Articulatory technique

Articulatory technique is a type of Osteopathic Manipulative Treatment (OMT) performed by osteopathic practitioners and U.S. trained osteopathic physicians. The physician uses low velocity and moderate to high amplitude forces to carry a dysfunctional joint through its full range of motion, with the therapeutic goal of increasing range of motion.^[1] Usually this requires multiple repetitions of engaging the motion restriction, easing off slightly and re-engaging the motion restriction in an articulatory fashion.

Pathophysiology of joint dysfunction

The central nervous system has the ability to excite or inhibit most of the tissues throughout the body. Increased activity within alpha motor neurons can cause increased muscle contraction. The longer the tissues remain in this hyperactive state, the greater the chance of somatic dysfunction occurring. The current hypotheses state that the more nerves remain in a facilitated state, the more prone they are to lead to soft tissue stiffness, contracture and pain.

Mechanism of action for articulatory techniques

In a general sense, articulatory techniques use repetitive springing motions or repetitive concentric movements of a joint through a restrictive barrier. The intent is to improve the overall range of motion by repetitiously changing the position of the restrictive barrier.

Specifically, articulatory techniques introduce physiologic movement into a joint space. Movement disrupts stiffness and contractures while decreasing the degree of facilitation in the joint. In addition, serotonin and noradrenaline levels have been shown to increase in response to OMT which results in the patient experiencing less pain.

Indications and contraindications

Articulatory techniques are useful in stretching restricted muscles, ligaments and capsules. Since the motions involved are slow and deliberate, physicians can easily monitor the patient's response to the treatment.

Absolute contraindications include patient refusal, open wounds, fractures, tendon avulsions, severe osteoporosis and metastatic disease. Patients taking anticoagulants, joint hypermobility and osteopenia should be given special consideration before articulatory techniques are employed.

Techniques

Articulatory techniques are just one example of osteopathic manipulative treatment. These techniques may be useful in the elderly, hospitalized patients and in preparation for other treatment modalities such as HVLA.

References

↑ "Glossary of Osteopathic Terminology" (PDF). American Association of Colleges of Osteopathic Medicine. April 2009. p. 28. Retrieved 25 August 2012.

Additional sources

Updated by Western University of Health Sciences/COMP OMM Department

Ward, Robert C. (2002). Foundations for osteopathic medicine (2nd ed.). Philadelphia: Lippincott Williams & Wilkins. ISBN 0-7817-3497-5.
Patriquin, DA (September 1992). "The evolution of osteopathic manipulative technique: the Spencer technique.". The Journal of the American Osteopathic Association. 92 (9): 1134–6, 1139–46. PMID 1429074.
Skyba, D.A; Radhakrishnan, R; Rohlwing, J.J; Wright, A; Sluka, K.A (November 2003). "Joint manipulation reduces hyperalgesia by activation of monoamine receptors but not opioid or GABA receptors in the spinal cord". Pain. 106 (1-2): 159–168. doi:10.1016/S0304-3959(03)00320-8. PMC 2732015. PMID 14581123. |access-date= requires |url= (help)

Osteopathic medicine (ICD-10-PCS 7)

General	Osteopathic medicine in the United States Osteopathic medicine in Canada

Treatments	Articulatory technique Balanced ligamentous tension Chapman reflex points Counterstrain Cranial Lymphatic pump Muscle energy technique Myofascial release Paraspinal inhibition Soft tissue technique Somatic dysfunction

Education	List of osteopathic medical schools Doctor of Osteopathic Medicine Accrediting Commission

Licensing	COMLEX NBOME

Organizations	AOA COA AACOM Student Council Specialty Boards Specialty colleges Directors and Medical Educators American Academy of Osteopathy

People	List of osteopathic physicians Andrew Taylor Still S. S. Still

Media	The DO The Journal of the American Osteopathic Association Osteopathic Family Physician

History	History California merger Flexner Report

Osteopathic medicine

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