Manual of Osteopathic Technique PDF
Preview Manual of Osteopathic Technique
MANUAL OF OsteopatTheicch nique ALAN STODDARD M.B.B,. S.D,. O.D,. Phys.Mcd COt/suitltP thDysIiIckIal le dicjne BrookH ospiLUloll,l t/Oll HUTCHINSON MEDICAL PUBLICATIONS Lolldoll HUTCHINSON MEDICAL PUBLICATIONSL TD /78-20G2r eaPto rtlalld LSorlrledeWolIl, l LondonM elbourneS ydney AucklanBdo mbayT oronto JohannesbNuerwg Y ork * Firsptl lhliOschteodb 1er9 59 SeconIdm pressJiaollllu a1r9y6 1 TltirIdm press(iRoenl ·jNsOeId')e mb1e96r2 FOllrI,mItp ressMiaorlc/h1 964 FiffIlm,pr essFieohnr ll/l9l6f6) , SixtIhm p"ss;AoU"K ll1s9t6 9 <0 Alan Stod1da9r5d9 Thibso okh as beseellil /T li mesp,r i"tielGdlr eaBlr ila;It OiWlh ilAer 'p apreb yA I/chPorre sWsi d hOllblyffW /i llB.r em/oblolt.oh f T ip/fEese's,e x 090 511221 CO NTENTS Prt/ares 7,9 PRINCIPLES OF OSTEOPATHIC TECHNIQUE Il Makinagd iangosisR estoratoifmo onb iliRleYl-axatoifoe nx traneous structuPraesss ive move(maernltisc ulation)-sIpencdiifiraced cjtu st mentsD irecstp eciafdijcu stments-Sptehcriufs-itMcsi -nimumf orce 2 THE DIAGNOSIS OF TilE OSTEOPATHIC SPINAL LESION 25 DefinitiCohna racteriTsytpiecsso fl esion-Diagnporsotciccd ure Mobilitteys ts 3 ATLAS OF TECHNIQUES 87 Articulatory techniques SortS-pteicsisfiutcee c htneicqhuncisques Neck Cervico-thaorreaacT ihco racairce aT horacciacg eL umbar regioPne lvis 4 THE INTERVERTEBRAL DISCS 230 Herniatdeids cPsr olapsdeids cCsh ronidci sdce egneratiSopni nal traction Appt'lIllix 260 Thea pophy<;feaacle ls-Tnhoer mamlo vementosft hes pineS urface markings II/dex 273 PREFACE TO THE SECOND EDlTlON Iti sw itcho nsiderpalbelaes aurnedn ota litptrlied e Itw hraittt eh is prefatcote h see conedd itioofmn y m anuaTlh.e f actth atth eriesa d emand fotrh be ooks howtsh eriess tinlele fdo rad escripotfti hoemn a nipulative techniquuseesbd y o steopaths. Onlyaf ewm inopro inhtasv bee eanl terientd h et echniqtuheesm selves, butt het heoretical doefst chreli epstiiwoornni ttbeynD r LouisBau rns thiryteya rs haagsbo e eonm itteIwd a.s a dvisbeydm ediccaoll leatguoe s do this, bseolc iatutisleske n owna boutth eh istoloagnidcm aolr bid anatomcyh angwehsi ch followt ots rpaiunjmaoali ntasn,dt heo bserva tiomnasd eb yD r Burnwse roen a nimaSlusc.h c hangdeosn otn ecessarily occuirnh umans pineasn,dm oreovtehrec hronolosgeiqcuaeln ocfte h ose changiesbs o untdo be fallacious. Thed escripotfti hoeno steopastphiincla els iionCn h apte2 ri sa des criptoifoa n c liniecnatli btays eodn o bservartaitohnte hra no ne xperi mentaelv idenacnedt, h eriesn od oubtth atth es yndroimsea realiTthye. reaswohny I p refteorr etatihnes pecieapli th'eots teopaftohrti hcic'so n ditiiostn h atth eo steopawtehrste h fei rtsoat t temtphted escripotfti hoins elu,einvtei atnydt hedye sertvhece r edfiottr h iIstm. i ghwte lble c allaend interdnearla ngemoefan v te rtebjroailnb tu,ts ucaht erimsr ealnloby e tter except ittwh oautl bde m orea cceptatbool pep onenotfts h eo steopathic concept. Whena ndb yw haptr ocetshseo steopastphiincla els imoenr geisn ttoh e disc syndirsdo embea tabbultea ,s I s ayi nC hapt4e rb Je lietvheam tu ch antecetdhceas d veonfts ymptoimnsd islce sioannsds, u cphr ocesmseersi t clossteu dy. Tohfuo ssw eh oa ricn tereisntt hesedu bjemcuts kte eopu re yes openf orn ewk nowledgienw hatevfeire ldi-tih fa sa nyb earionngt he subject. 10t hem eantiam ed escripotfit oenc hniqoufme asn ipulawthiiocnh haveb eenf ountdo h avep ractivcaallu eev,e nt hougehm pirically per formeids, desiIrtaw boluel.bed wonderftuobl e a blteo e xplaeixna ctly what happwheennsa joinits manipubluattt ehded, e taimlasya lways remaionb scuIrfet .h tee chniqduowe osr ka,si nf actth edyo u,s inmge thods baseodn a natomiacnadml e chaniccoanls iderawteia orneas c,h ievoiunrg objectiIvfte h.e p ractitdieovneelro ap kse en seonfts ies stueen siaonnd palpatiaonnd,l earntso c o-orditnhateve a riocuosm ponenitnsa ny manipulahtoiwoenv esri mplheew, ilalc hiesvuec ceMsasn.y p atiewnitlsl beg ratefaunldp, r ovidheedd oesn otf orgtehte c ontrian dicattioo ns manipulahteiw oinl l raise the ofsh tiamtsuesal nfdb o oftt hh ea rto f 7 8 PREFACES manipulaatsia o wnh oleI.w ouldh,o weveurr,g teh ep ractitniootnt eor concenterxactleu siovne tlhyed etaiolfst echniqnuoesrt, o l imihti s horiztoont hsei ngalnedi solastpeidn jaoli nbtu,ta lwaytsob eairn m ind thaotn ej oinitsj usatp arotf t hes keleftraalm ewoTrhke.w holsep inteh,e wholbeo dyt,h ew holmea nh ast ob ea djustteohd i esn vironment. PREFACE TO THE FIRST EDITION Thep urpoosfet hibso oki st os edto wna ndi llusttrhaemt aei nt ech niquoefsm anipulautsieoidnn o steopaptrhaicct iTchee.ra er en umerous techniqaunedms a nym oreo ft hema rei nc onstaunstet han1 h aved es cribebdu,tIh avien cluodnedlt yh osweh icIhp ersonhaallvfyeo untdo b e moste ffectTihveae .r to fm anipulaitsia o vne riyn dividmuaatlt earn d certtaeicnh niqaurmeeo sr e approfporsrio amtepe r actititohnaoentr hse rs. Thet echniqmuaeysa lhla veto b em odifietdot hen eedosf b othp racti tionaenrdp atieTnhted. e taoiflp sr ocedaurrceel easrolmye whpaetr sonal, but whtihlees mea y varyb etweeonn cp ractitiaonndae nro thetrh,e underlymientgh osdh oulbde b aseudp ont hes amep rincipTlheess.e princiIp hlaevse elaboinrt ahtefie rds cth aptbeurt,t hep ractitmiaoyn er welfiln dt hahte h ast oa daptth efi nedre tatiolh si msealnfdh isp atient. Ther eadweirl fli ntdh atth ep rinciopflt eesc hniqhueersee n unciated are somewhadti fferent fromt hosoef p revioousst eopattehxitcb oobkustI submitth atth eayr eb aseudp ona natomiacnadml e chanifcaaclat nsd a re supporbtyet dh ep racLiecxaple rieonfmc aen yy earosfa ctipvrea ctiinc e theo steopafitehlidc. Them anuailsm erelayno utliannedi sn ota na ttemtpotb ec ompre hensiNvoer.i st heb ookw rittjeunsf to rb eginnearnsd,w, h ilieti sp ri maridliyr ecttoet dh eo steopastthuidce anntd g raduaittie s,h opetdh at alplr actitioofnw ehrast,e vsecrh ooolft houghwti,lfi ln ds omethionfg valuieni tpsa geIs h.a vwer ittietfn o r tahlolsw eh oa spitroep erfecitni on thea rto fm anipulatainodna ,l thoutghheo steopatphriocf esshiaosn contribmuotreed thaannyo thetro t hee laboraotfit oenc hniqtuhees , arotf m anipulaiLsni ootnt he sporleer ogaotfi vteoh set eopRaatthh.e irt ist hep rerogaotfit vheep atieTnhte.p atiehnatsa righttoe xpeac th igh degreoefs kiilnla ltlh osweh op urpotrotp ractmiasnei pulatIitio sn . desiratbhleer,e ftorode i,s seminaaswt ied elays p ossibtlheea vailable knowledogfet hiwso rks ot hatth em aximumn umberosf s uffering humanimtayy d eribveen efiAts. f ara sI known,o pureloys teopathic technitqeuxet bohoaksb eenp ublisihnet dh icso unttrhyo ugshe veral excelloenneths a vbee ewnr ittienAn m erica. A greadte amlo rec oulhda vbee ewnr ittaennd,p robabwliylb le l ater, ont hew ider asopfOe sctteso patbhuytI, h avree strimcytseedpl rfi marily top ractical imnta htitbseo rosk . Itm ustn otb et houghhto,w evetrh,a bte cautsheem anuailsl imited tot echnique protcheadotus rteeso pattrheiact miesns to l imitTehde. underlypirnign ciopfOl set eopaitsth hya stt ructguorvee rfnusn ction, that 9 10 PREFACES disturbaonrcs etsru ctiunrw eh atevteirs swuiet htihn eb odyw illle atdo disturbaonffc uensc tioinnjt nhga t strauncdti,un rl eu rn,o ft hef unction oft heb odya sa wholeT.h e objective, tihnet rheeof sotreeo,p athic approaicsth h ceo mplertees toraotfti hoesnt ructiunrtaelg irnit thyeb ody. Thihsi gahi mm ayn otb ea chievbeudtt haitst hgeo aaln,d w hatever means areu sedt or estohraer moniosutsr uctiunrtaelg ratthieosnfe,a lwli thin thea mbiotf o steopathic practtihcifesr. a mWeiwtoohrfiko n s teopathic treatmeOnUtfc, h ief agemnacnyu amilas n ipulaotfij ooni nbtust,a lsoof importaanrcee tihmep rovemoefnp to stutrhee,e ncourageomfeg noto d lymphataincdv enoudsr ainatgheei, m provemoefnt th ea rterbilaolo d flowt,h er emovoaflm echanical obstructiomnesa nisbf yn ecseusrgical sary, the reopfvo issicteiroan, u seto hfee xercifsoerss t rengthening muscloerst hes tretcohfic nogn tracttiesds uTehset. h emies t hagti vean structursaolulnyfd r amewortkh,eb odilfyu nctiwoinlspl r oceehda r moniousalnydh ealthTihleye .l aboraotfit ohne soes teopamtehaiscu res belonrga thmeorr et oa textbooofPk r inciipnlO esst eopatbhuyts, u ffice ith erjeu stto e numerastoem eo ft hem ethods. Thet echniqoufem sa nipulatdieosnc rihbeerdea rel imitteodt he vertebcroallu mann dp elvipsa,r tilnyo rdetro k eept heb ookw ithin reasonableb ultai lmsibote sc autsheeo steopaitnhfliuce nucpeo nt hea rt ofm anipulaitismo unc hm ores ignificiansn pti ntahla ni no thejro int manipulas-tibountt her eademru stn ota ssumteh aots teopattrheiact menti sl imitteotd h esp inEev.e rjyo inetv,e rtyi sseuvee,rc ye lilnt heb ody influenecveesr oyt hesrt ructiuntr hea bto dyT.h eraer es timulaatnodr y inhibittroerayt metnovt iss cearnads oft (itsrseuaetsm;me anytb ed irected ton ormalitzhiean ugt onomniecr vosuyss teamf,f ecvtiic negr omolainodn vasomotiaonnds oo n.O steopatthrieca tmetnhte,nh ,a sa muchw ider significtahnacnem ereljyo intte chniqaunedst, h ereftohriems,a nuails butas malpla rotf t hel argseurb jeocfOt s teopaitthsye lf. Theraer ef Olmlari ns ectitoont sh eb ookT.h efi rscth aptdeera lwsi th thep rinciopflm easn ipulatteicvhen iqtubees; e conwdi tahd escripotfi on theo steopastphiincla els ioint,ss i gnificiannt cheeo veraplalt teornf theo steopactohnicce opft heaalntdhd iseafsoel,l owbeyd a detailed accouonftt hed iagnoosfit sh eo steopastphiincla els ioTnnt. h et hird sectitohnec hiesfu bstaonfct eh em anuailst ob ef oundI.ti sa na tlaosf techniqwuietsih,l lustraatdijoancestn ott h ed escriptiwoansst .h ouIgth t desiratbola er rantgheem ailetrh usso a st om aket hep rocedure more readiulnyd erstoIotid s.n otorioduisffilcyu tlotd escritbheed etaiolfs techniaqnudew, i thotuhteh elopf i llustraittii soa nlsm,o sitm possible. Ideally, teschhonuilbqdedu eesm onstrraattehdte hra bne r eaadb oubtu,t , evewni tthh eb estte achienrt sh ew orltde,x tboaorkeis n valuafbolrte h e studetnodt w elulp ona ndr efbearc tko t imaen da gaiIntw. i lbles eetnh at theraer et hreseu bdivisiinto hniscs h aptveirz,s. o ft-titsescuhen iques, PREFACES II articultaetcohryn iqaunedss pecitfeicch niqaunedst ,h ey daerael wti th regionsaolt lhya atl tlh et echniqoufee asc rhe giaorne i na convenient sequenfcoetr e achainndgt reatmpeunrtp osTehsefi. n aclh aptiesr devoted tot hem anipulatteicvhen iqwuheisca hr ea pplicatbot lheev ariosutsa ges ofi nterverdtiesblcre asli oannsd,i nt hisse ctitorna cttieocnh niqaurees descriibnde de tabielc autshee pyl asyu cahn i mportraonltie n t het reat mento fd islce sions. Durintgh ep reparaolfit ohni msa nuaIl h aveb eenm uchi ndebted tom y secretGairlyl,i Warni ghfto,rh erp ainstaaknidnp ga tietnytp ing andr etypitnomg y, r adiograEpdhietrKh,n ottf,o rt heh elsph eg avien makintgh eX -rafyi lmtso,M r.A .E .S ai tf ort hep hotograaplhsymo,y daughtaenrd M rs.B .S hearefro rb einsgu che xcellmeondte lst,o Drs.W . Hargrave-WiBl.sH o.Pn e,n tnaenyd D .T urnefro rre adianngd critictihzesic nrgi bputt,m osto fa lIlh avbee einn debtteoDd r .A ndrew TaylSotri wlhlo i n1 87s4t arttehdef irsscth ooilnO steopaatthK yi rks vilMlies,s ouUr.iS,. AW.i thoDurt.S tilpli'osn eerwionrgki nO steopathy, thea rotf m anipulawtoiuolnnd e vehra vea chievtehdep lacoefi mporl ancweh iciht h oldtso daSyt.e adialnydc ontinuosuisnlctyeh etnh ous andosf o steopahtahvsem adei tt heilri few'osr kt ou set himse thoodf treattihnegi njrueda ndt hes icSko.m em ayh avef ailleadm entaibnl y havinign adequkantoew ledogfte h ei nstrumtehnetwy e rue sinbgu tt he majorihtayv es ucceeidnerd e nderiinnvga luasbelrev itcome a nkinidn theeifrf otrota sd vantcheea ratn ds cienocfOe s teopathy. Them edicparlo fesshiaosln a ggefda rb ehintdh eo steopatphrioc fessiiondn e velopainndtg e achtihneag r otf m anipulaatnidoi nth ass adly neglecttheemd e chaniccaauls oefsd iseaasnedd isabiIlitit sby e.c ause oft hitsh aat s eparsactheo ooflt houghhatd t ob em aintaiinnet dh ep ast and shtaislt lo b em aintainbeudtw; h ent hel ruiem portaonfct eh e structfuarcatlho ars b eenf ullrye cogniazneddw ,h ent hem edicparlo fessihoansm odifieidt tsh inkionngt heslei neasn da ddemde chanical derangemteont thse liirs otfe tiologfiaccatloi rnds i seatshee,tn h erwei ll nol ongbeera nyn eefdo ras eparoartgea nizaatnidto hnew orlwdi lble a healthainedhr a ppipelra cteol ivien A.l reatdhyer ecogniotfit ohnei nter vertebdriasllce siboyno rthodmoexd icihnaesf ocusaetdt entoinot nh e spincaoll umint;ls o caaln dr emoteef feacrtebs e ttuenrd erstaonoddi ti s beinrge cognitzheadt tlheessieoc nasu sdei sturbaonfcl ehsea utonomic nervosuyss temo satse opahtahvcsel aimfeodmr a nyy earAst.p re,etnhte re isa keeann da wakeniinngt eriensm ta nipulaatnidom na nyd octors are tryidnigf ferteencth niqwuietsh osuutffi cieknnto wledagned w ithoau t propearn alyosfit sh ej oinmte chaniTchse.t echniqhueersoe u tlinaerde the outcoofsm oem ethilnigke ei ghyteya rosfd evelopmienmn atn ipula tioann da ret,h erefwoorret,h oyft hea ttentoifao lnwl h od esitroee xcel int himse thoodf p ractice. PNRIN CIPLOEFS O STEPOATHITCE CHNIQUE IOSTEOPATHYw ea rceo ncewrintethdh ees tabliasnhdmm aeinnt tenaonftc hene o rmsatlr ucitnutreagolrft i htbeyo dayn tdo a chieve theinswd e u sdei vemresteh oTdhse.ms eet homdasyb ec lassiinfi ed thrgereo ups: (IT)h et echnioqfju oeismn atn ipulia.teti.ho enn ,o rmaliozfa t.ion mobilaintpdyo sitainotdnh r,ee lief oft eanbsininoo rnmm uaslc les, ligamceanptssau,nl fdea ss cia. (2M)a nipultaetcihvneio qtuheteshr a jno int cordriercetcfitooernd s. examptloie m,p rcoiver culvaetnioaounnsdl, y mphdartaiicn tahgee , repositoifvo insicanengrsd ao ,tf its tsrueea tments. (3O)t hmeert howdhsi chahv aest heaiirmt hiem proveomrre enstt ora tioonfn ormal meicnht ahbneoi dcyss,u cahst hceo rrecotfi on posttuhrseeu ,r gicalo far benmoorvmaall w htiiacsrhsie um epse ding natuartet'esma ptrt est urtnhibeno gdt yon ormaanled,x ercainsde s activwihtiicehs t home alipn taaniidnm prnoovrem maelc hanics. Altlh ecsoem wei thtihbner oaadsepreo cftt ho es teopaaptphrioca ch, buitnt hbioso wke a rmea inly cownicttehhr feni erhdse ta diLnegut.s deatlh ewni tthhp er incoiftp hlteee sc hnoifjq ouien t manipulation. Our immedpiuartpeio sts here e storoafnt oiromna l coinntd hijeto iiwonent ss ardee alwiintgIh ti. s c leaurnlnye cetsosm aarnyi punloartmjeao li nts. Therebfeorfeod,re es crtihbdeie ntgao ifml asn ipultaetcihvneii qtiu se s, necestsoka nroyaw n udn derswthaaantbd n orsmtaailt pser esent. THE FIRSTP RINCIPLE,t heins,t hmea kionfga diaginsAo.ss t he establiosfah d mieangtn iosos fpi asr amount iImh paovdreet vaontceed aw hoclhea pter 2()tC oht ahppitrseo rb lIenim at.r dee scrtiebcehdn iques ofd iagnosism-ombaiiltnieltsyyt s-awrhoeif cg hr evaatl aunedm ust ofn ecesbseui stepyd r itooar n tye chnioqfmu aensi pulation. Ina rriavitan dgi agnoofst ihjseo int wfema uuslftti rst exclude patholcohgaincTgahelsa i.tts o s awye m usetx cltuhdoecs hea ndgueteso disewahsiecl he atdol ocsatlr ucatlutrearlia ntt ihovena rious com poneonftt shj eo icnhta;n gesm awyhm iisclhue sai dn ttoh inktihnaagt 13
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