Woman having visceral manipulation, the therapist's hands pushing into her abdomen.

The massage therapist knows all too well about the multiple strains that are found in each of his or her clients.

Visceral manipulation is a technique that addresses visceral dysfunction.

Visceral dysfunction is when fluids, nutrition and nerve conductivity are compromised. When the fascial attachments and supporting structures of the viscera are restricted, mobility (movement) and motility (inherent tissue motion pattern) will not function to provide for homeostasis or balanced health.

This visceral dysfunctional area will also have multiple parameters of restricted motion, thermal changes, perturbed fluid movement and associated neurological (spinal, sympathetic or parasympathetic) changes.

A Lifetime of Strains

The body generally accumulates many strains over a lifetime. The strain takes a certain amount of force to hold it there, exerting tension into the fascia. The one with the most force will have the biggest effect on the fascia. This is also called tensegrity.

Treating the most important strain will have the largest effect on the body. Forces that accumulate in our body can remain in the superficial layers of our anatomy or they can penetrate into the deeper layers to adversely affect the fascia of the organs, blood vessels or nerves.

If the primary strain is within these deeper tissues, the increased mechanical tension will compromise the fluid vessels (veins, retention of metabolic byproducts; lymph, relative edema; or arteries, decreased nutrition or oxygen) and the visceral-somatic relationship via the connective tissues and the autonomic nervous system.

If the client is making progress with your present program but seems to be at a plateau or the pattern keeps returning, you may want to consider how visceral manipulation can guide you to the deeper somatic cause of why the pain, inability to relax, breathing mechanism or muscle hypertonicity is not resolving.

The Roots of Visceral Manipulation

The roots of visceral manipulation began in Osteopathy under the guidance of Andrew Taylor Still, M.D., D.O., in the late 19th century.

Still had been trained as a medical doctor, but found that he could treat most diseases by palpating dysfunctional areas and treating them with his hands. Osteopathy means to “begin with the bones.”

An illustration from the 1800s showing a man kneeling before a client who is receiving visceral manipulation.

He discovered when he found an area where the bones were not properly aligned nor moving adequately, this area became the first guide for the practitioner in performing treatment. This area reflected where the forces of life are not moving properly.

Still began with the bones, but did not end there. In his writings, he constantly talked about joints, fascia, blood supply, nerves, internal organs and lymph flow. Still’s ideas were very clear: All tissues need adequate fluid, as well as nutritional and neurological exchange, to be healthy.

Precision in Palpation Skills

Knowing the anatomy of the human body became key in understanding the mechanism of how the viscera affected postures, movement, pain and balance.

One curriculum of visceral manipulation is under the guidance of Jean-Pierre Barral, P.T., D.O., at The Barral Institute.  Barral is a French osteopath who became curious about the visceral system and its relationships to structure and function.

Current Research on Visceral Manipulation

Scientists have taken an interest in visceral manipulation. Recent studies that have explored the benefits of visceral manipulation include:

“Effect of Osteopathic Visceral Manipulation on Pain, Cervical Range of Motion, and Upper Trapezius Muscle Activity in Patients with Chronic Nonspecific Neck Pain and Functional Dyspepsia: A Randomized, Double-Blind, Placebo-Controlled Pilot Study”

“The effect of visceral osteopathic manual therapy applications on pain, quality of life and function in patients with chronic nonspecific low back pain”

“Active Visceral Manipulation Associated With Conventional Physiotherapy in People With Chronic Low Back Pain and Visceral Dysfunction: A Preliminary, Randomized, Controlled, Double-Blind Clinical Trial.”

If you are interested in learning more precision in your palpation skills, more precision with specific techniques and helping your clients recover with more precise results, visceral manipulation may be a perfect choice for you.

Gail Wetzler, PT, DPT, EDO, BID, is director of Curriculum for The Barral Institute, in West Palm Beach, Florida. She also maintains a private practice in Denver, Colorado.

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