Interview Questions for Osteopathic Manipulative Treatment (OMT) for Pre- and Post-Operative Care

Osteopathic Manipulative Treatment (OMT) is a system of hands-on diagnosis and treatment focusing on the musculoskeletal system and its impact on the entire body. It’s based on the principles of the body’s inherent ability to heal and the interconnectedness of its various systems. Key principles include:

• Body Unity: The body functions as an integrated whole, and problems in one area can affect others.
• Structure and Function Interrelation: Structure (bones, muscles, ligaments, etc.) and function (movement, circulation, nerve transmission) are intimately related. Problems with structure often lead to functional impairment, and vice versa.
• Self-Regulation and Healing: The body possesses inherent mechanisms for self-regulation and healing. OMT aims to remove barriers to this process.
• Role of the Nervous System: The nervous system plays a crucial role in coordinating body functions and responding to stress. OMT addresses neurological influences on musculoskeletal dysfunction.

Imagine a car engine – if one part malfunctions (like a restricted fuel line – analogous to a restricted joint), it affects the entire system. OMT aims to identify and correct these ‘malfunctioning parts’ to optimize overall performance.

In pre-operative care, OMT plays a vital role in optimizing patient health and preparing them for surgery. By addressing musculoskeletal restrictions, we improve tissue mobility, reduce pain, and enhance overall physiological function. This leads to better surgical outcomes and faster recovery.

For example, a patient scheduled for hip replacement surgery might have significant stiffness and pain in their back and pelvis. Pre-operative OMT could improve joint mobility, reduce muscle tension, and optimize respiratory function, leading to less strain during and after surgery.

OMT improves surgical outcomes in several ways. Firstly, improved tissue mobility reduces surgical stress and trauma. Secondly, optimized respiratory function helps prevent post-operative pulmonary complications, such as pneumonia or atelectasis. Thirdly, decreased pain and improved mobility facilitate faster post-operative recovery and reduce the risk of complications such as deep vein thrombosis (DVT) or infection due to increased mobility and reduced muscle strain. Finally, better pre-operative patient preparation contributes to better compliance and mental preparation for the surgery itself.

Think of it as ‘fine-tuning’ the body before surgery. By addressing underlying musculoskeletal issues, we create a more optimal environment for healing and recovery.

Specific OMT techniques used pre-operatively include:

• Articulatory techniques: Gentle, high-velocity, low-amplitude thrusts to restore joint mobility. These are particularly helpful for addressing joint restrictions in the spine and extremities.
• Soft tissue techniques: Massage-like techniques to release muscle tension and improve tissue extensibility. These address myofascial restrictions that contribute to pain and limited mobility.
• Myofascial release: Techniques to address restrictions in the connective tissue (fascia) that surrounds muscles and organs. This improves overall tissue elasticity and reduces pain.
• Respiratory techniques: Techniques to improve respiratory mechanics and lung capacity, preparing patients for the physiological stresses of surgery.

The choice of technique depends on the individual patient’s needs and the specific surgical procedure.

Post-operative OMT is crucial for managing pain, improving mobility, and facilitating overall recovery. Surgery often leads to inflammation, tissue trauma, and scar tissue formation which can restrict movement, leading to pain and impaired function. OMT helps to address these issues directly and promote healing.

For example, after abdominal surgery, patients often experience significant pain and stiffness. OMT can address restrictions in the abdominal wall, spine and surrounding tissues to improve mobility and alleviate pain, promoting faster return to functional activities.

Various OMT techniques are used to address post-operative pain. These include:

• Soft tissue techniques: Gentle massage and stretching to reduce muscle spasms and pain.
• Lymphatic techniques: Techniques to stimulate lymphatic drainage and reduce inflammation.
• Counterstrain: Positioning techniques that release muscle spasms and reduce pain.
• Cranial techniques: Gentle techniques applied to the skull to reduce tension in the craniosacral system and promote relaxation.

The specific techniques employed are carefully selected based on the patient’s condition and surgical site to avoid any compromise to the surgical area.

OMT facilitates post-operative recovery by addressing the physical limitations imposed by surgery. Improved mobility reduces pain, speeds up healing, and minimizes the risk of complications. By restoring normal joint mechanics and reducing scar tissue restrictions, OMT promotes functional restoration and a faster return to daily activities.

Imagine a puzzle: Surgery creates missing pieces and scattered pieces. OMT helps to put the pieces back together, restoring the functionality of the system. The result is a faster and more complete recovery with less pain and improved quality of life.

Contraindications for Osteopathic Manipulative Treatment (OMT) in the perioperative period are crucial to patient safety. They are broadly categorized into absolute and relative contraindications. Absolute contraindications mean OMT should absolutely be avoided, while relative contraindications indicate caution and careful consideration.

• Absolute Contraindications: These include conditions where OMT could directly cause harm. Examples include:
• Unstable fractures: Manipulating an area with an unstable fracture risks displacement.
• Active bleeding disorders: OMT may cause hematoma formation or worsen bleeding.
• Severe osteoporosis with high fracture risk: Manipulation could result in a fracture.
• Malignancy in the area of treatment: Manipulation may spread the cancer.
• Acute inflammatory conditions (e.g., septic arthritis): OMT could exacerbate the infection.
• Aneurysms in the area of treatment: Manipulation could rupture the aneurysm.
• Relative Contraindications: These require careful assessment and may allow OMT with modifications or after addressing the underlying issue. Examples include:
• Severe pain or tenderness: Treatment modifications, such as gentler techniques, may be necessary.
• Recent surgery in the area (within 4-6 weeks): Depends on the type of surgery and healing progress. Gentle techniques can often be used after consultation with the surgical team.
• Certain medications (e.g., anticoagulants): Close monitoring is needed to mitigate bleeding risk. Collaboration with the patient’s physician is vital.
• Pregnancy (especially in the later stages): Requires specialized techniques and consideration of the maternal-fetal health.
• Osteomyelitis: Acute or severe infection could be worsened.

Each patient’s condition must be thoroughly evaluated before proceeding with OMT. It’s always safer to err on the side of caution and postpone treatment if there are any concerns.

Assessing patient suitability for OMT involves a comprehensive evaluation combining subjective and objective findings. Before surgery, the focus is on identifying musculoskeletal restrictions that could negatively impact the procedure or recovery. After surgery, the goal is to assess the extent of post-operative healing and whether OMT can safely promote recovery.

Pre-operative assessment:

• Review medical history: Identify conditions that might contraindicate OMT (see Question 1).
• Physical examination: Assess joint mobility, muscle tension, and postural adaptations that may interfere with the surgical procedure or recovery.
• Patient interview: Understand the patient’s expectations and concerns regarding OMT.
• Imaging review (if available): Consider X-rays, CT scans, or MRIs to assess bony anatomy, soft tissue condition, and presence of any pathology.

Post-operative assessment:

• Review surgical report and post-operative notes: This reveals the specifics of the procedure, any complications, and the current healing status.
• Wound assessment: Ensure proper healing and lack of infection before initiating OMT.
• Physical examination: Assess range of motion, pain levels, muscle strength, and presence of scar tissue restrictions.
• Patient-reported outcome measures (PROMs): Assess pain, function, and overall quality of life to track progress.

The decision to use OMT always involves shared decision-making between the patient, the surgeon, and the osteopathic practitioner.

I have extensive experience integrating OMT into surgical care plans. For example, I worked with a patient undergoing a total hip replacement. Pre-operatively, we addressed restrictions in the lumbar spine and sacroiliac joints that could have limited post-operative mobility. Post-operatively, my interventions focused on reducing pain, improving range of motion in the hip joint and surrounding areas, managing scar tissue restrictions, and optimizing lymphatic drainage to reduce edema.

In another case, a patient recovering from abdominal surgery experienced significant respiratory dysfunction due to splinting. OMT techniques focusing on thoracic mobility and diaphragmatic breathing restored respiratory mechanics and improved overall comfort.

The integration of OMT is highly individualized, requiring careful consideration of the surgical procedure, the patient’s overall health, and their recovery timeline. Collaboration with the surgical team is paramount to ensure the plan is safe and effective. For instance, I would coordinate with the surgeon to ensure that OMT does not interfere with any surgical implants, incisions, or healing processes.

Collaboration with surgeons is crucial for successful integration of OMT into the perioperative care plan. This collaboration typically involves regular communication and information sharing.

• Pre-operative consultation: I discuss the patient’s case with the surgeon, highlighting potential benefits of OMT and addressing any contraindications.
• Shared decision-making: We jointly decide on the most appropriate OMT interventions based on the patient’s specific needs and the surgical procedure.
• Ongoing communication: We regularly communicate progress updates and any adjustments needed to the OMT plan based on the patient’s response to treatment and surgical recovery.
• Post-operative evaluation: I work with the surgeon to assess the patient’s progress and adjust the OMT plan accordingly. This often involves monitoring pain levels, range of motion, and functional outcomes.

Effective communication ensures that both the surgical and OMT interventions are complementary and work synergistically to optimize patient outcomes.

OMT addresses musculoskeletal restrictions that frequently impede surgical recovery. These restrictions can be a result of the surgery itself (e.g., scar tissue formation, muscle guarding, joint stiffness), pre-existing conditions (e.g., postural imbalances, prior injuries), or compensatory changes the body makes to adapt to pain.

Specific OMT techniques target these restrictions by:

• Improving joint mobility: Techniques such as articulation and muscle energy techniques restore joint movement and reduce stiffness, improving range of motion and function.
• Reducing muscle tension: Myofascial release, counterstrain, and other techniques address muscle spasms and guarding, reducing pain and improving mobility.
• Addressing scar tissue restrictions: Gentle mobilization and myofascial techniques help prevent the formation of excessive scar tissue and address restrictions caused by existing scar tissue.
• Improving lymphatic drainage: Techniques such as lymphatic pump improve lymphatic flow, reducing edema and promoting healing.
• Improving posture and biomechanics: Addressing postural imbalances and abnormal movement patterns optimize musculoskeletal alignment, minimizing strain and promoting better recovery.

By addressing these restrictions, OMT helps to reduce pain, improve function, and accelerate the recovery process.

Like any medical intervention, OMT carries potential risks and benefits in the perioperative period. It’s crucial to carefully weigh these factors for each patient.

Potential Risks:

• Increased pain or discomfort: Although rare, some patients may experience temporary pain or soreness after OMT.
• Injury: Although unlikely with proper assessment and technique, there is a small risk of injury if contraindications are not properly addressed.
• Worsening of underlying conditions: OMT might exacerbate certain conditions (such as infections) if not appropriately applied.

Potential Benefits:

• Reduced pain: OMT can effectively relieve musculoskeletal pain, improving comfort and reducing the need for analgesics.
• Improved joint mobility and function: Improved range of motion and function are essential for optimal recovery after surgery.
• Reduced edema and inflammation: Lymphatic drainage techniques reduce swelling and inflammation, promoting faster healing.
• Improved respiratory function: OMT can restore normal respiratory mechanics, crucial after abdominal or thoracic surgery.
• Faster rehabilitation and recovery: Addressing musculoskeletal restrictions allows patients to progress through rehabilitation more quickly.

A thorough risk-benefit analysis is critical before undertaking OMT in the perioperative setting. Open communication with the patient ensures informed consent and management of expectations.

Documentation of OMT treatments is vital for legal and clinical reasons. My approach focuses on clarity, completeness, and accuracy. I use a standardized format that includes the following information:

• Patient demographics: Name, date of birth, medical record number.
• Date and time of treatment: Precise record-keeping is essential.
• Reason for treatment: Clearly stated indication for OMT (e.g., post-operative pain, restricted joint mobility).
• Specific OMT techniques used: Detailed description of the techniques used (e.g., myofascial release to the pectoralis minor, thoracic pump). I use clear terminology understandable by other healthcare professionals.
• Patient’s response to treatment: Documentation of any changes in pain levels, range of motion, or other relevant parameters.
• Any complications or adverse events: Thorough documentation of any unexpected events during or after treatment.
• Plan for future treatments: Outline of any planned follow-up treatments.

I ensure all documentation is legible, readily accessible, and integrated into the patient’s overall medical record. This allows seamless communication among the entire healthcare team and provides a complete record of the patient’s care.

Measuring the effectiveness of OMT interventions requires a multi-faceted approach, combining objective and subjective measures. We don’t rely solely on patient-reported outcomes, although those are crucial. Instead, we use a combination of methods.

• Objective Measures: These include quantifiable data such as range of motion (ROM) measurements using a goniometer, before and after treatment. We also assess things like muscle strength testing (using a dynamometer), and functional assessments such as timed tests for walking speed or stair climbing. Changes in these objective measures provide strong evidence of improvement.
• Subjective Measures: We rely heavily on patient feedback using standardized questionnaires, such as the Oswestry Disability Index for back pain or the Neck Disability Index for neck pain. These questionnaires assess pain levels, functional limitations, and overall quality of life. We also conduct regular check-ins with patients to assess their perception of improvement.
• Visual Analog Scale (VAS): A simple yet effective tool. Patients mark a point on a 10cm line to indicate their pain level (0=no pain, 10=worst pain). Tracking changes on the VAS over time provides a clear picture of pain reduction.
• Combination of Measures: The most reliable approach is to combine objective and subjective measures. For instance, a patient might report reduced pain (VAS score improvement) and demonstrate increased ROM in their shoulder after OMT for post-surgical stiffness. This combination provides a much more comprehensive understanding of treatment efficacy.

Ultimately, the goal is to demonstrate a clinically significant improvement in the patient’s condition, not just statistical significance. We always consider the individual’s functional improvements and overall well-being when evaluating success.

OMT in surgical patients presents unique challenges. The patient’s overall health status and the nature of the surgery significantly influence the approach. Some common challenges include:

• Post-operative Pain and Swelling: Pain and inflammation can limit the effectiveness of OMT techniques and make manipulation uncomfortable. Careful consideration is needed to adapt techniques to minimize discomfort.
• Surgical Incisions and Wound Healing: The presence of recent incisions necessitates extreme caution to avoid disrupting the healing process. We modify techniques to avoid direct pressure on the incision site and surrounding tissues.
• Medication Side Effects: Post-operative medications, such as analgesics and anesthetics, can affect muscle tone, coordination, and potentially the patient’s tolerance to OMT. We must carefully assess these effects and adjust our treatment accordingly.
• Patient Fragility and General Health: Surgical patients may have underlying health conditions or reduced physiological reserves. This necessitates a more cautious and individualized approach to ensure patient safety.
• Scar Tissue Formation: Scar tissue formation can restrict joint mobility and cause pain. Addressing scar tissue requires specific OMT techniques and careful assessment of its impact on surrounding structures.

Overcoming these challenges requires a thorough understanding of the patient’s surgical procedure, their medical history, and their current physiological state. Collaboration with the surgical team is crucial for safe and effective OMT integration.

Adapting OMT techniques based on age and medical history is paramount. Children, adults, and elderly individuals respond differently to treatment due to variations in tissue elasticity, bone density, and overall physiological capacity.

• Pediatrics: OMT for infants and children involves gentler, more passive techniques. The focus is often on facilitating cranial movement, improving lymphatic drainage, and addressing musculoskeletal restrictions that might hinder development. Techniques are adapted based on the child’s developmental stage and any underlying medical conditions.
• Adults: Adult patients typically tolerate a wider range of OMT techniques. The treatment strategy depends on the specific condition, the patient’s fitness level, and their pain tolerance. However, a cautious and personalized approach is still vital.
• Geriatrics: Older adults may have age-related changes like decreased bone density, reduced joint mobility, and increased fragility. OMT for the elderly requires careful consideration of these factors. We might use gentler, lower-force techniques and pay close attention to the patient’s response to treatment.
• Medical History: Conditions such as osteoporosis, arthritis, or previous fractures significantly impact the selection of OMT techniques. For example, direct high-velocity, low-amplitude thrust techniques might be contraindicated in patients with osteoporosis.

A thorough assessment of the patient’s individual needs and limitations is the cornerstone of safe and effective OMT treatment regardless of age. Careful communication and collaboration with the patient are essential throughout the process.

Respiratory complications after surgery, such as atelectasis (lung collapse) or pneumonia, are serious concerns. OMT plays a valuable role in improving respiratory function by addressing musculoskeletal restrictions that can impair breathing mechanics.

• Thoracic Pump: OMT techniques can enhance the movement of the rib cage and diaphragm, improving lung expansion and reducing atelectasis. Gentle mobilization of the ribs and thoracic spine helps to restore optimal respiratory mechanics.
• Diaphragmatic Mobilization: The diaphragm’s function is crucial for effective breathing. OMT techniques can address restrictions in the diaphragm, improving its ability to contract and expand during respiration.
• Lymphatic Drainage: OMT can stimulate lymphatic drainage, helping to remove fluid buildup in the lungs and reduce inflammation. This can be particularly beneficial in preventing and managing post-surgical pneumonia.
• Craniosacral Techniques: Gentle cranial techniques can facilitate the movement of cerebrospinal fluid, promoting improved circulation and overall respiratory function.

By addressing these musculoskeletal limitations, OMT can help patients breathe more easily, reducing the risk of respiratory complications and accelerating recovery. It’s important to note that OMT should be considered as an adjunct therapy and not a replacement for conventional medical respiratory management.

Scar tissue, a natural part of the healing process, can cause significant restrictions in mobility and pain if it becomes excessively dense or adhered to underlying tissues. OMT plays a critical role in managing post-surgical scar tissue.

• Soft Tissue Mobilization: Specific techniques are used to break down adhesions within the scar tissue and improve its pliability. This may involve gentle stretching and massage to the scar tissue itself and surrounding areas.
• Myofascial Release: This technique targets the fascia, the connective tissue surrounding muscles and organs, to release tension and improve mobility in the affected area. It can effectively address restrictions caused by scar tissue that has adhered to the fascia.
• Joint Mobilization: If scar tissue restricts joint movement, OMT can help restore normal range of motion through gentle joint mobilization techniques. This helps to regain full functionality.
• Early Intervention: Early initiation of OMT, when appropriate, can prevent excessive scar tissue formation and reduce the likelihood of long-term restrictions.

The goal of OMT in managing scar tissue is to promote healthy scar tissue remodeling, reduce pain, restore mobility, and prevent long-term dysfunction. The success of this approach depends on appropriate timing, appropriate technique selection, and integration with other therapeutic approaches such as physical therapy.

Addressing patient concerns and anxieties about OMT is vital for establishing trust and ensuring a positive treatment experience. Open communication is key.

• Education: Thoroughly explain the process, the rationale behind the techniques, and the expected outcomes. Use simple language and avoid unnecessary jargon. Answer all questions honestly and patiently.
• Demonstration: Before starting treatment, demonstrate the techniques on a less sensitive area, such as the arm or leg, to allow the patient to experience the treatment and feel comfortable.
• Active Listening: Listen attentively to the patient’s concerns, acknowledging their feelings and validating their anxieties. This helps to build rapport and trust.
• Collaboration: Work with the patient to create a personalized treatment plan that respects their preferences and comfort level. Adjust techniques as needed throughout the session based on their feedback.
• Pain Management: Assure the patient that the goal of OMT is not to inflict pain but rather to gently restore function and relieve existing discomfort. Use appropriate pain-management strategies, such as breathing techniques or relaxation methods.

By creating a safe and supportive environment, building a strong therapeutic alliance, and actively addressing concerns, we enhance the effectiveness of OMT and improve patient outcomes. Positive communication ensures patient satisfaction and compliance.

Osteopathic Manipulative Treatment (OMT) encompasses a wide range of techniques, broadly categorized as direct and indirect.

• Direct Techniques: These techniques involve applying a force directly into the restriction, aiming to actively break up adhesions and restore normal joint motion. Examples include high-velocity, low-amplitude (HVLA) thrusts, muscle energy techniques (MET), and articulation. In the perioperative setting, direct techniques may be cautiously applied once the surgical site has adequately healed and the patient is deemed stable. For example, after a shoulder surgery, gentle articulation techniques could address stiffness in the surrounding joints.
• Indirect Techniques: These techniques involve positioning the patient’s body or joint in a way that encourages the tissues to release tension and improve mobility passively, without forceful manipulation. Examples include counterstrain, facilitated positional release, and myofascial release. Indirect techniques are often preferred in the early post-operative phase due to their gentler nature and suitability for patients with pain, inflammation, or fragility. For instance, counterstrain techniques could effectively address muscle spasms after abdominal surgery.

The choice between direct and indirect techniques depends on several factors, including the patient’s condition, the stage of recovery, the presence of pain or inflammation, and the specific area being treated. A skilled osteopathic physician will select the most appropriate techniques to maximize effectiveness while ensuring patient comfort and safety.

Osteopathic Manipulative Treatment (OMT) works synergistically with other modalities, enhancing overall patient care. It’s not a standalone treatment but rather a crucial component of a holistic approach. For instance, in pre-operative care, OMT might be used to improve joint mobility and reduce muscle tension, preparing the patient for surgery. Post-operatively, it can help manage pain, reduce scar tissue restriction, and improve lymphatic drainage, complementing physiotherapy which focuses on strengthening and regaining range of motion. Medication, particularly pain relievers, can be used alongside OMT to manage acute pain while the OMT addresses the underlying musculoskeletal dysfunction. The integration is crucial for a well-rounded recovery.

Example: A patient scheduled for hip replacement surgery might receive OMT pre-operatively to improve lumbar spine mobility and pelvic alignment, thus optimizing surgical positioning and potentially reducing post-operative pain. Post-operatively, OMT could be combined with physiotherapy to address stiffness and improve functional mobility, while pain medication manages discomfort during the initial healing phase. The combined approach ensures faster and more complete recovery.

Managing adverse effects after OMT requires a calm and systematic approach. Adverse effects are rare, but can include temporary muscle soreness, fatigue, or headache. The first step involves careful listening to the patient and documenting their symptoms thoroughly. We need to differentiate between normal post-treatment soreness and a genuine adverse reaction. If the symptoms are mild, we might advise rest, hydration, and over-the-counter pain relief. However, if the symptoms are severe or persist, immediate action is necessary. This might involve reducing the intensity of subsequent treatments, adjusting the treatment plan, referring the patient to other specialists if needed (e.g., physician, neurologist), or completely ceasing OMT if symptoms are concerning. Open communication and a collaborative approach with the patient is paramount to address any concerns and ensure patient safety.

Example: If a patient experiences significant headache following treatment focused on the cervical spine, I would first ascertain the nature, intensity, and location of the headache. Mild, short-lived headaches might be managed with rest and hydration advice. However, a severe or persistent headache might necessitate a referral to rule out other underlying issues and possibly discontinue treatment until the cause is identified.

A growing body of research supports the use of OMT in pre- and post-operative care. Studies have demonstrated OMT’s effectiveness in improving respiratory function after abdominal surgery, reducing post-operative pain, and improving functional outcomes after various orthopedic procedures. For instance, research shows that OMT can help reduce the need for opioid analgesics post-operatively, a significant advantage given the opioid crisis. There’s evidence that OMT can also improve lymphatic drainage, reducing swelling and facilitating faster wound healing. The research methodology varies, encompassing randomized controlled trials, cohort studies, and case series. While more high-quality research is always needed, the existing literature provides promising support for the integration of OMT into surgical care pathways.

Example: Studies have shown that OMT techniques applied pre-operatively to improve thoracic mobility can lead to improved pulmonary function and reduced post-operative atelectasis (lung collapse) in patients undergoing thoracic or abdominal surgery.

Staying updated in the rapidly evolving field of OMT involves a multi-pronged approach. I regularly attend continuing medical education (CME) courses and workshops offered by reputable organizations like the American Osteopathic Association (AOA). I actively participate in professional societies, attending conferences and engaging in discussions with colleagues. I subscribe to relevant peer-reviewed journals and online databases (e.g., PubMed, MEDLINE) to stay abreast of the latest research findings. Mentorship with experienced OMT practitioners also provides valuable insights and practical guidance. Continuing education is not just about acquiring new techniques but also refining existing skills and understanding new perspectives.

Strengths: My strengths lie in my ability to perform a comprehensive musculoskeletal evaluation, accurately diagnose somatic dysfunction, and tailor OMT treatment plans to individual patient needs. I’m proficient in a wide range of OMT techniques, from cranial manipulation to myofascial release. I excel at building rapport with patients, fostering trust and effective communication. My strong anatomical knowledge forms a solid foundation for my clinical practice.

Weaknesses: Like any skilled practitioner, there are areas for continuous improvement. I am constantly working on refining my skills in complex cases involving neurological or visceral involvement. While I am proficient in many techniques, I am continually seeking to expand my expertise in specific areas, such as pediatric or geriatric OMT.

My preferred method of patient education is a collaborative and personalized approach. I begin by explaining the principles of OMT in simple terms, avoiding jargon whenever possible. I use anatomical models and diagrams to visualize the areas being treated and explain how the treatment works. I encourage patients to ask questions and actively participate in their care. I also provide written materials, such as handouts or links to reputable online resources, to reinforce the information discussed. Post-treatment, I follow-up to ensure they understand what to expect and how to manage any potential discomfort.

Example: When explaining a treatment focused on the thoracic spine, I might use a model to show the ribs and their articulation with the vertebrae, demonstrating how restricted movement can impact breathing. The goal is for patients to feel empowered and informed about their treatment.

I once encountered a patient scheduled for a laparoscopic cholecystectomy (gallbladder removal) who presented with significant pre-operative anxiety and a history of hyperventilation syndrome. My initial treatment plan focused on addressing musculoskeletal restrictions impacting respiration. However, during the treatment session, the patient experienced heightened anxiety and hyperventilation. I immediately adapted my approach, shifting from direct techniques to gentler, more calming techniques such as energy-based work and mindfulness exercises. I collaborated with the patient and the anesthesiologist to adjust the pre-operative management plan, incorporating relaxation techniques into the preparation. The patient ultimately experienced a smoother surgical experience and reported less post-operative pain and anxiety. This experience underscored the importance of flexibility and responsiveness in adapting treatment approaches based on a patient’s individual needs and response to treatment.