Manipulative Techniques

Osteopathic manipulative medicine (abbreviated as OMM) is an approach to manual therapy, a form of therapy that uses physical contact, used to improve the impaired or altered function of the musculo-skeletal system (somatic dysfunction) and is a form of complementary medicine. With roots in ancient Greek "frictions", manual manipulation has long been a part of health care. In 1864, Andrew Taylor Still, M.D., D.O.[1], the founder of modern osteopathic medicine, became dissatisfied with traditional medicine's offerings after his father and 3 children died from meningitis. He began incorporating manual medicine into his existing medical practices with debatable success. As a military surgeon, Still established credibility for manual manipulation in certain situations sometimes achieving better outcomes than his peers.

List of Techniques
Some techniques used in OMM are:
 * Balanced ligamentous tension (BLT)
 * Counterstrain
 * Cranial osteopathy
 * High-velocity low-amplitude thrust (HVLAT)
 * Joint mobilization – articulatory techniques
 * Lymphatic pump
 * Muscle energy technique (MET)
 * Myofascial release
 * Neuromuscular therapy, trigger point therapy or myodysneuric point therapy
 * Soft tissue technique
 * Visceral manipulation

Published Studies
In the United States, its country of origin, OMM is used by Doctors of Osteopathic Medicine (D.O.s) along with surgery and medication in treatment of patients. Outside the United States, practitioners of osteopathy (who may have the qualification of D.O. as a Diploma of Osteopathy, but do not necessarily have the same medical training as an American-trained D.O.) generally limit their scope to manual manipulation.
 * 10.6% of 1,031 surgical patients had pre-existing C3-4 SD; of those, 4% had postoperative pulmonary complications if they received OMT compared to 85% of those who did not get OMT. (Henshaw, et.al. The DO. Sept. 1963)
 * Thoracic lymphatic pump (TLP) reduced mortality in 1918 influenza pandemic from 5% in general population to 0.25% of those getting OMT. (Smith,RK.JAOA 1920;172–3)
 * TLP is as effective as incentive spirometry in reducing postoperative atelectasis and gave earlier discharge and faster resumption of preoperative FEV1 and FVC. (Sleszynski & Kelso. JAOA 1993; 93; 834–5)

There are different techniques applied to the musculoskeletal system as OMM. These techniques can be applied to the joints, their surrounding soft tissues, muscles and fasciae.

Also, OMM is a treatment that is intended to be used in conjunction with mainstream treatments where it is deemed appropriate. It is rarely used as a primary treatment regimen unless the D.O. is absolutely certain that the patient's problems are a result of a musculoskeletal somatic dysfunction. Furthermore, as with other medical treatment methodologies, there are certain situations where use of OMM is strictly contraindicated (for example, cervical spine HVLA techniques may never be used on patients with Down Syndrome).[citation needed]

While this OMM practice is traditionally ascribed to D.O.'s, it should also be noted that there are M.D. practitioners of OMM since many Osteopathic medical schools have created training programs for their M.D. counterparts. Recently OMM training programs have likewise been extended to other medical professionals including, but not limited to: Physician Assistants, Nurse Practitioners, Nurses, etc.