What is Visceral Manipulation?

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Visceral Manipulation

Did you know our organs have an association with each other? Organs are in constant motion when we walk, breathe and stretch (i.e. take a breath, and the kidney moves an inch). “Viscera” means organs and visceral manipulation is a manual therapy technique used to address the pain that accompanies potential organ immobility. The movement of organs is transmitted through fascia to other structures of the body; if we are healthy, then the organs and other structures (other organs, ligaments, bones, muscles) move with interconnected fluidity. The fluid movement of all structures is extremely important, and if a structure is not sitting in place, this can have detrimental effects causing blood vessels, and nerves to work ineffectively; the lack of fluid movement of organs, in turn, can cause blood flood and nerve supply to that structure to be diminished (i.e. cold feet because the liver is compressing on the vena cava).

Organs are suspended in our abdominal and thoracic cavities by pressures. These pressure can be disrupted by surgery, infections, sedentary lifestyle, bad diet, poor posture, pregnancy/delivery, contact sports, and car accidents to name a few. When the pressure is disrupted, then the organ can lose its mobility. When the organ is no longer freely mobile and is fixed to another structure the body is forced to compensate. The disrupted disharmony creates problems, creating abnormal tension, adhesion, and irritation that gives way to structural and functional problems throughout the body.

Is your right shoulder pain coming from your liver?

An example of this is the liver and right shoulder, the liver sits in the upper right quadrant of the abdomen. It is below the diaphragm, sits on top of the stomach, right kidney and intestine.

The large organ has many important functions, such as:

  • produces bile to break down fats
  • involved in the immune system
  • eliminates waste (medications, drug and alcohol)
  • stores and release glucose as the body needs it

The liver has a connection to the right shoulder via the right phrenic nerve “right shoulder is called the visceral shoulder”. The phrenic nerve comes out of C4 and innervates the diaphragm, the phrenic nerve is in close proximity to the liver. Any injuries, adhesions or abnormal location of the liver can compress on the phrenic nerve and cause right shoulder dysfunction (i.e. frozen shoulder, limited right shoulder abduction and external rotation).


Article written by Andrea Dowd, Athletic Therapist at Richmond World Health

Reference: Barral, J. P., & Mercier, P. (1988). Visceral manipulation. Seattle: Eastland Press.

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