Visceral Manipulation: who it’s for (and does it really work?)

I began taking Visceral Manipulation courses with the Barral Institute in 2021. A friend of mine and I decided we wanted to try something new, and VM was a totally foreign concept to our orthopedic PT brains! We showed up the first day and as the course began, we looked at each other and said, “what the heck did we sign up for!?”. The instructor was clearly brilliant and we knew some really awesome PT’s who used these treatment techniques and had great success. But as the instructor started explaining how we would listen to our patient’s body to determine how to treat them, palpate for organs, and then feel organ motility, I found myself doubting the entire concept.

I trained in our conventional medical system here in the US. We learned about anatomy and biomechanics, exercise prescription, and modalities that are used in most standard PT clinics (ice, estim, ultrasound, etc). Over the years I had realized how incomplete this approach was for many of my patients, and that is why I had transitioned out of a traditional insurance-based PT model a few years prior. Knowing that treating my patients more holistically had made a huge difference in my practice, I knew it was worth staying open minded about the potential benefits of visceral manipulation, despite my initial hesitation.

As we worked through the course, I felt more and more in tune with my hands. I also noticed at the end of each day I felt really tired. If you’ve ever taken a continuing education class, you know that it can be incredibly mentally exhausting learning so many new concepts. But this was a different kind of fatigue. The instructor explained how sensitive the abdomen and organs are, and that in a typical treatment session you would only treat 2-3 organs so you aren’t overloading your patient’s nervous system. We were doing a LOT more treatment than that, essentially overtreating each other all weekend. 

So I had felt some of the nervous system effects of visceral manipulation, but how would this translate to the patients I was treating? I was lucky that many of the patients I had been treating were incredibly open minded and happy to let me practice my new skills on them. I was also happy to see some pretty awesome results from the treatment techniques as well.

So who is visceral manipulation for? 

When other providers ask me who they should refer for visceral manipulation, I always have such a hard time answering because I truly believe most everyone could benefit from this type of treatment in some way. We hold a lot of emotions in our organs. Think about when you feel nervous or anxious about something – you often have an upset stomach or GI system. Most folks are also frequently overstimulated in todays world, and visceral manipulation techniques are a great way to activate our parasympathetic nervous system. Our organs also have fascial and ligament connections to our musculoskeletal system, so any restrictions throughout the ligaments and fascia may present as orthopedic symptoms (back pain, hip pain, etc).

Think about your body as a container and its contents. The container is your muscles, joints, fascia, ligaments, etc. The contents are your organs, nerves, and blood vessels. Sometimes there is a problem in the container, like if you sprain your ankle or tear a rotator cuff muscle. Other times, the problem may be in the contents. For example, you could have scar tissue on and around your uterus from a c-section. In that case the problem is in the contents, however, I often see patients who experience low back pain, pelvic pain, or hip pain related to scar tissue in and around their pelvic organs. The “container” responds by “hugging” and trying to protect the area the problem is located. If you release the container you may find temporary relief, but it will continue to go back into the protective pattern until the issue in the “contents” is improved or resolved.

So for folks who have tried all the things for their musculoskeletal pain – PT, massage, chiropractic, etc, sometimes visceral manipulation may actually be able to get to the root cause of the guarding and tightness.

Some specific diagnoses and symptoms I have seen improvement with using visceral manipulation include frozen shoulder, diastasis recti, low back pain, stomach pain (cyclical pain following a virus), pelvic pain, constipation, and chronic hip flexor tightness. I also love this resource from the Barral institute on the benefits of visceral manipulation.

Are you ready to explore the benefits of visceral manipulation? Schedule your appointment with me here. If you aren’t local to the Memphis area, you can find a Barral practitioner here.

Blog post written by Alexis Hutchison, PT, DPT, OCS