Has it ever happened to you, or have you ever heard someone tell you that, after surgery or after giving birth, pain started that wasn't there before?
Let's go to the operating room.
Some of the most immediate and interesting somatic dysfunctions to follow osteopathically in a post-surgical setting are those created by the positioning of the patient on the operating table.
Let's try to think for example of a knee operation, in which everything is positioned with a view to making the operation easier but perhaps the patient is left with a hypertensive elbow for the entire duration of the operation, as we all know, sometimes even hours! Hyperextension of the elbows causes signs and symptoms of the radial nerve. Equally, it could very well be that a foot is accidentally kept in excessive internal rotation.
Still speaking of knees, the positioning of a cushion under the popliteal cavity to maintain a certain degree of knee flexion may be necessary for the operation, but we know very well that if we do not constantly pay attention to ensuring that the heels do not rest 'on the hard' other problems can set in, pressure ulcers can start to form as soon as 15 minutes of blocking blood flow! Let us always remember that 'the rule of the artery is supreme'!
Now let's think about an operation for spinal cord injury at the C7 level, in which perhaps the arms were kept raised above 90 degrees and the hands above the elbows for perhaps 4 hours. It may very well have developed as a result of the brachial plexus.
Continuing we can therefore realize how it is quite simple to create 'exaggerated' flexions or extensions or rotations of segments even by simply moving the patient from the stretcher to the operating table.
In thyroid operations, the throat must be exposed to the maximum with hypertensive positioning of the head and consequent laxity resulting from anesthesia. During the operation, multiple somatic dysfunctions can arise, causing a wide variety of pains/discomforts post-operatively.
Let's also not forget that the use of retractors involves significant tissue pressure.
Under anesthesia the sedated patient is "soft" and when mobilizing him it is easy to reach what is the anatomical barrier instead of the physiological one.
In Osteopathy we know well that structure must be preserved for function.
We also think 'simply' about giving birth. As we all know, in order to obtain correct cranial movement ranging from the movement of the brain, to the effects on the dura mater, up to the sacrum, we need the skull and sacrum and all the structures involved to move in unison. When the brain flexes, the base of the skull extends upwards and the anchoring to the second sacral segment causes the movement of the sacrum upwards and backwards. During extension the opposite occurs, with the sacrum moving forward and downward. But couldn't anesthesia or simply positioning the new mother on the table with the sacrum supported and unable to move create a problem?
Returning to the initial question, how many people complain after surgery?
The anesthesia at first and then the painkillers mask the somatic dysfunction until, a few days later, the patients begin to have strange new pains.
American osteopathic anesthetists suggest that the best period for an osteopathic operation, whether a simple check or correction, should take place one week after surgery, obviously with different application methods depending on the surgery. However, close attention must be paid to the lumbar, cervical and thoracic areas as well as to the peripheral joints. The cranial approach is recommended as it optimizes the individual's vital force.
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