The greater omentum...what is that?

Chronic low back pain (CLBP) is a prevalent condition affecting millions of individuals. Traditional treatments often focus solely on the musculoskeletal system, neglecting the potential contribution of the connective tissue and organs to this complex issue. That is where visceral manipulation (VM) comes in: VM specifically looks at the interconnectedness between the organs and musculoskeletal system via our connective tissue, offering a unique perspective on alleviating chronic pain. Just as muscles can develop tension and restrictions, so too can the supporting structures of our organs. After all, they are working just as hard to keep our body functioning as smoothly as possible! As tension develops around our organs, one of two things (or both) can happen: either that tension begins to affect the organ's ability to do its function, or it affects the surrounding fascia, ligaments, and nerves thereby creating more tension and imbalance for those structures. When an organ experiences dysfunction or tension, it can create a domino effect leading to musculoskeletal imbalances in the tissues around it. For instance, the sigmoid colon can commonly develop tension around the fascial sheath that secures it in place. This sheath attaches to our back abdominal wall, near other muscles and nerves that would support low back and pelvic movement. Once tension is added to this sheath, it can easily affect the surrounding tissues as well. In the case of the sigmoid colon, tension here will commonly present as left low back pain, left sacroiliac restriction, or circulation issues of the left leg. Another example of visceral restrictions contributing to back pain would be the kidneys. The kidneys rest directly on top of a very powerful muscle called the psoas. The psoas is responsible for helping us walk through the action of hip flexion, as well as allowing us to bend over at the waist. The close relationship between the kidneys and psoas mean that dysfunction in one can very easily have an impact on another. Not only may you see issues with range of motion, but pain will develop as this dysfunction persists, usually creating a deep ache that starts on your back just below the ribs on the affected side. In cases of severe kidney tension, not only will it manifest in low back pain but it also has the ability to affect bladder function too, as the tension starts to affect the ureters. These are just a few examples of how organs and their fascial support systems can be involved with low back pain. For those suffering from CLBP without much improvement from traditional manual therapy, the alternative approach of visceral manipulation may provide the answer long searched for.

Bloating. Stomach discomfort. The pain that comes from straining when we go to the bathroom. Most of us have experienced constipation now and again, but for some it is an uncomfortable way of life. Clinically, constipation is recognized as fewer than 3 bowel movements a week. The causes can be numerous: dehydration, lack of fiber in the diet, anxiety/depression, and medication side effects could all be contributors to constipation. Laxatives are a common go-to in situations like these, such as Miralax or natural alternatives such as senna. And these can be wonderful solutions for the occasional bout of constipation. But for those who deal with constipation regularly, the use of laxatives serves as a proverbial band-aid for the problem, without addressing the root cause (not to mention the added risk of dehydration). So, what are a few ways to address chronic constipation naturally? 1. Get plenty of water . The more water you drink, the more makes it into your colon to help soften fecal matter and allow it to move more smoothly through the large intestine. Adding lemon to your water (in moderation) is also a boon: lemons contain citric acid, which is a type of natural laxative to stimulate bowel contractions. But make sure to limit your intake of lemon water to first thing in the morning, and at the end of the night, to ensure you don’t risk tooth erosion or possible acid reflux due to the acid content. 2. Make sure your diet contains lots of fiber . Look to incorporate whole grains, legumes, fruits and vegetables into your diet. Beans, lentils, apples, avocados, broccoli, and dried fruits such as prunes are all great options. 3. Adjust your position . Research has shown that posture during bowel movements can influence the ease of elimination. The best posture is to have the knees elevated above the hips, with a relaxed belly. This is why in recent years there has been such a push for products such as the Squatty Potty. 4. Perform abdominal massage . Gentle, scooping motions that follow the large intestine can help soften areas of hardened stool and encourage peristalsis (the movement of waste through the colon). To do this, start at the lower left portion of your abdomen and scoop downwards. Move your hands up 2 inches and scoop downwards again. Repeat until you are just underneath the ribs on the left side. Next, move your hands 2 inches to the right, and scoop towards the left. Move 2 more inches to the right, and scoop again towards the left until you reach the right side of your abdomen just underneath the ribs. Move 2 inches down towards your hip and scoop up towards the ribs. Move down 2 inches and scoop up. Stop when you reach the prominence of your right hip, then do one long massage stroke in the exact reverse order – up the right side, across to the left, and down the left side. You can repeat this whole process 3-4 times. 5. Incorporate essential oils with your abdominal massage . Due to their lipid solubility, essential oils can be absorbed through the skin to have an impact internally. Adding essential oils into your abdominal massage (above) enhances your likelihood of having a bowel movement. General blend: rosemary, lemon, peppermint. For children: geranium, patchouli, mandarin. During pregnancy: patchouli. For elderly: patchouli, rosemary, fennel. * 6. Get visceral manipulation treatments . It is very possible that the cause of your chronic constipation could be something mechanically restricting the bowels. A visceral manipulation therapist will be able to identify the areas of restrictions, and using gentle techniques, improve the resiliency of the tissues to allow for smoother and more regular peristalsis. *information obtained from The Complete Book of Essential Oils and Aromatherapy, by Valerie Ann Worwood.

It is not uncommon for me to go through a series of treatment sessions with an individual, discover lines of tension relating to one or two particular organs, and get asked “why is it like that?” It’s a fair question. We all want to have a better and deeper understanding of our bodies. And sometimes, the answer is relatively simple: car accidents can negatively impact the lungs, the liver, and a wide host of ligamentous structures. Eating inflammatory foods can have a serious effect on the stomach and intestines. Even our posture can create tension around our kidneys or pelvic organs. But it is important to remember that our bodies are both miraculous and mystifying, and in keeping tone with the latter, sometimes the answer we search for is not so easily identified. Recently, I began working with a 33-year-old woman who, among other things, was experiencing bladder incontinence issues. She was a very active woman: jogging and participating in yoga every day, eating a healthy diet including plenty of water and teas and meal prepping every week. She maintained a regimented schedule at her job as a software engineer, alternating seated versus standing at her desk. No history of childbirths or other pelvic conditions. And while I commonly begin to expect at this point that I will find lines of tension that go from the problem area to another region in the body (the true point of origin), that was not the case here. All assessment led straight to the bladder. Furthermore, after 3 sessions of treatment with very little change in the bladder incontinence, both she and I were getting frustrated. That was when I realized I had been overlooking a major component of her health: her mind-body wellness. I began discussing with her the possibility of somatization – the production of physical symptoms as a result of mental or emotional trauma. In her case, the bladder is often associated with control, or the inability to let go. As her eyes changed from narrowed skepticism to wide-eyed comprehension, I saw that we might be on to something. She then began to openly discuss the very strict childhood upbringing she had, and how to this day it was important for her to get everything right, because that was how she minimized getting in trouble with her parents. It was how she controlled the narrative, and she took that habit into adulthood. This discussion was not exactly a revelation for her; she had discussed this at depth in therapy several years before but thought she had fully moved on from this maladaptive coping mechanism; her bladder however begged to differ. Soon after, by tailoring our treatment using different essential oils and herbs, and by her revisiting her techniques she learned from therapy years prior, we finally resolved the bladder incontinence issues. The idea of internalizing our emotions is nothing new. How long have we been using the idioms “butterflies in my stomach” to describe our nerves and anxiety, “having a gut feeling” when our intuition warns us of something, or we “swallow our pride” to accept something humiliating? Research and books exist out there that go further into the exploration of how our emotions can impact our physiological function, but I cannot recommend enough the book “Understanding the messages of your body: how to interpret physical and emotional signals to achieve optimal health” by Jean-Pierre Barral. In it, Barral explains the emotions that commonly get stored in our bodies and can lead to the development of very real, very challenging, physical conditions. Some of these include: The heart, and its connection to guilt, hatred, and excessive attachment The liver, and its connection to anger, rage, and a tendency towards pessimism The stomach, and its connection to poor self-esteem, social stress, and a fear of failure The kidneys, and their connection to reactive fear, abandonment issues, and insecurity * The body remembers our traumas, whether they be physical or emotional. In our effort to pursue good health, it should be remembered that our physical health can be a mirror into our emotional well-being…if only we can be brave enough to look. *from “Understanding the messages of your body: how to interpret physical and emotional signals to achieve optimal health” by Jean-Pierre Barral