Classical Osteopathy brings a traditional view to the profession, it is not based on manipulation but on integration through Body Adjustment, and this is why we see Osteopathy as a form of art, as well as a science enhanced by a philosophy that helps us to understand the organism, the way it works and compensates.
Irvin Korr, in his address to the British osteopathic community in 1996 at the Commonwealth Institute London, said;
“I remind you further of another principle.You do not treat symptoms, you do not treat pain, you do not treat diseases, you do not treat parts of the body, you do not treat the musculo-skeletal system; you treat persons, you treat human beings. It is they who get well or not depending on the competence of their built-in health care system. I would like to hear you saying this more and more, that you are treating more than a musculo-skeletal system.”
The overriding principle of classical osteopathy is therefore not bony adjustment, but body adjustment. This historically relevant philosophy is what makes classical osteopathy distinct.
Classical osteopathy is a system of healing which was formulated over a hundred years ago by AT Still and then further interpreted by JM Littlejohn. It encompasses the Hippocratic concept of Vis Medicatrix Naturae, ‘the healing power of nature’, where the body is seen not as a machine, but as a vital living organism with a normal tendency towards self-healing, elimination and health. The development of disease depends on any factors which lowers the vital force or the vitalising processes of the patient and compromises the organism’s ability to recover. It follows therefore that the osteopathic lesion is not a bony lesion, but a physiological one and that any disease or disturbance must be addressed through physiological processes. This approach of health promotion is directly in contrast to orthodox medicine, which delivers a more linear/ pathogenic approach to treatment of disease and its symptoms via the use of pharmaceuticals. In osteopathy, health is not merely viewed as an absence of disease, but as a state of complete physical, mental and social wellbeing. The osteopathic therapeutic concern is therefore to adjust the body’s capacity to deal with environmental stressors, whether these be on a mento-emotional, physical or biochemical level. This process was termed simply as ‘Adjustment’ by JM Littlejohn and implies perfect structural adjustment, including bones, muscles, ligaments, blood vessels etc. , perfect neurological adjustment and adjustment of the individual to their environment by considering factors such as diet, hydration level, sanitation, social interactions, stress levels, sleep pattern and so on.
Although the body is vital living organism, it is, as are all structures, subject to the laws of gravity. Although this gravitational stress is normal, it is the inability to sustain this stress and the subsequent malposition of the body in relation to gravity that leads to altered physiology and hence disease. As Fryette reminded us “gravity is the great killer of the body”. Ignoring the effect of gravity will therefore provide temporary relief of the lesion state only. We have to think in terms of parallel and non-parallel forces and of curved forces as they act over the spinal arches and more importantly of the problem of weight-bearing as it operates on the normal or abnormal structure. The living organism must be mechanically sound but must also be segmentally and collectively free to be able to function normally. “Fixation at one point of the spine will find expression throughout the column.”
‘Polygon of Forces’ diagram:
The effects of gravity on the body can be represented by non-parallel lines traversing the spinal column - the structural line passing from the atlas to the coccyx balanced by the functional line from the atlas to the centre of gravity at the 3rd lumbar vertebrae. Vector lines can then be drawn from the atlas to the coccyx and the acetabula, thereby forming a large pyramid, based on the pelvis and a smaller pyramid balanced and inverted on the point at the apex of the large pyramid opposite the 4th dorsal vertebra. This polygon of forces provides us with a diagnostic model to illustrate three dimensional forces on the body. It is essential that the bases of these triangles be freely operative - which is possible only if the spine is properly integrated. Treatment must therefore “appeal to the lines”.
Curved lines or spinal arches provide a dynamic representation of the spinal column whereby the four arches provide a balance between the primary dorsal and sacral arch and the secondary cervical and lumbar arches. The most important factor in spinal balance is the double arch from D5 to 2L – commonly known as the ‘power house’ of the spine – acting as a link between the upper and lower parts of the body.
It is essential to our work as classical osteopath to remember that the above discussed straight and curved lines are essential for the wellbeing of the living moving body and that any functional derangement surrounding a spinal segment will result altered afferent nervous input, reduced circulation and nutrition, toxic conditions and atrophy. This is why “no amount of correction will avail much in the treatment and recovery of the patient, unless the static and dynamic structures are brought into play, alongside the joint release and relief of soft tissue rigidity”.