Q&A with Tom: Regarding Treatment Modalities/Philosophies

Hi Anatomy Trains,
I work as a masseur (clinical massage therapist) in Europe for a big healthcare provider, 20 minute sessions, 90 sessions a week. I have been working like this for 2 years, and while it has provided a steady pay check and lots of hands on experience, I am starting to want more. And in order to provide private treatments I both need and want better education for my clients. I will be taking a course next year (column therapy) with focus on on the spine from an osteopathic angle, and it’s kind of a gap filler for me. It will upgrade my skills and CV. enough for me to be able to charge more and provide more for clients than what I can offer in my present work, so that I can set up shop on the side of my current work. There is a catch-22 as a manual therapist, you need experience to become better, but you need to be better to get clients from where you can get said experience. This course will maybe qualify me for an osteopath education in my country. However I am not sure if it is, what I want to do, or if it is a good idea. Osteopathy seems to be more of a generalist approach, whereas Structural Integration seems a more specific treatment modality. There are pros and cons with being a generalist or a specialist, and I am not sure which one appeals to me, or which one is a good idea financially, since I will be working on my own in both cases.

How would you describe the differences between an osteopath and Structural Integration?
How can I decide which one is better for me?

A follow up question; I am very interested in biodynamic craniosacral therapy (BCST), which you recommend as a further education/treatment modality after KMI/FRSB in your online course information. Is BCST an altogether different treatment modality than cranial osteopathy? I see no point in becoming a regular CST (Upledger or cranial osteopathy) since that seems to me, to place in the same cul de sac I am in now as a masseur, which basically is just a watered down osteopath. But BCST seems to be a different treatment modality altogether, where one can actually offer something else than what a run-of-the-mill osteopath can offer.

I hope that you can help me with my questions.

FRSB - hands on
Good questions.

Your story is a very common one. You are correct – you need experience to be good, and you need to be good to get experience. Fortunately, you are over that hurdle, and now you want more – Great! It shows your dedication to your self-education, perhaps the most necessary component for successful therapy, just under empathy, the sine qua non.

Ida Rolf created Structural Integration under the philosophy of Osteopathy, so there is not a great deal of difference in philosophy between the two, SI, of course, emphasizes the soft-tissue / fascial component over the HVLA manipulations common to both chiropractic and osteopathy. Most osteopathic courses in Europe and UK now have re-included a lot of soft-tissue work in their curriculum, but I believe SI promotes a more ‘holistic’ (meaning systemic rather than symptomatic, tonic for the whole person rather than specific to a condition, addressing the global postural pattern in context rather than trying to fix problems).

In Europe, osteopathy has had a large influx from physiotherapy, which has left some schools abandoning the more global approach and replacing it with a more symptomatic, condition-based curriculum. I regret this change, but it may be temporary, and may not apply to all schools. In the US, osteopathy is largely medicalized, the graduates become doctors, and the manipulative skills are isolated to a few practitioners. That is sad, IMHO. Canada is better – if we were talking about Canada, I would be inclined to agree with you that osteopathy is more generalist. I think SI is more generalist compared to most osteopathic education I know about. But also a bit more limited, as osteopathy includes the thrusts, if you like popping joints.

So which you choose is a matter of where you want to go in life. I have rested easy in the harness of SI for 40 years, and certainly – as you might expect me to – recommend it. I also wanted to do the full osteopathic education (and certainly studied with many osteopaths when I lived in London in the 80s), but I did not want the school loans debt, and I am very dedicated to what be learned and taught from a generalist, global perspective, and have less interest in a practice based around pain. You have to decide where your interests lie. Which is better for you depends on who you get your education from and where, rather than the title you have at the end.

Might be worth finding one of our KMI graduates in your country and comparing what you get from each side – osteopathy and SI?

Biodynamic CST is certainly different form Upledger, though the Upledger courses are not a bad way to get started, just not a good way to finish. I see a lot of people ‘fooling themselves’ with BCST, and with CST in general – pretending to feel what they do not. Again, get a good education, and make sure you have the teachers’ hands on yours or vice versa. You cannot learn this subtle feeling from someone talking you through it – you need hands-on confirmation.

-Tom Myers