Osteopathy is a gentle form of manual therapy gaining tremendous interest due to its global approach in working with the body. This is in part due to the fact that osteopaths work with many aspects of the body: bones, joints, muscles, fasciae (conjunctive tissues), organs, nerves, blood vessels, cranial tensions, and for some osteopaths, energetic and emotional elements as well.
Osteopathy was initiated at the end of the 19th century by Andrew Taylor Still, an American doctor. Dissatisfied with the poor body of knowledge available to doctors, he was one of the first in his time to make advances in understanding the anatomy of the human body via human dissections. It is therefore not surprising that osteopathy is essentially rooted in anatomy.
In discovering the inside of the body, Still started to become interested in the role of each structure and in symptoms and health problems that may occur when these structures are hindered. For example, if ovarian arteries become entrapped in scar tissue inside the lower abdomen, what happens to the ovaries? If nerve signals are compressed due to vertebral pinching or fascia tensions, what happens to the organs or muscles they are meant to send information to? If the liver becomes congested due to tightness in the diaphragm muscle in which it is suspended, what happens to its capacity to metabolise hormones properly? to blood flow draining back to the heart from the lower half of the body?
Nerves, blood vessels and lymphatics all travel in fascia (conjunctive tissue around all body structures). So if a fascia is tight, circulation is slowed down. This means that organs, muscles and bones aren't properly fed, and their waste is not properly evacuated. This can cause pain in muscles and joints, but also lead to inadequate functioning of organs.
Fascia, circulation and infertility
« Many of the issues that contribute to infertility can be traced to scar tissue, fascial restriction, and lymphatic congestion in the pelvic region. Manual therapy techniques exist to release fascial restrictions, to mobilize tight ligaments, and to drain congested lymphatics, all of which can be applied to the reproductive system. »i J Am Osteopath Assoc. 2012;112(10):680-684
Reproductive organs and fertility
During a woman's orgasm, the uterus contracts repeatedly and its' cervix dips into the vaginal canal to collect sperm. This increases the probability of pregnancy. If the cervix is not pointing in the correct direction, this function can be impaired. This is one of the reasons, among many others, that releasing the uterine muscle and centering the uterus is important to gynaecological health and to optimise fertility. Tensions can also pull on the large ligaments, which wrap the fallopian tubes and thus create motility and mobility issues or compressions of these tubes.
Studies have found that manually restoring mobility and motility to structures affecting reproductive function had a positive impact in reducing infertility. In one study, « Improvements demonstrated in the condition(s) causing infertility were measured by improvements in tubal patency and/or improved hormone levels or by pregnancy ». (Altern Ther Health Med. 2015;21(3):36- 44.) (J Am Osteopath Assoc. 2012;112(10):680-684)
Cranial work and hormonal balance
In addition to manually restoring mobility to joints, muscles, fascia and organs, osteopaths also work on the structures of the head or cranium. This can be pertinent to some cases of infertility relating to hormonal imbalances, because the hypothalamus and pituitary gland are located in the cranium, and they are the main structures signalling hormonal function to the entire body..
The cranium is comprised of many separate bony plates that are joined by ligament or soft tissues. This allows for a minimal amount of flex. There are fasciae on the outside and inside of the cranium that can become tight and compress these sutures between the bony plates. When this happens, various symptoms can manifest themselves: headaches, hindered cognitive functions, symptom caused by nerve compressions of the 12 cranial nerves (affecting face, throat, tongue, eye muscles or sensitivity of ears, nose, mouth and eyes etc.). But at a deeper level, the areas of the brain that coordinate and signal hormonal function can also be affected. How does this work?
The cerebra-spinal liquid (CSL) that the brain floats in and is cleansed by is pumped into the ventricular pouches in the cranium 10 to 12 times per minute. This creates an expanse of volume which forces all the bony plates to slightly be pushed outward and then return. This, in the osteopathic world, is called the primal respiratory movement and can be felt by the practitioner’s hands. Practitioners can feel where compressions and mobility restrictions exist and then work to release them. This movement in essence creates a constant pumping motion of the entire cranium, which is understood to flush the CSL and increase blood circulation.) This pumping function is nature's way of insuring that the brain is highly vasculated. If this movement is hindered, the functioning of various aspects of the central nervous system can be affected, including those of the hypothalamus and pituitary gland. Cranial osteopathic care can restore this motility and proper vascularisation and thus affect hormonal levels in the body. (https://doi.org/10.1016/0965-2299(94)90017-5 , Menopausal symptoms: an osteopathic investigation
Author links open overlay panel
CarolineClearyDO, MNTOSJames P.FoxDO, MNTOS, Complementary Therapies in Medicine, Volume 2, Issue 4, October 1994, Pages 181-186).
There are many ways in which Osteopathic care can assist with fertility issues, some of which probably remain unexplained. But it is worth briefly mentioning its potential impact on emotional factors. Memories, especially of trauma, can imprint in the body. Oftentimes, during gentle manual therapy sessions, such as osteopathy, emotions can become exposed as the physical tensions they were linked to release. This is a scenario we frequently experience with women who have suffered sexual abuse for example. But perhaps less commonly recognised, women often hold the imprints of a lost child in their womb, be it due to miscarriage or abortion. It is important to help women let go of these imprints in order to release blockages in the physical structures, but also because if they do not, it is often during the next pregnancy that the emotions linked to a morning process surface, creating complicated and conflicting experiences.
In conjunction with other approaches aiming to improve fertility, osteopathic care is a very rich modality that can affect the process in various manners, be it through improved vascularisation or lymphatic drainage, better nerve function, cranial motility, hormonal balance, normalising impacted reproductive structures or helping release emotional imprints. It is non-invasive and without side effect, and so certainly to be considered in your global approach to resolving fertility issues.
Studies relating to Infertility treatment and Osteopathy
Combined Manual Therapy Techniques for the Treatment of Women With Infertility: A Case Series
Ten-year Retrospective Study on the Efficacy of a Manual Physical Therapy to Treat Female Infertility