Clients are occasionally caught off guard when I ask them to get undressed (to their underwear) before we start the hands-on portion of our session. Apparently this surprise is not uncommon. A recent U.K. study found that the lack of forewarning about the need to undress for treatment was one area where osteopaths did not meet patients expectations. You can read more about that study here.
“Do I really have to get undressed?” It’s a reasonable question. The short answer is, “Of course not.” I appreciate that you may feel uncomfortable and fully respect your wishes. But let me explain why I prefer to work this way and how it helps you get the best possible care.
If you’re stripped down to your skivvies, I can see the big picture of your health. I can assess more accurately and treat more efficiently. I rely on my sense of touch as much, if not more than my vision, so when I say ‘see,’ I often mean ‘feel’ – they’re practically interchangeable to me.
My first step is to observe your alignment, symmetry and body contours. A common finding is a ’tilted’ pelvis which will affect the position and mobility of your entire spine and can create neck or back pain as your body attempts to re-balance. It might also contribute to foot pain by changing the forces passing through your leg to the ground (think ‘fallen arches’ or bunions).
I also check for evidence of altered circulation or neurological function. Warmer or cooler, redder or whiter (especially in response to touch), drier or damper, swelling and tissue response to pressure – all offer clues. These findings can reflect not only the health of your skin, muscle and joints but also the function of underlying internal organs. Direct hand contact makes these changes easier to detect.
Taking a look can reveal forgotten (or considered not relevant) incidents in your health history too. I once had a client who failed to mention bypass surgery. Fortunately, I saw the scar on his leg from the vein removal as soon as he removed his pants! I’ve also discovered moles hiding in plain sight that needed further monitoring. You never know what a second set of eyes might find.
Next up, I ask you to perform a few simple movements. It’s easier to observe slight restrictions in your quality and range of motion without an intervening layer of fabric. Jeans, even stretchy ones, are the most challenging to work through as the seams inevitably lie at the sacroiliac (SI) joint – an important structure in osteopathic assessment.
Then we’re ready for treatment. I’m able to apply hands-on osteopathic techniques to individual structures more precisely, and better monitor the subtle responses as your body accepts the proposed changes, without clothes. I keep cozy flannel blankets on hand, so you can cover up, stay warm and fully relax once you’re on the table.
I hope that helps you understand why I ask you to get undressed. If you prefer to stay clothed, I suggest loose, lightweight clothing that allows unrestricted movement.
And just so you know, I’m not judging your hairy legs, barely-there underwear or lack of a pedicure. (Although a recent shower is always appreciated.) I’m way too busy making sure things are in the right place and moving properly so you can feel and function better.