I do not want to learn or have cervical HVLA performed on me.

[Promethean]

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So, anecdote time again, but I worked as a nurse at a major university hospital, on a stroke unit for a year and a half. I saw way too many cases of strokes and other serious injuries as results from chiropractic cervical HVLA. I never saw a single case that was described as resulting from an osteopathic HVLA treatment, but that may be due to a reporting error--if people where just saying chiropractor not knowing what an osteopathic physician is.

I don't mind having my own neck cracked by someone who knows what they are doing, and I crack it myself pretty constantly. But I cannot cannot cannot do it to someone else. I hate HVLA. I can set it up fine, but when it comes time to deliver the thrust, I can't do it. I am too concerned about harming the person. I've lost a few points on practicals for saying "And this is where I would apply a slight thrust through the restriction, if I were going to do that." Oh well. They can have those points.

I had serious concerns about whether I was going to be a failure as a DO if I couldn't perform these techniques, and I saw it as something that I needed to get over. But now, having gone to a couple of conferences and talked to practicing DOs, it turns out that I can have a completely successful practice and provide excellent results for my patients without ever performing a single HVLA maneuver, if that is what I want to do. At least, that is what I hear from other DOs who do use OMM regularly, but also choose not to use HVLA for one reason or another.

You gotta do what you gotta do to get through school, and some of that might mean learning techniques that you really do not want to use in practice. There are probably ways to accommodate most concerns, either by modifying the technique or just taking a hit on a practical / lab grade. But you don't have to let your practice be dictated by what you were taught in school. We have a lot in our toolkit and there is probably something in there that will work well for you and for your patients.

 

[Mr Roboto]

Only an OMS1 so pardon my ignorance. If the gentler techniques are risk-free and produce the same results, when is using HVLA indicated?

 

[samac]

Only an OMS1 so pardon my ignorance. If the gentler techniques are risk-free and produce the same results, when is using HVLA indicated?

Different scenarios for different things. Sometimes you can't get the desired result with muscle enegery or functional or stills.
For the most part I just use HVLA on young healthy individuals who are looking for quick relief. On most actual clinic patients I've used functional or blt most often because it's easy on them.
(Ps no I'm not a practicing physician, our school has a free OMT clinic)

 

[AlteredScale]

Only an OMS1 so pardon my ignorance. If the gentler techniques are risk-free and produce the same results, when is using HVLA indicated?

You'll get thrown a lot of "evidence" from your OMM professors that hvla is safe. They'll give you articles (almost all of which are from JAOA which you know full well is biased to hell) showing that there was no injury done to their patients.

From what I've been told at my school, you utilize hvla modalities after going through the steps of ME, MFR, to "get those tissues ready".


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[073116]

No big deal, you can skip the class during HVLA. In most schools it's just small penalty that will not realistically affect your final grade. In our school you ca njust opt out of HVLA during labs, lab is about other things too, not only HVLA, so you can just opt out of it saying you are not comfortable or your neck hurts. No one is going to force you do it. I think even in schools that you can't opt out of it - they still won't force you t odo it if you tell the myou are really not feeling comfortable doing it

 

[deleted480308]

I'll admit that a classmate and I just formed a simple "gentleman's agreement" that we would go through the motions of setting up thee maneuver but not actually do the HVLA. We were quiet and didn't make a scene about it. No issues

 

[EmergDoc2B]

Your school actually made you perform and receive HVLA on practicals?
Mine just requires to go through the steps and talk about it during practicals.
And in lab, if you don't want it done on you, you say you don't want it done.

Yes ,we were expected to perform HVLA.

 

[Rogert]

I'll admit that a classmate and I just formed a simple "gentleman's agreement" that we would go through the motions of setting up thee maneuver but not actually do the HVLA. We were quiet and didn't make a scene about it. No issues

This was more or less what was suggested by the staff at my school. You don't give a treatment to someone who isn't sick. You don't do HVLA on someone who doesn't have dysfunction.

 

[jw3600]

You don't do HVLA on someone.

Fixed it for you.

 

[Yadster101]

I'll admit that a classmate and I just formed a simple "gentleman's agreement" that we would go through the motions of setting up thee maneuver but not actually do the HVLA. We were quiet and didn't make a scene about it. No issues

what if you were to be tested on it?

 

[deleted480308]

what if you were to be tested on it?

HVLA is actually a procedure. So you just set it up to show that you know the proper evaluation and positioning. Then say you don't feel a hard endpoint so the actual ending thrust is not indicated. Return your patient to midline. Reassess as though you had performed the treatment. pass