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History & Development
Andrew Taylor Still was first on the scene following his remarkable discovery that the informed touch of the hand on the patient was of greater benefit than the use of drugs and some surgery, but it was John Martin Littlejohn who laid down the Principles and devised the Techniques that have survived every kind of test and have remained with us up to the present time.
It was Littlejohn who observed the physiological dominance in the function/structure equation and the importance of inhibition and stimulation in the nervous interplay, sympathetic and central. He also emphasised the role played by vasomotion in the control of the blood circulation.
But, perhaps his most important contribution to our principles is the statement that ‘you cannot adjust the abnormal to the normal.’ This was followed by an injunction to integrate the body for which purpose the Body Adjustment became a clinical necessity.
The Momentous Year
The year is 1897. John Martin Littlejohn was thirty two years of age and approaching a degree of mental absorption that was phenomenal. His mental qualities were those of a trained thinker who had been deeply schooled in the Humanities; his experience was that of an academician, who had spent much of his life with books and scholars and who had not mixed with the world of business, finance and opportunism; his training was mainly in those arts which lead to orderly thinking–logic, the law, languages, theology and philosophy–to which we must, most emphatically, now add anatomy and physiology. These are the qualities that John Martin Littlejohn brought to Osteopathy. His own description of this great incident in his life reads thus:
“Being an enthusiast in the study of anatomy and physiology, and myself a sufferer, exiled from my native land by the medical profession on the grounds of ill health, I was fascinated by Still’s ideas and then and there accepted the philosophy of his system, that based the foundation of his treatment of disease upon the medicine chest of the human body, and laid the foundation for the prescription of remedies in the adjustment of the body structure, to normalise the production, distribution and application of these remedies in the cure of disease.”
Practice & Principles
Littlejohn has reminded us that Order is the law of life and that Harmony is the principle of the body architecture and the body activities. Anything that throws this order and harmony into a condition of disorder is a productive cause of disease. Here we use the word ‘lesion’ to indicate any deviation in any tissue or organ of the body away from the normal. A misplaced bone, a contracted, contractured or tetanized muscle or displaced organ may form the basis of such a lesion and leading to all kinds of complications that may arise, involving especially the fluids of the body, the blood and lymph and the nerve force that represents the energy of the master and controlling the tissue of the body.
In the normal body, the blood is formed within itself for its own use and all other blood is foreign. If the blood does not follow its normal course anywhere along the circulation path, there is derangement. The nerve force represents vitality. With its centre in the brain, the nerves are distributed over the body, with subsidiary centres, having a distinct path and supplying a particular part or function in the body.
Applied Anatomy Head’s and Hilton’s Laws. The skeletal system. The cranial, spinal and sympathetic nerves. The plexi. The Spinal Centres. The 10th Cranial Nerve. The great Sciatic Nerve. Posture.
Applied Physiology The nature of the Osteopathic Lesion. The biological life of the spine. Changes associated with lesion conditions. Mobility and Immobility. The Cerebro Spinal Fluid. Arrhythmia.
Pathology Obstruction or irritation leading to mal-nutrition and neurosis, the latter underlying every form of disease. Commonly called pathology but is really modified physiology. Before morbid change there must be functional perversion. All diseased conditions start in exaggeration or diminution of normal physiological activity.
The human body is not a machine but it is subject to mechanical law. That is to say it is weight-bearing and the lines of stress are present in the living organism as they are present in every object on this earth-plane. Parallel, non-parallel and curved, the lines are arbitrary in operation, having a direction and magnitude that will only by denied at the expense of the body and no amount of corrective treatment will suffice in many cases if the stress remains.
The base-line, the axis of symmetry, the centre of gravity, the polygon of forces, the upper and lower triangles have been fully established and the accuracy of this scientific data is beyond question. The curved lines bring a new set of problems, representing the dynamics of the moving body of which the central ‘double arch’ or ‘power house’ of the spinal column, is the most important factor.
Certain vertebrae act as pivots and others as keystones and the balance of the arches is of special significance in the maintenance of recovery power from the effects of stress.
Diagnosis begins with observation in the erect position. We note body movement or its lack with particular reference to the spine and pelvis, in slow flexion as each vertebra comes into play singly or in groups. Palpation is then introduced, the fingers becoming antennae to pick up impressions of tissue change, tension, altered temperature and pain. This is followed by tests in all the cardinal movements of flexion, extension, rotation and sidebending.
The adjustive leverage employs the extremities with effect on the trunk of the body, the free hand supplying the fulcrum. Both must be coordinated and may be addressed to all structures. The articulation thus induced is mild and controlled, according to the condition and need of the area undergoing the process of adjustment. The leverage is continuous but the timing is critical. It must be emphasised that in the disordered body, no structure or function can evade involvement. This means that the body is a unit and must be treated as such. The body is a living organism or an invisible energy that demands our attention through the visible structures and is not to be ignored.
Copyright © IPR 2006 John Wernham
Note the easy relaxed hold in the technique shown
Learning Outcomes An awareness and understanding of the key principles, concepts & theories of osteopathy; an appreciation of the osteopathic view of health & disease; an ability to apply osteopathic principles in understanding particular disease processes and in relation to individual patient presentation
Content Principles of adjustment & integration; protocols of treatment (rhythm, routine, rotation, mobility, motility, articular integrity, coordination, correlation, mechanical law, stabilisation); vasomotion & viscero-motion, lymphatic system; vitality, trophicity, toxicity; total lesion concept; neuro-endocrinology & the constitution; acute & chronic disease processes
Learning Outcomes An awareness and understanding of the key mechanical theories & models used in body adjustment; an appreciation of the relationship between body mechanics and organic life; an ability to assess patients in relation to mechanical models; an ability to assess spinal mechanics in relation to visceral mechanics
Content Stress, strain, resultant forces, levers & fulcra; parallel lines (centre of gravity line, anterior & posterior body lines); non-parallel lines (anterior/ posterior & posterior/anterior tension lines); polygon of forces; spinal arch analysis; oscillation centres; common lesion patterns & review of comparative mechanical models
Applied Mechanics/ Technique Theory
Learning Outcomes An awareness and understanding of the physiological and non-physiological movements of the spine; an awareness of the various historical and current theories relating to spinal movement; an understanding of the variations in regional & segmental movement and an ability to apply theoretical knowledge in practice; an appreciation of principles-based technique
Content Review of theories relating to spinal movement (pre/post-Fryette); Fryette’s laws of motion (FSR, ERS) and lesionology; theories of regional and segmental mechanics; tripod theory and related lesionology, complex lesioning; practical workshops relating to evaluation & techniques based on physiological movements of the spine
Learning Outcomes An awareness and understanding of the formulation & categorizing of osteopathic & physiological centres; an ability to identify & discuss the physiological & pathological process relating to osteopathic centres; an appreciation of the use of osteopathic centres in evaluation & treatment; an awareness of the concept of hyperphysiology
Content Hilton’s & Head’s laws, dermatomes, viscerogenic reflexes; pathway of least resistance; sensory, general motor, vasomotor & collective centres; review of Denslow-Korr hypotheses and related neurophysiological models; study of Pottenger in relation to viscerogenic reflexes (viscerosensory, visceromotor and viscerotrophic)
Applied Anatomy & Physiology
Learning Outcomes An awareness and understanding of the mechanical and physiological relationship between superficial and deep structures of the body and between the various functional systems of the body; postural & visceral mechanics, body types (morphology); an ability to evaluate visceral health in relation to spinal and postural mechanics
Content Review of key anatomical structures relating to neurovascular and endocrine dysfunction; the intervertebral foramen; spinal canal and related anatomy; structural and physiological obstruction; study of Pottenger in relation to sensory irritation, toxicity and hyperphysiology; study of Goldthwaite in relation to body types and disease processes
Obstetrics & Paediatrics
Learning Outcomes An awareness and understanding of the important anatomical and physiological considerations relating to obstetrics and paediatrics; an understanding of the key indicators/contra-indications in evaluation and treatment of obstetric and paediatric patients; an awareness of specific protocols, methods and techniques relating to obstetric and paediatric evaluation and treatment
Content Review of developmental anatomy; spinal curve development; review of obstetric and paediatric pathology; theory and practical workshops to introduce clinical methods and techniques relating to pregnancy and infancy
Evaluation & Practice
Learning Outcomes An awareness, understanding and ability to evaluate the patient and apply the body adjustment in practice at a safe level of competence; an understanding of the need to vary and modify the body adjustment in relation to specific strategies; an understanding of the physiological basis of body adjustment in practice
Content Introduction to body adjustment, variations and adjunctive techniques; practical workshops relating to evaluation and practising of body adjustment; applying concepts of timing, management and treatment planning; contra-indications to full body adjustment and factors in acute care
Title: Postgraduate Foundation Course - Body Adjustment: Theory & Practice
Description of course: Postgraduate modular course comprising lectures, practical sessions, home-study course work, literature review
Aims & objectives: the development of the knowledge & transferable skills required to begin applying the philosophy, principles & concepts of Body Adjustment in practice; to stimulate an academic & practical interest in further studies relating to alternative approaches to medicine; to provide a route to Advanced Seminars.
Total hours: approximately 100 taught hours plus directed & guided home-study.
Teaching schedule: 20 days over a period of 6-9 months typically done in five 4–day seminars. This enables students to assimilate and practise what they have learnt during the seminars.
Course Fees: £450 per seminar
Teaching methods: speech, 2 & 3D visual presentation, demonstration & practical guidance, personal tutoring, directed & guided home-study
Prerequisite qualifications: graduates in osteopathy
Certificate on Completion of Course: JWCCO Certificate of Attendance and Achievement of Assessment Criteria
Assessment criteria: fulfilment of the learning outcomes relating to each module; this to be adjudged in accordance with specific marking criteria & by meeting the attendance expectation of 80% overall attendance
Assessment methods: written course work, review presentation, case-history presentation, practical examination by viva
Bibliography: set texts & references in relation to each module; guided literature review
Indicative content & learning outcomes: outlined for each module in Module Notes