EB vs traditional OMM?

[PT2MD]

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I was curious about how much OMM instructors provide their students with different perspectives on the techniques they teach in school? For example, we learned and accepted Fryette's laws as dogma in PT school, but now know there are conflicting data regarding this concept. At the time, we were taught the laws were just that; laws which have been validated and have very strong support.

I am curious about how DO schools handle the teaching of these manual therapies and if they offer a variety of perspectives on fundamental techniques and more esoteric techniques such as craniosacral manip etc.

I hope I'm not opening up a can of flame here, but this is something I'd like to know when deciding on my school (If I'm lucky enough to have a decision). I've no problem learning the techniques provided the instructors offer a range of perspectives on them. Looking back on my PT schooling, one could make the argument that they were sometimes indoctrinating vs educating. I was hoping DO programs (TCOM specifically!) are more developed.

Thanks for any input you can provide.

 

[Red Beard]

That there is evidence contradicting Fryette's "laws" is news to me. I don't doubt it, I've just never heard about it.

I would say that OMM teaching at our school is dogmatic in the sense that dissenting evidence is rarely presented, and little/poor supporting evidence for some things we learn is shown. We haven't covered cranial yet, but recently learned Chapman's points and I am thoroughly unconvinced as to their validity, either as a diagnostic tool or a treatment modality.

That being said, I was able to bring up my concern with one department head (a neurologist who heads our OMM department) who agreed and expressed frustration that certain aspects of OMM which have no clearly identifiable anatomic, physiological, or neurological basis and no good research are still presented as 'fact.'

So it appears that there are those in our profession who don't take everything at face value as given. If only more students and future osteopathic physicians would start to question things, our profession would eventually become one in which our treatment modalities have been run through the ringer, the useful separated from the useless which we can then discard.

The problem is that we are conditioned to believe that everything our white-coated professors tell us is well understood and documented. We suffer through 4 years of math, physics, chemistry, biology...we are used to memorizing the material and assuming someone, somewhere must have worked it all out for us long ago. This isn't the case with OMM, and we need to take a big step back as a profession and do the required work!

 

[osli]

I don't know... it always seemed to me like a majority of the students in our class questioned a lot of what we are taught in OMT. Not all of it, and not everyone questions the same things. And we may question some stuff that actually works, but would like to simply see better research support. Most DO's don't use OMT after they graduate, and from my personal observations it seems like most DO students didn't choose to go DO simply because of OMT training, just as most don't choose a school because they like the physiology department better than other schools.

But, it does seem like all of us get at least something out of OMT. It's a good review of anatomy, and in a very unintended way it helps you develop critical thinking skills and to better understand when you need to question any subject/topic/fact you are presented in your education and career. And I think some of the techniques are terrific - ME is my favorite and there appears to be a very solid physiological basis for it. And others just feel good, whether they improve things or not.

But at the end of the day, like a dozen other subjects, it's just something we are taught and have to pass on the way to becoming a practicing physician. 😎

 

[DragonWell]

My impression is that there are some parts of OMM that must be learned as "dogma" for board purposes. Fryette's would fit this, IMO. However, if you really talk to some OMM professors, most of them will agree that while Fryette's may be conceptually useful, using the word "law" is probably a bit of a stretch.

Cranial and Chapman's also seem to fit into the category of "must know it for the boards", but it's questionable how many docs actually believe in or use it.

 

[K3l3v]

It kinda depends on how and when you approached our professors (KCUMB-COM). In class, they had to get through all of the techniques/concepts with 240+ students, one day a week. You listened, you studied, and you did your best in lab. If you really wanted to be able to manipulate, you spent time outside lab/class practicing with friends/TA's/professors.

The one thing our professors were very good at was acknowledging that 'patients don't read the textbooks'. They kept reminding us to learn official dogma for the boards, but treat what we actually found.

As far as Fryette, like a lot of things in medicine and life, what he originally proposed is not what is currently taught. If you want to know what he said, read his writings. Same goes for Still or any other 'great mind in medicine'. You want a 'solid' argument for or against anything, I guarantee I can find it within 72 hours.

DO's have been slow in researching OMT. That is changing, slooooowly. OMT is very operator dependent. That said, treat it like any other medicine/procedure - use evidence when you've got it, and use your own clinical judgement/experience/wisdom when the evidence isn't available. How many drugs and procedures have been championed and then discarded in the last 10 years alone? All of them were backed by some kind of 'research' or another.

Just my $0.02

 

[Zerosixjt]

I have to agree with previous posts. We were taught to know certain things with respect to boards, but our instructor tried to point out research for us to look at when available.

He also often said, do what works for the patient, and encouraged us to come up with our own research projects to look at OMT.

The best thing that I can say is keep an open mind. The research is being done, but it may take some time to build up the evidence since there are just fewer DOs doing research when compared to our MD counterparts (a number issue, not a knowledge issue).

I hope that this helps, and good luck!