Functional Indirect Technique

Functional technique, or Still technique in Europe, is a comfortable osteopathic manual therapy technique for decreasing pain and restoring function to spinal segments, pelvis, rib cage and limbs. It fits into the categories of ‘indirect’ techniques because no barrier to motion is directly engaged such as with muscle energy technique or high velocity thrust technique. Instead, the barriers to free motion and normal biomechanics are identified but the joint is then taken in the opposite direction. It is from this ‘position of ease’ that the practitioner facilitates motion that is controlled by the body. It could be seen as a type of specific unwinding of a joint as the body first moves farther into the direction of ease and then moves itself through the previous motion limitation. Motion is restored after the body or nervous system appears to ‘learn’ that it need not guard against motion in the previously limited directions. When this occurs, the body does not appear to waste energy guarding or protecting the joint or soft tissue and normal efficient motion returns.

A.T. Still, the founder of osteopathy, practiced this technique in the later years of his life. Dr. Still’s grandson, George Laughlin D.O., is credited with passing the technique down to Ed Stiles, D.O. who defined the method more clearly using MET biomechanics to teach it in the United States.

Ed Stiles, D.O., theorizes that this internally driven movement of the body to self-correct the restricted motion that is seen with functional ‘indirect’ technique is a function of tensegrity of the musculoskeletal/fascial system. The physiologic mechanism may indeed be tied to the musculoskeletal/fascial tensegrity, or reflex/nervous system or some combination.  Regardless, it is a very elegant and relaxed method of regaining motion and efficient function to decrease pain.

Note: Functional technique has been taught several ways.  Most notably, Phillip Greenman D.O. FAAO at Michigan State University’s School of Osteopathy taught it both with and without facilitated movement. His evaluation leading up to treatment was also different from that of his friend Ed Stiles, D.O. FAAO. How it is taught to D.O.s in Europe also varies.