Gina Otterbein waves to the crowd during the Boston Marathon.
Osteopathy played a big role in helping Gina Otterbein overcome injury so she could run in the Boston Marathon. (For Spectrum Health Beat)

It was a Friday afternoon in early March.

Gina Otterbein was six weeks away from competing in the Boston Marathon when she suddenly felt heavy pain in her left foot while on her daily run.

“It was a sudden onset,” said Otterbein, a physical therapist. “I thought it was a stress fracture or some other significant injury.”

After a weekend of discomfort, Otterbein visited Jennifer Trpkovski, DO, the following Tuesday. Dr. Trpkovski specializes in non-operative sports medicine for Spectrum Health Medical Group.

After an X-ray showed no fracture, Dr. Trpkovski determined the injury could be the result of alignment issues.

She located the joint closest to the pain, grabbed both sides of the foot, and began slowly mobilizing the joint with her hands—that is, manually moving it in different directions with varying pressures.

“I immediately felt the tension go,” Otterbein said. “It was amazing. She was amazing. I was able to recover and in two weeks I was back to 100 percent.”


Dr. Trpkovski, an osteopath, specializes in treating the musculoskeletal framework using joint mobilization, spinal manipulation, gentle resistance exercises and other hands-on therapies.

In addition to adjusting the joint in Otterbein’s foot, she also “corrected the positioning” of Otterbein’s pelvis, which had become “slightly out of whack,” Dr. Trpkovski said.

The hip alignment issue and the foot issue were likely related, the doctor said.

“In general, we find that there are a lot of compensatory patterns in the body,” she said. “If you have a knee injury, your gait changes, and then your hips get out of alignment, which affects your back.

“When your biomechanics change, you can have muscle changes, and your spine can get out of whack,” Dr. Trpkovski said. “This can lead to a lot of problems all over the body.”

Osteopathy, though not well known to the average American, is a suddenly booming field.

In 1980, there were just 14 schools across the country teaching less than 5,000 aspiring osteopaths. Now there are 30 schools—including the state universities in Michigan, Texas, New Jersey and elsewhere—teaching more than 23,000 students.

In 2014, osteopathic schools turned out about 22 percent of U.S. medical graduates.

Osteopathy provides hands-on, patient-doctor interaction to diagnose and correct problems that some modern, expensive tests like MRIs and CT scans can’t always identify.


There are some similarities between osteopathy and chiropractic medicine.

Dr. Trpkovski said there’s a lot of “twisting, cocking and cranking,” as there might be with a chiropractor. But while chiropractors focus almost exclusively on the spine, Dr. Trpkovski focuses on the spine, plus the body’s hundreds of other joints and muscles.

In addition to the resetting of misaligned joints and muscles, Dr. Trpkovski also zeroes in on rehab and training the muscles to function properly.

Realignments can cause instant relief like they did with Otterbein, but people need to retrain their muscles once the imbalance is gone, Dr. Trpkovski said.

“Usually it requires a combination of treatment, and that’s the way I approach the problem,” she said. “So if there are imbalances, I correct them.”

Physical therapy can then help patients ensure the alignment and fixed imbalances are long-lasting.

“So it’s realignment plus stabilization through rehab—that’s the best solution,” Dr. Trpkovski said.


In April, Otterbein completed the Boston Marathon, her fourth marathon. She finished in under four hours.

“And the best thing about it: I didn’t have any foot pain or hip pain,” she said.

Otterbein said Dr. Trpkovski’s ability to diagnose and correct her hip alignment issues—in addition to fixing the joints in her foot—was key to getting her healthy.

After Dr. Trpkovski fixed her hip alignment?

“My muscles were more in balance,” Otterbein said. “That allowed me to strengthen all my muscles equally going forward. You have to look at the athlete as a whole, and that’s what she does.”