Holistic. In health care, this term is often used as an equivalent to “alternative medicine.” A more literal definition (found with a quick search on Google) is “characterized by comprehension of the parts of something as intimately interconnected and explicable only by reference to the whole.”
In health care generally, and physical therapy specifically, the focus can be narrow and look only at the area of symptoms and perhaps only the muscles and bones associated with that area. To broaden the scope one can start to look at the joints near the area of symptoms – the hip and the foot in a case of knee pain. With a holistic approach the therapist looks at the whole body – posture, movement patterns, social and emotional well being, and more. Initially this may be confusing to the patient – “Why are you looking/feeling there when my symptoms are here?” but this assessment process takes into account that all of our body systems function together i.e. It’s all connected!
I recently attended a continuing education training that deepened my holistic mindset even further – Visceral Manipulation (VM). Developed by Pierre Barral, a world renowned osteopath and physical therapist in France, VM uses gentle assessment and treatment techniques through specific manual pressures. The viscera are the organs in our body; liver, intestines, lungs, gall bladder, etc. They are surrounded by and connected to our muscles and bones as well as each other and although our organs can move – they are what actually makes your belly rise when taking a deep breath – they are not free floating either. VM evaluation looks for restrictions in the connections between the viscera and other structures in our body (including other organs) and treatment works to reduce these restrictions allowing all parts of the body to be brought into balance. The therapist may find restrictions in the intestines and once released mobility in the hip increases. Imagine, after years of struggling to find ease in Pigeon pose, being able to fully release without pain or compression after gentle mobilization of your abdominal organs!
Abdominal surgery, infections, trauma, and pregnancy all disrupt our visceral and musculoskeletal systems. Even minimally invasive surgeries that are done laparoscopically and leave only the tiniest of scars externally cause internal derangement by cutting through tissue and removing organs which leaves a space to fill. Our bodies shift to accommodate this new arrangement and this can lead to tension on other organs, on the fascia, or on the muscles and bones. During pregnancy the organs shift around – in a pretty incredible way – to make room for a growing uterus and baby and increased fluid volume. But it has 9-10 months to make this adjustment. After birth, there is a more sudden change in the volume of the abdominal contents which places more stress on the fascia and ligaments and can result in increased tension in some of these structures.
Visceral manipulation is used in conjunction with posture education, body mechanics training, strengthening, and mindfulness and relaxation that are already a part of our PT treatments. Here at Evolution we have several therapists with training in Visceral Manipulation; Alison Aiken, PT, DPT, CYT, Michelle Downing DPT, OCS, CFMT, RYT, and Meagen Satinsky MPT, PYT.
For more information on Visceral Manipulation see:
~ Alison Aiken PT, DPT, CYT

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