What's about visceral osteopathy?

[Nabor Costa]

Reading all this site, a lot of my knowledges have been demolished, and now i'm doubting about all, i need upgrading. All you have latest reseach about mecanisms of action of the body.

What about Visceral osteopathy?, I work more with Kuchera concept, and I thing that when visceral actuation is indicated result are very satisfactory. Do you know what this is cooking in this area?

[kongen]

Hi Nabor!

I recommend this book:
The Science & Practice of Manual Therapy: Physiology Neurology and Psychology
by Eyal Lederman

I've almost finished reading it, and he touches briefly on somatovisceral reflexes, and visceral therapy. In short he attributes the possible effects to stimulation of the limbic system (via tactile afferents and proprioceptors).

The concept of controlling/influencing the motor system (reprogramming movement patterns etc.) from the periphery, via stimulation of proprioceptors (spinal manipulation etc.) also gets a serious beating from mr. Lederman :)

Anders.

[Diane]

I've almost finished reading it, and he touches briefly on somatovisceral reflexes, and visceral therapy. In short he attributes the possible effects to stimulation of the limbic system (via tactile afferents and proprioceptors).

The concept of controlling/influencing the motor system (reprogramming movement patterns etc.) from the periphery, via stimulation of proprioceptors (spinal manipulation etc.) also gets a serious beating from mr. Lederman
I'm just reading the book, and concur with Ander's post. It's my take of the book too. Lederman is doing some very nice wielding of Occam's Chainsaw. :)

[Luke Rickards]

Hi Nabor,

I know the feeling. Don't worry, the doubt won't destroy you, and you will still be able to practice osteopathy when you come out the other end. I'd also recommend Lederman's book (in case you weren't aware, he is an osteopath).

I'd be interested to know what Kuchera's take of visceral osteopathy is. For those who aren't familiar, visceral treatment in osteopathy exists in a number of different versions.

Here is Nic Lucas (http://www.somasimple.com/forums/showthread.php?t=3063) a few years ago over at NOI.

1. Standard OMT in which it is considered that treatment of spinal somatic dysfunction will improve visceral function.

2. Treatment of viscera directly; from the basic colon massage to relieve constipation to stretching of the fascia between the bladder and the pubic symphsis in cases of 'unsolved' bladder frequency to stretching of 'adhesions', to the splenic and liver pumps which are thought to improve immune function and metabolism.

3. Visceral osteopathy which includes a concept of visceral motility (that each viscera has it's own optimum inherent motility about an axis or axes, which if altered can lead to visceral dysfunction). Treatment is very gentle and is similar to cranial therapy.

4. Cranial therapy, which is supposed to improve general well being and allow the body to heal whatever the problem is. Or, directly treating presumed cranial articular problems that are conceived of as interfering with vagus nerve function.

Most of these theories are seriously tenuous.

Manual therapy might be of help in some cases. Other than the direct effects that are possible with interventions such as colon massage, visceral treatment may also have some neuro-reflexive effects as suggested by Lederman, and various non-specific effects that often result from hands on care.

I wouldn't trust it for visceral pathology though. No way!

[Nabor Costa]

Hi all.

If you allow me, i'll present (more or less) the principles of visceral osteopathy for if anyone doesn't know them. I know 3 different concepts: the most famous and extended (at least in Europe) in Barral's method, the second method that I know (and I use this one) is Kuchera's method, and finally the method of Finet & Williane.

Barral's method is based on a more traditional concept of osteopathy, where you look for the lack of movement in the viscera. Barral says that the visceras have 3 types of movements: motor movement (it is the displacement that the viscera makes up and down inside the abdomen by the action of diaphragm) mobility (it is the movement that makes the viscera sliding againts each others during the respiration) and motility that is a movement characteristic of the viscera.

In this metod osteopath must find the restriction of movement in visceras and correct it.

Method Kuchera is based on find and correct arterial blood flow, venous and lymphatic, and to normalize the sympathetic and parasympathetic activity that arrives to the viscera.

Method Finet & Williane is based on fascial correction , testing sliding and displacement of tissues and correct them when they are reduced.

There are some other methods based in neurologic reflexes, but I don't know them.

After to expose (very basically) three different visions of visceral osteopathy here comes my first question: Is possible to act on the sympathetic ganglia with a mechanical stimulation? I'm not talking about a neurodinamic actuation, I'm talking about to push on the stellate ganglion for example...

What do you think about this???

[Diane]

Hi Nabor,
The commonality in these three approaches is that they assume the operator or therapist can do something, manually, to change the patient's physiology or structure. This seems at best, rather presumptuous, as the patient's own self-regulatory mechanisms are left out of the picture.

Instead, approaches which not only consider fully but which also place on center stage, the complete control the patient's own nervous system has over that which it will accept as exteroceptive input and that which it will read and reject, or else read and deal with as threat, is preferable in my mind - less confusing, less likely to generate perceptual fantasy.

[kongen]

Nabor,

Lederman attributes the effects of "visceral manipulation" to stimulation of the limbic system (via different afferents), which activates the bodys re-regulation mechanism (the motor system, autonomics and neuroendocrine system). The INTENT of the touch of the therapist and the patients brain INTERPRETATION of this touch decides if you succeed in stimulating the limbic system in a favourable direction. The interpretation of touch depends on previous and early life tactile stimulation and it's context (i.e. soothing or threathening).

Someone please correct me if I'm off base. Back to reading. More later.

[kongen]

Just wanted to add, that when stimulating the limbic system, you will get WHOLE BODY effects. It is not possible to stimulate specific organs or systems. The brain decides.

[Diane]

I second Anders' interpretation, yet again.

[Baecker]

Could you please explain what is ment by the INTENT of the therapist?

[Luke Rickards]

Nabor,

I agree with Diane.

We need to break down each hypothesis here into its various components and ask, "Based on what we currently understand, is this possible?" Some components may be possible, and others will be unlikely.

1. "Motor"(?) movement resulting from diaphragmatic excursion:I don't think anyone here would argue that teaching diaphragmatic breathing, if it isn't already present, is a useful intervention, and for many more reasons than addressing "visceral dysfunction".

2. Visceral mobility:There is no doubt that organs move around during body movement. This will be determined by the fascial compartments surrounding and binding them.
However, is it possible to reliably detect aberrant mobility? This seems unlikely based on our ability to detect dysfunctional movements in the spine, for example.
How can we determine whether such a finding is clinically relevant to the presentation? There is simply no reliable way to do this at the moment.
Considering that the only way to intervene would be to alter the fascial compartment, and that the forces necessary to do this cannot be generated by manual effort, is it possible that we can affect visceral mobility directly? Probably not.

3. Visceral motility:In visceral osteopathy this describes not only contraction of the hollow organs, as used in biomedical science, but also inherent axial motions of the solid organs. The latter idea is, well, a bit whacky (an osteopath once told me he was going to improve the proprioception of a patient's lungs!), so let's go straight on to the usual meaning.
Motility in the hollowing organs is controlled by the ANS, which leads us on to Kuchera and direct stimulation of the sympathetic ganglia.

It is highly plausible that manual therapy can affect the ANS, although such an effect would more likely be a general reflexive response rather than a specific change affecting a particular dysfunctional organ. Unless, of course, one is proposing a segmental somatovisceral dysfunction, however, these theories still have problems.
Can rubbing a sympathetic ganglion directly effect the function of the ANS in the required direction? I don't know.
Also, I remember techniques at uni that were supposed to directly stimulate the coeliac and hypogastric plexii, for example. There's a lot of stuff between the skin and these structures so this idea also seems dubious to me.

[Baecker]

Luke since you are a trained osteopath I like to know did you ever work in the visceral area or did you say there is no evidence to it and didn't try it out?

[Luke Rickards]

Baecker,

99% of the patients I see are complaining of NMS pain of some kind. The truth is, I've only once* come to a reasoned diagnostic conclusion that the origin of such a pain presentation was from an organ.

*(The patient had a hysterectomy after a 4 year battle with fibroids and her chronic LBP disappeared).

[Diane]

Baeker, do you have the Lederman book? If not, I can find that section (on intent) and quote it here.

[Baecker]

No I don't own the book yet...its on my list though it just got translated recently into german....

I must say i tried some visceral stuff and sometimes it worked for LBP but I hardly did it on a visceral pathology rather more for LBP. But I am pretty sure I am affecting some nerves there which are in this area. I don't buy into motility either.

One test I found useful described by Barral many times. E.g. LBP and the SLR is positive now if i press e.g at the caecum area and the leg goes higher with less pain then I am going to treat this area and often, not always the SLR improves.

I keep my mind open in this area, and I hear to many anecdotes from my teachers about its effectiveness to not treat this area. I just don't accept the motility/rythm stuff.

[Diane]

Baeker, if you pull in your focal length a little you'll realize that if you press a person's body anywhere, including the "caecum area", you'll be denting their body wall too, and all the nerves weaving through it, and at even shorter focal length, you'll be denting skin, and all the nerves weaving through it. In fact, I bet if you just dent the skin and leave your hand there, sooner or later, the SLR will change all by itself, like magic... without ever going anywhere near the caecum. ;)

[Luke Rickards]

I bet if you just dent the skin and leave your hand there, sooner or later, the SLR will change all by itself, like magic... without ever going anywhere near the caecum.Diane,

In fact, I do exactly this all the time for LBP. One hand over the iliocecal region, the other cupping opposite over the lumbosacral region. Countless times I've seen an SLR go from 45' to 90' in 1-3 mins.

I'm sure it has nothing to do with the cecum.

[Diane]

I'm sure it has nothing to do with the cecum.
I'm sure you're right.
I'm sure that any consideration of caecum is spurious.

[Baecker]

Hey, I didn't say I deny this.... Thats why I said caecum area! I am with you guys lol

[Baecker]

Just a question though. as an osteopath you must know this Luke, that the ileocaecal valve is often palpated and it feels like a little hard size of a plum. its often painful specially people with bowel problems but also LBP. do you think if we put our hands just over the skin area its different than if we palpate it directly?

[Nabor Costa]

1. "Motor"(?) movement resulting from diaphragmatic excursion:I don't think anyone here would argue that teaching diaphragmatic breathing, if it isn't already present, is a useful intervention, and for many more reasons than addressing "visceral dysfunction"

I think that diaphragmatic movement is important for a good visceral funtion, I think that aid in the drainage of visceral blood vein, favoring the trophism of tissues. Furthermore it is assumed (please correct me if it is nit well) that the movement of the diaphragm acts on the good innervation via the vagus nerve. Besides, if there is a adherence between two surfaces that can limit the slippage between viscera during respiration we suppose it can generate a hotbed of tension that produces afferents on metameric levels for reaching cause pain..... what do you think?

Considering that the only way to intervene would be to alter the fascial compartment, and that the forces necessary to do this cannot be generated by manual effort, is it possible that we can affect visceral mobility directly? Probably not.

maybe we cannot affect visceral mobility directly, but I think that we can act just on viscera. For example, I've made treatments to pacients with lumbar pain after a colonoscopy, and acting on colon with massage or pompages back pain feels better. I supose I'm acting on autonomic system so Kongen have said. The important thing for me is to know that the technique works if it is properly prescribed use. I know that some techniques is very dificult that work, for example acting on the kidney, but i think the important thing of all this is taken into account the information that we are applying to the nervous system and to know to what extent can reach homeostasis and regulate information visceral nociceptive.

Motility in the hollowing organs is controlled by the ANS, which leads us on to Kuchera and direct stimulation of the sympathetic ganglia.

Excuse me, what is ANS??:embarasse and LBP, SLR ???

Thanks all.

[Nabor Costa]

Just a question though. as an osteopath you must know this Luke, that the ileocaecal valve is often palpated and it feels like a little hard size of a plum. its often painful specially people with bowel problems but also LBP. do you think if we put our hands just over the skin area its different than if we palpate it directly?

Baecker, I treat the ileocaecal valve like a trigger point (I know that it is not same) but working with pacient tolerance of pain you put your finger over this point, push it and i put a flexion of the right hip until the point is reduced under my finger, wait a bite and normally it inhibits. After I make a pumping in the area for to soften the tissues.

[BB]

ANS: Autonomic Nervous System

LBP: Low Back Pain

SLR: Straight Leg Raise

[Diane]

Hi Nabor,
If you consider the arrangement of peripheral nerves in the trunk, you'll remember that they come round and through the body wall segmentally all the way to anterior midline. Here's a thread about their entrapment (http://www.somasimple.com/forums/showthread.php?t=2770).

It stands to reason that treating these nerves in the body wall could help downregulate pain felt/perceived/projected anywhere along their length, all the way around to the back.

Seriously, one can treat body wall from a nervous system perspective, never need to contemplate "mobilizing organs" at all. ;)

[Nabor Costa]

Hi Diane.

I'm begining to study neural physiology (again after a few years :D:D), in a few weeks I can understand your vision of the functioning of the body (give me some time to recycle myself ;)).

Thanks BB, I've scored this new abbreviations.

[kongen]

Back at school, psoas major triggerpoints/shortness was all the rage, and psoas the root of all evil :) Releasing "triggerpoints" of the psoas is likely just affecting the abd.cut.nerves!? At least you can not get away from that possibility.. Which in my mind is more likely.

[Diane]

Anders, I concur. :thumbs_up

To seriously, scientifically, think that one was treating "psoas" one would have had to remove the confounding factor of skin and body wall and all the circuitry they contain, first.

This is, of course, impossible to do.

Therefore, the next best move, conceptually, is to consider them, instead of that which lies inside, beneath them.

[Nabor Costa]

Kongen, I think that we are talking about different things. Psoas trigger point is a very diferent sensation than Ileocaecal valve. When ileocaecal valve is spasm you can touch it ,like Baecker said "a little hard size of a plumb".

Diane, but if you put a flexion in the hip and relax the abdominal wall, then you can arrived in depth, the fingertip may work in the union between the psoas major and the iliac muscle, this may be enough to relax them. Of course along the way you are acting on all receivers of the abdominal wall, but i think we also can be done on the receivers of the psoas if the pressure is sufficient.

[Diane]

Diane, but if you put a flexion in the hip and relax the abdominal wall, then you can arrived in depth, the fingertip may work in the union between the psoas major and the iliac muscle, this may be enough to relax them. Of course along the way you are acting on all receivers of the abdominal wall, but i think we also can be done on the receivers of the psoas if the pressure is sufficient.

Maybe you can, but why would you want to? Bother going that deep at all I mean?

[kongen]

Nabor,

I agree. I was responding to Dianes post about entrapment of the abd.cut.nerves, and how that might be mistaken for psoas major triggerpoints.

I have no experience with palpating the ileocaecal valve and it's potential clinical implications.

Anders.

[Luke Rickards]

the ileocaecal valve is often palpated and it feels like a little hard size of a plum. its often painful specially people with bowel problems but also LBP. do you think if we put our hands just over the skin area its different than if we palpate it directly?

When ileocaecal valve is spasm you can touch it ,like Baecker said "a little hard size of a plumb".

Baecker,
Yes, just touching the skin over the cecum is different to palpating the ileocecum directly.

Nabor,
How can you tell the difference between a spasm of the ileocecal valve and distension of the cecum?

if there is a adherence between two surfaces that can limit the slippage between viscera during respiration we suppose it can generate a hotbed of tension that produces afferents on metameric levels for reaching cause pain..... what do you think?I'm skeptical.

[Baecker]

Hmm i guess we cannot tell unless we open the abdomen. Anyhow do you think if I just touch the skin over this area is the same then deep felt contact with the valve?
I mean the valve surely has nerves as well otherwise it wouldn't hurt if we contact it. So by deeper pressure I might affect not only the upper layers but also deeper layers and the nerves with it.

[Diane]

Why do you think the "valve" would "need treated" in the first place?

[Luke Rickards]

Baecker, as I said, yes I do there there is a difference. Of course deeper contact will be registered by receptors further down, eg mechanoreceptors in the peritoneum and cecum. It is possible that such stimulation will result in a reflexive neurological response.

This might be quite useful for conditions involving constipation, for example, but I'd be careful about a hasty conclusion that distention of the cecum is the cause of LBP. If you want to test this theory, give your patients a laxative and make them eat soup for while. If they still have LBP, then you're probably wrong.

[Diane]

give your patients a laxative and make them eat soup for while. If they still have LBP, then you're probably wrong.

Or else a bowel tumor, which no one should be poking away at anyway...

[Luke Rickards]

Good point Diane.

[Baecker]

Why do you think the "valve" would "need treated" in the first place?

In classical osteopathy and in the courses I took it says that treating the are is indicated for people with "troubles in digestion, constipation, flatulence, soft stool which clings, etc... now in theory it is said if this area is dilated or whatever it disturbs the nerves as well the blood flow and might be a cause of LBP. Its just an e.g. what could happen you know the osteopathic ideas about chains and dysfunction.

I do check this area often and I treat it... I am a somewhat a wannabe osteopath, :p taking a lot of courses in this area.... I found their way of treatment and looking at the body fascinating...

I realized now that there is lot of deconstruction for me as well and I am realizing the brain is doing our job we are just giving the brain an option the rest is not up to us... thx for this site :clap2:

[Javier Gonzalez]

Diane said: "Or else a bowel tumor, which no one should be poking away at anyway."

I think the applications of the visceral osteopathy needs of an accurate differential diagnostic, and we always have to think in a lot of visceral diseases before being sure that we can afford the problem with an osteopathic treatment. And of course we need to think about a tumor in all of our diagnostics in manual therapy, not only in osteopathy.

[Diane]

"troubles in digestion, constipation, flatulence, soft stool which clings, etc.

Sounds to me eating different food would be more advisable than manual therapy for this little list of symptoms.. :)

[Luke Rickards]

:clap2::clap2::clap2:

[Diane]

I think the applications of the visceral osteopathy needs of an accurate differential diagnostic, and we always have to think in a lot of visceral diseases before being sure that we can afford the problem with an osteopathic treatment. And of course we need to think about a tumor in all of our diagnostics in manual therapy, not only in osteopathy.
Javier, I concur.

[Jon Newman]

Would injecting the smooth muscle surrounding the valve with botulunim toxin be helpful if spasm is indeed the problem?

I've seen mixed citations. This is, coincidently, an issue for the trigger point folks also.

[bobmfrptx]

This thread is interesting to me because I have seen wonderful results using MFR and Barral instructed techniques for a variety of conditions from IBS,GERD and infertility. I won't, unless asked, share my anecdotal references.
Friends of mine several clinics which focus on infertility and PID. www.clearpassages.com (http://www.clearpassages.com)
They have been published and have peer reviewed studies which have documented the sucess of manual care on the abolishment of fallopian tube adhesions and ultimately sucessful conception and delivery.
Here is one link. http://www.medscape.com/viewarticle/480429
There are others listed on the website.

[Bas]

Bob, interesting studies there. But to assume that the outcomes are due to the technique rather than the direct and personal attention in the therapeutic setting is a stretch.

[bobmfrptx]

Bas,
Are you suggesting that just by making these women comfortable, massaging them and creating an atmosphere of healing conception and delivery can also be obtained?
The increased flow thru a previously blocked fallopian tube was due to ???
Please clarify your response.
thanks.

[bernard]

The increased flow thru a previously blocked fallopian tube was due to ???

Is there any study that says that massage or MFR helps these medical conditions?
Was the flow measured before and after any gentle intervention?

[Bas]

Bob, it is not up to me to demonstrate anything. If a study makes a claim that a particular technique as an "X" effect, it is up to those claimants to demonstrate that it is NOT any of the other variables. The studies have not done that. All we know is that manual and emphatic interaction with a woman trying to conceive, shows promising outcomes. That's all. It says NOTHING conclusive about the applied technique.

[Bas]

Furthermore, it would nice to see the whole idea of psychoneuroimmunology acknowledged in the study of ANY therapeutic interaction. That alone can have radical effects on many conditions.
I seem to remember a study showing that a significant number of couples who try to conceive for years, and finally give up and adopt and "relax" about conceiving, suddenly get pregnant.
The psychoneuroendocrine interactions are so profound, that YES, I can easily see a gentle and relaxed and empathic therapeutic interaction have an effect of many organ functions, including reproductive....
This at least is more in keeping with what we already KNOW, than with a very complex construct of manual diagnosis/techniques for which NO reliable support is yet presented (reliability of diagnosing organ perfusion, organ position etc etc).

[bobmfrptx]

Furthermore, it would nice to see the whole idea of psychoneuroimmunology acknowledged in the study of ANY therapeutic interaction. That alone can have radical effects on many conditions.

I did mention psychoneuroimmunology in another thread and no one commented positively about it at all. The percentage of sucess seems high for this explanation however.

I do seem to recall that the study group did include people who had previous treatments.

[bobmfrptx]

can anybody acess this study?
http://linkinghub.elsevier.com/retrieve/pii/S0015028206024034
perhaps it has what we are looking for?

[Diane]

bobmfrptx, I couldn't find the article you wanted, but I found a few others by the same author(s). You can see them attached here (http://www.somasimple.com/forums/showthread.php?p=47841#post47841).

[bobmfrptx]

thanks diane, on elsevier I found it , but it would cost me 30.00 dollars to read. just wondering if someone had a subscribtion already.
on the clearpassages site they can be accessed to the abstract level
bob

[bernard]

Here it is =>
http://www.somasimple.com/forums/showthread.php?p=47844

[bobmfrptx]

Thanks Bernard.
The conclusions appear to confirm that the hands on therapy was effective for conception and childbirth.

It would be nice if there were more research trying to repeat their findings. But at this point I would agree with the authors of the study that this hands on approach is beneficial and an alternative treatment for clearing of a blocked fallopian tube.

[Baecker]

I won't, unless asked, share my anecdotal references.


I ask! I like to hear anecdotes....

[Luke Rickards]

Hi Bob,

The conclusions appear to confirm that the hands on therapy was effective for conception and childbirth.

I would agree with the authors of the study that this hands on approach is beneficial and an alternative treatment for clearing of a blocked fallopian tube.It's very difficult to get all the information needed to assess the validity of a study just from the abstract. Even so, I'm surprised at your strong support of the conclusions reported in this study - unless, of course, you only read the conclusion.

This was a retrospective study, with 8 participants. They don't tell you how many other people received the treatment, and failed, or whether the 8 were chosen because they looked 'promising'.

The conclusion says that the treatment offers a non-surgical option for patients with infertility from tubal blockage. However, only 4 of the eight (50%) were found to have altered tubes after the treatment. Only 2 of these gave birth, and one was after IVF. Of the 4 that were still not patent after treatment, 2 gave birth after IVF.

So essentially the birth rate was higher after failed manual treatment than it was after 'successful' manual treatment. 12.5% of patients (one person) who underwent the manual therapy had natural pregnancy and birth and we don't know whether this one person was a participant with only one tube blocked.

Effective? Are you sure?

[bobmfrptx]

Hi Bob,
The conclusion says that the treatment offers a non-surgical option for patients with infertility from tubal blockage. However, only 4 of the eight (50%) were found to have altered tubes after the treatment. Only 2 of these gave birth, and one was after IVF. Of the 4 that were still not patent after treatment, 2 gave birth after IVF.


"Of the 4 non-patent patients, one had a laparoscopy to remove the tubes, became pregnant through IVF but miscarried; another had a natural ectopic pregnancy after therapy; a third had a successful IVF pregnancy and live birth delivery, the fourth reported no pregnancy after therapy " directly from article

looks like one had surgery and had IVF but miscarried; third one also had IVF and delivered. fourth no pregnancy. second had natural ectopic pregnancy but they fail to say if carried to term....
So as I read it one birth, possibly 2. 50% with one being IVF.

The group with treatment had 3 babies delivered. Yes one IVF the other had 2 babies.


So essentially the birth rate was higher after failed manual treatment than it was after 'successful' manual treatment. 12.5% of patients (one person) who underwent the manual therapy had natural pregnancy and birth and we don't know whether this one person was a participant with only one tube blocked.

Effective? Are you sure?
So your conclusion that non-patent birth rate was higher is not what I read. It was equal to or less.

As I mentioned, it needs further study and better parameters.
I still hold that it was effective based on outcome. 3 new lives in the world.

[Luke Rickards]

Bob,

I think you misread. First, we can only talk about the first babies, because a lot of change can happen to the structures during a pregnancy, which might account for easier 2nd pregnancies.

Second, there was no separate 'group with treatment'. They were all treated.

Third, unless this is badly worded, the non-patent patients you refer to are the ones who for whom we must consider that the manual treatment failed, because there was no change in the patency of the tubes, which is the aim of the treatment.

It certainly is very easy to prove to you that things are effective, isn't it?

[bobmfrptx]

I ask! I like to hear anecdotes....

I had a client come to me for cervicalagia of 3 weeks duration. Eval revealed postural changes; forward head, depressed sternum, protracted scapula, apparrent pelvic obliquity with leg length descrepency. pMH included GERD of 26 years treated with meds.
In the process of treatment using my JFB MFR training to restore painfree ROM to the cervical spine I treated the whole body. As the postural corrections were obtained and the diaphragm lifted from the stomach, the GERD vanished. She was seen 8 visits +/-1. This was 4 years ago. I've followed this patient yearly for an evaluation and treatment visit at her request and her GERD remains absent.
The specific technique most often used for GERD, is a respiratory diaphragm release , however, the total body must be addressed for lasting changes. I have seen results with well over 50 clients.
I have other anecdotes, but they in themselves do not prove the mechanism or lead to specific protocols for manual correction of the "organs". We do not need to rehash the benefits of JFB MFR with some Barral as well because that leads nowhere. Suffice it to say I've seen it work well, repeatedly and often. I am still working on a study of the inner ear and manual correction of Otitis Media, which I have written about previously.
If you would like more please email me privately.

[bobmfrptx]

Bob,


Third, unless this is badly worded, the non-patent patients you refer to are the ones who for whom we must consider that the manual treatment failed, because there was no change in the patency of the tubes, which is the aim of the treatment.

50% effective for changes, 50% effective for delivery for both groups. So yes I did misread. Call it a draw or coin flip.


It certainly is very easy to prove to you that things are effective, isn't it?
As I mentioned yes it appears effective based on outcomes. Wouldn't you like to see further studies?

[Luke Rickards]

50% effective for changes, 50% effective for delivery for both groups.50% for changes of unknown clinical relevance. 12.5% for measured treatment effect leading to desired outcome. You often remind us how effective your MFR treatments are. I'm sure you would not be blowing the horn so loud if only 12-50% of your patients were happy.

Wouldn't you like to see further studies?You bet.

[bobmfrptx]

You are right Luke,
I would say that 90% of my patients are happy and they owe it mostly to my JFB MFR training combined with my background studies with Cyriax, McKenzie, Rocabado, Upledger,Gehin, Neame and Grodin to name a few.
But mostly and I will stick to this it is the JFB MFR approach to treatment.

And yes, I will look forward to more studies on what makes this human body so wonderfully complex and yet so simple at the same time.

[christophb]

I will look forward to more studies on what makes this human body so wonderfully complex and yet so simple at the same time

I think they already exist. Read up on the brain and nervous system. I think Ramachandran is a good start. Butler's sensitive nervous system really got me thinking about the complexities of pain.

[Luke Rickards]

I would say that 90% of my patients are happy Bob, I don't doubt it. You do realise though that there are countless practitioners around the world who would claim the same thing and have never heard of JFB?

[bobmfrptx]

Bob, I don't doubt it. You do realise though that there are countless practitioners around the world who would claim the same thing and have never heard of JFB?

Luke,
Sorry for your lack of trust, but you have a right to doubt my efficacy. On the other hand, my clients would support my statements. Having them through satisfaction surveys report this would not be enough "proof" for this group. It is however enough for the local MD's and clients to refer to me from as far away as 140 miles. I do no advertising BTW. All mine is word of mouth. And yes I do realise anyone can claim anything. SO? That doesn't refute what I have posted it just continues to perpetuate your doubt. So be it.
Diane has posted to me that anyone with a great pair of hands can be busy. True, but to be busy for over 20 years one must obtain results.
The mechanism of the results are what you question. I have read Ramachadran and others on the "new brain" research. Super stuff.
Hopefully, with the advent of more technology more advancement will continue.
In the meantime, "Those of you who say it can't be done, should stop interrupting those of us who are doing it."
I leave you to practice as you see fit.
Bob

[Luke Rickards]

Bob,

Did you read my post? I said I don't doubt your efficacy. And that's what I meant. You don't need to defend that to me at all. The point is that one doesn't need to be using JFB MFR to have a similar claim about results.

[Jon Newman]

Bob,

Consider re-reading Luke's post with a different set of eyes. I think you misinterpreted his point.

[Luke Rickards]

Thanks Jon, I beat you to it.

[bobmfrptx]

My apologies Luke. I was up late watching lunar eclipse and missed the "don't".
Sure, one doesn't need to have heard of JFB MFR. In my area, I have great results with clients who have been to other clinicians, chiro's, PT's etc without results. I attrubute this mainly to the lack of the total body approach and initiation of exercise way before the client has had the chance to lose the fear of their condition. I do not ascribe to the no pain no gain rule rather the know pain know gain rule.
Again, sorry for the misinterpretation.
bob

[Nick]

Bob,

Please look at the why of JFB-MFR. It has NOTHING to do with JFB or MFR. It has to do with your therapeutic presence and the impact of gentle contact and movement on someone with non-pathological mechanical pain.