Principles of Osteopathy- Part 2

Written by Osteopath Gemma Ahrens 

Structure and Function: Understanding How the Body Works as an Integrated System

Welcome back to our series exploring the four foundational principles of osteopathy. In Part 1, we looked at the idea that the body functions as a unified whole. Today, we move to the second principle, which helps explain how and why osteopaths pay such careful attention to the way different parts of the body move and interact:

“Structure and function are interrelated.”

This principle was originally described by Andrew Taylor Still, the founder of osteopathy, who observed that changes in how a structure moves (whether a joint, a muscle, or even the way someone breathes) can influence how that area functions. Modern research now supports the idea that mechanical, neurological, and physiological systems interact in complex ways, and that movement, load, and flexibility can influence comfort and performance in everyday life.

Importantly, this principle isn’t about perfection. Bodies come in all shapes, ages, and abilities, and there is no single “ideal posture” or “ideal movement pattern.” Instead, Osteopaths are interested in how your unique body moves, how it adapts, and how certain patterns may contribute to your symptoms or goals.

How Structure Can Influence Function 

Structure includes the anatomy you can see and touch such as joints, muscles and fascia, as well as deeper systems such as nerves, circulation, and respiratory mechanics. Function, on the other hand, refers to how these structures operate: strength, mobility, balance, and overall physiological performance.

Here are a few examples of how these can influence each other:

• Stiffness in one area can change how other areas move. For example, reduced hip mobility may increase the load on the lower back when bending or lifting.

• Breathing patterns can influence muscular tension. Rapid, shallow breathing is often linked with increased neck and upper chest activity.

Changes in load affect tissues. Muscles, tendons, and bones adapt to the stresses placed on them, either positively or negatively, depending on the situation.

These interactions don’t imply damage or long-term problems, but they can help explain why certain activities feel uncomfortable, or why treatment may focus on areas beyond where symptoms are experienced.

How Function Can Influence Structure

The relationship also works the other way around:

• Sedentary habits can lead to deconditioning, affecting strength, balance, and tolerance to activity.

• Regular movement and resistance training can support musculoskeletal health, including bone density and tissue resilience.

• Stress, sleep, and emotional load can change muscle activity, breathing mechanics, and sensitivity within the nervous system.

These examples highlight how behaviour and lifestyle can influence the structures of the body over time and why osteopathic treatment often includes advice about movement, exercise, and self-care strategies tailored to the individual.

How This Principle Guides Osteopathic Treatment

When an Osteopath assesses someone, they’re not only looking at the area that feels sore. They’re also considering:

• how different regions of the body share load

• how movement patterns might be contributing to symptoms

• how lifestyle factors could be influencing recovery

• how hands-on techniques might help improve comfort and function in the short term

• how exercise, pacing, and movement strategies may support longer-term improvement

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Hands-on osteopathic techniques such as soft tissue therapy, joint mobilisation, stretching, or gentle articulation may be used with the intention of improving mobility, reducing muscular tension, and encouraging ease of movement.

Osteopaths also integrate advice based on modern evidence, which may include exercises to gradually increase strength, improve mobility, or support more efficient movement patterns. The goal is to work collaboratively with each person, considering their health history, goals, and preferences.

Bringing It All Together

The principle that structure and function are interrelated reminds us that the body is constantly adapting. It helps Osteopaths think beyond isolated symptoms and consider the bigger picture: How you move, how you feel, and how your lifestyle supports your health.

The Whole-Person Approach

When someone presents to our clinic experiencing discomfort, we don’t just look at the area of pain. We will also consider:

• How the surrounding joints and muscles are moving

• Lifestyle factors (such as work, hobbies, or load patterns)

• Stress levels and overall well-being

• Posture and movement habits

• General health factors such as sleep, activity levels, or hydration

  
  

All of these elements can influence how the body feels and moves day-to-day. With this whole-body approach, we can determine different factors that may be contributing to a person's pain and discomfort, and work together to make lifestyle changes that will have a positive impact on a person's overall health and well-being.

In Part 3, we’ll explore the third osteopathic principle:

“The body is its own self healing, self regulating mechanism.”

References:

1. Cook, J. L., & Purdam, C. R. (2009). Is tendon pathology a continuum? British Journal of Sports Medicine, 43(6), 409–416.

2. Hodges, P. W., & Smeets, R. J. (2015). Interaction between pain, movement, and behaviour: Implications for rehabilitation. Pain, 156, S1–S2.

3. McGill, S. M. (2010). Low Back Disorders: Evidence-Based Prevention and Rehabilitation (2nd ed.). Human Kinetics.

4. Sherrington, C., et al. (2019). Exercise for preventing falls in older people living in the community. Cochrane Database of Systematic Reviews, (1).

5. Schleip, R., & Müller, D. G. (2013). Training principles for fascial connective tissues: Scientific foundation and suggested practical applications. Journal of Bodywork and Movement Therapies, 17(1), 103–115.

6. Narici, M. V., & Maffulli, N. (2010). Sarcopenia: Characteristics, mechanisms and functional significance. British Medical Bulletin, 95(1), 139–159.

7. Hodges, P. W., & Tucker, K. (2011). Moving differently in pain: A new theory to explain the adaptation to pain. Pain, 152(3 Suppl), S90–S98.

8. Adams, M. A., & Dolan, P. (2005). Spine biomechanics. Journal of Biomechanics, 38(10), 1972–1983.

9. O’Sullivan, P. B., et al. (2018). Cognitive functional therapy: An integrated behavioural approach for the targeted management of disabling low back pain. British Journal of Sports Medicine, 52(21), 1297–1298.