The Kidneys- Visceral Connections to Movement
Join me for a deep dive into the anatomy and physiology of the kidneys.
Explore how the kidneys are deeply embedded into our movement and humans and how closely the organs are related to the spine and extremities.
In this episode, you will learn why I am so adamant about not using hard massage tools or deep tissue to the area of the kidneys and why you may want to consider the kidneys when dealing with knee, back, and foot pain.
Resources mentioned:
Support Your Kidneys and Change Your Hips (and knees) Regen Movement Session
Liver Instagram Post
Episode 40 with Daniela Spear- Healing and Wellness Remade (Emotions and the viscera)
Barral Institute
Phillip Beach- Muscles and Meridians
LTAP Level 1 course
Considering the viscera as a source of musculoskeletal pain and dysfunction is a great way to ensure a more true whole-body approach to care, however, it can be a bit overwhelming on where to start, which is exactly why I created the Visceral Referral Cheat Sheet. This FREE download will help you to learn the most common visceral referral patterns affecting the musculoskeletal system. Download it at www.unrealresultspod.com
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Anna Hartman: Hey there, and welcome. I'm Anna Hartman, and this is Unreal Results, a podcast where I help you get better outcomes and gain the confidence that you can help anyone, even the most complex cases. Join me as I teach about the influence of the visceral organs and the nervous system on movement, pain, and injuries, all while shifting the paradigm of what whole body assessment and treatment really looks like.
I'm glad you're here. Let's dive in.
Hey, hey, welcome back to another episode of the Unreal Results podcast, another week. And here we are. So today I've been thinking like, what do I want to talk about and how, you know, I want to, you know, I've talked about the last couple of weeks, so I didn't want to get too far off the goal of the whole podcast, which is to always sort of bring it back to expose you to a more like.
Holistic way to look at the body and incorporating the visceral and the nervous system in. And so, um, I was like, you know what? I did a post on Instagram, man, maybe in December, all about like the liver, just like. Here's the liver. Here's the emotional components. Here's the things, right? And I was like, Oh, I really like that.
And I wanted to do it on other organs. And so I was like, I really, really actually like to do on the kidneys. Cause the kidneys is something that comes up a lot. Um, for my athletes. And, um, so that's what I want today's podcast to be on is the kidneys and, um, the kidneys connection to movement, the kidneys connection to like overall health, of course, and the kidneys connection to common musculoskeletal injuries and, um, aches and pains, that kind of thing.
So we'll dive right in. And I actually, um, Oh. A lot of the episodes I do, I don't take a ton of notes. Like I don't read, you know, it's not like I read off a script, it's just kind of going off the top of my head. And um, but sometimes when I do sort of write ideas for episodes, I sort of like just do a little brainstorm and like have like all these like facts and things I want to like get in.
So, um, I do have a little notepad with all that on, so I will be semi reading off of it at times, but only because I want to, like, make sure that we're, like, really, you know, getting in on all the facts. So, kidneys are a paired organ, right? We have two kidneys, and, um, they, The first thing that comes to mind when I think of the kidneys is the embryology of the kidneys and how the kidneys are actually embryologically, part of the mesoderm.
So the mesoderm is like the in-between layer. The in-between layer of the germ cell. Um, as the embryo is developing, becomes. Mesoderm and the mesoderm basically is our musculoskeletal system. So Philip Beach always says the mesoderm moves us. So a mesoderm is very connected to our movement in, in, in musculoskeletal system moving things in general.
And so, um, why that's interesting to the kidneys is because. Well, one, they are derived from a different germ layer than the rest of the organs. Um, and you see that even anatomically in the body, they're not related to the same space as the rest of the organs. So the kidneys are called retroperitoneal organs.
So they're, they're organs that actually sit behind the peritoneum, whereas the rest of the organs in our abdomen, um, and, and pelvis are. within the peritoneum, um, itself. So, there is a relationship though, right? It's, at the end of the day, it's still like one container, right? It's still our trunk. Um, but there's actually behind the peritoneum, there's a fascial layer called the fascial tolt, um, that's connected to the peritoneum.
And then there's a renal fascia that's connected to the fascia of tolt. The renal fascia actually, um, interdigitates or like, um, That's the right word, like becomes or is invested into the transverse abdominal fascia and the actual like fascia of the posterior abdominal wall. So another example of how intimately connected the kidneys are with our movement because the posterior border of the kidneys.
are is very connected to that renal fascia and that renal fascia is invested into our thoracolumbar um transverse abdominis like abdominal fascial containers so um super unique situation in that um With that, too, the other movement that occurs around the kidneys is they happen to live at the, like the, um, thoracolumbar junction.
So they were underneath the diaphragm, um, and The kidneys are sort of partway in the thorax and partway not in the thorax. Um, so they're right at the junction between the thoracic spine and the lumbar spine. That junction of the spine is also where the majority of our rotation happens, and not just our rotation in like rotational sports or like rotational, just like mobility, but when we're thinking about gait and walking the, the rotation that.
Is created with our bipedalism, right? The, the rotational pattern that is our gate that is generated in the trunk, that is sort of like the apex of that rotation is, uh, the thoraco lumbar junction, and it's amplified by our. limbs. It's amplified, our rotation of the trunk is amplified by our limbs. Phillip Beach talks a lot about, about this, a lot about this in his contractile field theory, which he describes in the book Muscles and Meridians.
And, um, it makes sense as well when you look at sort of where the legs sort of attach and where the, Um, arms attached, like where things are crossing, if that makes sense. So the legs, even though the hip bone attaches to the pelvis farther down, the muscles that move the legs, right, like the hip flexors.
Um, the psoas goes all the way up to the upper lumbar, lower thoracic, the thoracolumbar junction. And so that's really the beginning of our legs. So right there is a spot where the amplification is happening with the legs, the lower extremity. And then the upper extremity too, you know, you could even argue that the lat, um, attaches, you know, the upper extremity is one of the many attachments of the upper extremity to the spine.
And that the lat goes all the way down to T12, um, as well. So right in that thoracolumbar junction, the legs and the arms are crisscrossing. And so it's no wonder then that they become amplifiers of rotation. Um, this amplification of rotation in the, in these organs that tend to be on the thoracolumbar junction also tend to be our organs related to our fluid systems.
And so the kidneys is a big part of our fluid systems, both from a, um, blood fluid standpoint and a urine fluid standpoint, um, and even, you know, from a lymphatic standpoint a bit. So that sort of is a good chance for us to talk about a little bit about the physiology of the kidney. And, um, sort of then a little bit of like the symptoms that are related to kidneys.
So the kidneys from a physiological standpoint, um, maintain our blood pressure. They maintain our blood, um, acidity or alkalinity levels, right? Our pH balance of our blood, um, the kidneys produce vitamin D, they stimulate the production of red blood cells in our bone marrow. They maintain fluid balance and electrolyte balance.
Um, I think I already said that, that they help with the maintenance of blood pressure. So the rengen and angiotensin system that is within the filtration system. All the, uh, all those hormones and, um, chemicals that like determine. the filtration within the kidneys that is related to our blood pressure.
And that's a unique thing too because our blood pressure is very related to our movement. Um, and then also, um, the, the, um, Kidney helps with the excretion of toxins, obviously, from a urine standpoint, from a sort of talking about like the capacity or the volume of fluid that the kidneys sort of deal with the, they filter 200 quarts of water through our body a day.
That's a lot of quarts. Um, and we secrete about two quarts of urine per day via the kidneys and the ureters and the bladder. So, the kidneys are like high functioning things. And, um, have an intimate connection with then the liver because of the relationship to the blood flow and blood pressure and all the things.
So from a suspensory ligament standpoint or from a ligamentous or fascial connection standpoint, the right kidney is very connected to the liver. Very connected to the liver and the duodenum and like the ascending colon. The, uh, so it tends to be referred to commonly as the digestive kidney, whereas the left kidney is related more to the rest of the organs in the abdomen and pelvis.
Um, it's connected to the stomach, the pancreas, the spleen, the descending colon, the splenic flexure of the colon, um, and then, um, more so related to the genital organs. So it's often referred to as the urogenital organ or the, just the genital, um, kidney. Um, though it's funny that it's referred that way because it is connected to a lot of the other, um, A lot of the other digestive organs too, but the liver and the kidney just play such a big role together.
Um, that I think that's part of the reason why it's considered more of a digestive kidney. Um, they're especially related from a Emotional standpoint as well. Um, the emotions, I'll just go into it now. I don't know why I would not, but, um, the emotional standpoint, the organs that are related, sorry, the kidneys, the right kidney.
Emotionally is usually, um, taxed with, um, anger, frustration, especially like extreme levels of anger and frustration. And so it's almost like an overflow for the liver. So if you did catch that post that I posted on Instagram about the liver, I talked about that a lot. Um, and I'll link that post in the show notes.
And then also I'll link. The, to the episode I did with, um, my friend and colleague, Daniela Spear, because we talked a lot about emotions and specifically the emotion of anger and the relationship to the liver. And so that would be a good episode to listen. If the, if you, uh, are interested in that. And then the left kidney, the emotions related to that are, um, more associated with, um, sort of the root of our being, like who we are, like our deep roots.
And this sort of also sort of Makes sense from a connection of how the left kidney is considered the genit genital, your genital kidney because feelings of our root, our root of being tend to go with like the sacrum area, the sacral chakra in fact is called the root chakra which is in Sanskrit, Mulahara, but it is associated with like, you know, our deep sense of belonging.
So, um, interesting, too, that even though the kidneys are a paired organ, their functions and emotional components tend to be not paired at all, and they're not paired with the same organs. So that makes sense as well. And they're not paired with the same organs because the rest of the organs are not paired.
There is not a left and right liver, right, so that would make sense. Um, the, another like fun fact, most of the organs, all of the organs, um, actually, except for the kidneys, are connected to the body, to the skeleton, with suspensory ligaments. The kidneys actually are not connected with suspensory ligaments at all.
The kidneys are sort of like, free floating, um, in their fatty protective layer of fascia around them and supported underneath the diaphragm by two things, pressure and the support support. Via that fascial container, but that's pretty much the pressure support and then the attachment to the renal artery in the vein and At the hilum or root of the kidneys right because those renal arteries and veins are then attached to the abdominal aorta and the vena cava and so they're ultimately attached to our vascular system.
And, um, in fact, typically what causes some issues functionally and mechanically for the kidneys is when the kidneys start to either not be able to move at all and become kind of like frozen or have lost their pressurization and support and start to sort of, um, fall down with gravity. And there's different grades of this falling down.
The first, as it starts to fall down, it actually starts to take the kidneys lateral, but then As it continues to fall down, it sort of hangs on those vascular structures, and the inferior poles become more medial, and it actually turns the whole kidney into like a medial or internal rotation. And depending on this level, it's called, excuse me, this level of ptosis, P T O S I S, will do.
depend on what nerve, nerves get irritated and what the symptoms are. So in that third degree ptosis where we have that medial rotation, the kidney sometimes comes all the way over medial and starts to irritate the genito, genitofemoral nerve and we get symptoms related to the genitofemoral nerve.
As well as symptoms from the rest of the nerves too, obturator nerve and femoral nerve. And sometimes even lateral femoral cutaneous nerve because as it sort of falls down, it starts to almost like rub against or compress the lumbar plexus. And so you start to get sometimes symptoms of like hip flexor tightness, front of the quad tightness can be some symptoms of, um, liver mobility issues or liver pressure issues.
Uh, pressure of the container, right? Pressure maintaining the suspension of the diaphragm issues, not the same as blood pressure issues from functional problems to the liver. Um, so with that said, um, you know, I said one of the problems is when the liver doesn't move. So the liver is made to move. Um, within this container, within this fascial container, and it, the movement is directly linked to the breath, and Also, the body's rotation, so as we take an inhale breath and the diaphragm drops down, the kidneys will descend and go down as well.
Um, they usually, they can move, what do I have, I feel like I had written down, how many inches down that they can move, or centimeters down, uh, how do I not have this? Oh, three centimeters. On an inhale breath, the inferior pole of the kidneys can descend three centimeters. So that's about an inch and a bit.
Um, on the, uh, deeper breath, I've even seen it written in some literature up to five centimeters. So, um, that's That's a that's a big movement. And so That is also why sometimes when you look at the borders people will give you different Measurements of where the borders of the kidneys are in general The right kidney tends to be lower than the left kidney, but they tend to go between T T10 and L2, but can also be T12 to L3.
So that's sort of the space, the area that they frequent. The inferior pole tends to be a little bit more lateral than the superior pole. On top of the superior pole of the kidney is also where the adrenal glands live. So the function of the adrenal glands And our sympathetic nervous system response, right, our mobilization response are intrinsically linked to a healthy kidney.
And um, again, this is another like ode to how involved the kidneys are with movement. Um, And, and, so it makes sense too that one of the symptoms of a kidney that is not functioning well or is not able to move well is fatigue. Or, it's often a symptom of someone who had too much massage or manipulation to the kidneys or forced movement in the area of the kidneys without space.
And this is, you know, going to another little soapbox about the kidneys and why I want to talk about the kidneys. This is why I adamantly tell people not to get deep tissue in the area of the kidneys on the posterior abdominal wall. The depth of the kidney. At Grunfeld's triangle, Grunfeld's triangle is a space on the back between the quadratus lumborum and the erectors, where that renal fascia, transverse abdominis fascia comes in, where the kidneys are the most superficial.
It The kidneys in that area are only one and a half inches deep to three inches deep, depending on the person, depending on the anatomy, depending on the level the kidney is sitting at, one and a half inches deep. So this is the argument too of Hopefully you learned, if you do dry needling, hopefully you learned in that class that this is an area that you don't stick needles in.
Because some of the needles people use are longer than two inches. You don't want to injure the kidneys. They're very sensitive. Though they're a harder organ, they're not that hard at all. They're, they can be easily bruised, easily damaged, with blunt force trauma, with things in that area. And so understanding that they're not that deep should give you appreciation of why we're not using elbows and hard tools in that area.
So I have a like a hard no to hard tools in the gut and I have a hard no to hard tools in the area of the kidneys. Which basically are the area of your lumbar spine between your ribs and your pelvis just to the side of your erector spinae. Um, like, that's a really big deal. If that's the only thing you take away from this podcast, I hope that's it.
Um, the
Checking my notes, make sure I'm getting everything that I want to say. So, interesting enough, um, well, let's just talk about the innervation of it and the blood flow to it. So the innervation of, so the nerves of the kidneys are gonna be parasympathetic, is the vagus nerve, sympathetic is the renal plexus via the I think it's part of the celiac plexus, but it has its own little plexus, the renal plexus.
And those sympathetic nerves come off of the level of the spinal cord between T10 and T12. And obviously the vagus nerve is a cranial nerve, right? So that comes all the way up from our head, jugular foramen, goes through our neck, into our thorax, down through our thorax, pierces through the diaphragm, and then Has a plexus in and around the renal fascia and the kidney itself.
So, um,
that those are good key spots, right? So we're treating, we always looked anything we're treating, whether it be muscle or visceral or, you know, joint, whatever it is, we're always take a step back and look at its innervation and look at its vascular flow. So the vascular supply to the kidneys is the renal artery and vein.
The renal artery and vein come off the abdominal aorta just below the superior mesenteric artery, and that is at the level of about T12 to L2, so the renal arteries are usually about L1 to L3. So again, important. spinal segments. So sometimes when we look at the relationship to spinal segments and nerves, sorry, spinal segments and organs, this is some of the relationships that we see is this relationship between, um, changing the neural input or vascular input to and from the spinal cord or abdominal aorta to the organs itself, right?
So, um, this tells us that not only can we affect the kidneys by doing movement at or manipulation at T10 to T12 because of the sympathetic relationship, but we can also look to, um, the area of L1 to L3 for their vascular relationship to it as well. Um, and then two, just the fact that the kidney itself, like, basically hugs the spine.
So, again, we gotta think 3D ness. The spine is more anterior, the, the bodies of the spine are more anterior than obviously our spinous processes and the posterior wall. And so the kidneys sort of sit on the, on the like sides of the spine and the artery and vein cross the front of the spine and sort of have this like.
Like they bow around it a little bit. So there's already this like, even this relationship of rotation around the kidneys because they are on either side of the spine. And so they're relating to each other via rotation then. And side bending even. because of that. So, um, I think that's always kind of helpful to picture too is they're sort of like sitting behind the bony part of the body of the spine.
Um, obviously too that depends a little bit on like the size of the muscle in the posterior abdominal wall. If somebody has a pretty like hypertrophied posterior abdominal wall musculature, then they might be a little bit more closer to the front side. of the spine, but in general, um, you know, there is like a, sort of like a bowing around the front of that, um, spine of the renal artery and vein.
Um, so the other relationships, you know, when I, when I look at, um, let me give you some resources. So when I pull a lot of this information, a lot of it is from the, um, work I learned in the Barral Institute in their classes. Specifically, you learn about the kidney in the second visceral manipulation class, VM2.
And also, if you google viscerosomatic reflexes, you'll see some spinal levels there. That's more of like the sympathetic innervation to the artery or to the viscera from the spine. And then obviously the parasympathetic is from the cranial nerves. Um, but then in the Barral Institute, sometimes they give us, um, relationships to the spine that just has, or a relationship to the appendicular, um, skeleton.
And these are relationships more that Jean Pierre Barral has seen in his, you know, 50 years of practice. And he, notes, and I will confirm that in my 10 years of practice, I've seen these relationships as well, is that often vertebral restrictions at T7 are seen, and then the, in, then vertebral restrictions at L1 through L4 are seen with kidney problems.
Um, the, and again, like going back to how the kidneys are connected to our movement. If we think about the thoracolumbar junction and the influence of the limbs on the thoracolumbar junction, those are kind of the areas that is happening. So he doesn't specifically say this in our classes or in his books, but when I looked at the anatomy and I think about how these vertebral relationships could be.
true, that's what it makes me think of is like a relationship to how the limbs amplify our rotation at the thoracolumbar junction and how tied to movement of the kidneys and as Philip Beach says almost helping to pump or wring out the fluids along that thoracolumbar junction. So I don't know if it's true or not, but that's what he sees.
So look for vertebral restrictions at T7 and L1 through L4. And then the tib fib joint. So the proximal fibular joint is a big one. Almost always when I see a proximal tib fib joint, there is some sort of urogenital connection. And, um, also he notes, uh, the navicular and the fifth met, um, so think midfoot, um, or just fifth met.
issues, which this could speak to sort of, um,
I'm not even going to say what it speaks to. I'm just going to say that's what he notes. Um, and then the other big, like visceral referral is the knee. Whenever anybody comes in with knee pain, I am thinking, right? I think three. I think I always go backwards. What's the nerve connections with the artery connections and what's the visceral connections and knee is kidneys.
So, um, but also SI joint. That's kind of a really common frequent one. That's actually why the SI joint mobility locator test is the 1st of the LTAP test. So the LTAP test assessment protocol. SI joint is a very visceral joint. It's influenced by a lot of different visceral things. And so, um, hopefully if all you learn from me too is SI joint problem, think there's a visceral or nervous system component.
Uh, glenohumeral joint, um, arthritis, glenohumeral joint issues. He doesn't actually speak to a specific side, but it would make sense that it's probably the right side because of that. Very strong relationship of the right kidney and the right liver almost always when there's a liver issue There's a right kidney issue as well.
And then the left kidney specifically is also related to the tailbone, coccyx the first rib and the left side of the cervical spine, so
Interesting connections Absolutely. The other thing to note, that the posterior border of the kidneys are very intimately connected to the 11th and 12th rib. The 11th and 12th rib have a different movement, a different mechanic than the rest of the ribs. Those ribs open with a caliper function. And so the caliper opening of the ribs rely upon the ribs above it doing a good bucket handle, and then also allowing the thoracolumbar fascia and the abdominal container to be able to expand three dimensionally.
So this three dimensionality of this pressurization and this full breath pattern are really, um, have a strong relationship to the kidney. Um,
that's a lot. And I think that's kind of like all the notes I had, but so let me give you some overarching explanations. The kidneys are some, I don't know, explanations, so overarching like, let's wrap this up and like make it cleaner. The kidneys, very linked to the musculoskeletal system, specifically our rotation.
Great influence on the knee and the proximal tib fib joint as well as the midfoot. And the left kidney is more associated with urogenital. The right kidney is more associated with digestive. So,
there is that relationship. Tight feeling hip flexors, limited trunk rotation, limited side bending, limited three dimensional breath. These are all things that I would be curious about, a kidney issue. Someone who tends to, um, have a, stand in a sway back and don't, doesn't have a lot of space or ability to flex at the thoracolumbar junction.
They tend to put a little bit more pressure on the kidneys, um, which can lead to some fatigue issues and some adrenal function issues as well. Also, somebody who just complains of pain in that area, right? Actually, one of the, one of the symptoms of like adrenal feed. Fatigue is like pinpoint like pain, right?
Kind of at the super border of where the, um, kidneys are at, right? Right. Where the adrenal glands are at. So, makes sense.
I always try to like. Think in a way of like, okay, if somebody doesn't have the skills of someone who's gone through the Barral work and to can do the general listening and to determine when somebody has a kidney issue, and if you haven't done the LTAP and you don't have an ability to know when the kidney is, like, the body is directing you to the kidney, um, well, first of all, take the LTAP.
Uh, there's a in person course coming up in April and then an online course coming up soon too. But, um, I'm always like, well, how can you work backwards? So if you, if you see someone with a knee coming in and complaining of knee and you see some of these other signs, fib joint, stuck, um, You see midfoot stuck, you see lack of rotation, you see lack of three dimensional breath, or even any one of those things, before you treat the knee itself, try treating some of these Other things, T7, T10, T11, T12, work on three dimensional breathing, work on trunk rotation, do some sort of gentle supported breathing for the kidneys, getting them to slide back up under the diaphragm.
Um, I'll link that in the show notes. I think I have a video of that. Um, I actually have a whole region, a whole 45 minute region session around supporting the kidneys for happy, healthy knees and hips. So I'll link that. But this is what I'm, this is sort of what my point is, is that The kidneys matter. The kidneys have a huge influence in our daily life and health and have a big connection to our lower extremity especially and then back pain also and so why not consider that when somebody is coming in.
With a musculoskeletal thing, especially maybe somebody who's like, I've done all the things and nothing's helped. Try going somewhere else. Maybe it's not just an E thing, but also sometimes it's, I use this in like post op knee cases, is like Hello, swelling, you want to support swelling, you like fluid balance, fluid flow, make sure the kidneys are happy, you make sure the kidneys are happy, guess what happens, the knee feels better too.
So you get like more bang for your buck, right? So understanding this relationship, I think is actually extremely important to consider that the knees. Are influenced by things other than just the hips and the foot, right? And the knee itself. So hopefully this was helpful I know it was kind of a lot of like anatomy and a lot of like random information about the kidney but I want you to sort of get a peek into sort of what my What my thought process is, and I see, I, this happens all the time on Boxer.
Somebody in my courses will reach out to me and be like, I have this patient I did. You know, I did the assessment and this is what I came up and what am I missing? And I'll be like, well, if it's a knee, then I'm thinking kidney. I'm thinking lumbar plexus. I'm thinking, you know, T7. I'm thinking. Like, where are the other things?
Like, where else can we sort of rule in or rule out something else? So, this is also all about what the whole free download is. You know, the Visceral Reveral Cheat Sheet. It's sort of to work backwards like this. So, if you don't have a skill set like general listening, or the Locator Test Assessment Protocol, the LTAP.
Then you can still know that there's somewhere else to look to get results besides right at the joint itself or at the surrounding musculoskeletal joints. So hopefully that's helpful. If you're like me and you are having a fluid balance issue because like you, you have a tendency towards swollen legs, add some electrolytes in with your water.
Your kidneys will thank you, your blood will thank you, and your energy will thank you. It's all connected. Until next week, have fun with that information, looking forward to hearing how you use it and I'll see you next time.