This new series of articles will suggest a different perspective for you to view clients presenting with stubbornly chronic somatic dysfunctions. It will also propose a novel answer to the question, "How does the human body respond to stress?" Simply put, from the inside to the outside.

The place to start in this new perspective is with the movements that stress provokes within the anatomy of our visceral organs. All forms of external and internal stress stimulate visceral organs to respond via a combination of cringing, shortening, narrowing, and sometimes even twisting. Now add to this the concept that the visceral organs are a composition of sacs and tubes. The sacs surround our major organs including the brain and spinal cord, heart, lungs, and about half of the abdominal and pelvic organs are housed within the peritoneal sac. Tubes are the major components within our organs and they also connect them one to the other.

Repercussions for Stress

Stress provokes our sacs to cringe, while the tubes shorten, narrow, and sometimes even twist.¹ These combined multi-planar actions pull the body toward its center. This perspective further suggests that our organ systems are moored from our bones, suspended forward and downward from the cranium itself, and from the anterior surfaces of the cervical and lumbar spines.²

This is a different way to conceive how our anatomy is organized, and to perceive the interactions within our physiology, yet this is what my clients have taught me and what has helped me to assist them the most. With our visceral systems moored from our bones, being slung forward and down, it is quite easy to understand how visceral tensions would strain the interlocking nature of our axial spine producing dysfunctions of motion along its kinetic chain. Reflect on just how many of your clients come to you because of soft tissue pain along the spine whether in the cervical, thoracic, or lumbar regions.

Add to this the number of joint problems you work with on a daily basis. The viscera also discharge their tensions into segments of the spinal cord via viscero-somatic reflex arcs. These neurological reflex arcs also contribute to joint related dysfunctions of the upper and lower extremities. In response to whatever joint misalignment occurs, the soft tissues contract or even spasm to protect the related joints.

Follow the Hierarchy

This provides us with a hierarchy to follow within our therapeutic perception especially when dealing with chronic somatic dysfunction and pain. Chronic symptom profiles consistently include the tensions of organs conveyed by their suspensory ligaments to the bones from which they are moored; those that are affected by the discharge of visceral tensions, and then finally to the soft tissue structures whose primary job it is to protect the joints.

Conceiving of an inside-to-the-outside approach provides you with a broader and more functional palette for creating treatment strategies. Summarizing to this point, stress first affects our viscera with their suspensory ligaments, then our joints, then the myofascial structures dedicated to maintaining the integrity of the affected joints.

You may ask why are the viscera more primary? They begin their functioning first during our complex human development. In utero and as infants our human anatomy and physiology is ingesting, digesting, and excreting long before our musculoskeletal system is capable of producing voluntary movements. Lansing Barrett Gresham conceptualized this as an inverted triangle of human learning during our developmental movement sequencing.

Whatever develops first is more primary than what follows. It is a simple thematic whose time has come to be threaded into our perception of how the human body really works.³

Effective treatment of chronic difficulties has consistently evidenced that keeping this functional sequence clear in one's perceptual field produces better results for clients.

Compression, Congestion & the Dis-Coordination of the Nervous System

A second idea that has clearly evidenced itself for more than nearly 40 years of clinical practice is the triad of compression, congestion, and the dis-coordination of the nervous system. Soft tissues contract or spasm around joints that are displaced by the pull of the suspensory visceral ligaments. Such shortening of the soft tissues inevitably produces localized, regional and systemic states of congestion within the fluids of our bodies.⁴

Together, progressive states of compression and congestion confuse the nervous system about where and how often to deliver fresh blood. Along with this notion, a simple awareness has emerged; until old blood moves out, the delivery of new blood is slowed to find its way to the tissues and cells that need it the most.

This is exactly what happens when soft tissues go into protective spasm around a misaligned joint. The spasm itself participates in starving the joint surfaces, as well as themselves, adding to the progression of less range of motion and more pain due to the accreting ischemia.

The Viscero-Somatic Referral Region

There are additional perspectives and conditions to be considered. For now, simply allow yourself to reflect on what was just described through the all-too-common scenario of clients presenting with chronic right shoulder/upper back problems. The right shoulder and right upper back is generally accepted by the medical profession as a viscero-somatic referral region where the liver / gall bladder complex often discharges its tensions.

Add to your understanding that the heart and diaphragm embryologically originate in the neck at the level of C2 and descend caudally, coming to rest parallel to the anterior fifth rib. Include that the liver is suspended from the underneath side of the diaphragm by the coronary ligament.

The phrenic nerve is the sole motor nerve of the diaphragm yet, according to Dr. Jean Pierre Barral, the developer of Visceral Manipulation, the sensory side of the phrenic nerve receives input from the capsule of the liver, the gall bladder and the pancreas which are transmitted back to its origins at C3-4-5. This overlaps the brachial plexus' origins in the spinal cord from C4 - T2. It is from the brachial plexus that blood and nerve supply is distributed to the shoulder, arm and hand.⁵

Most of us have learned the crucial function of restoring the flow between the brachial plexus to the shoulder and upper back. Yet the notions of how and why visceral distress can feed into chronic musculoskeletal disorders has been overlooked. They now need to be included within the palette of our treatment strategies. All chronic symptom profiles have multiple tributaries. Many of them originate from within our visceral organs. Stress affects our visceral organs first. The body is an integrated whole.

The last article series on the common bile duct conveyed how central the liver, gall bladder and pancreas complex were to our evolutionary success and are on a day-to-day basis to our clients' quality of life. I continue to extend the invitation to become part of your clients' early detection team.

References

1. Alexander D. The "Sacs and Tubes Theory of Stress." Massage Today, January 2014.
2. Alexander D. The Body's Core Line and Central Linkage, Massage Today, May, 2014.
3. Gresham LB. The Body's Map of Consciousness. Integrated Awareness, 2018.
4. Gander K. What Is the Interstitium? Scientists 'Discover New Organ'. Newsweek, 27 March 2017.
5. Jean Pierre Barral DO, developer of Visceral Manipulation. Techniques described were learned from Dr. Jean Pierre Barral DO. The Barral Institute, 1986-1993.