Collagen Changes of Aging, A Classic Tale

Today marks the completion of my 4-week long OMT (Osteopathic Manipulative Therapy) rotation. One of the most laid-back rotations, my hours were similar to bank hours. I arrived at 9:30am and departed anywhere from 5 to 6pm. The patient load was relatively light and we would see 5-8 patients/day with each encounter lasting a minimum of 30 minutes to max 1+ hours. The doctor I worked can best be described as a 65 yo version of Ryah (y’all know him – 6’3″, talks with hands, and may or may not be a conspiracy theorist). Regardless, he was enjoyable to work with.

To get a sense of what OMT looks like in the private, outpatient clinic setting, imagine that all of your patients have Low Back Pain (LBP) and they have sought out EVERY other treatment but OMT. They have had multiple steroid injections, multiple MRIs (usually showing no change between injections), and even visits to the ER due to excessive and unrelenting LBP. They’ve been on every name brand pain-killer you can imagine and are now on Fentanyl and a handful of muscle relaxants from varying doctors. This is the classic, and worst case scenario, LBP patient that we encountered. Objectively, on PE, you have definite findings in this patient and know of several stretches (yes, stretches!) that can promote healing, but they are resistant to physical activity. One of these patients looked at me sardonically and said, “all he wants me to do is stretch?”  To which I said, “well, sounds like nothing else has helped” with a smile. Though it sounds mundane, elementary, and completely unsophisticated given how technologically advanced our society has become, many of the treatments we recommended were simply stretching and increasing physical activity. Many people take for granted their body’s ability to heal if it’s given the chance. There were a handful of patients that came through with LBP causing nerve pain/impingement and these patients were recommended steroid injections and sometimes (rarely) surgery. The Osteopathic Model truly promotes the body’s ability to heal itself if given the proper tools with which to do so and this is what we worked towards on each patient. Stretches, physical activity, and maintaining a healthy body weight are essential in allowing your body to absorb the physical stressors that we deal with daily.

We also had several patients with LBP due to Sacral Base Unleveling and Femoral Height discrepancies that were fitted for shoe/heel lifts. This doctor I worked with would customize shoe lifts in his office for his patients; he would have them bring in up to 3 pairs of shoes (plus indoor slippers) and he’d go into his work space, use his scalpel, and cut out a carbon copied shoe insert and stuck it into each shoe appropriately. Amazon can’t even do that!

Overall this was a pretty solid rotation and now I’m off to get some ice cream.


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