Approche tissulaire de l'ostéopathie

Heirs to Still Being or Having?

Index de l'article

Structure governs function

This brings irresistibly to mind the famous words attributed to Still: “Structure governs function”. This laconic phrase is quite an accurate synthesis of one of osteopathy’s fundamental concepts: the relationship between structure and function. However, it is not formulated in this manner in any of Still’s writing… What is more, when stated this way, the concept is ambiguous, in particular as a result of the interpretation of the word govern, whose meaning has, over time, been considerably altered. This ambiguity had led many osteopaths to pay more attention to structure than necessary. According to the Larousse Dictionary, to govern is to direct with the help of a rudder. However, a rudder’s function is to orient in a specific direction, not to push. In other words, the force, the driving power comes from the motor, a distinct system which is independent from the rudder.

In living systems, structure orients the life force. The power itself comes from life. Therefore, it is life that we must understand. For the purposes of our model, structure and function are defined as follows:

Structure: in the living world, structure is a material organization whose purpose is to orient the non-specific life force towards specific, manifest functions, in order to satisfy the organism’s specific survival needs.

Function: is non-specific life force made specific through being channeled and oriented by a given structure, in order to resolve any problems compromising the organism’s survival.

A System of Organized Consciousnesses

We have imagined the cell as consciousness contained within a membrane and centered around a fulcrum. The body too can be imagined as an arrangement of self-contained spaces, centered around multiple fulcra. An organized system of consciousnesses or a system of organized consciousnesses… In time, the juxtaposition of these contained systems or spaces produces volumes, and therefore shape and form, the whole continuously expanding and retracting. This pulsation is a perceptible manifestation of life - the breath of life - referred to as the tissular rhythmic impulse.

Thus, the body can be perceived as a rhythmic (expansion/retraction) pulsatile fluid entity, organized by a fibrous partitioning system (membranes, fascias), and mechanically centered around Sutherland’s fulcrum.

From this perspective, the first structure to actuate organization is the dura mater. Indeed, the multidirectional expansion/retraction tissular motion is transformed by the dura mater’s tautness, generating points of restricted motion and areas of unrestricted motion and freedom. It is, in effect, the dura mater which governs the system, which organizes its mechanics. The dura enables the emergence of differentiated patterns of motion in the cranio-sacro-vertebral system. These differentiated patterns of motion have been recognised since Sutherland’s time as motions of flexion/extension of the unpaired, midline structures and external/internal rotation of the paired and peripheral structures.

We also know that during the system’s phase of expansion, the external flexion/rotation of the structures situated along the cranio-sacro-vertebral axis causes a settling of all peripheral tissues directly attached to the base of the skull or the pelvis, while the ensuing ascent is generated during the phase of retraction which causes the internal extension/rotation. However, all peripheral tissue, osseous tissue included, is alive and therefore animated by its own rhythmic pulsation, or motility. Tissues manifest their motility individually within the movement of the whole, something that has been clearly demonstrated by Barral and Mercier in their visceral approach. Depending upon the attention and intention that guides our perception, we will feel one or other of these movements, which co-exist, as has been explained above. Osteopaths are now familiar with these different movements, and have attempted to codify them. Here, we will consider these movements to be integrated within broader movements, as relative expressions of more absolute phenomena relating to the process and manifestation of life itself.

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