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
1.1. 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
2.1. 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
3.1. 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:
Initial Multidisciplinary Assessment:
Medical evaluation
Biomechanical analysis
Screening for imbalances
Integrative Approach:
Structural osteopathy for joint restrictions
Physiotherapy for specific muscle strengthening
Adapted physical preparation
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
Structural Osteopathy
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.
Loudon JK, et al. (2016). Immediate effects of a manipulation on ankle range of motion. Journal of Manual & Manipulative Therapy, 24(2), 65-69.
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
Bordoni B, et al. (2020). Fascial Nomenclature: Update 2020. Cureus, 12(9), e10522.
Greenman PE, McPartland JM (2019). Cranial osteopathy: its fate seems clear. Journal of the American Osteopathic Association, 119(1), 56-57.
Upledger JE (2011). SomatoEmotional Release and beyond. North Atlantic Books.
Dance Medicine and Performance
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.
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
Stecco C, et al. (2018). Fascial Disorders: Implications for Treatment. PM&R, 10(2), 161-168.
Norton JM (2017). Cranial osteopathy: science or myth? The Journal of the American Osteopathic Association, 117(8), 517-524.
Systematic Reviews
Ernst E (2015). Alternative therapies for musculoskeletal conditions. Best Practice & Research Clinical Rheumatology, 29(4), 581-589.
Posadzki P, Ernst E (2011). Osteopathy for musculoskeletal pain patients: a systematic review. Clinical Rheumatology, 30(2), 285-291.
Complementary References
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.
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