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By Dr Sarah Varmalis, Senior Osteopath When most people think of osteopathy, they imagine joints being gently mobilised, muscle tension being soothed, and maybe some back pain relief. But osteopathy is so much more than just musculoskeletal care. It’s a hands-on, whole-body approach that can also support and restore balance to our internal organ systems. Yes, that means your liver, kidneys, stomach, lungs, intestines, and even your reproductive organs.  The Body’s Inner Landscape: Visceral Connections The Barral Institute has been a leading voice in teaching and researching how manual therapy can influence the health and mobility of the internal organs, a field known as visceral manipulation. According to their work, every organ in the body needs to move freely to function properly. Think of it like this: your diaphragm moves up and down 20,000 times a day with each breath. If your organs are restricted, that repetitive motion creates strain and compensation patterns throughout the body. Over time, these restrictions, caused by things like surgery, infections, trauma, inflammation or even emotional stress, can reduce an organ’s mobility. And when one part of the system isn’t moving well, it throws off the balance of everything else. That’s where osteopathy comes in. How Osteopathy Helps Organ Systems Osteopaths trained in visceral techniques gently assess the motility (natural rhythm) and mobility (movement in relation to surrounding structures) of the organs. Using light, specific techniques, often with barely any pressure, we aim to restore the subtle motion between organs and their surrounding fascia, ligaments, and muscles. This can have a profound effect not only on the function of the affected organ, but on your overall sense of health and wellbeing. Improvements can show up as:
Counterstrain and the Autonomic Nervous System Another powerful system we use is Counterstrain, especially the fascial and visceral branches of this method developed by Brian Tuckey. While traditional Counterstrain focuses on tender points in muscles, newer developments explore how fascia and nerves influence visceral dysfunction. One fascinating area is the autonomic nervous system - the network of nerves that keeps your organs functioning behind the scenes. Inflammation or tension in certain tissues can create reflexes that keep the body stuck in a heightened stress response. This contributes to chronic issues like IBS, anxiety, hormone imbalances or fatigue. Using gentle positioning and sustained pressure on precise reflex points (often found through cranial scanning techniques), osteopaths can unwind restrictions in:
What a Session Might Look Like In practice, a treatment for organ support might start with a cranial scan or palpation of the abdomen. You won’t necessarily feel a big adjustment like in some other therapies. Sometimes the techniques are so subtle you wonder if anything’s happening... until you realise you’re breathing easier, your abdomen is softer, or a pain you didn’t even mention has faded. Many patients report feeling deeply relaxed after treatment, with improved digestion, reduced bloating, or a general sense that their body is functioning better — because it is. Who Can Benefit? Visceral and neural-fascial osteopathic approaches can be helpful for people experiencing:
In Summary Osteopathy isn’t just about backs and necks. With the right training and a gentle, informed touch, we can assess and treat restrictions in organ systems, nerves and fascia, supporting your body’s ability to function, digest, detox and thrive. If you’ve tried everything else and still feel like something’s not quite right, your organs might be asking for some osteopathic attention. By Duke Autret, Myotherapist Mapping the ‘Inflammatory’ Terrain of a New Clinical Frontier In the age of chronic inflammation, persistent pain, long-haul syndromes, diffuse mystery symptoms and systemically ‘invisible’ illness conventional diagnostic models are breaking down. Patients present with seemingly random multisystem complaints like digestive, neurological, musculoskeletal, psychological etc, and are met with more symptomatic labels and pharmaceutical management, so modern healthcare finds itself increasingly challenged. Blood tests, MRIs, and CT scans often fail to detect the low-grade and ‘sub-clinical’ dysfunctions that millions live with daily. Yet beneath the threshold of detection lies a potent and persistent and only recently observable reality: inflammation trapped in the fascial system (the soft tissue scaffolding that organizes and communicates across the entire body). So what if the issue isn’t just at the level of tissue, or even the organ, but instead at the level of terrain? And what kind of terrain is fascia? Welcome to the clinical frontier of Fascial Counterstrain (FCS), a method that brings technical precision to a biological paradigm that has long been ignored.  Fascia: From Framework to Feedback System Traditionally thought of as inert packing material, fascia is now understood as an intelligent, contractile, and highly innervated organ. Fascia isn’t just structural, it’s sensory. It wraps every nerve, vessel, organ, and muscle and is loaded with nociceptors (pain sensors) and proprioceptors (motion, balance, posture sensors). It contains contractile cells (myofibroblasts) as well, and when inflamed, it becomes the central interface between body, brain, and environment. Whether the inflammatory driver is viral (e.g., post-COVID), chemical (PFAS, microplastics, spike proteins), metabolic (diet, blood sugar), or postural (strain), or injury (trauma), the body reacts with cytokine release. This sets off a cascade
Fascia and Inflammation When the body experiences trauma, infection, surgery, chronic stress, poor posture, or toxic exposures, inflammatory cytokines like IL-1B, IL-6, and TNF-alpha flood into the interstitial fluid, triggering the cascade:
Why Conventional Approaches Fall Short Pharmaceuticals travel in blood, not lymph. Most physical therapies target muscles, not neurovascular or visceral fascia. And traditional diagnostics don’t detect the subtle physiologic dysfunction in fascia or lymphatics. And moreover, this inflammatory stasis doesn’t just cause pain. It alters movement, impairs organ function, limits perfusion (blood flow and nutrient/waste exchange), and even contributes to neuro-degeneration and cognitive decline (think, brain fog, early dementia, post-viral syndromes). In fact, trapped inflammation in the brainstem can affect everything from digestion to heart rate to anxiety. This is the Inflammatory Paradigm; the recognition that many chronic conditions are driven by persistent, unresolved inflammation, not at the organ or blood level, but at the fascial and interstitial levels. Enter Fascial Counterstrain Fascial Counterstrain is not a “direct” technique in the traditional sense. It’s not about stretching or mashing tight tissues. It is a system of precisely targeted decompression designed to drain inflammation and restore fluid flow. By identifying tender points (the surface markers of deeper inflammatory reflexes) and applying exact vector-based positioning, practitioners can slacken specific fascial structures (e.g., the sheath of a nerve, the adventitia of an artery, or a ligament of the liver for example), reactivate lymphatic flow, and break the inflammatory loop. Results are often immediate and lasting. Patients can walk out with restored range of motion, less pain, and improved function, sometimes after decades of dysfunction. But the key is that deeper layers, not just the symptom, is what’s being treated. A Systems-Based Approach In FCS, dysfunction is not isolated. A tight psoas may be guarding a congested iliac artery. Piriformis syndrome might stem from an inflamed cecum. A TMJ dysfunction could be driven by trigeminal nerve irritation, brainstem inflammation or dysfunction of the mesentery! This approach requires systemic fluency, understanding not just muscles and bones, but vascular beds, autonomic reflexes, lymphatic flow, organ attachments, and the central nervous system. As such muscle guarding is oftentimes secondary. FCS is, therefore, true precision therapy, not because it uses advanced tech or pharmacogenomics, but because it targets the correct layer of dysfunction in the right sequence. Rather than mashing buttons on the game controller to try and make something happen, it’s playing the right sequence at the right time that makes it highly effective. Wellness vs Symptom Relief This goes beyond pain relief. FCS doesn’t just clear symptoms, it supports the whole system by improving perfusion, oxygenation, and neural conductivity, it supports tissue regeneration. But it also reveals something deeper, we are only as healthy as our terrain. If the body is perpetually inflamed, because of stress, sugar, poor sleep, endocrine disruptors, viral debris, or biomechanical strain, it will not heal, no matter how targeted our treatment. This is why frameworks like the “buckets of health” are also crucial to appreciate:
The Bigger Picture - Terrain, Not Just Technique Most patients (and clinicians) want discreet solutions. A method. A protocol. A “fix.” And FCS delivers that in many cases. But the truth is also that the context in which we live (environmentally, socially, nutritionally) is flooding the system faster than it can be drained. This means FCS must be understood not just as a technique, but as a diagnostic lens, a way of reading where the system is burdened, congested, or trapped. And from that lens, we must ask deeper questions:
Reclaiming Our Terrain Fascial Counterstrain isn’t a silver bullet. But it is a paradigm shift, a way of seeing the body not as a machine with broken parts, but as a fluid, intelligent system locked in struggles with its environment. A system designed to heal, if only we can help it along the way to free itself up. In a world filled with chronic inflammation, we don’t just need better medicine, we need a new map. And that map may just be drawn through fascia. If you're seeking an osteopath or myotherapist working in our clinic and you're ready to go beyond symptom chasing, if you’re seeking a clinical framework that bridges physiology, neurology, fascia, and fluid flow, then we invite you to reach out and ask us about who is your best fit to try out this exciting new modality for yourself! Precision with a Paradigm Fascial Counterstrain brings a rare offering, a technically precise treatment within a whole-body, systems-aware paradigm. By identifying tender points (surface markers of deeper fascial inflammation) and using indirect decompression techniques, FCS:
Coming Up Next: When Precision Fails Without a Paradigm In my next blog, we’ll zoom out further, to explore how modern medicine's obsession with precision can actually blind us to the larger systems that make us sick in the first place. Why do so many people seek discreet hacks instead of meaningful change? And how can clinicians bridge the gap between technical care and paradigmatic wellness? By Dr Sarah Varmalis, Senior Osteopath At Simple Wellness in Rowville, one of the most common questions we hear is: "Should I see a myotherapist or the osteopath?" With seven skilled myotherapists and one osteopath working side by side in the clinic, it’s no surprise people want to understand how each approach works, and which one might suit them best. The truth is, both therapies offer real value, just with different tools and treatment styles depending on what your body needs.  What Does a Myotherapist Do? Myotherapy is focused on relieving pain, tension, and dysfunction in the muscles and connective tissues of the body. It’s an evidence-based, hands-on therapy that supports everything from muscle tightness and sports injuries to postural imbalances and everyday aches. At Simple Wellness, our myotherapists draw from a wide range of techniques, such as:
What Does the Osteopath Do? While myotherapy often focuses directly on muscles and soft tissue, osteopathy takes a broader view of the body, looking at how the musculoskeletal system interacts with the nervous, circulatory, lymphatic, and even organ systems. At Simple Wellness, our osteopath uses a unique approach called Fascial Counterstrain. This gentle, highly specific technique works by identifying and releasing tension held in the fascia, the connective tissue surrounding everything from muscles and joints to nerves, blood vessels, and organs. Each session begins with a cranial scan, a subtle but powerful assessment method that helps locate areas of restriction throughout the body. Treatment then involves positioning the body into a place of ease, allowing the nervous system to let go of protective patterns and promote healing. It’s a calm, non-invasive approach that’s suitable for sensitive, complex, or long-standing issues. So, Which One Should You Choose? Both myotherapy and osteopathy can be incredibly effective—the best choice really depends on what your body needs and how it responds to treatment. And sometimes, a combination of both is ideal. Here’s a general guide to help:  The Power of Working Together One of the best parts of the Simple Wellness approach is the way our team works together. It’s not uncommon for someone to see a myotherapist for muscular tension, then the osteopath for deeper system-wide regulation—or vice versa. We believe in personalised care, not one-size-fits-all solutions. That means listening to your goals, understanding your body’s needs, and making sure you’re booked in with the right person at the right time. By Dr Sarah Varmalis, Senior Osteopath Counterstrain is a gentle, hands-on therapy that helps the body release tension, restore mobility, and calm an overactive nervous system. It works by identifying very specific points of irritation — often where fascia (connective tissue), nerves, blood vessels, or organs have become irritated or inflamed — and then positioning the body in a way that allows those tissues to “let go” of their protective reflexes. This isn’t a technique that forces anything to change — it invites the body to reset itself. Counterstrain is based on the idea that pain and restriction often come from the body trying to protect itself. When something gets overstretched or irritated, the body can clamp down around it. That’s helpful in the short term — it stops you from injuring yourself further — but over time, it can create layers of compensation and dysfunction. Counterstrain gently unwinds that.  A Short, Winding History of Counterstrain Like many good stories in osteopathy, this one starts with curiosity. Back in the 1950s, Dr. Lawrence Jones, an osteopathic physician in Oregon, was treating a man with chronic back pain. The patient couldn’t stand upright, and nothing seemed to help — not adjustments, not stretches, not rest. So Dr. Jones tried something different: he propped the man up with pillows in a way that felt totally comfortable — no pulling, no pain. He let the patient rest like that, and when the man stood up… he was about 80% better. Not just temporarily, either — the results lasted. Jones was fascinated. He started experimenting with this approach and noticed that if he held the body in these pain-free positions for about 30 to 90 seconds (sometimes shorter, sometimes longer), the body would often relax, reset, and the pain would diminish. He called the sensitive areas he worked on “tender points,” and over time, he mapped out over 200 of them. This method became known as Strain-Counterstrain (SCS). Fast forward a few decades, and one of the few physical therapists trained directly by Dr. Jones — Brian Tuckey — took the work even deeper. He noticed that a lot of dysfunction didn’t seem to be coming from muscles alone. Instead, it was showing up in the fascia around nerves, blood vessels, even organs. These deeper systems had their own reflexes and protective patterns. Tuckey refined the technique to target these more complex areas, and Fascial Counterstrain (FCS) was born. Today, there are thousands of known tender points — and we’re still finding more. How Does It Work? Your body is wired to protect itself. When something hurts — whether it's a twist, strain, inflammation, or infection — your nervous system often responds by tightening up around it. That’s a smart move at first, but if it sticks around too long, it can become part of the problem. Counterstrain works by gently placing the body into positions that turn off these protective reflexes. When we find the right tender point, we guide the body into a posture that’s as comfortable as possible — which might mean curling around it, twisting slightly, or supporting the area. We hold that position for 30 to 90 seconds (or a little longer, if needed), allowing the tissue to reset. This process can reduce pain, improve movement, and calm the nervous system — all without needing to stretch, crack, or force anything. Using the Cranial Scan to Guide Treatment One of the key tools I use in Counterstrain is the cranial scan — a gentle, hands-on assessment that helps pinpoint exactly where the body’s restrictions and tender points lie. By lightly palpating specific points along the skull with minimal force, I can feel for subtle restrictions or tension patterns in the tissues. For example, if I detect a restriction along the superior temporal line, that clue helps me identify which system or region in the body needs attention. This scan guides me in locating the precise tender points to treat, whether they’re related to muscles, fascia, nerves, or other connective tissues. It’s a bit like tuning in to the body’s signals, allowing the treatment to be targeted, effective, and incredibly gentle. What Does It Feel Like? Most people describe it as relaxing, relieving, or strangely satisfying. You’ll be guided into a very specific, comfortable position — often using soft bolsters or the practitioner’s hands for support. You don’t need to stay fully clothed during the session — wearing appropriate undergarments or soft clothing that allows direct skin access is usually recommended, depending on the area being treated. While the position is being held, you might feel warmth, pulsing, or even a wave of tiredness. That’s a good sign — your nervous system is shifting gears. After the release, the practitioner will slowly bring you out of the position and recheck the area. Often, people notice improved range of motion, less tenderness, or an immediate lightness in the body. What Kinds of Issues Does Counterstrain Help With? Because it works with the body’s reflexes and connective tissues, Counterstrain can help with a surprisingly wide range of issues — even some that don’t seem “muscular” at all. Here are just a few things it may help with:
What is Osteopathy? How is it different to other manual therapies like Physio or Chiro? What kind of things can Osteopathy help with? We asked these questions and more when we interviewed our new Osteopath, Dr Sarah Varmalis, who will be starting at Simple Wellness in Rowville on November 6th.  What is osteopathy?
Sarah says... "Osteopathy is a holistic approach to the body. Throughout the osteopathic degree, practitioners learn how to treat through the muscular, skeletal, vascular, fascial and organ systems. Not only do we look into multiple systems but also in multiple areas, say you come in for knee pain, I will most likely look at your ankle and hip, depending on how those structures are going I may go to your lower back or toes etc." How does osteopathy differ from chiropractic care or physiotherapy? Sarah says... "Osteopathy is more of a jack of all trades. Although you learn how to manipulate joints in university using HVLA (high velocity, low amplitude technique that elicited ‘popping’ or ‘cracking’ sound), you also learn about the soft tissue, organs, veins, arteries, etc. Chiropractors spend 5 years learning primarily to manipulate joints, Physiotherapists spend 4 years primarily learning exercises. So although I can do both of these things, my level of expertise in those treatment modalities may not be equal to those that specialise in them." What types of conditions can osteopathy treat? Sarah says... Osteopathy can treat various conditions, including jaw pain, headaches, neck and back pain, tendinopathies, bursitis, sciatica, plantar fasciitis, constipation, help with breathing difficulties, assist with some forms of tinnitus (ringing in the ear), some forms of incontinence etc. If you have an ache or pain or something in your system is a bit odd that you have noticed, let us know, as with our medical knowledge some of those things may trigger our medical brain linking some complaints to one central structure. How does osteopathy address musculoskeletal pain? Sarah says... "Using soft tissue or manual therapy techniques osteopathy addresses the area of pain and surrounding structures, as we believe in a holistic approach. If you feel like I am being too gentle, never fear, as sometimes clearing surface-level structures can be just as important if not more important than deeper ones. Sometimes you have to deal with the packaging before getting to the item inside and this can be true for the body as well." Can osteopathy help with sports injuries? Sarah says... "Yes, Osteopathy can help with sports injuries such as tendonitis, bursitis, ‘pulled’ hamstring, rolled ankles, recovery with bone fractures etc." How does osteopathy support recovery from chronic pain conditions? Sarah says... "Chronic pain is defined as pain that has been felt for more than 3 months. During this time the body will rewire the nervous system, mixing cables around to supervise and monitor the area of pain. Your body will also naturally compensate for this pain structure, so often when a tissue has entered a chronic state, a different approach may be necessary. Osteopaths are trained to peel back the layers of the chronic pain structures to try and get to the starting point, though some areas may take some more peeling than others." Is osteopathy suitable for children and adolescents? Sarah says... "Yes. Osteopathy can be used on all age groups, though for those under the age of 5, we recommend going to a pediatric osteopath, as they have been more thoroughly trained in the treatment of babies and toddlers." Can osteopathy help with headaches or migraines? Sarah says... "Yes. A lot of headaches and migraines can be helped by osteopathic manual therapy techniques, which have been further backed by research." How does osteopathy treat joint pain or arthritis? Sarah says... "The treatment of arthritis primarily involves moving fluid along and helping the joint being pulled or rotated in certain ways to decompress as much as it is able. Unfortunately, once arthritis has reached a certain point we are only able to get to a certain area of comfort level but can help surrounding structures and help by giving exercises and advice." What is the role of osteopathy in improving posture and alignment? Sarah says... "Poor posture is often a result of the body hugging an area of pain or dysfunction. Pain in the body is a result of its inability to compensate for an injury. One way to think of it is like a Jenga tower removing one block won’t cause the tower to fall, nor will the next, but eventually the tower will wobble with a slight breeze before tumbling down. The tower tumbling down here is when you feel pain, up until that point however your body was adapting and compensating for these little insults. As an osteopath, our goal is to find where this initial insult is located and correct it which can help with posture." Booking an appointment with Sarah is simple - she is available Monday to Friday starting from Wednesday November 6th, and online bookings are already open! If you're an existing patient of Sarah's, but new to our clinic, please choose an Initial Appointment. If you're already a patient at our clinic, you can choose a Return Appointment. Dr Sarah Varmalis is starting at Simple Wellness soon - so we wanted to interview Sarah to learn more about her and her approach to healthcare!  What areas of osteopathy do you specialise in?
I love working through the vascular, organ and fascial systems. I find that many things are hiding in these systems that can net better results for patients. Do you have experience treating specific types of injuries or conditions? In this post-COVID world, I have found a lot of people have lingering tension throughout their respiratory system. I have had great results helping alleviate some of the long COVID symptoms such as breathlessness and fatigue, and have helped reduce asthmatic episodes in a variety of patients. I have assisted with some incontinence issues with both female and male patients working through the bladder in a non-invasive manual therapy perspective and have also assisted those suffering from constipation with training received from the Barral Institute. I have had great results with headache and migraine patients using a combination of Counterstrain, Barral, and Cranial techniques to relieve the pressure throughout the head and neck. As someone with EDS (Ehler-danlos syndrome; a connective tissue disorder leading to increased levels of mobility throughout the whole system), I enjoy treating through their system with techniques that I have found work for me, focusing on the vascular and fascial systems. What is your approach to patient care? My primary approach is patient education. I love for my patients to be able to understand what is happening in their system and why it may be occurring. The body is like a Jenga tower and throughout our lives, we are constantly moving blocks around with every injury. Some systems have REALLY tall towers and are quite stable, others are not. I like finding these missing Jenga blocks no matter where the system leads me to create stability throughout. Osteopathy as a profession is a holistic approach to the body and I enjoy embodying this concept as a practitioner. How do you stay up to date with the latest advancements in osteopathy? To maintain my qualification as an Osteopath I am required to do 25 hours of professional clinical development per year, in 2023 I did 130 hours of external courses. I love to learn more about the body often brushing up on my anatomy, reading journal articles and as mentioned attending courses to advance my understanding of the human body. What are the most rewarding aspects of being an osteopath? I love being able to take away people’s pain, to show them things that they have taken as “oh that’s just my system” or “baseline pain”, that they do not have to live like that. Pain is not normal, and I want to help my patients as much as I can with the knowledge that I have acquired to achieve that. Keep an eye out for more about Sarah in the lead up to her starting at Simple Wellness! If you'd like to make a booking, we are already taking appointments for Sarah. Book online to save a time for your first consultation!  Starting on Wednesday November 6th, Dr Sarah Varmalis is joining our team!!
Sarah is an experienced Osteopath who simply loves to help make complicated health conditions easier to understand. She provides effective treatment and support to relieve symptoms and get to the bottom of the problem. Dr Sarah graduated Victoria University as an Osteopath in 2018 and has been working full time helping patients with all sorts of pain, injuries, and health conditions ever since. In addition to musculoskeletal care, did you know that Sarah can help support:
Sarah will be available Monday to Friday, and bookings are already available. If you have already seen Sarah at another location, but you are new to our clinic, please choose from the "Initial Appointment - Its my first visit" menu. If you are a patient of our clinic already, you can book from the "Return Appointment - I've been in before" menu to see Dr Sarah. |
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