Faking it in OMM.

[Brodiewankenobi]

There's a reason Harvard has an OMT program that is packed with a waiting list every year with MDs trying to get training in the techniques.

And I bet they ask lot of the same questions I am asking. This thread also indicates a ton of DO students are doing the same thing. Nothing wrong with being skeptical.

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[facetguy]

Two, show me controlled studies where OMM improved a condition compared to a sham treatment.

I'm going to take a guess here and assume you haven't done much looking.

 

[homeboy]

There's a reason Harvard has an OMT program that is packed with a waiting list every year with MDs trying to get training in the techniques.

There's also a reason why it's not tested on the the USMLE.

The very notion that MDs are jumping at the bit to learn OMM is ridiculous.

What, a GME course for 25 MDs makes it universally popular because it's at Harvard?

Bottom line: yes, people fake OMM in lab. You almost have to. And those that don't actually convince themselves that what they're feeling (eg. the SBS actually moving as detected by holding someone's ankle...) is real.

I faked it in practicals all the TIME: "feels like he's...rotated right, sidebent left"..."I think she has a ...left lateral torsion." Now, either I'm an EXTREMELY good guesser, my profs are full of crap, or they're just saying what they want me to hear to build my confidence as an osteopathic diagnostician. The first choice is just impractical, and the latter more LIKELY two are just, well, pathetic.

 

[hooperg]

OMT is by and large a great tool in any clinician's repertoire, but I do admit--and others will attest--that there are some dubious aspects i.e. cranial, which, in my opinion, set the profession back in the eyes of the outside world. OMT does have a large research backing with respect to efficacy. The study that I often point out is:

http://content.nejm.org/cgi/content/short/341/19/1426

A peer-reviewed, reputable journal validates the use of OMT for back pain. What more could one want?

I believe that the future for OMT is bright so long as fringe elements don't s*** all over the reputation as it emerges.

VR,
Gray, WVSOM 2010

 

[meister]

Get rid of cranial and make OMT a certifiable practice that any MD or DO can do as a bonus. Done.

The turf war is just stupid and makes us more vulnerable to turf wars from mid-levels and other practitioners.

 

[DOinMS]

This whole thread is . Why not just drop the pretense and get rid of OMM and leave that stuff for PTs and DCs?

Unite the profession and let's move on already. Not trolling but I honestly just don't understand...

I agree completely. I feel sorry for anyone currently in a DO school or hoping to attend who thinks OMT is something only DOs offer patients. True, we are the only ones who call it "OMT," but PTs and DCs do the stuff everyday. And our effort to force OMT into mainstream medicine is like trying to force a square peg into a round hole. Meister is spot on, but as long as the division is being perpetuated by the gray-haired old men and those in the new generation who buy into the rhetoric unity will never happen. Folks, the osteopathic profession is its own worst enemy.

 

[Lamborghini1315]

We refer to it as OPP (Osteopathic principles and practices). Well you can't expect to be detached from opp when you attend an osteopathic school. Its something you should accept and question it during your practice when you use the techniques based on your discretion. That's when you really hit the "reality"..you might see that something really works for your patient or whoever and you might continue to do it because it works in your experience!! So at this point its kinda like consuming everything you are asked to and then weeding out whatever you see less efficacious. I personally like muscle energy for a variety of issues and i will def offer that to my patients, no doubt! whereas not a big believer in hvla. So yea find your groove and stick with it...

 

[Brodiewankenobi]

We refer to it as OPP (Osteopathic principles and practices). Well you can't expect to be detached from opp when you attend an osteopathic school. Its something you should accept and question it during your practice when you use the techniques based on your discretion. That's when you really hit the "reality"..you might see that something really works for your patient or whoever and you might continue to do it because it works in your experience!! So at this point its kinda like consuming everything you are asked to and then weeding out whatever you see less efficacious. I personally like muscle energy for a variety of issues and i will def offer that to my patients, no doubt! whereas not a big believer in hvla. So yea find your groove and stick with it...

1st Bold-- Really?? Do you approach all of your classes like this? Even in a non-OMT lecture you should think critically about what you are being taught. If you don't develop the skills on how to ask questions about the efficacy of therapies in school how in the world are you going to learn these skills on the fly in your practice.

2nd and 3rd Bold-- This is the real power of evidence based medicine. It eliminates the "well it may not work in your practice, but in mine I found XYZ to be effective." The plural of anecdote is NOT DATA! Yes, physicians need to draw on their own experiences when deciding what therapy to use or dx to make. However, these decisions are most effective when they are supported with hard data.

 

[jp104]

1st Bold-- Really?? Do you approach all of your classes like this? Even in a non-OMT lecture you should think critically about what you are being taught. If you don't develop the skills on how to ask questions about the efficacy of therapies in school how in the world are you going to learn these skills on the fly in your practice.

2nd and 3rd Bold-- This is the real power of evidence based medicine. It eliminates the "well it may not work in your practice, but in mine I found XYZ to be effective." The plural of anecdote is NOT DATA! Yes, physicians need to draw on their own experiences when deciding what therapy to use or dx to make. However, these decisions are most effective when they are supported with hard data.

We refer to it as OPP (Osteopathic principles and practices). Well you can't expect to be detached from opp when you attend an osteopathic school. Its something you should accept and question it during your practice when you use the techniques based on your discretion. That's when you really hit the "reality"..you might see that something really works for your patient or whoever and you might continue to do it because it works in your experience!! So at this point its kinda like consuming everything you are asked to and then weeding out whatever you see less efficacious. I personally like muscle energy for a variety of issues and i will def offer that to my patients, no doubt! whereas not a big believer in hvla. So yea find your groove and stick with it...

Brodiewankenobi, this is what you should have really bolded. Understand something...sometimes you have to play ball. It's a stretch to assume that since Lamborghini (and I suspect many DO students) dutifully do OMM and maybe even fake it that we approach all of our classes like this. Most DO students would probably fully agree with you and want more EBM studies done for OMM. Anyways, life lesson over

 

[Lamborghini1315]

1st Bold-- Really?? Do you approach all of your classes like this? Even in a non-OMT lecture you should think critically about what you are being taught. If you don't develop the skills on how to ask questions about the efficacy of therapies in school how in the world are you going to learn these skills on the fly in your practice.

2nd and 3rd Bold-- This is the real power of evidence based medicine. It eliminates the "well it may not work in your practice, but in mine I found XYZ to be effective." The plural of anecdote is NOT DATA! Yes, physicians need to draw on their own experiences when deciding what therapy to use or dx to make. However, these decisions are most effective when they are supported with hard data.

Ok well you made all those inferences from my statement about accepting opp for what it is? Well are you currently attending a DO school? If no then you think you would have the grasp to understand the material that's provided in OPP? I don't make any assumptions or live by anecdotal evidence, this is medicine the whole medical world sticks by evidence based medicine, you didn't suggest anything "wow, why didn't i think that?!? Instead of going off tangent and missing my point try to understand this that every DO student which might exclude you has to come to terms with what they are presented and what they can take out of it..i was talking about how you should approach that particular situation. My response is in no way form suggestive of trying to set up a clinic where doctors try to implement or invent medical modalities on a fly! There's a place for that in the research lab but if you are an aspiring DO you should get involved in osteopathic research and may be you can resolve some of the kinks. But my advise is only pertinent to medical students that intend to use opp in their practice along with other things they have learned, i was just trying to help not muddy up your mind!

 

[facetguy]

2nd and 3rd Bold-- This is the real power of evidence based medicine. It eliminates the "well it may not work in your practice, but in mine I found XYZ to be effective." The plural of anecdote is NOT DATA! Yes, physicians need to draw on their own experiences when deciding what therapy to use or dx to make. However, these decisions are most effective when they are supported with hard data.

Of course, the more 'hard data' the better. But I think it would be going a bit too far to suggest that everyday medical practice is in its entirety truly 'evidence based'.

 

[Hurricane95]

We refer to it as OPP (Osteopathic principles and practices). Well you can't expect to be detached from opp when you attend an osteopathic school. Its something you should accept and question it during your practice when you use the techniques based on your discretion. That's when you really hit the "reality"..you might see that something really works for your patient or whoever and you might continue to do it because it works in your experience!! So at this point its kinda like consuming everything you are asked to and then weeding out whatever you see less efficacious. I personally like muscle energy for a variety of issues and i will def offer that to my patients, no doubt! whereas not a big believer in hvla. So yea find your groove and stick with it...

LOLZ!!

muscle energy? Use the force luke!!....
"We can't do it cap'n, we don't have the power!!"

How do you measure muscle energy....with your fingerpads? An ammeter? Do you use joules as the units?

roflcopters!

 

[Lamborghini1315]

LOLZ!!

muscle energy? Use the force luke!!....
"We can't do it cap'n, we don't have the power!!"

How do you measure muscle energy....with your fingerpads? An ammeter? Do you use joules as the units?

roflcopters!

hehe you know kinda like wolverine's claws, my muscle energy's impact is hard to measure but only noticed..lol

 

[BrianD]

LOLZ!!

muscle energy? Use the force luke!!....
"We can't do it cap'n, we don't have the power!!"

How do you measure muscle energy....with your fingerpads? An ammeter? Do you use joules as the units?

roflcopters!

Muscle energy does sound cheesy I think. It's basically just post-isometric relaxation.

 

[Lamborghini1315]

Muscle energy does sound cheesy I think. It's basically just post-isometric relaxation.

Yea seriously, instead of fighting about changing our degree designation..i much rather see a relabeling of some of the opp lingo, some of the stuff sounds so ancient!

 

[Hurricane95]

Oh ok...I actually just looked it up and it seems to be just a class of muscle stretches...im cool with stretching exercises. But you're right, they need to rename it. I got this mental picture of this CAM thing I saw once where they put electrodes on both ends of the biceps and were measuring "muscle current" or some other nonsense, in order to diagnose all diseases the patient will get in the future.

 

[TexasTriathlete]

Muscle energy is known to the strength and conditioning world as "proprioceptive neuromuscular facilitation" or PNF. It is legit, as I have used it on athletes in the past. It is also something I learned about in undergrad kinesiology.

 

[Animus]

Diagnose what?! What findings? Aren't your standardized patients healthy and well, or do they all have "findings"?

And how can they agree with you "most of the time" if you state any old finding with confidence?

That would be the equivalent of me examining a healthy patient and saying (with lots of confidence) that I can auscultate "lung cancer," and having the attending agree with me just because I said it "with confidence," even though I'm speaking complete BS. What are you looking for, seriously? Posts like this further cement the stigma that OMM practicioners are right up there with CAM users and snake oil salesmen.

I know a couple of DO's who are great docs, and it's NOT because of their judicious use of OMM. As a matter of fact they scoff at it and they themselves admit it was just a nonsense hoop they had to jump through to finish school.

Why do you try and act like you understand something you have never actually learned about? Your analogy is complete horse****. Even the "healthiest" of people could always use some form of adjustment, slight fascial or muscle treatment. Diagnosis of vertebral dysfunctions are always possible, however, you do not actually fully treat in class you just go through the motions. That is why you have rotations, you know like in every other area of medicine. You go through didactics but it does not mean you know how to treat patients yet, same for omm. Stop acting like you have a clue or can expound on something you know nothing about.

 

[Hurricane95]

Whoa, SOMEONE's defensive about their discipline.

Reread your own post. You proved my point. I don't have to learn about something in depth to know that it makes no sense to elicit findings successfully if you have no clue what you are looking for. It makes no sense that your examiners would agree with you no matter what you said, as long as "you state it with confidence." It makes no sense. And by definition, if EVERYONE has some form of "vertebral or MS problem," then these are not problems then, are they? They would be variants of normal. A healthy person has traits and function that lies within the spectrum of normal. A significant deviation from the normal range would be a problem, and a minority of people would hence have problems. I guess I can go around diagnosing my patients with abnormal heartrates since if they were more athletic they could be in the 40's or so instead of 60's, the "normal range" for most people.

I know several very good DO's, and they themselves say OMM is garbage that should be done away with. The only reason it is still around is because it is the only thing really that majorly differentiates MD from DO practice. DO's in charge want to be different and refuse to mainstream. OMM is a vestigial remnant. It also rakes in extra cash from gullible patients willing to pay extra for manipulation. It can even be harmful, as i've seen a couple of patients with their MS pain aggravated by having their "backs cracked" and "nerves adjusted." As far as benefits...placebo at best.

Get your head out of the hole in the ground buddy, and chill out.

 

[Animus]

Whoa, SOMEONE's defensive about their discipline.

Reread your own post. You proved my point. I don't have to learn about something in depth to know that it makes no sense to elicit findings successfully if you have no clue what you are looking for. It makes no sense that your examiners would agree with you no matter what you said, as long as "you state it with confidence." It makes no sense. And by definition, if EVERYONE has some form of "vertebral or MS problem," then these are not problems then, are they? They would be variants of normal. A healthy person has traits and function that lies within the spectrum of normal. A significant deviation from the normal range would be a problem, and a minority of people would hence have problems. I guess I can go around diagnosing my patients with abnormal heartrates since if they were more athletic they could be in the 40's or so instead of 60's, the "normal range" for most people.

I know several very good DO's, and they themselves say OMM is garbage that should be done away with. The only reason it is still around is because it is the only thing really that majorly differentiates MD from DO practice. DO's in charge want to be different and refuse to mainstream. OMM is a vestigial remnant. It also rakes in extra cash from gullible patients willing to pay extra for manipulation. It can even be harmful, as i've seen a couple of patients with their MS pain aggravated by having their "backs cracked" and "nerves adjusted." As far as benefits...placebo at best.

Get your head out of the hole in the ground buddy, and chill out.

Once again your post is full of misconceptions and idiocy. I never said they have a problem, I said slight dysfunction. The point was you can still diagnose normal people fine, you didn't figure that out I guess. I specifically said you do not really treat these problems...

I could care less about the few DO's you have talked to. The point is if you want to make a judgement about something learn about it. Do not sit around listening to *****s or making assumptions when you have 0 clue. The fact that you say it has no effect tells me you know nothing, if anything OMM is getting more and more evidence each day as to its benefits and/or lack there of. It is anything but a "remnant", as people stray more and more from medications, their side effects and future ramifications they look for more natural ways of healing. This is one of those modalities, I may not be the first person to scream it as the cure to all. But your ignorance and its emination, from every post you create, makes me wonder why you even come into this forum. I guess on some level you must consider yourself important enough for discussions about things you are not knowledgeable about.

 

[cyclohexanol]

Once again your post is full of misconceptions and idiocy. I never said they have a problem, I said slight dysfunction. The point was you can still diagnose normal people fine, you didn't figure that out I guess. I specifically said you do not really treat these problems...

I could care less about the few DO's you have talked to. The point is if you want to make a judgement about something learn about it. Do not sit around listening to *****s or making assumptions when you have 0 clue. The fact that you say it has no effect tells me you know nothing, if anything OMM is getting more and more evidence each day as to its benefits and/or lack there of. It is anything but a "remnant", as people stray more and more from medications, their side effects and future ramifications they look for more natural ways of healing. This is one of those modalities, I may not be the first person to scream it as the cure to all. But your ignorance and its emination, from every post you create, makes me wonder why you even come into this forum. I guess on some level you must consider yourself important enough for discussions about things you are not knowledgeable about.

Ok, so I've had a few hundred hours classroom/lab 'training' and a 4 week rotation in OMT (see signature). I am therefore qualified to make a judgment: it's bull**** (again, see signature) and I plan to never use it. I should rephrase... the vast majority of it is bull****. The few techniques that work are tantamount to massage. It doesn't take a genius to figure out that massages feel good, and that hardly qualifies the techniques as medical treatments.

 

[J1515]

I never said they have a problem, I said slight dysfunction.

This is where OMM runs into problems. Sorry, I don't buy this "everyone has a dysfunction" nonsense. How are you distinguishing a physiological dysfunction from a simple anatomical difference between individuals? What if God made a perfectly healthy and asymptomatic person's left ASIS 1 mm superior, but compensated by making his right femur 1 mm longer? Now you have all these OMM idiots yanking on his left leg and HVLA'ing his pelvis to try to "fix" something that isn't broken.

Diagnosing healthy, asymptomatic patients is worthless - this is what turns the majority of students off to OMM. We would actually fail a practical exam if we couldn't "find something wrong" with our partner.

Students should be rotating through an OMM clinic during the first two years and evaluated by an attending there who watches the students go through an H&P, structural exam, and treatment of a patient WHO IS ACTUALLY COMPLAINING OF SYMPTOMS.

 

[Animus]

This is where OMM runs into problems. Sorry, I don't buy this "everyone has a dysfunction" nonsense. How are you distinguishing a physiological dysfunction from a simple anatomical difference between individuals? What if God made a perfectly healthy and asymptomatic person's left ASIS 1 mm superior, but compensated by making his right femur 1 mm longer? Now you have all these OMM idiots yanking on his left leg and HVLA'ing his pelvis to try to "fix" something that isn't broken.

Diagnosing healthy, asymptomatic patients is worthless - this is what turns the majority of students off to OMM. We would actually fail a practical exam if we couldn't "find something wrong" with our partner.

Students should be rotating through an OMM clinic during the first two years and evaluated by an attending there who watches the students go through an H&P, structural exam, and treatment of a patient WHO IS ACTUALLY COMPLAINING OF SYMPTOMS.

I agree it is hard, but really it is no different from actually diagnosing in a clinic. If you had didactic alone sure you could diagnose some cases, but not many show up with virchow's triad or all the other symptoms they are supposed to.

It is even made harder by the fact that you get so little time at it. I find it stupid you fail practicals without finding a dysfunction, ours are not run like that. I am not a true believer by any means, and I agree the teaching process is soarly lacking in many areas. But it does have its place and will continue to get stronger imo not because of it is a cure-all, but because of the greater movement toward organics and natural meds.

 

[Animus]

Ok, so I've had a few hundred hours classroom/lab 'training' and a 4 week rotation in OMT (see signature). I am therefore qualified to make a judgment: it's bull**** (again, see signature) and I plan to never use it. I should rephrase... the vast majority of it is bull****. The few techniques that work are tantamount to massage. It doesn't take a genius to figure out that massages feel good, and that hardly qualifies the techniques as medical treatments.

And again I can at least tell from your posts that you do not go into detail about things you are unaware of. I will probably be like you one day, but that is not to say I do not find it interesting and useful. Not to mention the many people out there doing it daily and giving patients relief where they had none for years. It is obviously not an advanced science, but it can be reasoned out fairly well and I think using it will help much more than it will hurt in 99% of cases with proper care.

 

[cyclohexanol]

And again I can at least tell from your posts that you do not go into detail about things you are unaware of. I will probably be like you one day, but that is not to say I do not find it interesting and useful. Not to mention the many people out there doing it daily and giving patients relief where they had none for years. It is obviously not an advanced science, but it can be reasoned out fairly well and I think using it will help much more than it will hurt in 99% of cases with proper care.

1st bold: what??? How do you propose going into detail about things one is unaware of. I'd be happy to go into detail about why I think it's bull****, if that is what you're asking, but I honestly have no idea.

2nd bold: The existence of practitioners does not a valid practice make. Psychics have been out there doing it daily for years too... callme nao fer yer free readin'. The only difference is practitioners of OMT charge way more than psychics and actually believe they are helping.

3rd bold: This is where I refuse to bite. The notion that one can palpate micron differences in bone alignment (or the idea that this is even a problem), or feel 'restrictions' of the diaphragm through the ankle because 'everything is connected and therefore makes sense' is ridiculous. If you can suspend disbelief at this point then sure, you can reason through the rest of OMT. Otherwise, it's ALL dead in the water from beginning.

Honestly, I started school with an open mind and was excited about learning OMT. Then I was exposed to it, and here we are today...

 

[Animus]

1st bold: what??? How do you propose going into detail about things one is unaware of. I'd be happy to go into detail about why I think it's bull****, if that is what you're asking, but I honestly have no idea.

2nd bold: The existence of practitioners does not a valid practice make. Psychics have been out there doing it daily for years too... callme nao fer yer free readin'. The only difference is practitioners of OMT charge way more than psychics and actually believe they are helping.

3rd bold: This is where I refuse to bite. The notion that one can palpate micron differences in bone alignment (or the idea that this is even a problem), or feel 'restrictions' of the diaphragm through the ankle because 'everything is connected and therefore makes sense' is ridiculous. If you can suspend disbelief at this point then sure, you can reason through the rest of OMT. Otherwise, it's ALL dead in the water from beginning.

Honestly, I started school with an open mind and was excited about learning OMT. Then I was exposed to it, and here we are today...

First, was talking about hurricane and his prior posts. When he asked about findings and then giving an analogy that wasn't even close.

Second, I never contended that, however, when people go into something expecting physician like treatment and do not receive it they quickly give up. The fact that people come, get treatment and the practice is doing as well as it is, shows there is some belief/trust in it.

Third, I am not talking about much of the crazy stuff, but the increase of blood/lymphatics to areas, the stimulation of nerves and muscle reflex organs, etc all seem to be pretty logical to me. The way vertebra interact with the prior also seem a given.

Look, again I will say I am in the skeptic corner myself, but to not give it its due where it seems fairly credible is just as loony as saying it is the cure-all.

 

[TUNCOM]

When students are going through OMM class it would seem that the people who don't really believe in OMM (or are actually afraid of it in the neck area) could just go through the motions and not really crack necks and backs.

Is faking it possible?

Is faking prevalent?

Yes and yes! I went through OMSI and II not feeling sht 98% of the time. And my "findings" would be confirmed by the OMM fellows, WTF!

 

[NontradICUdoc]

The whole issue about whether or not OMM works or if it is just voodoo has been an issue in the Osteopathic community for a long time. You cannot just believe in something and then think that it will work. Allopathic medicine, at the time that A.T. Still,M.D. developed osteopathy still used Bleeding, burning, purging, and Mercury as mainstay treatments.

When thinking about OMM (Osteopathic Manipulative Medicine) you need to think about WHY do people, both physicians and patients, feel that it works?

To start with techniques such as HVLA (High Velocity Low Amplitude) and Muscle Energy both have the physician bring the bones or the muscles to the physiological barrier. This means that they put them into positions that they do not want to go, but where they should be able to go. Take for instance the person who has to turn their whole body just look at the blond spot while driving. This person should only have to move their neck and not their shoulders and their back. During an evaluation, the patient is asked to turn their head as far as they can and then the doctor does it for them. You can feel that the muscles do not want to continue. When you do further evaluation, you can actually feel that the vertebrae is not aligned properly. This may be seen on x-ray if you look at the pedicles. What this dysfunction does is put an un-needed strain on the muscles that are not only attached to those bones involved but all the muscles that are working to compensate and this creates strain and pain. The muscle wants to come to its resting point but it is stretched.

This is all using a mechanical principle whereby everything is interconnected and when the system is in homeostasis then there is ease of movement. However when only 1 portion is misaligned then parts of the system tense up and you do not get the same pliability.

OMM works to return the system to homeostasis.

Some people think that this is all chiropacty. This is not the case. Chiropracty only deals with the spine, while OMM also adds the extremities and muscles and other systems.

I am just as skeptical as other people when it comes to having OMM being the end all be all of medical treatment. It is NOT designed to be that way. It is just another method that can be used to help your patient. If the patient benefits from PROPER OMM treatment and their quality of life gets better then you did your job. But it has to be done properly.

There is nothing wrong with being skeptical. In fact, a person in medicine should be skeptical or else we would all be prescribing our patient Kinoki foot pads to detoxify the body like tree roots. But if a modality works, then it works. Question yourself if you believe that Accupuncture works?

 

[theraball]

What's all the fuss about? OMM works. For those who don't choose to use it, fine. But you did know you were going to osteopathic medical school, right? You didn't accidentally get off the train at the wrong station? So suck it up, learn the techniques, and maybe you'll get something out of it. Thousands of doctors are using the techniques very successfully, so why dismiss it based on a few months of experience?

In addition to mainstream medical knowledge, Osteopathy provides us with excellent palpation and musculoskeletal adjustment skills. I have spoken to quite a few cool, open minded allopathic medical students who are very supportive of the OMM component and wish it was offered at their schools. OMM is what's missing from allopathic curricula. In my opinion, doctors are not complete without OMM, or massage therapy, or shiatsu--anything that gets them a tactile, kinesthetic reflection of their patients' condition.

As for "faking it"--well life is full of opportunities to fake it. You can fake it in biochemistry as well--just cram a few days before the exam, go in and pass, then forget the stuff the next day. Then re-learn it for the boards, and afterwards forget it for good. It's too bad that OMM is so poorly taught in a lot of places. It's poorly taught at my school, too, but that's not going to stop me from taking it seriously. Then again, I did massage therapy prior to medical school, so I already know the value of hands-on therapy.

Honor and support your profession, and give OMM a chance. It will make your patients happier, and it will improve medicine. If you feel it's not evidence based enough, don't just reject it--do some research and prove it one way or the other, and add to the knowledge base.

 

[masterofmonkeys]

Can anyone cite some studies for my on OMM for rib dysfunction?

I'm a believer in it since it has done wonders for my QOL both in rib dysfunction and cervical radiculopathy (not rapid twisting in the latter case, but almost more of a myofascial stretch technique thingy).

But i have looked and failed miserably for research to wave in the faces of other allos on the efficacy in rib dysfunction, facet syndrome, and cervical radiculopathy. And I would dearly dearly like to.

 

[brucecanbeatyou]

In my opinion, doctors are not complete without OMM, or massage therapy, or shiatsu--anything that gets them a tactile, kinesthetic reflection of their patients' condition.

I don't take an MD seriously unless he has a massage therapy certificate as well.

 

[masterofmonkeys]

I don't take an MD seriously unless he has a massage therapy certificate as well.

I certainly don't take any MD seriously who can't demonstrate basic MSK evaluation competency. Most can't.

 

[Brodiewankenobi]

..

 

[jp104]

I certainly don't take any MD seriously who can't demonstrate basic MSK evaluation competency. Most can't.

This is a pretty silly blanket statement. Not every physician is going to deal with MSK issues day in and day out. Most do have some basic knowledge of MSK from their rotations and med school days. In order to have a civil discussion on OMM let's all please stay away from hyperbole Happy holidays all!

 

[EM2BE]

If you have ever seen anyone with a terrible dysfunction get relief, you know it works. Had a patient with debilitating scoliosis that could stand about 4 inches taller after treatment. That's an amazing outcome for someone who is so slumped over it's difficult to breathe. Had patients who were born with a short leg who get severe leg, hip, and back pain from being uneven. After adjustment, no pain. These are just a few examples of obvious success from OMM treatment. Keep an open mind and decide what you want after witnessing the correct use of OMM.

 

[JadinSleeper]

What a great thread!

I'm a DO, in residency now. I faked every evaluation of my second year when we were graded on diagnosis and treatment. I would mumble some crap about C3 being sidebent/rotated/subluxed with a burst fracture and spinal cord impingement, and NEVER ONCE did the "attending" OMM wizard who was grading me ever disagree. They usually enthusiastically agreed and gushed about my diagnostic skills.

Man, I am so glad to be done with that idiocy.

 

[Doowai]

Possible - yes
Prevalent - yes
(Relevant?) - no

Even if they check your 'diagnosis', they tend to ask first, then power of suggestion takes over so you are 'correct' 99% of the time. During cranial week, I stopped trying to feel things, and I'd just make up **** randomly, then low and behold the instructors would find the exact same made up **** that I did.

Wow, so you are a DO student, and your signature has a big "BS" sign by it, and you post this...... WHY are you going to DO school?

 

[cyclohexanol]

Because I was duped? I go to a DO school to be a physician. OMM sounded awesome before they started teaching it. After a couple months of lecture/lab, the BS sign started growing and never stopped (exponential growth rate during cranial lecture/lab).

Judging by the responses from other DO students, I'm not the only one who feels this way about OMM, and fakes diagnoses (although ALWAYS seems to get the correct diagnosis after telling the examiner). I may be the only one with a big "BS" sign next to my cranial rotation though... but really, I don't know many who think that it isn't.

Wow, so you are a DO student, and your signature has a big "BS" sign by it, and you post this...... WHY are you going to DO school?

 

[theraball]

What a great thread!

I'm a DO, in residency now. I faked every evaluation of my second year when we were graded on diagnosis and treatment. I would mumble some crap about C3 being sidebent/rotated/subluxed with a burst fracture and spinal cord impingement, and NEVER ONCE did the "attending" OMM wizard who was grading me ever disagree. They usually enthusiastically agreed and gushed about my diagnostic skills.

Man, I am so glad to be done with that idiocy.

So, you think OMM is "idiotic" simply because your teacher wasn't very astute (or, more likely, just let you pass because he didn't feel like hurting your medical career)?

 

[DD214_DOC]

I was curious about OMM and had an open mind going into my first year of DO school. After much learning and experience, I have since made up my mind. I shall leave it at that, and I would suggest most of you guys do the same. Regardless of which side you're on, public bickering of this magnitude is an extremely poor reflection upon the profession.

 

[theraball]

I was curious about OMM and had an open mind going into my first year of DO school. After much learning and experience, I have since made up my mind. I shall leave it at that, and I would suggest most of you guys do the same. Regardless of which side you're on, public bickering of this magnitude is an extremely poor reflection upon the profession.

With all due respect, if you consider those of us who are defending osteopathy to be "an extremely poor reflection upon the profession" then you are really out of touch.

What hurts the profession is letting people into osteopathic schools who have no interest in osteopathy, but merely use it as a back door into medicine because they couldn't hack the MD admissions path, and then get on a public chat board and boast about how they lied and faked it all through their OMM classes, and how idiotic they feel OMM is. That's simply pathetic and they deserve to be called out and discredited.

Good, hardworking, sincere osteopathic physicians have fought for decades to achieve the near-equality in practice rights that we now enjoy, while trying to preserve the things in osteopathy that make it different and valuable, so it's sad and distressing to see people like this coming through these programs only to spit on osteopathy after they graduate.

 

[medschoolsoon]

It seems like most of the "back-door" people and questrions about OMM and most of the bickering that DO students do could be alleviated if DO schools raised their admission standards to those equal with allopathic schools.

That way the "back-door" people would drop significantly and DO's in general would get more credit.

At least that's my thought.

 

[Cp22kjer]

It seems like most of the "back-door" people and questrions about OMM and most of the bickering that DO students do could be alleviated if DO schools raised their admission standards to those equal with allopathic schools.

That way the "back-door" people would drop significantly and DO's in general would get more credit.

At least that's my thought.

The great thing about what you mention is that this gap is closing every year.....

 

[Old_Mil]

With all due respect, if you consider those of us who are defending osteopathy to be "an extremely poor reflection upon the profession" then you are really out of touch.

You OMT fundamentalists aren't defending osteopathy. You're destroying it, just as you tried to 100 years ago.

 

[theraball]

It seems like most of the "back-door" people and questrions about OMM and most of the bickering that DO students do could be alleviated if DO schools raised their admission standards to those equal with allopathic schools.

That way the "back-door" people would drop significantly and DO's in general would get more credit.

At least that's my thought.

The great thing about what you mention is that this gap is closing every year.....

It would help with some things such as perceived DO quality, but I doubt it would help much with the differentness of being a DO such as access to neuromuscular techniques.

I think the real problem is a failure to teach OMM properly across the board. The quality seems rather variable from school to school. And, as some of the posters in this thread imply, they are passing people through who haven't really learned it.

If DO schools announced that you have to properly diagnose and treat dysfunctions or risk having to repeat a year, and really enforce this with proper oversight, and present the scientific basis for the techniques instead of "take it on faith" (they don't ask us to take it on faith at my school, maybe they do elsewhere), maybe it would weed out some of these "quackwatch" types.

 

[facetguy]

Is there much emphasis on the mechanisms of how/why OMT works, or is the training primarily focused on the actual performance of the various techniques?

 

[J1515]

If DO schools announced that you have to properly diagnose

The examiners can't even agree on a diagnosis. How many times have you thought you felt something, called a fellow over to check, they tell you that you're wrong, and then called a doctor over to check and they tell you something completely different again? Don't even get me started on cranial. Show me a study that shows reliability and agreement between 'experts' and then I will agree that it should be weighed more heavily.

 

[DD214_DOC]

I once proposed a "study" in which randomly-assigned people visited 3 stations manned by OMM experts. Each expert assessed and diagnosed whether a dysfunction was present on the patient assigned. The order was randomized for each station. No treatment was administered. Then a comparison was made to check for consistency between each examiner.

Nobody wanted to do it.

 

[JadinSleeper]

I once proposed a "study" in which randomly-assigned people visited 3 stations manned by OMM experts. Each expert assessed and diagnosed whether a dysfunction was present on the patient assigned. The order was randomized for each station. No treatment was administered. Then a comparison was made to check for consistency between each examiner.

Nobody wanted to do it.

That is because it would demonstrate the same thing that my "faking it through my MS2 year OMM exams" informally did. The interoperater reliability of osteopathic structural exams is non-existant. But this is to be expected when you try to turn what is essentially a massage into a dogmatic , quasi-religious set of procedures that is not allowed to be questioned or doubted, lest you incur the wrath of the osteopathically pure.

OMT has its (limited) uses. The foundation of a medical model is not one of them.

Oh, and I'm a proud DO as well as a healthy skeptic of some of OMT. There are many, many of us out there. Deal with it.

 

[scpod]

The examiners can't even agree on a diagnosis. How many times have you thought you felt something, called a fellow over to check, they tell you that you're wrong, and then called a doctor over to check and they tell you something completely different again?....

And how is that different from any other aspect of medicine? Take a patient we had this week. Three doctors examined the patient, took a history, and looked at the films. One thought it was sarcoidosis. Another thought it was TB. The last one thought it was "crack lung" from smoking drugs. Each had access to the same information and was allowed to do their own examination.

Medicine is NOT an exact science. having two (or more) doctors disagree on a diagnosis is hardly irregular. Having medical students, fellows and attendings disagree...is pretty close to normal.