Visceral Mobilization of the Gastrointestinal System with Ramona Horton

Aug 26 2017 to Aug 27 2017

Course Description Mobilization of Visceral Fascia: GI System


The fascial system consists of four concentric layers, with the visceral layer beginning at the naso-pharynx and ending at the anal aperture. This course will focus on theory and manual therapy technique for mobilizing fascial structures of the visceral system.


The abdominopelvic canister is a functional and anatomical construct comprised of the somatic structures of the abdominal cavity and pelvic basin, which work synergistically to support the midline of the body. The walls of this canister are occupied by and intimately connected to the visceral structures found within. In order to function optimally, the viscera must be able to move, not only in relation to one another, but with respect to their surrounding container.


Material will be presented that includes the science of and evidence behind the use of fascial based manual therapy with presentation of relevant visceral and fascial anatomy. Emphasis will be placed on clinical reasoning with the goal of immediate implementation of the techniques learned following this introductory course. Students will be instructed in an extensive number of treatment techniques, via the anterior and lateral abdominal wall. Course participants will be able to immediately incorporate evaluation and treatment of visceral fascia for patients with a variety of diagnoses related to pelvic health physical therapy.


Mobilization of the visceral fascia requires advanced palpation skills along with extensive knowledge of visceral anatomy. This two-day continuing education course is designed to provide comprehensive knowledge concerning the relationship between the connective tissue surrounding the visceral structures of the gastrointestinal system as it relates to physical therapy treatment such as chronic abdominopelvic pain, GERD, constipation, abdominal adhesions and urinary issues. This course is geared toward the experienced pelvic health therapist who wishes to integrate advanced manual therapy skills into their treatment regime.


This course includes extensive lab work; all course attendees should come prepared to participate as both clinician and patient. Male course attendees may participate fully in the entire course. Pregnant attendees may participate in a limited capacity, bringing a model for labs will facilitate the best learning experience, as deep palpation to the abdomen is not recommended in pregnant women.



1)      Minimum of pelvic floor level 1 training to include internal vaginal examinations and relative clinical experience.

2)      Fascial Mechanoreceptors Article from

3)      Review visceral anatomy terms (provided)

4).     There are NO Visceral Mob pre-reqs for this course other than the readings above


Goals and Objectives Level 1b: GI System

Upon completion of this course, participants should be able to:


1.    Understand the neurophysiology of fascial based manual therapy

2.    Understand basic fascial structure and function to include all four fascial layers and how they interrelate

3.    Describe the theory and application of mobilization of visceral fascial structures pertaining to pelvic floor dysfunction within the scope of a physical therapy practice

4.    Understand the biological plausibility of how alteration of the normal mobility of visceral fascial structures can contribute to pelvic floor dysfunction

5.    Cite potential causes for development of restrictions in the visceral fascia of the abdominal, pelvis, and thoracic cavity.

6.    Express a clear understanding of the visceral structures within the peritoneal cavity and how their normal mobility is related to somatic and autonomic function

7.    Differentiate between direct and indirect mobilization techniques and understand the proper application of each

8.    Identify visceral structures within the GI system via abdominal and pelvic landmarks

9.    Apply the technique of three-dimensional fascial mobilization to visceral structures, utilizing external approaches.

10.           Recognize and treat fascial restrictions throughout the pelvis, and abdomen as they may relate to diagnoses of dysfunction within the gastrointestinal system

10. Develop treatment sequencing with respect to global, local and focal fascial restrictions.

11. Understand the contribution of chronic G-I distention to central sensitization and the visceral-somatic reflex

12. Implement fascial mobilization techniques into a comprehensive treatment program for the patient with varied diagnoses to include urologic, gynecologic, gastrointestinal and pelvic pain as they relate to physical therapy treatment.


Course Schedule Day One August 26, check in 7:30 AM


8:00     Lecture: Concepts of Visceral Mobilization   Biological plausibility, clinical reasoning









Lecture - Evidence based fascial mobilization



Lab I - Palpation  and fascial stacking exercise



Lecture  - Liver fascial connections and impact



Lunch (on your own on Saturday)



Lab II - Mobilization of fascial attachments of liver


Triangular ligaments, Side lying mobilization with trunk movement, Self-treatment, the liver tango



Lecture - Stomach anatomy, dysfunction and evidence






Lab III- Mobilization of fascial attachments of esophagus:


Cricoid cartilage, Cardiac sphincter, Esophagus mobilization with trunk

4:30      Lab IV – Mobilization of stomach attachments                                                

5:30     Adjourn

Day Two Sunday, August 27


8:00 Review and questions from day one                               

8:30 Lecture – Small intestine/Peritoneal cavity                                

9:30 Lab V – Mobilization of fascial attachments, peritoneal cavity  Duodenum, Ligament of Trietz, Mesentery of small intestine

10:30 Break                                                                                        

10:45 Lab VI – Mobilization of fascial attachments, peritoneal cavity, Posterior parietal peritoneum, Abdominal wall/parietal peritoneum, Loops of small intestine/adhesions

12:00 Lunch (provided by Embody PT)

1:00 Lecture – Colon, fascial attachments and dysfunction              

 1:45 Lab VII - Colon: Cecum, ileocecal valve, facia of Toldt, sigmoid, flexures

3:00 Lab VIII: Fascial decompression to the abdominal wall                                  

4:00 Adjourn

PA PT CEU 14.75 hr pending


    Cost:  $525.00 

PLEASE NOTE: Time will be utilized as efficiently as possible, so plan to begin promptly at 7:45 for registration and intro on Saturday, and at 8AM on Sunday. We will provide lunch on Sunday to improve time. The course will end at 4PM. Please plan your travel arrangements around this teaching schedule. 

Snacks for breaks coffee/tea/water provided both days. Lunch on Sunday will be provided; lunch Saturday is on your own (Sewickley is a nice walking community with several easy places to eat)

Registration online:

or paper regsitration link below

PLEASE NOTE Course Dates ARE August 26-27, 2017 

Questions:  please contact

Ramona C. Horton, MPT graduated from the US Army-Baylor University program in Physical Therapy in 1985. She co-founded the Pelvic Dysfunction Program for Rogue Regional Medical Center located in Medford, Oregon in 1993 and currently serves as clinic lead practitioner for that program. She has completed extensive study in manual therapy with emphasis in visceral mobilization and fascial treatment to include studying urogenital manipulation with Jean-Pierre Barral DO, in Lyon, France. At the request of Kathe Wallace, Ramona developed a visceral mobilization course in 2007 and is currently faculty for the Herman & Wallace Pelvic Rehabilitation Institute, teaching multiple visceral and fascial mobilization courses throughout the country. Ramona has written and lectured on the topic of visceral manual therapy at multiple venues such as the APTA Combined Sections Meeting and for the Chartered Society of Physiotherapists.