Visceral osteopathy

The abdomen is much more than just the organs it contains. This region comprises the abdominal wall, the viscera, the diaphragm, the fascia, the muscles and various nervous and vascular structures. All of these are anatomically connected to the ribs, the spine and the pelvis.

Visceral osteopathy is a manual approach that I use to explore and work on the tissues in this region, paying attention to their mobility, tension and response to touch.

Fascia plays a particularly important role in my approach to treatment. It is a connective tissue that envelops and connects different structures within the body. Its anatomical continuities form part of the integrative perspective through which I approach the body.

Palpation allows me to explore these areas and adapt my techniques to what I find.

You may recognise yourself in one of these situations:

• Abdomen and back. You notice abdominal tension and, at times, you also experience stiffness in your lower back or upper back.
• Ribs and breathing. Do you feel stiffness beneath your ribs, find it difficult to take deep breaths, or notice that your torso doesn’t move much?
• Digestion, tension and rest. There are times when digestive discomfort, stress, sleep and physical tension all seem to change at the same time.

These are situations that are worth listening to and considering.

During the examination, we observe which movements are restricted, how the abdominal wall responds to touch and what is happening in the surrounding areas.

We also take into account your medical history and any previous diagnoses or medical assessments.

The diaphragm separates the chest from the abdomen and is constantly involved in breathing.

When we breathe in, the diaphragm contracts, the ribs move and the pressures within the torso change. The abdominal wall, the spine and the pelvis are all involved in this process.

That’s why I pay particular attention to how you breathe.

I observe the movement of the ribcage, examine the diaphragmatic region and assess any tension found in the surrounding tissues.

Anatomical connections and myofascial continuities allow me to integrate these regions within a single examination.

Based on this, we decide whether it is best to work on the diaphragm, the abdominal wall, the ribs, the spine or a combination of these areas.

The digestive system and the nervous system maintain constant two-way communication.

Through what is known as the gut-brain axis, digestive signals play a part in processes relating to sensitivity, bowel movements and the perception of what is happening inside the body.

This helps to explain why some people experience changes in their digestion during periods of stress, insufficient rest or increased physical tension.

There is also an important concept: interoception, our ability to perceive internal signals such as hunger, satiety, breathing or abdominal sensations.

During the consultation, I’d like to find out how you perceive these signals and whether you’ve noticed any connection with your symptoms.

Your body awareness provides information that complements what we find during the examination.

See stress, rest and bodily tension →

There is a phenomenon known as visceral referred pain.

Some pain signals originating from internal structures may be felt in areas other than their point of origin.

This is linked, amongst other mechanisms, to the way in which the nervous system receives and integrates information from the viscera and other bodily structures.

This is why certain internal discomforts can also be felt in the back or other areas.

This is a well-known neurophysiological relationship, although pinpointing pain in a specific area does not automatically mean it can be attributed to a particular organ.

During the consultation, we take these possibilities into account alongside the patient’s other symptoms, medical history and physical examination.

Understanding visceral referred pain →

Let’s start by looking at what’s going on with you.

I want to find out how you’re feeling, how long you’ve been feeling this way, what triggers your discomfort and how it affects your daily life.

We then carry out an assessment. Depending on your specific case, we may examine your abdomen, diaphragm, ribs, breathing, upper back and lumbar spine, pelvis and their myofascial connections.

Palpation is essential during this process.

My approach is primarily subtle and manual. I use gentle visceral techniques which I can combine with fascial, structural, diaphragmatic or sacrocranial work, depending on what we find.

There is no set sequence nor any specific area that we are obliged to treat.

Throughout the session, we continue to observe how your body responds.

My hands allow me to explore the tissues and any changes in them. You provide your own perception of what you’re feeling: whether you feel more comfortable, whether your breathing changes, whether any tension remains, or whether any technique feels uncomfortable.

Sharing this information helps us to tailor the treatment.

The aim depends on what has brought you to the practice.

Perhaps you’ve come in because of upper back pain that coincides with abdominal tension. Or because you’re experiencing persistent stiffness beneath your ribs that limits your comfort when moving and breathing.

During or after the session, you may notice changes in tension, mobility or comfort in the areas we have worked on.

You may also find that some changes become more noticeable over the following days, when you resume walking, resting, working or carrying out your usual activities.

I’d like to know how you’ve responded to treatment, what has changed and what symptoms remain. This information helps us assess your progress and decide how to proceed.

Visceral manual therapy forms part of my osteopathic approach. Its specific effectiveness in treating digestive disorders or resolving musculoskeletal pain has not been consistently demonstrated; therefore, digestive complaints requiring medical attention should be assessed and treated accordingly.

The aim is to understand how the symptoms you are experiencing are linked, to assess the structures involved and to work manually on the areas we have decided to treat.

We aim to restore comfort and mobility when these are restricted, reduce feelings of tension and gain a better understanding of how your body responds.

We always start with an individual assessment, paying attention to what we find through palpation and to what you yourself are noticing.

Your abdomen is also part of your body’s story. It deserves to be listened to.