The Five Diaphragms in Osteopathic Manipulative Medicine: Myofascial Relationships, Part 2

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The fascial continuum is a topic of debate, in particular, its classification into a nomenclature that researchers and medical figures can agree on. Most likely, the difficulty in finding the uniqueness of this topic lies in the fact that only some scientific figures with certain specialties write articles to state their point of view. We know, however, that a matter that involves the human body cannot be taken into consideration only by some scientific arguments, but by all the notions capable of completing a multidisciplinary and impartial vision. The fascia, too often, becomes a destination for earning and selling, to the detriment of the entire scientific community. The second part of the article on fascial nomenclature tries to obtain a new definition of what could be considered the fascial continuum, based on the most innovative information in the literature; the ultimate goal is to give free reflections on the subject in full intellectual freedom.

Section: Reviewmentioning

confidence: 99%

Fascial Nomenclature: Update 2021, Part 2

Bordoni¹,

Escher²,

Tobbi³

et al. 2021

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“…The pelvic floor is a large but thin muscle layer that forms the lower edge of the abdominopelvic cavity and between the pubic symphysis and the coccyx; the musculature is formed by the levator ani (puborectal, pubococcygeus, and iliococcygeus muscles) and the ischiococcygeus muscle [2]. During inspiration, the medullary and supramedullary breathing centers activate the XII cranial nerve to retrude the tongue, while the respiratory diaphragm is lowered, the musculature of the abdomen contracts (to prevent excessive forward movement of the diaphragm), the musculature deep back has less electrical activity, and the muscles of the pelvic floor are released (drops) [28].…”

Section: Pelvic Floormentioning

confidence: 99%

“…The pudendal nerve has autonomic components and is activated with the phrenic nerve by the actions of the pelvic floor, not simply combined with breathing (walking, posture) [28,38]. From the neurological point of view, we can say that there is a continuum between the five diaphragms, just as there is a myofascial continuum [1][2].…”

Section: Pelvic Floormentioning

confidence: 99%

“…The five diaphragms reflect the concept of another historical model with which the clinician guides the evaluation and the clinical decision, that is, the respiratory-circulatory model. The philosophy behind the latter and the five diaphragms is to allow the creation of space between the different body tissues (muscular, visceral, vascular, and nervous), as if there is the possibility of a better movement of the tissues (and therefore space) it is possible to find greater health and well-being for the patient [2]. Breathing and blood/lymphatic circulation allow better salutogenic homeostasis; the movement of the tissues, the increased space between the tissues themselves and the free movement of fluids is a health status.…”

Section: Introductionmentioning

confidence: 99%

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The Five Diaphragms in Osteopathic Manipulative Medicine: Neurological Relationships, Part 2

Bordoni¹

2020

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The main objective of the osteopath and that of osteopathic manipulative medicine (OMM) is to create space between the different tissues. The sliding capacity of the various tissue layers and between the different body components, up to the possibility of movement between cells is the salutogenic stimulus to allow the circulation of fluids, the biochemical exchange, and the adequate management of the multiple internal and external stimuli that perturb the body living. Movement is allowed by space and space is life. In this second part, the exposure of the anatomical neurological relationships of the five diaphragms continues, highlighting the relationships of the thoracic outlet, the respiratory diaphragm, and the pelvic floor. Finally, there will be clinical reflections to further corroborate the existence of the anatomical continuum and to lay the scientific foundations for an OMM approach to body diaphragms.

“…The founder of osteopathy, Dr Andrew Taylor Still, in 1874 described a fundamental concept for OMM, that is, that an injury arises when there is an interruption of fluids; this event can materialize as a somatic, visceral, and behavioural symptom [4]. The five diaphragms are part of the respiratory-circulatory model, where the latter's philosophy is based on the optimal circulation of body fluids through functional relationships between some segments of the body considered as diaphragms: tentorium cerebelli, tongue, thoracic outlet, diaphragm, and pelvic floor [5,6]. The nourishment and cleansing of all tissues by the blood and lymph, as well as their free circulation are fundamental for physical and mental health.…”

Section: Introductionmentioning

confidence: 99%

The Five Diaphragms in Osteopathic Manipulative Medicine: Neurological Relationships, Part 1

Bordoni¹

2020

Self Cite

In osteopathic manual medicine (OMM), there are several approaches for patient assessment and treatment. One of these is the five diaphragm model (tentorium cerebelli, tongue, thoracic outlet, diaphragm, and pelvic floor), whose foundations are part of another historical model: respiratory-circulatory. The myofascial continuity, anterior and posterior, supports the notion the human body cannot be divided into segments but is a continuum of matter, fluids, and emotions. In this first part, the neurological relationships of the tentorium cerebelli and the lingual muscle complex will be highlighted, underlining the complex interactions and anastomoses, through the most current scientific data and an accurate review of the topic. In the second part, I will describe the neurological relationships of the thoracic outlet, the respiratory diaphragm and the pelvic floor, with clinical reflections. In literature, to my knowledge, it is the first time that the different neurological relationships of these anatomical segments have been discussed, highlighting the constant neurological continuity of the five diaphragms.