The anatomy, biological plausibility and efficacy of visceral mobilization in the treatment of pelvic floor dysfunction

Author(s): R. C. Horton - Pages: 5–18

Abstract

This paper provides an overview of the technique of visceral mobilization. Founded on the principles of osteopathic manipulative therapy, this modality is employed by manual therapy practitioners throughout the world. Advancements in the field of pelvic physiotherapy have generated a better understanding of how the components of the abdominopelvic canister work synergistically to support the midline of the body and contribute to normal function. The walls of this canister are occupied by and intimately connected to the visceral structures found within the abdominal cavity. These midline contents carry a significant mass within the body, and affect the function of the somatic frame in three ways: referred visceral pain; central sensitization; and changes in local tissue dynamics. The evidence supporting visceral mobilization therapy (VMT) is limited, and there is an overabundance of case reports and observational studies in the literature. However, there is some higher-level clinical evidence that supports the inclusion of VMT within a comprehensive treatment programme for a number of pelvic physiotherapy diagnoses, including lower urinary tract dysfunction, chronic constipation and irritable bowel syndrome. The evidence supporting VMT for the treatment of adhesion-related disorders such as infertility shows promise, and further studies are currently in progress.

Keywords: fascia, manual therapy, osteopathy, pelvic dysfunction, visceral mobilization.