A cold-blooded look at Osteopathy

The Zoo Ost Limited approach

by Tony Nevin, BSc (Hons) Ost, DO

OSTEOPATHY is often referred to as a science and an art. Nowhere is this more relevant than when applied to the treatment of reptiles. This branch of the animal kingdom presents many unique, and at first glance baffling aspects that can easily put off the manual therapist.

Reptiles come in many shapes and sizes. Some are easy to handle whilst others are not. They all require specific knowledge to care for them properly, and many make excellent pets.

However they are a world away from your average soft, furry friends when it comes to assessing and treating.

Before I get ahead of myself now is probably a good time to look at some of the problems reptiles can get and which osteopathy may help. To do this we also need to understand the different aspects of their anatomy, physiology, and locomotor systems when comparing to the mammalian model.


All reptiles are vertebrates and all have a central nervous system that is recognisable to our own. Their vascular systems differ slightly, in that they are very energy efficient in using environmental help to assist with their core temperature. They are not truly cold blooded but rather more solar powered. They all have the senses and ability to thermo regulate in order to maintain a healthy core temperature, however if they get too cold or too hot then they seek environmental measures to address this via sun basking and water cooling etc ...

From a locomotor viewpoint, most legged reptiles suspend their body between their legs resulting in a gait pattern that meanders along. Chameleons are the only ones that spring to mind that place the limbs under their body, in the way that mammals do. This appears to be an evolutionary adaptation to an arboreal lifestyle.

Snakes and legless lizards create traction via their ribs and ventral scale patterns, and move with the classic serpentine action.

Where some of the internal organs are, and how they have adapted themselves, is of particular interest to the osteopath. Snakes have so many differences due to the need to contain everything within a long thin tube. Generally speaking the internal organs are arranged so that those traditionally on the right side are arranged cranial to those that would be on the left. They have a snorkel like adaptation to their trachea, which they poke out of the side of their mouths when they are swallowing food. Their GI tract can expand enormously, and all other internal organs have evolved to displace during the peristaltic action of ingestion.

Tortoises, on the other hand have evolved so that their lungs are situated just under the top of the carapace. This is fine, unless they are kept in a vivarium with only a heat mat. Depending on the ambient temperature they live in will dictate whether they need an overhead heat lamp source.

From a reproductive point of view some reptiles are egg layers, whilst others give birth to live young. Within the egg layer group, some will abandon the egg nest once the eggs are laid, whilst others will guard it until the young hatch. Certain species, such as Burmese Pythons will actually incubate their clutch, using strong muscle pulse contractions to maintain a constant temperature.

Nervous system and physiological adaptations

Reptiles have well-developed central nervous systems, and many have extra senses that allow them to identify heat sources as well as their direction and location.

Constrictor species of snakes have highly developed palpatory skills that allow them to apply specific pressure over blood vessels. The author has, on more than one occasion, experienced this first hand with boa’s where they feel with their ribs and then squeeze over the carotid arteries bilaterally.

This is one reason why it is always a good idea to have at least two people present when treating these types of patient.

Some of the conditions Zoo Ost Ltd get to see


Metabolic problems due to cold lungs are sadly still being seen. With these we try to stimulate better overall circulation as well as getting owners to install and use an overhead heat lamp suitable to their needs.

Leg injuries can result from accidents, or direct trauma. Dogs like to play with tortoises and limbs can suffer as a result.

Some older individuals bear scars around a hind limb as a result of tethering them to a peg when outside. In certain cases that Zoo Ost have had radiographed this has also revealed hip dislocation. Due to the chronicity of them it isn’t possible to relocate the femoral head.

Another reason we sometimes see tortoises is due to excessive shell shock, where a male has repeatedly smashed into another individual, either to dominate them, or to subdue them for mating. Soft tissue patterns similar to those found in whiplash victims can ensue.


Physical trauma between individuals is not unheard of, but probably the more common things we see are issues resulting from incorrect temperature environments affecting the locomotor system and general wellbeing. Extremes of temperature ranges can cause irreversible muscles damage due to altered enzyme action. Working closely with the animals vet can assist in better recovery rates, and longerterm restoration of health.

When handling lizards, and legless lizards, please be aware that many species can lose their tails as an extreme defence measure. Never handle one by its tail, no matter how tempting!


Although snakes are incredibly flexible they can still develop intervertebral movement issues. These can be the result of direct trauma, or through dehydration or an incorrect temperature environment. Less common nowadays are nutritional issues, as keeping reptiles has become more popular and better catered for.

There are still cases where people rehome tortoises that are the oldest members of the family! These can bear the signs of poor diet, and trauma that are evident in there musculoskeletal systems (MSK).


Treatment of a snake often requires synchronized handling that to the casual onlooker looks like you are merely holding it. This is where the art of osteopathy comes in. By encouraging the patient to orientate its movement through the hands of the practitioner it is possible to facilitate a return to normal resting states within the entire length of the MSK. This is not a technique you can easily teach, as you must literally feel it for yourself.

Those readers unfamiliar with certain modalities of osteopathy may find this a little strange, and bordering on the mumbo jumbo of the early days of complementary medicine.

In essence when carrying out this form of treatment the osteopath fluidly manoeuvres the patient so that over-contracting muscle origins and insertions are approximated thus altering sensory input from Golgi Tendon Apparatus’s to the spinal cord segment(s) that innervate them. This creates a very subtle rebooting to the muscle spindles via the motor supply. Snakes will automatically move through your hands, and arms, using the path of least resistance. By working with the patient it is possible to initiate changes throughout the entire MSK.

Generally reptiles respond well to this model of treatment. In Osteopathy we call it a Functional approach.

Essentially we are looking purely at restoring free, normal function. Note I have not used the word symmetry, as a fully functioning individual wont necessarily be symmetrical.

Now there’s a philosophical conversion for another article ...

A final word of warning, snakes don’t usually like you holding their head, and please ensure that you support their length evenly. The easy way to remember this is one hand a third of the way from the head, and the other a third from the tip of the tail. Sudden movements can excite snakes too, and always wash off the smell of any small furry pets you might also have. Even a Corn Snake bite hurts!


Tony graduated from the European School of Osteopathy in 1988, and took a later degree from the British College of Osteopathic Medicine, graduating in 2010.

Within a year of initial graduation he was approached to treat some horses. Liaising with the vet he found that there was a much greater willingness from the vet to work with him compared to the state of play with doctors on the human side back in the late 1980s.

Soon Tony expanded his animal work to cover small animal treatment, setting up the first referral clinic within a vets practice in Gloucestershire, as well as attaching himself to a wildlife hospital, and then several zoo’s and safari parks where he expanded the boundaries of osteopathic medicine to include species hitherto thought to be untreatable with manual medicine.

He helped found the Society of Osteopaths in Animal Practice, and was chair for 6 years steering it into the respected organisation that it now is.

Along the way he has lectured internationally, is clinical director on the only established MSc in Animal Osteopathy, has had scientific papers published, and is currently working on a comprehensive textbook on animal and bird osteopathy. To date his list of patient species exceeds 300 different kinds, many of these he has pioneered the successful treatment of.

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Tony Nevin