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OMT Minute  |   February 2018
OMT to Address the Physiologic Effects of Stress
Author Notes
  • From the Touro University College of Osteopathic Medicine-CA in Vallejo. 
  • Financial Disclosures: None reported. 
  • Support: This video was produced by Touro University College of Osteopathic Medicine-CA. 
  •  *Address correspondence to Danielle Emmet, 1310 Club Dr, Mare Island, Vallejo, CA 94592-1187. Email: danielle.emmet@tu.edu
     
Article Information
Osteopathic Manipulative Treatment
OMT Minute   |   February 2018
OMT to Address the Physiologic Effects of Stress
The Journal of the American Osteopathic Association, February 2018, Vol. 118, e11. doi:https://doi.org/10.7556/jaoa.2018.028
The Journal of the American Osteopathic Association, February 2018, Vol. 118, e11. doi:https://doi.org/10.7556/jaoa.2018.028
  
OMT Minute: OMT to Address the Physiologic Effects of Stress
eVideo. Suboccipital decompression and rib raising may reduce the physiologic effects of stress.
Emotional and physical stress induce a physiologic response in the human body. Activation of the hypothalamic-pituitary-adrenal axis and arousal of the sympathetic nervous system occurs, affecting multiple organ systems. This response allows humans to adaptively respond to emotional and physical stressors; however, chronic exposure to such stressors can lead to maladaptive alterations in our stress response, hormone levels, and allostatic load. 
Osteopathic manipulative treatment (OMT) may benefit patients facing chronic stress as it affects physiological and psychological markers of our stress response. Several OMT techniques, including suboccipital inhibition and rib raising (video), are associated with increased heart rate variability, improved autonomic homeostasis, decreased muscular tension, and reduced perception of stress. 
Mental stress is known to cause increased muscular tension through complex neurologic reflex loops. Suboccipital inhibition, also known as suboccipital decompression, may assist in decreasing that tension and improving autonomic nervous system homeostasis by inducing a parasympathetic response. The vagus nerve, which supplies parasympathetic innervation to much of the body, exits the skull via the jugular foramen in the suboccipital region. This technique is associated with increased parasympathetic tone and heart rate variability. 
Rib raising can be used to improve respiratory excursion and is believed to improve autonomic homeostasis by decreasing sympathetic tone. Its proposed mechanism of action is through the release of the costotransverse articulation, as just anterior to this joint is the sympathetic chain ganglia arising from T1-L2, which supply sympathetic innervation everywhere in the body. 
Hands-on treatment of the suboccipital and thoracic regions with these OMT techniques can help osteopathic physicians care for their patients’ body, mind, and spirit by supporting their physiologic resilience and homeostasis during stressful times. 
Acknowledgments
We thank Jeff Reedy for video production and editing. 
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OMT Minute: OMT to Address the Physiologic Effects of Stress
eVideo. Suboccipital decompression and rib raising may reduce the physiologic effects of stress.