Don’t Forget the Front

As osteopaths, we’re often thought of as “back specialists.” Patients frequently come to us for help with back pain, and much of our training and reputation centres on supporting the spine. But it’s worth remembering that people don’t only have backs—they have fronts too. And sometimes, it’s the front that needs attention.
Why the Front MattersThe body’s front is not just a passive surface; it contains key joints and structures that can play a major role in pain, restriction, and overall function. These include:

• The costosternal joints – where the ribs meet the breastbone (sternum).
• The sternoclavicular joints – at the front of the collarbones, vital for shoulder function.
• The pubic symphysis – the small but important joint at the front of the pelvis.

Inflammation or irritation at any of these sites can be surprisingly painful and can limit movement in the chest, shoulders, and hips. In many cases, hands-on treatment in these regions—alongside exercises and advice—can make a meaningful difference.
Sensitivities and Good PracticeOf course, treating the front of the body brings some unique challenges. The thorax, in particular, is an area where practitioners may hesitate due to the presence of breast tissue and the sensitivities around this. This is entirely understandable—but if we avoid these areas altogether, we may miss important contributors to a patient’s pain.
The key lies in:

• Clear communication – explaining what we’d like to assess or treat, why it’s relevant, and what options exist.
• Informed consent – ensuring patients are comfortable, fully understand the approach, and know they can stop at any time.
• Practical adjustments – using draping, positioning, or modified techniques to maintain dignity and ease.

Handled sensitively and professionally, treatment of the front can be safe, respectful, and effective.
A Whole-Person ApproachAs osteopaths, our strength lies in looking at the body as an integrated whole. Pain at the front can affect movement and posture at the back, just as problems at the spine can affect the front. By remembering both sides, we can give patients the most complete care possible.
So, next time you think “osteopath = back,” remember: don’t forget the front.

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