AAOMT
Philosophy & Treatment Approaches
AAOMT Philosophy
The AAOMT system offers a holistic approach to manual therapy. It is based on an intricate knowledge and understanding of clinical biomechanics and arthrokinematics. Treatment is always directed at the underlying mechanical basis of a complaint.
It recognises the interplay between the neurological, muscular and articular systems. This composite neuro-muscular-articular system is then considered to be a self-regulating system in a constant state of change in response to both intrinsic and extrinsic factors. These include factors such as age, trauma, structural abnormalities, posture, or overuse of a component.
The body as a whole can be divided into a series of segments that are linked by their biomechanical function (biomechanically linked functional segments). Alteration from the normal function of one component in a segment will lead to compensation and alteration of the rest of the segment and, over time, to other segments in the chain. The sequence of altered function and subsequent compensation will continue to spread (following Janda’s concept of vertical and horizontal generalisation) involving more and more segments throughout the body.
An example would be a symptomatic lesion of L5/S1 segment. Local hypermobility at the lumbosacral junction may be mechanically underpinned by hypomobility of hip structures. If neglected, the soft tissues (both ligamentous and muscular) in the lumbar spine become progressively more involved. If not corrected the condition will likely move to higher lumbar segments. Similarly, restriction of mobility in the hip will increase stresses acting upon the knee. Over time, if not arrested, this could progress proximally and distally through the spine and extremities until even the CNS is affected. The pathology becomes systemic with alterations in movement patterns, neurological and muscular tension, and joint mobility throughout. It is not uncommon for a lesion of the foot to impact biomechanically on cervical spine and temporomandibular joint - the presenting symptom may be cervical or TMJ pain alone.
Treatment Approaches
Treatment is directed at correcting all elements of the dysfunction. Consideration is given to the normal biomechanical function and to any pathological processes in place in any of the involved articular, muscular and neural structures. Symptom alleviation, while important, forms only one part of management.
Joint mobilisations are based on the individual joint arthrokinematics. Both peripheral and individual spinal segments are mobilised according to their varying facet planes and appropriate axes of movement for the movement restriction. Joint manipulations when required are an extension of these mobilisation techniques. Joint instabilities are managed with specific stabilisation techniques.
Soft tissue techniques are directed at ligamentous and capsular structures as well as disorders of muscle contraction and extensibility (utilising proprioceptive neuromuscular facilitation techniques as well as myofascial trigger point deactivation). Abnormal neural mobility is assessed and treated after surrounding structures are normalised. Altered patterns of movement and muscle activation, postural abnormalities and ergonomic dysfunctions are additionally assessed and corrected to remove ongoing strains on involved structures.
In summary, the AAOMT approach to manual therapy seeks to restore normal biomechanical function to all structures involved in and underscoring a pathology. It recognises interrelationships between biomechanically linked functional segments throughout the body, restoring balance to neurological, muscular and articular systems.