Technique of the Month Results: May 2020

Check out the RESULTS from the May 2020 Technique of the Month! We reviewed a technique classified by the demonstrator as Indirect or Functional Method.

What were respondents’ choices to classify the demonstrated technique?

  • Only 20 of 55 respondents (36%) indicated Indirect or Functional Method as their first choice for categorizing this technique. More respondents (27/55, 49%) indicated Balanced Ligamentous Tension or Ligamentous Articular Strain as their first choice.
  • Even when including second and third choices for categorizing this technique, only 65% (36/55) of respondents listed Indirect or Functional Method as one of their first 3 choices while 85% (47/55) indicated Balanced Ligamentous Tension or Ligamentous Articular Strain as one of their first 3 choices.

What did respondents say when they learned the technique demonstrator classified the technique as Indirect or Functional Method?

  • Respondents who Agreed with the Classification of the Demonstrated Technique (Indirect or Functional Method was one of their 3 choices)
    • Edna Lay taught this technique as BLT.
    • Please emphasize that the DO is introducing movement and, while this should be obvious, explicitly stating it helps the learner understand the process and connect the dots. First the doctor is careful to have the limb hang freely and then he shifts his chair to align himself and his midline with the midline of the limb then he begins to introduce movement. It must be stated explicitly so that the process is understood.
  • Respondents who Disagreed with Classification of the Demonstrated Technique (Indirect or Functional Method was not one of their 3 choices)
    • [As] far as I remember, I learned that technique once as a BLT-Technique and also in the video I heard ‘point’ and ‘balanced’. Anyway – I think, BLT und indirect method have much in common.
    • It seemed to me to be a more balanced ligamentous tension technique, I am not familiar with the term indirect functional method (until now), so I breezed right past that for an option.
    • Balanced, going with tissue motion

Did you miss your chance to review the May 2020 Technique of the Month video? Check it out and see whether you agree that the technique demonstrated falls into the category of Indirect or Functional Method.

Our thanks to Brian Degenhardt, DO, for demonstrating this Technique of the Month and to our volunteer patient, Zane Starks!

What do you think about the classification of this demonstrated technique as Indirect or Functional Method? Let’s talk about this below!

One thought on “Technique of the Month Results: May 2020”

  1. As demonstrator of the May Technique of the Month (TOM), the results may seem conflicting but in my opinion, they are not. The variability seen in the results illustrates overlapping of terminology and variation in training. So let me explain.

    As outlined in “A Teaching Guide in OMM,” second edition, ©2018, we see these two definitions:

    Ligamentous articular strain treatment – involves disengagement, exaggeration and taking the dysfunctional opposing ligaments to a point of balance

    Balanced ligamentous tension treatment method – Minimization of peri-articular tissue load and the placement of the affected ligaments in a position of equal tension in all appropriate planes so that the body’s inherent forces can resolve the somatic dysfunction

    Both labels have their origins in the time of Dr. Sutherland, and certainly define how the May Technique of the Month was performed and verbalized. Those definitions also support the rationale in DO-Touch.NET to combine those terms into one general category.

    Now if we look at the terms “Indirect/functional,” we find in DO-Touch.NET member Dr. David Eland’s chapter on Functional Technique in the fourth edition of the Foundations for Osteopathic Medicine (FOM) textbook, ©2018, that in the functional method, “diagnostic ease was readily converted into therapeutic motion that promoted ease, facilitating the return to “normal” or dynamic neutral.” In another section of this textbook, it was reported that “indirect, … , may be applied specifically to a joint …, does not engage the restrictive barrier, may include fascial or soft tissue loading or unloading … .” In the first edition of FOM, it defined indirect as the “moving of one bone or segment slightly in the direction away from the direction of correction (direction of the barrier) until the resistance of holding tissues and fluids is partially overcome and the tensions are bilaterally balanced allowing the release of ligaments and muscles.” It was in light of this background that the Indirect technique category was selected for the May’s TOM.

    I hope that these references indicate that the variation in results are not conflicting but illustrates variation is nomenclature used in our training. Clinically this probably has little relevance, but it has relevance as we try to scientifically interpret the data we collect from osteopathic practices around the world. Establishing consistently performed and labeled techniques within the network is the whole purpose of the Technique of the Month series and is critical for the rigor of our work.

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