What is Visceral Manipulation?

Viscera” are the internal organs of the chest and abdomen such as the liver, kidneys, lungs, intestines, gall bladder, heart, etc- and all the tissues that hold connect them. The core principal of visceral manipulation is that healthy organs need to be able to move within the body. If an organ is unable to move, your body will need to accommodate this either by limiting motion or creating a “work around” movement pattern to protect that organ. This can create pain in the short term, and/or postural asymmetries that can lead to pain and further damage down the road.

The goal of Visceral Manipulation is to release restrictions that can cause pain and movement problems so that you can feel and move better. Visceral Manipulation is a very gentle manual therapy treatment used to improve the mobility of organs, blood vessels, and their connective tissues.

how can organs cause pain and movement difficulties?

Your organs, blood vessels and nerves are not tacked solidly down inside your body cavity- they move when you reach, breath, and eat. They are held in place by fascia, membranes, and ligaments in a three dimensional way to allows for this movement. Sometimes factors such as poor posture, poor movement patterns, trauma, inflammation, infection, surgery and scarring can result in tensions or adhesions between connective tissue and membranes over organs and/or their ligaments (yes, organs have ligaments!) This can lead to restrictions in movement systems that causes pain- often somewhere else in the body- as the organs are forced to accommodate the condition.

A good analogy is to pull down on one side of your T-shirt while raising the arm on that same side. You will see and feel the pull from your lower abdomen all the way up in your shoulder. Now imagine that this T-shirt represents abdominal tissues with limited mobility. This tension could cause pain in the raised shoulder and change its bio-mechanics- even though there is nothing “wrong” with the shoulder joint itself. This pain is unlikely to improve with traditional physical therapy exercises, stretches, or mobilization to the shoulder itself, because the root cause of the problem- the restricted abdominal tissues– is not being addressed.

What Conditions Can Be Treated with Visceral Manipulation?

Conditions that can benefit from the use of Visceral Manipulation include:

  • Trauma Injuries such as whiplash, seat belt injuries, sports injuries, concussions, traumatic brain injuries
  • Musculo-Skeletal Disorders such as headaches, sciatica, back pain, hip pain, chest pain, sciatica spinal dysfunction, carpal tunnel syndrome, arm and leg pain
  • Pain Related to post-operative or post-infection scar tissue
  • Digestive Disorders such as bloating and constipation, nausea and acid reflux, GERD, swallowing difficulties
  • After Procedures and Surgeries such as hysterectomy, colonoscopy, stomach scope, or gall bladder removal

What are some examples of this?

There are many, many examples of how your organs can cause pain and difficulty with movement, but here are a few examples.

  • A person had their gallbladder removed 12 months ago and is now experiencing right shoulder pain. When the gall bladder was removed a scar was formed on the underside of the liver where it was once attached. This results in a small tension that restricts the liver’s natural ability to move along with your body. Normally, when you raise your right arm, your liver raises up a bit to accommodate the soft tissue connections they mutually share. However, because of this scar, the liver is unable to move as much as it once did. This results in a protective pain response, limiting shoulder motion when the arm is raised.
  • A person had an upper GI scope for a stomach ulcer a month ago, and is now unable to turn their head to the right because of pain. The esophagus is a highly muscular tube that connects your mouth with your stomach. During the procedure, the removal of the scope from the esophagus caused it to go into a muscular spasm. Because the stomach sits on the left side of the abdomen, the esophagus must lengthen when the head is turned to the right. However, it is not able to do this because of the spasm, resulting in a protective pain and difficulty when attempting to turn the head. When the muscle spasm in the esophagus is released, the protective response is no longer needed, and the neck pain is resolved.
  • People who have asthma often have chronic pain and restrictions in their neck and rib cage. The tubes in the lungs are made of smooth muscle and cartilage. During an asthma attack, these muscular tubes become tight and constricted- making it difficult to breath. When the asthma attack is over, some of the muscle can remain in spasm. This can cause pain and limited motion in the neck and thorax. Visceral manipulation treatments release the muscle tissues in these airways, allowing for improved mobility and a reduction of pain in this area. Some people even report improve ability to breath during exertion.

How often will I need Treatment?

Many people experience a significant improvement from visceral manipulation in three-five sessions while others may require more time.  While traditional therapy interventions are often carried out 1-3 times weekly, visceral manipulation is typically applied only time every one to three weeks to a given area.  This gives your body time to process and integrate the changes made during this session. (“the treatment session gently starts the healing process, and your body naturally finishes it over the following weeks.”)

“Eventually, disease and dysfunction rear their ugly heads, cropping up in destinations that can’t really be predicted…The symptoms of a visceral problem can be a backache, a joint problem…really, the effects can be felt everywhere.”              —  Dr. Jean- Pierre Barral


Visceral Manipulation can be an extremely valuable component of your physical therapy treatment plan. It can eliminate barriers to progress that are not addressed by typical P.T. interventions such as stretching, strengthening or other manual therapy techniques; and provide results that might not have otherwise occurred. McKinney Physical Therapy specializes in assessing/treating visceral mobility because we belief that a truly holistic view is necessary in order to fully restore the body for its best work, play and life.  Check us out! 


Resources:  https://www.barralinstitute.com/therapies/