visceral manipulation

What is Visceral Manipulation and do you need it to help your stiffness or pain?

If you desire to stay active, you will most likely deal with a sports injury, arthritis, or discomfort at some time.   Whether your pain or stiffness is coming from a muscle, tendon, joint breakdown, or cartilage damage like a meniscus tear, all musculoskeletal issues require three important factors in helping your body to heal.  The three factors that your doctors are not helping you to understand are circulation, fascia integrity, and homeostasis.  Visceral manipulation is a tool that we use in bringing all three factors for your body to self-heal itself from any injury.

We would like to first start off by saying that your body has its own intelligence and can self-heal.  All tendons and muscle injury heals in 6-8 weeks.  Bone fractures start to heal in 2-3 weeks.  If you protect a fracture, your bone will become stronger in that it will not need a cast in 6-8 weeks.  Your gut lining heals in 3 days.  Your skin replaces itself in 6 weeks.  The liver regenerates completely in 8 weeks.  Our brain needs 8 months to regenerate.

A part of this intelligence is that your body will protect you at all cost.  As a medical practitioner who combines Sports Medicine, Orthopedic Physical Therapy, and Holistic Medicine, our philosophy is deeply rooted in helping your body to understand that your body can move how you would like it.

We have written extensively on the importance of a mind-body approach, as our mind has a great ability to keep you from hurting yourself.  Think about the time when you have your mind made up.  No one was going to stop you from achieving what you planned for.  Now, imagine that you are strong and mobile.  Are you imagining yourself in your teenage days?  Now, picture your teenager self in a pitch dark room and you are deathly afraid of the dark.  Your strong youth is now frozen and full of tension.  Tension shunts or slows down blood flow to your muscles.  Your muscles are connected and acting in a pattern of a predictable fetal positioning of fear.

The purpose of this article is to help you to understand that you are more than your muscles and joints.  How you move and perform in life is dictated by the inner workings of your inner health.  Let us go back to the 3 factors.


The three factors that your doctors are not helping you to understand when it comes to muscle and joint injury healing are circulation, fascial integrity, and homeostasis.


All of your muscles, tendon, and ligaments need nutrients to stay healthy and bounce back from an injury.  Blood supply is vital to this equation.  There is a list of common tendons and muscles that have a tendency of getting injured due to the poor blood supply factor.  Your Supraspinatus muscle, a certain aspect of your Achilles tendon, and your wrist extensors are part of this short list of vulnerable muscles.

Your internal organs, like your liver, uterus, or small intestines, are not treated any different.  When you get into a car accident, your seat belt restricts your body from flying in the air.  The force can traumatize your muscles and the organs along the seat belt’s path.  As your muscles get injured and spasms, your organ can react in the same way.  The problem is that the body has to decide which tissue are more important.   Who needs more blood supply for you to live: organs or muscles?   Organs.  Common sense right?  It took us 8 years into our profession to understand that there is a hugely ignored system when it comes to musculoskeletal rehabilitation.

QUICK CASE STORY: We worked on a young lady in her late teens for ACL surgery rehabilitation (knee ligament).  She was doing well and getting her leg stronger as a soccer player.  She got into a car accident and her seat belt pushed her stomach into a spasm.  We initially did not jump to this conclusion as it is far-fetched.  When we evaluated and worked on her knee, nothing worked.  She came in limping and in crutches.  After we assessed her closely and looked at the big holistic picture, we noticed her stomach was in spasm.  We used visceral manipulation, and surprisingly, she was able to walk without her crutches as before her car accident.

Your body will not hesitate to give more blood supply to your organs and nervous system.  We wrote extensively on the nervous system is a big contributor to unresolved stiffness and pain.

How does Visceral Manipulation change this blood supply from our organs to the muscles and joints that need help?

The fascia system is considered the streets and highway of our body.  For those who unfamiliar with fascia, fascia is the thin film between the skin of a chicken and the muscles and organs.  It is literally the architectural framework that our body uses to transport nutrients, communicate energetically and physically, and expresses what we think.  Every organ is supported and surrounded by the fascial system.

Dr Thomas Myers has popularized the idea that the fascial systems are systemized by “tracks” that link muscles into patterns.  Visceral Manipulation is a gentle hands-on method that leverages the fascia to move the organs like a masseuse massaging your muscles.

There is upcoming research in this fascial field linking into what the ancient Chinese meridians or acupuncturist basis of healing is due to the fascia system.    If you have been following us, you know we preach the idea of training in fascial patterns.  The two systems are very similar.  Acupuncturist helps your body feel better by improving on the fascia’s ability to express Qi, or your internal health’s communication.  An Orthopedic manual trained Sports Physical Therapist can manipulate fascia tracks to allow you to express movement easier.  If you are more active, then you are more likely to tap into your happier state.  Happy emotional state tends to have a better internal health status.



Where are we going with this?  How does Visceral Manipulation fit into a muscle tension and joint discomfort solution?

Visceral and Vascular Manipulation are hands-on techniques that have been popularized by a French Osteopath, Physical Therapist, and TIME magazine nominated “Top 100 Alternative Medicine Innovator”, Jean Pierre Barral.

The manipulation focuses on using gentle forces to release tension held within your fascia that is connected to all the blood vessels and associated visceral organ.  The movement of the fascia will cause a shift to the inner highways so blood flow can move easier towards the places that need it most.  The common intention is to help regain the visceral organ’s natural rhythm and the following tension that comes with an off-beat rhythm.

Your organs are in perpetual motion.  They can be stuck in a spasm cycle (called motility) when there is a health concern or from direct trauma.  All organs move 30,000 times within your rib cage and pelvic cavity.  Research has shown that your kidneys move 4 inches with deep inhalation!  In a day, they move a little over a ½ mile.  Your liver moves an equivalent to 600 meters daily.

If you think getting your arm in a cast can cause muscle stiffness, wasting and other detrimental side effects, imagine what a lack of movement can do to your organs!  When there is an injury or sedentary work lifestyle, our fascia looks at a busy morning traffic jam.  Our goal is to free up this traffic jam so your fascia can allow blood and oxygen to move freely to your muscles, joints, nerves, and organs.  Healing can happen when this occurs.


QUICK CASE STUDY: A runner with a history of having an appendix surgery 10 years back was starting to have knee pain.  She performed numerous soft tissue massages and yoga stretches without relief.  She came to us and sought for help.  We found that her ligament called the Ligament of Cleyet, which 60% of females have, was not moving well.  The ligament connects from the cecum of the large intestines to the Right ovaries.  The appendix is at the end of the cecum.  Appendix surgery can commonly cause fascial “scar tissue” to the ligament that encases the femoral nerve.  The femoral nerve branches into the saphenous nerve.  The saphenous nerve brings sensation like the pain to your inner knee and inner shin (mimics shin splints also).


Factor number 3: Homeostasis.

Homeostasis is the where your body will find the need for “balance” or equilibrium.  Your body has four general cavities that have atmospheric pressure: cranium, chest, abdominal, and pelvic cavity.  These pressure can either have negative or positive atmospheric pressure.  If you imagine air will rebalance when there is a puncture to your lungs.

When we redirect tension within the fascia “highway” system, your body automatically rebalances the pressure within all four cavities.  If you imagine a tie can choke a neck more if it is bound tightly under a belt.  When you untie the belt, you release the double tension of wearing the tie and the tug of the belt.

QUICK CASE STUDY: We were working on a swimmer’s shoulder and headache pain.  She was constipated often.  We release her sigmoid colon within her pelvis and her headache resolved.  As we released the tension to her colon, her pelvic atmospheric pressure changed.  The tension that caused her constipation caused her cranium pressure and headache.


As you can see that it is important to find the root cause of any discomfort or stiffness you are feeling.  The tricky part is that it could be something simple and a “band-aid” massage or joint work will suffice.  In our world, a simple rule to follow is that if 3 sessions or 2 weeks of a self-care exercise is not resolving your problem, your body is protecting you from something.  We do not know what it is.  We do know that it will have to do with circulation, fascial integrity, and lack of homeostasis.  Never chase the pain and your body will thank-you.


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Dr Danh Ngo

Board-Certified Orthopedic and Sports Medicine Specialist

Doctor in Holistic Physical Therapy