Overview of Osteopathic Manipulative Treatment: Muscle Energy Procedure – Pelvic Dysfunctions
The pelvis, the lower part of the torso situated between the abdomen and the legs, is made up of several elements such as ligaments, muscles, and bones. These elements connect the main body structure (the axial skeleton) with the lower body parts (the lower extremities). Problems with this complex system can lead to symptoms like muscle pain, changes in the way you walk (gait abnormalities), and disorders affecting both the body’s viscera, or internal organs (viscerosomatic disturbances).
One common issue related to pelvis dysfunction is irritable bowel syndrome. This is a condition affecting the digestive system, which can be caused by either problems with the nerves in the pelvis or mental factors that lead to physical symptoms (psychosomatic issues).
Osteopathic manipulative treatment (OMT) is a specific technique used to treat these issues. This technique involves hands-on care where the doctor uses their hands to move and stretch the muscles in specific ways. The procedure, referred to as muscle energy (ME), is interactive and based on communication between the patient and the doctor. The patient actively participates during this procedure to aid in their own recovery. This approach has proven effective for managing pain in various parts of the body, from the pelvis right up to the elbow and neck.
Understanding how to correctly use this procedure can equip healthcare professionals to treat multiple types of pain in the pelvis, whether the pain originates from the muscles or from other causes.
Anatomy and Physiology of Osteopathic Manipulative Treatment: Muscle Energy Procedure – Pelvic Dysfunctions
The pelvis acts as a bridge, carrying the weight of the upper body and distributing it to the lower body when you sit, stand or walk. The pelvis, which looks like a bowl, is made up of three parts: the ilium, ischium, and pubis.
The ilium is the broad and fan-shaped part of the hip bone. It’s easy to visualise as a fan, where the wings of the ilium are the projections, and the body is the handle of the fan. The outer edge of the ilium is called the iliac crest and it bends forward to a bony landmark called the anterior superior iliac spine. What’s interesting about the ilium is that it connects with another bone located at the back, called the sacrum.
The ischium is another part of the pelvis and takes up the lower back portion. It even contributes partially to a deep socket in the pelvis, the acetabulum. This bone has a characteristic bump, called the ischial tuberosity, and a small spur, the ischial spine. There’s also a small and a large groove on this bone, named the lesser and greater sciatic notches respectively.
The pubis is the lower front part of the pelvis. It has two extensions, known as superior and inferior rami. It’s fun to picture this as having a sort of crest and tubercle on the body, similar to the hump and bump of a camel!
The pelvis is divided into two parts: the lesser (true) and greater (false) pelvis. This division is done by an opening called the pelvic inlet. There are also muscles attached to the pelvis that help with movement.
Some of these muscles are the iliacus, psoas, and rectus femoris, which are crucial for averting the hips. These muscles may get injured and cause sudden pain in the front of the thigh. Nerves coming from the lower part of the back control these muscles.
The gluteus maximus is a major muscle that helps in straightening the hips. Another group of muscles, including the pectineus and the adductors, move the hips towards the body’s center. Another set of muscles, most notably the gluteus minimus, medius, and tensor fascia lata, move the hips away from the body’s center. These muscles play a critical role in maintaining the balance of the pelvis as well as a proper walking manner.
Why do People Need Osteopathic Manipulative Treatment: Muscle Energy Procedure – Pelvic Dysfunctions
Osteopathic Manipulative Treatment (OMT) is a type of therapy often used for managing pain in several areas of the body. This includes pain in the base of the spine (sacroiliac), hip, groin, lower back, leg, and pelvic area. It’s a safe and effective treatment method that is commonly used by doctors particularly for problems relating to the pelvis.
The success of this kind of treatment (also known as Muscle Energy technique or ME), however, requires you, the patient, to participate actively in the treatment process. Through your involvement in specific movements during this therapy, you can help enhance its effectiveness and your own recovery.
When a Person Should Avoid Osteopathic Manipulative Treatment: Muscle Energy Procedure – Pelvic Dysfunctions
OMT, or Osteopathic Manipulative Treatment, is usually a safe procedure that carries very few risks. However, there are certain situations where it should not be used. For example, if flexing or squeezing a muscle causes extreme pain, or if a patient has broken bones or unsteady joints. Another situation where OMT wouldn’t be recommended is if a patient has recently undergone a different type of surgery. In these cases, OMT could potentially be harmful instead of helpful.
Equipment used for Osteopathic Manipulative Treatment: Muscle Energy Procedure – Pelvic Dysfunctions
For this procedure, we require a special table and stool called an OMT table and stool. These aren’t just regular tables and stools but have unique features that make it easier to carry out the procedure. Which specific type we use depends on the preferences of the one performing the procedure and the needs of the clinic.
Who is needed to perform Osteopathic Manipulative Treatment: Muscle Energy Procedure – Pelvic Dysfunctions?
Only a healthcare professional, like a doctor or a nurse, is needed to carry out the ME procedure.
Preparing for Osteopathic Manipulative Treatment: Muscle Energy Procedure – Pelvic Dysfunctions
Before any medical procedure, the doctor will have a detailed talk with the patient about the possible risks and benefits. This is so the patient can make an informed decision about their treatment. It’s also necessary for the doctor to understand the level of pain the patient is feeling before the treatment starts. This serves as a comparison point for them to understand how effective the treatment was in reducing the patient’s pain after the procedure.
How is Osteopathic Manipulative Treatment: Muscle Energy Procedure – Pelvic Dysfunctions performed
If you need to be treated for a problem with your pelvis, it’s important for your doctor to first check you for any problems in the pubic area. But since this is a sensitive area, your doctor should always ask for your permission before they start examining. So, what does the check-up involve? You would lie on your back with your legs straight. The doctor would then gently press below your belly button and move their hands down until they find the pubic symphysis (a joint at the front of the pelvis where the two halves of the pelvis meet). The doctor checks the pubic bones to see if they’re even and to check for any soreness.
To start the treatment, you’ll need to bend your knees at least 90 degrees and then let your knees fall out to the sides. The doctor will push their fist or forearm between your knees while you push your legs together. You’ll hold this for a count of three before relaxing. The doctor then would hold your knees together — you’ll try to pull your knees apart while they resist your movement. You’ll also hold this for a count of three. If you’ve felt a slight pop or movement during the treatment, we’re done. However, if you didn’t feel that, the steps will be repeated two more times. To finish off the treatment, you’ll perform a glute bridge – this is where you lift your buttocks and then lower it again, which allows the pelvis to adjust and reset. Lastly, the doctor will re-check the pubic joint to see if the treatment has worked. If it’s still uneven, the treatment will need to be repeated.
Before treatment can properly begin, the doctor will need to figure out some important details about your pelvic dysfunction. This may include whether one side of your pelvis is higher than the other (laterality), the position of the front (ASIS) and back (PSIS) of your hip bone, whether your hips rotate inwards (inflare) or outwards (outflare), and if one of your hip bones is more elevated than the other (superior innominate shear). Understanding these things helps your doctor use the right treatment techniques.
There are two tests that can help your doctor figure out which side of your pelvis is higher, the standing flexion test and the ASIS compression test. First, in the standing flexion test, you’ll be standing and bending forward while the doctor checks the movement of the back of your pelvis. The side where the back of the pelvis moves more than the other side is the dysfunctional side. In the ASIS compression test, you will lie on your back while the doctor pushes down one side of your hip then the other – the side that’s harder to push down is the dysfunctional side. Before doing these tests, it’s important to stretch your hamstrings (the muscles at the back of your thigh) because tight hamstrings can affect the test results. After performing these tests, the doctor will then compare the position of the front and the back of your hip bone on both sides.
For the treatment of different types of pelvic dysfunction, there are several methods a doctor might use. Each method depends on the specific type of dysfunction you’re facing. After each method, the doctor will recheck the position of the front and the back of your hip bone to confirm that the treatment has helped improve your condition. It’s also important to note that these treatment methods can be used on either side of the pelvis, not just one side.
Possible Complications of Osteopathic Manipulative Treatment: Muscle Energy Procedure – Pelvic Dysfunctions
Your doctor should let you know that you might feel sore after the treatment. This soreness might last from 24 to 72 hours. To help lessen the pain, you can drink plenty of water, get plenty of rest, and use ice or heat packs on the affected area.
What Else Should I Know About Osteopathic Manipulative Treatment: Muscle Energy Procedure – Pelvic Dysfunctions?
Pelvic somatic dysfunctions refer to problems in the low back, pelvis and hips that can cause different kinds of discomfort. The most common symptoms are pain in the groin and lower back. These symptoms can sometimes lead to unnecessary medication, imaging tests, or even surgeries.
OMT, which stands for Osteopathic Manipulative Treatment, is a type of treatment that can be done by any doctor trained in Osteopathy. This can be done right in their office. This treatment can help save patients from spending too much time and money on unnecessary procedures, and can also improve their quality of life. But for this to happen, the doctor must be well-trained in recognizing these dysfunctions.