"What am I missing?" is often the question in therapists' minds when a client returns time and time again with the same sports injury. Sure, we have numerous skills to address muscle and joint pain, and we know much of it is related to structural alignment, but what else can be done?

The answer may be found in the organs (viscera). According to French osteopath John Pierre Barral, DO, MRO(F), RPT, 90 percent of musculoskeletal problems have a visceral component. Our viscera have extensive connective tissue relationships to the musculoskeletal system.

At the Foundation of Human Anatomy

Visceral Manipulation (VM) is a manual therapy technique developed by Jean-Pierre Barral, one of TIME magazine's "Top Healing Innovators to watch in the new millennium." Built on a foundation of human anatomy, Barral's method focuses on the gentle, skillful handling of the organs of the body. VM training cultivates a fine sense of touch to know the differing textures of the body's tissues. Using this sophisticated touch, the practitioner listens to the body's tissues and uses high precision, minimal force techniques to release restrictions around the organs, nerves, blood vessels, joints, fascia and brain.

Like ocean waves; breath, heartbeat and the craniosacral rhythm keep the body in a state of perpetual motion. Optimum health relies upon this harmonious relationship. 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 stress that may manifest symptoms at the site, or even at distant points. Results can often be pain, weakness, balance and coordination problems, breathing problems, less-than optimal organ function, digestive problems and more.

Releasing Restrictions

The VM practitioner feels the altered motion and restrictive patterns within the viscera 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 often decreased pain and a return of the body's ability to adapt and restore itself to health.

For example, an athlete complaining of right neck and shoulder pain after a fall on the right rib cage can be treated with Barral's method. VM training teaches you that the liver has extensive connective tissue attachments to the diaphragm through 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. Most importantly, using the listening techniques you learn in VM training, the client's own tissues have pulled you to the liver, which must be addressed to effectively treat the neck and shoulder.

This scenario can be repeated for a wide array of sports related pain and injuries. 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.

For further information about Visceral Manipulation ( or any of the techniques developed by Jean Pierre Barral, D.O., MRO(F), RPT please visit www.barralinstitute.com.