Mothers & Babies

Structural Imbalances Lead to Lifelong Problems

Melicien A. TettambelMelicien A. Tettambel, DO, deliv­ered this address on osteopathic manipulative treatment at the American Osteopathic Association’s first National Symposium on Women’s Health, which was held Nov 7-8, 1998, in Chica­go. Board certified in obstetrics and gyne­cology and in osteopathic manipulative medicine, Dr. Tettambel was the 1998-99 president of the American Academy of Osteopathy (AAO) and the 1993-94 president of the Illinois Association of Osteopathic Physicians and Surgeons. She served for five years as the chairman of the American Osteopathic Board of Special Proficiency in Osteopathic Manipulative Medicine.

OSTEOPATHIC MANIPULATIVE TREATMENT (OMT) is not a therapy. It is not an adjustment. It is not chiropractic.

Instead, it is a treatment modality in which osteopathic physicians, or DOs, use their hands to diagnose and treat problems with your musculo-
skeletal system.

In providing OMT, DOs are concerned not only with your bones. They also are concerned about what is attached to those bones, such as your muscles, your blood vessels, your nerves and your brain.

DOs integrate OMT into the full scope of medical practice. They use it in conjunction with medications, diagnostic procedures, and surgery.

Among those who benefit greatly from OMT are pregnant women and their fetuses. For these patients, OMT not only improves the course of pregnancy, but it also can have lifelong benefits.

Here are just a few ways in which DOs can use OMT to benefit mothers and their infants:

  • DOs can use OMT to address problems that pregnant women experience as their uteruses grow and displace other organs.

For example, as fetuses get larger,they place more and more pressure on their mothers’ bladders, causing frequent and uncomfortable urination. DOs can use their hands in a diag­nostic way to assess tension in the connective tissue of women’s abdomens.They then can provide OMT to reduce the tension and to ease fetuses slightly out of their mothers’ pelvises.

In addition, posture changes throughout pregnancy. This can lead to women having difficulty moving from standing to sitting positions and vice versa. It also can lead to excessive stress being exerted on the nervous system. With OMT, DOs can improve women’s postures by adjusting their body mechanics so that they work more effectively.

  • Through applying the principles behind OMT, DOs can help pregnant women to use their body mechanics effectively during delivery so that they reduce the amount of time they need to push.

Prolonged pushing can place pressure on the bladder, which will weaken the pelvic floor. The more children women have, the weaker their pelvic floor can become.

One consequence of weakening the pelvic floor is that for a long time after giving birth, women may leak urine whenever they cough or sneeze. Another consequence is that women may develop bladder and bowel problems as they reach menopause.

  • By providing OMT to pregnant women, DOs can reduce the maternal mechnical stress and strain to which infants are exposed as they are being delivered.

During birth, an infant changes from the shape of a basketball to that of a banana as he or she descends through the mother’s pelvis. The infant’s ability to rotate his or her body becomes restricted. The infant’s soft tissues accommodate the bony structure of the pelvis as the infant descends, and some body parts, such as the cranium, become collapsible and even telescopic.

The larger the infant is compared to the mother’s pelvis, the more difficulties the mother and infant are likely to encounter during delivery. If the mother’s pelvis is small and the baby is large, childbirth is like trying to pass a basketball through a funnel, whereas if the mother’s pelvis is large and the. baby is small, it is like trying to pass a basketball through a hoop.

By altering the stresses and strains of birth, OMT can improve the long-term neurologic development of .an infant. OMT also can help to prevent abnormal physical development related to how the infant reshaped his or her body to pass through the pelvis.

  • By providing OMT to women shortly after they give birth, DOs can correct structural and postural imbalances that result from biomechanical restrictions during delivery.

If, for example, a women’s feet were not placed evenly in stirrups during labor or if the woman was lying crooked on her bed to relieve pressure on her buttocks during labor, she might feel afterwards as if her buttocks were crooked, as if she could not stand up straight and as if she could not walk evenly.

Over time, structural imbalances created by restricted movement can lead to chronic pain in such areas as the buttocks, the sides and the shoulders.

By using OMT to correct these imbalances early, DOs can help to prevent back pain and other musculoskeletal problems from developing.

Applying the principles behind OMT involves more than just correcting structural imbalances. It also involves making sure that pregnant women have proper nutrition, proper rest and proper exercise. The goal is to make sure that women’s bodies function as physiologically normal as possible during pregnancy to reduce structural stresses and strains.