What Is OMM? Understanding Osteopathic Manipulative Medicine with Dr. Drew Rose

Riordan Clinic [00:00:00]:
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Ron Hunninghake, MD [00:00:56]:
Well, welcome, everyone. Hello, everyone. It’s Dr. Ron Hunninghake. And I’m back again for the Real Health Podcast. And once again we have Dr. Drew Rose with us, who we introduced not too long ago. Dr. Rose. Drew. Dr. Drew.

Drew Rose, DO [00:01:10]:
Dr. Drew. Yes. Dr. Drew.

Ron Hunninghake, MD [00:01:11]:
Dr. Ron. Okay, we’re so happy to have you at the Riordan Clinic.

Drew Rose, DO [00:01:16]:
And I.

Ron Hunninghake, MD [00:01:17]:
And I think we covered what brought you here. Now, we want to let the. We want to let our audience know what you do. You’re an osteopath, and maybe we should just start with that. What is the difference between an MD, Chiropractor, Osteopath.

Drew Rose, DO [00:01:35]:
That. Yeah, absolutely. So in today’s world, as far as curriculum goes, curriculum’s pretty much been unified between MDs and DOs. The big difference these days is osteopathic students get 500 extra contact hours in the first two years. Laboratory contact hours. That is where you learn OMM, or Osteopathic Manipulative Medicine, as you alluded to it, is very similar to chiropractic medicine. And this all kind of goes back to a little bit of a history lesson. The late 1800s, when Dr. A.T. Still, he was the father of osteopathy. He’s a Kansas boy as well. And then D.D. Palmer, who was less than 500 miles away up in Iowa. Actually, I think they were separated about 12 years worth of time. But they came up with the same kind of philosophy that structure equals function. Or essentially, if something is off in the body or malaligned, that some sort of function is going to be off, too. So you kind of flash forward today’s day and age where, you know, you get some politics and everything going around. But ultimately, the main difference now is chiropractic have their own schools. They focus a lot on spinal adjustments and really kind of kind of go out from there. And then osteopaths now learn how to manipulate not just the musculoskeletal system, but the nervous system, the organ, and then something that we call the CRI, the Cranial Rhythmic Impulse. So craniosacral medicine is pretty big within the osteopathic world as well.

Ron Hunninghake, MD [00:03:08]:
Okay, so you’re kind of like doing whole body manipulation, so to speak?

Drew Rose, DO [00:03:13]:
Yes, absolutely. Head to toe.

Ron Hunninghake, MD [00:03:15]:
So a little bit more holistic, though I’m sure it varies from practitioner to practitioner. So how might this fit in? You know, you’ve been here at the Riordan Clinic now for several weeks, over a month, and you’re getting a feel for our patients, the Riordan Clinic patients. Obviously, we take a strong nutritional foundation to everything, but I think with you coming aboard, I think I’m certainly more interested in understanding what can we do to help the physical body and so address that a little bit more in terms of when you’re evaluating a person, what sort of things are you looking for? What sort of reasons do people come to you with and how do you help that?

Drew Rose, DO [00:03:59]:
Yeah, absolutely. The most common complaint we get as osteopaths, when somebody comes in for an OMM, Osteopathic Manipulative Medicine, that is treatment is low back pain. Low back pain is all across the board, all across the world. Yes. So we’ll just kind of take that as an example. So low back pain, you’re going to be looking at the area that’s painful, but you also want to look at the segments above and below, because we know, let’s. You know, you take a normal step when you’re walking. Your heel strikes the ground, you roll the weight to the ball of your foot, you push off and you go for the next step. When that force hits the heel, you can actually trace up the leg from joint to joint where the energy is actually being transmitted. So there’s a thought where, you know, the foot is one of the most active areas of the body, but if something is off, something in the ankle, something even as small as, like the big toe could be off. That could actually transmit some sort of malalignment all the way up into the low back. So when you do an exam, I’m going to be running my hands down somebody’s back, somebody around the hips, even examine all the way down the leg and kind of see how things are rotated. See if one leg is shorter than the other. So it’s not just the area that’s in pain. You got to find the area that is Malaligned to actually work with. When you find that segment, there are about 40 different recognized techniques that you can utilize on the patient. And just depending on all the different circumstances as to what brings the patient in, helps direct what, what technique is going to be better for that patient.

Ron Hunninghake, MD [00:05:41]:
Yeah, no, I hear that the osteopathic schools are kind of starting to open up again. There was a trend where osteopaths were becoming more like MDs, but now you’re kind of going back to your roots.

Drew Rose, DO [00:05:55]:
I think there’s a, there’s a light within the osteopathic world. Statistically, less than 10% of osteopaths graduate medical school and continue to utilize this skill set that we learn. So those of us that continue to utilize this within our everyday practice or even just life in general, there is, as I put it, you have a, you have a light that you want to shine brighter. And there’s a small subset of osteopaths that are, you know, galvanized and, you know, fighting for this, for people to utilize this more often. I also think the way health care has gone, where people are looking for a more natural and holistic alternative to, you know, conventional therapies, this is right up people’s alley because this is not talking about pharmaceuticals or supplements. It’s talking about a hands on technique with an educator practitioner.

Ron Hunninghake, MD [00:06:50]:
Let’s use another really common symptom that people come to me with or to all doctors, really. Headaches.

Drew Rose, DO [00:06:58]:
Yes.

Ron Hunninghake, MD [00:06:59]:
How do you, how do you handle headaches?

Drew Rose, DO [00:07:01]:
Yes. So speaking as a migraine sufferer, I understand headaches. So there is a sector of OMM where you go to a course, you get trained how to manipulate the cranial bones.

Ron Hunninghake, MD [00:07:19]:
Most people don’t think those move that much.

Drew Rose, DO [00:07:21]:
No, historically. So historically it was thought that they don’t move at all actually. And then NASA and I don’t have the exact study in front of me, and I don’t remember exactly when it was. I think it was in the 2000s, NASA actually did a study on their astronauts with within a microgravity environment where it actually shows that these bones with the sutures that are kind of interwoven like this, they’ll move up to 3 millimeters each. So there is a respiratory cycle too, where the fluid within your cranium that bathes your brain, the Cerebrospinal fluid, and it goes down into your spine, there’s a respiratory cycle of inhalation and exhalation. So naturally the bones have to move to compensate with that. There are courses that you can take where you Actually learn how to manipulate these bones. Excuse me. And learn the different techniques to unwind these kind of strains that you have. So when it comes to people with headaches, Headaches was actually the biggest reason we even have OMM. The. The story actually is that at still was a teenager and he was out herding cattle, I believe, but he was out in a field, and back then, the fences were fence posts with rope in between them. He, in the heat of the day, had a headache, found some shade laid down, kind of hooked the base of his cranium here on the. The rope, fell asleep, woke up, and didn’t have a headache anymore. And that is kind of what sprung him to believe that if there is a misalignment or something’s tight and you loosen it up, all of a sudden the function’s better. So we’re able to manipulate not just the bones in the body, but then the tiny little muscles at the base of the skull. Anything like that. That could actually help improve blood flow and therefore improve headaches, too.

Ron Hunninghake, MD [00:09:07]:
Yeah, well, probably many of our viewers know that when Dr. Riordan founded the Riordan Clinic, it wasn’t called the Riordan Clinic, it was the center for the improvement of human functioning. Sounds like this is right down the osteopathic alley.

Drew Rose, DO [00:09:21]:
Oh, absolutely.

Ron Hunninghake, MD [00:09:22]:
Yeah. So how do you feel like being able to get nutritional information, your osteopathic patients, which is what we kind of feature at the Riordan Clinic? How do you feel that will synergize what you can do?

Drew Rose, DO [00:09:34]:
Oh, I think it’s going to be a complete approach, actually. So just kind of going back a little bit. When I was a fellow learning all of this in medical school, we had a clinic that is all OMM. You didn’t do any of the meds or anything. Of course, it’s just part of education. There’s plenty of other clinics out there where DOs only practice this, but I really feel taking the Riordan approach is giving you a different angle as to trying to find that root cause of these issues. You know, whether it’s a low back pain, headaches, what have you, having a nutritional approach in getting those labs could ultimately help the overall health of the patient.

Ron Hunninghake, MD [00:10:15]:
Yeah. And so our patients often. And this is true of any kind of health problem. They’re. They’re not just one thing. A lot of patients come in and they may have headaches, they may have back pain, but they’re tired. Or they may have hypertension along with that fatigue, and they may be on other medications that are trying to suppress the symptoms, but are not necessarily getting to the root cause. So I don’t know. Does that encompass some of what your training has been involved with?

Drew Rose, DO [00:10:43]:
Oh, absolutely. There’s a lot of conversation that happens when you’re on the table with me. It’s, you know, you have to be able to interpret what your hands are feeling and being able to put everything into context is how you get to the root cause. You know, if somebody comes in with low back pain but they didn’t have an accident or strain their low back, then maybe your inflammatory markers are high. And we can’t tell that unless we do some sort of quantitative analysis, thus the labs. So I think taking it from a Riordan approach is only going to add an extra layer of information to help anyone that comes in.

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Ron Hunninghake, MD [00:12:19]:
And you also bring to the table another, another asset that a lot of doctors don’t have. I guess you were six years a hospitalist in Salina, Kansas? Yeah.

Drew Rose, DO [00:12:31]:
Correct.

Ron Hunninghake, MD [00:12:32]:
And what did that do for your understanding of human health and disease?

Drew Rose, DO [00:12:37]:
Yeah, so while I was a hospitalist, I also covered ICU about half the time that I worked. And what really hit home was a pandemic. So realizing that, you know, cookie cutter medicine does not help everyone, it helps placate symptoms sometimes. And it may help one person out of a subset of 10. But what happened to the other nine? It’s kind of a spectrum of how well we’re dealing with certain things. And I think that’s where a lot of people will like an OMM to Chiropracty. But I want to expand upon that because you get chronic diseases, things that you saw in the hospital, things like COPD, IBD, so inflammatory bowel disease, you know, it’s. It’s within the realm of OMM to be able to manipulate the ribs and the muscles, but also get down to the layers of fascia and pleura and other organs that might need a little bit of help, too. It’s. It really is individualizing care to that patient, no matter what they. What the diagnosis or working diagnosis is. And hospital medicine helped me focus in on. You can’t do the same thing for everyone.

Ron Hunninghake, MD [00:13:51]:
Individualized care.

Drew Rose, DO [00:13:52]:
Exactly.

Ron Hunninghake, MD [00:13:54]:
Yeah. Wow. I mean, quite honestly, I’m glad we’re having this discussion because, you know, I knew that osteopaths did this in general, but I didn’t realize you could be so universal in terms of looking at all kinds of problems from this. This perspective.

Drew Rose, DO [00:14:11]:
Perspective. Oh, absolutely. This is, you know, one of the four tenets that I think I spoke on in my last podcast when they. We were introducing myself. The four tenets of osteopathy are, you know, the patient is a unit of body, mind, and spirit. And having all three of those in alignment is what points you towards health. And then the second tenet is structure equals function and are reciprocally interrelated. So if you’re sick, you have some function that’s off, you can actually see a change in your musculoskeletal system because of that, and vice versa, if you have something out of an alignment that could cause function to be off. So being able to put your hands on somebody and tangibly feel those different changes in somebody’s body, and then having a way to work that out, not just physically, but then being able to talk it out. So mentally, being able to meditate on things, being able to lean into your spiritual practice, that helps people in more ways than we could even qualify. Quantify however you want to say it. Words cannot do it justice.

Ron Hunninghake, MD [00:15:19]:
Yeah. And we are a society of people getting older. I mean, yes, we have younger patients here, but I would say the majority of my patients are people who are dealing with the process of aging. And I know when I was. I used to work in Salina, too, and in the nursing home there, I could see where a lot of people, as they aged, got to be on more and more medications, which medications can be very useful. But on the other hand, they oftentimes are attempts to suppress a symptom.

Drew Rose, DO [00:15:52]:
Right.

Ron Hunninghake, MD [00:15:53]:
As opposed to look for the root cause. So I’m assuming that you can almost use this as part of the discovery process. And in people who are getting older, who are on medicines, maybe there are underlying physical factors yes, that could be addressed. That are not getting addressed in the five minute or ten minute appointment.

Drew Rose, DO [00:16:11]:
Oh, absolutely. It’s so my mind just went like 10 different places with that. Because you’re absolutely right. It’s one is to never underestimate the healing power of. Healing power. Excuse me, of touch. You know, just being able to put your hands on somebody is, in my opinion, a privilege as a physician. But to be able to put your hands on somebody and gather information, just minute amount of information can give you so much more data. To be able to kind of hone in on where the root cause is. And I think a lot of people take advantage of that as saying that it’s more hocus pocus or so. But, you know, one of the things that we taught in OMM lab first day is how sensitive the nerve receptors are on your fingers. And one of the exercises I would have my students do is give you a couple coins, put them in your pocket. Great. So put your hand in your pocket. Can you tell me if you’re touching a penny or a quarter? Pretty simple. Yeah. You can kind of tell if it’s a dime, a quarter or a penny. Nickel kind of throws people off sometimes. But can you tell me what the date is on the quarter?

Ron Hunninghake, MD [00:17:30]:
Oh, whoa.

Drew Rose, DO [00:17:32]:
So that’s about 1 millimeter or so. Yeah. And there is evidence where you could actually have that much information given to you.

Ron Hunninghake, MD [00:17:40]:
Yeah.

Drew Rose, DO [00:17:40]:
But over time, you know, living in a very anatomically gross world where everything is big, you learn to kind of suppress that information because otherwise you get overwhelmed. So what we do, day one is start retraining the brain.

Ron Hunninghake, MD [00:17:56]:
Sensitizing.

Drew Rose, DO [00:17:57]:
Exactly. To feel all these little things. Because some of these changes we’re talking about in the skin, we’re talking millimeters, just like we talked about with the skull. Three millimeters is all it moves. But when you put your hands on somebody, you can feel about six times per minute. The head fill up in flexion and then breathe out in extension.

Ron Hunninghake, MD [00:18:17]:
Yeah. And we produce an energy field around us. And I know, I’ve been to conferences where we rub our hands together and then you close your eyes and you can feel an energy field around the body. But if you’re not sensitive to that, and if you’ve only got five or ten minutes to talk to the patient, make the diagnosis, here’s your medicine, or even here’s your vitamin. That may not be enough. That may not be enough. If you’re trying to treat the whole person.

Drew Rose, DO [00:18:45]:
Yes. And so many things affect that EM field that you’re Talking about that electromagnetic field, it on the average person, you can feel it about 18 inches off the body or so. But there is a sector of OMM biodynamics that is where it really does deal with the energy flow. And I think this is where you get a lot of terms that are thrown out there, like auras, chakras, what have you. But the difference is no matter what culture you’re in, no one’s arguing that it exists. And if you’re again going back to structure and function, if you have some sort of restriction somewhere, you can feel that restriction within the energetic field as well. So a lot of what I do is trying to tap into not just the biodynamics of the person, but also going back to the basics of the structure of the patient too. It’s all equally as important. Yeah.

Ron Hunninghake, MD [00:19:46]:
If we didn’t have a field around us, our iPhones wouldn’t work.

Drew Rose, DO [00:19:49]:
Oh, no, no.

Ron Hunninghake, MD [00:19:51]:
So, okay, so looking forward, what do you hope to gain as far as being here? Because I know in your being in a hospital setting, you don’t always get to utilize what you learned. What, where do you think this can go? I’m thinking of people who come in with chronic fatigue syndrome or fibromyalgia, very complex illnesses. How can the OMM evaluation help kind of get to some root causes with those complicated syndromes?

Drew Rose, DO [00:20:22]:
Well, first and foremost, right off the bat, improving quality of life, that’s, that’s the immediate goal. Being able to wake up in the morning and being able to function, as opposed to taking a couple of hours before you can actually brush your teeth or something. A lot of patients with fibromyalgia have difficulty keeping their hands above, you know, arms above their shoulder and just going about the day. So right off the bat is improving overall functionality. But as you go through an OMM appointment, you really try to figure out what’s important to the patient or our co learners, that is, and trying to find those short term and long term term goals, but then also empower people that what you’re feeling is true. It is not something that’s just in your head. And even if it is in your head, guess what? Your mind and your body are connected.

Ron Hunninghake, MD [00:21:13]:
Yeah.

Drew Rose, DO [00:21:14]:
So let’s talk about it. Let’s see what we can do in finding those areas to improve on. I think that is the ultimate goal. The kinds of patients that are, you know, suited to having an OM appointment, really, the sky’s the limit. As you mentioned, fibromyalgia is huge. Chronic back Pain sufferers like we talked about mentioned inflammatory bowel disease, you know, manipulating the viscera. And what’s going on in your abdomen is. There’s so much there. But then I’ve also seen a lot of people with copd. Rib dysfunction is okay. It is difficult to live with. Absolutely. And then anybody that’s been in any kind of acute illness recently definitely could use some lymphatic drainage. And then anybody that’s been dealing with, you know, like you said, chronic fatigue or just any kind of chronic complex illness, your body is. Is screaming for some sort of assistance here. So from that standpoint, what I’m looking to gain is another skill set available to our co-learners here at Riordan to overall just improve the quality of life and to ultimately try to get back down to what that root cause actually is. Yeah.

Ron Hunninghake, MD [00:22:26]:
Most people are so used to having symptoms, having concerns, having diagnosis, and getting medications. And most medications act as blocking agents.

Drew Rose, DO [00:22:36]:
Yes.

Ron Hunninghake, MD [00:22:37]:
Well, they’re already probably blocked up, and maybe this is just a methodology to help them free up lymphatic drainage, circulation, colon problems, digestion. All of that depends upon flow. And what I hear you saying is that by assessing the. The physical body in a. In this. This way, this more holistic way, you can find out where the blockages are and hopefully open them up.

Drew Rose, DO [00:23:03]:
Oh, yeah. Yes. And that’s the ultimate goal. You want everything to flow not just from blood vessels, but lymphatic fluid, energy flow as well. You want all of this to be open and flowing freely. Third, tentative osteopathy. The body is capable of self healing, and if everything is imbalanced, ultimately, that is the goal is to find the health of every patient, or as we call you, co-learners. Yeah.

Ron Hunninghake, MD [00:23:31]:
So, Dr. Drew, I am excited that you’re working with us, and I hope you, the audience that’s listening, gets a new perspective on what, what OMM can do for them.

Drew Rose, DO [00:23:41]:
Absolutely.

Ron Hunninghake, MD [00:23:42]:
So thanks so much for joining us and we look forward to years to come.

Drew Rose, DO [00:23:47]:
Thank you.

Riordan Clinic [00:23:49]:
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