Amidst my mountain of homework (which is surprisingly enjoyable as I truly love Osteopathy) I have managed to shake off a few cobwebs and get some writing motivation. As many people involved in this profession my mind never stops running especially where it relates to exploring the whys and hows of things. Language seems to be a major issue when attempting to understand anatomy as well as applying adjustive corrections to a body because it is easy to get lost in words when one should focus on the anatomy that is literally at hand. In this ramble I want to express some of my thoughts on articulation. So please stick with me!
Generally the term articulation brings about thoughts of loud pops in the world of physical manipulation. For some articulation means general manipulation of joints as well as restoring ideal function to joints. For myself, at the moment at least, articulation is taking on a larger scope. We all need to be aware of becoming “addicted to the crack” (ie the popping sounds of joint capsules during joint manipulations) and for myself this means creating movement without the absolute need for noise. Extending that to the thought that we are “adjusting soft and hard tissues to one another” I am now mulling over thoughts of adjusting soft tissue to soft tissue.
Let me back up for a moment and refer to the word “articulation” – in a general sense this refers to the action/manner/state of being interrelated. It is self-evident that all parts of the body are related to one another in some way. Considering that all parts are interrelated it would make sense that there may be a dis-articulation of any tissue with relation to any other tissue. This is where the “find it, fix it, leave it alone” mantra begins to mean something. I am finding that looking to areas of expected dysfunction often fails me and I need to find a different way to test the anatomy at hand. My understanding of anatomy is continuously evolving and as as such I am improving my ability to test different tissues as they articulate with one another. Understanding the peritoneal folds in the abdomen and pelvis with respect to the ligaments that are created which attach organs to one another as well as to bony or muscular structures (as in the quadratus lumborum or psoas forming the posterior abdominal wall or the lesser omentum creating the hepato-duodenal and hepato-gastric ligaments) is an example of utilizing varying connections to “articulate” with one another as well as how one may need to search for dysfuction.
One of the reasons these thoughts started to enter my mind was seeing a picture of the hypogastric plexus laying in front of the sacral promontory and how it looked like a spiderweb of ligamentous tissue. Further understanding tells us that nerves ARE connective tissue that, strangely enough, also contains fluid vessels (in the form of arteries, arterioles, capillaries, venules, veins…please correct me if I am wrong). As a form of connective tissue with fluid vessels inside of it that passes through the whole body from the central nervous system to the peripheral nervous system to CONNECT and ARTICULATE with all tissues it is essential that not only the fluid and pressure dynamics are correct to ensure proper nerve function, it is also essential to have tissues articulating properly with one another to create the ideal spaces for nerve function (this would mean nerve to tissue, tissue to tissue as in muscle to tendon to bone to ligament to bone…).
To make this point meaningful, it is important to recognize and understand the relationships between all tissues as dysfunction may exist at any level and then the effects will spread through related tissues on a mechanical/anatomical path as well as a physiological path. It should be noted that sticking with dry and linear anatomy may not be the end all be all, it may very well be necessary to use VERY long levers such as the left shoulder to lift the ileocecal junction as that may be the articulation that is displaying dysfunction. With any issue it is necessary to understand far reaching anatomical and physiological connections if one desires to help correct any issue someone may have.