My job: Detective work key to success

Osteopath Kristi Milliken says sometimes it's hard to convince people to do stretching exercises at home. Photo / Ted Baghurst

Name: Kristi Milliken.
Age: 31.
Role: Osteopath at Kingsland Osteopaths.
Working hours: 40 hours per week with glide time and Saturday mornings.
Average salary: $55,000-$80,000 for reasonably established osteopath. Varies across the country, depending on patient charges and practice overheads.
Qualifications: Master of Osteopathy and Bachelor of Applied Science (Human Biology) from Unitec (only New Zealand tertiary provider).

What does an osteopath do?

People come to osteopaths for a variety of things - sports injuries, work-related issues, pregnancy and baby problems, headaches and other normal aches and pains.

We use a wide range of manual treatments, working gently with all components of the body, including muscles, joints and fascia (soft tissue covering muscles).

Osteopathy involves asking about symptoms and then working backwards to the cause which could often be a distance from the problem site. For example, lower back pain can be caused by an ankle injury that affects the way someone walks and therefore causes the back problem. I address the injury as well as the back pain to ensure the back comes right.

There is a lot of detective work involved. From the outside it may look like we do the same thing all the time but each patient is different in the way they've been injured, how it has impacted them, how they're feeling, and how they respond to getting better. It is never mundane; no two days are the same.

How does an osteopath differ from a physiotherapist or chiropractor?

We all have slightly different models for looking at the body while trying to achieve a lot of the same outcomes for patients. One difference with osteopathy is that most of our treatment is hands-on; no heat-treatment or ultrasound. Another is length of treatment. We usually see patients for 30 minutes each time, and average two to four treatments, unless the case is complex.

How did you get into osteopathy?

I was doing sports science at Auckland University and realised I wanted something more practical and hands-on that involved health. I did some research, then visited an osteo and physio three or four times for treatment. I also went to a chiropractor once. I found osteopathy treatment the most enjoyable and most beneficial, so I researched the background and concepts of osteopathy and decided to do the training.

After graduating I did locum work and also worked at this clinic and another multi-disciplinary clinic. My husband, also an osteopath, and I bought this practice three years ago.

What training is required?

Unitec's osteopathy qualification takes five years. The first three years is an applied science degree that includes anatomy, physiology and biomechanics, as well as osteopathic principles and techniques. I was lucky because I could cross credit some of my sports science papers into that degree. That is followed by a two-year Master of Osteopathy which includes working on real patients at Unitec Osteopathic Clinic.

Skills and qualities?

The most important qualities are to be personable, empathetic and enjoy people's company. You need quite an analytical mind to chase the story of the body and be interested in why people have problems and want to understand and help them. You have to feel comfortable working very close to people. Some students found that very hard initially but you get used to it quickly because we work on each others' bodies from early on.

Challenges?

Sometimes patients have multiple conditions which are a real challenge because you want them to get better but it is a slow process. And sometimes it's hard to convince people of the value of doing stretching exercises at home. We believe change is best achieved through a holistic approach which includes lifestyle advice to prevent injury recurrence.

A special project?

I have a passion for working with pregnant women. Recently I had a patient with a severe pelvis injury who was 30 weeks pregnant and struggling to walk. She'd been told she might have to have a caesarean. I found the pain at the front of her pelvis that was making it difficult for her to walk was caused by a rotation through her pelvis. Through treatment I was able to realign her pelvis and help stabilise the surrounding joints. Then I gave her stretching exercises for her legs and she started walking properly and had a natural birth. That was special, especially because I met and treated the baby.

Advice to people interested in studying osteopathy?

Visit an osteopathy clinic and see what it is like. Research the principles and whether they fit for you because the training requires a big commitment of your time.

And next?

The thing about osteopathy is that you can keep adding to your practice. I'm working with the La Leche League to develop knowledge of breastfeeding and lactation which I'll incorporate into my practice. I'd also like to do more teaching, too, because I feel it is important to give back to the industry.