Common MSK Findings Related to Lymphatic and Visceral Dysfunction

Vertebral Rotation as Revealed by Static Palpation

In manual therapy and osteopathic assessment, subtle segmental rotations are often identified via palpation—especially when informed hands detect tension or asymmetry along posterior elements. But what underlies these rotations? Is the vertebra truly the culprit, or is it adapting to something deeper?

Q1: What structure is dystonic to facilitate a segmental rotation?

• Posterior elastic tissue?

• Anterior elastic tissue?

This question challenges our assumption that vertebral rotations are initiated by local structures. Could the segmental shift reflect a fascial or fluidic pull from anterior structures, rather than local muscle imbalance or posterior stiffness? Q2: Could a state of behaviour of fluid or tissue pressure in the parietal cavity, thoracic cavity, or cervical space facilitate this segmental rotation?

Absolutely. Consider the following:

• Peritoneal or pleural fluid stasis may increase local tissue pressure, prompting an adaptive fascial tension.

• Visceral motility or restriction, including gut or lung tethering, can distort the tensional field anchoring vertebral segments.

• Lymphatic congestion may alter neuromyofascial tone through both mechanical and reflexive pathways.

Q3: Is it purely a segmental dysfunction or a systemic dysfunction?

This is the clinical fulcrum.

• A segmental dysfunction implies a strategy of local manual therapy—mobilizing the joint, addressing stiffness, or releasing regional muscular tension.

• A systemic dysfunction implies that treating a rotated segment alone won’t address the primary driver. In such cases, fluid flow, fascial continuity, or visceral mobility may be the deeper contributors.

A rotated vertebra may not be dysfunctional—it may be adaptive.

Notice L3 rotated......

Deep Dive Question:

Could a state of fluid or tissue pressure in any organ and/or lymphatic vessels behind the parietal cavity facilitate uni- or multi-segmental vertebral rotation?

This question invites clinicians to think beyond structure.

• Ascites, gut inflammation, or mesenteric congestion can alter tension in the anterior fascial line.

• Diaphragmatic restriction—especially crural tension—can transmit altered load patterns into thoracic and cervical segments.

• Viscero-somatic reflexes may play a role in neurogenic facilitation of asymmetrical tone.

Could a state of behaviour of fluid or tissue pressure in any organ and/or lymphatic vessels in or behind the parietal cavity FACILITATE diaphragmatic crural dystonia, with regionally interdependent changes in behaviour proximally? What might that look like clinically?

Clinical Lens: Diaphragm Dysfunction and Fluid Stasis

"Diaphragm dysfunction and fluid stasis can create tension in visceral tissues, altering spinal behavior and motor control."

A fluid-pressured crural diaphragm—unable to descend freely or respond to metabolic demand—may manifest:

• Crural dystonia

• Altered thoracolumbar mechanics

• Increased tone in cervical myofascial chains

Final Inquiry:

Could fluid or pressure states in the viscera or lymphatics FACILITATE crural dystonia, leading to regionally interdependent changes proximally?

And if so…

What might that look like clinically?

• A stiff neck that never resolves with local techniques

• A recurring T8–L2 rotation despite manipulation

• Cervical or cranial symptoms that shift only after addressing the abdomen

In Practice:

• Use listening to assess tension lines and fluid behavior

• Observe for asymmetric breath mechanics

• Consider manual release of mesenteric, diaphragmatic, or pericardial restrictions

• Ask: Is the segment telling a local story, or is it narrating a global one?