Motility in Osteopathy

An embryology based concept

Alain Auberville, Andree Aubin

• Publisher: Handspring Publishing
• Year: 2017
• ISBN:
  9781909141674
• Edition: 1
• Topic: Medicine
• Subtopic: Alternative & Complementary Medicine

Motility, relating to the vital energy of the human tissues, is a basic concept in osteopathy. This book presents a simple and systematic definition of motility, based on the movement of all of the body's structures during embryogenesis. Those initial movements, intrinsic to the energy of the tissues, are the essence of motility and, as such, they are crucial to the tissues' normal movement. These fundamental ideas expand the osteopath's clinical intervention techniques and deepen the understanding of both the bases of osteopathy and of human functions.Illustrated in two colours with clear and original line drawings and photographs, this book offers the new model of practice developed by Alain Auberville over his 30 years of experimentation and teaching; it is presented here by Andree Aubin, who has linked Alain Auberville's approach to classic osteopathic concepts in order to facilitate its integration into regular clinical practice.

Chapter 1

Theoretical Considerations

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Summary

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The purpose of this work is to define motility by linking it to the embryological movements that shaped all the tissues of the body and to the notion of the energy and vitality of these tissues. This concept of motility, which is faithful to the tenets of osteopathy, will guide our foray into the clinical possibilities.

This chapter outlines embryology-based motility, starting with a general description of the osteopathic field of clinical practice and a presentation of the discipline’s traditional principles. The relations between osteopathy and traditional Chinese medicine will also be examined. Embryology, as a theoretical basis, brings a complementary vision of the energetic phenomena used to define health and to understand pain or sickness. Finally, suggestions for the development and adaptation of palpation abilities in the context of embryology-based motility treatments will be given.

This hypothesis can and surely will encourage discussions, reflections, and hopefully, research on yet-to-be-explained bases for osteopathy.

Field of practice and basic osteopathic principles

This section revisits the principle of normal movement for each structure as an important baseline for osteopathy since its beginnings. The consequences of restrictions or hindrance of this normal movement are considered along with their local, regional or complex and systemic implications, and their possible effects on the structure itself.

Established in the late nineteenth century, osteopathy is a substantial crucible for new interpretations of anatomy and physiology from the perspective of therapy. As laid out by Andrew Taylor Still and his successors, one of the great osteopathic principles is that normal movement of the body’s structures is essential to their functions and to effective homeostasis. Movement, for now, is employed to describe both ‘mobility’ and ‘motility’; these will be defined more precisely later in the chapter.

According to this principle, the local physiology of a structure can be disturbed when its normal movement is hindered or is abnormal (what is called a ‘dysfunction’ in osteopathy). A dysfunction can be symptomatic, but it is most likely to be quiet in its first stages, especially if the dysfunction isn’t too sudden or intense or if it can be mitigated by the organism.

When the body reacts to the demands of this primary dysfunction, secondary modifications can occur in adjacent structures or near the primary dysfunction. These modifications can also affect further structures if they are related to the primary dysfunction via the mechanic, neurological or vascular links inherent in anatomical dispositions or physiological concerns.

If those secondary modifications effectively help in reducing the blockage or restriction on local movement and share the burden of its consequences, while maintaining function and structural balance, the bodily environment will successfully adapt to the primary osteopathic dysfunction. This adaptation, in specific contexts, can remain asymptomatic, although the energy expenditure can in fact be higher to maintain the organism’s function and balance.

Given specific circumstances, these new restrictions can become permanent, too, creating new dysfunctions. A dysfunction ‘chain’ can then perpetuate itself; it can be either short or long, affecting a single system or a whole region.

The organism’s response to the demands made on it is never generic and, from an osteopathic perspective, will be modulated according to the number of dysfunctions and their characteristics, as well as in relation to the affected structures. The intensity and chronicity of dysfunctions – as well as an individual’s morphology, genetics, activities, lifestyle, habits or background that limits adaptation possibilities – are other variables that shape the organism’s response to a dysfunction.

Clinical practice attests that the concept of a dysfunctional chain, with a strictly causal relationship, cannot totally explain the complexity of the organism’s adaptations and responses to restrictions and hindrances in one or many of its structures. The correct representation of the body’s general balance and adaptive modifications would probably require different concepts used in other areas as well (Davids et al. 2003), such as representing all the organism’s osteopathic dysfunctions as a ‘dysfunctional network,’ ‘schemas,’ or ‘complex balanced systems,’ instead of relying only on linear chains. Clinical reality leads us to consider adaptations as truly individual phenomena rather than explaining them with the recurring principles that are often viewed as absolute osteopathic truths.

When a complex dysfunctional network becomes permanent and reaches vital structures (for example, the diaphragm or nervous system), the ability of the organism to adapt is often reduced. Generally persistent systemic symptoms appear on top of already present local symptoms, eventually draining the body’s resources and intelligence, limiting the effectiveness of homeostasis and weakening the organism; it is the chronicity stage, in which the body cannot heal and stops responding, in part or in whole, to classical therapy. Literature is extensive on the chronic deficiency stages caused by a physiological or psychological dysfunction while not necessarily linked to any objective pathologic change (Williams 2008). They usually consist of chronic pain, hindered functions of organs or viscera (palpitations, constipation or diarrhea, for example), or extensive fatigue or exhaustion (Henningsen et al. 2007, Nimnuan et al. 2001). These conditions can affect teenagers and children as well, including babies (King et al. 2011). ‘Conventional’ medicine struggles with these cases, being considerably less efficient and less able to resolve the associated problem (Tyreman 2010).

Symptoms of these conditions, which can develop into exhaustion and diseases, reveal a lack of general adaptation to emotional and environmental stress. Their nature varies but they are generally intense and linked to the body’s regulation systems. Perturbations include sleep disorders (insomnia or non-restorative sleep) or mood disorders. Without being the direct cause or trigger, the lack of general adaptation can be linked to diseases (such as autoimmune diseases or insufficient immune responses, metabolic, cardiovascular or neuroendocrine diseases, or alteration of cognitive functions) and can also increase the impact of bad habits or lifestyle on general health.

Vital body structures and the body’s ability to adapt are also affected, without going through gradual alteration, if the organism is under short but intense stress. Decompensation can happen if a stress situation lasts longer than the organism’s ability to deal with it, although the organism can sometimes react very quickly when it reaches its turning point.

These osteopathic health and adaptation considerations can be linked to the concept of the allostatic load, which describes the organism’s processes for maintaining physiological balance by the regulation of its internal parameters according to external demands. Allostatic load is different and more complex than homeostasis, which describes the body’s ability to maintain its internal balance only (Juster et al. 2010).

Other consequences arise from osteopathic dysfunction: when restriction or hindrance of normal movement lingers, local modifications in the structure of the affected tissue can be observed, thus resulting in more than just a function restriction. This classic relation between structure and function is the foundation of osteopathic practice. An absence of normal or complete movement can therefore cause many types of alteration in the structure. Some of these alterations can be reversed, at least in part, if the normal movement resumes fairly quickly, but others cannot be restored by osteopathy.

The causal link between the degree of degeneracy of the structure and the symptomatology thus has another meaning. There is a clear, clinical advantage in considering the nature and intensity of symptoms and signs in relation to loss of movement rather than in relation to modifications of the structure. Examination of medical imaging of the vertebral column (Jensen et al. 1994), rotator cuffs (Connor et al. 2003, Sher et al. 1995), and tears of the knee’s medial meniscus (De Smet et al. 2008) shows that an altered structure is not necessarily associated with functional losses or pain.

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When faced with a primary dysfunction and its consequences, the body’s adaptive response can be local, regional or systemic. When this situation is beyond the organism’s adaptive abilities, not only can it become more vulnerable to other stressors, but the effectiveness of homeostasis can also decrease over time and diseases can occur, often signaled by structural changes in the tissues.

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The organism’s energetic functions

The relation between health and available energy is explained in this section by establishing links between Chinese medicine and osteopathy.

To describe the accumulation of all the demands made on the body experienced by an individual throughout his lifetime, osteopaths use the concept of ‘terrain.’ The characteristics of this terrain determine the quantity and quality of the available resources when responding to stressors or simply dealing with the passage of time; in other words, these resources represent the organism’s available energy.

This available energy corresponds to the vital energy capital allowed to an individual at birth, which includes genetic energy and renewable energy (mainly from oxygen, food, and water). There is a saying that illustrates our dependency and shows a certain hierarchy between these energy sources: Three minutes without air, three days without water, thirty days without food: beyond lies a threat to life. Other sources of emotional energy can be added (love and touch), as well as, according to traditional Chinese medicine, other fundamental emotions: joy, sadness, melancholy, self-awareness, anger, fear, and anxiety. Environmental elements are also taken into consideration: light and darkness, hot and cold, wind, humidity or drought, and atmospheric pressure. Some of this energy is used for day-to-day living and maintaining the basic metabolism, reducing the amount available; ‘incoming’ and ‘outgoing’ energy must then be balanced to maintain one’s health.

As this balance is essential to health, the intention of the osteopath is to optimize energy consumption in a dysfunction-free body with his interventions. He must stop or at least slow down dysfunctional processes by removing declines in, or hindrance to, movement because they otherwise result in excessive energy expenditure, leading to a decline in health or structural pathologies. The osteopath’s role is therefore to limit excessive energy expenditure and to encourage the unhindered expression of homeostasis, through considered treatment aimed at the conservation and renewal of vital energy.

It would be logical to consider their energetic functions when treating human patients. Simply put, what is the difference between a dead and a living being, if not that the living person possesses energy and the dead person does not? Between these two extremes, there is healthy life or life with illness. Available energy, considered here in the broad sense, is fundamental to the organism’s capacities.

Osteopathy’s concern for energy is historically shared by traditional Chinese medicine. The original and most fundamental concept of this centuries-old practice is the energy flow as the center of, and essential to, the body structures’ smooth operation. Energy must be able to flow in time and space in an organized fashion, following specific programs paced by hours, days, seasons, and years. In Chinese medicine, energy flow is essential in elaborating and maintaining physiology and homeostasis. A disruption in this flow will cause physiological alterations and reduce homeostasis capacity, and will cause symptoms to appear more or less rapidly depending on the hindrances to the intensity of the flow. Barriers to a free energy flow can cause problems because of energy overflow or depletion. This notion of energy void will be applied to the embryology-based motility concept.

Hence, the flow of energy could be the common meeting point between the embryology-based motility concept and traditional Chinese medicine.

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Osteopathy has a fundamental interest in energy: the quantity available, usage, conservation, and renewal. To ensure a free flow of energy, and prevent or treat diseases, the osteopath removes restrictions or hindrances to normal movement in all structures of the body.

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Embryological motility model

This section explains the staple concept of this work: embryological movement as the definition of each structure’s motility and a predominant characteristic of normal movement. Relations between motility and mobility, as well as motility dysfunction sources and the importance of renewable energy, are discussed.

Beyond the theoretical demonstration of its presence, what could be the source of the assessed energy that is normalized toward osteopathic therapy? Where is it located and how is it shown? How is it possible to apply the osteopathic principle of optimal movement in each structure to energy?

This work offers a unique perspective on these questions. This principle is based on the study of all of the body’s structures during embryogenesis, and can be applied to every human tissue since no structure stays in exactly the same place after its emergence. Indeed, all of the embryo’s structures move along the three-dimensional axis, from an origin to a definitive position. Energy is essential to the embryonic structure’s movement and development as it is the central element of the underlying ‘program’ that guides the finesse and acute chronology of these movements.

Embryogenesis is certainly the only stage of human life in which all of the body’s structures move autonomously, fueled by their own vital energy. This movement is the groundwork of motility and possesses all of its attributes. Primary to the development of all structures, it is also linked to what we could call fundamental energy.

Embryological organization being enduring and constant, the various movements of the structures during embryogenesis apply a direction and amplitude to the motility movements, setting them around a precise axis. Since osteopaths study the characteristics of the normal movement of each human tissue, it is, of course, in line with traditional osteopathic principles to evaluate and normalize embryology-based motility movements.

At first, the perception and evaluation of motility can appear elusive or even chimeric; however, conclusive clinical results vouch for its ...

Table of contents

• Cover
• Title Page
• Copyright
• Contents
• The authors
• Prefaces
• Introduction
• Chapter 1 Theoretical Considerations
• Chapter 2 Embryology-Based Motility
• Chapter 3 Thoracic and Caudal Plications
• Chapter 4 Nervous System
• Chapter 5 Psychoneuroimmune-Endocrine System
• Chapter 6 Cardiopulmonary System
• Chapter 7 Digestive System
• Chapter 8 Urogenital System
• Chapter 9 Musculoskeletal System
• Chapter 10 Clinical Intervention Protocol for the Motility Model
• Index