It is generally accepted, among healthcare providers, that manual therapy has several benefits in the care and treatment of children. One of the primary areas of concern, according to osteopathic medicine, is restricted motion of one or more vertebrae. Aside from having an influence on spinal movement, the 'health' of each spinal segment has far reaching consequences. The function of the neurological, endocrine, respiratory, cardiovascular, genitourinary and gastrointestinal systems may be affected by vertebral segments that have either anatomical, biomechanical or neurological relations to them.

Let us look at vertebra L1, for example. L1 is situated at the upper part of the lower back - just below the ribcage. Nerve fibres that emerge from L1 supply the hip joint and its muscles, the abdominal muscles, the large intestine, the uterus in the female, the prostate in the male, the kidneys and ureters, and the lymphatic and vascular centres of all of these tissues. Should L1 lose its ability to rotate, flex or extend, the nerves that emerge from it may be compromised, having a negative affect on the health of the tissues and organs it supplies. Generally, no pain is felt and no symptoms occur, and both the parents and child remain unaware of the lesion, or restriction. However, over a long period, from a few weeks to several years, the impact of the altered nerve supply manifests as organ dysfunction, causing symptoms such as back pain, digestive problems, premenstrual pain and the like, at which point much of the damage is irreversible.

Anatomically, our primary inspiratory muscle, the diaphragm, is connected to vertebra L1, as are various spinal muscles, part of the abdominal connective tissue, and the renal fascia, which is connected to the kidneys and is essential to their health. Any change in the resting position of L1 will affect the slackness/tightness of these tissues, having an effect on their function, which again, is generally not noticed until the damage is irreversible. Furthermore, due to the reduced range of motion at L1, one of its neighbors, T12 (which is immediately above L1) or L2 (which is immediately below L1), will generally display excessive 'compensatory' mobility, causing a predisposion to joint degeneration.

Similar connections exist with every vertebra, and as such, osteopathic medicine helps to prevent, or at least lessen organ dysfunction, tissue abnormalities and mechanical restrictions. Naturally, manual therapy is applied, with great success, to adults. However, the changes that occur in children are greater and last longer than those observed in older patients.