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Osteopathy: four core principles

4 core principles

The practice of osteopathy is founded on four core tenets, first outlined by its founder, Dr. Andrew Taylor Still.

The first tenet states that a person is indissociable, i.e. makes up a distinct unit. A person is composed of multiple biological elements influenced by her or his unique mood, environment, and activities. Body structures are interrelated and therefore affect each other. A person’s past history leaves traces on the body’s tissues, which can then influence that person’s adaptability in the present.

Second, structure governs function. Any deformity in the overall structure or posture will limit the individual’s functional capabilities. In addition, changes to an organ’s structure will reduce its function. The functionality of an individual and of her/his constituent parts depends on the quality of the structures that make up this individual. To be functional, body structures must be free of constraints.

Third, fluids and nerve impulses must be able to travel unimpeded throughout the body. This serves to balance the relationships between structures, and to coordinate function with other parts of the organism. As a result, fluids must circulate freely to ensure these structures can carry out their functions in harmony with the rest of the body.

Fourth, the body is self-regulating. Through its immune functions and tissue repair, the body is able to recover, heal, and regulate itself. Therefore, it does not require outside help to heal itself. However, dysfunction sets in when a succession of life events impacts the body to such a degree that it can no longer manage. At this point, the osteopath’s role is to remove enough barriers to ensure the body regains equilibrium.

The osteopath uses manual therapies to rebalance the individual and return the body to homeostasis. Therefore, osteopathy is practiced on the entire body, and all of its component parts, to relieve pain and improve function.

How osteopathy can enhance occupational therapy and physiotherapy practices

Through their teachings, exercises, and therapies, your rehabilitation team will educate you on how to recover and regain function. These professionals specialize in function and movement, and their approach is designed to correct functional limitations.

While osteopathy and physiotherapy have very similar techniques, the directionality of treatment is reversed. A physiotherapist will help you correct a disability that has set in following an event; whereas an osteopath will investigate the conditions that allowed this disability to set in following an incident. It may be a subtle difference, but the therapeutic goals are very different – although still complementary.

You have probably noticed that following a specific incident, most disabilities will resolve on their own, relying on the body’s natural ability to heal itself. You likely won’t need to see a physician, provided you allow sufficient time for your body to reset itself and the initial trauma wasn’t too serious. However, you might know someone with a similar injury; and even though your overall health and lifestyles might be similar, you won’t necessarily recover at the same rate. This is where an osteopath can overcome the dysfunction that allowed this limitation to set in. In collaboration with your rehabilitation team, the osteopath will help push you past a plateau, and recover more quickly.

It’s also possible that your recovery is slowed by an underlying health issue that physiotherapy or occupational therapy cannot resolve. This is another area where your osteopath can help.

Legal framework of osteopathy

Unlike physiotherapy and occupational therapy, osteopathy is not currently regulated by a professional order. Although the Office des professions du Québec recognizes this practice, they also understand the need for a legal framework to protect the public. Work is currently under way to create such an order; however, this gap currently prevents payers such as the SAAQ and the CNESST from covering osteopathy treatment costs.

In an effort to regulate member practices in their own way, various alternative medicine associations include osteopaths among their ranks. Osteopaths are free to choose the association to which they wish to belong for the purpose of issuing receipts for treatments.

Which client groups can benefit from osteopathy treatments?

Clients in every age group and with all health conditions can benefit from osteopathy. By treating individuals holistically, osteopathy works major body systems such as the central nervous and hormonal systems. It can also act on various bodily functions including digestion, movement, reproduction, the immune system, and circulation. Generally, a visit is recommended if you are experiencing pain, digestive problems, fertility issues, ear infections, headaches, or fatigue.

An osteopath can help you, whether you are an employee, retiree, or athlete, or whether you are a parent concerned about his child, a post-partum mother, or the victim of an industrial or road accident. However, this health service is not currently covered by the RAMQ, the CNESST or the SAAQ. As a result, you must pay for the visit yourself. That said, you can send a claim for this amount to your insurer, or declare it as a health expense on your tax return.

Given their number, your insurer might not recognize the specific alternative medicine association to which your osteopath belongs. You may want to look into this before your visit.

A typical osteopathic treatment

At your first appointment, your osteopath will ask you questions about your overall history. Don’t be surprised by this extensive questioning; it helps your osteopath develop hypotheses to explain the underlying reason for your visit. You may feel like you’re recounting your life story – but the information the osteopath collects at this stage will save valuable time during the physical assessment.

Wear comfortable clothes, because your osteopath may ask you to strip down to your undergarments. Your osteopath can glean a great deal from your general posture, and stripping down can facilitate this observation. Next, a palpatory exam will help validate the osteopath’s initial hypotheses. The osteopath will probably palpate (feel) various parts of your body, including your stomach and head. Following this information-gathering exam, the osteopath will carry out her/his first therapeutic treatments.

In follow-up appointments, don’t be surprised if the osteopath tests your body again, as she/he must assess the effects of the first treatment to plan subsequent ones.

Have a good treatment!

Sylvain Vigneux, Physical Rehabilitation Therapist


Still’s core tenets:
Still, A.T. (1902). The philosophy and mechanical principles of osteopathy. American Academy of Osteopathy. p. 16.

Ostéopathie Québec (in French only):

Office des professions du Québec (in French only):

Keywords :   osteopathy


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