When I tell someone that I practice osteopathic manual therapy, one of the most common questions I hear is, “Oh, so you’re a massage therapist?”
Well… not exactly.
Although both approaches involve skilled hands and an understanding of the human body, the philosophy, assessment, and treatment goals can be quite different.
Massage therapy is a valuable profession that can help relieve muscle tension, reduce stress, improve comfort, and support overall well-being. Many massage therapists also have extensive training in anatomy, movement, and specific therapeutic techniques.
Osteopathic manual therapy, however, approaches the body through a somewhat different lens.
Rather than focusing primarily on muscles and soft tissues, I look at the relationships between all the structures of the body… the organs, nerves, connective tissues, joints, blood vessels, lymphatic system, and nervous system.
Because sometimes the place where you feel pain isn’t the place where the problem began.
The Body Is More Than Muscles and Bones
Imagine someone coming into my office complaining of persistent shoulder pain.
They’ve had massages, stretched regularly, applied heat, and perhaps even received physical therapy.
The shoulder feels better temporarily, but the pain keeps returning.
Why?
Because the shoulder may not be the entire story.
Perhaps they underwent abdominal or chest surgery years ago. Perhaps their diaphragm has restricted movement. Perhaps there is tension involving the connective tissues surrounding the rib cage or altered mobility along a peripheral nerve.
Any of these may contribute to changes in how the shoulder moves and compensates.
In osteopathic manual therapy, I am interested in understanding those relationships.
Instead of asking only, “Where does it hurt?” I also ask, “What might be contributing to the discomfort?”
That question changes the way I approach treatment.
Structure and Function Are Connected
One of the foundational principles of osteopathy is that structure and function are interrelated.
The way your body is organized influences how it moves and functions. Likewise, changes in function can influence the physical structures of the body.
Consider your diaphragm.
Most people think of the diaphragm simply as a breathing muscle. But anatomically, it has relationships with the rib cage, lumbar spine, digestive organs, blood vessels, and surrounding connective tissues.
Every breath creates movement throughout the chest and abdominal cavity.
If the diaphragm has restricted mobility, it may influence breathing mechanics and the way surrounding tissues accommodate movement.
A massage therapist might address muscular tension around the rib cage and back.
In my work, I may also assess the mechanical relationships involving the diaphragm, abdominal organs, connective tissues, and surrounding structures.
Neither approach is inherently superior. They simply offer different ways of understanding and addressing the body.
Your Organs Need Mobility, Too
This is often the part that surprises people.
Your internal organs are not sitting motionless inside your body.
Your stomach, liver, intestines, kidneys, and other organs have connective tissue attachments and relationships that allow them to accommodate breathing, posture, and movement.
Through Visceral Manipulation, I assess the mobility of these tissues and their relationships with surrounding structures.
For example, someone who has undergone abdominal surgery may develop scar tissue or adhesions that restrict normal tissue movement.
Even after the incision has healed beautifully, the surrounding tissues may not move as freely as they once did.
Sometimes these restrictions contribute to pulling sensations, discomfort, or changes in movement elsewhere in the body.
A person may come in complaining of back discomfort, yet part of my assessment may involve exploring the mobility of the abdominal tissues.
This does not mean that all back pain originates in the organs. It means that the organs and their connective tissue relationships are part of the larger anatomical picture.
What About the Nervous System?
Another important distinction in my work is the attention I give to the nervous system.
Nerves travel throughout the body, passing between muscles, connective tissues, joints, and other anatomical structures.
They need to accommodate movement.
An old injury, surgery, inflammation, or changes in surrounding tissues can sometimes affect the mechanical environment of a nerve.
Through Neural Manipulation, I assess areas where nerve mobility or surrounding tissue restrictions may be contributing to discomfort.
I also incorporate CranioSacral Therapy, a gentle manual approach that focuses on the craniosacral system and its relationship to the rest of the body.
These techniques are not necessarily used separately.
Depending on what I find during an assessment, I may move between several approaches within a single session.
This is why I call my work integrated therapy.
So What Happens During a Session?
When someone comes into my office, I begin by listening.
Not just to their symptoms, but to their history.
Have they had surgery?
Were they involved in an accident?
Did their symptoms begin after an illness?
Are there digestive complaints, headaches, breathing difficulties, or other concerns that may be relevant?
How does their body respond to movement?
What treatments have they already tried?
I then use gentle, hands-on assessment to explore tissue mobility, restrictions, and relationships throughout the body.
Sometimes the treatment involves the area where the person is experiencing pain.
Sometimes it involves an entirely different region.
And sometimes, the most important part of the session is recognizing that a symptom needs further medical evaluation rather than manual treatment.
My goal is not to chase every symptom individually.
It is to understand the person as a whole.
Is Osteopathic Manual Therapy a Replacement for Massage?
Absolutely not.
Massage and osteopathic manual therapy can complement one another beautifully.
Massage may be exactly what someone needs for muscle tension, relaxation, recovery, or general well-being.
Osteopathic manual therapy may offer an additional perspective when symptoms are persistent, complex, or associated with previous injuries, surgeries, or movement restrictions.
The important thing is finding the approach that is appropriate for your individual needs.
Why I Practice Integrated Therapy
Over the years, my training has included Visceral Manipulation, Neural Manipulation, CranioSacral Therapy, arterial and lymphatic techniques, joint work, and other approaches to understanding the human body.
Each discipline has expanded the way I assess and treat my clients.
What continues to fascinate me is how interconnected we are.
A restriction in one area may influence movement somewhere else. A previous injury may change the way we compensate. An old surgical scar may remain relevant long after the original healing process is complete.
The body is not a collection of separate parts.
It is an extraordinary, interconnected system.
And the more we understand those relationships, the more thoughtfully we can approach treatment.
So, the next time someone asks me whether I do massage, my answer will probably remain the same.
Well… not exactly.
But I’d be happy to explain what I do. 😊