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Visceral Manipulation And Its Therapeutic Value



Often abbreviated to VM, visceral manipulation was developed by world-renowned French Osteopath and Physical Therapist Jean-Pierre Barral.

Comparative Studies found this approach beneficial and useful for the management and treatment of the following disorders but not limited to:

Acute Disorders

  • Whiplash
  • Seatbelt Injuries
  • Chest or Abdominal Sports Injuries

Digestive Disorders

  • Bloating and Constipation
  • Nausea and Acid Reflux
  • GERD
  • Swallowing Dysfunctions

Women's and Men's Health Issues

  • Chronic Pelvic Pain
  • Endometriosis
  • Fibroids and Cysts
  • Dysmenorrhea
  • Bladder Incontinence
  • Prostate Dysfunction
  • Referred Testicular Pain
  • Effects of Menopause

Musculoskeletal Disorders

Pain Related to

  • Post-operative Scar Tissue
  • Post-infection Scar Tissue
  • Autonomic Mechanisms

Pediatric Issues

  • Constipation and Gastritis
  • Persistent Vomiting
  • Vesicoureteral Reflux
  • Infant Colic

Emotional Issues

  • Anxiety and Depression
  • Post-Traumatic Stress Disorder

VM assists functional and structural imbalances throughout the body including musculoskeletal, vascular, nervous, urogenital, respiratory, digestive and lymphatic dysfunction.

It evaluates and treats the dynamics of motion and suspension in relation to organs, membranes, fascia and ligaments. VM increases proprioceptive communication within the body, thereby revitalizing a person and relieving symptoms of pain, dysfunction, and poor posture.

An integrative approach to evaluation and treatment of a patient requires assessment of the structural relationships between the viscera, and their fascial or ligamentous attachments to the musculoskeletal system.

Strains in the connective tissue of the viscera can result

  • from surgical scars
  • adhesions
  • illness
  • posture or
  • injury

Tension patterns form through the fascial network deep within the body, creating a cascade of effects far from their sources for which the body will have to compensate.

This creates fixed, abnormal points of tension that the body must move around, and this chronic irritation gives way to functional and structural problems.

Imagine an adhesion around the lungs.

It would create a modified axis that demands abnormal accommodations from nearby body structures. For example, the adhesion could alter rib motion, which could then create imbalanced forces on the vertebral column and, with time, possibly develop a dysfunctional relationship with other structures.

This scenario highlights just one of hundreds of possible ramifications of a small dysfunction - magnified by thousands of repetitions each day.

There are definite links between somatic structures, such as the muscles and joints, the sympathetic nervous system, the visceral organs, the spinal cord and the brain.

For example, the sinuvertebral nerves innervate the intervertebral disks and have direct connections with the sympathetic nervous system, which innervates the visceral organs.

The sinuvertebral nerves and sympathetic nervous system are linked to the spinal cord, which has connections with the brain. In this way someone with chronic pain can have irritations and facilitated areas not only in the

  • musculoskeletal system (including joints, muscles, fascia, and disks)
  • but also the visceral organs and
  • their connective tissues (including the liver, stomach, gallbladder, intestines and adrenal glands)
  • the peripheral nervous system
  • the sympathetic nervous system and even
  • the spinal cord and brain

Thanks to the dedicated work of Jean-Pierre Barral, a Physiotherapist (RPT) and Osteopath (DO), healthcare practitioners today can use the rhythmic motions of the visceral system as important therapeutic tools.

Barral's clinical work with the viscera led to his development of a form of manual therapy that focuses on the internal organs, their environment and the potential influence on many structural and physiological dysfunctions.

The term he coined for this therapy was Visceral Manipulation.

Visceral Manipulation relies on the palpation of normal and abnormal forces within the body. By using specific techniques, therapists can evaluate how abnormal forces interplay, overlap and affect the normal body forces at work.

The goal is to help the body's normal forces remove abnormal effects, whatever their sources. Those effects can be global, encompassing many areas of bodily function.

How Does/can Visceral Manipulation Help You?

VM is used to locate and solve problems throughout the body.

It encourages your own natural mechanisms to improve the functioning of your organs, dissipate the negative effects of stress, enhance mobility of the musculoskeletal system through the connective tissue attachments, and influence general metabolism.

Today, a wide variety of healthcare professionals perform Visceral Manipulation.

Practitioners include

  • osteopathic physicians
  • allopathic physicians
  • doctors of chiropractic
  • doctors of Oriental medicine
  • naturopathic physicians
  • physical therapists
  • occupational therapists
  • massage therapists and
  • other licensed body workers

How is Visceral Manipulation Performed?

Visceral Manipulation is based on the specific placement of soft manual forces to encourage the normal mobility, tone and motion of the viscera and their connective tissues.

These gentle manipulations can potentially improve the functioning of individual organs, the systems the organs function within, and the structural integrity of the entire body.

Harmony and health exist when motion is free and excursion is full - when motion is not labored, overexcited, depressed, or conflicting with neighboring structures and their mobility.

Therapists using Visceral Manipulation assess the dynamic functional actions as well as the somatic structures that perform individual activities.

They also evaluate the quality of the somatic structures and their functions in relation to an overall harmonious pattern, with motion serving as the gauge for determining quality.

Due to the delicate and often highly reactive nature of the visceral tissues, gentle force precisely directed reaps the greatest results.

As with other methods of manipulation that affect the body deeply, Visceral Manipulation works only to assist the forces already at work.

Because of that, trained therapists can be sure of benefiting the body rather than adding further injury or disorganization.

How Did Visceral Manipulation Begin?

Methods such as VM have been part of the medicinal cultures in Europe and Asia since prerecorded times.

Indeed, manual manipulation of the internal organs has long been a component of some therapeutic systems in Oriental medicine.

So it's no surprise that practitioners in many parts of the world have incorporated manipulations designed to work with the internal organs and their functions.

Jean-Pierre Barral first became interested in biomechanics while working as a registered physical therapist of the Lung Disease Hospital in Grenoble, France.

That's where he met Dr. Arnaud, a recognized specialist in lung diseases and a master of cadaver dissection. Working with Dr. Arnaud, Barral followed patterns of stress in the tissues of cadavers and studied biomechanics in living subjects.

This introduced him to the visceral system, its potential to promote lines of tension within the body, and the notion that tissues have memory.

All this was fundamental to his development of Visceral Manipulation. In 1974, Barral earned his diploma in osteopathic medicine from the European School of Osteopathy in Maidstone, England.

Working primarily with articular and structural manipulation, he began forming the basis for Visceral Manipulation during an unusual session with a patient he'd been treating with spinal manipulations.

During the preliminary examination, Barral was surprised to find appreciable movement. The patient confirmed that he felt relief from his back pain after going to an "old man who pushed something in his abdomen."

This incident piqued Barral's interest in the relationship between the viscera and the spine. That's when he began exploring stomach manipulations with several patients, with successful results gradually leading him to develop Visceral Manipulation.

Between 1975 and 1982, Barral taught spinal biomechanics at England's European School of Osteopathy. In collaboration with Dr. Jean-Paul Mathieu and Dr. Pierre Mercier, he published Articular Vertebrae Diagnosis.

Using his work with Dr. Arnaud as a foundation, Barral continued to investigate how the thickening of tissues in the body creates areas of greater mechanical tension that, in turn, pull on surrounding tissues.

That discovery led him to the theoretical and practical development of visceral listening techniques.

Barral's development of manual thermal evaluation began in 1971 during another treatment session. While treating a female patient, he felt a strong emanation coming from her mammary gland. He learned she had been operated on for a tumor in that area.

Researching this phenomenon with other patients, he discovered just how accurately areas of stress in the body could be located by palpating the associated energy, which proved to be thermal.

Consequent research has added manual thermal evaluation to many practitioners' evaluation tools.

With the help of Dr. Serge Cohen, a Grenoble radiologist, Barral also documented changes in the viscera before and after manipulation.

They employed x-ray fluoroscopy and ultrasound to record changes in position and motion, as well as fluid exchange and evacuation. Later they conducted additional research with a team of electrical engineers and technicians using infrared emissions from the body.

Jean-Pierre Barral began teaching Visceral Manipulation in the United States in 1985. Since then he has trained a team of International Teachers that teach Visceral Manipulation seminars around the world.

He has also authored numerous textbooks for healthcare professionals, including:

  • Visceral Manipulation
  • Visceral Manipulation II
  • Urogenital Manipulation
  • The Thorax
  • Manual Thermal Evaluation
  • as well as Trauma: An Osteopathic Approach, Manual Therapy for the Peripheral Nerves, and Manual Therapy for the Cranial Nerves (the latter three were co-authored with Alain Croibier, D.O.)

Jean-Pierre Barral has also authored a book for the general public, Understanding the Messages of Your Body, which discusses the link between our organs and our emotions.



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book your physio appointment or enquire now

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