Dr. Jane Xenos, D.O.

Dr. Xenos is board certified in Osteopathic Manual Medicine and her practice focuses exclusively on the use of this treatment modality.

Osteopathic manipulation for adults, children and infants.

Articles About Osteopathic Manual Medicine

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Osteopathic Treatment For Children with Down Syndrome

Osteopathy and Genetic Syndromes

One might wonder what the value of osteopathic manipulative treatment could be for a genetic syndrome. Osteopathic medicine is based on the principle that body structure and function are dynamically interrelated. When one improves the anatomic interrelationships of structural elements of the body (bones, muscles, membranes, tissues, fluids), one sees improvement in the function of the body. This holds true whether the causes of the structural abnormalities are genetically based or not. It is clearly evident in looking at the face of a typical child with Down Syndrome that there is a lot about structure that is less than optimal. Let's look at what improvements in function might be seen by improving the structure.

Down Syndrome, or Trisomy 2l, occurs in about one in 800 births. It is almost always the result of a third copy (trisomy) of some or all of the genetic material on chromosome 2l. Mental retardation and low muscle tone are probably the two most common hallmarks of Down Syndrome. There is also a much higher than normal incidence of heart and gastrointestinal tract defects which often require surgical correction. Many external body features are characteristic of the syndrome. These include, among others, an upward slant to the eyes; skin folds at the inner edges of the eyes; a flat, wide bridge of the nose; small, low-set ears; a shortened front to back dimension of the skull; a recessed midportion of the face and a protruding and often furrowed tongue. Some of these features contribute to the health complications seen in Trisomy 21, and some may play a role in the common neurodevelopmental problems. Changes in most features are possible through osteopathic manipulative treatment, and the improvements made structurally are likely to result in better function.

The Face and Respiratory Infections

It is commonly accepted that most children with Down Syndrome have more frequent and more severe respiratory infections, especially of the ears and sinuses. There are two reasons for this. One is that the genetics of Down Syndrome causes abnormalities in the immune system which make it more difficult to resist an illness once exposed and harder to heal from it once ill. The second reason lies in the structure of the facial features which makes drainage of these areas more difficult.

The midportion of the face (that area between the eyes and mouth) is small and typically set further back in the child with Down Syndrome. This means that the sinus cavities are smaller than normal and sometimes absent entirely. The wide, flat bridge of the nose blocks the openings through which the sinuses drain. The problem is compounded by the low-set position of the ears and the smaller than normal diameter of the eustachian tube which drains the middle ear to the back of the throat. When fluids fill the ears and sinuses - spaces that should be occupied by air-infections are likely to occur.

Drainage is further compromised by the differential growth of the upper and lower jaw bones. The upper (maxilla), being part of the midface, is small in comparison to the lower (mandible). This also promotes the mouth breathing, protruding tongue and difficulty enunciating language often seen in trisomic children. Through a very gentle touch, an osteopathic physician trained in the cranial concept, can help to normalize the relationships of the bones and membranes of the facial area. By assisting the midface structures to come forward, one can see a cosmetic change in eye shape, cheekbones, tongue/ mouth relationship and bridge of the nose. Usually the frequency and severity of upper respiratory infections are reduced as well.

Neurodevelopmental Concerns in Down Syndrome

Almost all children with Down Syndrome show delays in gross motor, fine motor development and language development. These skills often lag four months behind at one year of age and eight to ten months behind at two years of age. Language is frequently not gained until the fourth to sixth year. Though these delays are assumed to be genetically predetermined, let's look at the role that body structure might play.

Osteopathic theory asserts that neural pathways in the brain are designed to lay themselves down in precise geometric relationships. When the cranium (skull) is distorted in its shape, it is not possible for these pathways to develop normally. There are several factors contributing to the distorted cranial shape. The sutures, where one bone meets another, are often positioned abnormally in Down Syndrome. The membranes that encase the central nervous system and lie between the brain and the cranium have a powerful effect on the growth of the developing skull. These dural membranes usually demonstrate very poor mobility in the trisomic child. The front to back dimension of the cranium is typically shortened in Down Syndrome and is one more factor dictating distorted geometry for the developing neural pathways.

Osteopathic treatment can effect significant changes in the shape of the cranium through addressing the sutures and the tensions in the dural membranes. The distortion of the cranial mold appears to contribute significantly to the difficulty in performing coordinated motor tasks such as grasping and crawling. Most agree that mastery of these tasks is a necessary foundation for later learning. Osteopathic treatment, therefore, is an important part of the health plan for a child with Down Syndrome.

How Much Treatment is Needed?

Osteopathic manipulative treatment is tailored individually to the needs of each child. It is likely that a child with Down Syndrome will require six to ten weekly osteopathic treatrnents at the onset of care to begin to normalize the structural furdings. Once mobility begins to improve, the frequency of treatment can be reduced. The benefits of treatment will be maintained by continuing osteopathic care periodically throughout the life of the individual. Generally speaking, the earlier treatment is initiated, the more dramatic are the structural changes and the improvement in functional abilities and health.

A Doctor of Osteopathy (DO) is a fully licensed physician whose training includes, beyond the normal medical curriculum, extensive training in manual manipulation as a treatment to improve body function through addressing body structure. Although many osteopathic physicians are in family practice or providing specialty care, some have chosen to focus their practices on the hands-on approach which makes osteopathy unique. Of these, some have pursued additional training in cranial osteopathy, which is essential in the osteopathic treatment of children.

Dr.Xenos has had decades of practicing cranial osteopathy and currently teaches this specialty. She was trained by two of the world's leading authorities in cranial: Dr. Fullford, who was highlited in Dr.Andrew Weil's book, "Spontaneous Healing"; and Dr. Viola Frymann, who is regarded as the world's leading authority in cranial osteopathy. Dr. Xenos has also trained and has taught for the Upledger Institute.

Osteopathic Treatment and Ear Infections

The Problem of Ear Infections

Ear infections are the cause of more pediatric doctor visits in the first three years of life than any other medical problem. One child in three develops chronic fluid accumulation in the middle ear making the child prone to recurrent ear infections, and potentially causing minor hearing loss. There are many reasons for the prevalence of this medical problem. Due to the immaturity of their immune systems, young children have frequent colds, and ear infections can follow as a complication. Some previously healthy children begin to have ear infections when undergoing orthodontic correction. Some children have dairy or other nutritional sensitivities which contribute to the frequency or severity of infections. The most common predisposing factor, however, is early childhood trauma to the head, occurring either in the birth process or in early childhood injuries. Even C-section babies can be affected. When the structural restrictions caused by these traumas are resolved, the vast majority of children have a significantly reduced incidence of infection and a noticeable improvement in hearing.

The presence of fluid in the middle ear offers a hospitable environment for the growth of the organisms which cause ear infections. If the middle ear is free of fluid, ear infections are rare. Medical opinion differs on the solutions to fluid retention. The standard medical approach is to treat the infections with antibiotics. If fluid remains after the infection has cleared, a low level of antibiotic is often prescribed preventively over a long period of time. If infections or hearing loss persist, ventilating tubes are surgically placed. The osteopathic approach is to correct the cranial restrictions which are causing fluid retention and impeding fluid drainage.

Why Does Fluid Accumulate?

There are two widely held theories. One is based on the premise that as gases diffuse into the blood vessels of the middle ear cavity, the resultant negative pressure allows serum to exude from the blood vessels into the middle ear cavity. The second theory proposes that the fluid in the middle ear cavity is a product of an inflammatory process of the mucous membranes. An osteopathic theory concerns the excess fluid which can accumulate in the back of children's throats during teething, a common cold or from nursing or drinking a bottle while lying down. This fluid lies close to the opening of the eustachian tube which drains and ventilates the middle ear. When fluid remains present in the back of the throat, it may make its way, via the eustachian tube, into the middle ear cavity. Once there, it has a tendency to stay. Swelling of the mucous membranes worsens the problem by blocking the eustachian tube. The resultant loss of atmospheric air pressure in the middle ear compounds the problem.

Unfortunately, anatomy is no friend to this situation before about age four. The beautiful, round baby faces of infants and toddlers are associated with a eustachian tube which is nearly horizontal. Around age four or so, a child gains more vertical dimension in the face, and gravity can help in drainage. If one waited until the age of four or more, many children would literally outgrow the problem. However, the risks of more serious infections, the side-effects of prolonged antibiotic use and the risk of poor language development due to poor hearing make this an unacceptable solution.

How Can Osteopathy Help?

The small amount of motion present in the joint lines and membrane structures of the cranium (skull) has been well documented in osteopathic and other scientific sources. As the temporal bones of the cranium move in a normal manner, they assist the drainage of fluid through the eustachian tubes to the back of the throat. This normal mobility can be disturbed as a result of birth trauma or early childhood injuries. Osteopathic manipulative techniques can restore normal motion of the temporal bones as well as the whole cranial mechanism, and thus improve fluid drainage from the middle ear. If fluid is not present, ear infections are rare. Manipulative treatment also facilitates lymphatic drainage in the neck and chest and can improve arterial blood supply and venous drainage. Through assisting the immune system in this way, the improved overall health of the body also helps prevent future infections.

How Much Treatment Is Needed?

Children who suffer from recurrent ear infections often require weekly osteopathic treatment for a period of four to eight weeks. The duration and specific types of treatment offered vary with the individual child. Follow-up treatment on a periodic basis is essential to maintaining appropriate motion of the cranial mechanism and therefore the benefit of treatment. Osteopathic manipulative treatment addresses what is for many children the underlying cause ofchronic ear infections.

The treatment itself is a gentle, non-invasive form of hands-on manipulation. If children cry or complain while being treated, it is rarely because of pain. More often it is because they don't want to be lying down. Most can be entertained successfully with songs, stories or toys.


Just as ear infections are sometimes a complication of the common cold, so are inflammation and infection of the sinus cavities. The same mucous membrane which lines the nose and back of the throat extends into the sinus cavities, out to the middle ear as the eustachian tube and down into the lungs (where inflammation results in bronchitis). The sinus cavities, though fewer and smaller in children, serve to warm and moisten the air we breathe. They too can fill with fluid and be unable to perform this function. Their ability to function normally is dependent on unrestricted mobility of the bones and membranes of the cranium. By the same principles that underlie the osteopathic treatment of ear infections, osteopathic manipulation can help restore normal sinus function.

A Doctor of Osteopathy (DO) is a fully licensed physician whose taining includes, beyond the normal medical curriculum, extensive training in manual manipulation as a treatment to improve body function through addressing body structure. Although many osteopathic physicians are in family practice or providing specialty care, some have chosen to focus their practices on the hands-on approach which makes osteopathy unique. Of these, some have pursued additional training in cranial osteopathy, which is essential in the osteopathic treatment of children.

Neurodevelopmental Problems Osteopathic Perspectives

The Trauma of Birth

Some neurodevelopmental problems are associated with genetic syndromes, and some originate from known or unknown insults to the developing nervous system in utero. The vast majority, though, cannot be attributed to any traditionally diagnosable condition. It is in these cases that we must look to the role of birth injury.

A traumatic birth can have a role in neurodevelopmental problems either through direct injury to the central nervous system or through insufficient oxygen at the time of birth. The infant's central nervous system is irritated by the compression of its moldable head against the hard bones of the mother's pelvis both before and during birth. In more difficult births, this impact may be severe enough to cause neurodevelopmental problems. At birth the infant loses the maternal source of oxygen and must obtain its oxygen by breathing. Poor color or a birth cry which is delayed or weak can signal too little oxygen to the brain at this critical time.

In some cases the observed neurodevelopmental problems fit a particular pattern, and we find it helpful to use a label such as cerebral palsy, autism or ADHD. For many children, though, we have to accept the limitations we see without a diagnostic label. In either case oxygen compromise and birth trauma are frequently seen factors.

Osteopathic manipulative treatment can improve the child's neurologic function by resolving the effects of the compressive forces of a traumatic birth. Osteopathic medicine is based on the philosophy that structure and function are dynamically interrelated. Improvement in the structural relationships of bone, membrane, muscle and tissue is necessary to foster improved physiologic function.

The Common Causative Factors

The central nervous system has two primary sources of nutrition, oxygen and blood sugar, each essential to its function. Both are carried to the brain by way of the blood in the arteries and smaller blood vessels. Appropriate levels of blood sugar are usually maintained by adequate feeding and the automatic regulation of blood sugar done by the body. Ideal oxygen levels, however, are dependent on an uncomplicated transition from life inside the uterus to life outside. Lowered oxygen levels may be reflected in low muscle tone, poor skin color or too fast a breathing rate immediately after birth. Although inadequate oxygen levels may not threaten life in the first few minutes after birth, prolonged oxygen compromise will damage central nervous system function by robbing the brain of one of its two essential nutrients at this critical time.

Structural trauma to the infant skull, which can compromise central nervous system function, may be the result of prolonged forces of labor or the effects of instrumentation such as forceps and vacuum extractors. Such instrumentation is sometimes necessary to facilitate a more rapid delivery when fetal distress is present. The forces inherent in their use, though, may take their toll in the relationship of one bone to another or in irritation and tension on the membranes which surround the brain and spinal cord. Although the neurodevelopmental consequences of these structural problems may not be seen until later in childhood, some newborn difficulties may be the first signs of a neurodevelopmentally troubled child. These may include vomiting, colic, restlessness, agitated sleep, difficulty sucking and spastic muscles. The earlier osteopathic treatment is begun, the more likely a positive outcome, though treatment later can still be of substantial benefit.

How Does Treatment Help?

Osteopathic treatment helps the body to use its inherent abilities to heal by correcting structural disturbances. A few examples will help to demonstrate the principles involved in treatment for neurodevelopmental problems. When the compression on the baby's head distorts the foramen magnum, where the brain stem leaves the skull to become the spinal cord, the resultant pressure and irritation on the pyramidal tracts may cause spasticity of the limbs. Gentle release of these compressive forces corrects the distortion and the muscles can return to a normal tone.

The forces of labor can leave the newborn with overlapping cranial bones which irritate the meningeal membranes lying between the bones and the brain itself. Tremors, twitches and irritability often result and can be resolved when osteopathic treatment releases these membranous and bony restrictions. Seizures are commonly seen when there is an area of abnormal electrical activity on the surface of the brain. Osteopathic physicians have often found that these abnormally firing electrical centers are also sites of membrane restriction and /or cranial trauma. Addressing these sites can result in a lessening or cessation of seizure activity.

Improving the ability of oxygen to reach and nourish the central nervous system is an essential component of osteopathic treatment for neurodevelopmental problems. Several factors influence oxygen supply to the brain. The respiratory center of the brain requires the unimpeded fluctuation of cerebrospinal fluid to function well. The bony and muscular components of the rib cage must be free of restrictions to allow for deep respirations. Both arteries and veins must be unimpeded in their flow through muscles, bones and tissues. Finally, the bones and membranes surrounding the brain itself must move normally for oxygen to reach brain tissue.

Other Helpful Approaches

A child with neurodevelopmental problems often responds best to a variety of interventions. Although providing more than one approach at one time makes evaluation of the benefits of each impossible, the importance of early intervention minimizes this drawback. Depending on the nature of the neurodevelopmental problem, any of the following approaches may be a useful adjunct to osteopathic treatment: Physical Therapy, Occupational Therapy, Speech Therapy, Sign Language Instruction, Constitutional Homeopathy, Sensory Integration, Auditory Training, Neurodevelopmental Training, Developmental Optometry, Vitamins/ Minerals/Supplements. This list is not meant to be exhaustive but to include a variety of potentially useful approaches.

A Doctor of Osteopathy (DO) is a fully licensed physician whose training includes, beyond the normal medical curriculum, extensive training in manual manipulation as a treatment to improve body function through addressing body structure. Although many osteopathic physicians are in family practice or providing specialty care, some have chosen to focus their practices on the hands-on approach which makes osteopathy unique. Of these, some have pursued additional training in cranial osteopathy, which is essential in the osteopathic treatment of children.

Osteopathic Treatment and Orthodontia

The Connection

Osteopathic physicians appreciate ihe importance of orthodontic correction as a means to improve jaw and tooth alignment and are an important factor in fostering the best health of the individual. Many dentists recognize the importance of osteopathic treatment as an integral part of assisting the body in making an orthodontic correction and in maintaining good health thoughout the process.

The proper alignment of teeth is dependent on a correct anatomic relationship of the upper jaw (maxilla) to the lower jaw (mandible). To make changes in tooth alignment requires changes not only in the relationship of the maxilla to the mandible but also in complex relationships of these bones to several other bones of the face and skull. Osteopathic physicians have known and demonstrated that all places where bones come together in the skull have significant capability of motion in infancy and childhood and many maintain motion throughout life. Although very little motion is permitted at any one of these joints, that motion is essential to allowing a successful orthodontic correction. Osteopathic cranial treatment assists orthodontic correction by helping all the bones of lhe skull adjust to accommodate the orthodontic changes.

Osteopathic physicians seek to work hand in hand with orthodontists and dentists who recognize the importance of normal cranial mobility as a factor in the success of orthodontic correction. Through osteopathic manipulative treatment the physician can help the individual to better tolerate the orthodontic changes and can alert the dentist to the possible need to adjust the orthodontic plan. It is not uncommon to find that when osteopathic treatment accompanies orthodontis, the desired results are obtained in half to two-thirds the time estimated by the dentist, and the corretion is more likely to hold well over time.

Orthodontic Considerations

It is typical for the normal mobility of the cranium to be compromised somewhat during orthodontic correction. The degree to which this happens depends on the types of appliances used and on the ability of the patient to tolerate the changes brought about by the appliance. Because the teeth are imbedded in bone, this rigid relationship of teeth to each other results in rigidity in the motion of the maxilla and mandible and through them, limits the normal motion of other bones of the skull. Functional appliances, such as adjustable palate expanders, permit the cranial bones to retain more of their motion pattern during orthodontic correction. They are, therefore, preferable whenever they are capable of making the needed correction.

The topic of tooth extractions is a controversial one. While there are times when avoiding extractions makes the orthodontic plan unreasonably lengthy and complex, it is best to keep all the teeth whenever possible. Removing the canine teeth, which serve as stabilizers to the jaw can have profound negative consequences to the cranial mechanism and to the general health of the individual.

The tongue is a powerful force in forming the shape of the developing oral cavity. When the tongue is not functioning properly within the mouth, speech and breathing are also affected. Conditions such as respiratory allergies or asthma which prompt mouth breathing, foster an oral cavity more likely to need orthodontic correction. Children who continue to suck their thumbs or to use a pacifier after the age of about 30 months are more likely to have orthodontic problems requiring correction. Sometimes the osteopathic physician or the dentist will recommend myofunctional therapy devoted to correcting the position and action of the tongue, before attempting orthodontia.

Maintaining Health

A person's overall health can suffer both when jaw alignment is poor and when jaw and teeth are undergoing orthodontic correction. It is ideal when the only complication of correction is the experience of pain in the teeth for one or two days after obtaining or adjusting an appliance. Unfortunately some people suffer persistent headaches as a direct result of the compromise in bone and membrane mobility of the cranium.

Some individuals experience sinus and ear infections because of the compromised ability of the sinus cavities and middle ear to drain. Orthodontia impairs the rhythmic motion of several cranial bones which assist this drainage, and is, therefore, a factor in both infections and headaches. The temporal bones which form the upper portion of the jaw joint also house the eustachian tubes which drain the middle ear to the back of the throat. When motion is compromised here, fluid is retained in the middle ear, and ear infections or hearing loss may result.

Nausea and loss of appetite are complications, which may be annoying to an adult, but can be a serious problem in a school-age child with poor nutritional status. And in some individuals the compromised cranial mobility manifests in behavioral problems, distractibility and low tolerance to frustration. This can make life very difficult both at home and at school. Perhaps the most serious complication is persistent lethargy and fatigue. They are often accompanied by an immune system less able to fight off illness. Although some people sail through orthodontic correction with no apparent complications, many do not. Osteopathic treatment can help maintain good cranial motion during orthodontia thereby fostering better overall health.

Timing of Treatment

It is ideal to begin orthodontic correction with a fullv mobile cranial mechanism. An evaluation before beginning orthodontic correction is advised and may reveal the need for osteopathic manipulative treatment prior to orthodontia. This restores mobility which was compromised by birth trauma or childhood injuries. It is advisable to schedule osteopathic treatment within the first few days after obtaining an appliance or getting it adjusted. If the individual is not suffering any complications and the cranial mobility maintains good symmetry and vitality, further treatment is not needed. However, if health problems such as headache, respiratory or gastrointestinal illness, fatigue or behavioral complications ensue, osteopathic treatment is indicated.

A Doctor of Osteopathy (DO) is a fully licensed physician whose training includes, beyond the normal medical curriculum, extensive training in manual manipulation as a treatment to improve body function through addressing body structure. Although many osteopathic physicians are in family practice or providing specialty care, some have chosen to focus their practices on the hands-on approach which makes osteopathy unique. Of these, some have pursued additional training in cranial osteopathy, which is essential in the osteopathic treatment of children.

Osteopathic Treatment of Orthopedic Problems


The vast majoriry of orthopedic problems in childhood are seen in the lower extremities: the feet, legs, knees and hips. When one considers the vast changes that a small body must make as it grows from its cramped in utero position through crawling to walking, it is not surprising to find problems in the lower extremities. The orthopedic condition routinely evaluated for at birth is "congenital hip," where the head of the femur (upper leg bone) cannot seat itself in the too shallow depression present in the ilium (hip bone). Though it must be treated with bracing, osteopathic treatment helps to normalize the joint functions which were inevitably disturbed by the bracing. Osteopathic manipulative treatment, which looks to improve body function through addressing body structure, assists in the resolution of many common orthopedic conditions of childhood.

Tibial torsion, the outward bowing of the lower leg, is caused by the cramped folding of the baby's legs in utero, and often resolves spontaneously in the first year of life. However, if the torsion is accompanied by a distortion between the knee cap and the tibial bone, or between the tibia and the nearby fibula, these should be treated osteopathically, preferably before the baby begins to walk. When babies first stand, they often place their feet far apart for stability, thereby standing on the inside edges of their feet. If the stance remains wide beyond the first few months of walking, osteopathic treatment is recommended. Falling down hard on one's bottom is another normal component of learning to stand but is hard on the relationship between the sacrum (at the base of the spine) and the vertebrae of the lower back. This common insult, left untreated, is probably one of the underlying causes of low back pain suffered by adults.


Between l0 and 14 months of age, most children begin to walk. As more balance is gained, the distance between the feet should become the same as the distance between the hips, and the feet should point straight forward when the child stands, walks or runs. If this normalization of postural stance is not gained spontaneously, osteopathic evaluation and treatment should be pursued. The causes may be found in disturbed relationships of the bones of the pelvis or legs or in abnormal tensions of the connective tissues or muscles. Correcting these osteopathically early in life will foster healthy structural growth throughout childhood and adolescence. Although standard medical counsel advises waiting, with an expectation that gait abnormalities will resolve themselves, we all have seen school children and adults plagued with gait problems and the frequently associated back pain.

Do not be alarmed by "flat feet" in your toddler, since the instep is slow to develop. One should not be alarmed either by the development of "knock knees" in a three-year-old whose knees looked normal prior to this time. As the child develops arches and the bones change with growth, the knee alignment will, in most cases, become normal by age five. Osteopathic treatment addressing the alignment of the bones of the ankle and foot and knee can help in correcting both of these clinical problems at an appropriate time. Sometimes home-based exercises, sturdy shoes with arch supports or custom made orthotics are needed.

Many children in this age group are stretching their limits in gross motor skills. To jump from locations too high for the size of the child may result in compression of one or both ankle joints. If the child lands harder on one foot than the other, this can create a hip height discrepancy. This discrepancy is usually easy to correct with osteopathic treatment, but, if left uncorrected, can be a factor in the development of childhood and adolescent scoliosis and low back pain.

Older Children

Sports injuries are the cause of the vast majority of structural problems in this age group. Though they may not result in "skeletal deformity" (the common definition of an orthopedic problem), they are worthy osteopathic consideration. Children are a physically active lot, and unless there are good reasons why not, they should be encouraged and enabled to engage in the physical challenges that interest them. But they and their parents must be prepared to accept the periodic injuries that accompany physical activity. Knee injuries are common in basketball due to the necessity of rotating one's body over a foot planted on the court. Running sports, such as track and soccer, are ideally done only by children whose hip, knee and ankle line up vertically. Poor alignment fosters more frequent and more severe injuries. All activities played with balls involve the risk of impact from the ball, the most serious location being the head. The intentional "headers" of soccer are less damaging to the normal motion mechanics of skull joints than are accidental impacts. Football, gymnastics and snow or ice-based sports are fraught with potential injury. Osteopathic treatment to release the sprains, strains and bony misalignments as they occur is good insurance toward a healthy and pain-free adulthood.

Some skeletal problems of childhood affecting the hips and/or knees, such as slipped epiphysis, Perthes' disease, Osgood Schlatter disease and synovitis, require cessation of sports activities for variable periods of time. Though they each have their appropriate orthopedic treatment, the recovery of full and pain-free joint function can be aided by osteopathic treatment, both during and after the disease process.


Scoliotic curves of the spine are most commonly, though not exclusively, seen in girls between the ages of 10 and 14. The curves vary widely in their severity. The more severe fixed curves require bracing or surgical treatment. In scoliosis, the vertebrae are both sidebent and rotated. Ribs are displaced, and muscle groups are stretched or shortened. There is often a hip height discrepancy. Although discomfort is rare during adolescence, both pain and disability are likely to be experienced later in life if left untreated. Osteopathic manipulative treatment can be beneficial for both the more mild functional curves and for curves requiring more invasive measures. Osteopathic treatment can improve both spinal mobility and degree of curve.

A Doctor of Osteopathy (DO) is a fully licensed physician whose training includes, beyond the normal medical curriculum, extensive training in manual manipulation as a treatment to improve body function through addressing body structure. Although many osteopathic physicians are in family practice or providing specialty care, some have chosen to focus their practices on the hands-on approach which makes osteopathy unique. Of these, some have pursued additional training in cranial osteopathy, which is essential in the osteopathic treatment of children.

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