OMM focus: spine vs other areas

[rkaz]

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Hi all. I am wondering what percent of OMM is focused on the spine versus other areas of the body. How much time each week do you spend on manipulating your classmate's spines?

I am a bit sensitive to having my spine manipulated/touched/cracked... though have no issues with being touched in other places of my back, legs, or wherever is needed for class. I realize that (most likely) going to a DO school this year I will have to grin and bear it to some extent, but I am hoping to limit this exposure as much as possible. Is there any chance at all of this?

Thanks.

 

[facetguy]

You'll get over it.

 

[TexasTriathlete]

After sitting on your ass, hunched over, staring at your notes for 10 hours a day for a few months, you will be begging your classmates and omm profs to hvla you.

 

[theserbatron]

Hi all. I am wondering what percent of OMM is focused on the spine versus other areas of the body. How much time each week do you spend on manipulating your classmate's spines?

I am a bit sensitive to having my spine manipulated/touched/cracked... though have no issues with being touched in other places of my back, legs, or wherever is needed for class. I realize that (most likely) going to a DO school this year I will have to grin and bear it to some extent, but I am hoping to limit this exposure as much as possible. Is there any chance at all of this?

Thanks.

I misunderstood OMM completely entering osteopathic medical school last year. I was concerned about fellow students cranking and torquing on my head and neck, and OMM is miles away from that sort of behavior.

A lot of OMM techniques are myofascial, meaning they address muscle hypertonicities and fascial restrictions that result in reduced range of motion or poor posture. These include Counterstrain, FRP (Facilitated Positional Release), and Muscle Energy treatments.

There is no way to get around the spine; indeed, a lot of issues in the arms and legs make their way back to the spine in all kinds of crazy ways. The spine is a central component in OMM, but it is not the ONLY component and "cracking" your neck and back is certainly not what OMM is about. In my experience, OMM has been about addressing problems in muscle and joints that often affect posture, gait, and the free movement of joints.

If I had to do a numbers break down, I would say 1/3 of the material we learn and practice is directly having to do with the spine (diagnosis and treatment modalities), while the remaining 2/3 involves addressing upper and lower extremities. We typically had one to two labs a week, two hours each time. Hope this helps - shoot me a PM if you have any more questions, as I was in your boat last year. And enjoy the rest of your summer!

 

[djnels01]

Hi all. I am wondering what percent of OMM is focused on the spine versus other areas of the body. How much time each week do you spend on manipulating your classmate's spines?

I am a bit sensitive to having my spine manipulated/touched/cracked... though have no issues with being touched in other places of my back, legs, or wherever is needed for class. I realize that (most likely) going to a DO school this year I will have to grin and bear it to some extent, but I am hoping to limit this exposure as much as possible. Is there any chance at all of this?

Thanks.

You get over any reservations about palpating/being palpated by classmates really quickly in OMM labs. That's a good thing I think, you need to be comfortable touching your classmates since you'll be doing it in almost any field of medicine you go into (unless you do Psych of course).

There are other ways of practicing OMM besides just popping necks and backs. So if the "cracking" part is what scares you, rest assured that you don't have to subject yourself to 2 years of nothing but HVLA in lab every week. You'll learn Muscle Energy, Strain/Counterstrain, Myofascial Release, Still techniques, Soft Tissue, etc., all of which are fairly gentle modalities. If you're truly uncomfortable during a particular lab just say something that I'm sure they'll be able to accomodate your learning somehow.

At DMU we had OMM lab once a week for 1.5 hours. The majority of lab time 1st year for us was dedicated to the axial skeleton but only a fraction of that time involved "popping necks or backs."

You'll be fine.

 

[rkaz]

Thank you all for your comments. Yes, I am specifically afraid of the back cracking aspect, as I previously had my back hurt at a chiropractor's office, leaving me in pain for weeks. (It was actually the massage therapist who worked at a chiropractor's office who messed up my back, not the chiropractor himself... though coincidentally or not, that made me have to seek and pay for back pain treatment that his masseuse caused, and unfortunately his treatment only seemed to aggravate my mid-spine where the pain was, not help.) So the idea of having someone not knowing what he/she is doing mess up my back again with some rapid jerking movements... that makes me squirm with discomfort.

 

[facetguy]

Just explain your prior adverse reaction to manipulation to your professors and you should have no problem. Good luck.

 

[Powdermonkey]

Thank you all for your comments. Yes, I am specifically afraid of the back cracking aspect, as I previously had my back hurt at a chiropractor's office, leaving me in pain for weeks. (It was actually the massage therapist who worked at a chiropractor's office who messed up my back, not the chiropractor himself... though coincidentally or not, that made me have to seek and pay for back pain treatment that his masseuse caused, and unfortunately his treatment only seemed to aggravate my mid-spine where the pain was, not help.) So the idea of having someone not knowing what he/she is doing mess up my back again with some rapid jerking movements... that makes me squirm with discomfort.

The amazing thing (at least at my school) is that most of the time if a fellow student can't diagnose and fix the problem, the doc's that are in lab with us can. See, thats the problem with just about anyone else other than DO's "looking at/fixing" your back - they don't really go through a proper diagnosis before just manipulating you. They go straight to where it hurts and start in on you. All last year, we learned 3, yes 3, HVLA techniques. One for the lumbar spine, one for the SI joint and one for a rotated innominate (hip bone). I know we'll learn more next year, but as you can see, our 2 hour/week lab was dedicated to MUCH other than just HVLA. Muscle energy, balanced ligamentous (my personal favorite for any bone/joint), we got more intimate with our anatomy and physiology and the mechanics of how the bones and joints move and work, counterstrain, FPR, myofascial release, etc.

I hurt my back in high school running track and my doc told me that my MRI was clear (which it was) and that he didnt see anything wrong with me. Well, turns out I had some SI joint dysfunction. And you can't see dysfunction in a dynamic joint when its static. First week of school a 2nd year diagnosed and treated me and I was immediately... oh, I dunno.... 75% better. In a few days it came back, but I kept getting treated when it did. From 2nd years and from the docs we have. Sometime around Halloween a 2nd year was working on me for about 30 mins and whatever he did it fixed me for a looooong time. Every once in a while I can feel some pain and tenderness in the spot in my lower back, but if I adjust my posture it may go away. If not, I get checked, diagnosed and treated. Its something I'm gonna miss this summer.

 

[facetguy]

The amazing thing (at least at my school) is that most of the time if a fellow student can't diagnose and fix the problem, the doc's that are in lab with us can. See, thats the problem with just about anyone else other than DO's "looking at/fixing" your back - they don't really go through a proper diagnosis before just manipulating you. They go straight to where it hurts and start in on you.

I can understand professional pride and all, but you are painting with a very broad brush here.

All last year, we learned 3, yes 3, HVLA techniques. One for the lumbar spine, one for the SI joint and one for a rotated innominate (hip bone). I know we'll learn more next year, but as you can see, our 2 hour/week lab was dedicated to MUCH other than just HVLA. Muscle energy, balanced ligamentous (my personal favorite for any bone/joint), we got more intimate with our anatomy and physiology and the mechanics of how the bones and joints move and work, counterstrain, FPR, myofascial release, etc.

I hurt my back in high school running track and my doc told me that my MRI was clear (which it was) and that he didnt see anything wrong with me. Well, turns out I had some SI joint dysfunction. And you can't see dysfunction in a dynamic joint when its static.

This does unfortunately happen. It points out the difference between a purely structural mindset and a functional/dynamic one. And some of these functional deficits/imbalances/etc can be quite subtle and easy to miss, and it takes lots of practice and experience to get good at recognizing and treating them. Keep up the good work.

First week of school a 2nd year diagnosed and treated me and I was immediately... oh, I dunno.... 75% better. In a few days it came back, but I kept getting treated when it did. From 2nd years and from the docs we have. Sometime around Halloween a 2nd year was working on me for about 30 mins and whatever he did it fixed me for a looooong time. Every once in a while I can feel some pain and tenderness in the spot in my lower back, but if I adjust my posture it may go away. If not, I get checked, diagnosed and treated. Its something I'm gonna miss this summer.

 

[Slevin]

Within a month of med school I had my hand on my partners ass doing the ischeal spread... didn't know her and if her husband found out.... well I'd be in trouble 😛

 

[Powdermonkey]

I can understand professional pride and all, but you are painting with a very broad brush here.

Indeed. A vast majority of the time its true. Most chiropractors and other manipulation type health care individuals dont learn what we do and how everything is inter-related. I've NEVER been to a chiropractor that did anything other than check my spine and crack my neck. Check my OA? nope. Check my ASIS and PSIS levels to check for innominate dysfunction? nope. Check my sacrum? Nope. Properly diagnose and treat my spine before wrenching on me? In my my educated opinion now, no. So in my experience, no, I dont think they know totally what they are doing. Are there some good ones? Yes. But they are few and far between.

This does unfortunately happen. It points out the difference between a purely structural mindset and a functional/dynamic one. And some of these functional deficits/imbalances/etc can be quite subtle and easy to miss, and it takes lots of practice and experience to get good at recognizing and treating them. Keep up the good work.

Workin on it. OMT is something I'm really wanting to use eventually, though I doubt I'll have time in the ER. We'll see. My main point here though was that he never laid a hand on me, and was unable to diagnose my joint dysfunction. My family doc is a D.O. too, he just doesnt use manipulations. *shrug* Its frustrating.

 

[TexasTriathlete]

You know what sucks more than anything you can do to your back in OMM? The pubic tubercle palpation. I had my practical the other day, and we had to palpate each others pubic tubercles, and that flat out sucks. My partner for this is a huge dude. Probably 6'3" 260 or so. And those things are pretty tender, and hard to get at, so he plowed into me pretty good. I am a pretty big dude too, so I'm sure I let him have it. Plus its right next to the wiener.

And for all that trouble, I got like a 70 on the station.

 

[Powdermonkey]

Dude... The pubic symphysis flat out sucks. Its always tender, and most people dont understand that pushing like that is really uncomfortable. Or they do and just want to be jerks. Either way it sucks.

 

[Styria]

OMT is something I'm really wanting to use eventually, though I doubt I'll have time in the ER.

Was Dr. D'Eramo able to use it in the ER?

 

[Powdermonkey]

I'm pretty sure she used it. I have no clue how much though. It was probably more for during slower night shifts. But again, I dont really know. 🙂