Neural Manipulation - Jean Anne Zollars, PT, DPT, MA
“Neural” refers to the nervous system of the body, which includes the brain, spinal cord and the peripheral nerves of the legs, arms, trunk and head. Neural Manipulation (NM) was developed by Jean-Pierre Barral and Alain Croibier, osteopaths from France. NM is a hands-on therapy which helps to free up the nerves, brain and the connective tissue around the nerves, including the cranium, so that the nervous system functions better. Just like other tissues, a nerve functions correctly only when it is able to move freely. Restrictions or neural adhesions can cause pain and immobility, and result from trauma (falls, motor vehicle accidents, ankle sprains), surgeries, poor posture, repetitive motion (like carpal tunnel syndrome from use at a computer), diseases, and so on.
For instance, a patient fell down, and caught herself with her hand. She came into the clinic with shoulder pain. From the fall, not only was the wrist compressed, but the impact of that fall travelled through the nerves and fascia all the way up the arm to the spine. So, part of the treatment was working with the nerves involved. For this patient, the median and musculocutaneous nerves were involved, as well as part of the brachial plexus. Because specific nerves not only innervate the muscles, but also the joints, utilizing NM can be very helpful in chronic tensions in the joints.
The nervous system serves as a communication system throughout the body, connecting the brain with all the other tissues, such as organs, blood vessels, muscles and joints. So, NM is often coupled with other therapies, such as visceral manipulation (VM) or joint work. If a person has reflux and stomach pain, the therapist may use not only VM for the stomach, but also NM for the vagus nerve and sympathetic nerve plexuses.
In the cranium, neural manipulation differs from craniosacral therapy in a few ways. Both therapies work with the cranial bones and duramater. In neural manipulation, the therapist can also work with the brain itself, and the cranial nerves which come from the brainstem. These nerves register sensation of the face, tongue, jaw, as well as part of the control of swallowing, chewing, seeing, hearing, balance, to name a few. Thus, working with the cranial nerves can help with these functions.
The soccer coach of a 9 year old girl would not let her play soccer because of chronic pain in her ankle. Previously, she had two lateral ankle sprains. Working first with the neural tension in the superficial branch of the fibular nerve allowed the ligaments to loosen, and after 1 session, the young girl was back to playing soccer without ankle pain.
Further information about Neural Manipulation can be found at: www.barralinstitute.com
