OMM
OMM Fundamentals & TART Diagnosis
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OMM Fundamentals & TART Diagnosis

Somatic dysfunction, TART, direct vs indirect, barriers.

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◆Somatic dysfunction (the entity OMM treats)

  • •Definition: impaired/altered function of related components of the somatic system — skeletal, arthrodial, myofascial — and related vascular, lymphatic, neural elements
  • •Diagnosed by TART: Tissue texture changes, Asymmetry, Restriction of motion, Tenderness (need at least one but most need multiple)
  • •Acute somatic dysfunction: edema, erythema, warm, boggy, increased tone, painful with motion
  • •Chronic somatic dysfunction: ropy, fibrotic, cool, decreased tone, less tender, dull/aching

◆Naming the dysfunction

  • •Always named for direction of FREEDOM of motion (where it moves easiest), NOT the restriction
  • •Example: 'C4 FRSL' = C4 prefers Flexion, Rotation Left, Side-bending Left — restricted in extension, right rotation, right sidebending
  • •Cardinal motions: flexion/extension, rotation L/R, side-bending L/R, translation

◆Barriers concept

  • •Physiologic barrier: limit of ACTIVE motion
  • •Anatomic barrier: limit of PASSIVE motion (beyond = injury)
  • •Restrictive barrier (pathologic): premature limit due to dysfunction
  • •Elastic barrier: between physiologic and anatomic — engaged in HVLA
  • •Neutral position: where ligaments are balanced (midway between extremes)

◆Direct vs Indirect technique

  • •DIRECT: physician moves toward the restrictive barrier (against the freedom of motion). Examples: HVLA, muscle energy, articulatory, direct MFR
  • •INDIRECT: physician moves AWAY from the barrier (with the freedom of motion). Examples: counterstrain, BLT, FPR, indirect MFR, cranial
  • •Combined: still technique (indirect → direct), facilitated positional release

◆Major treatment systems

  • •Active: patient assists (muscle energy, articulatory with patient breathing)
  • •Passive: physician does the work (HVLA, soft tissue inhibition, MFR, counterstrain)

High-yield pearls

  • ◆Always describe dysfunction by direction it MOVES TO most easily (FREEDOM)
  • ◆Acute = swollen/boggy/warm; Chronic = ropy/fibrotic/cool
  • ◆Direct moves toward barrier; Indirect moves away from barrier
  • ◆If patient is too acute or sensitive → use INDIRECT technique (counterstrain, BLT, FPR)
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