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Dr. Stephen J. Kaufman

Denver, CO.

(303) 756-9567

Visceral Release Massage: An Effective Approach for Some Liver, Stomach, Gall Bladder and Heart Problems, including Chronic Fatigue

c. Stephen J. Kaufman, D. C. 2002

Abstract: Some procedures are described that may greatly improve the functioning of internal organs, including the liver, stomach, heart, small intestine, and gall bladder.

Introduction

Fred is a 50 year old man who had a coronary bypass two years ago. He has had a long unfortunate medical history dating back thirty years to radiation treatment for Hodgkins disease. Since his bypass, he has had a severe stomach problem allowing him to only eat a few bites at a time. He had constant distress in his stomach and a feeling that it wasn't in the right place. He is twenty to thirty pounds underweight as a result. He also has had severe shortness of breath, becoming exhausted when he exerts himself. He has constant severe neck and back spasms. He runs a very successful business but has extreme fatigue because of his physical condition.

His cardiac ejection fraction when I first treated him was 35% of normal, indicating a very poorly functioning heart. He has been told by leading G.I. and cardiac specialists that his conditions will never change for the better and he will have to live with them. He drove six hours each way to my office.

I treated him four times with visceral release procedures, by relaxing the diaphragm and repositioning the stomach. After the first few treatments, his stomach felt completely normal to him. He was no longer short of breath, and his energy level returned to high normal. His lung capacity normalized. He could eat normally, and without discomfort . He had another cardiac ejection fraction test done, and it was 81%! Both his family doctor and his cardiologist were completely stunned ,as this dramatic an improvement is rarely seen with this type of condition.

Apparently what happened in this case was that his stomach was pushed up through the esophageal hiatus of the diaphragm after surgery, and remained there. None of the physicians that he consulted ever actually felt or made contact with his abdomen. All I did was to physically relax his diaphragm and then pull the stomach down into it's normal position. This relieved the discomfort on the stomach, allowed him to eat normally, and allowed the diaphragm to descend properly during inspiration. This relieved his respiratory problem. Evidently this was enough to allow the heart to function normally , and the cardiac ejection fraction to greatly improve . Incidentally the tremendous neck and back pain that he had all cleared up, just as a result of the visceral manipulation. Nothing was done on the spine itself.

I have seen many patients with similar problems after surgery. Who knows how many people could be helped to feel better with this approach!

Tim is a 79 year old man who has had severe stomach pain since heart valve surgery several years before. He was very fatigued and short of breath. He could only eat a few bites at a time, and was constantly tired. I treated him with visceral release procedures to relax the diaphragm and pull the stomach down out of the esophageal hiatus. After his second treatment all his stomach pain ceased, he could eat normally , and his energy level gradually returned to normal. In addition he had been having some dizzy spells and numbness in his face. These all returned to normal.

Again with this patient, pulling the stomach down out of it's entrapment in the esophageal hiatus resulted in a dramatic , rapid improvement in both respiration and digestive function. Improvement of these two essential functions allowed the rest of his body to regain it's equilibrium and heal itself.

Patti was a thirty year old woman who had been in massive auto accident and almost died. She had severe back pain. Previous extensive chiropractic and acupuncture care for nine months had relieved some of her symptoms but the back pain remained. I examined her and judged that her right kidney was slightly out of place. I repositioned the kidney gently and she had almost immediate, lasting relief from her back pain.

I would estimate that 10-20% of the lower back problems that I see have a dropped kidney/ psoas muscle involvement contributing to their pain. When this is corrected there is often dramatic , lasting relief, and the correction rarely needs to be repeated. Of course , I have no definite evidence that it is actually a prolapsed organ that is being corrected, but it is a hypothesis consistent with the evidence: lifting the kidney superior does produce relief.

Rosco developed a lingering bronchitis which responded only slightly to herbal and nutritional treatment, and lasted for more than a year. He had more or less constant coughing and shortness of breath. After two treatments to release the diaphragm he had a dramatic increase in lung capacity and respiratory function.

Tony was a 27 year old , unemployed worker, and bright yellow for the past year after a bout of Hepatitis A. He also suffered from extreme fatigue and frequent colds. His illness resolved completely after a couple of weeks of treatments which included a lot of nutritional support, so I can't say that the manipulation of his liver was the only factor involved. My impression, however, is that the treatment would have been much slower without the physical treatment of his liver.

Diane developed gall stones during the last month of her pregnancy. ( She had been trying unsuccessfully to conceive for six years before I treated her originally. She became pregnant within two months of our treatment. That's a story for another paper, however.) She was advised to have her gall bladder removed. I treated some reflexes for the gall bladder , loosened the diaphragm and "pumped" the liver and gall bladder. During the third such treatment we both distinctly heard a "pop", like the cork coming out of a wine bottle. The stone must have moved out of the bile duct. She never had any further pain. This was fifteen years ago; she still has her gall bladder. (and two teenagers.)

Arthur was a very attractive young man with the worst case of acne I had ever seen. Aside from that he looked like Fabio. When I examined him I felt the liver's failure to fully detoxify his bloodstream and maintain hormonal balance may have been at fault. I performed a "liver pump" on him and stimulated reflexes to his liver. I treated him two or three times. When I saw him two days later his face had cleared up by 60-70%. I have never seen such a dramatic and swift improvement in acne before or since. This happened over twenty years ago. He maintained his improvement in the time that I knew him. Since then I have always paid attention to liver function in skin problems. They usually improve, but not as rapidly as Arthur did.

Patricia, a 30 year old housewife and mother of two, was brought to me in a state of collapse after being exposed to carbon monoxide poisoning. She could barely speak, and could not stand ; she was carried into my office by her husband. I referred her to the emergency room, but since she was already in my office, I gave her a treatment which consisted principally of pumping her liver. I figured in a toxic state this would aid the body's detoxification abilities. By the end of the session she had recovered her normal sensorium and was able to leave "at her own chosen speed". I saw her twice more and she had no sequelae whatsoever from her accident.

Deb was a 50 year old woman suffering from chronic fatigue syndrome for a period of five years. She had previous unsuccessful chiropractic and nutritional therapy. Although I did a number of structural corrections in her case, the key intervention is treatment to trigger points in the rectus abdominus muscles. Within several weeks she was completely asymptomatic. Her energy level was normal and all her other chronic fatigue symptoms cleared up.

I got the idea for this approach in 1988 from the book , Hara Diagnosis: Reflections on the Sea, by Matsumoto and Birch (5). I have found that most patients with chronic fatigue are benefited by treatment to eliminate these areas of tenderness. A future paper will describe this treatment in detail. I have a very high success rate with chronic fatigue thanks to this procedure. The problem as I see it is not just chemical but structural as well. Areas of spasm in the abdominal muscles may interfere with proper internal functioning, and may restrict the full excursion of the rib cage when the person breathes in. The body must actually be physically treated for a successful outcome, not just with nutrition. Most of the patients that I treat with chronic fatigue regain normal functioning within several weeks!

Abdominal muscle spasm may also contribute to low back and neck pain, headaches, shoulder pain, digestive problems, gynecological problems including dysmenorhea, and urinary disorders.

Method

In the chiropractic and osteopathic manipulative literature of the early 20th century, there was much discussion of visceral manipulation (1), (2) . Various techniques were promoted to reposition the viscera , relieve torque, and break up adhesions. Compression of internal organs was advocated under certain circumstances to improve functioning. Obviously this does not fix everything that's wrong but can often produce surprising results. I have used these procedures for many years and have found them to be very beneficial. Obviously one needs to diagnose the dysfunction and the specific need but that is beyond the scope of the present paper.

One effective but very gentle approach to visceral treatment is by neurovascular reflexes. These were developed by Dr. Terence Bennett, a chiropractor, in the 1930's (3). They are treated by a very light touch to multiple reflex areas, while at the same time the practitioner's other hand stretches the upper trapezius area. Generally one feels a gurgling under his fingers after 30 or 40 seconds. This feels like peristalsis under your fingers, and seems to indicate that the intestinal tract has quickened it's function. The positions of some of the more active neurovascular reflexes are as follows;

1) The pyloric valve- divide the navel into four quadrants. Lightly hold each quadrant with three fingers while stretching the upper trapezius.

2) The head of the pancreas- lightly hold and traction one inch below

the xyphoid process and one inch to the right, directly against the rib cage.

3) The ileocecal valve point is located where the ileac crest meets the rectus abdominus muscle. Many patients have problems related to ileocecal valve dysfunction. Generally the are will be tender to moderate pressure. Applied Kinesiologists have observed that a wide variety of symptoms can be due to ICV involvement, including headaches, constipation or especially diarrhea , gas, shoulder pain, skin problems, menstrual cramps , allergies, etc.

These points are all very useful for acute or chronic digestive function. They are each held for 30-40 seconds while stretching the upper trapezius muscle with the other hand.

4) The liver point is one inch up from the area where the mid nipple line intersects the bottom of the right rib cage.

Bennett performed a lot of fluoroscopy and claimed to have seen increased peristaltic movement of fluids when he would stimulate the points.

The following visceral techniques need to be seen in person to be properly learned.

5)Diaphragm function is extremely important and influential, for the abdominal organs as well as the lungs and heart. Apparently it was primarily a dysfunction of the diaphragm that caused much of the problem with Fred's heart. When the diaphragm was released, his ejection fraction increased substantially. Basically the practitioner can run his fingers under the rib cage and very gently but steadily applies pressure to effect a relaxation of the diaphragm. Any areas of tenderness can be held until they abate somewhat. It is extremely important to apply light pressure and not bruise the underlying flesh. Dr. Gaby wrote an article on "respect for tissue " which I love; one should always be mindful of the tissue's capacity to heal.

6) The esophagus passes through the esophageal hiatus of the diaphragm to join the stomach. Mild pressure around this area to free any restrictions and pull the stomach down is often helpful. It is apparently common for the stomach to slide up slightly into the diaphragm; gently pulling it down gives many people relief from upper G.I. discomfort.

7) Further down the G.I. tract, between the last part of the small intestine and the large intestine is the ileocecal valve. This lies approximately at the level where the ileac crest meets the rectus abdominal muscle. This is often tender on people, and can give rise to a multitude of symptoms. Very light pressure, directed upward towards the left shoulder , often gives people relief, from digestive problems and even headaches, neck pain, or low back pain! Often there will be a loud borborygmi or gurgle when pressure is applied here. Pressure must be very light and gentle, as the appendix lives just next door.

8) The liver can be pumped or squeezed by simply massaging it, with the left hand on the rib cage pressing inferiorly while the right hand massages superior. This is often tender . A slightly deeper pressure will milk the gall bladder and may help with sluggish bile flow, and possibly gravel or stones. Neither this nor any of these other techn

9) The liver and gall bladder can also be helped by pulling and stroking the right rib cage laterally . This is difficult to describe in writing.

10) Some patients have upper G.I. bloating and gas that seems to be due to a spastic or "jammed" pyloric sphincter. This can be helped by taking a contact one inch directly below the navel and firmly but gently pulling down towards the feet.

Summary

Many practitioners use various reflex or acupressure /acupuncture points to enhance visceral functioning. Less known in recent times but still effective are techniques that aim to directly massage and stimulate various internal organs. Practitioners of these techniques feel that the internal organs are actually being repositioned in some cases. This is hard to verify at present but could probably be done with current imaging technology, if proper studies were designed. I have tried to show that substantial improvement in patient's conditions can be obtained, at least occasionally. Although nutritional management is certainly imperative, we must not neglect the benefits of actually putting hands on the patient in selective circumstances. Much can be done if our hands act in an educated, intelligent and intentional manner to directly affect body function. In all cases it is important to be gentle and not exceed the patient's tolerance. As Alan Gaby, M. D. has said, "respect for tissue" is paramount.

Stephen J. Kaufman, D. C. , is a practicing chiropractic physician in Denver, Colorado. He has practiced chiropractic, applied kinesiology, myofascial and trigger point therapies, acupuncture, acupressure, Thought Field Therapy, yoga, and cranial osteopathy since 1978. He has developed many new techniques in soft tissue therapy and has published over 75 professional papers. He can be reached at (303) 756-9567. 2693 South Niagara St., Denver, CO., 80224.

References:

1) DeJarnette, M.B., D.C. Bloodless Surgery. Privately published,1930.

2) DeJarnette, M.B., D.C. Chiropractic Manipulative Reflex Technique. Privately published, 1960.

3) Martin Ralph. D.C. Dynamics of Correction of Abnormal Function. 1977.

4) Martin Ralph. D.C. Practice of Correction of Abnormal Function. 1979.

5) Matsumoto, K. and Birch, S. Hara Diagnosis: Reflections On the Sea. Paradigm Publications. 1988