Table Of ContentMANUAL OF
OsteopatTheicch nique
ALAN STODDARD
M.B.B,. S.D,. O.D,. Phys.Mcd
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HUTCHINSON MEDICAL PUBLICATIONS
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090 511221
CO NTENTS
Prt/ares 7,9
PRINCIPLES OF OSTEOPATHIC TECHNIQUE Il
Makinagd iangosisR estoratoifmo onb iliRleYl-axatoifoe nx traneous
structuPraesss ive move(maernltisc ulation)-sIpencdiifiraced cjtu st
mentsD irecstp eciafdijcu stments-Sptehcriufs-itMcsi -nimumf orce
2 THE DIAGNOSIS OF TilE OSTEOPATHIC SPINAL
LESION 25
DefinitiCohna racteriTsytpiecsso fl esion-Diagnporsotciccd ure
Mobilitteys ts
3 ATLAS OF TECHNIQUES 87
Articulatory techniques SortS-pteicsisfiutcee c htneicqhuncisques
Neck Cervico-thaorreaacT ihco racairce aT horacciacg eL umbar
regioPne lvis
4 THE INTERVERTEBRAL DISCS 230
Herniatdeids cPsr olapsdeids cCsh ronidci sdce egneratiSopni nal
traction
Appt'lIllix 260
Thea pophy<;feaacle ls-Tnhoer mamlo vementosft hes pineS urface
markings
II/dex 273
PREFACE TO THE SECOND EDlTlON
Iti sw itcho nsiderpalbelaes aurnedn ota litptrlied e Itw hraittt eh is
prefatcote h see conedd itioofmn y m anuaTlh.e f actth atth eriesa d emand
fotrh be ooks howtsh eriess tinlele fdo rad escripotfti hoemn a nipulative
techniquuseesbd y o steopaths.
Onlyaf ewm inopro inhtasv bee eanl terientd h et echniqtuheesm selves,
butt het heoretical doefst chreli epstiiwoornni ttbeynD r LouisBau rns
thiryteya rs haagsbo e eonm itteIwd a.s a dvisbeydm ediccaoll leatguoe s
do this, bseolc iatutisleske n owna boutth eh istoloagnidcm aolr bid
anatomcyh angwehsi ch followt ots rpaiunjmaoali ntasn,dt heo bserva
tiomnasd eb yD r Burnwse roen a nimaSlusc.h c hangdeosn otn ecessarily
occuirnh umans pineasn,dm oreovtehrec hronolosgeiqcuaeln ocfte h ose
changiesbs o untdo be fallacious.
Thed escripotfti hoeno steopastphiincla els iionCn h apte2 ri sa des
criptoifoa n c liniecnatli btays eodn o bservartaitohnte hra no ne xperi
mentaelv idenacnedt, h eriesn od oubtth atth es yndroimsea realiTthye.
reaswohny I p refteorr etatihnes pecieapli th'eots teopaftohrti hcic'so n
ditiiostn h atth eo steopawtehrste h fei rtsoat t temtphted escripotfti hoins
elu,einvtei atnydt hedye sertvhece r edfiottr h iIstm. i ghwte lble c allaend
interdnearla ngemoefan v te rtebjroailnb tu,ts ucaht erimsr ealnloby e tter
except ittwh oautl bde m orea cceptatbool pep onenotfts h eo steopathic
concept.
Whena ndb yw haptr ocetshseo steopastphiincla els imoenr geisn ttoh e
disc syndirsdo embea tabbultea ,s I s ayi nC hapt4e rb Je lietvheam tu ch
antecetdhceas d veonfts ymptoimnsd islce sioannsds, u cphr ocesmseersi t
clossteu dy. Tohfuo ssw eh oa ricn tereisntt hesedu bjemcuts kte eopu re yes
openf orn ewk nowledgienw hatevfeire ldi-tih fa sa nyb earionngt he
subject.
10t hem eantiam ed escripotfit oenc hniqoufme asn ipulawthiiocnh
haveb eenf ountdo h avep ractivcaallu eev,e nt hougehm pirically per
formeids, desiIrtaw boluel.bed wonderftuobl e a blteo e xplaeixna ctly
what happwheennsa joinits manipubluattt ehded, e taimlasya lways
remaionb scuIrfet .h tee chniqduowe osr ka,si nf actth edyo u,s inmge thods
baseodn a natomiacnadml e chaniccoanls iderawteia orneas c,h ievoiunrg
objectiIvfte h.e p ractitdieovneelro ap kse en seonfts ies stueen siaonnd
palpatiaonnd,l earntso c o-orditnhateve a riocuosm ponenitnsa ny
manipulahtoiwoenv esri mplheew, ilalc hiesvuec ceMsasn.y p atiewnitlsl
beg ratefaunldp, r ovidheedd oesn otf orgtehte c ontrian dicattioo ns
manipulahteiw oinl l raise the ofsh tiamtsuesal nfdb o oftt hh ea rto f
7
8 PREFACES
manipulaatsia o wnh oleI.w ouldh,o weveurr,g teh ep ractitniootnt eor
concenterxactleu siovne tlhyed etaiolfst echniqnuoesrt, o l imihti s
horiztoont hsei ngalnedi solastpeidn jaoli nbtu,ta lwaytsob eairn m ind
thaotn ej oinitsj usatp arotf t hes keleftraalm ewoTrhke.w holsep inteh,e
wholbeo dyt,h ew holmea nh ast ob ea djustteohd i esn vironment.
PREFACE TO THE FIRST EDITION
Thep urpoosfet hibso oki st os edto wna ndi llusttrhaemt aei nt ech
niquoefsm anipulautsieoidnn o steopaptrhaicct iTchee.ra er en umerous
techniqaunedms a nym oreo ft hema rei nc onstaunstet han1 h aved es
cribebdu,tIh avien cluodnedlt yh osweh icIhp ersonhaallvfyeo untdo b e
moste ffectTihveae .r to fm anipulaitsia o vne riyn dividmuaatlt earn d
certtaeicnh niqaurmeeo sr e approfporsrio amtepe r actititohnaoentr hse rs.
Thet echniqmuaeysa lhla veto b em odifietdot hen eedosf b othp racti
tionaenrdp atieTnhted. e taoiflp sr ocedaurrceel easrolmye whpaetr sonal,
but whtihlees mea y varyb etweeonn cp ractitiaonndae nro thetrh,e
underlymientgh osdh oulbde b aseudp ont hes amep rincipTlheess.e
princiIp hlaevse elaboinrt ahtefie rds cth aptbeurt,t hep ractitmiaoyn er
welfiln dt hahte h ast oa daptth efi nedre tatiolh si msealnfdh isp atient.
Ther eadweirl fli ntdh atth ep rinciopflt eesc hniqhueersee n unciated are
somewhadti fferent fromt hosoef p revioousst eopattehxitcb oobkustI
submitth atth eayr eb aseudp ona natomiacnadml e chanifcaaclat nsd a re
supporbtyet dh ep racLiecxaple rieonfmc aen yy earosfa ctipvrea ctiinc e
theo steopafitehlidc.
Them anuailsm erelayno utliannedi sn ota na ttemtpotb ec ompre
hensiNvoer.i st heb ookw rittjeunsf to rb eginnearnsd,w, h ilieti sp ri
maridliyr ecttoet dh eo steopastthuidce anntd g raduaittie s,h opetdh at
alplr actitioofnw ehrast,e vsecrh ooolft houghwti,lfi ln ds omethionfg
valuieni tpsa geIs h.a vwer ittietfn o r tahlolsw eh oa spitroep erfecitni on
thea rto fm anipulatainodna ,l thoutghheo steopatphriocf esshiaosn
contribmuotreed thaannyo thetro t hee laboraotfit oenc hniqtuhees ,
arotf m anipulaiLsni ootnt he sporleer ogaotfi vteoh set eopRaatthh.e irt
ist hep rerogaotfit vheep atieTnhte.p atiehnatsa righttoe xpeac th igh
degreoefs kiilnla ltlh osweh op urpotrotp ractmiasnei pulatIitio sn .
desiratbhleer,e ftorode i,s seminaaswt ied elays p ossibtlheea vailable
knowledogfet hiwso rks ot hatth em aximumn umberosf s uffering
humanimtayy d eribveen efiAts. f ara sI known,o pureloys teopathic
technitqeuxet bohoaksb eenp ublisihnet dh icso unttrhyo ugshe veral
excelloenneths a vbee ewnr ittienAn m erica.
A greadte amlo rec oulhda vbee ewnr ittaennd,p robabwliylb le l ater,
ont hew ider asopfOe sctteso patbhuytI, h avree strimcytseedpl rfi marily
top ractical imnta htitbseo rosk .
Itm ustn otb et houghhto,w evetrh,a bte cautsheem anuailsl imited
tot echnique protcheadotus rteeso pattrheiact miesns to l imitTehde.
underlypirnign ciopfOl set eopaitsth hya stt ructguorvee rfnusn ction, that
9
10 PREFACES
disturbaonrcs etsru ctiunrw eh atevteirs swuiet htihn eb odyw illle atdo
disturbaonffc uensc tioinnjt nhga t strauncdti,un rl eu rn,o ft hef unction
oft heb odya sa wholeT.h e objective, tihnet rheeof sotreeo,p athic
approaicsth h ceo mplertees toraotfti hoesnt ructiunrtaelg irnit thyeb ody.
Thihsi gahi mm ayn otb ea chievbeudtt haitst hgeo aaln,d w hatever means
areu sedt or estohraer moniosutsr uctiunrtaelg ratthieosnfe,a lwli thin
thea mbiotf o steopathic practtihcifesr. a mWeiwtoohrfiko n s teopathic
treatmeOnUtfc, h ief agemnacnyu amilas n ipulaotfij ooni nbtust,a lsoof
importaanrcee tihmep rovemoefnp to stutrhee,e ncourageomfeg noto d
lymphataincdv enoudsr ainatgheei, m provemoefnt th ea rterbilaolo d
flowt,h er emovoaflm echanical obstructiomnesa nisbf yn ecseusrgical
sary, the reopfvo issicteiroan, u seto hfee xercifsoerss t rengthening
muscloerst hes tretcohfic nogn tracttiesds uTehset. h emies t hagti vean
structursaolulnyfd r amewortkh,eb odilfyu nctiwoinlspl r oceehda r
moniousalnydh ealthTihleye .l aboraotfit ohne soes teopamtehaiscu res
belonrga thmeorr et oa textbooofPk r inciipnlO esst eopatbhuyts, u ffice
ith erjeu stto e numerastoem eo ft hem ethods.
Thet echniqoufem sa nipulatdieosnc rihbeerdea rel imitteodt he
vertebcroallu mann dp elvipsa,r tilnyo rdetro k eept heb ookw ithin
reasonableb ultai lmsibote sc autsheeo steopaitnhfliuce nucpeo nt hea rt
ofm anipulaitismo unc hm ores ignificiansn pti ntahla ni no thejro int
manipulas-tibountt her eademru stn ota ssumteh aots teopattrheiact
menti sl imitteotd h esp inEev.e rjyo inetv,e rtyi sseuvee,rc ye lilnt heb ody
influenecveesr oyt hesrt ructiuntr hea bto dyT.h eraer es timulaatnodr y
inhibittroerayt metnovt iss cearnads oft (itsrseuaetsm;me anytb ed irected
ton ormalitzhiean ugt onomniecr vosuyss teamf,f ecvtiic negr omolainodn
vasomotiaonnds oo n.O steopatthrieca tmetnhte,nh ,a sa muchw ider
significtahnacnem ereljyo intte chniqaunedst, h ereftohriems,a nuails
butas malpla rotf t hel argseurb jeocfOt s teopaitthsye lf.
Theraer ef Olmlari ns ectitoont sh eb ookT.h efi rscth aptdeera lwsi th
thep rinciopflm easn ipulatteicvhen iqtubees; e conwdi tahd escripotfi on
theo steopastphiincla els ioint,ss i gnificiannt cheeo veraplalt teornf
theo steopactohnicce opft heaalntdhd iseafsoel,l owbeyd a detailed
accouonftt hed iagnoosfit sh eo steopastphiincla els ioTnnt. h et hird
sectitohnec hiesfu bstaonfct eh em anuailst ob ef oundI.ti sa na tlaosf
techniqwuietsih,l lustraatdijoancestn ott h ed escriptiwoansst .h ouIgth t
desiratbola er rantgheem ailetrh usso a st om aket hep rocedure more
readiulnyd erstoIotid s.n otorioduisffilcyu tlotd escritbheed etaiolfs
techniaqnudew, i thotuhteh elopf i llustraittii soa nlsm,o sitm possible.
Ideally, teschhonuilbqdedu eesm onstrraattehdte hra bne r eaadb oubtu,t ,
evewni tthh eb estte achienrt sh ew orltde,x tboaorkeis n valuafbolrte h e
studetnodt w elulp ona ndr efbearc tko t imaen da gaiIntw. i lbles eetnh at
theraer et hreseu bdivisiinto hniscs h aptveirz,s. o ft-titsescuhen iques,
PREFACES II
articultaetcohryn iqaunedss pecitfeicch niqaunedst ,h ey daerael wti th
regionsaolt lhya atl tlh et echniqoufee asc rhe giaorne i na convenient
sequenfcoetr e achainndgt reatmpeunrtp osTehsefi. n aclh aptiesr devoted
tot hem anipulatteicvhen iqwuheisca hr ea pplicatbot lheev ariosutsa ges
ofi nterverdtiesblcre asli oannsd,i nt hisse ctitorna cttieocnh niqaurees
descriibnde de tabielc autshee pyl asyu cahn i mportraonltie n t het reat
mento fd islce sions.
Durintgh ep reparaolfit ohni msa nuaIl h aveb eenm uchi ndebted
tom y secretGairlyl,i Warni ghfto,rh erp ainstaaknidnp ga tietnytp ing
andr etypitnomg y, r adiograEpdhietrKh,n ottf,o rt heh elsph eg avien
makintgh eX -rafyi lmtso,M r.A .E .S ai tf ort hep hotograaplhsymo,y
daughtaenrd M rs.B .S hearefro rb einsgu che xcellmeondte lst,o
Drs.W . Hargrave-WiBl.sH o.Pn e,n tnaenyd D .T urnefro rre adianngd
critictihzesic nrgi bputt,m osto fa lIlh avbee einn debtteoDd r .A ndrew
TaylSotri wlhlo i n1 87s4t arttehdef irsscth ooilnO steopaatthK yi rks
vilMlies,s ouUr.iS,. AW.i thoDurt.S tilpli'osn eerwionrgki nO steopathy,
thea rotf m anipulawtoiuolnnd e vehra vea chievtehdep lacoefi mporl
ancweh iciht h oldtso daSyt.e adialnydc ontinuosuisnlctyeh etnh ous
andosf o steopahtahvsem adei tt heilri few'osr kt ou set himse thoodf
treattihnegi njrueda ndt hes icSko.m em ayh avef ailleadm entaibnl y
havinign adequkantoew ledogfte h ei nstrumtehnetwy e rue sinbgu tt he
majorihtayv es ucceeidnerd e nderiinnvga luasbelrev itcome a nkinidn
theeifrf otrota sd vantcheea ratn ds cienocfOe s teopathy.
Them edicparlo fesshiaosln a ggefda rb ehintdh eo steopatphrioc
fessiiondn e velopainndtg e achtihneag r otf m anipulaatnidoi nth ass adly
neglecttheemd e chaniccaauls oefsd iseaasnedd isabiIlitit sby e.c ause
oft hitsh aat s eparsactheo ooflt houghhatd t ob em aintaiinnet dh ep ast
and shtaislt lo b em aintainbeudtw; h ent hel ruiem portaonfct eh e
structfuarcatlho ars b eenf ullrye cogniazneddw ,h ent hem edicparlo
fessihoansm odifieidt tsh inkionngt heslei neasn da ddemde chanical
derangemteont thse liirs otfe tiologfiaccatloi rnds i seatshee,tn h erwei ll
nol ongbeera nyn eefdo ras eparoartgea nizaatnidto hnew orlwdi lble a
healthainedhr a ppipelra cteol ivien A.l reatdhyer ecogniotfit ohnei nter
vertebdriasllce siboyno rthodmoexd icihnaesf ocusaetdt entoinot nh e
spincaoll umint;ls o caaln dr emoteef feacrtebs e ttuenrd erstaonoddi ti s
beinrge cognitzheadt tlheessieoc nasu sdei sturbaonfcl ehsea utonomic
nervosuyss temo satse opahtahvcsel aimfeodmr a nyy earAst.p re,etnhte re
isa keeann da wakeniinngt eriensm ta nipulaatnidom na nyd octors are
tryidnigf ferteencth niqwuietsh osuutffi cieknnto wledagned w ithoau t
propearn alyosfit sh ej oinmte chaniTchse.t echniqhueersoe u tlinaerde
the outcoofsm oem ethilnigke ei ghyteya rosfd evelopmienmn atn ipula
tioann da ret,h erefwoorret,h oyft hea ttentoifao lnwl h od esitroee xcel
int himse thoodf p ractice.
PNRIN CIPLOEFS O STEPOATHITCE CHNIQUE
IOSTEOPATHYw ea rceo ncewrintethdh ees tabliasnhdmm aeinnt
tenaonftc hene o rmsatlr ucitnutreagolrft i htbeyo dayn tdo a chieve
theinswd e u sdei vemresteh oTdhse.ms eet homdasyb ec lassiinfi ed
thrgereo ups:
(IT)h et echnioqfju oeismn atn ipulia.teti.ho enn ,o rmaliozfa t.ion
mobilaintpdyo sitainotdnh r,ee lief oft eanbsininoo rnmm uaslc les,
ligamceanptssau,nl fdea ss cia.
(2M)a nipultaetcihvneio qtuheteshr a jno int cordriercetcfitooernd s.
examptloie m,p rcoiver culvaetnioaounnsdl, y mphdartaiicn tahgee ,
repositoifvo insicanengrsd ao ,tf its tsrueea tments.
(3O)t hmeert howdhsi chahv aest heaiirmt hiem proveomrre enstt ora
tioonfn ormal meicnht ahbneoi dcyss,u cahst hceo rrecotfi on
posttuhrseeu ,r gicalo far benmoorvmaall w htiiacsrhsie um epse ding
natuartet'esma ptrt est urtnhibeno gdt yon ormaanled,x ercainsde s
activwihtiicehs t home alipn taaniidnm prnoovrem maelc hanics.
Altlh ecsoem wei thtihbner oaadsepreo cftt ho es teopaaptphrioca ch,
buitnt hbioso wke a rmea inly cownicttehhr feni erhdse ta diLnegut.s
deatlh ewni tthhp er incoiftp hlteee sc hnoifjq ouien t manipulation. Our
immedpiuartpeio sts here e storoafnt oiromna l coinntd hijeto iiwonent ss
ardee alwiintgIh ti. s c leaurnlnye cetsosm aarnyi punloartmjeao li nts.
Therebfeorfeod,re es crtihbdeie ntgao ifml asn ipultaetcihvneii qtiu se s,
necestsoka nroyaw n udn derswthaaantbd n orsmtaailt pser esent.
THE FIRSTP RINCIPLE,t heins,t hmea kionfga diaginsAo.ss t he
establiosfah d mieangtn iosos fpi asr amount iImh paovdreet vaontceed
aw hoclhea pter 2()tC oht ahppitrseo rb lIenim at.r dee scrtiebcehdn iques
ofd iagnosism-ombaiiltnieltsyyt s-awrhoeif cg hr evaatl aunedm ust
ofn ecesbseui stepyd r itooar n tye chnioqfmu aensi pulation.
Ina rriavitan dgi agnoofst ihjseo int wfema uuslftti rst exclude
patholcohgaincTgahelsa i.tts o s awye m usetx cltuhdoecs hea ndgueteso
disewahsiecl he atdol ocsatlr ucatlutrearlia ntt ihovena rious com
poneonftt shj eo icnhta;n gesm awyhm iisclhue sai dn ttoh inktihnaagt
13
