A study in Classical Osteopathic Technique
An Introduction to the Classical Techniques
Full notes to accompany the videos can be found below
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Stage 1
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Introduction
Mervyn Waldman, President of the ICO, introduces this study in Classical Osteopathic Technique.
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Examination
The Classical Osteopathic examination process is a refined, whole-body approach—assessing movement, compensation, and force patterns from first glance through to the standing passive examination, guided by the mechanical principles of Littlejohn, Hall, and Wernham.
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Body Adjustment Examination
It is said that at least 70% of the Body Adjustment routine is assessment. Here, Mervyn explores the routine purely from this perspective, demonstrating how assessment seamlessly flows into adjustment.
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Body Adjustment Treatment
Switching focus to treatment, Mervyn explores the detailed applications within the routine that make it such a comprehensive, integrated, whole-person process.
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Seated Examination
Each examination position offers a unique perspective on the patient's condition. The seated position removes the influence of the legs on pelvic and spinal mechanics, while allowing the body weight to shift more anteriorly onto the discs—freeing the facets for clearer assessment without compressive load.
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Standing Examination
With the patient in an easy, neutral position, leverage from the pelvis transmits movement from the legs and pelvic girdle into the spine. This allows assessment of movement relationships, spinal curves, group and individual vertebral balance, spinal soft tissue rhythm, and overall integration. Leverage from the head and neck can be applied down to the fifth dorsal vertebra and, with the shoulder girdle as a lever, even lower.
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Stage 2
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Introduction
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Foot
Respecting the local mechanics of the foot arches, examination and treatment of the feet is precise, physiological, and thorough.
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Pelvic Abdomen
Neither Still nor Littlejohn advocated extensive abdominal treatment. However, here we examine carefully applied visceral release, decompression, and articulation of the abdominal and visceral regions.
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Upper Extremity Thorax
Treatment of the arm and shoulder in the supine position flows naturally into a long-lever approach for thoracic and rib articulation.
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Throat, Head and Face
A thorough explanation and demonstration of Littlejohn’s approach to the cranium, including applied lymphatic, sinus, and throat drainage techniques.
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Supine
As the most restful position for most patients, supine allows accessible free movement of the limbs and cervical spine for both examination and treatment.
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Stage 3
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Prone Body Adjustment
Mervyn presents the prone aspect of the Body Adjustment in detail, aiding understanding of its broad applications in this orientation.
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Inhibition Stimulation
Transforming physical input into physiological responses is most significantly achieved through Inhibition and Stimulation. These techniques range from pain relief and sympathetic nervous system calming, to stimulating underactive neurological responses.
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Adjunctive Prone Technique
The prone position provides convenient access to techniques for releasing anterior spinal ligament restrictions and for applying various valuable articulatory methods.
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Sidelying Technique
The side-lying position offers access to movements that may be restricted in acute cases— mechanically or in the context of poor health. It allows broad access to the spine without weight bearing, ranging from precise lumbar diagnostic examination to coordinated engagement of diagonal fascial chains.
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Supine Technique
This section explores a variety of supine techniques—from the iliosacral leg-tug adjustment, the 'Chicago' L5, and the 'dogs' dorsal spinal release, to pelvic adjustments and minimally invasive visceral approaches.
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Stage 4
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Introduction
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Techniques in the seated position
With the patient seated on the treatment table, adjustments can be directed to the anterior cervical soft tissues, the cervico-dorsal junction and upper rib articulations, lateral thoracic curve release, and traction-articulation movements into the thoracic spine, including the classic ‘Spinster’s Thrill’ technique.
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Seated Extremity Technique
While seated, adjustments can be made from the shoulder to the fingertips using long-lever techniques, as well as precise work on the knee and its attachments.
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Stool Techniques
Using the osteopathic stool's height and accessibility, Mervyn demonstrates adjustments to the shoulder joints and cervical and dorsal spine.
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Astride Techniques
In this position, torsional release can be applied from the mid-thoracic spine down to the pelvis, along with anteroposterior springing techniques for the thoracolumbar region.
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Bedside Misc Techniques
When working with acutely ill or disabled patients, bedside adaptability is essential. Here, Mervyn explores the range of techniques accessible from this position.
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Notes
Examination
“It requires hours of study to perform a few minutes of effective technique” - H Fryette Mervyn Waldman, President of the ICO, introduces this study in Classical Osteopathic Technique. Mervyn co-authored with John Wernham, the Institute’s co-founder, the series of books on Classical Osteopathic technique (The Fundamentals of Osteopathic Technique, Osteopathic Technique Volumes 1 and 2), which have served as a guide to the basis and application of our technical approach. Mervyn has always demonstrated and taught a clear mastery of Classical technique after studying not only directly from the master technicians of John Wernham and Thomas Hall but also the texts of the pioneer osteopaths of the profession. We hope you enjoy this series of videos and encourage you to learn it in the context of a full course in Classical Osteopathy. It is a very potent way to treat mind and body. As such it is vital to understand the mechanical and physiological principles upon which these techniques and the Body Adjustment Routine are based. Although this technical approach is very safe when learned with the guidance of fully trained and experienced Classical Osteopaths, we cannot take responsibility of the results of anyone practicing from these videos which are designed as an aide memoire for those having studied on our courses or to inspire interest in those who aspire to do so.
Initial Osteopathic Examination
Vital to the eventual adjustment is a thorough examination and the Classical Osteopathic approach has its own unique perspective on this. The examination is carried out largely with the patient passive. After the Introduction to this seminar Mervyn demonstrates the Initial Osteopathic examination, getting a perspective on the posture, the patient’s centre of gravity, body contour and configuration. The spinal alignment, anteroposterior and lateral curves, are considered as well as the relationships of the pelvic and shoulder girdles. The applied mechanics of the spine are noted to be further clarified in the next stage of examination.
Standing Examination
(Operator Seated)
Commonly, the examination of the patient is carried out with the operator seated with the patient standing, back towards, in front of them. The patient is initially inspected from this perspective with the patient standing easy. Their head is then dropped forward, feet together to counter the patient from stabilising themselves, so they can be moved freely. Any regions of extension can also be neutralised so that the actual mobility in the spine in that area can be clearly defined from restricted mobility due to facet approximation or weight bearing. The relative movement of the pelvic and shoulder girdles are compared. The motility of the spine is assessed. The rhythm of the paraspinal musculature is examined along with the texture, tone, heat, humidity, trophicity and even the unctuosity of the surface tissues are all taken into consideration. Each vertebra is assessed in the context of its individual mobility, its relations to its immediate neighbours, the region and relationship to the spine as a whole. Movement, as with the treatment process itself, is from lever to fulcrum; the examining hand, which is soft, broad and relaxed, to best serve as a sensitive palpating ‘antenna’.
Seated Examination
Another approach is to examine the patient seated. This changes the perspective and the relationship to gravity. The pelvic examination reveals integral movement without the involvement of the legs, and the patient is stabilised in the seated position. As defined by Littlejohn, “integrated mobility”•