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C1: You must be able to conduct an osteopathic patient evaluation and deliver safe, competent and appropriate osteopathic care to your patients.

Evidence:

I have committed one day a week throughout my osteopathic studies to improve my diagnostic accuracy. This habit has strengthened my ability to identify red flags and contraindications more systematically.

Reflection on Overall Attainment:

My training at the ESO has improved my confidence in structuring thorough osteopathic evaluations. I now approach each case with a clear, reasoned framework that supports both safety and efficacy.

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A1: You must listen to patients and respect their individuality, concerns and preferences. You must be polite and considerate with patients and treat them with dignity and courtesy.

Evidence:

Listening to and respecting patient individuality and preferences is central to my practice. A patient expressed anxiety about previously uncomfortable treatments with another practitioner. We collaboratively agreed on a treatment plan respecting her comfort level.

Reflection on Overall Attainment:

Reflecting on my growth, osteopathy has enhanced my awareness of patient autonomy. Previously guided by clinical experience alone, I now actively incorporate patient perspectives. This has significantly improved trust and treatment outcomes.

Autonomy: What’s Shared Decision Making Have to Do With It? - PMC

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Autonomy: What’s Shared Decision Making Have to Do With It?

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. Author manuscript; available in PMC: 2019 Feb 1.

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A2: You must work in oartnership with patients, adapting your communication approach to take into account their particular needs and supporting patients in expressing to you what is important to them.

Evidence:

Working in partnership with patients is essential in my practice. I adapt my communication style to meet each patient´s unique needs. Encouraging patients to express their priorities ensures a collaborative and effective treatment approach.

Reflection on Overall Attainment:

My ability to adapt communication has notably improved with osteopathic training. Initially, i struggled to identify subtle non-verbal cues indicating discomfort or uncertainty. Now, i proactively adjust my interaction style, greatly enhancing patient engagement and satisfaction.

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A3: You must give patients the information they want or need to know in a way they can understand.

Evidence:

Providing clear, understandable information is vital in patient care. Recently, i simplified explanations of spinal mechanics to a patient unfamiliar with medical terms. Using analogies helped her clearly grasp her condition.

Reflection on Overall Attainment:

I have recognized the importance of simplifying complex concepts effectively. Osteopathy has taught me to consider patients educational backgrounds more carefully, improving my ability to communicate clearly and meaningfully.

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A4:You must receive valid consent for all aspects of examination and treatment and record this as appropriate.

Evidence:

Obtaining valid consent is fundamental in my practice. Before every examination and treatment i clearly explain all procedures to the patient. I ask for verbal consent before going any further. The consent is written into the clincal records in a dedicated section.

Reflection on Overall Attainment:

Osteopathic training has emphasized the importance of detailed consent. Previously, my approach was more informal. Now, my documentation and clarity regarding consent are consistenly thorough and professional.

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A5: You must support patients in caring for themselves to improve and maintain their own health and wellbeing.

Evidence:

Recently, i guided a patient with persistent back pain in developing personalized home strategies and lifestyle modifications. Regular follow-up appointments or check-ins by email, ensured the patient felt motivated and supported.

Reflection on Overall Attainment:

My osteopathic training has reinforced the value of empowering patients with tools and knowledge for self-management. Previously, my advice was general. Now, i prioritize individual tailoring of self-care strategies, enhancing patient adherence, empowerment, and their ability to take charge of their own health.

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A6: You must respect you patients´ dignity and modesty.

Evidence:

Respecting patient dignity and modesty remains a core aspect of my clinical practice. I adjust my approach to the individual, give them time and maintain clear communication throughout the consultation, especially in vunerable situtations.

Reflection on Overall Attainment:

My osteopathic training has strengthened my sensitivity to non-verbal cues. I aim to maintain modesty and professional boundries to build lasting trust.

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A7: You must make sure your belief and vlaues do not prejudice your patients´care.

Evidence:

Ensuring that my personal beliefs and values do not influence patient care is a professional obligation i take seriously. I once treated a patient whose health beliefs differed significantly from my own. I remained neutral, listened respectfully, and adapted my explenations.

Reflection on Overall Attainment.

My osteopathic training has helped me separate personal views from clinical reasoning, ensuring that each patient receives as unbiased and respectful care as possible.

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Global listening

Test before and after treatment

Do not be afraid to get people off the couch in the middle of the treatment to retest

Relieving test

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B1: You must have and be able to apply sufficient and appropriate knowledge and skills to support your work as an osteopath.

Evidence:

During a recent case, a patient presented with unresolved shoulder pain. I integrated osteopathic assessment with my physiotherapy background to identify underlying rib dysfukction contributing to the complaint.

Reflection on Overall Attainment:

My education with the ESO has significantly enhanced my diagnostic and manual skills. I am now more confident in selecting and applying techniques that are both safe and effective. This growth ensures my interventions are clinically reasoned and tailored to individual patient needs.

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B2: You must recognise and work within the limits of your training and competence.

Evidence:

Recognising and working within the limits of my competence is fundamental to safe practice. I once treated a patient with complex neurological symptoms beyond my current scope. I referred them the GP and asked to consider a neurologist.

Reflection on Overall Attainment:

I have learned the importance of recognising when specialist input is required. My training has reinforced the value of professional boundries in ensuring patient safety and effective care.

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B3: You must keep your professional knowledge and skulls up to date.

Evidence:

Keeping my professional knowledge and skulls up to date is a key part of my clinical developement. I regularly attend courses and online meetings regarding concussion.

Reflection on Overall Attaintment:

I find that ongoing education keeps my clinical reasoning sharp and techniques relevant. Staying current not only strengthens my competence but also ensures that i can offer patients the most evidence-informed care available.

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B4: You must be able to analyse and reflect upon information related to your practice in order to enhance patient care.

Evidence:

After managing a case of persistent hip pain, i reviewed the treatment outcomes and patient feedback to reassess my initial approach.

Reflection on Overall Attainment:

I realised the importance of structued reflection in improving decision-making. This process now informs how i adapt future treatments, allowing me to refine my practice continuously and deliver more effective, patient centred care.

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C2: You must ensure that your patient records are compehensive, accurate, legible and completed promptly.

Evidence:

All patient records are stored safe within a protected system. I always use a framework with a case history template that include main complaint, consent, mecdial history, systematic history, lifestyle, safety tests, examination, treatment plan and follow-up.

Reflection on Overall Attainment:

Clinical record keeping is not just an administrative task, but a critical part of clinical accountability. My current routine ensures documentation is both timely and thorough, strengthening the quality and safety of patients care.

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C3: You must respond effectively and appropriatly to requests for the production of written material and data.

Evidence:

Responding effectively to requests for written material and data is part of my responsibility as a healthcare professional. I collaborate with GPs, specialists and insurance companies with the consent of my patient.

Reflection on Overall Attainment

I have learned the importance of clarity and professionalism in written communication. Prompt and appropriate responses help maintain trust, support the administrative process and uphold professional standards.

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C4:

You must take action to keep patients from harm.

Evidence:

During a session, a patient reported new neurological symptoms that were outside the expected pattern when tested. I stopped treatment and referred to their GP for further investigation.

Reflection on Overall Attainment:

I have become more vigilant in recognising sign that may indicate underlying pathology. My training at the ESO has helped me respond decisively and appropriately.

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C5: You must ensure that your practice is safe, clean, hygienic, and complies with health and safety legislation.

Evidence:

Ensuring that my practice is safe, clean and hygienic is part of my daily routine. I follow disinfection protocols after each treatment and the treatment space is regularly cleaned to comply with health and safety standards.

Reflection on Overall Attainment:

Attention to hygiene and safety is not only regulatory, it actively contributes to patient trust and care quality.

Standard 12 - hygiejne

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Klinikken kan redegøre for hygiejnen på klinikken, både i forhold til lokaler og inventar og blandt personalet jf. Nationale Infektionshygiejniske Retningslinjer (NIR).
Rengøring
Klinikken kan redegøre for, at rengøring af lokaler og inventar er sikkerheds- og sundhedsmæssigt forsvarligt for patienter, pårørende, fysioterapeuter og klinikpersonale. Rengøring skal udføres, så risikoen for smittefare reduceres, og forurening ikke spredes.
Behandlingsbrikse, apparatur og øvrige hjælpemidler til flergangsbrug
Klinikken kan redegøre for, hvordan rengøring af risikoområder, fx behandlingsbriks, træningsapparatur, anvendt apparatur og udstyr mm. rengøres i forhold til forskrifter udstukket fra leverandører, Sundhedsstyrelsen eller andre relevante aktører.
Håndhygiejne
Der gennemføres god håndhygiejne ved anvendelse af hånddesinfektion og håndvask. Der skal forefindes håndhygiejnefaciliteter og håndhygiejnemidler i de lokaler eller nært tilstødende lokaler, hvor der udføres undersøgelse og behandling.

Klinikken kan redegøre for, hvordan håndhygiejne håndteres i klinikken, særligt på disse områder:

1. Håndvask og hånddesinfektion

2. Stillingtagen til brug af håndsmykker og armbåndsure

3. Stillingtagen til brug af arbejdsdragt.

Smittefarlige p atienter Hygiejne ved hjemmebehandling
Klinikken har en retningslinje for håndtering af smittefarlige patienter. Der gennemføres dog ikke screening af patienter. Nationale Infektionshygiejniske Retningslinjer for håndtering af smittefarlige patienter følges.

Klinikken kan redegøre for, hvordan hygiejnespørgsmål håndteres og italesættes i forbindelse med behandling i patientens eget hjem.
Hygiejne ved bassintræning
Dette omfatter håndhygiejne, herunder anvendelse af håndvask, sprit og evt. brug af handsker.

Klinikken kan redegøre for, hvordan hygiejnen håndteres i forbindelse med bassintræning, herunder:
Hygiejne ved ridefysioterapi

1. Håndtering af patienter med inkontinens

2. Håndtering af pludselig opstået urenhed i bassinet, herunder afføring

3. Håndtering af udstyr/hjælpemidler i vandet

4. Kontrol af klorindhold, rensning, kontrol for bakterier mv. ved eget bassin.

Ridefysioterapeuten kan redegøre for håndtering af hygiejne i forbindelse med ridefysioterapi, herunder faciliteterne på rideskolen/ridestedet:
Øvrige forhold, herunder bortskaffelse af akupunkturnåle

1. Rengøring af undersøgelsesrum og eventuelle redskaber

2. Rengøring af toilet

3. Mulighed for vask og afspritning af hænder m.m.

Hvis der på klinikken forefindes andre redskaber eller forhold, der kan påvirke hygiejnen, tages der stilling til håndtering heraf. Hvis klinikken fx har akupunkturnåle, opbevares og bortskaffes disse uden risiko for patienter, fysioterapeut, klinikpersonale eller andre på klinikken.

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I perioden 2019-2022 blev der udarbejdet faglige standarder til akkreditering af fysioterapipraksis. Læs standarden om hygiejne.

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C6: You must be aware of your wider role as a healthcare professional to contribute to enhancing the health and wellbeing of your patients.

Evidence:

I often discuss lifestyle factors such as a sleep, stress and movement habits during treatment sessions to support long-term patient outcomes.

Reflection on Overall Attainment:

I see my role extending beyond symptom management. My osteopathic training has strengthened my ability to educate and empower patients, encouraging healthier choices that contribute to their overall wellbeing.

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D1: You must act with honesty and integrity in your professional practice.

Evidence:

Recently, I treated a patient with chronic low back pain who was hoping for immediate relief. I explained clearly that improvement might be gradual and outlined a realistic prognosis based on clinical findings.

Reflection on Overall Attainment:

I recognise how honesty fosters trust and protects patient welfare. My osteopathic training has reinforced the importance of clear communication and ethical responsibility, especially when managing expectations and long-term outcomes.

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D2: You must establish and maintain clear professional boundaries with patients, and must not abuse your professional standing and the position of trust which you have as an osteopath.

Evidence:

Establishing and maintaining professional boundaries is essential to protecting the therapeutic relationship. I once treated a patient who began to share highly personal information unrelated to their care. I gently redirected the conversation to maintain focus while ensuring they felt heard and respected.

Reflection on Overall Attainment:

I have become more aware of how easily boundaries can be tested in a clinical setting. I have developed strategies to uphold professionalism while maintaining empathy and trust.

Effective Patient-Physician Communication Based on Osteopathic Philosophy in Caring for Elderly Patients

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Effective Patient-Physician Communication Based on Osteopathic Philosophy in Caring for Elderly Patients

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The objective of this article is to discuss effective communication strategies between elderly patients and their physicians from the perspective of osteopathic heritage. The patient-physician communication styles of Andrew Taylor Still, MD, DO, and early osteopathic physicians (ie, DOs) may have influenced how DOs today communicate with their patients. Historical literature describes how Still would discuss with his patients the causes of their health problems using analogies and language they would understand, and how, when caring for a patient at the end of life, he empathically provided emotional support for both patients and their families. Early DOs advocated setting clear expectations for patients regarding clinical outcomes and carefully listening to patients to build trust. The Osteopathic Oath, which calls for the DO to view the patient as a friend, may also affect patient-physician communication. Early osteopathic philosophy and culture, as modeled by Dr Still in his approach to elderly patients, should inspire today’s DOs in their communication with their elderly patients.

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D3: You must be open and honest with patients, fulfilling your duty of candour.

Evidence:

Openess and honesty with patients is one of my key focuses. A patient once experienced temporary discomfort after treatment. I explained why this can happen and discussed how we would monitor their response moving forward.

Reflection on Overall Attainment:

I have learned that honesty and transparancy, even in difficult moments, strengthens the therapeutic relationship. My osteopathic education has reinforced the value of owning outcomes and supporting patients through the full course of their treatment.

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D4: You must have a policy in place to manage patient complaints, and respond quickly and appropriately to any that arise.

Evidence:

If i have a complaint in the clinic i always strive to process the complaint in writing with openness and professionalism.

Reflection on Overall Attainment:

I understand that patient feedback, even when critical, offers valuable insight for future change and growth.

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D5: You must respect your patients´rights to privacy and confidentiality, and maintain and protect patient information effectively.

Evidence:

I always ensure patients that sensitive discussions happen in private and i store all records securely in compliance with data protection regulations.

Reflection on Overall Attainment:

I have learned that protecting patient information is not only a legal requirement, it is key to build trust.

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D6: You must treat patients fairly and recognise diversity and individual values. You must comply with equality and anti-discrimination law.

Evidence:

I once supported a patient who required cultural considerations around gender specific care. I adapted the session setup and communication style to align with their values and comfort.

Reflection on Overall Attainment:

I have awareness on cultural differences and i respect individual identity in the clinic.

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D7: You must uphold the reputation of the profession at all times through your conduct, in and out of the workplace.

Evidence:

Upholding the reputation of the osteopathic profession is a responsibility i take seriously. I am mindful on how my actions reflect on the profession.

Reflection on Overall Attainment:

I recognise that the professionalism extends beyond the clinic. ESO has helped me understand how consistent, respectful behaviour strengthens public trust and contributes to the image of osteopathy.

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D8: You must be honest and trustworthy in your professional and personal financial dealings.

Evidence:

I ensure transparancy in my fee and provide clear explanations of treatment costs before beginning treatment.

Reflection on Overall Attainment:

I understand that honesty builds trus. I aim to maintain ethical standards in all financial interactions, both in the clinic and personal.

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D9: You must support colleagues and cooperate with them to enhance patient care.

Evidence:

I monthly work alongside colleagues to provide the best possible care. A colleague and i work more with concussion patients and we usually share the course of treatment. I treat a few times and then my colleague do the same and we switch to provide fresh eyes on the case.

Reflection on Overall Attainment:

I have come to value open communication and shared decision-making with colleagues. Collaboration not only improves patient outcomes but also provide mutual respect and learning among practitioners.

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D10: You must consider the contributions of other health and care professionals, to optimise patient care.

Evidence:

I often refer patients to other health care professionals. When working with concussion patients i collaborate with neuro-optometrists.

Reflection on Overall Attainment:

Reflecting on this, i see how interprofessional collaboration is key to holistic care. The strenghts of other professionals enhances the patient experience and the clinical outcome.

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D11: You must ensure that any problems with your own health do not affect your patients. You must not rely on your own assessment of the risk to patients.

Evidence:

Ensuring that my own health does not affect patient care is a responsibility i take seriously. I get professional treatment on a monthly basis to maintain optimal health.

Reflection on Overall Attainment:

My osteopathic training has reinforced the need to objectivity when it comes to my own health.

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D12: You must inform the GOsC as soon as is practicable of any significant information regarding your conduct and competence, cooperate with any requests for information or investigation and comply with all regulatory requirements.

Evidence:

I understand the need to inform the GOsC of any significant issues regarding my conduct or competence and i am prepared to cooperate fully with any investigation.

Reflection on Overall Attainment:

I view transparancy with regulators as a safeguard for patient welfare and trust.

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I use Driscoll´s ´What´ Model to structure reflection. In one case, I asked myself: "What happened?" after a patient returend with unresolved knee pain. "So what?" led me to realise i had not considered their running technique in enough detail. "Now what?" prompted me to include a more thorough biomechanical asssessment of running in that case and future cases.

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Driscoll (1994) developed this model of reflection based on the three simple questions - What? So what? Now what? - originally asked by Terry Borton (1970). The model provides one of the simplest frameworks for reflection. In practice you should ask yourself the three questions after a critical incident that has taken place and you want to extract learning from.

'What?' helps you describe the situation you want to learn from. You should identify the facts and feelings of the situation.

'So What?' allows you to extract the meaning of 'What?'. Moreover, you should question what knowledge you and others had in the situation, and what knowledge or theories that could help you make sense of the situation.

'Now what?' allows you to create an action plan for the future based on the previous questions.

Below is further information on the model - each stage includes guiding questions to ask yourself and a couple of examples of how this might look in a reflection.

This is just one model of reflection. Test it out and see how it works for you. If you find that only some of the outlined questions are helpful, focus on those. However, by thinking about each stage you are likely to engage more critically with your learning experience.

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One of the simplest frameworks of reflection - by moving through three reflective stages, you will think about an experience, its implications, and what that means for the future.

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A pregnant woman came to the clinic with low back pain and pelvic pain. Through a thorough case history, i identified postural strain and possible hormonal influences to contribute to her pain and discomfort.

I explored how gentle osteopathic techniques and postural patient education could help relief her symptoms. I also encouraged close collaboration with the midwife for the patient to get strategies to cope with the situation.

This experience strengthened my ability to provide individualised care while considering safety and comfort for the patient. The experience contributed to a better understanding on how to help her best, by searching for evidence to back up my treatment plan.

Osteopathic manipulative treatment for low back and pelvic girdle pain during and after pregnancy: A systematic review and meta-analysis - PubMed

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Affiliations

¹ Institute for Osteopathic Studies, Fürst-Bülow-Str. 10, 57074, Siegen, Germany. Electronic address: info@iniost.de.

² Institute for Osteopathic Studies, Fürst-Bülow-Str. 10, 57074, Siegen, Germany. Electronic address: jan-david@franke-center.de.

³ School of Therapy & Social Work, Fresenius University of Applied Sciences, Germany. Electronic address: Belz.Sebastian@t-online.de.

⁴ Centre for Chronic Disease Prevention and Management, College of Health and Biomedicine, Victoria University, Melbourne, Australia; A.T. Still Research Institute, A.T. Still University, Kirksville, MO, USA. Electronic address: gary.fryer@vu.edu.au.

Affiliations

¹ Institute for Osteopathic Studies, Fürst-Bülow-Str. 10, 57074, Siegen, Germany. Electronic address: info@iniost.de.

² Institute for Osteopathic Studies, Fürst-Bülow-Str. 10, 57074, Siegen, Germany. Electronic address: jan-david@franke-center.de.

³ School of Therapy & Social Work, Fresenius University of Applied Sciences, Germany. Electronic address: Belz.Sebastian@t-online.de.

⁴ Centre for Chronic Disease Prevention and Management, College of Health and Biomedicine, Victoria University, Melbourne, Australia; A.T. Still Research Institute, A.T. Still University, Kirksville, MO, USA. Electronic address: gary.fryer@vu.edu.au.

Abstract

Background: Low back pain (LBP) is a common complaint during pregnancy. This study examined the effectiveness of osteopathic manipulative treatment (OMT) for LBP in pregnant or postpartum women.

Methods: Randomized controlled trials unrestricted by language were reviewed. Outcomes were pain and functional status. Mean difference (MD) or standard mean difference (SMD) and overall effect size were calculated.

Results: Of 102 studies, 5 examined OMT for LBP in pregnancy and 3 for postpartum LBP. Moderate-quality evidence suggested OMT had a significant medium-sized effect on decreasing pain (MD, -16.65) and increasing functional status (SMD, -0.50) in pregnant women with LBP. Low-quality evidence suggested OMT had a significant moderate-sized effect on decreasing pain (MD, -38.00) and increasing functional status (SMD, -2.12) in postpartum women with LBP.

Conclusions: This review suggests OMT produces clinically relevant benefits for pregnant or postpartum women with LBP. Further research may change estimates of effect, and larger, high-quality randomized controlled trials with robust comparison groups are recommended.

Keywords: Low back pain; Osteopathic manipulative treatment; Postpartum; Pregnancy; Spinal manipulation; Systematic review.

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American Osteopathic Association Guidelines for Osteopathic Manipulative Treatment (OMT) for Patients With Low Back Pain.

Task Force on the Low Back Pain Clinical Practice Guidelines. Task Force on the Low Back Pain Clinical Practice Guidelines. J Am Osteopath Assoc. 2016 Aug 1;116(8):536-49. doi: 10.7556/jaoa.2016.107. J Am Osteopath Assoc. 2016. PMID: 27455103

Chiropractic Care for Adults With Pregnancy-Related Low Back, Pelvic Girdle Pain, or Combination Pain: A Systematic Review.

Weis CA, Pohlman K, Draper C, daSilva-Oolup S, Stuber K, Hawk C. Weis CA, et al. J Manipulative Physiol Ther. 2020 Sep;43(7):714-731. doi: 10.1016/j.jmpt.2020.05.005. Epub 2020 Sep 6. J Manipulative Physiol Ther. 2020. PMID: 32900544

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national center for biotechnology information

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Osteopathic manipulative treatment for low back and pelvic girdle pain during and after pregnancy: A systematic review and meta-analysis - PubMed

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This review suggests OMT produces clinically relevant benefits for pregnant or postpartum women with LBP. Further research may change estimates of effect, and larger, high-quality randomized controlled trials with robust comparison groups are recommended.

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A 7-week-old baby was brought to the clinic due to unsettled behaviour and difficulties feeding on one side. A detailed birth history revealed a prolonged delivery with difficulites during the last part of the delivery.

On examination, the child showed reduced neck mobility and tension in the thorax.

I used gentle, age-appropriate techniques and advised the parents on positioning and supportive exercises and care at home.

This case helped me understand the importance of early life mechanical stressors and their potential impact on behaviour, feeding and development.

Manual therapy of infants with postural and movement asymmetries and positional preference | Manuelle Medizin

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Manual therapy of infants with postural and movement asymmetries and positional preference - Manuelle Medizin

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Background There are different therapeutic approaches to persistent positional preference (kinematic imbalance due to suboccipital strain, KISS) in infants. There are no evidence-based or controlled studies investigating the effect of manual medicine treatment in children aged 3–6 months, particularly in combination with a home exercise programme. The presented monocentric study on one-time manual medicine treatment of infants aged 14–24 exhibiting these symptoms aims to close this gap. Methods This study comprises a controlled double-blind trial and per-protocol-analysis. Primary outcome was the 4-item symmetry score (4–17 points). The second measurement was performed after 4–6 weeks. Results A total of 62 infants were treated and evaluated (mean age 17 weeks). The intervention and control groups started with a symmetry score of 12.9 ± 2.1 and 12.5 ± 1.7 points, respectively. In the intervention group the score improved by 4.9 ± 2.4 to 8.0 ± 2.7 points, in the control group it improved by 2.9 ± 2.9 to 9.6 ± 3.0 points. The difference between the groups was statistically significant (p = 0.03). Both groups had significantly better values over time (p < 0.001). No adverse events or side effects were observed. Conclusion Manual medicine treatment of infants with postural and movement asymmetries as well as positional preference in combination with a home exercise programme is superior to a home exercise programme alone. Both treatment concepts achieved significant improvements. However, the manual medicine treatment played an important role in reducing the symmetry score value for the affected children, such they were no longer in need of treatment.

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In my osteopathic training i use Gibbs´ Reflective Cycle to systematically evaluate clinical experiences. By describing events, examining my feelings and analyzing outcomes, I identify areas for improvement. This structured approach enhances my clinical reasoning and future patient care.

For example, after a treatment that led to unexpected soreness for a patient, i used the cycle to describe the event, analyse the response and identify what i could improve. This structured reflection helped me modify my technique and enhance communication in future sessions.

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One of the most famous cyclical models of reflection leading you through six stages exploring an experience: description, feelings, evaluation, analysis, conclusion and action plan.

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In addition to clinical work, I have worked for several years with a team in the Danish Basketball League. Sports injuries are a weekly occurrence, and my role often centres around maintaining athlete availability through the management of overuse symptoms.

This environment requires regular communication with players, coaches, the team manager and owner. Osteopathic training has deepened my understanding of how factors outside the MSK system can contribute to recurrent symptoms. This has influenced my approach to common injuries by encouraging a broader and more integrated clinical perspective.

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In clinic, I worked with a 52-year-old woman who had thoracic spinal fusion surgery from T4-T12, 20 years ago. She presented with progressive stiffness, reduced respiratory motion and intermittent discomfort in the cervical and lumbar spine, likely due to comensatory strain and long-term adaptive patterns.

This case provided insight into the long-term sequelae of spinal surgery and the importance of supporting the body´s adaptation over time. Through detailed case history and functional assessment, we tailored a treatment plan with focus on improving mobility in adjacent spinal regions, reducing muscular tension and supporting respiratory function.

My osteopathic training helped me approach this case holistically, recognising the need for long-term management rather than immediate resolution.

This experience reinforced the value of osteopathy in managing chronic conditions through consistent, patient-centred care.