It is a science in which the body is handled holistically with special evaluation and treatment methods that have a scientific basis in order to reveal the body's own healing mechanism within the organic laws accepted by considering the chemical and physical elements of the human body in terms of anatomy, physiology, and psychology.

History of Osteopathy

Osteopathy was developed in 1874 by Andrew Taylor Still (1828-1917). Still, a surgeon lost his wife and three children to meningitis after the Civil War. After that, he thought that the medical treatments applied at that time were somehow incomplete and that there should be other methods. And he spent the rest of his 40 years studying the human body and developing new treatments. While naming these new methods, he wanted to explain that the etiological basis of disease and physiological dysfunctions is caused by an impaired musculoskeletal system by using the words "osteon" and "pathos, patina". Still realized that in order to achieve a healthy body, all parts of the body must work in harmony. With this approach, he developed osteopathic treatments for the holistic handling, evaluation, and treatment of the body for treatment.

In 1892, the first osteopathic school in Missouri opened the “American School of Osteopathy,” and the school is now known as AT Still University. Those who graduate from this and similar schools graduate with the title of "Osteopath". In 1897, the first graduates formed the American Osteopaths Association, which began the standardization of education. In 1898, the American Institute of Osteopathy began publishing the Journal of Osteopathy, and Osteopathy is now defined as a profession. Andrew Taylor Still's students then traveled to various countries and spread this science.

Dr. Still's science and philosophy of osteopathy are based on four basic principles. These principles are as follows:

• All the structures in the body work like a single unit. From the smallest cell to the largest bone, all anatomical structures are alive and have dynamic rhythmic movements.
• The body has the capacity for self-regulation and self-healing.
• Structure and functions are related to each other.
• Treatment methods should be based on these principles.

Today, the philosophy of Still has been reinterpreted and these four principles have been updated:

• Humankind is a dynamic unit of function.
• The body has a capacity for self-regulation that comes from its own nature.
• Structure and function are interrelated at all levels.
• Treatment methods should be based on these principles.

According to the holistic perspective of osteopathy, the function of any part of the body depends on the function of other body regions and their harmony with each other. If we need to explain with an example, for example, individuals with jaw joint problems may have spinal problems due to their neighborhood. The hip joint, knee, or even ankle problems may be observed due to facial connections. Problems such as attention deficit may develop as a result of visceral problems or alterations in the mobility of cranial bones. This cycle can proceed oppositely, with spinal problems leading to jaw joint problems or visceral problems.

Osteopathy Models of the World Health Organization

As stated by the World Health Organization in osteopathy, basically 5 structure-function relationship models are accepted. These models guide osteopaths in evaluation and treatment:

• Biomechanical structure-function model
• Respiratory/circulatory model
• Neurological structure-function model
• Biopsychosocial structure-function model
• Bioenergetic structure-function model

Considering these models, osteopaths perform osteopathic evaluations and apply their treatments with osteopathy techniques. These techniques include muscle energy techniques, myofascial relaxation techniques, visceral techniques, cranial osteopathic techniques, soft tissue and joint techniques, and high-speed low-amplitude manipulations. By applying these techniques, they perform their treatments with direct or indirect techniques.

Conditions in Which Osteopathy is Used

• In the lumbar, neck, and back pain, and hernias
• In migraine and tension-type headaches
• In posture disorders such as scoliosis, kyphosis
• In the removal of pain and adhesions after surgery
• Stress and nervous tension
• Chronic fatigue
• In sleep disorders
• Neuralgia
• In respiratory problems
• Sports injuries
• As a supportive agent in the treatment of hormone disorders
• Supportive in chronic neurological diseases
• In circulatory problems (blood and lymphatic system)
• In movement and function disorders
• In walking, balance, and coordination disorders
• Fibromyalgia syndrome
• Arthrosis changes such as joint stiffness, calcification
• In joint blockages, spine and rib blockages
• Jaw joint problems (chewing problems, bruxism, crepitation in jaw movements )
• Visceral osteopathy is used as a supportive treatment for constipation, diarrhea, urinary incontinence, indigestion, gas, abdominal pain, spastic colon, ptosis, and dysfunction of the digestive organs.
• Swallowing in infants, vomiting, craniosacral osteopathy in head deformity
• Allergic and chronic diseases
• Acute pains
• It can be used as a supportive treatment for osteopathy in rheumatic diseases.

Osteopathy in the world

Osteopathy is recognized in Australia, Canada, European Union countries, France, Belgium, Germany, New Zealand, Portugal, England, America, Egypt, and India.

Osteopaths receive a minimum of 5 years and 1500 hours of training based on anatomy, physiology, and pathology, including evaluation and treatment methods. Osteopathy treatments are covered by the state in many countries. Persons who complete training programs that include practical and theoretical applications take the oral exam and the written exam with a jury of three people at the end of the 5th year. Those who pass the exam become osteopaths. Osteopaths who were accepted by submitting the final thesis to the jury D.O. (Diploma in Osteopathy.)

Osteopaths are educated in three ways in Europe. Although it varies between countries, education periods and authorities vary:

• First, osteopathy education can be received after high school in the form of undergraduate education. However, when trained in this way, their powers are limited.
• Secondly; Physiotherapists can receive osteopathy training and work within the framework of the osteopathy law.
• Thirdly, as an education system applied only in Germany, America, and Canada, physicians are osteopaths. From these countries, osteopaths in Germany and Canada are mostly osteopaths who have received physiotherapy training.

Osteopathy in Our Country

The first osteopaths in Turkey were 13 physiotherapists who attended their training at the Institute für Angewandte in Germany in 2009. Today, there are approximately 120 physiotherapists trained in osteopathy in Turkey. In recent years, many physicians participate in these trainings given by osteopaths of physiotherapist origin who have received training from Germany in Turkey. Currently, there are more than 10 osteopathic physicians in Turkey. In 2014, the Ministry of Health included osteopathy within the scope of complementary medicine regulation. According to this regulation, physiotherapists and physicians who have completed 5 years of training can apply osteopathy.

Departments of Osteopathy

• Structural osteopathy: It is the osteopathy department focused on musculoskeletal system problems.
• Visceral Osteopathy: Visceral structures are the osteopathy department that focuses on their vascular, neural, and facial connections.
• Cranial osteopathy: It is part of the cranial bones and their connections to each other, the meningeal membranes, focused on the role of cerebrospinal fluid.

Osteopaths try to reveal the cause of dysfunction while shaping their treatment. These anatomical, and physiological connections take into account the components of the treatment and the osteopathic special evaluation methods they make. After revealing the primary cause of dysfunction, the treatment is shaped accordingly. Treatment sessions usually range from half an hour to an hour. A break of 24-48 hours is required between osteopathy sessions. Since osteopathic treatments aim to trigger the body's own healing mechanism, the body is given time to reveal this effect.

Asst. Prof. Dr. U. F. Şule BADILLI DEMİRBAŞ / Specialist Physiotherapist Ayça AKLAR ÇÖREKÇİ
 

Yeditepe University Faculty of Health Sciences 
Department of Physiotherapy and Rehabilitation