Visceral Manipulation (VM)

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Visceral Manipulation addresses the interrelationship of function and structure among the internal organs and the musculoskeletal system. This gentle form of hands-on therapy was developed by craniosacral therapist Dr. John Upledger in collaboration with French osteopath and physical therapist Dr. Jean-Pierre Barral after, among other things, Barral studied the rather rough manipulations used by European folk healers known as bonesetters. The therapy the two created during the 1980s is closely related to Osteopathy and Rolfing Structural Integration and recognizes that the continuous connective tissue of the body (the fascial network) supports both the visceral core and the internal organs Visceral Manipulation also considers that organ mobility, rather than position, is the key to proper functioning. To perform optimally, both the fascia surrounding the organs and the organs themselves must be able to glide smoothly past and around each other while the body is in motion. Visceral Manipulation, also known as an organ-specific fascial mobilization technique, is a gentle method of normalizing visceral mobility, tone, and function by removing an assortment of adhesions (areas where membranes have become stuck together because of previous trauma, surgery, infection, pregnancy, poor posture, sedentary lifestyle, or injury). These adhesions can create constrictions, compensations, or areas of tension that can lead to constipation, neural disorders, structural imbalances, and an assortment of organ mobility issues. Since, in addition to surrounding all the organs, the fascial network runs throughout the whole body, VM also helps provide a balance between the body surface and the core while also strengthening the support of each internal organ.

During a treatment, the practitioner initially makes a thorough, three-dimensional assessment of areas where tension exists and how the organs are oriented within the visceral cavity. It has been recognized that the thickening of tissues (adhesions) in the body creates areas of greater mechanical tension that will pull on surrounding tissue and that the relationship between the viscera and the spine is a very close one because of their fascial interconnection. When abdominal adhesions occur, the result can be compensations that can twist and pull on the surrounding tissues, affecting spinal balance. A restriction in the bladder can cause a problem in the joints of the hip, and vice versa. A lesion in the lungs can lead to neck pain, and an adhesion in the gallbladder or groin can result in a painful restriction in the shoulder.

When treating the abdomen, the practitioner applies progressively deeper pressure with the fingers to this area while the client is lying face up, so it is important that the recipient has not recently eaten, has an empty bladder, and is relaxed during the session. A session incorporates specific, gentle, rhythmic techniques for engaging and releasing tension in the body. Light hand pressure flows into the lines of tension, instead of against them, to locate and release any adhesions. Most often, the more intense the client’s sensations, the greater the relief will be, although tenderness also suggests the existence of more extensive adhesions that are in need of treatment. As part of the process, organs may be repositioned within the visceral cavity. VM also acts to stimulate the self-correcting tissue response in the body through specific manipulations of the ligaments, viscera, and particularly the fascia between and around the organs to create a harmoniously balanced state in which each organ can work compatibly with the others.

This form of bodywork is appropriate for treating a variety of digestive disorders such as ulcers, urinary tract infections, bladder problems, certain hernias, colon spasms, impotency, and constipation. Abdominal work can actually affect the lungs, heart, spleen, stomach, intestines, and kidneys not only physically but emotionally, since each of these organs is closely identified with certain emotional traits. Since emotional trauma can cause a tightening or constriction in the organs, a significant psychological release can often result from the manipulations. VM is well suited to be integrated with other types of massage therapy.

More recently, Jean-Pierre Barral joined with French osteopath Alain Croibier to develop the modality called Neural Manipulation, which is based on the results of their collective clinical research. Neural Manipulation concentrates on the relationship between the cranium and spine and their neural components. Since local nerve restrictions can have an effect on the rest of the body, especially in terms of ease of movement and pathological changes, manipulations using precisely applied pressure identify and release these restriction, which may have been caused by a broad spectrum of disturbances and trauma. Additionally, stimulation of the nerves has been shown to have a significant effect on the corresponding visceral organs.

In addition, Barral and Croibier developed the Manual Articular Approach (MAA), formerly known as the Global Joint Treatment, which is a comprehensive approach to the treatment of joints, especially the major joints of the spine and pelvis. MAA integrates all components of joint function and movement, as well as the connection of the joints to the viscera and the emotions. It examines the nerves of each joint along with the ligaments, arteries, bones, meniscuses, and attachments, and also looks at all of the relationships between the bones of the body. The treatment involves the mobilization of soft tissues associated with bones and joints.

German Rolfer Dr. Peter Schwind, who also worked with Jean-Pierre Barral, combined elements of Rolfing Structural Integration, Craniosacral Therapy, Visceral Manipulation, osteopathic mobilization, and other manual methods to create a way of treating connective tissue known as the Fascial and Membrane Technique (FMT). The focus of FMT is on the modification of the structure of the body by using a combination of form-stabilizing techniques, precise and gentle mobilization that includes special visceral techniques similar to those used in Myofascial Release, and craniosacral work emphasizing adjustments to the upper jaw. The treatment process directly and simultaneously affects the bridges between the fascia that surround the visceral, cranial, and musculoskeletal systems and thus may act on many interrelated systems at the same time. Emphasis is also placed on the diagnosis and treatment of breathing patterns as manifested in the myofascial structure. This is another example of how modalities are created by integrating unique combinations of existing therapeutic approaches to healing.

Contact:  Upledger Institute – or Barral Institute –


This modality comes from “Our Inner Ocean”, a book by Captain LeCain W. Smith: The author, LeCain W. Smith, learned early in life that his personal path to awakening was through ocean sailing, bodywork, and transformational energetic experiences. When living on the sea, making friends with the elements and with nature, he uncovered his passion for adventure, exploration, fitness, and health. He spent many years studying and experiencing bodywork and practicing yoga, qigong, breath-work, and meditation. This passion, combined with seeing numerous friends struggle with health problems, eventually drove Smith to reach out and help others through the writing of this book. If this endeavor changes the life of only one person, he will consider it a success.

Good health is something we all aspire to, but it’s so much more than just being free of disease. A perfectly functioning body, tranquil mind, and vibrant spirit working together harmoniously create the joy and happiness that put the good in good health and the worth into a life worth living. Our Inner Ocean describes ancient and new holistic modalities of practitioner-applied bodywork and revitalizing self-care practices.

Learn more about Our Inner Ocean – A World of Healing Modalities, Click Here!