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Visceral Mobilization and the Lumbar Spine

“…visceral manual therapy can produce immediate hypoalgesia in somatic structures segmentally related to the organ being mobilized…”

This statement is taken from an article written by MCSweeney and colleagues published in the Journal of Bodywork and Movement Therapies in 2012. The authors, who state that there is a lack of research that explains underlying mechanisms for visceral mobilization, aimed to determine if visceral mobilization could produce local and/or systemic effects towards hypoalgesia. The measurement of hypoalgesia, defined by the IASP as “diminished pain in response to a normally painful stimulus,” was assessed by use of a hand-held manual digital pressure algometer for pressure pain threshold (PPT). Sixteen asymptomatic subjects were recruited from an osteopathic school and were treated on separate occasions with a visceral mobilization of the sigmoid colon, a sham intervention of manual contact on the abdomen, and a control of no intervention. Six females (mean age 23.7) and ten males (mean age 27.7) completed the single-blinded, randomized study.

The visceral manipulation technique was administered in the supine position by contacting the left sigmoid colon and drawing it superomedially for one minute, and repeated at a frequency and duration determined by the therapist base on each individual’s tissue response. The sham treatment included one minute of light tough contact over the umbilical area, and no position of ease or tissue barrier was engaged. The algometer was placed 1 centimeter to the left of the L1 spinous process, a location known to correspond to the segmental level equal to the colon. A site on the hand was used as a distant area for comparison. The authors concluded that visceral mobilization of the sigmoid colon was found to produce analgesia in tissue that is related segmentally.

The clinical practice relevance was difficult to determine, however, this study used new techniques to determine that there is an immediate and measurable effect on the body. While therapists who treat with visceral mobilization and other soft tissue techniques know that the interventions have helped their patients, having further experimental and clinical validation of the value of these techniques is critical. If you are interested in learning more about fascial approaches to easing pain and improving function in your patients, check out the courses offered by faculty member Ramona Horton.

Ramona will be teaching her Mobilization of the Myofascial Layer: Pelvis and Lower Extremities course three times this year, with the next event in Nashua, NH June 3-5. Her Mobilization of Visceral Fascia: The Urinary System course is available three times as well, next in Kirkland, WA on June 24-26. If you're ready for the advanced course, and some wine tasting(!), check out Mobilization of Visceral Fascia: The Reproductive System of Men and Women on October 14-16 in Medford, OR.


McSweeney, T. P., Thomson, O. P., & Johnston, R. (2012). The immediate effects of sigmoid colon manipulation on pressure pain thresholds in the lumbar spine. Journal of bodywork and movement therapies, 16(4), 416-423.

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Upcoming Continuing Education Courses

Mobilization of the Myofascial Layer - Medford, OR Satellite Location

Nov 6, 2020 - Nov 8, 2020
Location: Asante Rogue Valley Medical Center

Nutrition Perspectives for the Pelvic Rehab Therapist - Seattle, WA (POSTPONED)

Nov 6, 2020 - Nov 8, 2020
Location: MTI Physical Therapy

Mobilization of the Myofascial layer: Pelvis and Lower Extremity- Greenville, SC (Postponed)

Nov 6, 2020 - Nov 8, 2020
Location: Bon Secours St. Francis Health System

Mobilization of the Myofascial Layer Satellite Lab Course

Nov 6, 2020 - Nov 8, 2020
Location: Replacement Remote Course

Mobilization of the Myofascial Layer - Athens, GA Satellite Location

Nov 6, 2020 - Nov 8, 2020
Location: Thrive Integrated Medicine

Mobilization of the Myofascial Layer - Greenville, SC Satellite Location

Nov 6, 2020 - Nov 8, 2020
Location: Bon Secours St. Francis Health System

Mobilization of Myofascial - Self-Hosted

Nov 6, 2020 - Nov 8, 2020
Location: Self-Hosted Course

Nutrition Perspectives for the Pelvic Rehab Therapist - Remote Course

Nov 7, 2020 - Nov 8, 2020
Location: Replacement Remote Course

Athletes & Pelvic Rehabilitation - San Diego, CA (Postponed)

Nov 7, 2020 - Nov 8, 2020
Location: Comprehensive Therapy Services

Pelvic Floor Level 2B - Somerset, NJ Satellite Course

Nov 7, 2020 - Nov 8, 2020
Location: Sports Medicine Institute

Pelvic Floor Level 2A - Grand Rapids, MI (SOLD OUT)

Nov 7, 2020 - Nov 8, 2020
Location: Mary Free Bed Rehabilitation Hospital

Pregnancy Rehabilitation - Washington, DC (Postponed)

Nov 7, 2020 - Nov 8, 2020
Location: GWUH Outpatient Rehabilitation Center

Bowel Pathology and Function -Middletown, CT (Postponed)

Nov 7, 2020 - Nov 8, 2020
Location: Middlesex Hospital

Bowel Pathology and Function - Remote Course

Nov 7, 2020 - Nov 8, 2020
Location: Replacement Remote Course

Pregnancy Rehabilitation - Remote Course (SOLD OUT)

Nov 7, 2020 - Nov 8, 2020
Location: Replacement Remote Course

Pelvic Floor Level 2B - Satellite Lab Course

Nov 7, 2020 - Nov 8, 2020
Location: Replacement Remote Course

Pelvic Floor Level 2B - Marietta, GA Satellite Location (SOLD OUT)

Nov 7, 2020 - Nov 8, 2020
Location: Southern Pelvic Health

Pelvic Floor Level 2B - East Norriton, PA Satellite Course

Nov 7, 2020 - Nov 8, 2020
Location: Core 3 Physical Therapy

Pelvic Floor Level 2B - Cranford, NJ Satellite Course

Nov 7, 2020 - Nov 8, 2020
Location: Ivy Rehab Physical Therapy

Pelvic Floor Level 2B - Manchester, IA Satellite Course

Nov 7, 2020 - Nov 8, 2020
Location: Physical Therapy Solutions

Pelvic Floor Level 2B - Richmond, VA Satellite Course

Nov 7, 2020 - Nov 8, 2020
Location: Pivot Physical Therapy

Athletes & Pelvic Rehabilitation - Remote Course

Nov 7, 2020 - Nov 8, 2020
Location: Replacement Remote Course

Pelvic Floor Level 2B - Self-Hosted

Nov 7, 2020 - Nov 8, 2020
Location: Self-Hosted Course

Pelvic Floor Level 2A - Bay Shore, NY (Postponed)

Nov 8, 2020 - Nov 9, 2020
Location: Touro College: Bayshore

Mobilization of Visceral Fascia: The Gastrointestinal System - Jackson, WY Satellite Location

Nov 13, 2020 - Nov 15, 2020
Location: Four Pines Physical Therapy

Mobilization of Visceral Fascia: The Gastrointestinal System - Fairlawn, NJ (Postponed)

Nov 13, 2020 - Nov 15, 2020
Location: Bella Physical Therapy

Mobilization of Visceral Fascia: The Gastrointestinal System - Self-Hosted

Nov 13, 2020 - Nov 15, 2020
Location: Self-Hosted Course

Mobilization of Visceral Fascia: The Gastrointestinal System - Fargo, ND Satellite Location

Nov 13, 2020 - Nov 15, 2020
Location: Apex Physical Therapy & Wellness Center