Embryologically, the largest mesodermal derivative is connective tissue encompassing blood, cartilage, bone, and connective tissue proper. Collagen is a major component of connective tissue proper and more specifically white fibrous tissue. Fascia, the largest component of white fibrous tissue, contains linear sheets of collagen found in superficial, deep, and subserous layers. Collagen is piezoelectric, functioning as a transducer of mechanical and electrical energy. Electrical impulses are generated in the collagen by compressive and distraction forces within the musculoskeletal system. These impulses trigger a cascade of cellular, biomechanical, neural, and extracellular events as the body adapts to external stress. In response to internal stress, components of the extracellular fluid change in polarity and charge affecting fascial motion. This somatic dysfunction, whether caused by internal or external stress, is identified as tenderness, asymmetry, altered motion, and tissue texture changes. Somatic dysfunction is also caused by visceral somatic relationships mediated at the level of the spinal cord. Specific patterns of somatic dysfunction in the paraspinal connective tissue are related to specific organs and act as diagnostic markers. Osteopathic manipulative treatment is a manually applied procedure used to treat somatic dysfunction. Through the application of compressive and distraction forces, the physician identifies altered patterns of motion in the fascia. Physicians trained in osteopathic manipulative techniques are able to normalize the somatic dysfunction and in so doing encourage healing. Physicians able to integrate osteopathic manipulative treatment into standard medical and surgical care have an advantage in meeting the needs of their patients.
Ohio University College of Osteopathic Medicine, Athens; and Kirksville College of Osteopathic Medicine, Grandview Hospital and Medical Center Campus, Dayton, Ohio, USA.
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