- CranioSacral Therapy
- SomatoEmotional Release
- Neural manipulation
- Barral Brain Therapy
- Visceral manipulation
- Manual Lymphatic Drainage
In our facility (private physical therapist office), each patient can choose from a range of specialized manual techniques that work with the soft tissues of our body near the central and peripheral nervous system ( Barral Brain Therapy and Neural Manipulation ) and in the internal organs of the abdomen, pelvis and chest ( Visceral Manipulation ).
We can also offer you rehabilitation methods oriented to the reduction of swelling ( Manual Lymphatic Drainage ) or to relaxation, balance of the autonomic nervous system and overall release of fascial tension ( CranioSacral Osteopathy and Somatoemotional Release ).
Further information on the therapies can be found above.
To make an appointment for manual therapy, please contact us at:
CranioSacral Therapy
The human craniosacral system includes the membranes (meninges) and cerebrospinal fluid (cerebrospinal fluid) that surround and protect the brain and spinal canal. This system originates in the skull (cranium) and continues down to the sacrum (os sacrum). Any restrictions or limitations (tensions/blockages) in the membrane system can directly affect the diverse physiological functions of the central nervous system. Craniosacral therapists palpate the craniosacral rhythm, which directs them to possible restrictions in the patient's body. They then correct these current or active restrictions with the help of innate self-healing mechanisms.
The roots of craniosacral therapy go back to the early 1900s, when the eminent osteopathic physician William Sutherland worked. In his more than 20 years of research, he explored the concept of cranial bones that were, from his perspective, arranged to move. Sutherland eventually developed his theory into a structural therapeutic concept known worldwide as cranial osteopathy.
In 1975, osteopathic physician John E. Upledger began research that attempted to confirm Sutherland's theory of moving cranial bones as well as the importance of the physiological function of the craniosacral system. Upledger's team used a different therapeutic approach than many osteopaths before him. Instead of focusing on the cranial bones, he became more interested in the fluids and membranes that are part of the craniosacral system, as well as the mechanisms that "move" the cerebrospinal fluid within the skull and spinal canal. Upledger's research showed that cerebrospinal fluid circulates within the brain and spinal canal through the expanding and contracting movements of the semi-closed hydraulic craniosacral system. This movement occurs at a normal rhythm of 6 to 12 cycles per minute, which we refer to as the craniosacral rhythm. Upledger later consolidated his findings into a therapeutic concept known as craniosacral therapy (CST).
CST therapists are trained in the skill of palpating the subtle craniosacral rhythm so that they can identify areas of restricted freedom of movement at the level of the intracranial and spinal membranes, particularly the outermost layers of the meningeal system i.e. the dura mater. If the therapist reaches a site of specific restriction, he or she "holds" this position and waits for the tissues to relax. This requires the use of very gentle hand pressure. Very often the marking of the place of imbalance by the therapist, but actually unconsciously also by the patient's body, starts the craniosacral system and its self-correcting mechanisms.
The ten-point protocol
CST consists of a number of techniques, but they have a common basis. Each step of the therapy is designed to be both an evaluative (diagnostic) and corrective (therapeutic) tool.
1. Induction of the resting point
2. Release of the transverse fascia: pelvic floor, diaphragm, upper thoracic aperture, hyoid bone and atlantooccipital articulation
3. Decompression of the lumbosacral transition, medial compression of the hip blades and traction of the dural sac
4. Rocking and sliding within the dural sac or tube
5. Frontal traction (frontal bone mobilization)
6. Parietal traction (mobilization of the parietal bones)
7. Decompression of sphenobasilar synchondrosis (cartilaginous connection at the base of the skull)
8. Temporal techniques (mobilization of temporal bones)
9. Compression and decompression of the temporomandibular joint
10. Compression of the 4th cerebral ventricle (resting point induction)
It is not necessarily necessary to follow the exact order of the above protocol, but it is essential to observe the accuracy of the application of each procedure or therapeutic technique. Advanced CST therapists often modify the order of the Ten Point Protocol based on the individual needs of the patient. Using the protocol to examine or diagnose the function of the craniosacral system can provide the therapist with a sometimes surprising insight revealing the primary origin of the patient's difficulties. Very often, this takes the therapist to places far removed from the patient's site of pain, etc..
CST in our practice
The beauty of craniosacral therapy lies in the gentleness of the pressure with which it aids the free flow or mobility of body fluids, membranes, muscles and fascia. As a result, this technique can be incorporated into any therapeutic approach with respect to the patient's treatment focus. The positive effect is related to a wide range of self-correcting body innate mechanisms. CST literally normalizes the environment in which the central nervous system functions. Thus the therapeutic effect of this technique encompasses a wide range of sensory, motor and neurological problems.
Author of article: Lisa Upledger, D.C., CST - D
Lisa has worked at the Upledger Clinic in Palm Beach Gardens, Florida, USA since 1991.
Translated and edited from the original English by Mgr. Helena Toušková, CST - D.
SomatoEmotional Release
Have you ever heard of a case where a long-ago injury has caused the patient's pain or discomfort long after the primary cause, i.e. the injury, has been healed in the patient's body. In clinical practice, this is not as unusual a case as we might think. Although Craniosacral Therapy relieves tension in the tissues, e.g. caused by a recent trauma or injury, from a holistic therapeutic perspective it is also necessary to release emotional tension, the subsequent release of which allows for a comprehensive healing of the effects of the recent trauma. In these cases we speak of the SomatoEmotional Release® technique.
SomatoEmotional Release® (SER) is based on research conducted in the 1970s by John E. Upledger and biophysicist Zvi Karni. Their clinical studies led to the discovery that the human body very often retains the emotional impact of trauma, especially of an intense emotional nature. Emotions are very often hidden by us and there is an accumulation of them on a physical and psychological level.
SomatoEmotional Release® talks about the predilection storage sites and refers to them as the area called the energy cyst. It further states that our body has some adaptive capacity for these predilection areas of emotional stress, but that these decrease over time and the daily "buildup" of other stressors can result in an overall decrease in tolerance and the development of more severe dysfunction. Impairment in physical function leads the patient to see a physician or physical therapist and manifests with a wide range of symptoms and dysfunctions.
SomatoEmotional Release® offers a calm and safe environment for the patient allowing the release of pent-up emotions. A therapist trained in this technique usually engages in a therapeutic dialogue with the patient, while still maintaining physical contact with the traumatized part of the patient's body. The process of release is supported or facilitated for the patient by simple dialogue or visualization without the need for analysis or deeper understanding of the emotional context. Very often, during the therapeutic dialogue, the patient's body assumes the equivalent position it had at the time of the trauma. This is a natural process for the body, which allows the release of accumulated emotions, resulting in a softening to total relaxation of the tissues and body.
Patients' reactions to SomatoEmotional Release® vary widely, but the most common are:
- Spontaneous awareness or recall of the time surrounding the trauma, resulting in the release of hidden emotions tied to the traumatic moment in question and already forgotten.
- The expression of unexpected and usually negative emotions such as fear, sadness, anger, frustration, guilt, etc.
- Subsequent feelings of relief, lightness and/or joy.
SER is a complex and body-natural process that allows for the final release of emotional stress associated with a traumatic experience that causes the persistence of e.g. physical pain symptoms. It is not a coercive technique, on the contrary the therapist or rather the facilitator is there to support the patient in every step of his/her release.
SER should not be confused with or substituted for a psychological or psychotherapeutic interview. Therefore, the SER technique should not be offered to psychiatric patients or patients with more serious psychological disorders without appropriate therapeutic expertise.
Neural manipulation
Neural manipulation (NM) was developed in clinical practice by the French osteopath and physiotherapist Jean-Pierre Barral. French osteopath Alain Croibier further collaborated with Barral and developed the NM technique. The Neural Manipulation courses are based on the teaching of clinical techniques personally developed by Barral combined with Croibier's scientific knowledge.
Neural Manipulation explores the mechanical relationships between the skull and spine i.e. the rigid frame and the envelope - the dura and neural elements. It includes investigations and therapeutic approaches to address limitations (restrictions) of dural and neural components that are not commonly addressed to address musculoskeletal symptoms. Neural manipulation identifies and releases local neural restrictions, while simultaneously examining the influence of these local fixations on the rest of the body and addressing more complex (global) dysfunctional patterns by assessing this relationship.
A nerve functions properly only when it is able to move freely in surrounding structures. Neural manipulation facilitates nerve conduction and intraneural blood supply for local and systemic responses (reactions). By understanding the detailed anatomy of neural manipulation, we can clearly see the potential for altering a pathological condition in the presence of limited nerve conduction or mobility.
Manual therapy applied to peripheral and cranial nerve therapy follows standard principles of nerve mobility and function. For optimal nerve function, the nerve must be able to move freely within its environment.
This free movement is essential for:
- Nerve conduction
- Electromagnetic conduction
- Intraneural blood supply
- Intraneural nerve supply
- Local and systemic reactions - responses
Neural fixation
When a nerve is fixed, it usually loses its ability to glide and/or stretch within its length. Intra or perineural pressure increases markedly and concomitant changes in consistency occur. The nerve pathway (nerve course) shows functional interference (blood supply or electrical and/or electromagnetic conduction).
During fixation, smaller nerve segments may harden. They are perceived as so-called nodules and are very sensitive or even painful to touch. These 'knots' are a manifestation of intraneural interference, congestion of physiological pressure points or local fibrosis. The nodules can be released very quickly, sometimes within a single therapy session.
Palpation of cutaneous branches of peripheral nerves can be useful for evaluation as well as for therapeutic clinical considerations. When evaluating cutaneous branches, i.e., if they are sensitive to pressure or painful, we detect fixation of deeper nerve branches.
Neural manipulation and its effect on organs
Visceral manipulation techniques can affect the musculoskeletal system and vice versa. It is important to mention that the release of sensitive nerve ganglia can have a beneficial effect on the functioning of the corresponding visceral organs. Nerve manipulation is involved in all bodily functions and without proper nerve control, visceral activity cannot be maintained or sustained. Nerve stimulation is centrally processed and sent back to the body as so-called feedback. This sequence of physiological reactions or responses occurs in the case of zero nerve interference (fixation). Proper evaluation or examination is essential for good therapeutic results. Treatment of a normal or healthy nerve segment (without fixation) has no side effect, but in the case of a local nerve it may provoke irritation.
The general view is that we perceive trauma as a serious injury that causes tissue damage. This definition encompasses the various effects of external forces acting on our body. For example, not every joint trauma leads to a fracture or dislocation. Medically, patients are often considered perfectly healthy, even if their health or condition is not the same as it was before the trauma occurred. The same is generally true for neural manipulation and nerves. Traumatic nerve lesions are usually not recognizable or well defined in the clinical picture. Instead, a wide spectrum of disorders (symptoms) are usually found. Due to ambiguity or lack of evidence (through conventional examination methods and imaging procedures), symptoms are often overlooked.
Often, functional nerve lesions develop after neurotropic diseases (such as herpes zoster) or as a result of faulty posture. Much more commonly, they are produced by the application of mechanical forces and energies: friction, pressure (compression) or tensile forces (stretch). To produce a lesion, the trauma need not be severe. They are often repetitive microtraumas. For example, non-physiological movement, a harmless sprain, faulty posture or muscle contraction. Pathological processes can occur intra and extraneurally.
Intraneural trauma affects distinct neural structures:
- demyelination, neurinoma, hypoxia of some fibres (in conductive nervous tissues)
- epineural scarring, perifascicular oedema, fibrosis, irritation of the arachnoid space or dura (in nerve connective tissue)
These pathological categories are rarely found separately. In practice, they are usually found in combinations. Extraneural disorders are mainly caused by narrowing of the spinal canal. Trauma can also affect the "nerve ganglion" or functional junction of nerve tissue. For example, it may result in nerve or epidural hematoma, epineural tissue fixation, dural adhesion in the spinal canal, etc..
Disorders of intra and extraneural functional origin often occur in tandem. In our opinion, they are closely associated with and/or even cause nerve fixation dysfunction. Our goal is to treat this type of fixation with manual technique, or at least to minimize its negative consequences.
How can nerve manipulation help you?
Peripheral nerve treatment can affect the so-called facilitated areas or segments, thus promoting a general or systemic effect. Manual treatments are basically effective as a result of mechanical influences that cause a nerve stimulus transmitted at a local or central level. Manual neural manipulation alters intra- and extraneural pressure, improves sympathetic tone function of blood vessels due to autoinnervation of sympathetic ganglia and sympathetic tone innervation of peri-neural connective tissues, which are positively influenced by treatment by fixation in nerve sheaths.
How is neural manipulation performed?
The treatment of nerves is done through the precise application of pressure. The tension of the perineurium and all other nerve connective tissues is transmitted down to the root sheaths, so that this distal contact has both a mechanical and reflexogenic central effect.
Barral Brain Therapy
Jean-Pierre Barral has been interested in the brain for more than forty years. After treating many people with head trauma, stroke, brain disease and psychomotor disabilities, he has developed an original manual technique that combines gentleness and maximum manual precision.
- The structural approach of manual therapy focuses on the vascular, nervous, meningeal, ocular, barometric and cerebral circulatory systems.
- The functional approach of manual therapy examines smell, hearing, vision, language, coordination, proprioception, emotions, etc.
The brain is inherently plastic, and in Barral's words, manual therapy can help us restore the "internal bridges or connections" in the brain that are vital to the lives of people with a variety of neurological difficulties.
Links to youtube video here:
https://www.youtube.com/watch?v=rNJPXKuRPwk
https://www.youtube.com/watch?v=8Q-NLuXwNtY
https://www.youtube.com/watch?v=keexAQdf1yM
Visceral manipulation
It is a type of therapeutic work that aims to promote normal tone and movement not only between the internal organs and their connections. Likewise, other factors that limit the "movement" of the internal organs can be positively influenced i.e. tension in fascia, nerves, blood vessels, as well as emotional tension.
Visceral Manipulation (VM) is based on the understanding that movement is a fundamental condition of life and any restriction (limitation) of this movement also affects our overall health. The same principle is applied to our internal organs. A healthy organ has an optimal function, the basic condition of which is movement. Movement is transmitted between organs and other body structures through the fascia.
Inflammation, trauma, repetitive movements, negative environmental influences, poor lifestyle, faulty posture and emotional stress can cause loss of soft tissue mobility. All tissues heal through adhesions or scar formation, which are areas where the arrangement of fibrous fibers is altered. In this way, the injury or trauma is literally stored in the soft tissues and can affect our bodily functions for many years after the trauma has resolved. The altered traumatic area can cause secondary functional changes or symptoms that usually do not resolve until the original site or cause of the injury is therapeutically addressed. For these purposes, VM does not directly target the site of pain or dysfunction, but finds the central source of tension (strain) through a general examination.
In Visceral Manipulation, we distinguish between two motor skills that are important for normal function of internal organs, namely motility and mobility. Mobility expresses the movement of the organ and surrounding tissues in relation to each other and the ability of the organ to adapt to surrounding compressive forces or stresses, and motility is the intrinsic active mobility of the internal organs, probably conditioned by their intrauterine development.
Already the word "visceral" associates the internal organs of the human body. The VM technique works primarily with the fascia that surround or support our internal organs. Manipulation in this case should be perceived more as mobilization, as it is performed very gently and slowly, unlike classical manipulative techniques.
The examination and therapeutic techniques of visceral manipulation are still being developed by the French osteopath and physiotherapist Jean Pierre Barral since the 1980s. Barral discovered and scientifically substantiated the bilateral connection between internal organs and painful symptoms or dysfunctions in the joints, vascular and nerve supply of internal organs.
Objectives of Visceral Manipulation
VM focuses on finding and therapeutically influencing tissue tension and subsequent normalization of function primarily within the motility and mobility of internal organs. The VM technique is based on the principle of the ability to feel and follow the tissues in promoting self-relaxation. It is very common that before the actual VM technique, the therapist tries to positively influence the vascular and nervous connections of the organ concerned.
The general aims of VM can be summarised as follows
- Return of physiological mobility to the soft tissues and consequent influence on the overall mobility or momentum of the human body.
- Release and influence of tension in soft tissues, including adhesions and scars.
- Increasing the regenerative capacity of soft tissues.
- Promoting arterial and venous circulation.
- Restoration of normal nervous system function through the promotion of nerve stimulation in the treated area.
- Improving detoxifying metabolic body functions.
- Reducing inflammation and pain.
- Improving hormone circulation within cellular metabolism.
- Normalizing muscle tone and promoting proper function.
- Reducing spasm (tension) in areas of increased soft tissue tension.
- Return of normal sphincter function within the digestive and urogenital tracts.
- Promoting physiological fluid movement and maintaining the balance of the lymphatic system etc..
- Increasing joint mobility.
- Supporting the body's adaptive and regenerative capacity leading to health, balance and overall vitality.
- Overall positive effect on our emotions and sleep activity.
What does the VM technique look like in our practice?
It is a gentle therapy that locates and then relieves areas of abnormal tension within the whole body. It is based on the specific placement of gentle manual pressures that condition the normal tone and mobility of organs, nerves, vascular connections and surrounding soft tissues. Trained therapists use the rhythmic mobility of the body systems to investigate the effect of pathological abnormal forces on the physiological forces of our bodies. VM uses gentle compression, mobilization and stretching of soft tissues. Although the VM therapist works on tissues located deep within our body, his/her work is non-invasive and rarely ever painful. Only gentle manipulation can improve or potentiate the functionality of individual internal organs, organ systems, and the structural and functional integrity of the human body. Once the source of the problem is resolved, symptoms begin to decrease and the body returns to health.
How effective is the VM technique?
The VM technique has been developed over 40 years by Jean-Pierre Barral. He has worked with tens of thousands of patients in his lifetime and has conducted many studies to assess the validity and success of the VM technique. Thus, there are countless clinical studies that confirm the effectiveness of each VM technique. Anyway, the VM technique is still evolving in its development to better understand the functions of our human body.
The text was translated and edited by Mgr. Helena Toušková from the book "A Pathway to Health - How Visceral Manipulation can help you"by Alison Harvey.
Manual lymphatic drainage
What is manual lymphatic drainage?
It is a tactile technique that focuses on the lymphatic system, which is located at the interface between the skin and the subcutaneous tissue. This system has the task of removing metabolic products. Failure of this drainage is manifested by the gradual development of swelling that is oriented towards the periphery or the root of the affected limb.
Possible applications of this manual technique
The aim of the tactile technique of manual lymphatic drainage is primarily to promote the outflow of lymph from the tissues without enhancing blood flow. At the same time, the drainage has an effect on other tissue structures, i.e. the nervous system in terms of reducing pain and on the muscles, which tend to relax.
Manual lymphatic drainage is used to influence swelling conditions (apart from swelling in cardiac, renal and hepatic failure), and to supplement the management of painful post-traumatic, post-operative, migraine and rheumatoid conditions. It is widely used to regenerate the body after strenuous physical exercise or for cosmetic purposes. Special therapeutic movements can also help to regenerate affected skin tissue (scars) or in the abdominal area easily solve problems with constipation, etc.
In our physiotherapy practice, we mainly focus on the drainage of the deep lymphatic system, which includes the lymph nodes and lymphatic pathways in the area of the deep artery and venous system. Our primary area of interest is the drainage of the visceral organs of the thoracic, abdominal and pelvic cavities. We use drainage of the deep lymphatic system and visceral organs in combination with soft techniques of Visceral Manipulation (Viscerolymphatic Drainage). We also focus on the superficial lymphatic system of the neck and superficial lymphatic drainage of the sensory organs of the head (eye, ear, nose and oral cavity). We then combine the drainage of the superficial lymphatic system with Craniosacral Osteopathy techniques.