When I did my osteopathic training in the early 90’s a large proportion of undergraduate education was placed on the spine in terms of understanding morphology, biomechanics and function. The spine was seen as the ‘central pillar’ of the musculoskeletal system, and in osteopathic philosophy the musculoskeletal system is seen as the window into restoring function and health to the patient. Manual treatment was based around local joint release with a variety of methods dictated by a biomechanical assessment of aetiology.
Credence was given to spinal cord segmental influences in understanding how spinal dysfunction occurs, and to how treatment effects local autonomic, motor and sensory output on corresponding skeletal and visceral structures. However, no credence was given to the central control of the spinal column as a unit, or the importance of postural reflexes in maintaining upright posture and prevention of spinal dysfunction.
My shift in thinking and treatment approach has been to take a step back and evaluate postural dysfunction in terms of stability of the individual and the strategies that they use to maintain upright posture when standing still and when challenged. The question I ask is: