Continuing Education for Osteopathic Physicians Greenman | Osteopathic Principles and Practice Greenman

Osteopathic Philosophy

The osteopathic profession subscribes to the following tenets:

The human body is a dynamic unit that is capable of self-regulation and self-healing.
The well being of a person can be represented by the state of their body, mind, and spirit.
Structure and function are reciprocally interrelated.
Treatment focuses on restoring and optimizing joint mobility, as well as blood and lymph circulation

Somatic dysfunction may be defined as an impairment, or altered function, of related components of the somatic (body framework) system: skeletal, arthrodial, and myofascial structures, and related vascular, lymphatic, and neural elements (Foundations for Osteopathic Medicine, 2nd ed, pg. 1249).

Somatic Dysfunction may be diagnosed by the presence of some, but not necessarily all, of the following:

Tissue Texture Abnormalities -- Tissues may feel hypertonic, rigid, fibrosed, atrophied, or edematous.
Asymmetric Motion -- Bones, muscles, or joints may lack symmetry when compared to related structures.
Restriction of Motion -- A joint will have reduced range of motion (ROM).
Tenderness to Touch -- Palpation of tissues may be painful.

Somatic dysfunction can be further classified as shown in the following table.

History Recent Injury Long-standing Condition

Tissue Texture Abnormalities Elevated muscle tone and/or muscle spasms, boggy edema, moist skin Decreased muscle tone, decreased or no edema, dry skin, fibrotic and/or ropy tissues

Asymmetric Motion Reduced rotation or side-bending to one side Reduced rotation or side-bending to one side with compensation in other parts of the body

Restriction of Motion Hypomobility resulting in reduced range of motion (ROM) that is painful with movement, sluggish quality Hypomobility with decreased or no pain, normal quality within the ROM that remains

Tenderness to Touch Severe, sharp, minimal evidence of somato-visceral effects Dull, achy, burning, evidence of somato-visceral effects

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History	Recent Injury	Long-standing Condition
Tissue Texture Abnormalities	Elevated muscle tone and/or muscle spasms, boggy edema, moist skin	Decreased muscle tone, decreased or no edema, dry skin, fibrotic and/or ropy tissues
Asymmetric Motion	Reduced rotation or side-bending to one side	Reduced rotation or side-bending to one side with compensation in other parts of the body
Restriction of Motion	Hypomobility resulting in reduced range of motion (ROM) that is painful with movement, sluggish quality	Hypomobility with decreased or no pain, normal quality within the ROM that remains
Tenderness to Touch	Severe, sharp, minimal evidence of somato-visceral effects	Dull, achy, burning, evidence of somato-visceral effects