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MOD173 – Visceral Manipulation
Definition:
Visceral manipulation is a hands-on therapy that involves gentle manual manipulation and mobilisation of the internal organs, fascia, and connective tissues to release restrictions and adhesions in the body’s visceral organs, such as the liver, intestines, and kidneys. This technique aims to improve organ function, alleviate pain, and restore structural balance and vitality, thereby promoting overall health and well-being. Developed by French osteopath Jean-Pierre Barral, visceral manipulation is based on the principle that the body’s internal organs should have a certain degree of mobility and motility (intrinsic movement) to function optimally. By addressing imbalances and dysfunctions in the visceral system, this therapy can also positively influence the musculoskeletal, nervous, and circulatory systems, enhancing the body’s natural healing processes.
Explanation:
Practitioners use subtle palpation techniques to assess the mobility, motility, and position of visceral organs within the abdominal cavity and pelvis, identifying restrictions, adhesions, or dysfunctions that may contribute to pain, dysfunction, or discomfort. Through precise manual interventions and gentle mobilization, they aim to release tension, optimize organ function, and promote overall well-being. This therapy is based on the principle that organs should have a certain degree of movement to function optimally. Practitioners also consider the interconnectedness of the body’s systems, recognizing that dysfunction in one area can affect others. The technique may be used to address a wide range of conditions, from digestive issues to musculoskeletal pain, and is often integrated with other manual therapies for a holistic approach to health.
Evidence to Efficacy:
Scientific research on the efficacy of visceral manipulation (VM) is limited but suggests potential benefits for various conditions, including digestive disorders, pelvic pain, musculoskeletal imbalances, and post-surgical adhesions. Here are some key findings from studies and systematic reviews:
Chronic Low Back Pain: A systematic review published in the Journal of Bodywork and Movement Therapies (2019) indicated that visceral manipulation might reduce non-specific low back pain in the short term by influencing the visceral range of motion.
A study protocol published by the University of Sydney aimed to investigate whether the addition of VM to standard physiotherapy improves pain outcomes in people with low back pain. Initial findings suggested that VM might provide additional benefits in reducing pain and improving function over a standard physiotherapy regimen.
Digestive Disorders: A randomised controlled trial (RCT) conducted by Attali et al. (2013) focused on patients with Irritable Bowel Syndrome (IBS). The study found significant decreases in self-reported diarrhoea, abdominal distension, and abdominal pain following visceral osteopathic manipulation, compared to a placebo.
Respiratory Function: A study by Stepnik (2020) examined the effects of VM on respiratory function in healthy individuals. While the study did not find significant differences between the treatment and control groups, it noted an increase in peak expiratory flow in the intervention group.
Pelvic Pain and Dysfunction: Visceral manipulation has been reported to be effective in addressing pelvic pain and dysfunction, including conditions such as endometriosis, pelvic inflammatory disease (PID), and chronic pelvic pain syndrome. By releasing restrictions and improving the mobility of the organs in the pelvic region, VM can help reduce pain and restore normal function.
General Health and Well-being: A review by the Barral Institute highlighted that VM could improve peristalsis, digestion, and lymphatic drainage, reduce swelling, and enhance diaphragmatic breathing. These benefits contribute to overall health and well-being by optimising organ function and promoting balance in the body’s systems.
Governing Body:
The International Alliance of Healthcare Educators (IAHE) is one of the organisations that provides training and certification in visceral manipulation.
The Barral Institute and the International Association of Healthcare Practitioners (IAHP) provide training, certification, and resources for practitioners of Visceral Manipulation Therapy, with a focus on anatomical knowledge, hands-on skills, and clinical application.
What Good Looks Like:
In the context of visceral manipulation, here’s what a good experience should look like:
Initial Consultation: The practitioner should conduct a thorough health assessment, discussing your medical history, current symptoms, and treatment goals. They should explain the visceral manipulation process, its potential benefits, and any possible side effects.
The Treatment: The practitioner should use gentle, precise touch to assess and treat the abdominal and pelvic areas. Techniques should be applied with care, respecting your comfort levels. The practitioner should communicate throughout the session, explaining what they’re doing and checking in on your comfort.
During the Session: You may feel subtle movements or sensations in your abdomen as the practitioner works. The experience should not be painful, though you might feel some mild discomfort or pressure. You may notice immediate changes in how your abdomen feels, such as reduced tension or improved mobility.
Outcomes: Improved digestion and elimination: You may experience better bowel movements and reduced bloating. Reduced pain and discomfort: Abdominal or pelvic pain should decrease over time. Enhanced organ function and mobility: You might feel a sense of ‘lightness’ or improved movement in your abdomen. Greater sense of well-being and vitality: Overall, you should feel more energetic and balanced.
Post-Treatment: The practitioner should provide aftercare advice, such as staying hydrated and avoiding strenuous activities for a short period. They should explain any potential temporary reactions, like mild soreness or increased urination.
Long-term Benefits: With regular treatments, you should notice cumulative benefits such as improved digestive health, reduced chronic pain, and enhanced overall well-being.
What to Ask a Practitioner:
Here are some questions to help you choose the right practitioner for Visceral Manipulation (VM), along with desired answers:
What conditions do you typically treat with Visceral Manipulation?
Desired answer: VM can be used to treat various conditions such as digestive disorders, pelvic pain, musculoskeletal imbalances, post-surgical adhesions.
How do you assess a patient to determine if Visceral Manipulation is appropriate?
Desired answer: The Practitioner should be able to talk you through their end to end process – from performing a thorough evaluation, including a detailed health history, physical examination, and specific visceral mobility and motility assessments to determine if VM is suitable for you.
What should I expect during a Visceral Manipulation session?
Desired answer: The Practitioner should explain their entire process and how it should feel at each stage. This is likely to include the fact that it is a gentle hands-on technique so the feelings should be subtle sensations, but the treatment should not be painful.
Are there any risks or side effects associated with Visceral Manipulation?
Desired answer: VM is generally very safe when performed by a trained practitioner. Some patients may experience mild soreness or temporary changes in symptoms as the body adjusts.
Resources for further information:
- Herman & Wallace Pelvic Rehabilitation Institute
- Institute of Physical Art
- Books: “Visceral Manipulation” by Jean-Pierre Barral and Pierre Mercier
Related Therapies:
Related therapies to consider alongside Visceral Manipulation Therapy include other forms of manual therapy, such as
Osteopathy (MOD121): A system of medicine that emphasizes the physical manipulation of muscle tissue and bones to diagnose, treat, and prevent illness or injury, based on the principle that the body’s systems are interconnected and capable of self-regulation and self-healing.
Craniosacral Therapy (MOD90): A gentle hands-on technique that releases tensions deep in the body to relieve pain and dysfunction.
Myofascial Release (MOD095): A soft tissue therapy for the treatment of skeletal muscle immobility and pain.
As well as holistic approaches to digestive health and pelvic wellness, such as
Holistic Nutrition (MOD68): An approach to diet and lifestyle that considers the whole person – body, mind, and spirit.
Yoga (MOD182): A physical and spiritual practice that combines postures, breath control, and meditation. Yoga can complement Reiki by promoting physical flexibility and mental clarity, enhancing overall well-being.