Let us not be so narrow minded to think that we as Osteopathic Students or Osteopathic Operators own manual therapy. Let us not be so narrow minded as to think we can not learn about our profession from sources that have nothing to do with manual therapeutics. What I will present below is two videos of a gentleman named Rickson Gracie (the most highly regarded and successful fighter from the Gracie Jiu-Jitsu family) displaying the importance and usefulness of intelligent application of leverage.
If you took the 25 minutes to watch both videos it should be apparent what minor differences in positioning, intent, and application of leverage can create in terms of self defense.
The lesson I want to share is not about self defense, it is about application of leverage. The application of leverage is a universal principle such that efficiency is possible, such that accomplishing tasks becomes easier, such that actually accomplishing a task is possible when faced with resistance. In manual therapeutics, especially in Osteopathy, it is imperative to understand functional anatomy to create changes in that very anatomy as it presents itself to you. The way to do this is to work with the way the anatomy moves by applying leverage and avoiding a direct fight. The reality of biological tissue is that it is alive! There is a real person on your table that has neurology and physiology that will react and respond in a generally predictable way. If you as an Operator impose your will on the patient they will fight without even trying, they will resist because they have an entire division of their nervous system devoted to doing so (the sympathetic system).
If you use leverage appropriately without turning on the natural fighting responses of your patient you can get the desired result quickly and without a lot of energy being expended. This means that a treatment does not need to take an hour. This means that a treatment does not to be highly repetitive. This means that a treatment is barely noticeable due to its brevity, gentleness, and respect of the living body on the table. This does not mean it is always 100% comfortable for the patient however it does mean that the discomfort is minimized as opposed to being attacked.
Interact with the neurology as it presents. If it is a sympathetic nervous system expression then make the appropriate choice just the same as if it is a parasympathetic expression. Interact with the soft tissue as it presents. If the soft tissue is hypertonic decide if it is a recent trauma, a mechanical stretch, or just how that patient is wired. It is of great benefit to go the way the tissue and the neurology like to go (aka indirect) before correcting it to a neutral mechanic through intelligent leverage. As in Brazilian Jiu-Jitsu, it is important to set up your submissions so that they actually work.