I didnt expect OMM to be so hard

[relish]

I would have to say out of all the subjects studied thus far in medical school, OMM is the most difficult to understand. The whole sacral torsion and innomanates concepts are just not registering. I continually give bad diagnosis and the whole subject is difficult. Maybe an OMM genius out there can help a loser on the bottom of the OMM ladder with some study tips or suggestions.

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[Amra]

First off, don't be so damn hard on yourself. I'm sure there are many people that have been palpating people for years - they're usually the ones that grab a girl's ass in a crowded room - yet they don't count....

OPP palpation and diagnosis is a learned skill - gets better with practice. Actually, the "learned skill" is the ability to be CONFIDENT in what you feel. Remember, neurophys? We all can differentiate so many microns of stimulus (unless your neuronally damaged - w/c is a whole other story).

At NSUCOM, as a MS2, I've had the opportunity to work both in the OPP clinic and in a free clinic sponsored by the UAAO (OPP Club). I've also been fortunate enough to be described as "good with my hands" and at OMT. I still, with patients, use a sheet of paper to describe sacral torsions, my hands to describe innominate challenges and vertebral somatic dysfunctions, and I still place the head in the position that it is "living" before I reverse planes for HLVA or ME.

Professionally speaking, I get to chance to explain to the patient what is "off" and how we're going to fix it. Personally, I talking myself through the Dx and Tx - keeping everything straight in my own head.

Practice. If your an M1, grab a classmate and say "hey, lemme try something - it will only take a minute." Most people are okay with this, as they'll probably need a body to practice on in the future and you DID say only a minute If you are a MS2, practice on the underclasspeople. That is there acknowledged yet never agreed upon role: test dummies for the sophomores

If you build it, they will come (movie quote, anyone?). More applicable, if you practice it, your belief in what you're feeling will come.

And, if you get the chance, goto Convocation. 100% hand-on learning - plus skiing this year!

Good luck!
-A

 

[bustbones26]

I had to read the chapter on sacral at least 100 times before I fully understood it. In fact, I don't know how I past the test on it because I'd say I didn't even fully understand it until my MS2 year.

Now look, you are going to have all kinds of egos running around your school bragging, thinking they are somebody special because they know sacral well and you don't. Who cares!! Take the time to learn it at your own pace! Don't get nervous, don't dare ever think, :everbody else understands it except for me" because even though people want you to think that, trust me its not always true.

Hang in there, only you are important, only what you can take from the course is important. Even if you get only a C in the damn class, take from it what you will. Do your best. Remember, someday, you have to practice medicine and make your own decisions, how ever damn smart everybody else thinks they are doesn't matter then.

 

[DrQuinn]

One thing that will help you out learning sacral is to take a notecard, or a small piece of paper. Draw out the inferior and superior poles, and hold it at each corner (left upper and right lower corner). Rotate it so it rotates LEFT. See how the bottom left corner pops up and the upper right corner goes down? Now use your mind's eye and imagine that is the sacrum.

Now rotate the paper so it rotates RIGHT. See how the upper right moves towards you? (up)? That means the "base" of the sacrum has moved towards the skin. Reason why the Lumbosacral spring test is positive (and the R superior pole won't move when you palpate).

That's how I remembered all the sacral torsions, just used the test paper as an example.

When you get to unilaterals, yer on yer own...

Now I might be wrong in my description, I am relatively anti-OMM and don't use it at all, but that's how i remembered everything.

Q, DO

 

[Dr JPH]

I would suggest picking up an OMM board review book.

They usually have pretty good pictures, particularly for sacral stuff.

QUINNs idea with the notecard (I use my school ID) is the way to go. If you need a tutorial on that, let me know. I can give you step by steps.

JPH

 

[OMMFellow06]

If you make a nice little table on the sacral dysfunctions it's so much easier. (Sorry, I can't seem to make the tables come out so well when I submit the post, but if you match up the Lefts and Rights with the diagnoses, I think you can figure it out)

Seated flexion L, R
Deep sulcus L, R
ILA R, L
Diagnosis R on R, L on L

Seated flexion L, R
Deep sulcus R, L
ILA L, R
Diagnosis L on R, R on L

Hope this makes it easier. I never use the paper sacrum, I think it's a lot easier with the table. Good Luck.

 

[Ohiobuddhist]

The previous posts have pretty much highlighted the two ways to internalize all that OMM stuff. You can either get a 3D picture in your head or you can memorize a table...I have seen people be successful at my school with both methods. Personally, I have to picture all the anatomy in my head before I can really use this stuff - especially sacral and innominates. I would definitely recommend the simplified layout in Savarese OMT Review. The text in DiGiovanna is pretty good, but I find the sacral pics in there kinda crappy. Good luck.