What's in a name?
Updated: Aug 31, 2019
YouMove Osteopathy awaits its launch on Friday, the 6th of September, and I couldn't be more excited!
I will have appointments available as of Tuesday, the 10th of September and look forward to servicing the Mount Eliza community as well as its surrounding suburbs, including Frankston, Seaford, Mornington, Mount Martha and other suburbs on the Mornington Peninsula.
But why “YouMove” Osteopathy?
Firstly, if you can’t be bothered reading my rant, I’ll summarize it for you right now.
1. YouMove! I’ll do the rest. Nearly every musculoskeletal problem requires a graduated return to activity and goal-specific rehab. You have a role in your recovery. This is rarely complicated. Simple familiar movement and strengthening the area with a tweak here or there is usually enough.
2. Nobody moves like YouMove! I read a lot of musculoskeletal literature, because I love what I do. However, I never lose sight of the fact that the person in the treatment room is an individual with specific care needs and their own characteristics responsible for their pain.
Now, in the time I’ve saved you reading this whole piece, go on and like my socials! ;-)
Here’s the full story,
“You move” would have to be the most common words I find myself saying. It comes in two forms.
Firstly, any self-respecting practitioner will have a strong interest in research. Whether they are completely evidence-based or they are simply interested. A practitioner who loves what he does will follow research, just because he wants to.
When it comes to musculoskeletal health, essentially the research says… You need to move. Don’t take back pain lying down. Tendon injuries require load to remodel and sports injuries require a graduated return to the activity. The obvious exceptions being some injuries, like fractures or ligament tears, which need a short time to settle before we load them. Even in these cases, however, some movement and load becomes essential after that period of rest. Loading the injured area effectively tells the connective tissue cells how to align themselves.
What research suggests is the best form of movement changes with the season. What really matters in most situations is that… YouMove.
The other time I’m dropping this phrase is when I'm explaining to someone why we are managing their pain different to the person who referred them, or why the approach used for their favourite athlete isn’t the best option for them. I remember spending a weekend at a seminar learning a specialized approach for frozen shoulder. I hit the next frozen shoulder presentation with vigour, ready to display my new found skill. However, the person couldn’t even lay in the position required to do the technique. “Scrap that,” I said, “we’re going to treat you according to how YouMove”.
It’s an Osteopathic approach focused around you!
Nobody has lived the life you have, with your genes, your job, your hobbies and the unfortunate injuries or illnesses you've sustained in the past. The set of variables responsible for you pain will be different to everyone else. We live in a wonderful world of science, which has been responsible for huge advancements in modern medicine. Evidence based medicine works! By definition! It works like this, “Prove to me that it works and I’ll prescribe it.” This is fantastic for medication because most people metabolize them similarly enough that one drug will have the intended outcome with known side effects for most people. Because of this, they are easy to research. You can give a placebo pill and compare different drugs without the subject knowing.
This doesn’t mean that something which hasn't been researched doesn't work. White willow bark was not considered evidence based, until we were able to synthesis the active ingredient within it (Spiraea), research it to the enth degree and call it Aspirin. Sometimes we research a drug to have an intended benefit and it ends up being used for something else. One drug was developed for high blood pressure and chest pain. Despite it not really working very well, patients wanted more and more of it. You might be familiar with this medication, it’s called Viagra. Endep was developed for managing depression and anxiety. So at first, you might be taken aback when your doctor prescribes it for chronic pain or headache.
For research to work, we need to restrict all variables except for one. Too many variables reduces the chance that the outcome is a result of your hypothesis. Everything in health care seems to do roundabouts and always comes back towards treating the individual.
AT Still founded Osteopathy in 1892. Way back then, he believed that all elements of a person’s body, mind and spirit had to be incorporated into the total care of that person. Nowadays, medicine doesn’t like that phrase, it’s not scientific enough. “Spirit”. Instead, we call it the “biopsychosocial model.” That’s a way cooler name! This is viewed as so important that third party payers such as WorkCover and TAC check up on us to make sure we are treating according to this model.
So where do we fit in as Osteopaths?
Well, we have good evidence for a lot of our techniques in isolation. Manipulation, for example, is a great option for speeding up recovery in acute low back pain. However, it’s not the only treatment option and in some cases, another technique might be better. Some people simply don’t want their back cracked, so we use other techniques. Osteopaths have a huge bag of tricks, which means we use an approach that works for you.
We know that back pain takes longer to get better if you stay in bed. We know that stronger backs have less pain recurrence. We know that strength training will help remodel a pathological tendon and speed up recovery time. Ten years ago, we were obsessed with prescribing eccentric load. Later, isometric load became the way to go. Now, guess what! It depends on the person! Here we go again. Some tendons are painful around inflamed joints. In this situation, we want to load the tendon without the joint moving so as to not irritate the joint. In a chronic tendinosis without joint involvement, a high eccentric load might work better and could also help improve muscle pliability. Again, in one of the most researched musculoskeletal problems, it depends on what is right for you as an individual. What we can research is simple isolated variables.
What about hands on manual treatment? Does massage work? Manipulation? Dry needling
How do you research this when one appointment might include 5 or 6 different techniques along with exercise prescription, all relative to the specific way YouMove?
For me to do research on the individualized treatment I will provide for you, I would need about a thousand clones of you. So until someone invents a cloning machine, it will be impossible to effectively research manual therapy from a wholistic perspective (the ‘w’ in wholistic is not accidental).
It is crucial to incorporate we know has been proven through research. But at the same time, understand that we can also provide benefit to you with skilled hands-on application of technique specific to your problems, even though that is impossible to research. We call this “evidence-informed practice” as opposed to “evidence based practice.”
So my promise is to keep up to date and stay informed with medical research, whilst simultaneously taking the time to assess your specific movement pattern, addressing the problems responsible for your pain and helping you achieve your goals.
Because nobody moves like you do.