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Types Of Bodywork/Modalities

Visceral Manipulation and Chi Nei Tsang

Visceral Manipulation and Chi Nei Tsang are two other very useful modalities, especially when done energetically. Visceral Manipulation was developed by French Osteopath Jean Pierre Barral. Personally, I view it as a Westernized form of Chi Nei Tsang, which is essentially Tibetan visceral organ massage.

Because of the interrelationships of the visceral organs and their various ligamentous attachments to the diaphragm and abdominal walls, restrictions and/or adhesions involving the visceral organs can translate into some surprising dysfunctions totally removed from the abdomen. As just one example, restrictions in the cecum area of the ascending colon can put pressure on nerves passing through the pelvis, which can result in unexplained pain in the right knee. Other restrictions can cause problems in different vertebral segments because of attachments to the posterior abdominal wall along the spine. There are techniques in VM that are useful for treating hietal hernias, acid reflux, uterine and bladder prolapse, and the release of deep abdominal adhesions post-surgery.

Conversely some of the mechanical, manual release techniques are far too aggressive for anyone with tissue fragility. For someone with “basic” hypermobility, not involving tissue fragility, I would consider the techniques safe to perform, even at level 1 training. For someone with VEDS, however, I consider ALL of the mechanical, manual, organ mobilization techniques to be ABSOLUTELY CONTRAINDICATED, regardless of the level of training. My reason is very simple – they involve a physical, manual stretching of the organ or structure. And since many of the organs are deep within the abdominal cavity, this also means fairly deep and sometimes somewhat invasive palpation. I consider the potential risk of tissue or organ trauma to be excessive, with no possible benefit that outweighs that potential risk.

I do not consider the WORK to be contraindicated, far from it. I think it has definite potential, even for someone with VEDS. It is just some of the techniques that I feel are contraindicated. Personally, I would have no qualms at all about doing any of the work myself on someone with VEDS, even with only level 1 training, because I would do all of it energetically. The “touch” would either be extremely light, with no deep pressure or physical movement at all, or it would be done totally off-body.

The issue is finding a practitioner who can, and will, do it energetically. There were 30 students in the class I attended, plus four teaching assistants, and one teacher. Backgrounds included three chiros, several LMT’s, PT’s, OT’s, a Rolfer, and a self-proclaimed “certified torturer.” Each of these people will tend to approach the work based on their training and mind-set. The more physical or aggressive their background, the more physical and aggressive their working approach is apt to be.

Two key components of VM involve organ mobility and motility. Mobility is movement of the organ via external force, such as gravity, fascial pulls, manual pressure, etc. Motility is the inherent rhythms and cycles within the organ itself. These run at a rate of about 7-8 cycles per minute and involve clockwise and counterclockwise oscillations, lateral and medial rolls versus mid-line of the body, superior/inferior glides (head to foot), or anterior/posterior rolls (front to back), depending on the specific organ.

Motility work is far more gentle than mobility work, but the degree of invasiveness still depends on depth of the organ and how aggressively the practitioner palpates to reach the organ. Because of this, I would still rule out BOTH mobility and motility work for someone with VEDS, UNLESS it is done energetically. Superficial motility work shouldn’t be a problem, whereas deep mobilization work definitely presents excessive risk. Even so, I still feel the safest approach where VEDS is concerned is for an absolute contraindication for all of the mechanical, manual releases, regardless of tissue depth, and whether it is VM or Chi Nei Tsang.

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