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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Manipulative Therapies

Manipulative therapies can be defined as methods of resetting a particular body part in order to precipitate a healing response in that body. Quite often the treatment is applied at a distance away from the actual symptoms, to obtain satisfactory results.

There are several types of manipulative therapies, among which most importantly are: osteopathy, craniosacral therapy, visceral manipulation, articular manipulation, neuromeningeal manipulation, chiropractic, massage and reflexology, to name a few.Every method described below has a video following it to present it in greater detail.

Osteopathy is a therapy that uses manipulation on the whole body in order to reduce discomfort, improve muscle performance, joint movement and restore the person to full health, by working on the muscles, ligaments and skeleton.

Craniosacral therapy is a gentle, hands-on method of evaluating and enhancing the functioning of a physiological body system called the craniosacral system – comprised of the membranes and cerebrospinal fluid that surround and protect the brain and spinal cord. Using a soft touch generally about the weight of a nickel, practitioners release restrictions in the craniosacral system to improve the functioning of the central nervous system.

Visceral manipulation

is a gentle hands-on therapy that works through the body’s visceral system (the heart, liver, intestines and other internal organs) to locate and alleviate these abnormal points of tension throughout the body. At optimal health, the relationship between the organs (viscera) and structures of the body (muscles, membranes, fasciae and bones) remains stable despite the body’s endless varieties of motion. But when one organ can’t move in harmony with its surrounding viscera due to abnormal tone, adhesions or displacement, it works against all the body’s organs and structures. This disharmony creates fixed, abnormal points of tension that the body is forced to move around. That chronic irritation, in turn, paves the way for disease and dysfunction.

Articular manipulation, another part to the manipulative therapies curriculum, works on the premise that different layers of the body starting right from the deepest layer of bone to the muscles, ligaments, blood vessels and nerves, all working together to create an interdependence and unity of the body’s structure. These layers interact with the central nervous system through neural components and motor components. Specific emotions with specific personalities also have an effect on the CNS which affects all these layers. Keeping a balance in these different layers maintains joint pressure. The pressure inside a joint is important. In a healthy joint exists a negative pressure,. All the joint structures stick together to create a sucking effect inside the joint, a kind of “togertherness”. When dysfunctional the negative pressure decreases (becomes more positive pressure) which destroys the cartilage, and the joint falls apart.

Neuromingeal manipulation is a precise treatment of nerves in the body that are causing pain. This is achieved by rolling or gliding movements of the said nerve combined with movement of the extremities or joints in order to relieve any loss of mobility or tightness the nerve  may have.

Chiropractic is a therapy which involves treatment on the musculoskeletal system with paticular emphasis on the spine and nervous system. it can help shoulder and low back pain and help relieve asthma,constipation and digestive problems.

Massage, another modality in the manipulative therapies family is a very pleasant therapy that utilizes stroking, kneading and other techniques to manipulate the soft tissues of the body. It is ideal for stress relief, relaxation and as a remedial treatment for physical and emotional problems.

Reflexology falls into the manipulative therapies category mainly for its ability to relieve stress and decrease digestive problems. The technique involves applying pressure to points on the feet and sometimes the hands. therapists believe that they can stimulate energy by reflex action to a related muscle or organ and encourage healing.

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