Immediate effects of osteopathic manipulative therapy on thoracoabdominal mobility, respiratory muscle strength and pulmonary function in healthy men: Preliminary crossover trial

Is Usmle Step 2 CK the New Usmle Step 1 for Ophthalmology Residency Applications? A San Francisco Match Analysis.

Osteopathic Manipulative Treatment (OMT) After Vestibular Schwannoma Resection: Methods and Framework From a Recent Retrospective Study

The atlanto-occipital joint plays a fundamental role in integrating proprioceptive, vestibular, and visual inputs, which are essential for postural control. Functional alterations in this region may affect body stability, even in asymptomatic individuals. The present study aimed to investigate the immediate effects of a single session of high-velocity, low-amplitude osteopathic manipulation on the stabilometry in asymptomatic, physically active university students. This experimental, cross-sectional study included 24 university students (mean age: 23 ± 3.9 years). Participants were evaluated using a baropodometric platform at 3 time points: before, immediately after, and 2 minutes after the intervention, under 2 conditions: eyes open and eyes closed. The variables analyzed were: center of pressure displacement area, center of pressure path length, and mean square velocity. Results showed greater postural instability immediately after the manipulation, with increased center of pressure area and path length. After two minutes, a reduction in mean square velocity was observed, indicating the beginning of postural reorganization. The eyes-closed condition resulted in the highest sway values, highlighting the critical role of vision in balance. These findings suggest that upper cervical manipulation can trigger acute neurophysiological responses, which are detectable by sensitive instruments, even if not clinically evident. It is concluded that the beneficial effects of cervical manipulation are not immediate but emerge over time. Future studies with longer post-intervention follow-up periods it is recommended, to better understand the sensorimotor adaptation process of the postural control system following osteopathic manipulation.

Congenital heart diseases are the most common congenital malformations, affecting 4 to 9 per 1000 children, with increasing global prevalence. As surgical mortality rates decline, the focus has shifted toward improving the quality of life and perioperative outcomes for pediatric patients. Multidisciplinary rehabilitation, including osteopathic care, is increasingly incorporated into recovery programs. Osteopathic manipulative treatment combines manual techniques with lifestyle guidance to alleviate postoperative pain and promote recovery. This project report describes the impact of osteopathic manipulative treatment (OMT) on pain and somatic dysfunctions in hospitalized pediatric cardiac patients, using validated pain assessment tools. It presents a retrospective analysis of data collected as part of a humanitarian volunteer project. The project report follows a retrospective descriptive study design, using patient note forms from children aged 0-18 years undergoing cardiac surgery at the Sri Sathya Sai Sanjeevani Center in India between October 2023 and March 2024. A total of 29 experienced osteopaths recorded pain assessments at three time points-pre-surgery, post-surgery, and pre-discharge-using age-appropriate pain scales (FLACC, Wong-Baker Faces, and Numerical Rating Scale). Somatic dysfunctions were evaluated and classified using ICD-10 M99 codes. Data analysis involved descriptive statistics and pre-post comparisons using statistical software (Excel and OPENEPI). The study included 564 children (60.5% male, mean age 5.8 ± 4.3 years). The most common congenital defects were ventricular septal defects (38.5%) and tetralogy of Fallot (21.6%). The average hospital stay was 15.9 ± 11.1 days. Significant reductions in pain scores were observed from the Intensive Care Unit to the postoperative ward (p < 0.001). Similarly, somatic dysfunction severity decreased significantly across hospitalization phases (p < 0.001). The thoracic region and rib cage were the most frequently affected areas. No adverse events related to osteopathic manipulative treatments were reported. This project report indicates that osteopathic manipulative treatment is safe and feasible for pediatric patients undergoing surgery for congenital heart disease. Pain scores and somatic dysfunction severity decreased during hospitalization. However, the lack of a control group, the heterogeneity of the patient population, and the short observation period limit the ability to draw causal conclusions. These findings provide a descriptive framework for integrating OMT into multidisciplinary pediatric cardiac care. Future studies should involve prospective, multicenter designs with control groups and longer follow-up periods to assess clinical, functional, developmental, and quality-of-life outcomes.

The pediatric surgical workforce in the UnitedStates faces increasing strain due to a limited supply of specialists, geographic maldistribution, and rising complexity in pediatric cases. Rural and underserved communities experience the greatest gaps in access to timely, specialized care. Additionally, existing literature lacks integration of osteopathic perspectives in workforce development discussions, despite the holistic and preventive contributions of osteopathic medicine to patient care and physician well-being. This review analyzes current gaps in the pediatric surgical workforce and propose actionable solutions through an osteopathic lens, including the integration of osteopathic principles such as whole-person care, preventive health, and osteopathic manipulative treatment (OMT). A narrative literature review was conducted utilizing peer-reviewed publications, workforce data, policy reports, and the 2023 National Academies of Sciences, Engineering, and Medicine (NASEM) report on the pediatric subspecialty workforce. The review considered sources published between 2003 and 2024. Search terms included combinations of "pediatrics," "pediatric surgical workforce," "osteopathic medicine," "OMT," "healthcare disparities," and "surgical access," and they were applied to PubMed, Google Scholar, and gray literature databases. Inclusion criteria prioritized national US data on workforce distribution, diversity, burnout, and training. Then the studies were selected. No formal meta-analysis was conducted. Approximately 1,150board-certified pediatric surgeons practice in the UnitedStates, equating to approximately 18.2 surgeons per one million children. Access remains concentrated in urban academic centers, leaving rural regions dependent on general surgeons or patient transfers. Minority and uninsured children experience significantly lower rates of surgical intervention. Workforce burnout and limited training pipelines exacerbate shortages. Although no formal outcomes synthesis was performed, osteopathic contributions such as OMT for postoperative care and holistic, team-based education models were identified as underutilized assets in existing workforce strategies. The pediatric surgical workforce must be expanded and diversified to meet growing and unevenly distributed care needs. Integrating osteopathic principles-including whole-person care, OMT, and provider wellness-into training, recruitment, and care delivery offers a holistic framework for sustainable improvement. Future workforce strategies should incorporate these perspectives to enhance both patient outcomes and provider resilience.

Effects of osteopathic manipulative treatment on cardiovascular function: a systematic review and meta-analysis

Osteopathic Manipulative Treatment for Chronic Obstructive Pulmonary Disease: A Systematic Review

Previous studies have sought to improve pitch performance and shoulder function utilizing the Muscle Energy Technique (MET) or Spencer's technique. The results of these studies have been mixed. Some found immediate, but short-lived, improvement to different planes of the range of motion (ROM) of the throwing shoulder. None found improved velocity or investigated further pitch metrics, such as spinrate. This study is the first to measure the effects of osteopathic manipulative treatment (OMT) among key points of the kinetic chain, measuring ROM of the shoulder and the hip, as well as pitch metrics beyond release velocity. Baseball pitchers from a local collegiate baseball team were offered participation in this study. Pitchers had to be medically cleared for participation as members of the team and had to be given permission by the coach to join the study. Sixteen pitchers were assessed for inclusion, and 13 of the 16 were randomized into OMT and control groups for a prospective cohort study. One dropped out of the control group upon randomization, and one member of the control broke baseline protocol, leaving six members in the experimental group, and five members in the control group. Data, including pitch metrics, active ROM, and demographics were collected at three time points with statistical analyses comparing data between groups. Kerlan-Jobe Orthopaedic Clinic Shoulder and Elbow Score (KJOC-SES) was collected twice. After the third time point, the control group was crossed over to receive the OMT protocol also. Data were analyzed utilizing paired t-tests and Fisher's exacttest. Six pitchers received intervention (OMT), and five pitchers received no intervention (control). Overuse injuries developed in the control group only, preventing two of the five members of the control group from throwing further pitches for data collection at 5 weeks. When analyzed by Fisher's exact test, those in the control group were 9.29times more likely to develop an injury than those receiving a single application of OMT. The only significant difference in pitch performance was an immediate 0.74 mph reduction in effective velocity in the OMT group (p=0.048), not sustained at the 5-week follow-up. Immediately posttreatment, the intervention group appreciated a 7.16° advantage in shoulder internal rotation over the control group (p=0.017). Five weeks posttreatment, the intervention group appreciated a 9.44° advantage in shoulder external rotation (p=0.047). Bilateral hip extension was immediately significantly improved in the treatment group (p<0.001). Left hip flexion was significantly improved in the treatment group when compared against the control group both immediately by 6.76° (p<0.011) and at 5-week follow-up by 12.87° (p<0.001). An advantage in right hip flexion was significant only at 5weeks by 5.89° (p<0.02). A single application of OMT is a low-risk intervention to prevent overuse injuries in the elite overhead athlete. While this study found differences in velocity, ROM, and injury risk, this study was limited by the sample size (n=11). A larger sample group is needed both for reproducibility and for assessment of other pitch parameters such as horizontal break, vertical break, and pitch extension.

Background: Marma Sharir represents a distinctive anatomical framework in Ayurveda. Marma points are vital sites formed by the convergence of muscles, vessels, ligaments, bones, and joints. In modern medicine, myofascial trigger points are commonly observed as localized areas within skeletal muscles that display increased tenderness and are frequently associated with pain and functional limitation. Although rooted in different medical paradigms, both concepts emphasize structurally vulnerable and clinically significant regions of the human body. Objective: To analyse the anatomical and functional correlations between Marma Sharir and Myofascial trigger points and to explore their relevance in integrative pain management. Material and Methods: Classical Ayurvedic texts including Sushruta Samhita and Ashtanga Hridaya were reviewed for descriptions of Marma Sharira. Contemporary literature related to myofascial trigger points, fascia, neurophysiology, and pain mechanisms was analysed. Correlations were established based on anatomical location, tissue composition, and clinical significance. Results: Several Marmas demonstrated close anatomical correspondence with commonly identified myofascial trigger points, particularly in regions rich in neurovascular structures and myofascial continuity. Shared features include increased nociceptor density, fascial involvement, and functional vulnerability to mechanical stress. Conclusion: Marma Sharir and myofascial trigger points exhibit significant anatomical and functional overlap. An integrative interpretation of these concepts provides a rational anatomical basis for combined therapeutic approaches in contemporary pain management.

Osteopathic manipulative treatment (OMT) encompasses a wide range of diagnostic and treatment techniques for many conditions, but few studies have evaluated OMT use on injured patients. We aimed to describe the use of OMT on injured patients from a nationwide sample of emergency department (ED) encounters. We performed a retrospective analysis of the 2018-2022 Nationwide Emergency Department Sample (NEDS) datasets. We included all ED encounters with an injury diagnosis as well as an osteopathic diagnosis or treatment, including International Classification of Diseases-Tenth Revision (ICD-10) Clinical Modification (CM) codes M9900-M9909, ICD-10 Procedure Coding System (PCS) codes 7W00X07-7W09X9Z, and Current Procedural Terminology/Healthcare Common Procedure Coding System (CPT/HCPCS) codes 98925-98929. We calculated the Injury Severity Score (ISS) and the predicted probability of injury-related in-hospital mortality for each encounter utilizing the ROCmax method. Except for counts, all statistics at the encounter level are weighted to account for the complex survey design. Among 29,966,447 ED encounters with an injury diagnosis within the study period, we identified 1,686 with at least one osteopathic diagnosis or treatment code, 6.0 per 100k injury encounters (95 % confidence interval [CI] 4.2 to 8.2). A minority of encounters (574 [35.5 %]) were at level 1 or 2 trauma centers. Although 677 (39.7 %) were admitted, the median ISS was only 1 (interquartile range [IQR 1, 4]), and only 62 (2.9 %) had computed tomography (CT) orders. The predicted probability of injury-related mortality was low, 1.5 % (IQR 1.3, 2.0). Most encounters had a somatic dysfunction diagnosis without an osteopathic treatment code, 1,239 (75.9 %). The most common site of injury, as well as the body area with somatic dysfunction diagnosis and osteopathic treatment, was the thorax. In this nationwide sample, few injured ED patients received OMT, the majority only received a somatic dysfunction diagnosis without osteopathic treatment, and most had minor injuries. These results offer real-world insights into the use of OMT among injured ED patients and may inform efforts to promote its adoption.

Osteopathic manipulative treatment as a complementary and integrative approach to mitigate stress, anxiety, and depression: A systematic review.

Background: Osteopathic manipulative therapy (OMT) has attracted attention as a management modality for chronic low back pain (CLBP), a very common and costly problem in primary care. This narrative review intends to evaluate the efficacy of OMT in real-life situations beyond the confines of a predetermined study protocol. Methodology: The search started with a review of the current literature through published articles on the following search engines: PubMed, Google Scholar, and Scopus. It used combinations of different keywords in various forms, including osteopathic manipulative therapy/treatment, low back pain, and chronic back pain. Discussion: Several studies point that OMT successfully helps in alleviating pain and increases function in CLBP patients. Overall, patient satisfaction with OMT is quite high. However, challenges arise from the inconsistencies in its usage among osteopathic physicians. Extensive research indicates that OMT may lead to outcomes such as decreased pain intensity, reduced disability, and lower medication usage. However, further studies are required to assess the usefulness of osteopathic techniques in CLBP treatment. Recent trends on OMT suggest that it is useful in the management of CLBP. Conclusion: Although research supports OMT’s acceptance, barriers remain to its complete integration into the medical field. Additional studies should address the existing evidence lacunae concerning other conditions related to chronic pain management. While it is easier said than done, finally incorporating OMT into real practice will bring all the benefits it is capable of through more effective treatment of the patients.

BackgroundChronic pain is a significant public health issue linked to reduced quality of life and higher healthcare costs. Its complex etiology complicates treatment plans, leading many to seek complementary health approaches (CHAs). However, utilization patterns and clinical effects remain understudied.ObjectiveTo quantify the association between chronic pain and CHA utilization in US adults, focusing on osteopathic manipulative treatment and other non-traditional modalities, and to evaluate whether associations persist after adjusting for demographics.MethodsA cross-sectional online survey of 3022 US adults examined CHA use among individuals diagnosed with chronic pain in the past year. Statistical analyses included Chi-Square tests of bivariate associations and logistic regression to evaluate associations with and without demographic adjustments. CHAs were categorized into the five NIH-defined groups: Physical, Psychological, Nutritional, Combined, and System-Based, encompassing nearly 30 interventions. CHA usage, favorable expectation, and favorable experience of these modalities were analyzed.ResultsIndividuals with chronic pain demonstrated significantly higher overall utilization of CHAs than those without (aOR = 2.36, 95% CI: 1.44–3.87), including osteopathic manipulative treatment (aOR = 3.29, 95% CI: 2.15–5.02). Despite low expectancy for positive outcomes across groups, chronic pain patients reported lower expectations for various modalities. Favorable experience for Any CHA among those with chronic pain was high (93.5%), especially for physical CHAs, acupuncture, and art, music, or dance therapy.ConclusionThe increased use of CHAs among chronic pain patients underscores unmet needs in conventional care. Future longitudinal research should further clarify the factors influencing CHA adoption and evaluate their therapeutic efficacy.

Intra-articular injury to the knee can have numerous sequelae, one being an acutely locked knee. A patient suffering from this pathology will have pain, mechanical symptoms, and decreased range of motion in the sagittal plane. Different causes can lead to the resulting locked knee; however, it is commonly seen after bucket handle tearing of either meniscus. A locked knee may lead to an osteochondral defect and subsequent degeneration, predisposing patients to early osteoarthritis. As a result of this anatomical and biomechanical limitation in these patients, surgical management is often indicated. In this case report, we explore the possibility of using an Osteopathic manipulative technique as a possible therapy to “unlock” the knee and avoid surgery.

This study was undertaken to build upon the work of J. Gordon Zink, DO, FAAO, by developing a novel screening examination (Expanded Zink screen) that can correlate with proper identification of somatic dysfunction, the area of greatest restriction (AGR), and effective treatment in soccer players, which would elevate the osteopathic profession and advance the field of medicine. The objectives of this study are to determine whether the Expanded Zink screen can accurately correlate with the somatic dysfunctions found in soccer players, with what ended up being treated, and with effectiveness of treatment as measured by spirometry. We performed a correlational study that involves female collegiate soccer players during the season who signed up to receive osteopathic manipulative treatment (OMT) after providing written informed consent. We screened 8 University of Pikeville (UPIKE) women's soccer players; exclusion criteria included any pre-existing health problems, such as bleeding disorders, congenital malformations, and spinal cord injuries. Each soccer player underwent pre-OMT spirometry measurements. Next, each soccer player received a screening examination ("Traditional Zink" screen or "Expanded Zink screen") from Operator 1. The soccer player then received the same screening examination from Operator 2. Operator 2 then found somatic dysfunctions and performed OMT. Finally, Operator 1 completed a re-screen of the soccer player utilizing the initial screen and noted any changes in findings. The soccer player then completed post-OMT spirometry measurements. We find that all players in both groups after receiving OMT have a normal lung function pattern or one that improved from an obstructive pattern to a normal pattern as measured by spirometry. All eight soccer players had lumbar somatic dysfunction, innominate somatic dysfunction, and lower extremity somatic dysfunction. All players had all four junctions equalized post-OMT. Seven out of the eight players had cranial somatic dysfunction, and five of them had their cranial somatic dysfunction treated first, including Player 5, who showed clinically significant improvement in lung function post-OMT. Player 5's ribs were treated second in the treatment sequence. A novel Expanded Zink screen accurately correlated OMT of exhaled ribs to lateral asymmetry in rotation at the cervicothoracic junction in Player 5. Spirometry measurement post-OMT in Player 5 revealed clinically significant improvement in lung function showing 32 % change from obstruction to a normal pattern, which we attribute to correction of restrictive ribcage motion/dysfunction utilizing OMT. Both cranium and rib treatments accurately correlate with Expanded Zink screen findings of cranial and rib somatic dysfunctions in Player 5. The Expanded Zink screen can be utilized as a screening model for the hypothesized correlating body regions to identify significant somatic dysfunction and to augment the physician's ability to detect key body regions that need OMT. Through the use of the Expanded Zink screen, we discovered an out-of-pattern rib somatic dysfunction, which may have led to what we call a "restrictive ribcage motion/dysfunction." This type of rib motion may have been the cause of the obstructive pattern on pre-OMT spirometry seen in Player 5. Once the rib was treated, the restrictive ribcage motion resolved, which allowed lung function to be restored to normal.

The benefits of breastfeeding are well established, from reduced incidence of common childhood infections to decreased incidence of sudden infant death syndrome and infant mortality. Offering support to breastfeeding mothers should be a key aspect of care in the perinatal period. The purpose of this study was to evaluate whether utilization of a standardized osteopathic manipulative treatment (OMT) protocol as an adjunct to lactation support improves feeding dysfunction in breastfed newborns. This was a single-blinded, randomized, controlled, prospective pilot study of healthy, full-term neonates identified by an International Board Certified Lactation Consultant (IBCLC) as having feeding dysfunction. Neonates were subsequently randomized in an alternating fashion into an OMT protocol treatment vs. sham treatment. Infant LATCH (Latch, Audible swallowing, Type of nipple, Comfort of birth person, and Help birthing person needs holding infant to breast) scores were assessed by nurses and IBCLCs during hospitalization assessed with mean and median score improvement between groups. Forty infants were included in the study, divided into a sham group (n=21) and OMT group (n=19). The groups had similar characteristics. The change between pre- and postintervention LATCH scores were calculated for each group, respectively. The mean LATCH score change in the OMT group was 2.0±1.8. The mean LATCH score change in the sham group was 0.9±1.2. The mean LATCH score change in the OMT group is statistically significantly greater than the mean LATCH score change in the sham group (p=0.030), indicating that the OMT group had greater improvement in their LATCH score compared to the shamgroup. Healthy newborns with feeding dysfunction who were randomized to receive two OMT treatments during their hospitalization demonstrated a statistically significant moderate improvement in the changes in the median modified LATCH score compared with newborns randomized to the sham group. However, the effect size was moderate, at best. The LATCH score changes between groups cannot be highly attributed to the OMT interventions. However, there were no adverse effects of treatment. These findings suggest that OMT may be a safe adjunct to traditional lactation support in the care of healthy breastfed newborns with feeding dysfunction. Future studies could investigate other factors, such as the length of time that mothers breastfeed their infants after the two initial treatment sessions or potentially including a separate arm for neonates with ankyloglossia.

BackgroundPostoperative ileus (POI) is a common condition that increases length of stay (LOS) and resource utilization. However, treatment consists primarily of supportive care. No workflow addressing measures to promote early bowel function recovery following abdominal surgery was in place at Mayo Clinic Health System Hospital in Mankato. Osteopathic manipulative treatment (OMT) may provide a cost-effective and low-risk option for reducing LOS of surgical patients. The primary aim of this quality improvement project was to decrease LOS of patients at risk for POI following abdominal surgery by implementing a standardized OMT protocol at Mayo Clinic Health System Hospital in Mankato, MN.MethodsThis was a single-center, non-randomized, mixed retrospective-prospective quality improvement project taking place from 2021-2023 taking place at Mayo Clinic Health System Hospital in Mankato, MN. Surgical patients admitted for abdominal surgery with an expected length of stay greater than a day were invited to participate and receive treatment with a pre-defined OMT treatment protocol including seven techniques. Patients under 18 were excluded. A total of 33 patients were enrolled over two cycles, February 1, 2022 - April 30, 2022, and February 1, 2023 - April 30, 2023. A baseline comparison group of 55 patients was retrospectively compiled following these same criteria over a period from January 1, 2021, to April 30, 2021. The primary outcome measured was LOS in days. Secondary outcomes were time to first bowel movement, time to first flatus, 30-day readmission rate, and postoperative LOS.ResultsThe baseline group had a median LOS of 7.0 days and while the OMT group had a median LOS of 6.0 days resulting in a non-significant median difference of -1 days [Hodges-Lehmann estimator: -1, 95% CI (-3.0, 0.00), p=0.128] as well as an effect size r=-0.19 [95% CI (-0.44, 0.03)] favoring the OMT group. No significant difference was found in secondary outcomes. Subgroup analysis revealed a significant reduction in median LOS [Hodges-Lehmann estimator: -2.99, 95% CI (-5.00, -1.00), p=0.011, r=-0.38] and postoperative LOS [Hodges-Lehmann estimator: -2.00, 95% CI (-3.99, 0.00), p=0.028, r=-0.33] in patients who underwent open surgical procedures.ConclusionsIn this quality improvement (QI) initiative, the incorporation of a standardized OMT protocol was associated with a non-significant reduction in LOS and postoperative LOS. However, patients undergoing open surgical procedures did show a significant reduction in both LOS and postoperative LOS. These findings suggest the feasibility of this protocol; however, due to the limitations of the study, they warrant further investigation in properly powered, randomized-controlled trials.

There are many reasons why prospective medical students may choose osteopathic medical schools, including geography, familiarity, lifestyle choices, and a focus on the musculoskeletal system, including osteopathic manipulative medicine. However, osteopathic medical schools have several potential disadvantages for students wishing to pursue an orthopaedic surgery residency, including the lack of a home department and residency program, less research exposure, and decreased opportunities for away rotations compared with their allopathic counterparts. Moreover, many orthopaedic surgery residency programs do not consider interviewing or ranking osteopathic candidates and most residency programs do not have any osteopathic residents. Consequently, osteopathic medical students have decreased match rates compared with allopathic students, and this trend is expected to worsen over the next decade. Even for osteopathic students who successfully match into orthopaedic surgery residency, there is decreased opportunity to pursue several orthopaedic subspecialty fellowships. For osteopathic physicians who wish to have an academic career, additional barriers are faced, including being less likely to be hired as residency program faculty or to participate in academic meetings and journal leadership. There are opportunities to improve success, by enhancing mentorship and sponsorship for osteopathic students and physicians pursuing academic careers in orthopaedic surgery.

Abstract Introduction: Temporomandibular joint dysfunction (TMD) occurs from many causes including trauma, genetics, and arthritis and manifests as jaw pain, difficulty chewing, and/or lock jaw. The typical medical treatments are physical therapy, splint therapy, injections and surgery. However, osteopathic manipulative treatment (OMT) is a less explored approach and has some supporting evidence in the literature that may offer a less invasive and promising alternative. Case: A 67-year-old male was in a motor vehicle accident where he sustained jaw fractures three months prior to presenting to the Osteopathic Treatment Center with tinnitus, head injury, jaw pain with posterior right premature contact, and painful chewing. Initially, the patient was treated with maxillomandibular fixation, where pins were surgically placed for eight weeks. This was followed by intraoral osteopathic manipulative treatment (OMT), starting with osteopathic cranial manipulative medicine (OCMM), and then incorporating soft tissue techniques, myofascial release (MFR), muscle energy, and the Still technique. Discussion: This case illustrates the debilitating nature of temporomandibular joint dysfunction and how difficult it is to control and treat. TMD often requires a multimodal approach involving both conservative and invasive techniques such as utilizing OMT and the various modalities, including OCMM. The case presented here is unique due to the acute nature and development of the dysfunction and use of OMT within 3 months of his accident. Conclusion: This case study suggests that OMT can improve the quality of life for patients with TMD secondary to trauma. The use of cranial techniques followed by head and neck treatments was an effective management approach for this patient with TMD pain.