Proprioceptive Coherence: An Expanded View of the Mechanics Behind the Indirect Method and the Introduction of an Innovative Variation

Proprioceptive coherence is proposed as a novel osteopathic treatment technique whereby the desired technique response is rapid, resulting from the sensory integration of multiple diverse proprioceptive, somatosensory, nociceptive, neuroendocrine elements contributing to focal somatic dysfunction. Volitional components involving the cerebral cortex, emotional contributions from the limbic system as well as prioritization of the motor responses to dysfunction contribute to mechanisms putatively involved with the technique. The technique has a unique obligatory focus on a temporal element. To better comprehend this treatment approach, diverse determinants of somatic dysfunction such as altered proprioceptive input, muscular influences, nociception, spinal cord processing and higher level central processing are discussed including muscular, aspects of mechanical transduction and tensegrity, nociception, spinal cord, and central processing. The diagnostic component of this technique involves identification of primarily interoceptive, proprioceptive and somatosensory related tissue alterations and considers a secondary exteroceptive contribution. The treatment phase is dictated by perception of precise balancing of localized forces on the area of dysfunction. A mandatory physician participation is dictated by the feed forward unique chronoception component. At the completion of the technique, rapid therapeutic effects are perceived by both the physician and the patient. This paper is intended to appeal to the scientist in all of us; the lover of osteopathic manipulative techniques, and the healer we embrace as practicing osteopathic physicians. To help establish proprioceptive coherence as a novel technique, a comparison to common forms of osteopathic treatment based upon the indirect method is presented. It is proposed that proprioceptive coherence is a novel technique with unique mechanisms however others may consider the technique as a refinement of existing indirect methods.