How should OMM be adapted for patients with osteoporosis?

• A. Emphasize non-thrust, low-force, indirect techniques (MET, MFR, soft tissue, rib raising) and avoid HVLA to prevent fracture.
• B. Use high-velocity thrusts to mobilize joints quickly.
• C. Avoid any manual contact and only use modalities like ultrasound.
• D. Perform aggressive rib springing to increase bone density.

Answer: (A)

Fragile bones in osteoporosis mean you must minimize fracture risk while still addressing somatic dysfunction. The safest OMM approach uses non-thrust, low-force, indirect techniques that gently influence the fascia, muscles, and lymphatics without loading the bones. Techniques like muscle energy, myofascial release, soft tissue work, and rib raising can relieve tension and improve mobility while keeping forces well below the threshold that could cause a fracture.

High-velocity thrusts involve rapid, substantial forces that can exceed the weakened strength of osteoporotic bone, increasing the risk of vertebral or rib fractures, so they are avoided or used with extreme caution if ever considered. OMM still relies on hands-on assessment and treatment, so removing manual contact altogether is not appropriate. Aggressive rib springing applies direct, forceful loading to the ribs and chest wall and can similarly provoke fractures.