osteopathic manual therapy: a perspective on preconception

What is Osteopathy?

Osteopathic Manual Therapy (OMT) is a therapy which is not characterized by a specific technique used to treat specific conditions. Physiotherapists are generally known for their exercises, chiropractors for their manipulation techniques and massage therapists for their hands-on muscle work. OMT uses a variety of different techniques which include massage, joint mobilization and very gentle cranio-sacral techniques. While it may sound similar, one of the main differences between these techniques is the application based on the principles unique to OMT. Most importantly, one of the basic principles is “structure governs function; function governs structure” meaning that if there is a problem in the structure, may it be a joint, muscle or an organ, the function of that structure will also be impaired, and vice versa. That being said, this is very important when looking at fertility and conception! The osteopathic manual therapist has essential knowledge of anatomy and physiology and is able to detect mobility restrictions which may be affecting organ function, thus influencing fertility and conception.


How is Organ Mobility Important to Conception?

In women, the areas to look at are the pelvic room containing the genital organs and the intestines; the associated musculo-skeletal structures such as the spine, ribs and pelvic bones; and the skull.

The uterus is a cone-shaped organ which is flat front to back. Being a very mobile organ, its position depends on whether the bladder and intestines are empty or full as it sits between the two. Generally the uterus is bent and tilted forward. The fallopian tubes extend from the uterus to the ovaries and are very mobile structures, coming into contact with the small intestines, bladder and parts of the colon. The ovaries are almond-shaped and supported through various ligaments attaching them to the uterus and fallopian tubes in addition to the pelvic wall and lumbar fascia.

It is important for all these structures to move freely to function optimally. The uterus can often become displaced or compressed by the large intestine, especially if constipation is an issue. The accumulation of feces in the lower colon will push the uterus into a different position and also obstruct venous drainage leading to pelvic congestion. The ovaries playing an important role in hormone balance, must also be mobile, and have enough blood supply and drainage. As the veins are very long and thin, it is easy for them to become compressed by other structures. A slipped rib pushing down on the structures above the ovaries and dysfunction of the small intestines can cause congestion of the ovaries by compressing these small blood vessels.

Optimal organ function is also influenced by the autonomic nervous system which is made up of both sympathetic (stressed) and parasympathetic (relaxed) parts. The sympathetic nerves exit from the spinal column at organ-specific segments. If any of these segments become irritated or restricted, it can change the parasympathetic state, creating a stress response, in turn constricting the blood vessels to and from the organs, leading to irritation and stagnation.

The parasympathetic nerves to the pelvic organs exit the sacrum, the triangle-shaped bone at the end of the spine. Again, these nerves can become irritated if there is a dysfunction of the sacrum. Any trauma to the sacrum or tailbone, for example, falling or slipping and landing on your behind, may cause a change in the neurological system and poor drainage of the pelvic area, leading to stagnation and further irritation to the organs.

Another area of importance is the skull and its containing structures. The hypothalamus and pituitary gland are both involved in hormone balance and may be affected by the bones and connective tissues in and around the skull. Any head trauma may cause strain patterns in the skull causing congestion in the head. Proper drainage and blood supply of the head are necessary for these glands to communicate properly with the rest of the body. The osteopathic manual therapist will aid drainage and blood supply by freeing up boney and muscular restrictions around the neck and thoracic cavity.

For the osteopathic manual therapist, all of these structures have to work in harmony to allow for proper health and therefore must assess the whole body.

For the woman, it is important for all the surrounding structures to be mobile, such as as the tailbone, spine and ribs to ensure a properly functioning nervous system and proper drainage from the abdominal cavity.

And a Word on the Gents

To increase the chance of conception, it is also important to consider both the quantity and quality of the sperm produced by the man. The same principle of “structure governs function; function governs structure” applies to men. The sperm is produced in the testes, which are specifically located outside of the abdominal cavity to maintain a constant lower temperature than the body’s core temperature. Should the temperature of the testes elevate, sperm production will be affected. The prostate glad is a walnut size organ seated just beneath the bladder and is responsible for producing seminal fluid, which nourishes, transports and protects the sperm as it travels through the female reproductive tract; therefore it plays a key factor in male fertility.

Reduced drainage of the pelvis due to intestinal dysfunctions or surgeries for example will lead to congestion in the lower abdomen and thus poor drainage of the prostate and testes. An elevated temperature in the testes may for example occur due to a varicocele, the enlargement of the spermatic vein. The spermatic vein drains blood from the testicle back to the heart, which reduces when enlarged, thus increasing the temperature.

It is clear, that there are a lot of areas the osteopathic manual therapist needs to look at when addressing fertility and conception. As the body will be treated as a unit, the patient will not just receive benefits for one area, but for overall health and well-being!


Natalie PatemanNatalie Pateman, BSc. is a U.K. trained, and qualified osteopathic manual therapist and cranio-sacral therapist. She has completed a 4-year full-time course in osteopathy at the British College of Osteopathic Medicine in London (U.K.) followed by additional courses in cranial osteopathy, pediatric osteopathy and animal osteopathy. To learn more about Natalie, click here.



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