The earliest historical account to the manipulative therapy practice in Europe dates back to 400
BCE and has shown a parallel development throughout many parts of the world.
Throughout the centuries, manipulative procedures have been fluctuating in line with the medical
Historically, manipulation may derive its genesis from parallel occurrences in many regions of
the world where a range of musculoskeletal disorders, including spinal abnormalities, have been
It is observed that manipulation of the spinal cord is and has been extensively mastered in many
cultures and often in remote populations such as the Balinese of Indonesia, the Lomi-Lomi of
Hawaii, in areas of Japan, China and India by the shamans of Central Asia, by sabodors in
Mexico, by bonesetters of Nepal as well as by bonesetters in Russia and Norway. ( Erland
Pettman, 2007 )
Historical account to Greece is the primary conclusive evidence of spinal manipulation
The detail in which this therapy is presented demonstrates that the manipulation procedure was
well settled and preceded the reference dating from 400 BCE.
In his books on joints, Hippocrates (460–385 BCE), who is often referred to as the father of
medicine, was the first physician to describe spinal manipulative techniques using gravity, for
the treatment of scoliosis. In this case, the patient was tied to a ladder and inverted ( Withington
ET. 1928 )
The second technique he described seemed to be the use of a table with different straps, wheels,
and axles that eventually allow traction to be applied.
To treat a "gibbus" or prominent vertebra, the hand, foot, seated body weight, or a wooden lever
could be used to convey spinal pressure or pressure. Hippocrates pointed out that physical
exercises should supplement this treatment next.
Claudius Galen (131–202 CE), a noted Roman surgeon, provided evidence of manipulation
including the acts of standing or walking on the dysfunctional spinal region. ( Schiotz EH,
Cyriax J. 1974 )
For more than 1600 years, the implementation of the therapy table used by Hippocrates and his manipulation methods managed to survive.
In his medical treatise Book of Healing, Avicenna (also known as the Doctor of Physicians) from Baghdad (980–1037 CE) included descriptions of Hippocrates ' practices.
A Latin translation of this manuscript was printed in Europe which further influenced future scientists like Leonardo Da Vinci and significantly contributed to the development of Western medicine at the end of the Middle Ages.
Originally, manipulative therapy was the pillar of the two prominent alternative health care systems, osteopathy, and chiropractic, both established in the latter part of the 19th century as an outcome of allopathic medicine inadequacies.
With medical and osteopathic physicians initially instrumental in implementing manipulative
therapy to the physical therapy career, physical therapists have since performed serious
contributions to the field, thus bolstering the claim of the profession to have manipulative
therapy within its legally controlled field of expertise.
Visceral Manipulation supports the functional and structural imbalances of musculoskeletal,
pulmonary, nervous, urogenital, cardiovascular, digestive, and lymphatic pathology throughout
the body. The dynamics of movement and suspension in regards to organs, membranes, fascia,
and ligaments are assessed and treated.
The world-renowned French osteopath and physical therapist Jean-Pierre Barral devised Visceral
Manipulation (VM). Comparative studies discovered it useful for multiple disorders.
Visceral manipulation was the term he devised for this therapy.
VM increases proprioceptive communication within the body, revitalizing a person, and
alleviating medical problems like pain, dysfunction, and poor posture.
An integrative approach to a patient's assessment and treatment requires evaluation of the
viscera's structural relationships and their fascial or ligamentous configurations to the
Strains in the visceral connective tissue can be caused by surgical scars, adhesions, disease,
posture, or multiple injuries.
Tension patterns develop deep within the body by the fascial system, generating a chain reaction
of effects much further from their causes for which the organism must counterbalance.
This produces fixed, unnatural tension points that the body gets to relocate around, and this
chronic irritation leads to functional and structural problems.
To give such an example, we can allude to a scenario where adhesion is developed around the lungs.
The adhesion could, for example, significantly change the movement of the rib, which could then create imbalanced forces on the vertebral column and eventually establish an unstable link with other mechanisms.
There are clear connections among somatic structures like muscles and joints, sympathetic
nervous system, visceral organs, spinal cord, and brain.
The sinuvertebral nerves, for example, internalize the intervertebral disks and have close attachments with the sympathetic nervous system that innervates the visceral organs.
The sympathetic nervous system and the sinuvertebral nerves are connected to the spinal cord that has appendages with the brain.
In this way, someone with chronic pain may have inconveniences and facilitated areas not only in the musculoskeletal system (including joints, muscles, fascia, and disks), but also in the
visceral organs and their connective tissues (including the liver, stomach, gallbladder, intestines, and adrenal glands), the peripheral nervous system, the sympathetic nervous system, and even the spinal cord and brain. (Barral Institute)
Thanks to the constant effort of Jean-Pierre Barral, today, healthcare professionals can use the
visceral system's rhythmic movements as significant therapeutic techniques.
Visceral manipulation is centered on the palpation of normal and anomalous powers that exist
within the body.
Barral's clinical employment with the viscera spurred him to develop a form of manual therapy
that focuses on the internal organs, their environment, and the potential impact on many
structural and physiological dysfunctions.
Therapists can investigate how anomalous forces interact, overlap, and influence the regular
forces of the body at work by using specific techniques.
Visceral Manipulation promotes your own biological processes to improve the efficiency of your organs, abate detrimental effects of stress and inflammation, reinforce mobility of the musculoskeletal system throughout the connective tissue attachments, and regulate overall metabolism.
Today, a wide variety of healthcare professionals perform Visceral Manipulation.
Practitioners include osteopathic physicians, allopathic physicians, doctors of chiropractic, doctors of Oriental medicine, naturopathic physicians, physical therapists, occupational therapists, massage therapists, and other licensed bodyworkers. ( Barral Institute )
Visceral manipulation is centered on the specific placement of tender manual energies to promote the normal mobility, condition, and movement of viscera and its connective tissues.
Such soothing manipulations can ultimately improve the ability to function of individual organs, the mechanisms in which the organs work effectively, and the whole body's structural integrity. There is cohesion and wellbeing when there is freedom of movement. When movement is not strived, over-excited, despondent, or in conflict with adjacent structures and their mobility.
Visceral manipulation therapists evaluate both the dynamic functional processes and the somatic arrangements performing individual activities. They also assess the quality of the somatic formations and their tasks concerning an overall balanced model, with movement serving as the norm for managing quality. Fantastic results are accomplished by gentle forces, precisely directed, due to the delicate and often intensely reactionary disposition of the visceral tissues.
Like other manipulation techniques that have a profound effect on the body, Visceral Manipulation operates only to support the forces already at work. For this reason, trained therapists can be sure of benefiting the body rather than bringing yet more harm or dysfunction.
Visceral manipulation has been efficacious in the medical care of various dysfunctions.
These are presented in a list below:
Pelvic Floor Dysfunction Chronic Pelvic Pain Fibroids & Cysts Endometriosis Dysmenorrhea Dyspareunia Infertility Interstitial Cystitis Bladder urgency/frequency Bladder incontinence Prostatitis Urinary and sexual dysfunction associated with an enlarged prostate Referred penile and testicular pain Constipation and Bloating Irritable Bowel Syndrome GERD, Acid Reflux Chronic Spinal Dysfunction Sciatica Fibromyalgia Joint Pain Post Operative Scar Tissue Anxiety and Depression Post Traumatic Stress Disorder
A History of Manipulative Therapy - Erland Pettman ( J Man Manip Ther. 2007; 15(3): 165–
174.doi: 10.1179/106698107790819873 )
Sigerist HE. A History of Medicine, Vol. 1: Primitive and Archaic Medicine. New York, NY:
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Withington ET. Hippocrates. With an English Translation. Cambridge, MA: Harvard University
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Schiotz EH, Cyriax J. Manipulation: Past and Present. London, UK: William Heinemann
Medical Books; 1974. [Google Scholar] [Ref list]
Haldemann S. The Principles and Practice of Chiropractic. 2nd ed. Norwalk, CT: Appleton and
Lange; 1992. [Google Scholar] [Ref list]
Visceral Therapy | Manual Physical Therapy - Boise.
Visceral Manipulation (VM) with Mariann Sisco, PT, CST-D ....
Discover Visceral Manipulation - barralinstitute.com.
Visceral Manipulation (VM) | Beyond Basics Physical Therapy.
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