Visceral Manipulation Enhances Structural Integration
Jeffrey Burch, Certified Advanced Rolfer
Osteopathic
principles are the foundation of structural integration. On the way to developing structural integration
Ida Rolf read Osteopathic literature and
studied with Osteopaths. In her
unique evolution of Andrew Taylor Still’s work, Ida Rolf emphasized the
interaction of the human body with gravity.
Other derivatives of Osteopathy emphasized and developed other
facets, for example Fritz Smith’s Zero
Balancing and Lawrence Jones’
Counterstrain. Marriages between structural integration and its
Osteopathic cousins are particularly fortuitous. In the next article in this series I will explore about the
bigger picture of our lineage, going
back before Osteopathy to the Bone Setters.
In the present article I
describe how structural integration and one Osteopathic derivative,
Visceral Manipulation, enhance each other.
Fascial
Continuity
The
human body is held together and given its shape by connective tissue. Developing early in fetal growth, all of the
connective tissue in the human body is continuous. There is a lot of it: about 20% of the weight of the human body
is connective tissue. Collectively this
connective tissue matrix is the Organ of Support. As structural integrators we work with the Organ of Support to
assist our clients to a better relationship to gravity and to life.
My
experience with unpreserved cadavers has shown that our manipulative techniques
are effective on the physical properties of the connective tissue matrix even
after death. . The Organ of Support also contains a vast
network of peripheral and autonomic innervations. Much of what we do as structural integrators is a conversation
with the nervous system particularly the gamma loops and the autonomic nervous
system.
Core
A
crucial bodily balance is that between surface and core. A surface is easy to describe, the nature
and location of core has been an ongoing debate for all of structural
integration’s half century of development.
Currently, advanced Rolfing® instructor Jan Sultan and others describe
core as ‘the visceral space’, not referring to the organs themselves, but to
the membranous container of the organs and its inherent pressure system.
The
membranes supporting the internal organs have multiple and extensive
connections with the rest of the Organ of Support. French Osteopath Jean-Pierre Barral has demonstrated that
manipulation of the visceral support system has profound and lasting effects on
the organization of the rest of the
body. To leave the visceral support system out of structural integration is
to ignore a large and literally central part of the Organ of Support. The visceral support membranes have rich
autonomic innervation: the number of
neurons in the visceral support system exceeds the number of neurons in the
spinal cord and brain stem. The several
nerve plexi of the visceral support system are literally another brain, named the
Enteric brain, and function as a
crucial entry point for our conversation with the nervous system.
Here
are two examples of how the visceral support system affects structure, one in
the abdomen and one in the thorax.
Abdomen
The 25
feet of the small intestine are
supported by a membrane called the mesentery.
If the small intestines are removed with the mesentery attached, and the
small intestine is stretched out in a line, the mesentery appears as a 6 inch
long curtain hanging from one edge of the intestine. In the body the edge of the mesentery not attached to the
intestine is collected and attached along a 6 inch long line running from the
duodenojejunal junction in the upper left quadrant of the abdomen to the
illiocecal valve in the lower right quadrant.
Between these two end points the mesenteries attach to the back wall of the abdomen crossing the
lumbar spine at a diagonal and also crosses the superior portion of the right
sacroiliac joint attaching to both sacrum and ilium. The diagonal line of attachment of the mesenteries to the back
wall of the abdomen is called the Roots of the Mesenteries.
Tension
in the mesenteries, and particularly tension in the Roots of the Mesenteries,
will rotate the lumbar spine and fixate the right sacroiliac joint. It is a routine demonstration in Visceral
Manipulation classes to first assess lumbar and sacral position and mobility,
then free the mesenteries. Post
testing of the lumbars and sacroiliac
joints shows that a very few minutes of light visceral manipulation
makes profound change in Lumbosacral position and mobility.
Thorax
The
lungs are surrounded by two layers of pleural membranes. The pleura are essentially fascial sheets associated with organs. The inner or visceral pleura forms the
surface of the lungs. The outer or
parietal pleura invests the inner
surface of the chest cavity. Between
the two layers is a small amount of
serous fluid. This lubricant and the
potential space it occupies are maintained at slight negative pressure by the
lymphatic system. This negative
pressure means the two pleural surfaces cannot move away from each other, just
like two sheets of wet glass can slide on each other but cannot be pulled
apart.
The
top of the parietal pleura forms a dome 2-3 cm above the first rib. The apex of this dome is suspended in part
from the bottom side of the middle scalene muscle by the Suspensory Ligament of
the Lung. In addition, Sibson’s
Structure attaches the pleural apex to the anterior surface of the transverse
process of C7, sometimes C6, and occasionally also C5. Sibson’s structure contains highly
variable proportions of collagen, elastin, smooth muscle fiber and striated
muscle fiber. This variability has led to this same structure to be named a
fascia, ligament or muscle in different texts.
Contractures
and adhesions of the pleura are easy to come by. Hard coughing can break ribs.
Everyone has had colds and the flu.
Most of us have had blows to the chest. Pleural adhesions and contratures accumulate through life and
are so common as to be considered a ‘normal’ feature of aging. Pleural restrictions are easily visible
during surgery or dissection. We take
more than 20,000 breaths per day. If
there are pleural adhesions and contractures, these 20,000 aberrant breaths are
a fine opportunity for repetitive strain injuries. Since the lungs are suspended from the cervical vertebrae, this puts a tremendous strain on the
neck. The cervical paraspinal
musculature becomes tight in its attempt to resist this pull.
When
we feel scalenes which are not only tight but also pulled inferior this is a
sign of strong pleural restrictions.
Freeing the pleura often quickly relieves neck strain and improves head
position. The brachial plexus passes
adjacent to or through the middle scalene:
pleural pulls on the middle scalene routinely impinge on these nerves
supplying the arm and hand. The
vasculature supplying the arm and hand courses as a bundle with the brachial
nerves and are similarly compromised by
pleural restrictions transferred to the scalenes by the suspensory ligament of
the lung History of respiratory
illness is a documented risk factor for
carpel tunnel syndrome.
Folk
Healers have manipulated organs since antiquity. These folk traditions continue today throughout the world. In Europe folk healers who work with the
biomechanics of the body are known as Bone Setters. Andrew Taylor Still MD,
founder of Osteopathy, mentions manipulating organs in his writings,
however this remained a small part of Osteopathy until the last quarter of the 20th
century when French Osteopath
Jean-Pierre Barral learned that some of his patient’s biomechanical problems
were getting better because they were visiting bone setters in the French Alps,
who were manipulating their organs.
Barral studied the rather rough manipulations these Bone Setters were
using. He applied his Osteopathic
knowledge to the organ support system and over the years made large
developments in the art and science of Visceral Manipulation. He has published seven books on Visceral
Manipulation and teaches it worldwide. Visceral
Manipulation is the cutting edge of Osteopathy today.
Incorporating
Visceral Manipulation into structural integration provides the keys to fuller
and more efficient core / sleeve integration.
The manipulative strategies used for visceral manipulation were
originally developed by Osteopaths for use on fascia and ligaments. Now we can learn these efficient, low force
methods in Visceral Manipulation classes and then apply them to other
connective tissue as well. The assessment
methods taught with Visceral Manipulation allow us to quickly prioritize what
to do first, so the body can unfold easily and naturally. The end result is better integration for
our clients with less effort from us.
For a more detailed discussion of how Visceral Manipulation
enhancesstructural integration, see Massage and Bodywork magazine April/May
2001.
I
highly recommend the Visceral Manipulation training offered by the Upledger
Institute. www.Upledger.com 1-800-530-8875. Alternatively I offer Visceral training tailored specifically to
the background and needs of structural integrators.
Caution:
Do not attempt visceral manipulation without thorough training. Organ support membranes are delicate and
highly reactive tissues.
References
Barral, Jean-Pierre
& Mercier, Pierre; Visceral manipulation, 1988 Eastland Press
0-939616-06-8
Barral, Jean-Pierre; Visceral manipulation II, 1989 Eastland
Press 0-939616-09-2
Barral, Jean-Pierre; The Thorax, 1991 Eastland Press
0-939616-12-2
Burch, Jeffrey P, “Interdisciplinary Structural Integration:
finding the balance”; Massage & Bodywork April/May 2001 pp 22-31.
Feitis, Rosemay, & Schultx, Lewis, Remembering Ida Rolf,
1996 North Atlantic Books 1-55643-238-0
Gevitz, Norman; The D.O.’s,
osteopoathic medicine in a
America, 1982 John Hopkins University Press
0-8018-4321-9
Hood, Wharton; On bone-setting (so called) and its relation
to the treatment of joins crippled by injury, rheumatism, inflammation, &c.
&c. 1871 Macmillan.
Lederman, Eyal; Fundamentals of manual therapy physiology neurology
and psychology, 1997 Churchill Livingstone 0-443-05275-1-8
Patterson, M.M. & Howell, J.N. eds; The central
connection:somatovisceral and
viscerosomatic interaction 1989 international symposium, 1992
University Classics, Ltd. 0-914127-29-2
Still, Andrew; The Philosophy and mechanical principles of
osteopathy, 1902 Hudson-Kimberly
Copyright 2002 Jeffrey Burch
Originally published in ‘Structural
Integration / June 2002
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