00:00
Manipulation is the therapeutic
application of a force.
00:04
And a force can come from
a lot of different ways.
00:06
I can provide the force as a provider.
00:08
The force can come from gravity.
00:10
It can come from physiologic
actions within a patient—
like the heartbeat, like respirations
or the fluctuation of cerebrospinal fluid.
00:18
Every osteopathic medical student
is taught 7 different ways
to do manipulation,
to free up motion in the body.
00:26
And we’re going to talk about each
of those 7 types of manipulation,
what they are, and how they differ
so you can identify what’s being done
or how you might treat a patient
with a particular issue.
00:38
The 7 different types can be broken
down into many different ways.
00:41
I like thinking of them as
3 tissue treatments
which will be myofascial, lymphatic,
and soft tissue
and those are where we treat the
tissue to get a response.
00:53
There is a release by positioning
called counterstrain
where if you hold the body in
a particular position,
the body will start to heal itself.
01:01
The neural mechanisms will
take over and reorient
how the body is thinking
about what’s going on.
01:07
There are 2 more muscle based
articulatory techniques
that are more dramatic in what you see
and that’s high velocity, low
amplitude thrusting
and muscle energy.
01:17
And the 7th type is cranial osteopathic
manipulative medicine
where the craniosacral rhythm
and the motion of the cranium
is manipulated to help free up motion
and make a person feel better.
01:29
So let’s start reviewing each of the 7 types.
01:32
The first type of manipulation we’re going
to talk about is called lymphatic pump.
01:37
The lymphatic pump is when you deal
with the lymph system in the body.
01:41
The body has lymph everywhere.
01:43
It kind of bathes the tissues,
bathes the body
but sometimes it starts to pool
or get caught in diaphragms
where it doesn’t go through easily.
01:53
And we try to manipulate it
by easing up motion, helping motion,
and helping a person’s lymph system
return and get redistributed.
02:03
I’m going to start by showing you
a thoracic/lymphatic pump
and that’s basically where you find
a position in the chest
where you may have a coagulation of lymph
and you just generally push on it
and help the lymph flow.
02:18
And it’s usually a rhythmic helping
of the lymph in the body flow.
02:23
Then you check the diaphragm.
02:25
There are 7 diaphragms in the body.
02:26
I’m going to check the thoracic diaphragm
and the pelvic diaphragm now
just to make sure there’s freedom of
motion and freedom of flow.
02:38
And if there is freedom of flow,
you just massage the lymph to return.
02:43
So we can come and make sure that
you get flow of the lymph
through the tissues
then end up in the periphery.
02:58
That’s the lymphatic pump.