MARCO CHIANTELLO – Structural osteopathy | 2022 February 25/26

Lecturer: Marco Chiantello, D.O.


The biomechanical model proposed by dr Philip Greenman in his book “Principles of Manual Medicine” is undoubtedly a milestone of osteopathic teaching worldwide. This approach has been developed and taught by him and dr Fred Mitchell at the Michigan State University – College of Osteopathic Medicine for many years.

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Learn the evaluation and treatment model proposed by dr Philip Greenman at the University of Michigan.

Consider the role of the musculoskeletal system in the body and its relevance in diagnostics and treatment.

Deepen evaluation and treatment techniques according to this approach.



The biomechanical model proposed by dr Philip Greenman in his book “Principles of Manual Medicine” is undoubtedly a milestone of osteopathic teaching worldwide. This approach has been developed and taught by him and dr Fred Mitchell at the Michigan State University – College of Osteopathic Medicine for many years.
The book has been written based on this model’s initial ideas. It has been translated into many languages and spread worldwide. Since the book’s publication and its last review, the research and teaching proposed at the College of Osteopathic Medicine have evolved and improved thanks to the contribution of other colleagues of dr Greenman, such as dr Carl Steele. He has continued this teaching tradition and applied these principles in clinical practice for many years.

Dr Marco Chiantello was lucky enough to directly spend much time with dr Steele, learning the approach and the teaching method and introducing it in Italy.
This model’s innovation  lies in the combination of palpatory evaluation, biomechanical and physiological principles, manual skills, and technical effectiveness. In this framework, the osteopathic treatment becomes continuous dynamic feedback between the patient and the osteopath and gradually leads the patient to health improvement.
What strikes when observing highly experienced osteopaths working with this approach is the transition from a treatment made up of separate sequences to a dynamic osteopath – patient system which harmoniously evolves towards health improvement and integration of the dysfunctional areas.

Dr Greenman does not consider the biomechanical model only as an evaluation method that searches for structural dysfunctions and removes them in sequence. Instead, he interprets it as a fluid system condensed in a frame, the skeleton, which is suspended and floats within a particular fluid system: the muscles. This system’s balance always combines with the control activity carried out by the central nervous system. In this way, the model itself is a continuous dialogue between the musculoskeletal system and the central nervous system. The autonomic nervous system also manages the relation between the bowel and structure, so we deal with a fully integrated network that interacts dynamically in both directions (bowel-structure and structure-bowel), creating a communication channel between the parts.
Probably dr Greenman and his colleagues at Michigan State University did not consider their model in this perspective, but their gestures and how they approached patients during treatment displayed awareness and intrinsic knowledge of this interpretation.
The codification of the techniques and their subsequent modifications, especially those carried out by dr Carl Steele, mostly represent communication, a dialogue between osteopaths and patients. The language is the movement of the osteopath together with the patient’s body. Therefore, the technique is not an aim in itself but becomes the key to convey the message proposed by the osteopath. This continuous communication is a real exchange: the patient learns through the osteopath’s inputs a well-functioning pattern, the osteopath modulates the wide range of tissue responses to his inputs and increases his palpatory and perceptive skills.




Introduction to the biomechanical concept and review of biomechanical dysfunctions and topographic anatomy

Neurogenic inflammation and integration of the neurological features that define somatic dysfunction

Considerations on the sclerotome pain chart

Differential evaluation of the visceral fascia in relation to the standing flexion test

The seated flexion test in three phases

Hip drop test and its interpretation

Evaluation of sacroiliac joint in standing position (we will practice a transformed technique that allows for a more precise and reliable evaluation)

Lumbar evaluation in standing position

Sacrum evaluation in prone position.Palpation practice focused on communication and management of the curvature apex. Specific assessment of single-segment dorsal dysfunctions in seated position. Distal, proximal, and medial dorsal tract

Assessment of the cervical tract

Muscle energy techniques: rationale and clinical observations

Effective muscle energy techniques for the dorsal tract

Practical session on the pelvis

Notes on embryology of the vertebral system. Role of the parasympathetic nervous system and the links with the musculoskeletal and visceral system

Effective muscle energy techniques for the cervical tract



Effective muscle energy techniques for the lumbar tract and sacro-iliac complex

Palpation of the ribs and advanced techniques

Integration of the upper limbs in the management of C1 and C2 dysfunctions

High velocity low amplitude techniques. Historical synthesis and basic concepts

Improvement of the palpatory skills in high velocity low amplitude techniques with the “dog” method.  Focus on critical regions

High velocity low amplitude variations on the thoracolumbar and cervicothoracic region

High velocity low amplitude techniques on the lumbar and pelvic region. Strategies and skills improvement

High velocity low amplitude techniques on the cervical region. Safety issues

Clinical synthesis: application of the biomechanical approach in an osteopathic treatment



All lessons will be in Italian.



The course will be held at the centre in Via Cardinale Mezzofanti n.13, Milan (Milano Forlanini Railway Station).

We recommend the following facilities for those who need to stay overnight in a hotel.



The cost of the course is €300.

Additional information


2 giorni


Advanced Osteopathy Institute (via Cardinale Mezzofanti 13, Milano)