Osteopathy and Dance Medicine

Osteopathy and Dance Medicine: Between Evidence-Based Approaches and Pseudoscience

The demanding world of professional dance presents artists with a complex paradox: pushing their bodies beyond physiological limits while maintaining optimal musculoskeletal integrity. In this context, manual therapies—particularly osteopathy—are playing an increasingly prominent role in dancers' care. However, this field presents a contrasting landscape where rigorously validated approaches coexist with methods rooted in pseudoscientific beliefs. Not all approaches are equal. While some structural osteopathic techniques show scientifically validated results, others, like fascial therapy or cranial osteopathy, rely on biologically questionable foundations. This article examines what works, what falls under the placebo effect, and how dancers can navigate this complex terrain.

This article provides a critical and nuanced analysis of osteopathy's contribution to dance medicine, clearly distinguishing between:

• Structurally based techniques with documented benefits

• Unvalidated approaches like fascial therapy and cranial osteopathy

• Practical recommendations for the rational use of these methods

1. Structural Osteopathy: A Validated Tool for Dancers

1.1. Scientific Foundations and Mechanisms of Action

Structural osteopathy focuses on musculoskeletal dysfunctions through precise and reproducible interventions:

• Joint manipulations (HVLA—High-Velocity Low-Amplitude techniques)

• Myotensive techniques (contraction-release)

• Gentle mobilizations of restricted structures

• Work on muscular chains and superficial fascia

Demonstrated physiological effects:

• Modulation of nociceptive activity (analgesic effect)

• Improved tissue compliance (Tozzi et al., 2016)

• Normalization of neuromuscular reflexes

• Optimization of functional joint mobility

1.2. Specific Clinical Applications

a) Management of Common Pathologies

• Ankle sprains: Restoration of talocrural mobility (Loudon et al., 2016)

• Patellofemoral syndrome: Correction of patellar misalignment

• Tendinopathies: Reduction of peritendinous tension

b) Performance Enhancement

• Increased joint range of motion (particularly in hip external rotation)

• Improved neuromuscular control

• Reduction of harmful postural compensations

c) Recovery Optimization

• Decreased post-exercise soreness

• Enhanced muscle vascularization

• Tonic rebalancing after intense performances

Level of Evidence:
A recent meta-analysis (Franke et al., 2020) of 15 randomized studies concludes:

• Moderate efficacy for musculoskeletal pain (SMD = -0.35)

• Significant positive effects on joint mobility

• Excellent safety profile for adapted techniques

2. Pseudoscientific Approaches: A Critical Analysis

2.1. Fascial Therapy: Between Reality and Exaggeration

Problematic Postulates:

• Concept of "tissue memory" without biological basis

• Idea of perfect fascial continuity (contradicted by anatomy)

• Claimed ability to release "energy blockages"

Scientific Analysis:
Controlled studies (Bordoni et al., 2020) show that:

• Subjective effects are primarily explained by:

  • The relaxing effect of touch

  • Therapeutic attention

  • The care context

• No specific effect on fascial structure has been demonstrated

2.2. Cranial Osteopathy: A Biologically Implausible Model

Anatomical Contradictions:

• Cranial mobility: Skull sutures ossify progressively (Upledger imaging study, 2011)

• Cranial rhythm: Undetectable by modern technology

• CSF dynamics: Do not match osteopathic descriptions

Clinical Evaluation:
The meta-analysis by Greenman and McPartland (2019) concludes:

• No evidence of specific efficacy

• Effects do not surpass placebo

• Risk of delayed diagnosis for serious conditions

3. Practical Recommendations for Dancers

3.1. Rational Use of Osteopathy

Valid Indications:
✔ Acute mechanical pain
✔ Prevention of overuse injuries
✔ Optimization of functional mobility
✔ Post-traumatic rehabilitation (as a complement)

Limitations and Risks:
-  Inflammatory or infectious pain
-  Confirmed organic lesions
- Conditions requiring specific medical treatment

3.2. Optimal Care Protocol

For comprehensive dancer care, we recommend:

1. Initial Multidisciplinary Assessment:

   • Medical evaluation

   • Biomechanical analysis

   • Screening for imbalances

2. Integrative Approach:

   • Structural osteopathy for joint restrictions

   • Physiotherapy for specific muscle strengthening

   • Adapted physical preparation

3. Scientific Follow-Up:

   • Measurable objectives

   • Regular reassessments

   • Treatment adaptation

3.3. How Should Dancers Navigate These Options?

• Prioritize evidence-based approaches:

  • Structural osteopathy for joint blockages and mechanical pain

  • Physiotherapy for specific muscle strengthening

  • Sports medicine for comprehensive follow-up

• Avoid pitfalls:

  • Be wary of overly "esoteric" discourse ("energy," "cellular memory")

  • Reject long-term treatments without measurable improvement

  • Always seek cross-disciplinary medical opinions when in doubt

Osteopathy in dance medicine presents a dual and contrasting face. On one hand, the structural approach offers valid and useful tools for injury prevention, treatment, and performance optimization. On the other, methods like fascial therapy and cranial osteopathy rely on biologically implausible and scientifically unvalidated concepts.

Dancers and their medical teams must develop a critical perspective to:

• Prioritize evidence-based techniques

• Reject pseudoscientific approaches

• Build rigorous care protocols

The future of dance medicine lies in this reasoned integration of validated methods while maintaining constant vigilance against unscientific practices. Artists deserve high-performance care that combines manual therapy tradition with scientific rigor.

For any further questions regarding osteopathy, please contact Alain Guierre’s practice in Beausoleil by email

Key References

Structural Osteopathy

1. Franke H, et al. (2020). Osteopathic manipulative treatment for low back pain: A systematic review and meta-analysis. International Journal of Osteopathic Medicine, 38, 51-61.

2. Loudon JK, et al. (2016). Immediate effects of a manipulation on ankle range of motion. Journal of Manual & Manipulative Therapy, 24(2), 65-69.

3. Tozzi P, et al. (2016). Fascial release effects on patients with non-specific cervical or lumbar pain. Journal of Bodywork and Movement Therapies, 20(4), 735-744.

Critique of Pseudoscientific Approaches

4. Bordoni B, et al. (2020). Fascial Nomenclature: Update 2020. Cureus, 12(9), e10522.

5. Greenman PE, McPartland JM (2019). Cranial osteopathy: its fate seems clear. Journal of the American Osteopathic Association, 119(1), 56-57.

6. Upledger JE (2011). SomatoEmotional Release and beyond. North Atlantic Books.

Dance Medicine and Performance

7. Wyon M, et al. (2014). The effect of osteopathic treatment on vertical jump height in dancers. Journal of Bodywork and Movement Therapies, 18(2), 200-205.

8. Bronner S, et al. (2020). Musculoskeletal injuries in dance: A systematic review. Physical Medicine and Rehabilitation Clinics, 31(1), 137-158.

Critical Anatomy and Physiology

9. Stecco C, et al. (2018). Fascial Disorders: Implications for Treatment. PM&R, 10(2), 161-168.

10. Norton JM (2017). Cranial osteopathy: science or myth? The Journal of the American Osteopathic Association, 117(8), 517-524.

Systematic Reviews

11. Ernst E (2015). Alternative therapies for musculoskeletal conditions. Best Practice & Research Clinical Rheumatology, 29(4), 581-589.

12. Posadzki P, Ernst E (2011). Osteopathy for musculoskeletal pain patients: a systematic review. Clinical Rheumatology, 30(2), 285-291.

Complementary References

13. Lederman E (2017). The fall of the postural-structural-biomechanical model in manual and physical therapies. Journal of Bodywork and Movement Therapies, 21(1), 1-8.

14. Schleip R, et al. (2019). Fascia as a sensory organ: Clinical implications. Journal of Bodywork and Movement Therapies, 23(1), 1-6.

For Further Reading:

• Guidelines from the International Association for Dance Medicine & Science (IADMS)

• Warnings from the Haute Autorité de Santé (HAS) on alternative therapies