Subtleties: OMM in a Unique Perspective

By Elizabeth Stachtiaris, OMS III

“Did you see him leg yield outward after his neck rounded?” I excitedly asked my medical classmate as I sat atop my horse, out of breath after an exhausting equine workout. My audience-of-one confusedly stared up at me. “Um…what?” I quickly realized that the visual and palpable movements of both my steed and myself, that were clearly observable to me, were too minimal for a novice to perceive. I quickly responded, “Oh, never mind. Watch me jump this oxer,” opting to display a more obvious feat.

Equestrianism is a sport of elegance and efficiency, incorporating myriad subtle movements of the rider aimed to transform the team into an unstoppable force ready to face various challenges, such as large jumps or intricate dressage techniques. A beginner might be able to rudimentarily complete these tasks with superfluous actions, which frustrate the horse and render the performance atrocious for spectators. However, a skilled equestrian masks his actions, making his riding seem effortless, while maintaining complete control of the animal underneath him. These nonverbal communications relayed to the horse allow both individuals to become a unified duo able to complete enormous tasks in competition.

The skill of subtlety only comes with years of practice. There are no short cuts. A beginner in horseback riding looks to professionals with admiration and jealousy, hoping to one day attain the skills necessary to become a successful equestrian. As an experienced rider, I cherish my years of training and ability to compete at a high level. However, as a third year medical student at NYIT College of Osteopathic Medicine, I now identify as a frustrated novice in the department of Osteopathic Manipulative Medicine. On the first day of OMM, our professors reassured us that mastery of palpation only comes with time, patience, and practice. They preached that as trained physicians, we would be able to feel numerous somatic dysfunctions and treat them with both our hands and medical innovations, practicing a holistic view of healthcare. In disbelief I laid my hands on my partners back, attempting to listen to the body with my fingers. I felt nothing. I heard nothing. I struggled in this field of medicine completely out of my comfort zone, inspired to persevere only by the doctors’ encouragement. My classmates, who did not feel anything either, and I simply performed the required techniques mandated by the curriculum, hoping that one day we would develop the necessary palpatory skills necessary to exemplify esteemed osteopathic physicians.

Despite the grueling medical school curriculum, I rode my horse every morning before classes, enjoying a field that I have mastered as a respite from the frustration and confusion of osteopathic education. A rider does hundreds of subtle movements with his hands and legs per riding session, communicating nonverbally to his partner. As I performed these equine techniques for my fellow osteopathic medical student, it was clear that he did not perceive them, and merely saw me as a girl on a horse “making him go.” I then realized the similarities between equestrianism and osteopathic manipulative medicine. A rider must partner with the horse, just as the physician must team with the patient’s body. The physician’s hands must nonverbally communicate with the body, patiently listening for anything it has to say. They must learn the body’s limits and incorporate them into treatment methods aimed to ameliorate physical dysfunctions. Both the physician and patient must cooperate to achieve the common goal of health, just as the horse and rider must collaborate to jump over a five-foot oxer.

After many years of working with my horse at high levels of competition, we have formed a strong and loving bond. As a future osteopathic physician, I trust that my many hours of palpatory practice will grant me the necessary skills to form a special relationship with my patients, along with the ability to offer them an extra tool in the medical field to alleviate their pain. As a third year medical student, I know that I must be patient to acquire the subtle skills of osteopathy. However, I am aware that there are no short cuts to expertise. I must allow my separate lives as the equestrian and the medical student to integrate in order to become a well-rounded physician.