Picture this: Your osteopathic manipulative medicine professor is demonstrating techniques on you in lab before you and your classmates pair up for more hands-on practice.
Today’s lesson focuses on the cervical spine, but something isn’t right with your neck. Based on feel, your professor thinks you have a chronic condition. He suggests a full examination and bloodwork, which points toward what he sensed through touch: you have signs of an autoimmune disease.
This is what happened to Alyssa Salera (DO ’26), a PCOM Doctor of Osteopathic Medicine student, who was diagnosed and treated by Alberto Giardini, DO ’19, an assistant clinical professor of Osteopathic Manipulative Medicine (OMM).
“It made me believe so much more in OMM because he just felt my neck one day and, quite literally, said ‘do you have any autoimmune conditions in your family history?’” Salera said of the experience, which occurred toward the end of her first year of medical school. “On the spot. It’s pretty cool.”
Salera said students are taught to examine tissue texture as correlating with acute versus chronic conditions. In OMM, a muscle or tissue abnormality caused by a chronic condition can feel more ropey, like a cord. A more acute symptom can feel “boggy” or spongy. Limits to range of motion, and whether the impacted area feels warm or cold, also can factor into a diagnosis.
In Salera’s case, she arrived to an appointment with Giardini with a red facial rash—nicknamed a butterfly rash—indicative of lupus. She often experiences knee pain and swelling after running, which can also be symptoms of a condition like lupus. The same goes for consistent fatigue that goes beyond the bounds of a tired medical student.
Since that day in the OMM lab, Salera underwent an antinuclear antibody test and a related screening for more specific antibodies. They weren’t conclusive. Salera said she’ll do further testing if symptoms become more prevalent.
“I just know in the back of my head that that could be a diagnosis, and if symptoms are flaring up I can get bloodwork and take those next steps,” she said recently. “But I don’t feel I need to do that right now.”
In the meantime, she’s asked family members to explore their health more deeply, as autoimmune conditions have large hereditary components.
“There is so much information you can glean from putting your hands on your patient and examining them, an art that is slowly being lost with many physicians,” Giardini said. “It is the second thing we teach students in medical school, right after ‘Listen to your patient!’ The fact that Alyssa learned this about herself during a lesson on palpation hopefully means she will not forget it for the rest of her career and can carry it forward.”
Currently completing clinical rotations during her third year, Salera is drawn toward pediatrics. Her appreciation for OMM continues to run deep.
“For Dr. G to be so smart and to use his hands to help students, including me and what could potentially be a life-changing health situation, that’s huge,” Salera said. “That’s a level of genuine care.”
Established in 1899, Philadelphia College of Osteopathic Medicine (PCOM) has trained thousands of highly competent, caring physicians, health practitioners and behavioral scientists who practice a “whole person” approach to care—treating people, not just symptoms. PCOM, a private, not-for-profit accredited institution of higher education, operates three campuses (PCOM, PCOM Georgia and PCOM South Georgia) and offers doctoral degrees in clinical psychology, educational psychology, osteopathic medicine, pharmacy, physical therapy, and school psychology. The college also offers graduate degrees in applied behavior analysis, applied positive psychology, biomedical sciences, forensic medicine, medical laboratory science, mental health counseling, physician assistant studies, and school psychology. PCOM students learn the importance of health promotion, research, education and service to the community. Through its community-based Healthcare Centers, PCOM provides care to medically underserved populations. For more information, visit pcom.edu or call 215-871-6100.
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