Orthopedic Manual Physical Therapy (OMPT) also known as OMT (Orthopedic manual Therapy) is a subfield of physical therapy that is not only recognized by the American Physical Therapy Association but is also the only specialty based on manual manipulative techniques that is also recognized by the American Medical Association.
OMPT utilizes a system in which a specific segment of restriction is identified as limited, painful, or hypermobile. This method of evaluation allows us to quickly narrow our examination and focus our time on treating the problem areas. Traditionally, therapists treat a patient’s condition based on their symptoms; unfortunately symptoms in one joint don’t always correlate with the problem. For instance, pain in the hip and thigh could suggest hip problems, thigh problems, or conditions involving the spine. In addition, it does not identify whether muscles, tendons, ligaments, nerves, or bone is involved. Improper identification of the structure then leads to improper treatment.
Symptom localization: based on the OMPT’s advanced integrated knowledge of anatomy, biomechanics, and function of the musculoskeletal system.
Symptom Localization Techniques: a process initially developed by Olaf Evjenth and then expanded by Creighton and Krauss at Oakland University. There are several components to this process. One being to identify if the tissues irritated are joints, soft tissue, or neural tissues. This is confirmed with careful palpation and movements. Another component is to define the region and then the segment(s) that are most involved or hyper-reactive. To confirm the areas of involvement the therapist will move you into a position that provokes your primary complaint or just to the verge of your complaints. Then they will move that joint out of the position of discomfort or further into the provoking position based on kinesiological and physiological movement patterns. A skilled practitioner should be able to narrow your pain complaints to one or two segments and then specifically treat those segments based on other findings.
Then after the segments and structures are identified and localized, the OMPT applies passive mobility testing to determine how that segment is working and how that could affect their function and complaints. After the structure(s) and dysfunction are identified the OMPT can then develop an effective treatment plan. The advanced OMPT training allows us to specifically and effectively evaluate and treat the cause of all orthopedic problems, especially delicate neck and back structures. In addition the OMPT approach emphasizes the use of safe specific stretches, soft tissue techniques, three dimensional traction, therapeutic exercise, as well as mobilization/manipulation techniques when appropriate to the joints including the spine.
Passive Mobility Testing: is a procedure that the skilled practitioner uses to evaluate how well your individual joints move compared to people your same age as well as compared to your other joints (on the opposite side of your body or in relation to spinal segments above and below). Those joints that are interpreted as tight will typically benefit from stretches, mobilizations, or manipulations while those that are loose would be harmed by further stretching but benefited from stabilization exercises.
Treatments that occur at a center specializing in OMPT may appear similar to treatments at another center but with a close eye have distinct advantages. An OMPT is a physical therapist with orthopedic experience that has pursued additional advanced training and education at an accredited university developing clinical specialty skills. The residency program ensures that the techniques illustrated in the classroom setting are demonstrated safely, effectively, and economically to the patient. Therapeutic exercises provided by OMPT practitioners are similar to other practitioners but modified to reduce aberrant stress to the joints. These exercises are often combined with self traction techniques between sets to reduce pain while allowing the patient to get the benefits of active exercise.
Manual techniques are performed all across the state and country. Manual practitioners basically use their hands, or other part of their body, to assist in the intervention. Manual techniques performed by OMPT practitioners are slightly different in their skill set, theory, and expertise. Specific Techniques that are instructed and practiced by OMPT’s include: mobilization/manipulation, functional massage, specific stretches, and three dimensional traction. Many of these techniques are described by Olaf Evjenth in his multiple publications as well as John Krauss PhD, PT, OMPT.
Joint Mobilizations and manipulations: involve moving the segment perpendicular or parallel to the joint surface in a manner designed to reduce pain, increase the circulatory and fluid dynamics or increase joint movement and capsular stretching.
Functional massage: massage techniques that incorporates motion with massage. The technique is to compress the target tissue(s) and move the associated joint to cause a muscle shortening or lengthening. It is designed to reduce pain, improve hemodynamics, decrease adhesions, and improve soft tissue gliding.
Specific Stretches (manual muscle stretching): is a technique designed to improve the resting length of the muscle(s) without causing damage to the joint structure. Techniques such as static holding and hold relax are used based on patient tolerances and goal of treatment. OMPT’s use the principles of advanced anatomy and kinesiology to preposition the patients involved limb or trunk in an asymptomatic position. Then the practitioner systematically elongates the specific tissue between the joints.
Three dimension traction: is a manual technique that separates two opposing joints to alleviate pain caused by arthritis, edema, and nerve irritation. This technique involves the skill and knowledge of the OMPT to preposition the joint in an optimal position without negatively affecting the surrounding joints. These can be graded to treat pain without causing further stretch in a loose joint or to improve motion and positioning of structures within a joint to restore normal gliding.
For more information on the OMPT program please call Oakland University at 248-370-4041.