omm at other schools

Here is our general format:


1st Semester: Muscle Energy DX and TX
2nd Semester: Functional DX and TX
3rd Semester: HVLA DX and TX
4th Semester: Advanced Material (ex. Cranial)


That is the simplified version because there are more topics covered, but in general, that is the nuts and bolts of it as far as diagnosis and treatments go. The phil. of osteopathy is taught throughout.

 

DOSouthpaw,

you all have your omm divided by treatment type and not by system?
do you think that is better or worse than dividing it by system?
how do you diagnose something differently if you are going to treat using muscle energy or HVLA

also, out of curiosity, what is "functional" dx and treatment?

thanks

 

Well, it's kinda like both. We go by technique and system. At the end of the first semester, we will be able to screen and treat every part of the body (except cranial) using muscle energy.

When I say DX and TX with Muscle Energy/HVLA/etc.. you are right, only the treatment is different, the Dx is still the same. What I meant was, that in lab, we still practice screening all the time. By the end of the second year, a mediocore student in OPP should be able to do a complete Neuromusculoskeletal exam and treat the AGR in about 3 min. That is why it is rediculous that more DOs don't use OPP in their practices.

Personally, I like it this way better because it keep HVLA out of the hands of untrained hands. By the time the first year is over, ones palpatory skills should be very good, especially after a semester of functional(more on that later), so being able to localize with HVLA will be much better. If one can properly set a patient up, the force required for a good HVLA is very small, and sometimes not even required at all because just the process of setting the patient up makes the dysfunction release.

Functional is a system of indirect techniques where the technicion takes the dysfunction to the area of greatest ease and holds it there. It is usually done with a Motor Hand and a Sensory Hand. One hand monitors the dysfunction and the other hand positions the patient. When the sensory hand feels the tissues begin to move (or release) the motor hand moves the body in that direction and keeps the body from returning to the previous position. The technician keeps doing this until the dysfunction resolves

Some people call this the Still technique because it is the technique that AT Still used later in life. Not many schools teach it because of many different reasons.

1) AT Still didn't teach techniques, so not many people learned it.
2) One person who did learn it was Still's grandson (George Laughlin), and he was kinda blackballed by the profession for starting a competeing school in Kirksville. (our OPP chair learned these techniques from this guy back in the day)
3) Some people think that it is too hard to teach.
4) The mechanics behind it are the least understood.
5) The techniques are kinda scary because the body just kinda starts "unwinding" itself.

If you have more questions please let me know!

Later!

 

UNECOM:

1st year - HVLA, ME, Counterstrain, Soft tissue - on everything except upper extremity

2nd year - all of the above on upper extremity, plus BLT, FPR, Cranial, other miscellaneous facial techniques. 2nd semester of 2nd year is spent learning viscerosomatic reflexes as well as the other techniques mentioned above.


It's fun knowing HVLA already, because as a 2nd year there are so many 1st years with sore necks and backs to practice on while they are going thru gross anatomy...

 

so is functional the same as strain counter strain,

or is it facilitated positional release (same as above but with added torsion)

 

Those two would be considered functional techniques as well. As far as I know (since I'm only in the 1st semester I haven't found out the full extent of what we are taught first hand yet) we do more work on dynamic functional procedures. Greenman defines them as "the process (that) follows the inherent tissue motion"(Principles of Manual Medicine 2nd Edition, p. 107). While in Strain and Counter Strain you hold the position of greatest ease for about 90 sec and then reposition, in dynamic techniques you find the area of greatest ease and then follow the inherent tissue motion by continuously seeking the area of greatest ease and avoiding bind. It's like you let the body's natural, intrinsic forces unwind the lesion.

 

thanks DOSouthpaw,

 

Maybe I can help...

Functional technique is, as SouthPaw described, a method of manipulation in which the body segment is taken to ease in all planes of motion. Johnston is the current guru on this technique and has a book published called Functional Technique (amazingly creative, huh?). It is going through some revision now and will be published as a 2nd edition soon. He is a doc in Virginia somewhere, I think.

Counterstrain is totally different from functional, as is FPR.

These three techniques can be grouped under the heading of "indirect techniques".

SCS was developed by Jones and FPR was an extension of SCS using a compressive force for faster activation of neuromuscular effect developed/popularized by Schiowitz (spelling??) who just retired from being Dean at the New York school.

I hope this helps...

 

At AZCOM it appears they take a different approach...a general introduction to all the techniques then they expand upon the basic knowledge. We are also on the quarter system so it is a bit different. First quarter: General OMM stuff..fryett, gross motion, physiologic motion, nocicptive theory, Dx,soft tissue, articuatry, HVLA, muscle energy, myofascial release, counter strain. This quarter we've taken the general techniques we learned and advance them for example first quarter we learned hvla but limited it to pisiform/thenar thrust and muscle energy on most extremity muscles this semester we did hvla k-crunch, spinal muscle energy...etc i think you get the picture. I wonder if the cirriculums will ever be standardized.

 

Do you mean the "Kirksville Crunch?"

 

bump

 

they teach you the texas twist (pisiform/thenar thrust) separate from the kirksville crunch? We were taught them simultaneously. We were only required to perform one or the other on the practical.
As for 1st year OMM at NYCOM, it's broken up into regions. 1st block(we have exams every 5 weeks) was history of Osteopathy and medicine. The lab was myofascial techniques for cervical through lumbar region. 2nd block was thorasic diagnosis, ME, HVLA, counterstrain, FPR. Third block was cervical diagnosis, ME, HVLA, counterstrain, FPR. The rest of the year will me similar with lumbar, sacral, and ribs.
Second year is upper and then lower extremity and cranial. I'm not really sure what else as I'm only a 1st year and I can't look that far into the future without feeling overwelmed.
Hope everyone enjoyed their winer break, eventhough it is rather short. Good luck for the coming year!