few less things in the tool belt.

Not utilizing medicine and surgery is just a 'few less things in the tool belt?' Seems like a hell of a difference in the tool belt to me. Seems like Batman's utility belt versus a piece of frayed rope tied around your waist.

There are journals you can read to discover these things- www.jmptonline.org, www.chiroandosteo.com to name a few.

I'm well aware of the available research for spinal manipulative techniques. My point was that the OP who claims all chiro is legit and all OMM isn't doesn't seem to have forged an opinion based on this information. Furthermore, I still think that nearly all studies supporting the efficacy of spinal manipulation in general make a case for the use of OMM

HVLA is a common technique, as if flexion-distraction, and actually a little mobilization which is HALV...and it does work (I have inside knowledge of the mechanism of the techniques)🙂

Good; then you're well aware of the upsides of utilizing OMM.

 

[hawkeye pierce]

Jagger, I think they both work. I think you are misinterpreting my statements. I chose to apply to DO schools only because I want to learn OMT. I don't know what I said to make you think that I think OMT is bunk. You did not confuse me with the OP did you? I've seen studies though honestly too lazy to look them up. Rest assured though at no point was I attacking omt. Sorry for the confusion. I look forward to learning the many methods of OMT.

 

[Phil Dunphy]

Jagger,
I should note, I said omm isn't effective. I will be attending an osteopathic medical school not a chiropractic school. I was simply saying that chiro works. It is a broad statement with lack of double blind placebo controlled research. However, surgery and OMT have the same problems.

I think you made a typo

 

[hawkeye pierce]

Thanks phil. I fixed it. Thanks for pointing out what was going wrong.

 

[JaggerPlate]

Jagger, I think they both work. I think you are misinterpreting my statements. I chose to apply to DO schools only because I want to learn OMT. I don't know what I said to make you think that I think OMT is bunk. You did not confuse me with the OP did you? I've seen studies though honestly too lazy to look them up. Rest assured though at no point was I attacking omt. Sorry for the confusion. I look forward to learning the many methods of OMT.

Yeah I agree with Phil ... I don't think you did it intentionally, but if you look at the quoted post (both Phil and I quoted it) you blatantly said "OMM isn't effective." Probably was just an honest mistake.

From my personal experience, I just recommend going into it with an open mind. I already know people who've worked with it, studied it, practiced it, and aren't fans/don't plan on really going very far with it, and I have no issues with this. I look at it in the same sense that some people love anatomy and hate physio, while others like physio and hate anatomy ... it's all subjective.

I'm glad you're excited to learn it. It's challenging and can be a bit difficult to balance sometimes (with a full medical school course load + the OMT component), but it's interesting stuff and it's always nice to hear that future DO students are looking forward to it.

 

[hawkeye pierce]

Jagger,
Yeah again sorry. I had looked at the quote and kept mentally adding the missing word (i've now changed it to have the correct wording). I am definately excited to learn it.

 

[JaggerPlate]

Jagger,
Yeah again sorry. I had looked at the quote and kept mentally adding the missing word (i've now changed it to have the correct wording).

I do the same thing all the time.

I am definately excited to learn it.

👍 Good luck! Let me know if you ever want opinions on OMM texts, tables, keeping up with it, etc. Not that I'm an expert by ANY means, but definitely an interest of mine so maybe could offer some semi-useful advice.

 

[vanbamm]

Not utilizing medicine and surgery is just a 'few less things in the tool belt?' Seems like a hell of a difference in the tool belt to me. Seems like Batman's utility belt versus a piece of frayed rope tied around your waist.

I'm well aware of the available research for spinal manipulative techniques. My point was that the OP who claims all chiro is legit and all OMM isn't doesn't seem to have forged an opinion based on this information. Furthermore, I still think that nearly all studies supporting the efficacy of spinal manipulation in general make a case for the use of OMM.



Good; then you're well aware of the upsides of utilizing OMM.

Depends on the approach and condition. Most MS cases in a DC clinic are things don't require either, but with others, yes we are at a disadvantage and need to refer to someone who does have those things at their disposal. I am okay without treating with med or surg. and also recognize when it is needed- funny thing about the belt; is there is actually a belt technique I was introduced to that involves using body weight to distract (chiro. prof. is 5 "6" and 130 lbs so patients are typically alot bigger than him)...not a fan, but gets creativity points.

I haven't seen too much against OMM either, which is good and a reason why I figure it is still taught at osteopathic schools?...another tool for the D.O. to put in the belt if wanted.