Visceral Considerations For Rehab & Exercise Pros

It’s all about what’s on the inside that counts on this week’s episode of the Unreal Results podcast. This episode is recorded from a talk I did for Katie St. Clair’s mentorship program where I just happened to dive deep into the viscera, in particular the connections between organ health and overall body function.  In this episode, you’ll hear about the mechanics of how the viscera move within the body and the physiological importance of maintaining visceral mobility for vitality and function.  You’ll hear specifics such as the impact of thoracic and cervical mobility on cardiovascular function, and practical techniques like bronchial tube stretching.  As a rehab or exercise professional, this is a comprehensive episode you won’t want to miss!

Resources Mentioned In This Episode
Learn the LTAP In-Person in one my upcoming courses
Episode 76: The Hidden Signs: Detecting Red Flags & Visceral Referrals
YouTube Video: Bronchial Tube Stretch



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.

    Hello. Hello. Welcome back to another episode of the Unreal Results podcast. This week I have a episode for you that is actually an excerpt of a presentation I did for Katie St. Clair's Empowered Performance Academy, which was her mentorship program. Um, last year I talked to them about this concept of a whole organism approach, but what we really explored was The effect of the visceral mobility and its attachments to the musculoskeletal system and how that gets reflected in our movement and why it should be important to consider when we're looking at the musculoskeletal system and biomechanics and movement in general.

    So without further ado, we'll get to this excerpt. I hope you enjoy it and I hope it provides some sort of like overarching Good insight for you on the viscera and the musculoskeletal system. Uh, this is also great to the timing of this because, uh, this week in the online LTAP level one course, we are diving into the viscera and exploring specifically the viscera cavity.

    So you'll hear me go in depth quite a bit on those viscera, especially in this excerpt as well as the rest of the viscera and the abdominal and pelvic containers. So enjoy.

    So, what is visceral mobility? Uh, visceral mobility is the range of motion the organs move within the hard frame. It's determined by ligaments. diaphragm and pressures within the containers.

    Just like the organism, the whole body, if mobility is diminished, then the function will be affected over time. So we know sedentary, sedentarianism, Right? Being sedentary is like a very high risk for mortality, right? The, when we stop moving, we, or lose the ability to move, our likelihood of not being well goes up very high.

    And this is true also on a more micro level of the organs and even a micro level of the cells within the organ themselves. Everything needs movement in order to maintain its vitality and its health. So organs, the way they connect within the tissues, one, there's this, they're like pressurized, right? The pressure, the negative pressure in our thorax helps to lift all the organs in our abdomen and pelvis.

    But also, they're attached, the ligaments, to the skeleton. And so this means that there is like joints under there. So just like the ankle joint articulates, the two bones of the ankle joint articulate with all these ligaments, and need to move. The ankle joint needs to move for function. Same thing happens in your liver and your diaphragm.

    It makes a joint and the liver and the diaphragm have to move like a joint in order to allow good movement of the body. And that's a great example of like what Part of the body then with that movement globally relate to an osteokinematic standpoint, it would be trunk flexion, trunk rotation, trunk side bending is dictated by the ability for that deeper joint of the liver and the diaphragm to go right.

    So, um, With that said, the same thing that limits mobility in the musculoskeletal system in the joints, right, not going through full ranges of motion, not moving, sedentary being sedentary, or injury, right, damage to the tissues, injury that often happens with some sort of whiplash type motion, like whiplash, not just car accidents, whiplash is a motion of energy being applied to the body and reverberating throughout it, that's what creates, um, disruption in tissue during injuries, pathology, etc.

    Right? That scar tissue, that sedentariness, that locks down our mobility, and it does so in the organs as well. So when we have limited mobility in our organs, our organ function starts to diminish. It reminds me of, like, if you ever played, like, Mortal Kombat or, like, Street Fighter, and as you're fighting somebody and, like, things are happening to your body, your, your life force energy, like, your, your, your, your life on your guy starts to Go down, right?

    The battery life goes down. Same thing is happening. When we start to lose our mobility, the function, the vitality of that organ starts to be limited. This is also too, why I think, you know, I always go back to like, well, why is exercise just like, So good for the body, like why is exercise so good? And of course, like people are like, Oh, this is endorphins.

    Oh, it's the cardiovascular benefits. Oh, it's the joint mobility, but also because all of that stuff also keeps our organs moving because our organs are connected to our skeleton. And so when we keep our organs moving, they keep functioning at a higher level. And that helps us to survive. Um, Which is why, you know, again, why exercise can be more powerful, so powerful.

    So visceral motility is a little bit different than visceral mobility. Um, visceral motility is an expansion and contraction of the cells of an organ. It has a pattern or rhythm. that mimics the, the pattern of migration from the midline during embryological development. So everything started, we all, everything's connected.

    We started as one cell, and as the cells multiply and divide, it happens in the midline, and then it's travels out to the borders to become the organs, to become the parts of the body, right? The different tissues. And so that rhythm, which is a constant rhythm of movement away from midline, but then a contraction and expansion, right?

    A folding and unfolding is how the embryo creates the fetus and develops into a little human. Um, that is a remembered pattern that stays in ourselves. And so you can actually feel it with your hands. Um, And our motility is also eventually what makes up the mobility. So the mobility of our organs are a bigger version of the pattern of motility.

    Um, so the motility of the organ, and again, this relates to just the cellular motion too, has to do with the vitality of the organ. But as a mobility, like we just talked about, is the mobility limit. is limited, then the cellular expansion pattern gets limited as well and vitality starts to diminish.

    Visceral motility is different than peristalsis. Oftentimes, people use the word motility for how the gut structures function to move food through the gut, and that is actually called peristalsis. Um, and that is another form of movement, um, but it is not the same as visceral motility. So now we're going to break down sort of mobility at each sort of, um, visceral structure for you.

    So moving on to the thorax, um, the visceral mobility of the medial synapse, the pericardium, and the heart. Um, the heart is actually free and unattached inside the pericardium.

    The pericardium is like a sac that surrounds the heart. Um, the only sort of like fixation of the heart within that pericardium is the vessels that are going into the heart from the lungs. And from the rest of the vasculature, but it, it actually does not have ligaments to it. It is just maintained within the, uh, vessels and then the sack of the pericardium.

    But then the pericardium has ligaments to the spine and the rib cage. And holds it sort of in there. The, um, heart and the pericardium are covered by the left lung. Like a little flap of left lung comes in front of the heart. And I like to think of it as like giving the heart a little bit of a hug. In fact, the lung cancer association, um, logo is a heart with like the lung or sorry, yeah, is a heart.

    with the lungs hugging it. And I just was like, this is a great image. Um, and it just is again, shows like an additional layer of protection of our heart, right? So, um, that's when I lay out the hierarchy of the heart. I'm like, uh, the organs on like brain and then heart and then lung. Um, behind the heart is the esophagus.

    And, uh, the movements of the heart go anterior and inferior, um, left axial rotation and then posterior superior right axial rotation. So the way it moves is as it, um, rotates. To the left it moves anterior and inferior and as it moves to the right it moves posterior and superior. So it's doing this. That is its motility as well as its mobility.

    I love this picture because you get to see how the pericardium is suspended and how intimately connected it is with the cervical spine and the thoracic spine but also the back side of the sternum. And this is so important. One of my favorite things actually to experience in terms of pericardium and heart in a movement standpoint is understanding.

    This next picture, so then you get to see the inferior pericardial ligaments and its attachment to the diaphragm. So the frontal pericardial ligament. So what happens when you take an inhale is your diaphragm drops down. But your sternum lifts up and your spine goes into extension, right? And so what does that do to the ligaments of the pericardium?

    It stretches them out. And if there's a sac right there, that means as the ligaments get pulled this way, the sac gets squeezed. And that sac getting squeezed, it actually is like a massage to the heart and, and helps the heart pump, right? So it improves your cardiac output. with an inhale breath. So our ability to breathe three dimensionally actually helps to take stress off of our heart muscle from having to do the work of pumping the blood out and increasing the cardiac output.

    So the interesting thing about this is, As people age, they tend to get, um, very stiff and sometimes even completely fused between the manubrium and the sternum, which is the top little bone and then the bottom bone of our like main chest bone here, that becomes fused. And so they no longer get that thoracic extension and that sternal lift with an inhale breath, which if that's not happening, Then the ribcage can't open up as well as possible, which also probably means that the diaphragm is not able to drop down as well.

    And so what happens to the heart then? The heart has to work harder to pump the blood because it doesn't have this mechanical assist anymore. And the correlation is when people, I can't remember what study it was, but I read a study that it was basically like people who have a fused manubrial sternal joint, the older population, are also more likely to have cardiovascular, um, disease.

    And I was like, well, that totally makes sense from a mechanical standpoint. This also, too, I get on a soapbox about this relationship because I work with so many NFL players, and what's interesting with NFL players, if you look at their long term mortality, uh, one of the highest risks that they have post football is cardiovascular disease, heart attack, and, like, cardiac death.

    And it used to be thought that this, well, not used to be, it's still thought that this is more related to our, the health markers of like inflammation and, um, diabetes and, you know, like all the, just the poor health. And it used to be in football that like the. Linemen, especially, were these overweight people who ate a lot of food and just could eat whatever they wanted and, like, being fat and big was, like, rewarded.

    Well, football nowadays is a totally different thing. Like, the linemen are, like, lean, mean machines. Like, it's rare to see somebody, like, obesely overweight. Sometimes when they retire, they do gain weight. Um, but, I've been seeing some of the football players who have died from cardiac arrest post football career have actually been some of the fittest people.

    One of my friends and athletes, um, Kwame Lassiter, he was a football player, played for many years. In his retirement, he became a yoga instructor. He was like, looked, looked like he was in better shape than he was when he played. And he dropped dead from a heart attack at a very young age. I think he was like in his forties.

    And it was so sad to see and you see that actually more and more of these guys that look fit, do all the things for the health, eating well, not drinking, like getting their blood work dialed in, but they're still having heart attacks. And what happens is. From a movement standpoint in the heart, when we're accelerating, um, we're, when we're accelerating, kind of like if we're in the car, like think about a car instead of running or something.

    But when the car is accelerating, that means you sitting in the seat of the car, your body is accelerating through space too. That's physics. When the car abruptly stops, right? If you hit on collision, you something, you hit something like you hit a brick wall, the car stopped, but you still keep going, right?

    That's why we wear a seat belt, right? But you still keep going. And then the seat belt pulls us back and we go the other way. And then the seat. stops us, right? So our pericardium are all the organs, but especially the pericardium and the liver, because it's so heavy, they're moving at that same rate of speed.

    And so the body, when it gets hit, when it's running down the field, and then either stops to change direction quickly, which athletes do all the time, or gets hit by somebody and stops. The organs are still accelerating forward and the only thing to stop them, they don't have muscles to stop them like the body, the musculoskeletal, the whole organism does.

    It has these ligaments to stop the movement, right? And you can see there's room in the chest for the heart to go forward, but the ligaments check that movement and pull it back. Over time, the ligaments get stiffer and stiffer, right? As that whiplash energy is applied to them. They either get stiffer because they're storing energy from that force applied to them, or they get stiffer because every time they have to check the range of motion, like they have little micro tears.

    And we know as a structure gets damaged, the inflammatory response comes in and repairs it and tries to make it stiffer, adds more collagen and different type of collagen and the tissue is not as elastic or hydrated as it once was and so the things get stiffer and we know from that study With the older population that when the joints around the pericardium gets stiff, then the heart disease comes, right?

    So this is my theory of understanding like, geez, maybe one of the reasons why our football players are at such high risk for heart disease is because they're losing this mechanical mechanical help to pumping the organ the pumping the blood and pumping and keeping the heart healthy and the heart itself has to do more work because we don't have the mechanical deformation happening to help pump the pericardium again this is all sort of like um world according to anna like this is my hypothesis but it sort of kind of makes sense whether it's true or not i don't know but what it's true To me, it feels so true and believable, uh, that it's like one of the things I make sure I do when I work on all my athletes is, um, I, I do a manual therapy and movement to address this stiffness within the pericardial ligaments because it's so powerful and I'm.

    I'm going to talk about it today, but also like the diaphragm, you know, and you all know this very well as a big, like a muscle for core container stiffness and the faster you move your limbs. The more the diaphragm has to stiffen up to stabilize the spine. And so on most of my athletes, I see them with super stiff diaphragms, but it makes sense because they're moving at such high velocities and their limbs are moving and they're doing all this dynamic movement.

    That their diaphragm has to choose to be a stabilizer a lot of the time. So it just gets hypertrophied and stiff. So anyways, went off on a little tangent there, but it's a tangent that I really think is important and also kind of drives home the importance of what we do when we're mobilizing people.

    It's not just for exercise and look good and body health, but it is helping our organs as well. So the. So now you can imagine the movements related to this visceral mobility is going to be thoracic extension, cervical range of motion, thoracic flexion, rib mobility, and thoracic rotation. This is a great picture of the different layer, the pleura, the, the sac.

    That the lungs live in, so they live in sacs too, and these sacs attach, uh, to our cervical spine and our first rib. So, um, real big driver sometimes of neck pain is our lungs. Uh, they rotate or spin and also just like the heart when they, um, laterally, when they internally rotate, they move forward in the body as they go up.

    And then as they actually rotate, they move posterior and back. So what do you think that is? As they inhale, they move posterior and back. And as you exhale, they move anterior and up. Here's a picture of deeper, the lung itself and the tubes. The great, the greatest thing I can also teach you about the viscera is if it is a tube, it loves a direct stretch.

    So tubes like to be stretched. So I actually have on YouTube a, um, self bronchial tube stretch that feels so good, um, to really connect within the tubes and be able to stretch them out is like Oh, wonderful. This is also one of the benefits of humming. Humming with um, added in with that stretch is helping to stretch out the trachea part too because of the vibration that is created with it.

    Just kind of like a vibration gun that we use for massage. Our humming can do the same thing and create a little bit of reflexive relaxation within that tube and allow it to be stretched a little bit as well.

    This is a picture of the pleural ligament. So the orange part is the pleura. Um, the, the tip of the orange part is called the pleural dome. And then these ligaments go from the pleural dome to the bodies of the cervical vertebrae, the transverse process of the cervical vertebrae, and then the first rib.

    Down in the liver. So the liver is a huge organ and a very heavy organ, and we actually don't ever really feel the weight of that organ because of that negative pressure from the thorax. It's sort of unweighting it a little bit. It makes a capsule, a joint capsule with the diaphragm, which is called Glisson's capsule.

    Um, The movements of the liver are anterior and posterior roll, which is just the name for flexion and extension. So anterior roll is flexion, posterior roll is extension. That is, um, that is provided by the relationship with the falciform ligament. That's the main ligament that checks anterior and posterior roll.

    The suspensory ligaments of the liver, which are on the corners of the liver. You have a, um, hepatic sensory ligament and you have a, um, Um, splenic sensory ligament, which is on the left side. Those hold up the corners of the liver. So that provides inferior and superior glide, which is also in the liver's world, a side bending.

    So superior glide would be the part of the liver that goes up to, um, Towards the armpit, and then, um, inferior glide is as it comes back down. This is checked by the suspensory ligaments, especially the left suspensory ligament. Um, and then you have internal and external rotation. Internal and external rotation, oh, I don't think I have a picture of it here, but, is, um, the axis of rotation is actually around the vena cava.

    And the abdominal aorta, so it on the backside of the ligament, there's the ligament on the backside of the liver, there's a little indent and the vessels live right there and there's a legal ligament that goes over from one side of the liver to the other side of the ligament over those vessels and then the spines right next to it, but the liver then rotates around those vessels.

    So those vessels. So this is why when someone has a liver that's not moving very well, they're more prone to swelling in their legs. This is the primary reason why mobilize them help because it opens up that entire, um, hose to the lower extremity to the gut and the lower extremity. So gut health problems, right?

    If you're not digesting things well, sometimes it can be a blood flow issue to the intestines. The superior and inferior mesenteric artery and vein come off of the abdominal aorta and the vein below the level of the liver. So the liver can be a big contributor to gut problems just from a fluid flow sense as well.

    So trunk rotation, thoracolumbar junction, thoracolumbar junction flexion and extension, So important for liver mobility, side bending, and then shoulder range of motion is really related to the liver because of a nerve connection, um, in relationship to the neck, which I think we'll talk about in a little bit, and, uh, same thing with cervical range of motion.

    The large intestine. It's a tube, so it loves to be stretched. Um, and hopefully you see the anatomy of where this tube is, and you can see the 3D, excuse me, the 3D ness of it. The splenic flexure, which is the left corner of the, colon is like posterior. So whereas the sigmoid colon is pretty anterior in the bowl of your pelvis.

    So that gives a three dimension of this to it. So hopefully you see that to lengthen the colon, it's not just side bending, but it is side bending and rotation, um, as well as extension or can be flexion. So rolling patterns are great for stretching the tubes. The ascending and descending parts of the colon are actually really fixed to the posterior abdominal wall, uh, which means that more important for them to be stretched.

    Um, this transverse colon and the sigmoid colon are really flexible. The sigmoid colon can end up on the upper right. upper quadrant when it's full of shit, literally. Um, but it's super mobile. So sometimes no rhyme or reason to where it is, but just know it's really mobile. So usually when we're trying to improve mobility of colon, it's usually, um, we can get a lot of bang for our buck when we're mobilizing the ascending and descending colons and the corners, the flexures of the, of the colon.

    So this is going to relate to side bending, rotation, and extension. The stomach and the esophagus. So the stomach is very flexible and it's various shapes. Do yourself a favor and google stomach shapes on a google search and you will see pictures of all the different shapes of stomachs and it will blow your mind.

    Uh, what we traditional view of the stomach, which is the picture here, is not typical. on most people. So in the Barral classes, we actually trace or like we find the borders of the stomach and we trace with a pencil or a pen on the skin, everybody's stomach, and then we all line up in class and look at each other's stomach and it's like all over the place, like how far down the stomach goes, the shapes, it's crazy.

    If it is, going to be stuck in one direction. It's usually that it gets sucked up too much by the pressure in the thorax and is too superior. So it really loves to be mobilized by being pulled down. So in a J stroke motion. The esophagus, it's also a tube. So it likes to be stretched. So pulling the esophagus down is really important.

    Obviously the esophagus goes all the way up to our mouth. So even doing tongue mobility stuff can be really helpful for the esophagus itself, and understanding that a fulcrum point is at the pericardium is, is, can be helpful as well. And then where it connects to the stomach, it always, people are always surprised how high up it is, it's nipple line.

    So the gastroesophageal sphincter, Which is the, uh, sphincter muscle between the esophagus and the stomach is, um, between rib 5 and 6. So that's the top of your diaphragm. So a lot of people are like, where are my lungs? And they point to their, they put their hands on the side of their rib cage and I'm like, that's your liver and your stomach.

    Your lungs are above that. So, sometimes just orienting to yourself to what is in your structure is going to be super powerful. Um, esophagus and stomach will limit or be involved in side bending, rotation, extension, and cervical extension. Another fun fact about the stomach, much like with the colon that I talked about, the, the, the fundus, the top of the stomach, um, is actually posterior.

    So sometimes when my stomach gets really full and uncomfortable, I actually have pain posterior, and that's a very common, um, spot to feel uncomfortable, especially in, um, acid reflux and GERD problems as well. But it's like, I can feel almost like the fundus of my stomach getting full and pushing into my posterior thorax wall.

    I think when I went through the foundational courses of the visceral manipulation curriculum, that was like one of the biggest mind blowing things for me is like,

    understanding the 3D ness of the organs, which says a lot because actually in undergrad, I dissected cadavers and I dissected the abdomen. And so it's like, I saw the 3D ness. I touched the 3D ness with my hand and I still didn't really appreciate it on a live body in front of me until I drew all the organs on, on the front sides and the backside in the class.

    And I was like, Oh my gosh, that is three dimensional. I think what a concept because in the cadaver, since it's not full of. fluid in life, you actually don't see the 3Dness. The stomach just looks like a floppy sack on the front of the abdomen. The colon is like a deflated tube laying on the back of the abdomen, so you don't get to see the, the, the space of everything

    within a cadaver. So it's probably why I didn't appreciate the 3D ness of it all. So the kidneys are interesting in that they are actually not connected to the hard frame with ligaments. They're the only organs that are not connected to the ligaments. They are packed in a fatty fascial slip and suspended by pressure only.

    Which means as we age or as we do a lot of like high impact things, um, And also, as we lose the negative pressure in our thorax from lack of mobility, our kidneys start to fall down. And as they start to fall down, they start to irritate the lumbar plexus nerves and cause a lot of hip and back pain, um, and leg pain, thigh pain.

    So the other fun fact about the kidney is the kidney developed, um, embryological with a mesoderm. The mesoderm is also the, um, Mesoderm is also the muscles, the, the musculoskeletal system. So the kidneys are very connected to our movement and our musculoskeletal system. The fun they're they function as a filter and so they're really, you know, a big part of our fluid system, our fluid balance system, which is also why they live, um, At our thoracolumbar junction that is a primary area that we're twisting our body and that twisting helps to much like the compression of the pericardium and the thorax helps to pump the blood.

    The twisting helps to move all the fluids throughout the body as well. Um, Oh, the mesoderm also, um, creates the mesentery and the meninges in the brain, which I thought was really interesting as well. So connections, embryological connections. So the kidneys can significantly limit rotation around the thoracolumbar junction when they are not moving as well as thoracolumbar flexion.

    Tends to be too like an adrenal fatigue pattern, tends to be someone who's a little stuck in extension and it's almost like you're mechanically crushing the adrenal glands a little bit. So it makes sense that they're not happy. So restoring thoracolumbar joint, thoracolumbar junction flexion can be really powerful.

    A little, um, understanding of where the kidneys are. The superior pole of the kidney is at the level of a T10. The inferior pole can be anywhere between L2 and L4, lower down as they start to fall down, which is medically called ptosis, P T O S I S. Um, and keep in mind that the inferior pole of the kidney is only about 2 or 3 inches deep.

    So it's pretty close to our, um, back muscles, which is why you shouldn't be dropping elbows in this location or using very hard tools, massage tools in this area, because you can, um, damage your kidney. You can cause, you can bruise the kidney. You can, um, injure the structure of the kidneys and that will make you feel like shit very rapidly.

    It, uh, kidneys are very linked to our energy levels and, um, our fatigue levels. And, uh, also our eyesight quite a bit. So, um, the quickest way to feel like crap is to overtreat the area of the kidneys. And obviously very linked to the function of our adrenal hormones. Oh, when we take a breath too, they can move, um, up to three centimeters.

    three centimeters. That's a huge range of motion. So they move a lot. So moving down into the pelvis, the bladder, uterus, and the rectum. Um, if you don't have a uterus, a prostate will be in that same sort of orientation behind the bladder, but it is from anterior to posterior bladder. uterus, rectum, so they're kind of stacked.

    Um, you can also think of them stacked in from above. The bladder is the shoulder, shortest, the uterus is the next tallest, and then the rectum is the next tallest. Um, they are all suspended in the pelvic bowl with suspensory ligaments, um, of various different names, but a bunch of different ligamentous or fascial containers that hold these to the wall of the innominate bones in the sacrum in the pubic bone.

    I find it hard to look at this picture and not then see how SI joint mobility has a lot to do with the health of the viscera inside of it, because if all we can appreciate is the fact that the uterus changes shape when we have a baby in it, or the uterus changes shape when we have our period, like our uterus is changing shape and moving, then throughout our monthly cycle.

    And, um, if you can't see how that pulls on the ligaments inside the pelvic bowl and has a tendency to create an inflare or an outflare of the pelvis or a nutation or counter nutation of the sacrum, then I'm like, I don't know how I can help you. But I will say it till I am red in the face that SI joint mobility is often not an SI joint ligament problem.

    It is a visceral and nervous system. We already talked about how the central nervous system attaches in the sacrum. It is oftentimes very Not consistent upon assessment, right? The March test, the Gillet's test is known to be a not reliable test. It's not reliable because the joint mobility is not like joint mobility in other joints.

    It is very intimately connected to our viscera and nervous system and is actually part of the locator test assessment protocol. This is the joint that gives us the best information of what the body is protecting. Visceral central nervous system or peripheral nervous system and musculoskeletal. It's a very great picture to see.

    The mobility of these organs is going to be, they're already on the midline, so there's not going to be a whole lot of side bending and rotation as part of it. Their mobility is all about gliding down and up and down and back and forth. Um, the pelvic position affects the organs. The organs affect the pelvis position, vice versa.

    Mobility is dependent on the pelvic floor mobility. And the rest of the pressures within all the different ca cavities, which we'll look at in a second too. This is like one of the most golden parts of this lecture for you. Um, this is, um, a great picture of the visceral somatic reflexes. So these are the sympathetic and parasympathetic connections to are the organs at the different levels of the spine.

    So remember how I said that, why I think Pilates is so powerful because. It does segmental spine mobility, and it understands how to maximize mobility through all those 25 to 32 moving parts. Well, when you do that, you are positively affecting every single one of these structures. Every single one of these structures.

    Because the sympathetic and parasympathetic connections are going to dictate how well the organ is functioning. So. Um, this is also a way for us who don't know how to directly do visceral manipulation, how you can still affect the viscera. You know how to mobilize the spine at these different levels, or maybe even no manual therapy to the spine at these different levels.

    So if you have not, if you think your liver is not moving very well, then you can go to T5 to T9 and do some things there, and I bet you your liver will start moving better. Okay, so this is also a great, this is why this becomes such a powerful slide to use as a reference because this gives you access to ways to treat the body in ways that you didn't maybe consider before.

    So some general visceral referrals, so pain, pain referrals happen. So here's the thing about the viscera. The visceral organs. Um, they don't have a whole lot of nerves to them. And so, messages from the visceral organs to the brain when something is not right, gets a little muddied about what's going on and often then is represented by somatic pain.

    Pain in our musculoskeletal system. This is very well known from a heart standpoint. Most of you know that the signs of a heart attack are left arm pain, jaw pain, chest pain, upper back pain, right? So, but all the organs have these viscerogenic referrals, and so, um, and it's not just when they're about to shut down, like a heart attack, um, it can just be when they're not moving very well that they give these mixed messages to the brain, so the common ones.

    Are listed here. Um, with that said, the body, when it goes into a protective pattern around these organs, remember one of the principles was that the body hugs the lesion, and so then you could also have aches and pains and movement dysfunctions in different parts of the body because of the change in posture and dynamic.

    Alignment organized around that structure. So these are just classic viscerogenic referrals based on the nerves. Relationships, whereas what comes up when we actually use the locator test assessment protocol and figure out what. organ or what structure the body is protecting, we might see someone's ankle mobility completely change after I treat their right side of their lung.

    There's not a viscerogenic connection, but there's a dynamic alignment connection because everything literally is connected. So even the, these, these slides are really helpful and can be a cheat sheet, right? In fact, I have these slides as a visceral referral cheat sheet that I offer as a free download, but.

    It's not everything. This is why we still assess. We assess because we don't know how everything is connected and we don't realize how the body organizes itself around something that is important. And so, the Locator Test Assessment Protocol helps us to figure that out. But these can be just helpful, um, ways for us to go about that, especially if you don't have something like the Locator Test Assessment Protocol.

    And the other enable, you know, but if you want to start integrating and understanding and a treatment or movement focus around the organs and see what happens like this is a great place to start. So these next slides to show you the connections from a spine as well as referral pattern standpoint. So, um, I don't know why I have it just on the lung, but really the C3 through five location is a lot of the organs because the C3 through five is the nerve roots of the phrenic nerve, the nerve roots of the phrenic nerve.

    The phrenic nerve is one of the sensory nerves to the organs of the neck. The thorax in the upper part of the abdomen. This is why we get so many general visceral referrals to the neck and upper extremity. This is the whole basis of my education called never treat the shoulder first. So, I know we're getting towards the end of our time, so I'm going to kind of wrap it up on this piece of looking at the visceral fascial connections.

    So, the visceral fascial connections, um, and you all, you know, because I know, like, talking about pressures is a big part of, sort of, some of the teachings that you know from a core and movement standpoint. And it's just really helpful to see these fascial connections. All the containers are related to each other, right?

    So everything is connected. We started as one cell, but here is another way to look at how everything is connected with the fascial containers. And when you change pressure in one container, right? If you change pressure in your thoracic container, which. Theoretically, it's one of the easier containers to manipulate and change pressure of because of its relationship to the lungs.

    It has an effect on all of the pressures. It's going to affect the pressure in the cranium, in the neck, in the abdomen, and in the pelvis. And this is because of this relationship of the fascial containers. Um, But also remember that all visceral referrals are driven by the nervous system, motor control is driven by the nervous system, mobility is granted by the nervous system, and pain is regulated by the nervous system.

    So understanding all these connections are really helpful as well. And this is actually, you know, this is why I provided that slide for you, but also this is a good one to sort of wrap it up with. The The innervation to the peritoneum, which is the sac that all those, um, organs live in, is, I said, the phrenic nerve for the upper part, but the lower part and the middle parts have segmental innervation by the sympathetics of T6 through L2, but then also, uh, the obturator nerve.

    The obturator nerve innervates the lower part of the parietal peritoneum. So oftentimes the quickest way that I treat the viscera from a global reflexive standpoint is through the accessory nerve, which is the cranial nerve number 11, um, to our upper trap, as well as. the obturator nerve. Accessory nerve, because it is intimately connected to the phrenic nerve and the vagus nerve, which is the other nerve that innervates the sensory information to the gut organs.

    So accessory nerve and obturator nerve are really two quick ways that I can know I'm going to influence a lot of the containers of the organs.

    You know, knowing that there is like so much more to learn.

    In fact, actually, I do want to share this last, this last thing. Let me go back to my shared screen. Is this how I always like to wrap up? Presentations with this quote that I love from Jean Pierre, he says the door has opened a crack, and we can only imagine the vast expanse waiting behind it, our knowledge of the human body is so small compared with the unbounded intricacy and richness, it possesses.

    It is important to start the journey of discovery even though we cannot see where it will lead. Let us be grateful for all that our occupation offers even if it is not always easy. So I love that, um, I love that quote for him and it is just like a, you know, hopefully that's what you're feeling right now is like, whoa, there is a lot that I haven't even considered.

    And instead of feeling overwhelmed by it, hopefully you feel inspired by it. Like that, not only is there more to learn because I know you love to learn, but there is so many more ways that you can help someone be well and improve their health and how they feel and their function and their lifetime or career longevity, whether it be a professional athlete or like.

    a mom or you or even a kid like anybody, right? Like that's what the name of the game is all about making people feel better and making sure that they, you know, live a long life and are able bodied till the end and go to sleep one day when they're 100 and just peacefully pass away instead of having their health decline and feel like they're a prisoner in their own body.

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Decoding The Nervous System For Health Pros