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4838 E.Baseline Road
Suite 103
Mesa, AZ 85206
Tel: 480.926.8000

Osteopathic Manipulations

osteo-manOsteopathic Manipulative Therapy is used by Osteopathic physicians to treat musculoskeletal disease as well as to improve the body’s self-regulating systems.The main goal is to treat somatic dysfunction. Somatic dysfunction is defined as the impaired or altered function of related components of the body’s system including:

  • Skeletal,
  • Arthrodial
  • Myofascial structures
    • Related vascular
    • Lymphatic
    • Neural elements

The goal of therapy is to increase range of motion, decrease swelling and reduce pain. Some of the common techniques used are listed below:

Muscle Energy

Muscle energy techniques address somatic dysfunction through stretching and muscle contraction. For example, if a person is unable to fully raise her arm, the treating physician raises the patient’s arm near the end of the patient’s range of motion, also called the edge of the restrictive barrier. The patient then tries to lower her arm, while the physician provides resistance. This resistance against the patient’s motion allows for isometric contraction of the patient’s muscle. Once the patient relaxes, her range of motion increases slightly. The repetition of alternating cycles of contraction and subsequent relaxation help the treated muscle improve its range of motion.  Muscle energy techniques is not appropriate in patients with fractures, crush injuriesdislocationsjoint instability, severe muscle spasms or strains, severe osteoporosis, severe whiplash injury and recent surgery


Counterstrain is a system of diagnosis and treatment that considers the physical dysfunction to be a continuing, inappropriate strain reflex, which is inhibited during treatment by applying a position of mild strain in the direction exactly opposite to that of the reflex.  After a counterstrain point tender to palpation has been diagnosed, the identified tender point is treated by the osteopathic physician who, while monitoring the tender point, positions the patient such that the point is no longer tender to palpation. This position is held for ninety seconds and the patient is subsequently returned to her normal posture. Most often this position of ease is usually achieved by shortening the muscle of interest Improvement or resolution of the tenderness at the identified counterstrain point is the desired outcome. The use of counterstrain technique is not appropriate in patients with severe osteoporosis, pathology of the vertebral arteries, and in patients who are very ill or cannot voluntarily relax during the procedure.

High-velocity, low-amplitude

High velocity, low amplitude (HVLA) is a technique which employs a rapid, targeted, therapeutic force of brief duration that travels a short distance within the anatomic range of motion of a joint and engages the restrictive barrier in one or more places of motion to elicit release of restriction. The use of HVLA is not appropriate in patients with a fracture, history of a pathologic fractureosteomyelitis, osteoporosis, and severe cases of rheumatoid arthritis. HVLA should not be performed in patients with vascular disease such as aneurysms, or disease of the carotid arteries or vertebral arteries.  People taking ciprofloxacin or anticoagulants, or who have local metastases should not receive HVLA.

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