The Mechanical Influence of the Viscera
One of the main challenges that comes with medical specialization is the tendency for healthcare providers to become hyper-focused on their speciality rather than looking at the patient as a whole. This can lead to diagnostic blind spots, which often hold important clues about one’s overall health.
Physical therapists are traditionally taught to look only at the musculoskeletal system. If symptoms do not appear to be movement-related, then the therapist should refer the patient to a medical doctor for further workup. However symptoms, especially chronic symptoms, are rarely this cut-and-dry.
Let’s take the liver, for example. It’s a huge, dense organ that sits just beneath the right lower ribcage. In an overburdened liver, restrictions or internal resistance can develop within or around it’s tissues. Because the liver is so huge, it can have a massive impact on the mobility of the ribcage. The ribcage will then dictate the posture of the shoulder blades, neck, and even pelvis. This means that if a patient presents with shoulder pain, it’s very possible that the breadcrumb trail of mechanical and postural shifts leads back to the liver.
The stomach is another organ that can have powerful mechanical influences on the body. Any inflammation of the stomach or lower esophagus tends to create a downward force that can pull the neck into a forward posture. Over time, this prolonged neck posture can lead to degenerative joint disease, cervical stenosis, cervical radiculopathy, and more. This means that individuals with acid reflux, stomach ulcers, or weak stomach acid are likely also experiencing some amount of compression of the cervical spine.
This approach is invaluable for individuals experiencing chronic pain or illness because it bridges the gap between the mechanical body and the physiological body. Liver enzyme tests may not always reveal the full picture of liver health, whereas the tissues of the body never lie. Restrictions within tissues always indicate some level of inflammation, whether that’s mechanical damage, inflammation from toxins, or inflammation from viruses or bacteria.
Sometimes the mechanical presentation is the only symptom that indicates something is wrong. I find this often with inflammation of the nervous system. One patient I worked with in the past came to me with relentless right shoulder pain. We started with the typical PT approach, addressing scapular posture, movement re-education, strengthening and mobility. His pain would improve temporarily, but always return over the next couple days. I found consistent restrictions in his right brachial plexus, the bundle of nerves that branch off the side of the neck. But direct neural mobilization only helped short term. We began discussing his health history in more detal, and he revealed a history of shingles. With some dietary changes, introduction of the Heavy Metal Detox smoothie, and addition of some immune boosting supplements, this patient was able to overcome a long history of shoulder pain that was never truly mechanical.
Staying healthy is becoming harder and harder these days, as our world becomes more toxic and polluted. Treating chronic health issues is ever more complex, and requires a multi-faceted approach that is sorely missing in the traditional medical model. Physical therapists trained in visceral mobilization have a unique ability to provide insight into the physiological health of the body that isn’t always captured by modern medial testing. Deciphering pain is rarely straightforward, but the right assessment can provide a vast amount of information that links together the musculoskeletal system, the visceral system and the neurological system in ways that modern healthcare often fails.
