Visceral Manipulation: The bodywork you’re not getting, but should be

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I’ve done a LOT of different therapies in my life and am a self-professed bodywork junkie. You know how people say “What would you do if money was no issue?” My answer has always been: the exact same thing I’m doing now but I’d have housekeepers several times a week, I’d fly first class, and I’d get bodywork weekly, not monthly. It’s a non-negotiable for me.

Recently I had the extreme pleasure and eye-opening experience of working with Caitlin Capistran, DPT, who specializes in a very unusual type of bodywork called Visceral Manipulation. In just one session with her, she helped open up a couple of key places in my abdomen that were blocked. Lingering digestive issues I’d not been able to fully resolve without reliance on complicated supplement protocols and very specific dietary strategies were resolved immediately and completely. I was impressed, to say the least.

I now consider her an integral part of my care team for myself and my clients (at least the lucky ones who are here in Portland, OR with us). Because this form of bodywork is so unknown and yet so powerful, I asked her if she’d share the concepts here with you, along with some guidance on how you can find your own Caitlin wherever you live. I’ll turn it over to her…

Here you are: you’ve put in the work to dial in your diet, you’re drinking plenty of water, and taking the (rather spendy) supplements your functional medicine practitioner prescribed, yet things just aren’t progressing the way you wish they would. Maybe you still have symptoms like abdominal discomfort and bloating, or anxiety and trouble sleeping, or even pain and tension in your muscles and joints. It’s possible that some of these symptoms could be coming from physical restrictions in your organs. This is when it may be a great idea to add in the support of a skilled bodyworker.

Can bodywork really help my organs?

With the right approach – absolutely!

Remember, just like muscles and ligaments, organs are physical structures made of living tissue that need to move well in order to function well. Each organ has its own unique physical properties, optimal location, particular way of moving, and specific relationships to other body parts.  When the physical structure of an organ is disrupted or altered in some way (for example, you’ve had a surgery, pregnancy, or physical injury like a fall or car accident) the function of the organ can be impacted. Vice versa: if the function of an organ has been impacted (by infections or chronic illness perhaps) the structure starts to change – often becoming tight and less mobile – thus further reducing its ability to function well. Bodywork known as “visceral mobilization” can help to restore the mobility of these organs, in much the same way that massage can help to restore the mobility of a tight muscle.

To make it concrete, let’s take a moment to consider the structure of your intestines: they’re essentially just a very long muscular tube that runs from your stomach (just below the left ribcage) to your anus. This intestinal tube has a specific organization to it with an optimal location for each portion of the tube: the small intestine connects to your stomach and occupies the center of your abdomen, the large intestine wraps around it, running from just above your right hip in a clockwise direction across your upper abdomen under the ribcage, and down toward the left hip. Embedded at specific locations within the intestinal tract are several sphincters (small bands of muscle) that serve as valves, opening and closing to regulate the flow of food and digestive juices. The intestines are designed to move, getting massaged up and down by your diaphragm with each breath. But (don’t worry!) your intestines aren’t just floating around loose in your abdomen – they’re encased in special connective tissue that anchors them to your spine and nearby internal structures.

Now imagine that something has disrupted the connective tissue around your intestines – perhaps you had a surgery (like an appendectomy, hernia repair, C-section, or back surgery) where things were moved out of their normal location and the connective tissue was cut or otherwise damaged. In the process of healing, your body (very wisely) will lay down scar tissue to repair the damage. Unfortunately, scar tissue isn’t as stretchy and pliable as the original tissue, and now the scarred area starts to lose its ability to move as freely as it once did. Over time, if the area doesn’t get the chance to stretch and regain its mobility (which usually requires targeted stretching/mobilization) it will continue to get tighter and denser forming little sticky spots or “adhesions” that bind down the organs (and surrounding tissue). Adhesions around the intestines start to restrict parts of your intestinal tract – kind of like having kinks in a hose – which makes it hard for food to pass through your intestines as easily as it once did. This can lead to digestive issues like constipation, bloating, abdominal pain, reflux, poor absorption, and hemorrhoids. It can even cause referred pain to your back, hips, and knees, or constitutional symptoms like fatigue and poor immune function.  Dysfunction of other abdominal organs like the liver, gall bladder, stomach, kidneys, etc. can cause similar issues or may contribute to other symptoms like acid reflux, headaches, sluggish detoxification, neck/upper back pain, shoulder pain, scoliosis, incontinence, nausea, and vomiting.     

Surgery or injuries aren’t the only way organ dysfunction can arise. Chronic stress, illness, infections, and exposure to high levels of toxins (including medications) can affect the organs and lead to less-than-optimal function. For example, say you have a sensitivity to a particular food, each time you eat this food it will irritate your stomach and intestines. Because the stomach and intestines are made of muscle, the irritation can cause muscle tension and spasming in your digestive tract. When the muscle spasms and constricts it not only impedes your digestion but signals to your nervous system that something is wrong. When the nervous system continuously registers this signal of distress, it begins to ramp you up into a state of fight or flight. When this is irritation of the digestive tract is ongoing, your nervous system and body can get stuck in fight or flight mode and lose the ability to return to a relaxed state. When you’re in this fight or flight state your body is getting signals (via stress hormones like adrenaline and cortisol) to prioritize immediate survival by running or fighting, and it is not prioritizing resting, digesting, and healing. Once you get stuck in this stress-response loop, the cycle can be difficult to break, even once the offending irritant has been removed. This is where bodywork can be an essential tool in resetting the cycle by restoring normal function to the organ and getting the nervous system out of this distressed state.

This same cascade can happen with any organ that is in distress for any reason. This can manifest not only as physical symptoms but (since we have one nervous system that governs both our physical function and mental/emotional state) also as generalized anxiety, irritability, difficulty relaxing and resting, and a whole host of other stress symptoms.

That doesn’t sound good, how do I know if my organs need support?

In addition to the symptoms listed above, and the ones that originally brought you to see a functional practitioner – like chronic fatigue, brain fog, digestive issues, etc. – here are a few other indications that you may have something going on with an organ.

You have:

  • Pain/tension in your back, shoulders, or hips that doesn’t get much better with stretching, exercise, or massage.
  • Anxiety/stress that don’t seem to be related (or in proportion) to any particular events/circumstances in your life.
  • Difficulty getting a full, easy breath without effort.
  • Points in your abdomen that feel tender to touch.
  • Symptoms that aren’t responding to your treatment protocol the way (or at the rate) you were expecting.
  • A history of significant accidents/injuries like a car accident, surgery, or a big fall/impact.

I have some of these things… what can I do?

If you’re already working with a functional medicine practitioner, that is a great start! If you suspect you may have something going on with an organ it is always good to support both its function and its structure. To find someone who can support the structure through bodywork look for a practitioner who is trained in “visceral mobilization” or “visceral manipulation” which is an approach used to treat the internal organs through hands-on treatment. It can be practiced by a variety of practitioners including physical therapists, chiropractors, osteopaths, naturopaths, and massage therapists. This is a unique skill set and most bodyworkers have not been trained in this approach, so you will have to do some research to find a practitioner who does this work. It falls under the category of “manual therapy” so you may search for someone trained in that and ask if they are well-versed in working with the viscera.

What exactly is visceral mobilization…how does it work?

Visceral mobilization originated from osteopathic medicine, which recognizes that all of the parts of the body must be moving well and be in good relationship to the rest of the body in order for the body as a whole to feel good and function well. When you work with a practitioner who understands this philosophy, they will look at your whole body (and consider all of your symptoms and medical history) to identify the root cause of your symptoms. Through their evaluation they will hone in on the parts of your body that are not moving optimally and use hands-on treatment techniques to restore optimal movement and alignment of the tissue in your body. This often feels like very gentle touch around the target organ, or sometimes firmer touch that feels like a massage.  Working with the organs in this way can restore optimal function of the organs and help to reset the nervous system, bringing it out of “fight/flight” and back to “rest/digest,” which restores the body’s natural ability to heal itself.  

When the root cause is identified and a finely-tuned treatment approach is used to correct the underlying cause, you may feel a response in your body relatively quickly.  Some people feel a change after one treatment session, and others may feel a shift after a few treatments. How soon you feel a response to treatment (and how big the response is) depends on how severe the issue is, how long you’ve been experiencing it, as well as many other health/lifestyle factors.

If you’re interested in exploring whether bodywork may be helpful for supporting your organs, find a practitioner in your area who is trained in Visceral Mobilization and call and ask if they have experience treating patients with symptoms similar to yours.

Interested in learning more?

The Barrall Institute offers trainings for health care practitioners to learn Visceral Manipulation and offers a simple explanation of Visceral Manipulation if you’d like to explore further, click here.

Caitlin Capistran, Doctor of Physical Therapy
Dr. Caitlin is a trauma-informed bodyworker who takes a holistic approach to working with the body. She specializes in manual therapy, including visceral mobilization and myofascial release. Caitlin uses gentle hands-on treatment techniques to restore balance and ease within the body. Her work supports people experiencing digestive issues, pain, muscle tension, fatigue, chronic illness, and mental health issues.

Contact Info
Phone: 503-479-8349

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