An Overview of Selected Manual Medicine Methods

Cranial-Sacral Therapy (CST)
The cranial-sacral system addresses bones and membranes that surround the central nervous system. Restrictions here can strain neural tissues and affect coorespondingly innervated somatic areas, organs, or tissues. CST uses light manual techniques aimed at inducing relaxation responses that decrease, unwind, or remove neural tissue strain. CST, while particularly effective for treatment-resistant headaches, also have positive bearing on varied cases of unresolved chronic muscle and joint pain. Case studies show usefulness in helping resolve some digestive and neuro-endocrine disorders. Learning curves, attention spans, and memory retention are often reported improved.

Movement Therapies and Postural Re-alignment
Postural habituation and any form of trauma or sudden mal-positioning are the most common causes of tissue structure / function imbalance. Compensations include often inappropriate tissue lengthening and shortening. Somatic dysfunctions over time build up and bear heavily on joints and their surrounding / supporting structures. Muscle length / strength imbalance identification allows for both prevention and proper resolution of Neuro-myofascial syndromes. Postural and Movement Rehabilitation addresses these imbalances.

Lymphatic Drainage Therapy (LDT)
Trauma, physical deconditioning, lack of exercise, myofascial restrictions, and local tissue / area inflammation can cause lymph stagnation. Buildup of cellular debris and inflammatory mediators reinforce the nociceptive cycle and somatic dysfunctions. LDT can improves circulation and helps resolve edema. Joint and soft tissue swelling can be significantly reduced. Chronic pain syndromes can be improved or partially resolved.

Neuromuscular Techniques (NMT) / Neuro-myofascial techniques (NMF-T)
Fascial restriction and muscle hypertonus are highly responsive to various NMF techniques. Major techniques include Myofascial Releases, Muscle Energy Techniques (MET), Positional Release Technique (PRT), and Trigger Point-Proprioceptive Therapy.
Reflexive De-afferentation Techniques (RDTs) have evolved from Neuro-myofascial techniques. Pain cycles easily broken with NMF techniques include headaches, nape and shoulder pain, TMJ pain, knee and foot pain. Mechanical and repetitive strain injuries that may be addressed with NMF-T include mechanical low back pain syndromes, thoracic outlet syndromes, “frozen shoulder,” carpal tunnel syndrome, lateral epicondylitis, and plantar fasciitis.

Articulatory techniques (ART)
Soft tissue injury and cumulative joint trauma result in joint ROM restrictions and / or pain. These techniques involve taking joints through their restrictive and compliant motion cycles. They improve joint range or motion and help ablate joint pain cycles.

Visceral Manipulation (VM, Ventral OMT techniques)
Trauma, lack of exercise, physical deconditioning, cumulative soft tissue injury, inflammation, surgery, or obesity can displace, restrict, tighten, or scar ligament and fascia that surround, support, or suspend organs. Fascial and ligamentous injury can result in focal strains that cause tissue or organ dysfunction and injury. Pain and inflammation cycles are facilitated. VM uses soft vectoral techniques aimed at re-engaging normal suspension or movement of internal tissues / organs.
The notion of tissue restrictions or compliance to movement extends to the viscera. Organs, fascia, mesentery, and visceral ligaments move along and in relation to each other in much the same way that we know normal fascia-muscle compartments do. This notion of mobility in relation to each other is differentiated from intrinsic organ motility. Organs are mobile in relation to each other and often possess an internal movement or motility. As all fascia moves with breathing, the lungs move as we breathe, the stomach and intestines move in relation to each other during peristalsis, the urinary bladder shifts location somewhat when we piss. Viscera also move around a bit with ambulation. Visceral mobility restrictions are thought to restrict normal fluid, solid, and impulse conduction through individual organs. VM addresses these restrictions.
Musculoskeletal conditions linked to visceral involvement include:
1. Mid to low back pain: The colon’s attachment to the back of the abdominal compartment may be strained. This can lend ligamentous tightness or displacement which, in turn, can inhibit normal spinal movement. These spinal segmental dysfunctions result in their related pain constellations.
2. Neck stiffness and pain: The suspensory ligaments of the lung and the pericardium all attach to cervical vertebrae. Ligamentous involvement here can cause cervical joint compression and flexion cervical somatic dysfunction. A forward head posture may thus actually be more closely related to a lung problem than to a thoracic spine dysfunction.
3. Shoulder restrictions and pain: Most paramedical personnel are familiar with the fact that gallbladder inflammation can result in pain that radiates to the right shoulder. Nerves that supply the suspensory ligaments of the liver stem from the spinal segment that innervates the shoulder. Liver suspensory ligament involvement may thus result in shoulder somatic dysfunctions.
4. Peripheral joint pain: Visceral compartment restrictions can transmit tension via adjacent myofascial trains into the limbs. These tension lines can cause compressive and torsional joint irritation and dysfunction.
5. Comparative Studies have found Visceral Manipulation also Beneficial for:
Somatic-Visceral Interactions
Chronic Spinal Dysfunction
Headaches and Migraine headaches
Carpal Tunnel Syndrome
Hip and Knee Pain
Sciatica
Whiplash
Seatbelt Injuries
Chest or Abdominal Sports Injuries
Visceral Manipulation has been known to improve:
1. Fatigue: Abnormal fascial tension or scarring from at the visceral suspension system may result from inflammation, surgery, and blunt or countercoup trauma. Loss of organ mobility due to restrictions of surrounding and supporting tissues have been linked to general fatigue. By example, lessened fatigue has been reported by whiplash-injured VA patients. Faster recovery rates and lower incidences of depressive symptoms have likewise been reported.
2. GI motility disorders: Ileus, constipation, and irritable bowel syndrome: Abnormal fascial tension or scarring from at the small and large intestinal suspension system may result from inflammation, surgery, or blunt trauma. This causes restrictions that negatively alter bowel motility and function.
3. Hemorrhoids: The venous drainage from the rectum toward the liver is impeded when the hepatoduodenal ligament is abnormally tight. The resultant vascular congestion can cause or aggravate hemorrhoids.
4. Incontinence: Ligamentous tightness and muscle hypertonus may limit proper urinary bladder expansion and emptying.
5. Comparative Studies have found Visceral Manipulation Beneficial for:
Digestive Disorders
Bloating and Constipation
Nausea and Acid Reflux
GERD
Swallowing Dysfunctions

Women’s and Men’s Health Issues
Chronic Pelvic Pain
Endometriosis
Fibroids and Cysts
Dysmenorrhea
Bladder Incontinence
Prostate Dysfunction
Referred Testicular Pain
Effects of Menopause Pain Related to
Post-operative Scar Tissue
Post-infection Scar Tissue
Autonomic Mechanisms


Pediatric Issues
Constipation and Gastritis
Persistent Vomiting
Vesicoureteral Reflux
Infant Colic

Emotional Issues
Anxiety and Depression
Post-Traumatic Stress Disorder
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