Visceral Manipulation Applications for Whiplash and Trauma – Importance of an Integrative Approach Synopsis: This is a specialized course focusing on the impact of whiplash and trauma as seen from new evaluation and treatment perspectives Course Length: hours (lecture and demonstration, and some evaluation/techniques participants can implement in practice) – course can be expanded up to hours long An integrative approach to evaluation and treatment of any musculoskeletal dysfunction requires assessment of the structural relationships between the viscera, and their fascial or ligamentous attachments to the musculoskeletal system All viscera have physiological motion that relates to normal pain-free movement; so knowledge of these relationships and the anatomy involved are essential to see patients within an integrated framework For example, the heart is suspended by ligaments attaching it anteriorly to the sternum and posteriorly to C4-T4 In a whiplash the suspensory ligaments of the heart are injured These ligaments have no nociceptors, so one does not feel those injuries Weeks following, the injured membranes become fibrosed as they heal, putting tension on the lower cervical and upper thoracic vertebrae Work on the painful areas of the neck typically does not produce lasting results Visceral Manipulation helps to restore the span and elasticity of the pericardial support ligaments Clinical experience has shown that this tends to make rapid and lasting improvement in neck pain following whiplash Course Highlights and Objectives: • Study the three primary areas of trauma as they relate to whiplash: physical laws, evaluation and treatment • Understand how whiplash creates restriction patterns throughout the body, particularly in areas rarely understood or addressed • Identify techniques that encompass the whole body, as the whole body receives collision forces in a whiplash injury, not just the cervical spine • Discover new applications of Visceral Manipulation principles and techniques as they can be utilized for patients presenting whiplash and other conditions involving trauma Bibliography Allison, M.C., Dhillon, A.P, Lewis, W.G., Pounder, R.E Inflammatory Bowel Disease London, England: Mosby International Limited, 1998 Arbuckle, B.E., The Selected Writings of Beryl E Arbuckle, DO, FACOP Indianapolis, IN: American Academy of Osteopathy, 1994 Ashcraft, K., Holcomb, G., Murphy, J Pediatric Surgery- Edition Philadelphia, PA: Saunders Elsevier, 2005 Barral, Jean-Pierre Manual Thermal Evaluation Vista, CA: Eastland Press, 1996 Barral, Jean-Pierre The Thorax Vista, CA: Eastland Press, 1991 Barral, Jean-Pierre Urogenital Manipulation Vista, CA: Eastland Press, 1993 Barral, Jean-Pierre Visceral Manipulation Vista, CA: Eastland Press, 1988 Barral, Jean-Pierre Visceral Manipulation II Vista, CA: Eastland Press, 1989 Barral, JP., Croibier A Trauma-An Osteopathic Approach Seattle, WA: Eastland Press, 1999 Becker, RE Life in Motion-The Osteopathic 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Gastro-Intestinal Tract Eindhaven, Denmark: Centrex Publishing Co., 1960 Lederman, Eyal The Science and Practice of Manual Therapy, Second Edition Pennsylvania: Elsevier, 2005 Legacy of Osteopathy to Children The Collected Papers of Viola M Frymann, DO Indianapolis, IN: American Academy of Osteopathy, 1998 Moore, Persaud Before We Are Born: Essentials of Embryology and Birth Defects 5th Edition W.B Saunders, 1998 Nemett, DR., Fivush, BA., Mathews, R., Camirand, N et al “A Randomized Controlled Trial of the Effectiveness of Osteopathy-Based Manual Physical Therapy in Treating Pediatric Dysfunctional Voiding.” Journal of Pediatric Urology 4, 100-106, 2008 Netter, FH., Felten, DL., Jozefowicz, R Netter’s Atlas of Human Neuroscience Teterboro, NJ: Icon Learning Systems, 2003 Perlemuter, L., and Waligora, J Cahiers D’Anatomie Vol 1–6, 3d ed Paris, France: Masson, 1975 Scherzer, Alfred, Tscharnuter, Ingrid Early Diagnosis and Therapy in Cerebral Palsy Madison, NY: Marcel Dekker, Inc 1982 Singer, Edward Fasciae of the Human Body and Their Relations to the Organs They Envelope Philadelphia: Williams and Wilkins, 1935 Stone, Caroline A Visceral and Obstetric Osteopathy Pennsylvania: Elsevier, 2007 Trowbridge, Carol Andrew Taylor Still 1828–1917 Kirksville, MO: The Thomas Jefferson University Press, 1991 Ward, R Foundations for Osteopathic Medicine Lippincott Williams & Wilkins, 2002 Weintraub, William Tendon and Ligament Healing: A New Approach Through Manual Therapy North Atlantic Books, 2001 Background about The Barral Institute 2010 will be the 25 year anniversary of Jean-Pierre Barral’s teachings in the U.S Prior to 2006, Jean-Pierre Barral's Visceral Manipulation Seminars and Nerve Manipulation Seminars were managed by the International Association of Healthcare Educators (IAHE - managed by the Upledger Institute) In 2006 Jean-Pierre Barral formed The Barral Institute (BI) to continue the advancement of his research and seminars BI continues to work with IAHE for administrative support of the seminars while offering seminars across the U.S., Canada and world-wide Jean-Pierre Barral, D.O., MRO(F) Jean-Pierre Barral is a Registered Physical Therapist and Doctor of Osteopathy who serves as Director (and Faculty) of the Department of Osteopathic Manipulation at the University of Paris School of Medicine in Paris, France He is a Member of the Registre des Ostéopathes de France He earned his diploma in Osteopathic Medicine in 1974 from the European School of Osteopathy in Maidstone, England, and went on to teach spinal biomechanics at the institution from 1975-1982 He developed the modality of Visceral Manipulation based on his innovative theory that each internal organ rotates on a physiological axis In collaboration with Alain Croibier, D.O Jean-Pierre Barral has also developed the modality of Nerve Manipulation based on their on-going clinical research Barral is author of the books: Visceral Manipulation Visceral Manipulation II The Thorax Urogenital Manipulation Manual Thermal Evaluation (formerly Manual Thermal Diagnosis) An Osteopathic Approach to Trauma: Focus on Whiplash Manual Therapy for the Peripheral Nerves Manual Therapy for the Cranial Nerves Understanding the Messages of Your Body Alain Croibier, D.O., MRO(F) Alain Croibier is a Doctor of Osteopathy in France He is a Member of the Registre des Ostéopathes de France and a Member of the Academie d’Osteopathie de France Together with Jean-Pierre Barral, Alain Croibier has developed the modality of Nerve Manipulation based on their on-going clinical research Alain Croibier is an Instructor for Visceral Manipulation and Osteopathic Diagnosis at the Osteopathic College, A.T Still Academy, Lyon, France He is also an International Instructor for Visceral Manipulation and Nerve Manipulation for The Barral Institute Croibier is author of the following books: An Osteopathic Approach to Trauma: Focus on Whiplash Manual Therapy for the Peripheral Nerves Manual Therapy for the Cranial Nerves Manual Therapy Evaluation Techniques How Did Visceral Manipulation and Nerve Manipulation Begin? Methods such as Visceral Manipulation have been part of the medicinal cultures in Europe and Asia since prerecorded times Indeed, manual manipulation of the internal organs has long been a component of some therapeutic systems in Oriental medicine So it’s no surprise that practitioners in many parts of the world have incorporated manipulations designed to work with the internal organs and their functions Jean-Pierre Barral first became interested in biomechanics while working as a registered physical therapist of the Lung Disease Hospital in Grenoble, France That’s where he met Dr Arnaud, a recognized specialist in lung diseases and a master of cadaver dissection Working with Dr Arnaud, Barral followed patterns of stress in the tissues of cadavers and studied biomechanics in living subjects This introduced him to the visceral system, its potential to promote lines of tension within the body, and the notion that tissues have memory All this was fundamental to his development of Visceral Manipulation In 1974, Barral earned his diploma in osteopathic medicine from the European School of Osteopathy in Maidstone, England Working primarily with articular and structural manipulation, he began forming the basis for Visceral Manipulation during an unusual session with a patient he’d been treating with spinal manipulations During the preliminary examination, Barral was surprised to find appreciable movement The patient confirmed that he felt relief from his back pain after going to an “old man who pushed something in his abdomen.” This incident piqued Barral’s interest in the relationship between the viscera and the spine That’s when he began exploring stomach manipulations with several patients, with successful results gradually leading him to develop Visceral Manipulation Between 1975 and 1982, Barral taught spinal biomechanics at England’s European School of Osteopathy In collaboration with Dr Paul Mathiew and Dr Pierre Mercier, he published Articular Vertebrae Diagnosis Using his work with Dr Arnaud as a foundation, Barral continued to investigate how the thickening of tissues in the body creates areas of greater mechanical tension that, in turn, pull on surrounding tissues That discovery led him to the theoretical and practical development of visceral listening techniques Barral’s development of manual thermal evaluation began in 1971 during another treatment session While treating a female patient, he felt a strong emanation coming from her mammary gland He learned she had been operated on for a tumor in that area Researching this phenomenon with other patients, he discovered just how accurately areas of stress in the body could be located by palpating the associated energy, which proved to be thermal Consequent research has added manual thermal evaluation to many practitioners’ evaluation tools With the help of Dr Serge Cohen, a Grenoble radiologist, Barral also documented changes in the viscera before and after manipulation They employed x-ray fluoroscopy and ultrasound to record changes in position and motion, as well as fluid exchange and evacuation Later they conducted additional research with a team of electrical engineers and technicians using infrared emissions from the body Jean-Pierre Barral and Alain Croibier began collaborating and developing the modality they call Nerve Manipulation in 2000 based on the clinical work they were doing with patients Through precise release of the nerves themselves, they found that patients were responding much faster than previously Jean-Pierre Barral began teaching Visceral Manipulation in the United States in 1985 Jean-Pierre Barral and Alain Croibier began teaching Nerve Manipulation in the United States in 2004 Since then Jean-Pierre Barral has trained a team of International Instructors that teach Visceral Manipulation and Nerve Manipulation seminars around the world Barral and Croibier continue to research and develop manual therapy techniques while maintaining full clinical practices www.barralinstitute.com ... Visceral Manipulation and Nerve Manipulation Begin? Methods such as Visceral Manipulation have been part of the medicinal cultures in Europe and Asia since prerecorded times Indeed, manual manipulation. .. from the European School of Osteopathy in Maidstone, England Working primarily with articular and structural manipulation, he began forming the basis for Visceral Manipulation during an unusual session... Manipulation Vista, CA: Eastland Press, 1993 Barral, Jean-Pierre Visceral Manipulation Vista, CA: Eastland Press, 1988 Barral, Jean-Pierre Visceral Manipulation II Vista, CA: Eastland Press, 1989 Barral,