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Friday, September 10, 2010

What is a Visceral Somatic Dysfunction?

Visceral Organ Dysfunctions (VMDs ) are internal organ problems that arise from problems that affect the mobility and motility of these organs. As the treating physician or therapist, VMDs are something to consider when you’ve done what you can for musculo-skeletal problem resolution, and strangely still find yourself unable to deliver results that you are routinely happy with. You may have one of those “this should be fixed by now” moments. So, the question arises: have you found the primary dysfunction? Also, is the primary truly a framework problem? Is it possibly instead an internal organ dysfunction that is causing the constellation of abnormalities you have had problems correcting?

Visceral Organs may be limited in their natural motility or in their mobility in relation to the other organs. This is particularly true for when strong adhesions and scar tissues are present. The inciting history would include focal or generalized inflammation. Often, the first cause was trauma or surgery.
 
Somatic Dysfunction Recurrences are often due to Visceral Organ Primary Dysfunctions. Keep in mind, however, that the most common reasons for unresolved or recurrent somatic dysfunctions include (1) mis-diagnoses and (2) incorrect treatment. A mis-diagnosis almost always ensures that you then choose the wrong treatment approach. That is why we should always endeavor to treat what we see, and not what we expect. On the other hand, using a hammer where a screwdriver was needed will often make things worse a lot faster.
 
Other areas to look at would include proper identification of the true Primary Somatic Dysfunction. The “Primary” is the one area that most affects the other areas. By example, a recurrent Shoulder Somatic Dysfunction with multiple supposed primary tendinopathies and Tendinitides can in fact be the result of an incomplete diagnosis. Often, a subacromial bursitis is the inciting primary. In this example, this is the prime pathology that caused the entire rotator cuff weakness via reflexive inhibition. Think of it as the body trying to guard this area by turning off aggravating movements. Without addressing this primary, the involved tendons are kept in an inflammatory cycle, and the muscles are weakened.
 
Basically, pain begets inflammation, begets the inflammatory cascade, begets muscle spasm, and feeds back upon itself as more pain. In this light, the first rule of osteopathy may be more clearly understood: “the rule of the artery is supreme.” If we can improve circulation and lymphatic clearance, we can cut off inflammation and break the pain cycle.
 
May we fit in the prime rule of Reflexive De-afferentation Technology? “Turn off Pain first.” Turn off pain. Turn off reflexive guarding and protective modes. Improve circulation. Remind the body of how it functions when it functions best. Then let the body do what it does best: adapt and heal.
Keep in mind that Viscero-somatic reflexes are also a reverberating circuit. We can do all we can for the shoulder, but if the Gallbladder was the “Primary,” all our work would go nowhere.
Visceral mobilization techniques include mobilization techniques and motility enhancement techniques. Mobilization can be direct or indirect. Indirect techniques for mobilization include reflexive releases and long-levered techniques.

Direct techniques involve local contact, or at least contact that is transmitted directly through tissues adjacent to the organs we want to move around. When we break adhesions or scars this way, organs move more freely in relation to the other organs and structures they articulate with.
Long-levered visceral mobilization techniques utilize organ extensions or connections as handholds for transmission of therapeutically corrective forces. By example, the lungs may be moved via articulating the trachea. The stomach may be moved via an esophageal handhold. The heart may be articulated via a carotid handhold. The brain may be similarly articulated via a traction hold on the carotid vessels.

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