Dr. Susie Gronski


But You're a Physical Therapist, Why Are You Practicing "Voodoo Therapy"

I can't tell you how many times I've been asked, "what the hell is visceral manipulation?" I've been practicing visceral manipulation for the past 4 years and let me tell you it's been a game changer for me and for my patients. 

I even made my mom a believer and if you know her, you know how big of a skeptic she is. 

So my mom calls me, sick as a dog barely whispering over the phone saying " Susie, I don't know what's wrong with me.  I feel so sick. My stomach hurts. I'm nauseous, dizzy and my arms are weak. I can barely get out of bed." She begged me to come take a look at her. My mom never asks me for help. EVER. So, I knew something was up. I told her not to panic and that I'd be over soon. 

My mom's an accountant, runs her own business and just had one of the worst tax seasons ever, or so she says. But then again, she says this every year. For 3 months, she's been working around the clock, under high stress, adrenaline always pumping, and to top it all off, she's hit menopause. So you could imagine what state her body and mind were in.

I walk into the home only to find mom in the bedroom looking like death. Still in her PJ's with her room looking like a hurricane just stormed by. I asked her "ok, so what's going on?" She starts crying, telling me how much pain and agony she was in this past week. She's been unable to eat because her throat would close up and she'd get acid reflux so bad that she couldn't even swallow water. She had shortness of breath, weakness in her arms, and overall felt like shit. To be honest, she looked like shit.

Calmly, I checked her blood pressure and heart rate. Normal with a slightly elevated resting heart rate of 94 bpm. I checked her eyes, muscle strength, and sensation. All normal. I reassured her that she wasn't dying. Phew! I then played detective using the skills I've learned from my visceral training. Ah ha! It was the fascia of the liver with the gallbladder. Makes sense to me as both these organs are highly sensitive to stress and not to mention the hormone fluctuations due to menopause. I quietly did some work, allowing her body to take the lead. After I was done, she sat up and I checked her vitals again. Her heart rate went down from 94 bpm to 77 bpm. The color in her face returned and her breathing was much calmer. She looked at me with wide eyes and awe saying "what the hell did you just do?" I smiled, chuckled under my breath and said, "oh nothing, just listened to your body." She sprung up out of her bed like a spring chicken feeling energized, clear, and experiencing no symptoms whatsoever. She told Luke "you know what kind of miracle worker you have? I can't believe what she just did." My husband and I just looked at each other and smiled. After that day, she felt great and was able to drive to Florida just as she planned. 

I'm here to tell you, I'm not a miracle worker. I just try to facilitate better communication between the brain and the nervous system. Bottom line you can't separate the mind from the body and vice versa. Trusting my hands to "listen" to the tissues, to guide me to create a better environment for healing to take place.  

Here's some history on visceral manipulation:

  • Developed by Jean-Pierre Barral, a french osteopath and physical therapist, whose curiosity began while studying and dissecting cadavers in a lung disease hospital

  • He discovered patterns of stress and adhesions in cadavers and applied this knowledge while studying biomechanics in living people

  • He began teaching visceral manipulation in the USA in 1985 (must be a sign since this is the year I was born haha)

  • Visceral manipulation is also known as "liquid osteopathy"

Ok, I still don't get it

To some, visceral work is a sham because it's not supported by lengthy, peer-reviewed research or funded by big pharma. For one thing, it's not a money maker. For me, visceral manipulation is the missing link to manual therapy. Being an integrative physical therapist, my philosophy is to treat the whole body and not just the symptoms. Visceral manipulation is a wonderful tool that allows me to trust my hands as my primary diagnostic tool, to "listen" to the patient's body, to be the detective that finds the inherent driver of pain, dysfunction, and compensation. It's not magic, voodoo, or a gimmick. A skilled visceral practitioner goes through intensive training, practicing the art of fine tuning and improving the sensitivity of their hands to feel precise tension patterns throughout the body. I always give the example of a wine connoisseur, a person with expert knowledge and training to discern the fine tastes of wines. They train their taste buds to be very specific, peeling away the taste of each flavor in the wine. Visceral therapists do the same. They train their hands to be very specific and sensitive to various tissue textures, depths, motion, fluid, and emotion. 

Visceral practitioners don't claim to heal or fix anyone. The philosophy is about creating an environment suitable for the body to heal on its own. At the end of the day, the only person responsible for your health and the outcomes of your healing potential is YOU. You just have to trust in your body's own inner wisdom and believe that it's intelligent enough to heal itself. Think about it this way. You get a paper cut on your finger and it starts bleeding, you don't stare at it telling it to heal do you? That's just mad. Instead, you trust that it's going to heal on its own. 

When I graduated from physical therapy school, I practiced conventional therapy. If you came in with a shoulder problem, I just worked on your shoulder. Who cares about what your back, legs or feet were doing, you've got a shoulder problem so that's where the problem's gotta be, right? Not necessarily. I discovered that for some clients, no matter how many exercises I gave or how many times I stretched and mobilized them, they still weren't getting better. Why? I knew there had to be something else, something I'm missing. So bouncing from job to job, I was wringing out the juice to find that exact tool, that piece of the puzzle that made sense to me. This journey eventually led me to visceral manipulation and it changed my whole perspective on treating the human body.

While many therapists are struggling with meeting their productivity quotas, pressured by corporate standards, it's no wonder that the art of manual therapy is dwindling and taking a very hands-off approach. For me, this is ridiculous. People yearn to be touched, listened to and cared for. Not just looked at as another number or another body part. Most physicians don't have the time to touch their patient's, given 7 minutes per patient if they're lucky. So why should I be forced to do the same? Our hands are the greatest gift to give our clients and there's something to be said about that. Human connection, no matter what tool you prefer to use, is the bottom line. You want to be heard, touched and genuinely cared for. 

So to all those that moan and groan about evidenced based this and evidenced based that, I say who cares. Evidenced based practice consists of 3 things: clinician experience, patient experience, and research. Not just research. Some of the greatest discoveries and developments were created just from experience. The research came later. I say if it works, it works so go for it. At the end of the day, the goal is to make a difference in your life regardless of what "tools" I choose to use. After all, doesn't the confidence in my choice of technique have a huge effect on its success?