What is osteopathy?
"Life is movement." This is the basic premise of osteopathy, coined by Andrew Taylor Still (1828-1917). As early as the second half of the nineteenth century, he was the founder of osteopathy in the USA: The mobility of all bones, muscles and nerves, all organs, down to the tiniest cell of the body, is the necessary precondition for the smooth execution of every process in the body. Even the smallest injury or tension limits the body's mobility and disturbs its natural harmony. In working with his patients, Still applied his sound knowledge in anatomy and physiology. He aimed at facilitating a better functioning of the organism by improving circulation and by activating the body's self-healing powers. Osteopathy is based on the notion that a disturbed structure, e.g. the shoulder joint, must not be looked at in isolation from the rest of the body. On the contrary, every part of the body must be viewed as a cogwheel that adjusts to the organism as a whole. From this perspective, osteopathy views the body as a unit rather than as individual parts that have no relation to each other. On this basis, osteopaths use palpation to find disturbed structures and then attempt to improve mobility in the affected structures by means of highly differentiated manual techniques during treatment, hereby removing the dysfunction completely or in part.
Our body is smarter than we think. The body functions as a unit. When a part of it is disturbed, it can cause the entire organism to lose its equilibrium. In the osteopathic view, however, our body has the ability to develop compensatory mechanisms, both to avoid strain on the disturbed structures and to ensure the trouble-free operation of the organism as a whole. In this way, many small limitations ("dysfunctions") can arise over time, which the body compensates for but which nevertheless add up to the "straw that breaks the camel's back." At some point, the body arrives at the end of its compensatory capacity, and symptoms arise: Osteopathy hence often regards postural changes (e.g. pelvic misalignment) or pain in the area of the locomotor system as signs that the weakest link in a long chain of compensated dysfunctions becomes visible as disease. An example can illustrate the perspective of osteopathy:
Let us imagine a patient with back pain in the lumbar spine. This pain can have its cause in the area of the lumbar spine, e.g. excessive wear. This wear can be the manifestation of a long compensatory chain with postural changes. Scars in the abdominal area (C-section, appendectomy scar, etc.) can cause postural changes to avoid strain on the area around the scar. The scar itself might have never caused any problems because the body compensated for it with a postural change. Surgery in the abdominal area very often results in adhesions in the abdomen. The organs become attached to each other and are unable to move freely. The free movement of all organs, however, is a necessary requirement for the healthy functioning of the body. The uterus can, for example, adhere to the intestines or the urinary bladder. As a result, we can see pain in the lumbar spine during menstruation. Perhaps our imaginary patient also slipped on black ice a long time ago, landing with great force on the buttocks. The tailbone was thereby displaced, which due to the special anatomy of the spinal column and nervous system can manifest in the head: The back pain could now be compounded by headache or tinnitus. Osteopathy searches for correlations and attempts to restore free mobility in all disturbed structures. Osteopathy has reached its limit where structures are destroyed. It is unable to repair the wear in the lumbar spine but it attempts to restore the body's maximum possible mobility and hence its compensatory capability. Let me give another example, rather amusing but vivid: A man has a rock in his shoe and asks himself: "What do I care about the rock? I can't feel it at all." He does not feel it because he is holding his foot at an angle. As a consequence, he is also holding his knee and his hip at an angle, which leads to pelvic obliquity. Ultimately, his spine becomes distorted. He continues on like this for quite a while, has long forgotten about the rock, and now complains of a headache which he does not feel at night but throughout the entire day, starting about half an hour after he gets up. Sometimes the pain even radiates all the way into the arm. What is cause, what is effect?
Osteopathy in Germany
Training in osteopathy can be completed in Germany within 5-6 years in a part-time study course at a number of different schools. These schools should be recognized by the Federal Association for Osteopathy (Bundesarbeitsgemeinschaft für Osteopathie, BAO), and their training should be in alignment with international programs. At the end of this training, candidates must pass an examination in front of an interdisciplinary jury. To complete the training, the successful candidate can write a final paper, which must again be presented in front of a jury. Afterwards, the title "Osteopath D.O." is awarded. In addition, certain specialized fields of osteopathy can be mastered in individual courses in a relatively short time-frame. Because the term "osteopathy" is not protected in Germany, we find great qualitative differences among individual practitioners. You can find a list of practitioners in compliance with the criteria mentioned above under www.osteopathie.de, the website of the Verband der Osteopathen Deutschlands (VOD, German Association of Osteopaths).