Celebrating Osteopathy

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“But why?”

This question plagued me for years. As a teen, I had back issues and a number of knees issues. Despite seeing a handful of health professionals in different fields, satisfactory solutions were hard to come by.

I was given a diagnosis. I was given treatment plans. Hands on therapy. Exercise prescriptions. Orthotics. Maybe it was health professionals refusing to humour a kid…but I never got a satisfactory reason for my issues.

Sure, the meniscus was damaged. But why? Why did this happen? What can we do to ease my anxiety over the same thing happening again?

This cycle replayed itself a number of times in different iterations through high school and university. Through that time I studied kinesiology, trained like a professional athlete and worked as a personal trainer and strength coach.

Without realizing it, dots started connecting themselves. Studying biomechanics, psychology, physiology, and applying these concepts in the gym was doing something to me. I was beginning to see the many layers of complexity of the human body. I was beginning to see how they interact.

This is when I discovered osteopathy. Though osteopathy has been around since the 1870’s, I hadn’t heard of it until my fourth year of university. The field used the right keywords to catch my attention: holistic and comprehensive.

Holistic is among the most misused words in health and fitness. Despite this misuse, osteopathy is an excellent embodiment of the term for one reason; the term guides the practice. The principles that underly the founding of the field are the same ones that drew my interest. These are the same principles that feed this idea of holistic practice. The same principles that guide my work today.

Osteopathy is built around the idea that the human body inherently tends toward health. In the absence of barriers to health, the body will be healthy. The human body is an incredibly complex machine. Far more complex than any technique a human mind can apply through a human hand. The osteopathic goal, then, is to help the body do its thing.

Osteopathy is largely a manual therapy, meaning that the majority of the work is applied through hands-on techniques. We’ve got a vast repertoire of techniques at our disposal; some resembling other therapies like massage and joint mobilization. Some are unique to osteopathy, like cranial-sacral therapy and visceral manipulation.

It’s tempting to look at osteopathy as this collection of hands-on techniques and little else. You come in with back pain and we use the “back pain techniques”. Not so. We’re a patient-focused profession and I work as hard as I can to live up to this terminology.

Patient focused means that this therapeutic effort is about you. When you come in to see me in the clinic, we’re forming a partnership to change your experience. It’s not about applying the right label. It’s not about proving anything or making sure that you fit into the osteopathic system. It’s about using the skills in the room to solve your problem.

When we first meet, we’ll spend some time talking about you. I want to know about you; the way you view your body, your symptoms, your therapy expectations, your work, your life. These may not become major factors, but they all contribute to this holistic picture that helps me understand where you’re coming from.

As it turns out, where you’re coming from is incredibly important. A single mother of three that works full time is in a very different position from a student athlete. It’s not to say that one is better than the other. It simply means that we must take the realities of your life into account when we plan our work together. This is the essence of a patient-centred approach.

I want to know the story of your injury, your pain or your diagnosis. Knowing how events have unfolded and the path you’ve walked so far is incredibly important. Again…the more we know and understand here, the better.

Eventually we’ll come to some conclusions about how to proceed. All of that talk about your views and your perspective come into play in this moment. What do we expect to do with our therapy work? What would an ideal outcome be? How much time and energy can we devote to that? How would life change if we could achieve that goal?

After we’ve decided what we’re shooting for, we can decide how to measure it. How do we know when you’ve hit your goals? When you can sit comfortably? When you can return to sport? When you can walk without pain? These are not only good goalposts, they’re also good criteria to guide us.

Now we can get to the fun part. Another of the fundamental principles behind osteopathy is that structure and function are inherently linked. The structure of your body is inherently linked to how that body functions. This is intuitive and it helps us guide our work.

Among the first things I’ll do is investigate affected areas and the areas I think are likely to contribute heavily to the issue. If you have lower back pain, there’s a very good chance that I’ll palpate your lower back, investigating soft tissue quality, joint movement and your sensitivity. There’s a good chance I’ll look at your hips and your upper back as well. These areas will all give me structural clues to work with.
My work from this point on is about connecting those clues and forming basic ideas about how these clues feed into your issues. For example, your lower back pain may be evident in the tension in your lower back muscles. This doesn’t mean the lower back is the ‘at fault’ area, though. It’s just as likely that there are important factors in your hips, ankles, feet, and upper back all contributing equally to this issue.

As I assess these clues, I’ll work on bring them back to balance. Much of the time that means releasing tight tissues and mobilizing tight joints. This is all done with an intensity we agree upon together; though more pressure may lead to a faster release, a sensitive person may end up more tense as a result of deep work.

These techniques are all hands-on, meaning I’ll use my hands to affect some change in your body. We use a collection of soft tissue release techniques, muscle energy techniques, joint mobilizations, visceral manipulation, whatever is necessary to remove the barrier.

This is where our vast collection of techniques comes in handy; we don’t have to dig deep if it doesn’t work for you. There are other ways. As Dan John would say, “the goal is to keep the goal, the goal”. You aren’t in the clinic to fit into my system. You’re here to benefit from my expertise, and we can only expect that outcome if I fit my expertise to you.

So we investigate contributors and culprits. We order them from biggest to smallest offenders. Then we set about addressing these culprits. Recall; the human body will take care of itself in the absence of barriers. If we can remove these barriers, good things will happen.

Sometimes these changes can be swift and sweeping, taking place over the course of just a couple of visits. Much of the time the issues are chronic by the time they get to me and a little more time together is warranted. It’s a difficult thing to predict off the bat because the process is dependant on tiny factors…like your body and how you live your life.

The goal with all of this work is to help you live the life you envision for yourself. This may mean living pain free, it may mean optimal performance, it may simply mean doing the things you want to do without fear of injury. Whatever the vision is, that’s our goal together.

I won’t beat around the bush with what this goal requires. Though I’m good with my hands, they aren’t entirely magical. It’s very likely that your issue will require homework on your part to maintain. It’s very likely that your issue will require a slight lifestyle shift in order for it to truly be resolved.

This may mean addressing your posture, addressing how you exercise, addressing if you exercise, or any number of movement or lifestyle habits. It’s not my job to sell you on the convenient approach; my work is about helping you find lasting resolution. If there’s a clear way forward, we’ll discuss exactly that.

Due to the relative obscurity of osteopathy in Canada, I tend to see a particular type of person. The majority of people I see in the clinic are those that have suffered through chronic pain and symptoms. They’re often people that have tried a number of other therapies and still have unresolved symptoms. Much of the time these are people that have given up on that vision a few times over.

Though I often work with those that have experienced chronic pain, I see all types. Osteopathy is actually applicable to an incredible number of issues. Musculoskeletal pain and injuries make up the majority of the work we do, which of course encompasses just about any ache or pain you can feel throughout your body. A number of other symptoms are equally well-served; like headaches and digestive issues.

Osteopathic therapy has many similarities to other therapies, but the differences are what really make us manual osteopaths. Any time I work with a new patient, the origins of the field are kept in the forefront of my mind; treat the person holistically, as a person, and seek balance between structure and function. Find the obvious barriers to the body healing and remove them from the equation.

These ideas may seem simplistic but they end up being the guiding lights that keep us on track when looking at the big picture. The big picture, after all, is you. It’s your body. It’s your ability to live your life. Every technique is applied through this lens.

Osteopathy was founded nearly 150 years ago with the same noble principles that drive the field today. Though the field may still remain obscure and the methods somewhat mysterious, the methodology is not.

Find the barriers to health. Remove them. Live a good life.

It was through my first osteopathic study that I learned to connect the dots in my own life. After almost a decade of injuries, pain and unsatisfactory answers, I was able to look at the bigger picture and understand the origins of my own issues.

If you find yourself asking, “but why?”, it may be time to book in to see me. If you want to understand why your body is doing what it’s doing, it may be a good time to book in. If you want to understand your circumstances and find a viable path to walk towards health, you know what to do.

Check me out at Body Balance Health & Physiotherapy!

Conor O’Flynn

Welcome Conor O’Flynn to the Body Balance Health & Physiotherapy Team

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In other Body Balance Health & Physiotherapy news we would like to welcome Conor O’Flynn to the team!

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About Conor

Conor is a manual osteopath who was born and raised in Wallaceburg, Ontario. He studied Kinesiology at Wilfrid Laurier University in Waterloo, Ontario, earning a Bachelor of Arts. While studying at Laurier, Conor developed worked as a personal trainer and varsity strength coach for the university, discovering the need for an integrated fitness and therapy model.

After university, Conor earned a diploma in manual osteopathic practice (DOMP) from the National Academy of Osteopathy in North York. He returned to Waterloo and provided osteopathic therapy in both physiotherapy and alternative medicine clinics.

Conor’s therapeutic work focuses on musculoskeletal issues of all kinds. He uses manual (hands on) therapy techniques to restore balance and integrity to the body, removing the barriers to healing and recovery. He works hard to keep his techniques and practice up to date with current pain science and manual methods.

Conor is passionate about exercise, and bridging the gap between therapy and fitness. He prefers to gear his therapy towards an active recovery, placing the patient in control of their recovery process and transitioning to a healthy, vibrant life.

A lifelong athlete, Conor is a nationally qualified powerlifter. He’s competed at the national level in both muay thai kickboxing and grappling competitions. He is a prolific writer and is always looking to improve his fitness and therapy services.

Osteopathy and Chronic Pain

Osteopathy is an old therapy, going into its 144th year as a health practice in 2018. Though this might be viewed as a drawback – deeper roots to keep the profession stuck in the mud – it can actually work the opposite way. The long history provides perspective and allows for the old to be viewed on a spectrum with the new.

In the case of osteopathy, this means that the field has changed and will change dramatically. As it should. The original practice still makes up a large amount of what is considered osteopathic work today; manual therapy applied in an effort to achieve favourable outcomes and avoid more invasive interventions.

Viewed in this broad lens, the field is wide open to adapting to pain science as it changes and new evidence emerges. A 2016 article by Williams and Craig – titled “Updating the definition of pain” – provides many insights to apply as we move forward with manual practice.

Williams and Craig provide the following definition of pain, “Pain is a distressing experience associated with actual or potential tissue damage with sensory, emotional, cognitive and social components”(Williams and Craig, 2016). The incredibly important assertion that pain is an experience is a good start. That this experience may involve actual OR potential tissue damage is equally important.

In the case that actual tissue damage has triggered a nociceptive experience, osteopathy can provide manual care that seeks to parse, relieve, and re-integrate the areas in question. The goal is to remove obstructions to recovery and factors that feed into nociception, allowing the individual to once again feel like an integrated and functional unit.

In the case that there is only potential damage or perceived damage, osteopathic therapy can still be useful. A manual approach can be used to begin to restore confidence in an area of the body, provide novel stimuli which may interfere with nociception, and lay the groundwork for changing perception of the area through more active means, like exercise.

Through manual work and simultaneous discussion and education of the patient, the therapist can change both the objective expressions and the subjective perceptions which may contribute to the sensation of pain. We can guide the patient through the common narratives that often contribute to pain becoming or remaining chronic.

My own osteopathic work has been largely directed at realigning a patient’s focus as they navigate a painful experience. Often the instinct is to focus on the painful sensation and the things that one cannot do as a result of the pain. In my interactions with patients, I can help direct their attention toward doing what is necessary to improve toward a more functional state.

As pain experiences become chronic, the link between actual tissue damage and perceived pain weakens (Juch et Al, 2017). It’s important that the patient is able to form a therapeutic alliance with a practitioner they can trust. It’s more important that this practitioner helps to guide perception towards function and acceptance of pain itself rather than suggesting that a simple hands-on technique can “fix” the pain.

Manual Osteopaths are not among the professions allowed to perform diagnostics in Ontario. While at first this seems like a shortcoming, it does in fact put Manual Osteopaths in an interesting and unique position.

Rather than focusing on the diagnosis process and finding a label for the painful input, osteopathy is free to parse out the connection between tissue and pain that so many patients can get stuck on. Moreover, we can work on accepting conditions however they may currently present and set specific and meaningful goals with the patient.

This goal setting may not fit any other criteria beyond the patient, but that won’t matter. We can choose tasks that are meaningful to the patient, or on changing experiences currently affected by pain. This may be something personal and difficult to quantify in the clinic,but it may provide the patient with a tangible goal that they truly desire. This allows for the patient to feel a little empowerment, and in doing so removes reliance on the practitioner in question.

Osteopathic therapy is manual therapy. Manual Osteopaths work with their hands. Among the guiding principles of the practice, though, is removing obstacles that prevent healing. My hands may not be able to stimulate healing themselves, but they are more than capable of helping a patient feel better and liberating tissues to allow for better movement and experiences.

Through manual work, shared goals, working with acceptance and perspective, and forming an empowering therapeutic relationship with the patient, manual osteopathy is a useful tool in the treatment of chronic pain.

Williams AC, Craig KD. Updating the definition of pain. Pain. 2016; 157(11):2420-2423.

Juch JNS, Maas ET, Ostelo RWJG. Effect of Radiofrequency Denervation on Pain Intensity Among Patients With Chronic Low Back Pain: The Mint Randomized Clinical Trials. JAMA. 2017; 318(1):68-81.

 

Running and Osteoarthritis: Does Recreational or Competitive Running Increase the Risk?

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Published: Journal of Orthopaedic & Sports Physical Therapy, 2017 Volume:47 Issue:6 Pages:391–391 DOI: 10.2519/jospt.2017.0505

Recreational runners had less chance of developing knee and hip arthritis compared to nonrunners/sedentary individuals and competitive runners. The researchers concluded that running at a recreational level for many years—up to 15 years and possibly more—may be safely recommended as a general health exercise, and benefits hip and knee joint health. Their findings indicate that remaining sedentary and forgoing exercise increases your rate of knee and hip arthritis, compared with regular recreational running. However, high-volume and high-intensity training also may increase your risk for arthritis. Other researchers who found a link between high-volume and -intensity runners with knee and hip arthritis defined high-volume running as running more than 57 miles (92 km) per week. The benefits of running are numerous. This study allows you to be confident that recreational running will not harm, and may improve, your hip or knee joint health.

 

Merry Christmas from Body Balance

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Wishing everyone a very Merry Christmas and a safe and happy New Year. We will be closed after Dec.23rd and will re-open in our new location starting January 2nd, 2017 at 1315 Michigan Ave. See you there!

BIG NEWS!!!!!!!

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We are excited to announce that we will be moving to a new location on January 2nd, 2016. We will be joining “Pure” Powered by On Edge Fitness at theirs and our new location at 1315 Michigan Ave, next to the Goodwill. We are looking forward to the new opportunities that exist in this location and will continue to not just meet but exceed the expectations of the patients we treat.

Stay Tuned!

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We have a big announcement coming on Friday, December 2nd! Check back then for the exciting news.

We are Growing

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Body Balance Physiotherapy would like to welcome Larissa Moore, Physiotherapy Resident.  Larissa will be starting October 11th, 2016 and is looking forward to starting her professional career in Sarnia.

Celebration!

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Body Balance Physiotherapy are celebrating our 11th year in the Sarnia-Lambton community!  Join us for coffee and goodies all day long 🙂

We Will Be Closed

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Please note that the office will be closed on Friday, August 12th, and Friday, August 19th.  Sarah Thomas, RMT will be working these days so please contact her directly on her mobile to make or change appointments: 519-330-7517