How Does Osteopathy Work?

Additional Core Osteopathic Concepts

Now, how do we do it? 

The first process is getting acquainted with the child. We may show them an interesting toy, or an assistant may read a book. We will talk with and get to know the child.

In the process of getting acquainted, we are running our fingers over the various joints between the bones in the head to find out whether there is any over-riding of any of the bones, whether there is any irregularity, whether one bone is pushed up against the other, and also whether there is any imbalance in the structure of the bones of the head.

Then we may move down to the spinal area. We come down the neck, and then we come down through the thoracic area, the rib cage, and the vertebral area and down into the lumbar area.

After that, we evaluate the legs, the hip joints, knee joints, and ankle joints. Then we evaluate the sacrum. The sacrum is that large bone that you can feel if you put your hand behind you (it's about the size of the palm of your hand in an adult). In the infant, that is still five bones, not just one. The rhythmic motion of the sacrum is brought about with breathing. Every time you breath, you move that sacrum between the pelvic bones. We place one hand on the sacrum and the other hand is on the pelvic bones, evaluating how the sacrum moves within the pelvis. The sacrum is very important because it has a very strong connection through the connective tissue to the base of the skull. If there is a problem with the sacrum, it can create tension at the base of the skull, causing this area to function inappropriately.

By using our hands and varying the tension on these areas, we can balance the pelvis and sacrum as well as the lumbar spine. If during delivery, the baby doesn't descend smoothly and progressively through the birth canal, there can be a problem. As the baby's spine has to negotiate its way around the mother's sacrum, it can get stuck in that position. This may tend to produce a side bending in that lumbar spine. This does not show itself outwardly at this age because this baby isn't standing. The spinal curve may not show itself until the baby begins to stand. An osteopath, by palpating it at this age, can find the problem and take care of it (it only takes about 90 seconds). In effect, we can take out that twist that has become “locked in” through the birth process.

Next we evaluate the head area. Sometimes, in order to keep a little baby quiet and happy, it either nurses or sucks on the bottle while it is being treated. The area of the baby's head that leads the way out of the birth canal is the occipital area, the back of the head. It is the area that will take the brunt of obstruction if there is a delay in delivery.

When there has been a long delivery, perhaps sixteen, twenty, or twenty-four hours for a first baby, there is a significant risk that trauma has occurred to the baby’s skull. Research, some of which was done at the Osteopathic Center for Children, has found an association with prolonged labor and later learning disabilities.

If the baby is not the first child, a labor exceeding twelve hours is a concern. Sometimes we find mothers who have been in labor for several days, or perhaps even more importantly, there had been a period of false labor before the real thing began. False labor can be particularly damaging because the contraction is occurring, and the baby's head has nowhere to go because the birth canal is not opening. So, the baby is being compressed from above and below.

In each of these cases, it is the occipital area that takes that impact. The occipital area (base of skull) is where the hypoglossal nerve to the tongue and the vagus nerve to the digestive tract pass through the skull. These are the first areas that show show the stress of the birth.

One of the most important questions we can ask is this: "Did your baby have any trouble vomiting, spitting up?" If the answer is "yes" then we know that there was some degree of a problem in this area at birth.

Within the occiput (base of the skull) is a large opening through which the whole brain stem becomes the spinal cord. All of the nerve pathways that go to every structure in your body below the base of the skull must pass out through that hole in the occiput. Therefore, if the occiput is deformed by such pressures as we have described, the injury to the nervous system may vary all the way from the child who has mild spitting up to the child who is hyperactive... the child who is uncontrollable, who is aggressive, who eventually goes on to have learning problems, behavior problems, and the whole gamut. So, this is a most critical area -- the area that we always look at when we look at newborn babies.

Then we consider the skull as a whole. The skull is made up of some twenty-six bones. At this age, some of those bones are in several parts. Therefore, the potential for compression in one or more areas is quite great if there was compression in the mother’s pelvis on the baby’s head during birth.