Originally posted by PACtoDOC
The problem at our school is that we get very little training these days in OMM. Its more like a cursory survey of OMM, and those like me that want to learn it well have to practice it a lot outside class. When we are in lab, we often are only there for an hour or two and may learn 3-4 techniques. If we don't pick it up then, thats all she wrote!! We later have a practical quiz which is more like a one on one tutorial session. I just cannot seem to feel what it is I am supposed to be feeling. I understand the concepts, and practice it on my wife a lot, but I just can't feel the movements I am supposed to with any accuracy. We are in cervical right now and I have a lot of trouble assessing segmental motion. IS it just me, or does this come later?
Matt
I'm sorry to hear you're having such problems. To some degree this may vary from school to school, but even here in Kirksville you gotta be proactive if you want to be really good.
My suggestion is to seek out your professors and ask to shadow them as they see patients. Good teachers will give you a trial by fire and test your diagnostic skills on each patient that comes in, and help you catch things you've been missing. This way you can see the big picture and relevance of some of the techniques you learn, and the outcomes for patients that benefit from them. You will most likely find that the OMM that is taught in class is QUITE different than OMM that is used by specialists. Diagnosis is often made by quick visual screen of posture, a history, and very brief physical screen- and treatment revolves around treating the "key" lesion- something that is difficult to teach in class and wont be on the boards as such. You'll also find that no two specialists are the same, and while you might hate the way someone practices or the model in which you were taught (and thus generalize to all of OMM), but you might really like the next specialist you follow. Its worth looking around a little.
The issue with testing OMM in double blind efficacy studies is that its just not a great treatment modality for this kind of research. Imagine trying to do double blind efficacy studies for surgery- its not easy to do. Too much relies on the skill of the surgeon/OMM specialist, and faking treatment can't be done "blind," nor can it really be done by someone outside the field who could be blind to expected efficacy- since skill level is quite important for success (unlike acupuncture, for example, where needles can be placed in designated spots by a lay-person).
The majority of research in OMM thus far is outcome-based. not ideal, but at least it is something.
I have only had limited exposure thus far to OMM for asthma and allergy patients but general autonomic tone can change quite a bit over the course of a treatment and I wouldn't be suprised if you see some improvement for chronic asthma (ask your docs if they've had luck with this, and have them show you what they do). With things like allergies though I wouldn't expect more than a temporary fix, since these are usually environmentally mediated. You can still use your DO preventative routine- look carefully in the history for environmental exposure to chemicals at work or home, and maybe talk about an air purifier if its pollen or dust.
If all else fails, stick with the meds PRN
cheers,
bones