Explicit Leverage…

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We have done an overview of the concept of lever, wedge, screw previously. Here we take another look at the use of levers with discussion of short, long, and mixed leverage. The aim is to provide some examples of how these concepts look in action, especially in ways that may be semantically unclear.

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What Do They Look Like in Action?

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Here we display multiple concepts that have been previously demonstrated and discussed by using them through the arm. Some of the concepts include: contact is control, relational motion, long/short/mixed lever, working perpendicular to fiber direction, as well as working through soft tissue before moving joints.

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Old School: Seated Side Bending for Ribs

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Here we take a look at a description from “Osteopathic Mechanics” by Edythe Ashmore. The description centers on ribs however, as we show in the video, the basic hold (with some change) is useful for the vertebral column as well.

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Old School: Seated Thoracic Extension

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Here we demonstrate and discuss a method described in multiple places in old osteopathic literature, seated thoracic extension. This method allows for some brief discussion of patient positioning (the space between us is unstable, less table means I need to make the patient stable, and the anatomy should be exposed/free to move/preferably visible), contact is control, as well as the pros and cons of the method.

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From One Thing Know 1000…

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In the video below we utilize treating the scapula generally to highlight concepts of patient positioning, leverage, control, implicit learning, and explicit learning. The aim is to further discuss these concepts so that you, the consumer of this information, may have a greater understanding of the concepts in action.

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Cognitively Complicated…

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The active search for motion dysfunction in a presenting patient is one that may very easily become complicated. A patient arrives and provides their subjective symptoms and then a manual osteopathic practitioner has a need to identify the motion dysfunctions that a patient displays. There are a very large amount of motion tests that may be performed by manual osteopathic practitioners (see here for a book preview with examples) and this is the crux of the challenge we will discuss here…there are so many tests that it may be cognitively challenging to figure out what the heck to do.

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Know the Way Broadly…

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Here we demonstrate a method using the knee as a wedge/fulcrum for vertebral extension that is described in may early osteopathic books. The aim is not so much to demonstrate the method as it is often too strong with the amount of leverage that may be created, the aim is more to use the method to highlight overarching components that guide treatment. We identify lever/wedge/screw, palpation with something other than the hand (the knee in this case) while recognizing that it is not as sensitive as the hand, multisensory integration (keep your hands and eyes on the prize), as well as the use of implicit and explicit learning.

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