GETTING OVER WHIPLASH _ THE MISSING BIT?

Physiotherapists are aware that spinal dysfunction can cause organ dysfunction if the nerve pathways to the organs are affected. But consider for a moment the reverse possibility. Dr Jean-Pierre Barral has demonstrated, using a variety of imaging techniques, that this can be a two way street organ dysfunction can indeed have a profound effect on the spine How? All the internal organs have a direct or indirect connection to the spine via their support ligaments. Therefore any tension in these ligaments can put tension on the spine. If this causes misalignment of the vertebrae it can lead to the need for muscular compensation. Although the support ligaments are richly innervated they have very few nocieptors, so we are rarely aware of tensions in these ligaments until the ability of the musculature to compensate for the tension is exceeded. We then feel pain. An example? A good one is Whiplash: the sudden acceleration or deceleration applied to parts of the body usually due to trauma. We typically think of the neck as taking the main brunt of the force but other organs and areas can be affected - for example the heart. Recall that it is surrounded by pericardium and held in position by suspensory ligaments. The pericardium is attached to the sternum via the sternopericardial ligament, to the diaphragm via phrenicopericardial ligament and posteriorly to the vertebral bodies of C4T4 via the vertopericardial ligament. During whiplash the heart, which is a dense hollow organ, can also be accelerated forward (or backwards) thus damaging the suspensory ligaments. Since there are few nociceptors in the ligaments we feel no pain; however as the ligaments heal they may fibrose, start to put tension on the lower cervical and upper thoracic spine because of their attachments and thus cause misalignment and an increase in pain in these areas. This may explain why patients have more pain weeks after the injury and why treating the cervical spine does not always produce lasting results. Visceral Manipulation has techniques which give rapid and lasting results by helping to restore the elasticity of the pericardial support ligaments. Jean-Pierre Barral is a French Osteopath who is pioneering visceral manipulation. He teaches regularly, has written a number of books and has devoted a lot of time to exploring and validating what is happening when he works with the techniques using ultrasound, fluoroscopy and other imaging methods. He does not write about any new technique until he has seen success in 200-300 patients!

Jo Crill M.C.S.P If you are interested in learning more about visceral manipulation or would like to know about introductory weekends please contact Jo Crill on 020 8874 9602 or e-mail crilldawson@hotmail.com or Cliff Jones +44 1235 851549 cliff_jones@mac.com