PT Classroom - Sports Injury and Visceral Manipulation by Lorrie Harper MSPT, CVTP

Lorrie Harper MSPT, CVTP is a licensed physical therapist, certified Visceral Manipulation practitioner and Pilates instructor. Her clinic in Eden, Utah specializes in manual therapy and intelligent movement. She has a passion for human anatomy, manual therapies and the dynamics of human movement and is thrilled to be teaching Visceral Manipulation through the Barral Institute sharing the powerful manual techniques of the French Osteopath Jean-Pierre Barral.

Sports Injury and Visceral Manipulation

Many athletes suffer from recurrent injuries and persistent muscle and joint discomfort. As hands-on therapists we know that much of it is related to structural misalignment. We have numerous skills to address muscles and joints to help our active clients; however, when they return time and again with the same alignment problems we addressed in previous visits do you ever wonder “What am I missing?”

The organs (viscera) may be the answer to that question. According to French osteopath John Pierre Barral, 90% of musculoskeletal problems have a visceral component. Our viscera have extensive connective tissue relationships to the musculoskeletal system. And the nervous system is very good at maintaining as little stress as possible on the viscera, often at the expense of the muscles and joints. So how do we treat the organs? Visceral Manipulation often referred to as the missing link in manual techniques, is the answer.

Visceral Manipulation (VM) is a manual therapy technique developed by Jean-Pierre Barral, a French osteopath that TIME magazine named “one of the Top Healing Innovators to watch in the new millennium”. Viscera, refers to the organs of the body. Manipulation from the dictionary is defined as “skillful handling”. Hence, Barral's work is the gentle, skillful handling of the organs of the body. Visceral Manipulation training with the Barral Institute teaches a practitioner organ anatomy and its relationship to the musculoskeletal system, as well as cultivating a fine sense of touch to know the differing textures of the body’s tissues. Using this sophisticated touch the practitioner listens to the bodies’ tissues and uses high precision, minimal force techniques to release restrictions around the organs, nerves, blood vessels, joints, fascia and the brain.

Like ocean waves breathing, the heart beat and craniosacral rhythm keep the body in a state of perpetual motion. Optimum health relies upon a harmonious relationship between the bodies’ tissues; the organs must glide easily against each other, and against the surrounding muscles and bones. Physical trauma, repetitive movement, illness, infection, poor posture and surgery can cause organs to adhere to each other or to the surrounding structures. This restricted tissue creates a point of tension that the body must now move around. With every breath, step and stretch this compensatory movement creates abnormal lines of tension that may manifest symptoms at the site of injury or at more distant points. The result is structural and functional changes throughout the body causing pain, weakness, balance and coordination problems, decreased breath capacity, less than optimal organ function, digestive problems and more.
The VM practitioner feels the altered motion and restrictive patterns within the viscera, and throughout the body and uses VM techniques to release these restrictions improving structural alignment, joint and muscle motion, organ mobility, organ function, and overall movement. The result is decreased pain and a return of the body’s ability to adapt and restore itself to health.

As an example, your football or volleyball athlete arrives at your office complaining of right neck and shoulder pain after a fall on the right rib cage. From your VM training you know that the liver has extensive connective tissue attachments to the diaphragm via its visceral ligaments. These ligaments may have shortened due to trauma, and the altered rib cage alignment has forced abnormal movement of the shoulder blade on the rib cage, ultimately affecting the more vulnerable shoulder joint. In addition, you learned the phrenic nerve innervates the diaphragm and the visceral peritoneum of the liver, which may be referring pain to the 3rd through 5th cervical vertebrae, which connects to the brachial plexus potentially causing symptoms in the right arm, neck and/or right shoulder. Most importantly, using the listening techniques you learned in your VM training your client’s own tissues have pulled you to the liver and you know to effectively treat the neck and shoulder you must address their liver.

This scenario can be repeated for a wide array of sports related pain and injury. Left leg sciatic pain related to the sigmoid colon, low back pain related to the small and large intestine, right sciatic pain related to the cecum or liver, left shoulder pain related to the stomach. In fact, Visceral Manipulation can effectively treat whiplash and seat-belt injuries, low back pain, neck pain, hip pain, shoulder pain, sciatica, headaches and migraines, carpal tunnel, joint pain, digestive disorders, acid reflux, post-operative scar tissue pain, swallowing dysfunction, chronic pelvic pain and more.

If you would like further information about visceral manipulation or any of the techniques developed by Jean Pierre Barral, D.O., MRO(F) please visit

Last revised: August 20, 2018
by Lorrie Harper MSPT, CVTP

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