In this article I will be using the words and ideas of pioneers of osteopathic medicine who devised and refined Functional Technique to describe exercises which will ensure that you have the beginnings of the concept at your fingertips.
Functional technique is gentle, absolutely safe, attractive intellectually and deserving of the devotion it requires to perfect its use - from all therapists and practitioners who wish to offer their patients the best in bodywork.
Its one and only drawback is the level of concentration it demands and the mental fatigue it produces because of this.
What is functional technique
The term ‘functional technique’ grew out of a series of study sessions held in the New England Academy of Applied Osteopathy in the 1950s under the general heading of ‘a functional approach to specific osteopathic manipulative problems’.
In functional work palpation for ‘a position of ease’ involves a subjective appreciation of tissue as it is brought through positioning towards ‘ease’, to a state of ‘dynamic neutral’, rather than relying on a report by the patient as to reduction in pain as positioning is pursued, as is the case in Strain/ Counterstrain.
Theoretically (and usually in practice) the palpated position of maximum ease (reduced tone) in the distressed tissues should correspond with the position which would have been found were pain being used as a guide.
Bowles gives an example: "A patient has an acute low back and walks with a list. A structural diagnosis is made and the fingertips palpate the most distressed tissues, within the area of most distress. The operator begins tentative positioning of the patient, preferably sitting. The fingertips pick up a slight change toward a dynamic neutral response, a little is gained, a little, not much, but a little. A little, but enough so the original segment is no longer the most distressed area within the area of general distress. The fingers then move to what is now the most acute segment. As much feeling of ‘dynamic neutral’ (ease) is obtained here as possible. Being temporarily satisfied with slight improvements here and there, this procedure continues until no more improvement is detectable. That is the time to stop. Using tissue response to guide the treatment the operator has step by step eased the lesioning and corrected the structural imbalance to the extent that the patient is on the way to recovery."1
Hoover summarises the key elements of Functional Technique2
- Diagnosis of function involves passive evaluation as the part being palpated responds to physiological demands for activity made by the operator or the patient.
- Functional diagnosis determines the presence or absence of normal activity of a part which is required to respond to normal movement demands. If the participating part has free and ‘easy’ motion it is normal, if it has restricted or ‘binding’ motion it is dysfunctional.
- The degree of ease and/or bind present in a dysfunctional site when motion is demanded is a fair guide to the severity of the dysfunction.
- The most severe areas of dysfunction are the ones to treat initially.
- The directions of motion which induce ease in the dysfunctional sites indicate precisely the most desirable pathways of movement.
- Use of these guidelines automatically precludes undesirable manipulative methods since bind would result from any movement towards directions of stress.