By Jolynn Weiler
It was a misunderstanding that eventually led to a breakthrough for Jean-Pierre Barral, DO, RPT (both European degrees). Dr. Barral was using articular and structural manipulation to treat a patient with back pain in Genoble, France. Focusing on the area of discomfort, the physical therapist relied on spinal manipulation to encourage pain relief. After about two or three weeks of sessions had passed, the patient announced that he was felling decidedly better.
It seemed like a success for Dr. Barral, but further investigation revealed something of a twist. "I asked him if it was a specific treatment I did, and he said, 'Dr. Barral, it wasn't because of you. It was because of an old man I saw; he pushed something into my abdomen,'" reflected Dr. Barral during a recent interview with ADVANCE. "So I tried to figure out what kind of treatment he could have done."
More than 20 years and many books later, the physical therapist and doctor of osteopathy has got it all figured out. It's called Visceral Manipulation, a technique studied, developed and named by Dr. Barral himself, and taught across the world.
The Technique based on the notion that motion makes the body go 'round, visceral manipulation focuses on the breathe-in, breathe-out movement of the interior organs, such as the lungs, kidney, pancreas and spleen. When an adhesion or displacement occurs within the viscera due to injury or trauma, an irritation is caused within the system. The normal movement of the body is disrupted, and its organs are forced to move abnormally to accommodate the condition.
Eventually, disease and dysfunction rear their ugly heads, cropping up in destinations that can't really be predicted, explained Dr. Barral. "The symptoms of a visceral problem can be a backache, a joint problem…really, the effects can be felt everywhere," he said. A form of manual therapy, visceral manipulation relies on the hands to revive normal mobility of the interior organs through soft manual force. Through palpation, therapists identify abnormal tension around certain ligaments. "You put your hand on the body and let your hand manipulate until it finds the tension." Said Dr. Barral.
The Patients A patient-friendly procedure, visceral manipulation can be used on individuals ranging from the very young to the very old. "We adapt the manipulation accordingly and adjust the hand pressure with respect to the type of patient," Dr. Barral explained, adding that under no means should the procedure ever cause discomfort to the patient. Patients actually enjoy the treatment, appreciating the relief they feel as the therapist softly works out the tension from their systems, he explained. If a patient doesn't improve after three sessions, Dr. Barral considers it a good indication the individual needs to see another therapist.
Professional Reaction Twenty years have passed since Dr. Barral's book Visceral Manipulation first hit the shelves. Since then, the text has been translated into several languages, including Japanese, German, and Russian, and has been shadowed by the follow-up Visceral Manipulation II (Seattle: Eastland Press, 1989). Through the years, the clinician has both endured and enjoyed professional success, pointing out that he'd rather be treating patients than penning books. "I just finished my eighth book, and I hope it's the last one," he shared.
Overall reaction to visceral manipulation has been positive, to say the least. "They love it," Dr. Barral beamed of his professional peers. For example, in his native France, students must now pass a test in visceral manipulation in order to earn their osteopathy degrees.
On the lecture circuit since 1988, Dr. Barral has taught the technique to physical therapists and PT assistants across the world. When ADVANCE caught up with him several weeks ago during a brief stay in New Orleans where he taught a course, "Visceral Approach to Trauma and Whiplash," he was just coming off a two-week trip to Russia. The Frenchman shared his observations on the differing mindsets between Russian and American physical therapists. "American people are rather fast. They want to do something very quickly, they move a lot, and they learn one technique after another. Russians, on the other hand, are much closer to Europeans in that they take their time.
But both ways are good, of course.