Osteopathic Manipulative Medicine


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Osteopathic Manipulative MedicineEdit

Osteopathic Medicine is a medical philosophy and practice, founded by Andrew Taylor (A.T.) Still in the midwestern United States in 1874.
Andrew Taylor Still

Osteopathic medicine is based on 4 distinct tenets:

  1. The human is a unit of mind, body, and spirit.
  2. The body is innately capable of self-regulation, self-healing, and health maintenance.
  3. Structure and function are reciprocally interrelated.
  4. Rational Osteopathic treatment is based upon an understanding of the basic principles of body unity, self-regulation, and the interrelationship of structure and function.

Hands-on osteopathic diagnosis and treatment can help patients achieve a high level of wellness by focusing on treatment of acute and chronic problems, as well as health promotion and disease prevention. In osteopathic medical school, doctors of osteopathic medicine (D.O.'s) are uniquely trained to palpate, diagnose, and treat the human musculoskeletal system in hands-on lab settings.

This book begins with an introduction to osteopathic manipulative medicine (OMM), discussing basic concepts of integrated functional anatomy and treatment models, with a brief survey of relevant concepts pertaining to the neuromusculoskeletal examination. It continues with a discussion of the axial spine, followed by the upper and lower extremities. After the axial and appendicular skeleton, the text delves into osteopathic cranial manipulative medicine (OCMM).

Objectives are listed at the beginning of each chapter to primarily identify learning goals. Prior exposure to anatomy is assumed.

A series of open-ended questions compliment the Review Questions found at the end of each Chapter as linked below. (Answers are provided on a separate page.)

Table of Contents:

Chapter 1 - The Basics of Osteopathic Manipulative Medicine Chapter 2 - Treatment Models Chapter 3 - Cervical Spine
  • 1.1 Osteopathic Concepts and Principles
  • 1.2 Motion and Barriers
  • 1.3 Somatic Dysfunction
  • 1.4 Palpation and Planes of Movement
  • 1.5 Palpation and Planes of Movement
  • 1.6 The Osteopathic Structural Exam
  • 1.7 Fascia
  • 1.8 Review Questions
  • 1.9 Answers to Review Questions
  • 2.1 Major Treatment Techniques
  • 2.2 Review Questions
  • 2.3 Answers to Review Questions
  • 3.1 Anatomy and Musculature of the Cervical Spine
  • 3.2 Somatic Dysfunctions of the Cervical Spine
  • 3.3 Treatment of Somatic Dysfunction of the Cervical Spine
  • 3.4 Review Questions
  • 3.5 Answer Key to Review Questions
Chapter 4 - Thoracic Spine Chapter 5 - Clavicle, Sternum, and Ribs Chapter 6 - Lumbar Spine
  • 4.1 Anatomy and Musculature of the Thoracic Spine
  • 4.2 Somatic Dysfunctions of the Thoracic Spine
  • 4.3 Treatment of Somatic Dysfunction of the Thoracic Spine
  • 4.4 Review Questions
  • 4.5 Answers to Review Questions
  • 5.1 Clavicle Anatomy and Somatic Dysfunctions
  • 5.2 Sternum Anatomy and Somatic Dysfunctions
  • 5.3 Ribs Anatomy and Somatic Dysfunctions
  • 5.4 Review Questions
  • 5.5 Answers to Review Questions
  • 6.1 Anatomy and Musculature of the Lumbar Spine
  • 6.2 Somatic Dysfunction of the Lumbar Spine
  • 6.3 Treatment of Somatic Dysfunction of the Lumbar Spine
  • 6.4 Review questions
  • 6.5 Answers to Review Questions
Chapter 7 - Innominates, Hip, and Pelvis Chapter 8 - Sacrum and Pubic Chapter 9 - Lower Extremity and Gait
  • 7.1 Innominate, Hip, and Pelvis Anatomy
  • 7.2 Innominate, Hip, and Pelvis Somatic Dysfunctions
  • 7.3 Treatment of Innominate Somatic Dysfunctions
  • 7.4 Review Questions
  • 7.5 Answers to Review Questions
  • 8.1 Sacrum and Pubic Anatomy
  • 8.2 Sacrum and Pubic Somatic Dysfunctions
  • 8.3 Worked Examples of Sacrum Diagnoses
  • 8.4 Treatment of Sacrum and Pubic Somatic Dysfunctions
  • 8.5 Review Questions
  • 8.6 Answers to Review Questions
  • 9.1 Knee Anatomy
  • 9.2 Knee Somatic Dysfunctions
  • 9.3 Treatment of Knee Somatic Dysfunctions
  • 9.4 Foot and Ankle Anatomy
  • 9.5 Foot and Ankle Somatic Dysfunctions
  • 9.6 Treatment of Foot and Ankle Somatic Dysfunctions
  • 9.7 Gait
  • 9.8 The Dirty Half Dozen Causes of Low Back Pain
  • 9.9 Review Questions
  • 9.10 Answers to Review Questions
Chapter 10 - Upper Extremity Chapter 11 - Viscerosomatic Reflexes and Chapman's Points Chapter 12 - Lymphatics
  • 10.1 Shoulder Anatomy
  • 10.2 Shoulder Somatic Dysfunctions
  • 10.3 Treatment of Shoulder Somatic Dysfunctions
  • 10.4 Elbow and Forearm Anatomy
  • 10.5 Elbow and Forearm Somatic Dysfunctions
  • 10.6 Treatment of Elbow and Forearm Somatic Dysfunctions
  • 10.7 Wrist and Hand Anatomy
  • 10.8 Wrist and Hand Somatic Dysfunctions
  • 10.9 Treatment of Wrist and Hand Somatic Dysfunctions
  • 10.10 Review Questions
  • 10.11 Answers to Review Questions
  • 11.1 Reflex Somatic Dysfunctions
  • 11.2 Innervation of the GI tract
  • 11.3 Chapman's Points
  • 11.4 Viscerosomatic Dysfunction Treatments
  • 11.5 Review Questions
  • 11.6 Answers to Review Questions
  • 12.1 The Lymphatic System
  • 12.2 Lymphatics Treatment Techniques
  • 12.3 Review Questions
  • 12.4 Answers to Review Questions
Chapter 13 - Neuroanatomy Primer Chapter 14 - Osteopathic Cranial Manipulative Medicine Chapter 15 - Additional Treatment Techniques
  • 13.1 Neurological Evaluation
  • 13.2 Muscle Strength Testing
  • 13.3 Deep Tendon Reflexes
  • 13.4 Sensory Dermatomes
  • 13.5 Neuroanatomy of the brachial plexus
  • 13.6 Neuroanatomy of the lumbosacral plexus
  • 14.1 Introduction to Osteopathic Cranial Manipulative Medicine
  • 14.2 Anatomy of the Head (Cranium)
  • 14.3 Cranial Somatic Dysfunctions
  • 14.4 Treatment of Cranial Somatic Dysfunctions
  • 14.5 Review Questions
  • 14.6 Answers to Review Questions
  • 15.1 Facilitated Positional Release
  • 15.2 Balanced Ligamentous Tension
  • 15.3 Still techniques
  • 15.4 Review Questions
  • 15.5 Answers to Review Questions
Chapter 16 - Applications of Osteopathic Manipulative Medicine
  • 16.1 Head and Neck
  • 16.2 Cardiopulmonary
  • 16.3 Gastrointestinal
  • 16.4 Pregnancy
  • 16.5 Pediatrics
  • 16.6 Geriatrics
  • 16.7 Hospitalized Patients
  • 16.8 Example Case and Documentation

Authors and ContributorsEdit

The primary author is Lenny Powell DO, assistant professor in the Department of Geriatrics and Gerontology and the Department of Osteopathic Manipulative Medicine at Rowan University School of Osteopathic Medicine, however, this work is a compilation of work done by others with organization, additional narrative, and visualizations. This project initially started as a review guide for my students and evolved into a book. However, due to the demands and frequent updates I plan to make to this work, I have transitioned it from a physical book to an electronic one. It is a work in constant progress; others are encouraged to add information (subject to review) and contribute!

Specific acknowledgments include, from Rowan University School of Osteopathic Medicine, in addition to others inadvertently omitted:

  • Danielle Cooley DO - Chair of Department of Osteopathic Manipulative Medicine
  • Alex King DO - for his editing efforts and additional figures
  • Jim Bailey DO
  • Cate Fusco DO
  • Barry Hoffman DO
  • David Abend DO
  • Todd Schachter DO
  • Millicent Channell DO
  • David Abend DO
  • Aubrey Olson DO
  • David Mason DO
  • Sajid Surve DO - for some of the treatment descriptions and images used; now at University of North Texas
  • Knic Rabara DO - now at Baylor College of Medicine
  • Frederick Barnum IV DO
  • Mrs. Kathy Kupiec


References are placed within the text. In the event a reference was inadvertently missed or one requests more information on the covered topics, here are several excellent sources. All are available for purchase on Amazon.

  1. Thieme’s “Atlas of Anatomy: General Anatomy and The Musculoskeletal System”
  2. Thieme’s “Atlas of Anatomy: Head and Neuroanatomy”
  3. Nicholas and Nicholas’s “Atlas of Osteopathic Techniques” - Third Edition
  4. Channell and Mason’s “The Five Minute Osteopathic Medicine Consult”
  5. Surve's "Manual of Osteopathic Principles and Practices" (Rowan SOM OMM1 course manual)
  6. Educational Council on Osteopathic Principles (ECOP) - Glossary 2017


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