MANUAL THERAPY

GOOD VIBRATIONS? By Prof. Eyal Lederman DO, PhD

INTRODUCTION Oscillatory or harmonic-like techniques are commonly used in osteopathy and are also found in many other manual disciplines including shiatsu, Trager method and pulsing. However the clini- cal application of this technique has not yet been fully investi- gated. I have been involved in research and development of the harmonic technique since 1989, starting with a research project at the British School of Osteopathy and later evolving into a doc- toral project in collaboration with the Kings College Physiotherapy Department and The Centre for Professional Development in Osteopathy and Manual Therapy (1,2,3). The outcome of these studies identified the physical effects of the techniques on tissue and resulted in the expansion of a new tool set represented by the harmonic approach.

The body is a frame connected by a series of elastic spring-like structures. When a physical force is applied to different areas of the body they start to rock rhythmically, displaying distinct natural frequencies (also termed resonant frequencies) (1). In physics this form of oscillation is known as harmonic motion. In the the harmonic technique (HT), the therapist induces distinct patterns of oscillation in different areas of the patient’s body. These oscilla- tions are different from rhythmic motion seen during rhythmic articulation. During HT the therapist ‘tunes-in’ to the patient’s own natural frequencies, whereas in rhythmic techniques the frequency of oscillation is imposed on the patient. A recent study by Waugh (4) has confirmed that the pelvic oscillation seen during HT is indeed harmonic in nature with a resonant frequency of 1.15 Hz.

At a glance the difference between harmonic and rhythmic techniques may seem minor, however significantly less energy is required in order to maintain movement when the body is oscillating in its natural frequency than when imposing an unnatural frequency. This means that the practitioner is able to apply the harmonic technique for a continuous period without becoming tired but would quickly become exhausted if attempting to apply the same repetition of movement using rhythmic techniques. Where the goal is to assist in repair, the process seems to be most effective when the movement is repeated over several hundred cycles. For example, in treating a frozen shoulder, the glenohumeral joint is oscillated for almost 30 minutes (about 1000-1500 cycles). Personal observations have

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Increasingly over the last few decades, evidence has accumu- lated to show that movement plays an important part in the tissue repair and adaptation process. As a result the way in which we treat our patients with musculoskeletal problems has also changed. In osteopathy there has been a particular drive to develop manual movement approaches that can com- plement the body’s own repair and adaptation process. This has resulted in the development of a group of osteopathic techniques which involve rhythmic, passive oscillation in joints and tissues and have become known as the harmonic technique.

This article describes the evolution of this tech-

nique, the clinical evidence for its effectiveness and some examples of the application of these skills.

revealed that this can reduce the period of the acute pain phase significantly. This number of repetitions would be difficult to achieve by other rhythmic techniques.

THERAPEUTIC EFFECT OF THE HARMONIC TECHNIQUE The potential effect of HT on different body processes can be explored using the dimensional model of osteopathy (1,5). In this model the effects of any manual technique can be seen to occur in three different body dimensions: 1) tissue (physical dimension) 2) neurological (also neuromuscular) 3) psychological (6).

Tissue dimension Over the last 20 years, research has demonstrated that movement optimises tissue repair following injury and that passive motion can

GOOD VIBRATIONS? HARMONIC TECHNIQUE –

GOOD VIBRATIONS?

sportEX dynamics 2007;12(Apr):16-19