What do the knee joint capsule, the hip joint capsule, the sacroiliac joint, the adductors of the hip, pectineus, the ovary, and the popliteal artery all have in common?

The obturator nerve. The obturator nerve, arising from L2-4, has both a sensory and motor component that can affect or be affected by the structures mentioned above. An inflamed ovary in pubescent girls can compress the obturator nerve that passes behind it, causing medial knee pain. This is often mistaken as pain from chondromalacia patella. Osteitis pubis is frequently diagnosed when the real perpetrator is compression of the obturator nerve somewhere along its length. A few items to consider in our assessment and differential assessment of the compression are viscera, a vertebral joint, a disc, or fascia.

Barral Manual Therapies look at the whole person. During the evaluation process, after restrictions or areas of immobility are identified, the related tissues released through precise treatment. The type of treatment depends upon where the restrictions are found. For example, if the liver is restricted, the treatment would include Visceral Manipulation. If the sciatic nerve is restricted, then Neural Manipulation would be a focus. And if the carotid artery is restricted, the treatment would involve Visceral Vascular Manipulation. This is why Jean-Pierre Barral has developed integrative manual therapies that work together to support the overall well-being of a person. Right shoulder pain and limited shoulder joint motion could be caused by liver restriction, or tension in the supraspinatus, infraspinatus and anterior shoulder capsule, or also tension in the right phrenic nerve to the respiratory diaphragm.

Visceral Manipulation is based on the specific placement of soft manual forces to encourage the normal mobility, tone and motion of the viscera and their connective tissues. These gentle manipulations can potentially improve the functioning of individual organs, the systems the organs function within, and the structural integrity of the entire body.

Harmony and health exist when motion is free and excursion is full - when motion is not labored, overexcited, depressed, or conflicting with neighboring structures and their mobility. Therapists using Visceral Manipulation assess the dynamic functional actions as well as the somatic structures that perform individual activities. They also evaluate the quality of the somatic structures and their functions in relation to an overall harmonious pattern, with motion serving as the gauge for determining quality.

Due to the delicate and often highly reactive nature of the visceral tissues, gentle force precisely directed reaps the greatest results. As with other methods of manipulation that affect the body deeply, Visceral Manipulation works only to assist the forces already at work. Because of that, trained therapists can be sure of benefiting the body rather than adding further injury or disorganization.

Learn the facts about Barral Institute Therapies. Discover our Manual Therapy Techniques and their benefits. This flyer is informative for your clients. ​Click here

This is not an exhaustive list of contraindications. We trust that each practitioner will study the work further to understand indications and contraindications in relation to working with clients with New Manual Articular Approach. 

There are very few contraindications overall for New Manual Articular Approach. Pay attention to these signs: unexplained muscle atrophy, unexplained elevated temperature, sudden loss of balance or vertigo, Chiari malformation, unexplained memory loss or mental confusion, arterial hypertension, transient ischemic attacks, significant lymph ganglion swelling, acute ear-nose-throat infections, and acute inflammation of unknown etiology.