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Visceral Mobilization
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Visceral Mobilization - October 5, 2005 8:40:00 AM
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hmgross
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Does anyone out there do this technique and how do you know there is a "restriction in the horizontal fissure of the right lung"?? (from a office note --an Occ Med MD)
I guess I would like to understand what the rationale is and how a person is supposed to be able to identify restrictions and how that relates to pain and dysfunction.
Any studies out there or personal experiences?
Thanks.
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Re: Visceral Mobilization - October 5, 2005 2:06:00 PM
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Jon Newman
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The only way I know how to mobilize the lungs is to breathe, cough, sneeze, etc. I suppose a person could consciously try to breathe to different parts of the lungs too.
The only other visceral mobilization that I know of would be to consume a grande bean enchilada. I hadn't joined in any of the previous threads' toilet humor so I thought I get a HEAD start.
jon
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Re: Visceral Mobilization - October 5, 2005 4:54:00 PM
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Dr.Wagner
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While I have never heard of anything termed "restriction in the horizontal fissure", I am quite sure there is nothing therapy can do for that except encourage deep breaths.
I am sure the doc is meaning something anatomical, and I don't know the context.
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Re: Visceral Mobilization - October 5, 2005 5:46:00 PM
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FLAOrthoPT
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ugh i hate visceral mob and such. but i am a concrete thinker. Look up Weiselfish/updike, etc...there are volumes of books on this crap, sorry did that show my bias?
Ben
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Re: Visceral Mobilization - October 5, 2005 6:46:00 PM
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hmgross
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Doc Wagner,
I am at home now, so I don't have the patient's chart in front of me, but I believe this is all based on some sort of office exam (I had a different patient tell me the exam consists of the MD placing his hands a few inches from the body and humming--sounds a little weird to me)--I will try to pick a few more things off my memory, which isn't too great these days. He also mentions restrictions in the intestines, and ?uteroligaments.
I like the enchilada idea Jon, but the sad thing is that the MD mentioned in the note that, since I am not trained in visceral mobilization, he wanted the patient to see a physical therapist about an hour's drive away who I guess IS trained to do this, so to me THAT is the crappy part. Sorry, I am not writing well, I think it is time to retire for the evening.
Oh, and this is an MVA work injury, with multiple areas involved (mid-back, low back, elbow wrist ankle pain). So....were does the lungs and intestines fit in to the picture?! (MRI, xrays negative).
Ben, I will look into the Weiselfish/updike stuff, but I am thinking I may share your bias.
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Re: Visceral Mobilization - October 5, 2005 6:58:00 PM
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Synergy
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Holly,
[QUOTE]...I had a different patient tell me the exam consists of the MD placing his hands a few inches from the body and humming--sounds a little weird to me...[/QUOTE]As you may well know, patients sometimes engage in hyperbole and the truth gets lost entirely, however, if what this patient describes is in fact true then it sounds like BS...plain and simple! Does this doctor use crystals and other various forms of whatnot during his exams as well?
The sad thing is that he's sending the patient to another PT 'qualified' in this type of approach. I'd love to see the techniques to manually correct a "restriction in the horizontal fissure" of a lung that just so happens to be SURROUNDED by the rib cage. :)
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Re: Visceral Mobilization - October 6, 2005 1:49:00 AM
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Sebastian Asselbergs
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Wait a minute folks. There are courses being taught on "Visceral Manipulation" - usually based on Barel's (sp?) work. It was as far as I know, first introduced through Upledger's carniosacral therapy courses here in North America. I have heard therapists' talk about the liver being "twisted" and causing lumbo-pelvic imbalances - about adhesions between the pancreas and....and more.... Some DO's in the States are into this and up here PTs, MTs and our own version of Osteopaths. I have yet to see any reasonable explanation of the techniques, the diagnostic approach, and the purported effects of the manipulation - other than case histories (mostly based on the CST-type evals).
PTs can get CEUs for this.....A load of cr** if you ask me.
I treat my liver with completely different techniques (martinis and G&Ts) .....
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Re: Visceral Mobilization - October 6, 2005 1:59:00 AM
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Lukey
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There is an osteopathic physician in France by the name Jean-Pierre Barral who has written three volumes on osteopathic visceral techniques (about 10-15 years old now I think). From the description of the doctors diagnostic technique I have a feeling he might be using some version of Barral's work. A lot of this stuff is of the cranial therapy bent, ie lightly touching the skin to feel inherant mobility (vs motility) of the organs and abdominal tissue, axes of motion of the liver and duodenum, mesenteric restrictions and other such crap.
For some reason this is extremely popular in some circles and everyone is jumping on the band wagon (Upledger etc)
Holly, if this is the case, don't feel disappointed you aren't part of his referral 'club'.
Luke
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Re: Visceral Mobilization - October 6, 2005 2:09:00 AM
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Lukey
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Sebastian, we must have been writing at the same time.
Luke
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Re: Visceral Mobilization - October 6, 2005 2:33:00 AM
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avalon
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[URL=http://www.upledger.com/therapies/bio_jpb.htm]Jean-Pierre Barral[/URL]
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Re: Visceral Mobilization - October 6, 2005 2:35:00 AM
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avalon
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Luke,
[QUOTE]axes of motion of the liver duodenum, mesenteric restrictions and other such crap[/QUOTE]Is it really possible?
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Re: Visceral Mobilization - October 6, 2005 2:46:00 AM
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Lukey
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Henry,
Do you think it is possible?
Luke
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Re: Visceral Mobilization - October 6, 2005 2:52:00 AM
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avalon
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Luke,
Diane told me already it was almost impossible.
I trust what Diane tell us.
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Re: Visceral Mobilization - October 6, 2005 2:59:00 AM
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Lukey
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Yes, Diane is trustworthy in these matters. (I'm not sure about the 'almost' bit though)
Luke
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Re: Visceral Mobilization - October 6, 2005 3:54:00 AM
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avalon
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Luke,
(almost)
What's about the colon?
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Re: Visceral Mobilization - October 6, 2005 4:30:00 AM
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Yogi
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Logically, traumatic adhesions could occur in any tissue. Non-traumatic, I'm not so sure.
Not particularly sure how useful it is, but in chest PT we learned to differientially actively inflate one lobe over another, typically one side lower, so it is possible Jon.
Frankly I would suspect a rib displacement, esp. with an oblique hit in the collision.
Or old pneumonial scars, or infiltrate, but you said mri, x-ray was neg.
What's an Occ Med MD, occupational med?
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Re: Visceral Mobilization - October 6, 2005 4:40:00 AM
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Lukey
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Henry,
Barral differentiates between the normal motility of the hollow organs and a concept of mobility that describes an 'inherant' motion that occurs on various axes to the rhythm of the Primary Respiraory Mechanism (Cranial Impulse). Obviously these two palpatory experiences are very different.
Luke
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Re: Visceral Mobilization - October 6, 2005 4:49:00 AM
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Diane
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No "almost" about it. Ready for this? Any "effect" is produced by neuromodulation, only; any idea that organs can be contacted directly and affected from outside the skin/protection of the brain through body wall are perceptual fantasy. (Likewise with vertebrae, but here the orthopaedic perceptual fantasies are more entrenched, and more hotly defended...)
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Re: Visceral Mobilization - October 6, 2005 5:13:00 AM
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JLS_PT_OCS
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Now Diane, with the latest study over in the "Diagnosis and Palpation..." thread about PA mobility assessment, you may have to come off your stance a bit about using that to help guide treatment. There appears to be at least a small thing that is not a perceptual fantasy about it. I'm no fan of palpatory diagnostic models, either, but it does complicate the issue a bit, don't you think?
:)
And I think Yogi is right on about this visceral stuff.
J
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Homo Vegetus
"It isn't what you're able to do that requires your courage but rather what you have come to understand and are willing to express." - Barrett Dorko, Writer and Physical Therapist
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Re: Visceral Mobilization - October 6, 2005 5:22:00 AM
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avalon
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Diane,
I was just kiddin' about the concept of manipulation. It is easy to "touch" a colon but it will remain as you said, layers that are touched firstly and it doesn't change anyway the neuromodulation thing.
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