Osteopathic manipulations in PT

[TheNewGuy8]

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Hi All,

I was curious: Are there any programs in the US that teach osteopathic manipulations to PTs? I have been a pre-DO student for a while (in the middle of apps right now) and recently had some great conversations with DPT students about the field and found that all the things that really jazz me about medicine seem to be the primary focus of DPT programs whereas in DO schools these things are shoved way to the side and often even looked down on.

I've been looking more into DPT programs and will apply this cycle but I was wondering if anyone had any experience with a marriage of osteopathic manipulations and PT.

I know I could do the DPT degree and then do the part time canadian osteopathic training.

Thanks!

 

[noyceguy]

Hi All,

I was curious: Are there any programs in the US that teach osteopathic manipulations to PTs? I have been a pre-DO student for a while (in the middle of apps right now) and recently had some great conversations with DPT students about the field and found that all the things that really jazz me about medicine seem to be the primary focus of DPT programs whereas in DO schools these things are shoved way to the side and often even looked down on.

I've been looking more into DPT programs and will apply this cycle but I was wondering if anyone had any experience with a marriage of osteopathic manipulations and PT.

I know I could do the DPT degree and then do the part time canadian osteopathic training.

Thanks!

As a PT you can do manips with a doctor's orders - however this is true for NC and it may vary by state. So as long as you get permission you can manip as much as you want I guess.

 

[Fiveoboy11]

As a PT you can do manips with a doctor's orders - however this is true for NC and it may vary by state. So as long as you get permission you can manip as much as you want I guess.

You don't know what you're talking about

 

[dizzy88]

I don't know about this Canadian program you're thinking about, but PTs do learn manipulation in school. In fact, it was a large portion of our coursework when we covered hypo mobility. Our state practice act also doesn't indicate that we need "permission" to do so. You can also direct your continuing education accordingly if you want your skills to grow in this particular area.

 

[goyo1010]

You don't know what you're talking about

👍

I don't know about this Canadian program you're thinking about, but PTs do learn manipulation in school. In fact, it was a large portion of our coursework when we covered hypo mobility. Our state practice act also doesn't indicate that we need "permission" to do so. You can also direct your continuing education accordingly if you want your skills to grow in this particular area.

👍

 

[noyceguy]

From the NC practice act:

"Physical therapy does not include the application of roentgen rays or
radioactive materials, surgery, manipulation of the spine unless prescribed by a physician licensed to practice medicine in North Carolina, or medical diagnosis of disease."

http://www.ncptboard.org/

See your state's practice act to answer your question.

 

[fallingreason]

From the NC practice act:

"Physical therapy does not include the application of roentgen rays or
radioactive materials, surgery, manipulation of the spine unless prescribed by a physician licensed to practice medicine in North Carolina, or medical diagnosis of disease."

http://www.ncptboard.org/

See your state's practice act to answer your question.

It may not include manipulation but does it include grade 5 mobilization? Oh semantics =P


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[Fiveoboy11]

From the NC practice act:

"Physical therapy does not include the application of roentgen rays or
radioactive materials, surgery, manipulation of the spine unless prescribed by a physician licensed to practice medicine in North Carolina, or medical diagnosis of disease."

http://www.ncptboard.org/

See your state's practice act to answer your question.

This the exception, not the rule. There certainly is a few states that place baseless restrictions upon PT's? But, where's the reasoning or rationale or evidence? And to me it would not be an order in NC, because the PT does not have to do it. All it is, is following a nonsense law, because there's no other option.

 

[goyo1010]

It may not include manipulation but does it include grade 5 mobilization? Oh semantics =P


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Haha, exactly! If the state practice act does not allow "manipulation of the spine", then you can certainly document that you performed a "Grade V mobilization of the spine".

 

[noyceguy]

Grade Vs or manips require a doctor's order in NC. PT schools in NC do teach manips as part of our training. I would assume other schools in the US do the same...

 

[jesspt]

Haha, exactly! If the state practice act does not allow "manipulation of the spine", then you can certainly document that you performed a "Grade V mobilization of the spine".

And what do you tell the licensing board/judge/jury when you did a "grade V mobilization" without a physician's order, knowing full well that they and spinal manipulation are one and the same?

You want to play fast and loose with your license that's fine, but I'm pretty fond of mine and wouldn't risk it being censured by doing something that is easily avoided.

Having spoken to PTs in NC, their common practice was to include spinal manipulation specifically in the plan or care (if they felt it was indicated) and send it to the physician in order to have them sign it. They typically sent the plan of care to the referring physician anyway, and this covered their backside.

 

[noyceguy]

Yes, that is my understanding as well, that a therapist in NC will typically decide on manips during the initial assessment. This way they don't have to ask for it later.

As far as the reasoning for this restriction in NC, I am not sure why this is. We are certainly taught the basics, but I would expect you would have to do quite a bit of work to refine your skills (a mentorship, continuing ed, seminars, etc) before you start really doing manips on patients. At least that is what I would do. Although certainly you could start doing them right out of school if that is your desire.

 

[TheNewGuy8]

The is interesting for NC - but what about the rest of the country? I was under the impression PTs in most states could perform Grade V's legally.

This gets to a question of the practice that I have - if a patient comes in with pain/tingling in their right leg and the doc 'prescribes' whatever a normal non-body-centric doc might prescribe for that assuming they dont know much about the musculoskeletal system (which seems to be true for most primary care docs). But if you, the PT, think that maybe they need a lumbar adjustment and piriformis work, can you go ahead and do that? Or can you only ever do what a doctor explicitly tells you to do?

 

[goyo1010]

And what do you tell the licensing board/judge/jury when you did a "grade V mobilization" without a physician's order, knowing full well that they and spinal manipulation are one and the same?

You want to play fast and loose with your license that's fine, but I'm pretty fond of mine and wouldn't risk it being censured by doing something that is easily avoided.

Having spoken to PTs in NC, their common practice was to include spinal manipulation specifically in the plan or care (if they felt it was indicated) and send it to the physician in order to have them sign it. They typically sent the plan of care to the referring physician anyway, and this covered their backside.

Unfortunately yes, the decision to do this is solely based on one's professional judgment. I would honestly not "play fast and loose" with my license even with issues of semantics with practice acts/laws--anything that would basically threaten the status of my license. I'm a scaredy cat like that. However, in states like NC, I have heard the same thing done by the CIs of the students that have gone to intern there.