The Hands-on Approach—Manual Therapy (cont.)

We have posted several articles on manual therapy techniques in the past couple weeks. Many of these we use in our everyday practice.  One technique that is new to us is visceral manipulation.

We have never heard much about it or used it until one of our clinicians, Sarah Levitt, went to a continuing education course on the therapy.  She has found it very useful in her practice, and we thought we would touch on the subject a bit.

What is Visceral Manipulation? 

“Viscera” relates to the internal organs of the body, such as the liver, kidneys and intestines. Visceral Manipulation (VM) is a manual therapy developed by French physical therapist and osteopath, Jean-Pierre Barral.  He believes that this delicate manual therapy is the missing link in the treatment of recurring musculoskeletal pain, postural distortions and biomechanical dysfunction.

Jean-Pierre Barral first became interested in the movement of the body (biomechanics) while working at the Lung Disease Hospital in Grenoble, France with Dr. Arnaud, a recognized specialist in lung diseases and a master of cadaver dissection. Barral was able to follow patterns of stress in the tissues of cadavers as he 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.  Barral’s clinical work with the viscera led to his development of this form of manual therapy that focuses on the internal organs, their fascial environment and the potential influence on structural and physiological dysfunctions. The term he coined for this therapy was Visceral Manipulation.

Jean-Pierre Barral began teaching Visceral Manipulation in the United States in 1985. Since then he has trained a team of international instructors that teach Visceral Manipulation seminars around the world. He has authored numerous textbooks for healthcare professionals, and has also authored a book for the general public.

How does the treatment work?

VM aids your body’s ability to release restrictions and unhealthy compensations that visceral manipulationcause pain and dysfunction.  VM does not focus solely on the site of pain or dysfunction, but evaluates the entire body to find the source of the problem.  Many times, the dysfunction and pain are far from the site that actually needs treatment.  The VM therapist feels for altered or decreased motion within the viscera, as well as restrictive patterns throughout the body, and then applies VM techniques.  These techniques consist of gentle compression, mobilizations and elongation of the soft tissues.  As the source of the problem is released, the symptoms will start to decrease as the body returns to greater health.

Visceral Manipulation can benefit:

  • Chronic musculoskeletal pain
  • Headaches and Migraines
  • Sciatica
  • Back, hip and knee pain
  • Repetitive strain injuries, e.g. Carpal Tunnel Syndrome
  • Whiplash and other physical trauma
  • Shoulder periarthritis and capsulitis
  • Restricted range of motion
  • Post-surgical pain and Scar tissue
  • Pelvic floor health issues, e.g. bladder incontinence

How Can Organs Cause Pain and Dysfunction?

Your organs are in perpetual motion, such as your lungs as you are taking a breath in and out.  This movement of organs is transmitted through fascia to other structures of the body. When you are healthy, all the structures move with an interconnected fluidity. All of this movement is important as it influences activities throughout the body from the tiniest cellular pulsations to rhythmic contractions of the heart and blood flow. Optimum health relies on a harmonious relationship between the motions of the organs and other structures of the body.

There are many reasons for an organ to lose its mobility: physical traumas, surgeries, sedentary lifestyle, infections, pollution, bad diet, poor posture and pregnancy/delivery. When an organ is no longer freely mobile but is fixed to another structure, the body is forced to compensate. This disharmony creates fixed, abnormal points of tension and the chronic irritation gives way to functional and structural problems throughout the body – musculoskeletal, vascular, nervous, urinary, respiratory and digestive, to name a few.


Sarah Levitt, MPT, PRPC is our pelvic floor rehabilitation practitioner practicing out of our Clarkston location.  If you would like to know more about this treatment or how it could help you, contact her at or call (248) 620-4260.

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