I have confession to make as we start the New Year.
Well to be honest, I have several confessions to make, but the one I want to share with you now is that despite my breadth of current training as a family medicine physician, and desire to care for people at all stages of life, I feel God is strongly pulling me more and more towards the world of pediatrics.
Yep, kids, kids and more kids.
You’ve probably heard me say on the podcast before that while I do not have kids of my own, YET, I am drawn time and time again to the world of our youth and seek more than ever to nourish strong family dynamics and supportive relationships so that kids can flourish.
I have been fortunate to have found a couple incredible mentors when it comes exploring integrative and osteopathic principles within the scope of pediatric care: Greg Gelburd DO and Jef Groesbek DO. While by no means do I feel capable yet of fluently performing manual manipulations on my patients, the foundations of osteopathic medicine are rooted far beyond simply addressing skeletal alignment. Osteopathic medicine is foundationally whole person, whole mind, whole body care and is precisely the approach I seek when looking to identify root cause disturbances for my patient’s suffering.
In an effort to bring about more awareness to both osteopathic principles and a special population of courageous children: those with cerebral palsy, I wanted to share some insights and ideas that have been growing in me since my first experience in 2013 volunteering and participating in workshops with Ruth Goldeen, OT, an occupational therapist at the University of Virginia specializing in yoga and play for children with special needs (cognitive, emotional and physical).
Osteopathic Therapy for Cerebral Palsy
Osteopathic medicine is a field that not everyone understands but that provides an alternative or a supplement to traditional medicine. For children with cerebral palsy, there can be great benefits of working with these medical practitioners who focus on the musculoskeletal system, the part of the body that can commonly cause these children pain and mobility challenges. Ongoing research is proving that osteopathic therapy may be able to treat individuals with cerebral palsy to relieve pain, reduce spasticity in muscles, and improve mobility.
What is Osteopathy and Osteopathic Manipulation?
Osteopathy is practiced by a trained and licensed osteopathic doctor. These doctors have undergone all the same training as medical doctors (there is an incredible one in my current residency class; thanks David Clark DO!), but also have special training in approaching patients in a preventative and holistic way, using a gentle manipulation practice to the musculoskeletal system, called osteopathic manipulation therapy.
The idea behind this is that all the systems of the body and brain are connected and cannot be treated in isolation. By gently stretching, pulling, massaging and manipulating the muscles and joints, an osteopathic doctor can promote wellness and healing as well as bring relief to specific symptoms. This kind of work is most often used for musculoskeletal issues, like back pain or injuries.
Cerebral Palsy and the Musculoskeletal System
With this in mind, osteopathic therapies seem like the perfect match for someone with cerebral palsy. Cerebral palsy is a condition that is caused by brain damage but manifests in both neurologic and musculoskeletal symptoms. There are different types of CP and each individual has unique symptoms of varying degrees, but most children with this condition struggle with pain, mobility, muscle strength and tone, and muscle control. Treatments usually focus on using surgery, medications, and physical therapy to manage symptoms. But are there other options?
Can Children with Cerebral Palsy Benefit from Osteopathic Medicine?
Many parents turn to osteopathic doctors for an alternative or complementary treatment to help their children. Osteopathic doctors may use manipulation therapy throughout the body, on problem joints, on specific muscles, or on the neck and head. Research into how effective these manipulations are for children with cerebral palsy is limited, but there is some emerging evidence showing that it is likely very helpful.
In one study involving 55 children, those who received osteopathic manipulation therapy had better outcomes compared to a control group. They saw improved mobility and a greater ability to control their muscles. Another study proved that osteopathic manipulation could actually help improve constipation in children with cerebral palsy, a secondary symptom many struggle with and one that is well appreciated by clinicians like myself well versed in functional medicine and improving digestive health. While there aren’t many other studies currently evaluating this therapeutic technique for treating cerebral palsy, there is plenty of anecdotal evidence from individuals who have benefitted and plans for ongoing osteopathic and cerebral palsy research.
I am and will always be a proponent of evidenced informed and individualized care using the lowest risk/highest reward therapies available. Most importantly, these therapies must be alignment with the values of the patient and family, and osteopathic care certainly seems like a reasonable low risk therapy that could benefit many children with CP. It is important to note that parents of children with cerebral palsy find and work with licensed and trained osteopathic doctors with experience working with similar patients. While I am neither a DO or have significant experience caring for patients with CP, I have strongly believed it is my duty to seek out workshops and experiences beyond the scope of my current training such as those provided to me by Ruth Goldeen and the osteopathic curriculum in my residency program, to acquire knowledge so I can better treat and ultimately inform a child’s family and supportive medical team of any practices that may be helpful to their child.
In the end, we, as medical professionals should be able to work together to give a child the best possible outcomes.
We, together, best.
As I confessed in the beginning and I confessed within the paragraphs above, kids are my passion and I don’t yet have fluency in osteopathic manipulation, but I am learning every day thanks to my mentors in medical school and current residency training.
It is as I see it, precisely what the world and God is calling me to do.