Diagnostic skills
Page created: March 23, 2021
Notes
Introduction to OMM
Diagnostic skills
WHAT IS SOMATIC DYSFUNCTION?
Somatic dysfunction is a restriction or impaired function that can occur in bones, joints, muscles, and fascia, resulting in decreased range of motion, pain, and improper nerve functioning (increased or decreased autonomic nervous activity). Blood supply and lymphatics may also be altered, which results in impaired healing and immunity, and lymphatic congestion.
| DIAGNOSTIC CRITERIA FOR SOMATIC DYSFUNCTION (TART) | ||
| TISSUE TEXTURE CHANGES | Surrounding tissue may be edematous, tender, fibrotic, atrophied, or hypertonic | |
| ASYMMETRY | Bones, muscles, or joints may feel asymmetric to the surrounding structures (e.g., more posterior spinous process, more superior ischial tuberosity) | |
| RESTRICTION | Joints with somatic dysfunction are restricted in motion. Under normal physiologic conditions, a joint has two barriers:
The restrictive barrier in somatic dysfunctions is pathologic; it lies before the physiologic barrier and prevents full range of motion | |
| TENDERNESS | Painful sensation reproducible during palpation of tissues | |
Figure 1. The normal ranges of motion and barriers of a vertebral body.
| ACUTE VS. CHRONIC SOMATIC DYSFUNCTION | ||
| FINDINGS | ACUTE | CHRONIC |
| TISSUE TEXTURE CHANGES | Edematous, erythematous, boggy; hypertonic muscles | Edematous (less than an acute somatic dysfunction), no erythema, cool dry skin, fibrotic; ropy muscles |
| ASYMMETRY | Present | Present with compensation in other areas of the body |
| RESTRICTION | Painful restriction with movement | Restriction with less or no pain |
| TENDERNESS | Severe, sharp | Mild / moderate, dull / achy |
Author: Arman Israelyan, OMS-III
Editor: Matt Lipinski, DO
Illustrator: Aileen Lin, MScBMC
Editor: Robyn Hughes, MScBMC