15 Old Perth Rd, Bassendean WA 6255
For an appointment in Bassendean please telephone: 9279 1805
92 Blechynden Street, Bridgetown, WA 6255
For an appointment in Bridgetown please telephone: 9761 4558
The first visit includes a case history, examination and treatment, takes 40 minutes and costs $120. At the end of this visit the patient is given a treatment plan and some idea of the total length of the treatment. Follow up visits are 30 minutes and cost $100.
I aim to fix your problem in the shortest time and most effective way possible. On average it takes 3 visits to fix one problem but if there are several problems or the problem is complex then it may take longer. The number of treatments needed depends on how long you have had the problem, how severe it is, and your body’s ability to respond to treatment and maintain improvement. After each treatment you should notice a reduction in the severity of your symptoms. You may notice that other areas that have been uncomfortable in the past are also feeling better.
Although most patients need a standard 30 minute treatment a longer visit is sometimes needed. For example if the patient has several problems or if in addition to treatment, the patient needs to learn some exercises or a particular skill. Sometimes a shorter visit of 15 minutes is needed. This may be useful when a simple technique will fix the problem or if tests are not possible because the problem is acute and too painful to treat.
To determine which system is involved and what is responsible for an illness a careful case history is necessary to elicit and evaluate the facts. Osteopaths utilise both orthodox and osteopathic methods of diagnosis. The physical examination includes a searching palpatory investigation, with X rays, pathology tests, orthopaedic and neurological tests used when required to rule out suspected pathology. Please note X-rays and pathology tests are not included in the treatment costs.
Osteopaths examine the body’s alignment while standing to evaluate the effect of gravity. They use palpation to test for restriction or excess motion at joints. Changes to skin, muscle and other tissues can also be identified by palpation.
The patient’s information, the clinical examination, observation, and palpatory findings together assist in the formulation of a diagnosis.
It is important to empower the patient with the skills needed to manage their own health. I teach these skills so that patients don’t need to keep coming back with the same problem. Rarely is ongoing treatment necessary. Advice may be given relating to work habits, posture, stress and exercises.
Rest is the most fundamental treatment and exists as physical rest, mental rest, sensory rest and as physiological rest or fasting. All may be beneficial at different times.
Hydrotherapy is the application of heat or cold through the medium of water to increase or decrease blood flow, relax the patient, reduce fever and reduce localize inflammation or swelling.
Manipulation includes a variety of techniques for muscles, tendons, fascia and ligaments. There are passive techniques, in other words solely done by the therapist, and there are active techniques, in other words done by the patient, and there are assisted techniques, in other words done by the therapist but assisted by the patient.
Some of the osteopathic techniques that I use include:
Kneading – rhythmic pressure perpendicular to muscle fibres, usually for relaxation
Stretching – moving the two ends of the muscle apart to lengthen it (passive technique)
Friction – firm pressure applied over a small surface area for breaking down adhesions.
Springing – slow rhythmic repetitive pressure and release of a bone using a short lever.
Articulation – repetitive movement usually using a lever taking the joint through its range of motion (passive technique)
Muscle Energy Techniques – used to lengthen short muscles and increase the range of movement at joints (assisted technique)
High velocity low amplitude thrust – short, quick movements used to unlock joints in order to get them moving.
I have chosen techniques that work, are safe and I trust. It is important for me that I use techniques that have a logical mechanical basis for how they work and I have found to be effective over my 30 years in practice.
It is impossible to predict exactly how every patient will respond to treatment but patients should notice considerable relief after the first treatment. Often your range of motion is noticeably increased and pain levels are decreased.
In the evening you may feel a little tired. This is because the treatment will take some vitality from your system. Your vitality levels should however return to normal by the next day and after a good nights sleep. It is recommended that you rest after treatment.
When a ligament, tendon or muscle is injured it forms scar tissue. This scar tissue can be felt as a hard and fibrous change in the muscle. Although scar formation is necessary at the start of the healing process it becomes and obstacle if the body does not remove it naturally. A technique called transverse friction may be used to remove it. Pressure is applied over a small area and the technique is only used when the condition is chronic, in other words when there is no acute pain. Transverse friction can result in mild discomfort and some superficial bruising the next day but the discomfort usually lasts less than 48 hours. I aim to cause the minimum discomfort but sometimes for the treatment to work there may be some tissue irritation. Firm pressure may be necessary to get the most optimum result. Lighter pressure will get results but the patient will need more treatments and so the cost will be greater. Although the goal of treatment is fixing the problem I modify my treatment to needs of each patient and the form the treatment takes is negotiable.
Some people prefer that the high velocity thrust technique is not used in the osteopathic treatment. If this is the case then there are alternative techniques. The osteopath should inform you in advance if the technique is of benefit and request your permission.
Osteopathic treatment is not covered by Medicare unless you are under an Enhanced Primary Care (EPC) plan. As part of the Enhanced Primary Care Program a $50 Medicare rebate can now be claimed for osteopathic treatment of chronic musculoskeletal conditions for up to 5 treatments per year. Medicare EPC plans for chronic disease treatment can be organised through your GP. The plan is part of a national initiative for a multi-disciplinary approach to the treatment of chronic conditions such as back pain, disc disease, RSI and headaches. Chronic means a continuous or intermittent medical conditions lasting for more than 6 months.
If you are experiencing chronic musculoskeletal symptoms and would like to have treatment through the EPC program ask your GP if you are eligible to go on the program. If you are eligible then your GP will write you out a referral form with details of your treatment plan. All you then have to do is give this form to your osteopath who will commence treatment. At the completion of treatment the osteopath will report back to your GP.
The full cost of the osteopathic consultation is still paid by you the patient on the day of treatment. You are given a receipt stating that your treatment falls under the Medicare EPC program. You then need to take the receipt with you to your local Medicare office. Please note: Medicare includes osteopaths under the umbrella of Allied Health professionals.
For more information see the Medicare website: Medicare Website www.medicareaustralia.gov.au
Chiropractors can be divided into two types: straights or mixers. Straights consider vertebral subluxations to be the cause of all disease whereas mixers are open to the possibility that diseases are also caused by other factors. Both types emphasize the spine and spinal manipulation but mixers will combine spinal manipulation with other techniques.
Just as there are different types of osteopaths there are also different types of chiropractors. Some generalisations however can be made.
Osteopaths treat the peripheral joints in the arms and legs as well as those of the spine, whereas chiropractors mainly concentrate on the spine.
Osteopaths use a range of techniques, whereas chiropractors mainly use one technique, the high velocity thrust. Some chiropractors employ a masseur to treat the muscles.
Osteopaths treat all muscles and joints, whereas chiropractors mainly treat the joints of the spine.
Osteopaths and some mixer chiropractors believe that illness can be due to a wide range of causes, whereas straight chiropractors believe that all illness originates in the spine.
I follow the motto ‘find it, fix it and leave it alone’, whereas in general chiropractors tend to use shorter treatment sessions and work over a longer period.
Osteopathic treatment is not aimed at changing a patient’s posture but at helping the body adapt to stresses more efficiently, whereas chiropractors in general say they are attempting to change posture, for example to straighten out a scoliosis. Osteopaths talk in terms of somatic dysfunction, reduced vitality, and better circulation and emphasize palpation in diagnosis, use soft tissue and long lever joint manipulation techniques, consider the general structures of the body (muscles and other soft tissues, blood supply, nerve function, spinal and peripheral joints) and osteopathic treatment time is between 30 and 60 minutes. Chiropractors talk in terms of spinal subluxations and innate intelligence and believe that mechanical interference with nerves reduces energy flow. They rely heavily on X-rays, use short lever impulse thrust techniques, mainly treat the spine and treatment time is generally between 5-15 minutes.
There are many different types of physiotherapists working in a range of medical fields – sports, wound care, cardiopulmonary, geriatrics, orthopaedic and paediatrics. Sports physiotherapists work with injured athletes, hospital based physiotherapist focus on rehabilitation and the treatment after surgery or trauma, and other physiotherapists work in offices, private clinics, hospices, fitness centres and at education and research centres. So when making a comparison between osteopaths and physiotherapists I shall be comparing osteopaths working in private clinics with physiotherapist working in private clinics.
Osteopaths mostly work alone in private practice as primary health care physicians and make their own diagnosis, whereas most physiotherapists tend to work as part of a medical team, often following the diagnosis and instructions of a medical doctor.
Osteopaths use their hands to palpate and treat, whereas physiotherapists rely on machines such as ultrasound for diagnosis and treatment. I aim to fix most conditions within three visits, depending on the complexity of the problem, whereas physiotherapy is generally over a more extended period.
Although all osteopaths currently have the same training this was not always so. Some osteopaths never did any formal training and became registered as osteopaths through the Grandfather Clause. They may have served a short apprentice with an osteopath, or were self taught or taught by their father. When the laws registering osteopaths were passed in Australia in the 1980s and 1990s anyone who could prove they had practiced osteopathy for over ten years was given freedom to practice osteopathy and registered under the Grandfather Clause.
Each osteopath thinks and practices a bit differently. Some osteopaths combine other modalities and techniques with osteopathy. Acupuncture and massage are the most common adjuncts to osteopathy. Within the osteopathic profession there are differences of opinion with regards to philosophy and technique. Some osteopaths practice cranial osteopathy or craniosacral therapy and believe that the cranial bones move at a cycle of about 12 pulses a minute and when this cycle is broken by trauma or other causes that it leads to dysfunction. It is my opinion that there is insufficient evidence for the craniosacral rhythm and that this is a placebo. Any benefit from this technique is due to the intentional or unintentional treatment of the atlanto-occipital joint – a part of the body that does have movement and profoundly influences health.
Ref: 1. Downey et al. Craniosacral therapy: the effects of cranial manipulation on intracranial pressure and cranial bone movement. Journal of Orthopaedic & Sports Physical Therapy. 2006.
2. Moran et al. Intraexaminer and interexaminer reliability for palpation of the cranial rhythmic impulse at the head and sacrum. Journal of Manipulative & Physiological Therapeutics. 2001.
Health is a positive state of vitality a balance between physical, mental, social, emotional and other needs of the body and not merely the absence of symptoms and signs of illness. Vitality is a constantly changing force which determines one’s resistance to stressors acting upon the body. It is when vitality is low that the body is most vulnerable and its natural defences can be overwhelmed. Vitality is not something which can easily be measured. It does exist however and can be deduced even by someone untrained in medicine. A person can be without symptoms of any illness yet lacking in vitality. Only factors natural to the body are suitable for building vitality and health.
Factors which build vitality must be appropriate qualitatively, quantitatively and at the right time ie sleep after activity, food when hungry, stress to stimulate. Misuse of one’s body, injury, pain and dysfunction all use up vitality. If vitality is depleted faster than it can be replenished this results in ennervation. As well as the obvious tiredness and energy drain low vitality also affects metabolic processes such as digestion. Waste products of metabolism will not be removed quickly from the body. The accumulated waste causes toxaemia and leads to illness.
Factors which build vitality include sound nutrition, work, rest, exercise, sleep and relaxation, being in tune with natural instincts like thirst and hunger, or lack of hunger, good hygiene, adequate clothing and housing, living in a healthy environment of soil, plants, sun, air, water and animals, sexual and social relations, play and recreation, maintaining a positive mental attitude, dignity and self reliance, and a belief system, The body requires these factors both in health and sickness. Only the proportions differ.
Disease is the process whereby the body is attempting to restore equilibrium and return to its natural state – health. Symptoms are the expression of this process brought to the conscious awareness, the tip of a pathological iceberg. Symptoms are signals that some thing is wrong and obviously must be relieved. The disease process however should not be suppressed unless there is danger of irreparable tissue damage because this is the most significant factor in recovery (eg cough reflex). Our bodies are like the environment with its sensitive ecology and we tamper with it at cost. The disease process should be respected, understood and utilised to the greatest advantage.
For certain problems treatment may not be necessary because if the body has sufficient vitality it will heals itself, for example the common cold. Simply removing causes and providing the body with its health needs may be enough. Non-interference when appropriate is good medicine but requires experience and sound judgment. When treatment is required then unless there is danger of irreparable damage it should be conservative in nature, in other words safe, effective and health enhancing.
A joint is working physiologically well when in harmony with the other joints around it. Hypomobility or restricted mobility if allowed to persist may result in compensatory hypermobility or excessive mobility. The converse is also true. If for some reason a joint has become hypermobile, perhaps through trauma or over-manipulation, then an adjacent joint may become restricted. For this reason it is important that persons untrained in the use of manipulation do not use this technique. It is essential that only restricted joints be manipulated. The abuse of the high velocity technique even by practitioners trained in its use is a cause for concern.