Indications for osteopathic treatment

Association of Osteopaths Germany e.V. - Press Release 2008 

Adelheid Wünsch D.O. is an osteopath with her own practice in Herrsching am Ammersee. Her specialty is the osteopathic treatment of pregnant women 

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Why should pregnant women be treated osteopathically? 

It is essentially about two things: to make the expectant mother as comfortable as possible during pregnancy and to ensure that the child is well supplied with nutrients and has enough space to grow. 

How do you go about it? 

You can divide a pregnancy into three equal-length sections, trimesters. Each of these trimesters has its own focus. Therefore, it is advisable to examine pregnant women osteopathically once per trimester and then treat if necessary. 

What happens in the first trimester? 

In the first trimester, cell division takes place and the individual organs of the growing child are formed. The body of the expectant mother adjusts to the pregnancy and later birth. Hormones cause all tissues to become soft. This "becoming soft and flexible" of all structures can be supported osteopathically. This is especially important when blockages are present, for example due to a caesarean section, but also an appendectomy scar or the consequences of a laparoscopy can block structures, as can falls on the pelvis, blockages of the spine or the rib joints.
So in the first trimester, the main concern is to check and, if necessary, restore the mobility of the mother's outer shell, i.e. pelvis, muscles, joints, etc. 

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There is another point why osteopathy is recommended. During a normal pregnancy, the mother should not take any medication if possible. But what should a pregnant woman do, for example, with headaches or migraines? Here, osteopathy can definitely help and prevent the pregnant woman from having to take painkillers, for example. 

What about the pregnancy-related nausea? 

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Unfortunately, this can hardly be treated osteopathically! 

What happens in the second trimester? 

Now the baby is growing significantly. First-time mothers sometimes only now realize that they are pregnant. Due to the growing child, the mother's statics change and the tissues continue to soften. As a result dysfunctions that may have existed for years can now no longer be compensated for and cause discomfort for the first time. 

I observe again and again that children lower themselves too early, i.e. lie stable in cranial position well before the 30th week of pregnancy. The head is then already in the mother's pelvis. The child can no longer move as a whole, but only "wriggles". After birth, such children often show blockages in the upper cervical vertebrae and skull asymmetries. Reasons can be problems in the upper abdominal area or a blocked diaphragm of the mother. This pushes the baby down and slightly forward, taking away the space for the baby to move freely.
A blocked diaphragm can usually be treated very well osteopathically and frees the child from its too-early cranial position and the mother not infrequently from heartburn, a common accompaniment to pregnancy. 

In osteopathic terms, the second trimester is essentially about keeping the uterus mobile and balancing the changing static. 

What happens in the last three months of pregnancy? 

The now significantly changing statics can increasingly cause problems and lead, for example, to sciatica. In addition, the tissue of the expectant mother now tends to water retention in the arms and legs. This can lead to numbness in the hands, for example. In the case of the arms, the reason may be the increasing size of the breasts. With its increasing weight, it makes the lymph drainage in the chest and head area more difficult, and the tissue, which has less tension, contributes its share. A lymphatic drainage or even osteopathy can help here. 

If water collects in the legs, then often the child lies deep in the pelvis and prevents so that the lymph can drain well.
. Varicose veins can also develop in this way. Then the child lies more on one side above the affected leg and interferes with venous return. By the way, hemorrhoids and vaginal varices can also develop in this way. Affected women talk about such problems understandably reluctantly, yet an osteopath, by, among other things, carefully pushing the child a little further up from the outside, can alleviate such discomfort. 

But it also happens that a child does not lower itself into the birthing position? 

Right. Then you have to investigate what the reason is. Is about the psoas muscle hardened? This runs from the lumbar spine, to which it is attached laterally, longitudinally through the abdominal cavity down to the inside of the thigh bones. If the muscle is too tight, it pushes the child forward and takes up the space needed to lower it. 

The more a child matures, the more often he will kick his little feet or box his little hands. To the extent that the mother has dysfunction, the child protects this area. And it does so by turning its back towards that area. So if a child does not lower himself and instead leans with his back against the mother's liver, for example, it may mean that the mother's liver is not functioning in the best possible way and definitely cannot take kicks or punches. 

Summarizing, the third trimester is all about the baby keeping its mobility in utero. 

Can an osteopath also prepare the birth itself? 

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Sure. For example, for a complication-free birth in the cranial position, the centering of the child is very important. This means that the child's head must rest centrally on the inner mother's mouth and gradually open it. Otherwise, the contractions will push the baby down, but it will be much more difficult for the head to find its way through the cervix and the baby will be compressed. Here, vaginal labor can be used and the baby can usually be centered without any problems. 

What happens osteopathically after the birth? 

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As far as the birth has proceeded normally and mother and child are doing well, an osteopathic examination is recommended about three to six weeks after the birth. 

What is examined? 

In the case of the mother, the aim is twofold: to resolve the consequences of the birth, such as blockages in the pelvis and spine. Cuts, tears, the use of forceps or suction cup, but also to minimize or eliminate incontinence or pain during sexual intercourse and to support the organism in the regression of pregnancy-related changes.
. However, the body can only complete this regression when the mother is no longer fully breastfeeding her child, i.e. about six months after birth. Until then, the tissue is still very soft, the uterus must regress and the statics readjust. Mothers should therefore not engage in intensive sports during this time, because they are exercising into their soft tissue. However, postnatal gymnastics is highly recommended. After the six months, a final osteopathic examination is recommended. 

And what is examined in the child? 

Here the osteopath will check reflexes, movement behavior and posture. Does the baby drink well, sleep well, how is the bowel movement, can the mother put the child down or must she always carry it with her? These can then be indications of a possible disorder. 

The osteopath checks in particular the pelvis, spine, cervical spine and the skull with its sutures and fontanelles. Did it suffer sprains or strains during birth, or does the child show discomfort that arose during pregnancy, for example, due to lack of space? The earlier we osteopaths can detect and treat possible complaints, the better we can help to ensure that no serious problems arise for the child from them later. 

Mrs. Wünsch, thank you very much for the interview!