Visceral Manipulation In Pediatrics

As we already know, visceral manipulation is organ specific fascial mobilization. In other words, our viscera or organs are treated specifically in relation to their associated structures and surrounding connective tissue. In order to maintain good health in the body the viscera must move in harmony with the other structures in the body. If this does not happen, the presence of organ restrictions can create fixed points of tension in our system around which the body now needs to move. This paves the way for disease and dysfunction.

A visceral restriction is just like a myofascial restriction, except that it is within the organ or in the connective tissue outside of the organ. A visceral restriction develops from an inflammatory process, in which an exudate is formed. This exudate thickens and becomes a harder, denser, drier area. Restrictions are caused by infection, birth trauma, in-utero malpositioning, falls, abnormal neural activity, medications and toxicity.

The practitioner can determine the area of greatest restriction by “listening”. “General listening” indicates the site of the greatest tension in the body at that time while with local listening, the practitioner’s hand is attracted more specifically to the level of the restriction. Next, the practitioner identifies by palpation the specific structure that is involved, then embarks on the release that the body needs.

For instance, if a baby has reflux, with “general listening”, the listening goes to the upper stomach. “Local listening” will help identify if the restriction is between the stomach and liver or the stomach and diaphragm (where the esophagus goes through the diaphragm), or perhaps between the esophagus and pleura of the lung.This specific area needs to be treated. This is the basic technique in all “visceral manipulation” sessions.


When treating a baby or child with visceral manipulation, the therapist contacts the organ and structure related to that organ, and treats in the direction of ease. For example, if the baby with reflux has tension between the stomach and liver,the therapist contacts the lesser curvature of the stomach with one hand, the left lobe of the liver with the other hand. By contacting these two organs, the organs will start a “listening”, a movement into the direction of ease. In this case, the stomach and liver will pull towards each other until a tissue release is palpated. A release feels like a softening of the tissue. The restriction is freed so that the stomach and liver slide and glide on each other.

After the area is treated, the next step is to re-listen to the body. Very often the listening takes you to the left occipitomastoid suture – the suture between the temporal and occipital bones. Now if we look at our anatomy, we see that the vagus nerve exits in the jugular foramen between these two bones. We may even feel a “line of tension” between the occipitomastoid suture and the upper stomach. This would make sense anatomically because of the pathway of the esophagus and vagus nerve as they both travel through the thorax. Thus, when we “line up the tension”, or engage the two structures between our hands so that we can feel a specific tension, we may release these structures and thus help the child with their symptom of reflux.

The video below talks about the various applications of visceral manipulation in children.

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