Positive Health Online

The Three Tenets of Osteopathy, as defined by the founder Andrew Taylor Still are:

1. Structure governs function;
2. The body is a self-healing mechanism;
3. The rule of the artery is supreme;

Osteopathy was established in 1874 in the rural United States by Andrew Taylor Still. Still was fascinated by the mechanics of the body but also had a Native American background and was influenced by the shamanic view of health. He believed that the body has all the medicines necessary to maintain health; however if the structure was not right these medicines could not get to the areas that need maintenance and repair, therefore resulting in ill health. Correcting the structure allows self-healing. The vascular system is how the intrinsic elements of health can be transported to where they are required.

Now, over a century and a half later we can examine these principles in terms of our modern understanding.

Looking at the second of the tenets, all complementary health systems would subscribe to the idea that the body is self-healing. The concept of homeostasis in conventional science is another way of expressing the same. The third tenet can be expanded to include other communication systems.

For me, structure can be expanded beyond the classical mechanical view into explanations such as given by quantum mechanics. Currently, I believe we are in the process of developing a new paradigm to include the latter into our world view.

So, in addition to viewing the human being as a set of hard tissue levers (bones moved by and moving soft tissues (cartilage, tendons, ligaments and fascia) we see structure in other ways:

Tensegrity – [tensile integrity]

A concept of musculoskeletal relationships based on the work of Buckminster Fuller; refers to the forces of tension (provided by muscles, tendons, ligaments and fascia) pulling on structure (bones and joints) that help keep the body both stable and efficient in mass and movement.[1]

These principles also apply to the cytoskeleton consisting of filaments, microtubules and microtrabeculae [2] and the extracellular matrix (ECM). The ECM includes the interstitial matrix and the basement membrane. The interstitial matrix is present between various animal cells (i.e., in the intercellular spaces). Gels of polysaccharides and fibrous proteins fill the interstitial space and act as a compression buffer against the stress placed on the ECM. But more than just packing, this gel is structured along tensegrity principles.[3]

Electromagnetism

Electrical activity in nerves and across cell membranes is well known. However, researchers such as Robert O Becker[4] postulated that electrical currents were key to limb regeneration in animals and bone healing.

The Heartmath Institute[5] see the heart as a powerful electromagnetic organ that communicates with the brain.

It has been observed that the triple helix configuration of collagen molecules with periodic hydrogen atoms within the structure gives liquid crystalline and piezo electric properties to the matrix, creating another communication system within the organism.

I would postulate that electromagnetic structure is a key determinant of health and is one that has been largely ignored by the scientific establishment as it is unfashionable as it is unprofitable.

Neurological and Psycho/emotional

Neurological and psychological patterning are associated with muscle and visceral tone via the somatic and autonomic nervous system.

Inputs and Outputs

For the body to self-heal, that is restore and maintain homeostasis it requires nutrition, air, water, and motion; it also needs to get rid of waste and toxins. The body is in a constant state of change parts of are being constructed, parts maintained and parts dismantled.

All of the above illustrate the principle that: “Health is a dynamic process through the maintenance of homeostasis in order to effect function.”

Maintaining a good structure is essential to maintaining health. As well as structure governing function, poor functioning affects optimal structure. The structure/function relationship is therefore two-way.

When Things Go Wrong

Our structures have to exist in a dynamic environment both internally and externally; the fact they maintain homeostasis for us most of the time is almost miraculous.

However, a stressed environment be it acute or chronic can cause the system to become suboptimal or in extreme cases fail.

The osteopathic approach is to restore homeostasis using manual methods that either guide the organism back to a more balanced state or work with the processes that have become stuck. This achieved by creating an external fulcrum.[6] This, of course is primarily manual but can be supported by herbal, homeopathic and psychological as well as conventional methods.

Whilst osteopathy is perceived to be primarily about backs, application of these principles can lead to some surprising results in terms of overall health.

Fig 1 Lateral View of Female Pelvis and Ligaments
https://www.researchgate.net/profile/Peter-Petros-3/publication/236630021/figure/fig3/AS:299547474579463@1448429091783/Muscles-and-ligaments-of-the-pelvic-floor-3D-schematic-sagittal-view-ano-rectum.png

Gloria (69) (name changed) consulted me regarding low back pain. She also had been diagnosed with a first degree uterine prolapse. This caused symptoms such as a dragging sensation in the lower abdomen, urgency to urinate and discomfort on sitting. The symptoms had appeared following an infection with a violent cough. Whilst here may have been an inherent weakness with ageing and a history of 3 births including an episiotomy, the forces generated by repeated coughing on the pelvic floor were likely to have triggered the prolapse.

Fig 2 Ligaments of Uterus Superior/Inferior view
 https://teachmeanatomy.info/pelvis/female-reproductive-tract/ligaments/

As can be seen by the diagrams above, the complex array of soft tissues in the area of the uterus and vagina attaching to the adjacent bones, pubis, sacrum, coccyx and other pelvic bones means that if the tensions are altered hypo and hypertensive areas can be created. This would result in distortion of the tissues facilitating dysfunction such as a prolapse.

On examining the patient two features were highlighted in the pelvic area. Firstly, the pubic bone was superior on the left and tender to palpation. This meant the attachment of the pubocervical ligaments would be tensioned improperly. Secondly external palpation of the fascia of the pelvic floor, lower abdomen and sacro-coccyx showed a complex torsional pattern. Gentle adjustment of the pubic bone and some craniosacral and fascial unwinding resolved the symptoms within a short time and to date they have not returned.

Fig 3 Segmental Relationships of the Sympathetic Nervous system
https://www.researchgate.net/figure/2-Fibers-of-the-Sympathetic-Nervous-System-Greenstein-2000_fig3_267854863

James (37) (named changed) came with low back pain, fatigue and IBS. The low back issue had resulted from lifting heavy furniture during a move. The low back pain was easily resolved with manipulation, but after discussion he resolved to see what the treatment could do for his other symptoms. The fatigue was treated homoeopathically as well as looking at lifestyle.

He has suffered with IBS since a teenager following food poisoning. We used homeopathy, diet and supplements to help with the symptoms, but I was intrigued to find a significant restriction in mobility between a group of vertebrae stretching from T11-L2 with some flattening of the curve and a noticeable right rotation in that area. The erector spinae muscles were hypertonic and tender to pressure. I postulated that increased activity of the spinal segments (facilitated segments)[7] indicated increased nervous tone to the sympathetic nerve supply to the gut and that this would increase the irritability of the gut.

Adjustment of that area subsequently improved the symptoms significantly. With other patients I have found that chronically irritated segments, when treated, can improve organ function. Commonly this can occur when shock has over-excited the lower thoracic vertebrae creating an area of tension associated with tightness in the diaphragm (difficulty taking a deep breath) and heightened emotional sensitivity. In addition, segmentally related organs would be affected. This has been associated as a contributory factor to the development of pathology.

The human being is highly complex; we kid ourselves if we think we know more than a fraction of all there is to know. We as practitioners need to remain humble and enjoy the fact that working to restore homeostasis in a patient is a career long voyage of discovery. The waters we chart in this process are only part of the vast ocean of knowledge, but hopefully our contribution will advance the understanding for our colleagues to come.

 References

1. https://medical-dictionary.thefreedictionary.com/tensegrity
2. https://microbenotes.com/cytoskeleton/
3. https://en.wikipedia.org/wiki/Extracellular_matrix
4. https://robertobecker.net/research/regeneration/
5. https://www.heartmath.org/research/science-of-the-heart/heart-brain-communication/
6. http://www.positivehealth.com/article/craniosacral-therapy/fulcra-in-osteopathy-and-craniosacral-therapy
7. http://www.asthme-osteopathie.com/en/irvin-korr-explanation/