Osteopathy recognizes the profound influence of trauma on the normal functioning of a living organism. Trauma disorganizes life processes. Trauma can be physical or emotional. It can be a deliberate life saving event such as surgery, intended for good, but an insult to the normal structural integrity none-the-less. Trauma may result from a profound disease process, such as the laying down of scar tissue in the lungs following a severe pneumonia. Trauma may be an obvious single large event, such as a car accident, or it may be as subtle as repetitive action, gravity, and time.
We do not simply one day have a disease. Life affects us. For every effect there is a cause. Cause is typically not a singular event. Genetics, nutrition, physicial trauma, toxic exposures, emotional influences all converge to create the present moment. Osteopathy does not cure genetic disease or malnutrition (obviously). Osteopathy, however, can assist our physiology, helping to establish the most optimal means of negotiating the complexities of these influences. Osteopathy seeks to discover "cause," and treat at the level of "cause."
All complex living creatures, are organized by a nervous system. This nervous system distributes impulses throughout the body to maintain a state of dynamic balanced tension. It keeps us erect. It allows us to see, feel, move about, think, etc. It maintains integrity and balance.
The circulatory system allows all the essential building blocks and metabolic waste products to be moved about, so that all the essential processes of life can occur unimpeded and in due time.
All this activity is contained within a structural framework. From a single cell whose integrity is determined by an outer membrane and internal "skeletal" fibrous matrix....to the gross anatomical level, where bones give form, suspended by a ligamentous and fascial mechanism. These structural mechanisms provide support and organize the activities of life, that these activities may be optimized with full vitality.
Imagine, if you will, a shimmering field of delicately balanced neurologic activity, permeating every cell of the human body. Consider how in health these impulses are precisely distributed; capable of nimbly shifting and reorganizing as we move about our daily lives. Imagine a traumatic force imposed upon this shimmering field of balanced activity.
Trauma affects living organisms. When we receive a blow to our bodies, it does not merely pass through us. The energy of the impact leaves an impression. The balanced tensions distributed by the nervous system become agitated. Kinetic Energy becomes stored, as Potential Energy.
The dynamic organizing principle within our bodies must re-organize. The trauma implants itself in the fascia, and the nervous system now arranges itself around the focus of that implanted trauma. I refer to this phenomenon as an Injury Pattern. It is akin to the walling off of a calcified tubercular bacilli in the lungs. It is protective, but it is disruptive. This happens on a microscopic level. It happens everyday. It is often inconsequential. However, if the impact is huge, or of long duration, or many small insults accumulate... then the reorganizing of balanced tensions becomes significant.
When bones break, the energy of an impact is often simply discharged. In a clean break, the body might not even create an injury pattern. In this instance, the body can actually heal more thoroughly. Contrary to common thought, it is when no bones are broken, that chronic injury patterns become imprinted, creating lifelong dysfunction. (Of course, some trauma is so severe, even when bones break, the injury patterns are significant.)
Degenerative Arthritis is the result of a long standing traumatic influence. Bones grow in the direction of the stresses put through them. This is known as "Wolfe's Law." This is why orthopedists will place a walking cast on a broken leg. The physical stress of walking helps the broken bones grow together more readily.
Suppose an old whiplash injury sets up a complex strain pattern through the cervical spine (neck). Over time, if the energy of the trauma remains in the tissues, the bones will change shape and grow, following the strain. The bones erode and spur. This can be seen on an x-ray, and is called Degenerative Arthritis. Because we are each genetically unique, we differ in the degree to which we develop this arthritic response to chronically held soft tissue strain. Eventually everyone has some degenerative arthritic changes seen on x-ray. After the age of 50 mild degenerative arthritic changes are considered a normal finding. Two reasons for this are:
- Everyone has experienced some trauma in their life.
- We cannot escape Gravity (a constant "micro-trauma") and Time.
Degenerative Arthritis literally changes the shape of the bones. If advanced enough, the vertebrae will no longer rest upon one another with ease. What once was a state of rest, now requires active work. And when there is injury superimposed, the resources for negotiating the strains are limited. Osteopathic Manipulation does not restore the bones back to a more normal shape, however, it removes the strain, restoring some physiologic flexibility and allows the tissues to better negotiate the arthritic changes.
So when Osteopaths take a history....they are interested in all the blows to the body that each of us has experienced. Many patients will say... "I have never been injured...I never broke any bones or went to a doctor." We so easily forget that fall down the stairs, or the car accident (where the car rolled three times); where we got up and were surprised we were not hurt. We readily dismiss the importance of these events. These injuries do, in fact, change us; we simply do not recall the way we were before the injury. The body, however, does not forget. These traumas imprint themselves in the tissues causing us to compress, twist, and contract. Only years later might these injury patterns create health problems. The extra cellular fluids that bathe each cell and provide a nourishing environment....become stagnant. It is not just blood, and lymphatics, but all the liquid secretions of the body, even the cerebrospinal fluid that surrounds and nourishes the brain.
“The cerebro-spinal fluid is one of the highest known elements that are contained in the body, and unless the brain furnishes this fluid in abundance, a disabled condition of the body will remain. He who is able to reason will see that this great river of life must be tapped and the withering field irrigated at once, or the harvest of health be forever lost.”
AT Still MD
The Bottom Line: Old traumas are often under-appreciated when considering the cause of illness. Osteopathy provides a unique perspective, and in some instances an unexpected solution.
Copyright © 2000 Mark E. Rosen, DO FCA
Revised: July 5, 2008