I am regularly asked what is the difference between an osteopath and a chiropractor; or a physiotherapist and an osteopath. The usual scripted answer is philosophy; and osteopaths do have an axiomatic set of principles that guide their work. However, thats not what really sets osteopaths apart. Chiropractors, physiotherapists and osteopaths all have five years of university training, each is taught the same clinical assessment skill, special orthopaedic assessments, neurological assessments, and simple active, passive and active resisted range of motion assessments. What differentiates an osteopath as a manual therapist can be summed up in two words; palpatory assessment – they focus of their examine is by touch.
This is not to say that chiropractors, physiotherapists don’t touch people or use this sense to assess but osteopaths from their very first class are taught to focus on their palpatory assessment. Osteopaths are taught to assess TART; texture, asymmetry, range of motion and tenderness in a very palpatory way. Texture and tenderness are obviously about touch sensation but osteopaths are interested in how the range of motion feels; its end feel, the quality of the movement in their hands and the feeling of symmetry in the tissues under their hands. Over many years of practice the hands of the osteopath become palposcopes capable of perceiving the integrity of bones and ligaments, the quality of the vascular perfusion of tissues, the neurological integrity as well as the tonicity of muscles and tendons. Studies indicate that after 20 years of practice something extraordinary seems to happen to osteopaths – their bookings and earns suddenly increase substantially (Orrock, PJ 2009, ‘Profile of members of the Australian Osteopathic Association: part 1 – the practitioners’, International Journal of Osteopathic Medicine, vol. 12, no. 1, pp. 14-24.). What is the driver behind this profound change hasn’t been thoroughly teased out but palpatory knowledge must be high on the list of causes.
The same is true of treatment as well as assessment, chiropractors, adjustment trained physiotherapists and osteopaths are all trained to stretching, massage, adjust and perform muscle energy techniques and they all have access to and prescribe exercise regimes – what differentiates the professions is the focus. What is important? Cavitating joints? The exact degree of movement a joint ? Or how it feels to move for both the practitioner and the patient. For the experienced and well regarded osteopath the answer is the last of these. It is their aim above all to assist their patient to find pain free movement as a basis for their recuperation and prolonged quality of life.
Laurence Axtens - Osteopath 