OBSTETRICS AND GYNAECOLOGY IN OSTEOPATHY
12.2.2013 Lecture no. 1 - Introduction - Physiology changes during pregnancy
The lecture was very inspiring, consisting of the theory only. We have learnt many interesting facts about changes and adaptation of the pregnant female body. It seems that specialising for pregnant patients could be very rewarding as there is not many therapist that do work with the pregnant ladies to achieve uncomplicated birth and the health of the mother and baby. dr sandler talked about his own experiences and highlighted the fact that he is very sought for therapist.
I have already been thinking of my further professional development as working with children as paediatrision and specialising in pregnancy care. So far I have come across with Renzo molinari and dr sandler and they are very inspirational osteopaths that make me feel enthusiastic about osteopathy and its certain aspects.
below is the example of the notes taken during the obs and gynae lectures:
I have already been thinking of my further professional development as working with children as paediatrision and specialising in pregnancy care. So far I have come across with Renzo molinari and dr sandler and they are very inspirational osteopaths that make me feel enthusiastic about osteopathy and its certain aspects.
below is the example of the notes taken during the obs and gynae lectures:
19.2.2013 Lecture no. 2 - Visceral osteopathy and diaphragm work during pregnancy
Due to grow of the fetus and uterus, the pregnant ladies experience a lot of changes in their abdomen and the diaphragm is pushed up upon, disallowing it descend. Dr sandler intruduced to us a very interesting diagram from his book explaining the relationships between visceral organs and how they are connected together via a system of the ligaments. in pregnancy it is impossible to follow Barral's advice on how to find particular structures in the abdomen and pelvis, thus this diagram is a helpful way of understanding where possibly the organs could be in the pregnant tummy.
Dr Sandler introduced very interesting visceral technique when we were sending the vibration stimuli into the areas of adhesions of the structures in the pelvis and abdomen - VISCERAL THRUST - this really made a lot of difference it the way students felt.
Other techniques we learned today was diaphragm release in the seated position. I found it quite unpleasant having it done on myself perhaps due to extra abdominal fat and the way the technique was performed, by gathering the abdominal skin so the ulnar borders of the hand can access the area below the costal margin. Once hands are there, the patient gets from the position of leaning forward to leaning backward with upper body and head resting on the shoulder of the therapist, which separated the hands laterally, dragging the tissues of the diaphragm, and then with the palms of the hands compressing the lower ribs down to achieve the release.
Dr Sandler introduced very interesting visceral technique when we were sending the vibration stimuli into the areas of adhesions of the structures in the pelvis and abdomen - VISCERAL THRUST - this really made a lot of difference it the way students felt.
Other techniques we learned today was diaphragm release in the seated position. I found it quite unpleasant having it done on myself perhaps due to extra abdominal fat and the way the technique was performed, by gathering the abdominal skin so the ulnar borders of the hand can access the area below the costal margin. Once hands are there, the patient gets from the position of leaning forward to leaning backward with upper body and head resting on the shoulder of the therapist, which separated the hands laterally, dragging the tissues of the diaphragm, and then with the palms of the hands compressing the lower ribs down to achieve the release.
26.2.2013 - Lecture no. 3 - TSp techniques of manipulation and soft tissue
Due to changes in the posture and breathing of the pregnant patient, there are many complains of the upper back pain and neck paint. Dr Sandler showed us seated techniques for releasing soft tissue of the trapezius, seated techniques for rib stretches, seated lift off (TSp HVT) and sidelyng HVT to the TSp. HVT techniques have to be delivered with certain modifications:
•Modifications include –No rotation techniques applied to the lumbar spine that can cause abdominal compression –Side bending techniques are better with a small “body drop” –Care with the shoulder and the pectoral girdle as you can cause an overstrain here –Minimal levers and specific very short and very crisp amplitude.
I personally find lift offs very difficult, as perhaps my own limits in the function of the spine and recurrent disc injury do not allow me to carry the technique well enough. I liked the idea o swinging of the patient's upper body once wound up in order to achieve the cavitation. Dr sandler done it on me and it felt amazing. I will have to practice these to achieve perfection as they feel so good!
•Modifications include –No rotation techniques applied to the lumbar spine that can cause abdominal compression –Side bending techniques are better with a small “body drop” –Care with the shoulder and the pectoral girdle as you can cause an overstrain here –Minimal levers and specific very short and very crisp amplitude.
I personally find lift offs very difficult, as perhaps my own limits in the function of the spine and recurrent disc injury do not allow me to carry the technique well enough. I liked the idea o swinging of the patient's upper body once wound up in order to achieve the cavitation. Dr sandler done it on me and it felt amazing. I will have to practice these to achieve perfection as they feel so good!
5.3.2013 - Lecture no. 4 - Cranio - sacral treatment and pubic symphasis assessment.
the pubic bone is palpated only anteriorly and superiorly by osteopaths. it is considered to be an intimate area by GOsC and thus consent for examination of the intimate area is needed to be signed. we palpate for any shifts between left and right innominate on the pubic symphasis. we are palpating for ◦Bone ◦Ligamentous tension ◦Fluid ◦The PRM.
We were shown how to palpate the cranio sacral rhythm with the patient side lying. I felt uncomfortable and could not pick up anything even though i usually very easily pick up rhythm.
We were shown how to palpate the cranio sacral rhythm with the patient side lying. I felt uncomfortable and could not pick up anything even though i usually very easily pick up rhythm.
19.3.2013 - Lecture no. 5 - Lumbar roll HVT and CSp HVT. Myofacial release of the mediastinum.
we were introduced into the slight modifications of the HVT techniques. first of all, the CSp seemed to be quite easty, also called nuts of the table :-) , where the table is quite low, the patients head flexed considerably, and the practitioner steps over to the side of the couch on which the aplicator is. then rotation and sidebend forces are added and HVT delivered as ususal, apart with higher rate of success (in my case).
Lumbar HVT: •Flexion is introduced down to the lesion again but not beyond the lesion. •Minimal rotation •The fingers are palpating the spinous processes to feel the response to the motion • the osteopath’s right arm is being used to stabilise the shoulder girdle whilst the left applies the thrust in rotation towards the pelvis. •The fingers of the right hand are employed in palpating the segment concerned
Myofascial release was very interesting, the idea of using the belt buckle area as the point from which the movement originates, was very helpful. the seated patient was moved with my hands over the front of the chest and on the top of the back (standing on patients right side) in all directions, only by listening to the fascial pull and ease. we were looking to find the point of ease in flexion/extension, sidebending, rotations, superior and inferior shift. once the point of the ease was found, 90 seconds of waiting for a heat to build up and fascial pull release was commenced.
Lumbar HVT: •Flexion is introduced down to the lesion again but not beyond the lesion. •Minimal rotation •The fingers are palpating the spinous processes to feel the response to the motion • the osteopath’s right arm is being used to stabilise the shoulder girdle whilst the left applies the thrust in rotation towards the pelvis. •The fingers of the right hand are employed in palpating the segment concerned
Myofascial release was very interesting, the idea of using the belt buckle area as the point from which the movement originates, was very helpful. the seated patient was moved with my hands over the front of the chest and on the top of the back (standing on patients right side) in all directions, only by listening to the fascial pull and ease. we were looking to find the point of ease in flexion/extension, sidebending, rotations, superior and inferior shift. once the point of the ease was found, 90 seconds of waiting for a heat to build up and fascial pull release was commenced.