The Legacy
of
Stanley Schiowitz, DO, FAAO
Dennis J. Dowling, DO, MA, FAAO
No Conflicts to declare
Graduated from high school at age 15
St. John’s University ages 15-18
AGE 18
“It’s time for the Dr. Moe Levy
Story”
Philadelphia College of Osteopathy
Graduated at age 22 in 1944
Apprenticeship with Moe Levy, D.O.
1944-1946
Stanley Schiowitz, D.O., F.A.A.O.
Private Practice in Brooklyn 1945 – 1977
Senior Attending Physician, Department of Family Practice, Interboro General Hospital, New York
1966 – 1977
DME Interboro Hospital 1971-1977
Past President NYSOMS
Stanley Schiowitz, D.O., F.A.A.O.Chair of NYCOM OPP Department 1977 – 1991
Stanley Schiowitz, D.O., F.A.A.O.
Robert G. Thorpe, D.O., F.A.A.O.
Eileen L. DiGiovanna, D.O., F.A.A.O.
Mary Hitchcock,, D.O., F.A.A.O.
Gary Ostrow, D.O
Andrew “jack” Tatom,, D.O
MY NYCOM “BROTHERS” and “SISTERS”
“I.O.”
First Rib
MONITOR
“Figure Four”
Physician’s monitoring arm must be more
cephalad
• Patient supine• physician stands on same side as dysfunction (typically an elevated rib)• physician uses the same sided hand to monitor rib (right hand monitors
right rib, left hand monitors left rib)• arm on same side is abducted slightly (10 degrees) and shoulder flexed to
approximately 90 degrees physician uses his other arm• physician exerts downward pressure towards the rib along the long axis of
the arm• monitoring arm acts as a fulcrum• a slight amount of increased shoulder flexion is introduced (this also
creates relative further internal rotation of the shoulder)• abduction is introduced• further internal rotation is introduced• return to neutral• reassess
First Rib
First Rib
“I.O.”“INSTANT OSTEOPATHY”
How Long? A few seconds
Basic Rules of F.P.R.• Diagnose
• Put region/joint into Neutral (flatten curves)• places joint into idling position
• Monitor continuously
• Add facilitating force (usually compression or torsion)• reduces proprioceptive and nociceptive “noise”
• Add freedoms in all three planes (Flexion/Extension, Sidebending, rotation)• reduces muscle spindle activity
• allows reduction of gamma gain
“If compression doesn’t work, try traction. If it doesn’t work going to
the right, go to the left. Simple philosophy.”
“Someday, someone will explain to me what the hell I am doing.”
• Hold position for five seconds
• Determine alteration of tissue tension
• Return to Neutral
• Reassess
• Barriers can then be challenged (“wiggle” “jiggle”)
• Reassess
Basic Rules of F.P.R.
“Any mechanical dysfunction in the body can affect any
other part of the body and therefore can affect any system of
the body (and vice versa). When treating a patient, never
treat them for a diagnosed medical condition. Treat the
musculoskeletal change, and if the patient feels better then
you are both lucky. Maybe it will help, maybe it won’t.”
Functional Technique?Harold Hoover, DO
1896 – 1966Functional Technique
1940s
Charles Bowles, DO(1904 - 1984)
William Johnston, DO, FAAOFunctional Technique
1970s
PASSIVE - INDIRECT
“Still’s Technique”Charles Hazzard, Ph.B., DO
The Practice and Applied Therapeutics of Osteopathy
Second Revised Edition1901
Richard Van BusKirk, PhD, DO, FAAO The Still Technique
1990s
Andrew Taylor StillThe Philosophy and
Mechanical Principles of Osteopathy
1902
How Long? A few seconds
• Hold position for five seconds
• Determine alteration of tissue tension
• Return to Neutral
• Reassess
• Barriers can then be challenged (“wiggle” “jiggle”)
• Reassess
Basic Rules of F.P.R.
“But, Stan, you never wrote
about challenging the barriers.
What gives?”
PASSIVE – INDIRECT & DIRECT
“I don’t treat the way I teach, I get down to
smaller and smaller motions.”
Still Technique
Facilitated Positional Release
Still Technique
Facilitated Positional Release
TWIN TECHNIQUES with DIFFERENT FATHERS
“Did Stan Schiowitz know that his FPR
was the third iteration of the Still
Technique?”
“No, he didn’t…”
“He knew that it was the
second.”
F.P.R.J Am Osteopath Assoc. 1990 Feb;90(2):145-6, 151-5.
Still TechniqueJ Am Osteopath Assoc. 1996 Oct;96(10):597-602.
A form of Myofascial Release• Counterstrain & Functional techniques are positional
techniques
• Facilitated Positional Release and Still technique rely on both the positional component and…
… a facilitating force
• They both start INDIRECT and then become DIRECT
• They are both very TIME EFFICIENT
“It is important to learn efficiency in time and effort. “
Contraindications
• Localized pathological tissue conditions• Infection
• Cellulitis
• Osteomyelitis
• Cysts
• Tumors
• Fracture
• Increase or significant alteration of symptoms
• Inability to tolerate position
Learned from Moe Levy, D.O. (his mentor):
1. Always do a complete H&P
2. Always do a rudimentary structural exam
3. Always use OMT whenever you can.
Type of Technique
• Passive - the patient does nothing
• Indirect - Treatment is directed primarily away from the barriers
• (Direct - barriers can be challenged afterwards)
• (Occasionally we ask the patient to do something [i.e. isometrics])
Dr. Schiowitz’s Legacy Dean NYCOM 1992-2002
• Had an Educational Consortium established more than a decade prior to most other COMs. Hospitals had to establish internships and residencies as well as rotations for students
• Many other of the literally thousands of alumnae, interns, and residents who have learned from Dr. Schiowitz have become leaders in the profession as well serving as medical directors, residency directors, deans, and professors.
• As the Dean of Allied Health at New York Institute of Technology from 1995 to 2000, Dr. Schiowitz oversaw the development of programs in nursing, physician assistants, occupation therapy, physical therapy, and nutrition; and a masters’ degree in business administration.
Stanley Schiowitz, D.O., F.A.A.O.
Robert G. Thorpe, D.O., F.A.A.O.
Eileen L. DiGiovanna, D.O., F.A.A.O.
Mary Hitchcock,, D.O., F.A.A.O.
Gary Ostrow, D.O
Andrew “jack” Tatom,, D.O
• NYIT-NYCOM OPP Department became the Stanley Schiowitz, DO, FAAO Department of Osteopathic Manipulative Medicine
• Dean Emeritus NYCOM 2002-2011
• Scott Memorial Lecturer (ATSU-KCOM)
• the Louisa Burns Memorial Lecturer (AOA),
• David Heilig Lecturer (PCOM).
• A.T. Still Medallion American Academy of Osteopathy
• Honorary Life Membership from the American Academy of Osteopathy
• Dale Dodson, D.O. Award.
• Distinguished Physician of the National Academies of General Practice
• 2005 inductee into AOA mentor Hall of Fame.
• The AOA Distinguished Service Award