Richard A. Feely, D.O.

What is Osteopathy?

Osteopathy is a complete school of medicine in the United States. It is a separate and distinct medical profession with unlimited practice rights in the field of medicine and surgery. It is a medical art and science with a unifying holistic philosophy of body, mind and spirit.

Unlike in England, in the USA an osteopathic doctor is a fully licensed and trained physician and surgeon like an MD but with the addition of osteopathic manipulation. Each DO is licensed by each individual state to practice Osteopathic Medicine and Surgery. An English DO to practice in the US would have to take 4 years of Osteopathic Medicine at a US college plus 3 years of residency/internship, then pass a national or state board exam. He would then be able to apply and receive a state license.

What is Osteopathic Manipulation?

Osteopathic manipulation is a manual medical procedure that the physician applies to a patient. This manual hands on technique involves putting joints and tissues through a range of motion, releasing membranous articular strain, muscle spasm and tight joint capsules and ligaments. Osteopathic manipulation alleviates somatic dysfunction.

What is Somatic Dysfunction?

Somatic dysfunction is impaired or altered function of related component of the somatic (body framework) system. Skeletal, arthrodial, myofascial structures and their related vascular, lymphatic and neural elements.

What is the Osteopathic profession like?

The osteopathic profession is a group of over 36,000 physicians and surgeons throughout the United States that are involved in unlimited medical practice providing diagnosis and treatment in all standard medical specialties including family practice, internal medicine, neural surgery, cardiovascular surgery, obstetrics and gynecology, general surgery, cardiology, neurology, internal medicine, etc.

What is Osteopathic Manipulative Medicine?

It is a primary care specialty emphasizing in depth application of the osteopathic philosophy and special proficiency in osteopathic diagnosis and treatment.

What is Osteopathic manipulative treatment?

A diagnosis followed by therapeutic application of manually guided forces by an osteopathic physician to alleviate somatic dysfunction. This is accomplished by a variety of techniques.

(1) articulatory treatment-a low velocity moderate to high amplitude technique where a joint is carried through a full range of motion with the therapeutic goal of increasing freedom of range of motion.

(2) counterstrain- a system of diagnosis and treatment developed by Lawrence Jones, D.O. that considers the dysfunction to be a continuing inappropriate strain reflex which is inhibited by applying a position of mild strain in the direction exactly opposite to that of a strain reflex.This is accomplished by the use of specific point tenderness related to the disc dysfunction and followed by specific directed positioning to achieve the desired therapeutic response.

(3) cranial treatment-the diagnosis and treatment by an osteopathic physician using the primary respiratory mechanism.

(4) dalrymple treatment-a veinous lymphatic drainage technique applied through the lower extremities also called petofascial or peal lymphatic pump

(5) directed treatment-any technique engaging the restrictive barrier and then carrying the dysfunctional component in the direction of the restricted barrier.

(6) Exaggeration treatment-operater movement of the dysfunctional component away from the restricted barrier through and beyond the range of voluntary motion to a point of possible increased tension or an indirect procedure that involves carrying the dysfunctional part away from the restrictive barrier and then applying a high velocity low amplitude force in the same direction.

(7) facilitated positional release- a system for indirectly myofascial release treatment developed by Stanley Schwart D.O. The component region of the body is placed in a neutral position diminishing tissue and joint tension in all planes and an activating force compression or torsion is added.

(8) functional treatment- an indirect treatment method in which the physician guides the manipulative procedure while the dysfunctional area is being palpated in order to combine a continuous feed back of physiological response to induced motion. The physician guides the dysfunctional part so as to create decreased sense of tissue resistance.

(9) galdraith treatment- a manipulative technique where the restrictive barriers disengage the dysfunctional body is moved away from the restrictive barrier until tissue tension is equal in all planes and directions.

(10) inhibitory pressure treatment-the application of steady pressure of soft tissue to reduce reflex activity and produce relaxation

(11) ligamentous articular strain- a set of myofascial release techniques described by Howard, & Rebecca Lippencot

(12) lymphatic pump-a term coined by C. Earl Miller, D.O., Howard and Rebecca Lippencot D.O., see Earl Miller D.O. to describe the impact of intrathoracic pressure changes on lymphatic flow. This was the name given originally to the thoracic pump technique before the more extensive physiological effects of the technique are recognized.

(13) mandibular drainage-a technique used to effect increased drainage of the middle ear structures via the ustation tube and lymphatic, similar to the galdraith treatment.

(14) muscle energy treatment-a term 1st used by Fred L.Mitchell, SR. D.O. to describe the form of osteopathic manipulation treatment in which the patient voluntary moves the body as specifically directed by the physician. This direct patient action is from a precisely controlled position against the defined resistance by the physician. Similar to isometrics

(15) myofascial treatment-any technique directed at the muscle and the fascia, treatment form first described by Andrew T. Still and his early students which engages continual palpatory feedback to achieve release of myofascial tissues.

(16) direct myofascial treatment-the restrictive barriers engaged by the myofascial tissue, the tissues are loaded with a constant force until a tissue release occurs.

(17) indirect myofascial release-the dysfunctional tissues are guided along the path of least resistance until freed movement is achieved

(18) positional treatment-a direct segmental technique in which a combination of leverage, patient ventilatory movement and a focrum are used to achieve mobilization of dysfunctional segments, may be combined with springing or thrust technique

(19) range of motion-movement of the body part to its physiological or anatomical limit in any or all planes of motion

(20) soft tissue treatment-procedure directed towards the tissue other then the skeletal or arthrodial elements, a direct technique which usually involves lateral stretching, linear stretching, deep pressure, traction and/or separation of muscle origin and insertion while monitoring tissue response and motion changes by palpation. Also called myofascial treatment.

(21) Spencer treatment-a series of direct manipulative procedures to decrease soft tissue restrictions around the shoulder

(22) springing treatment-a low velocity, moderate amplitude technique where the restrictive barriers engage repeatedly to produce an increased freedom of motion

(23) thoracic pump-technique developed by C. Earl Miller, D.O. which consists of intermittent compression of the thoracic rib cage

(24) thrust treatment-a direct technique which uses high velocity low amplitude forces also called mobilization with impulse treatment

(25) traction treatment-a procedure of high or low amplitude in which the parts are stretched or separated along the longitude axis with continuous or intermittent force

(26) visceral manipulation-techniques in which viscera are positioned to a point of fascial balance typically the viscera are moved toward the fascial attachments.

What is the Osteopathic philosophy?

Osteopathic medicine is a philosophy of healthcare and a distinctive art supported by expanding scientific knowledge. Its philosophy embraces the concept of the unity of the living organism structure and function. Art as the application of the philosophy as the practice of medicine and surgery and all its branches and specialties. Its science includes the behavior, chemical, physical, spiritual and biology knowledge related to the establishment and maintenance of health as well as the prevention and alleviation of disease. Osteopathic concepts emphasize the following principles:.

(1) the human being is a dynamic unit of function

(2) the body possess self regulatory mechanisms which are self healing in nature

(3) structure and function are interreciprically related

(4) rational treatment is based upon wise use of the above principals

What is an Osteopathic structural examination?

An examination of the patient by an osteopathic physician with emphasis upon the neuromuscular skeletal system including palpatory diagnosis of somatic dysfunction of visceral somatic change in context with total patient care.

The examination is concerned with the range of motion of all parts of the body performed with the patient in multiple positions to provide static and dynamic evaluation.

What is palpatory diagnosis?

The term used by osteopathic physician to denote the process of palpating the patient to evaluate the neuromuscular skeletal and visceral systems.

What is cranial rhytmic impulse?

A palpable rhythmic fluctuation believed to be synchronized with the primary respiratory mechanism.

What is the primary respiratory mechanism?

A matter proposed by William G. Sutherland D.O. to describe the interdependent function among five body components:

(1) the inherit motility of the brain and the spinal cord

(2) the fluctuation of the cerebral spinal fluid

(3) mobility of the intracranial and intraspinal spinal membrane

(4) articular mobility of the cranial bones

(5) involuntary mobility of the sacrum between the ilia or pelvic bones.

What is postural decompensation?

What is postural decompensation?The distribution of body mass away from the ideal when postural homeostatic mechanisms are overwhelmed. It occurs in all planes but is classified by the major planes affected. Coronal plane decompensation are scoliotic changes, horizontal plane postural decompensation are rotational changes, sagital plane postural decompensation are kyphotic or lordotic changes.

What is the somato visceral reflex?

An involuntary nervous system response to sensory input. Sum total of any particular involuntary activity. Localized somatic stimulation producing patterns of reflex response in segmentally related visceral structure.

What is a visceral somatic reflex?

A localized visceral stimuli producing patterns of reflex response in segmental related somatic structures.

What is the cranial sacral mechanism?

A term loosely used to refer to the connection between the occiput and the sacrum by the spinal dura mater as used by William G. Sutherland D.O.

What is spinal facilitation?

The maintenance of a pool of neurons, motor neurons or preganglianic sympathetic neurons in one more segments of the spinal cord. In state of partial or subthreshold excitation. In this state, less afferent or other presynaptic stimulation is required to trigger the discharge of impulses.

Page modified on 5/15/2011