craniosacral therapy - j. upledger, et al., (eastland, 1983)

Extrinsic Neuromusculoskeletal System Dysfunctions Which Influence the CHAPTER 14 Diagnosis by Evaluation of Craniosacral System Function and \Vhole Body Response 242 CHAPTER 15 Examinat

Craniosacral Therapy

Craniosacral Therapy

JOHN E DPLEDGER, D.O., F.A.A.O AND JON D VREDEVOOGD, M.F.A

Eastland Press

SEATTLE

1983 by Eastland Washington 9811 L

International Standard Book Number: 0-939616-01-7

Printed in the United State s of America

Photolithoprinted by

Third Printing 1984

To Our Families

John Matthew, Mark, Mike and Rob

and

Kim and Jon

Extrinsic Neuromusculoskeletal System

Dysfunctions Which Influence the

CHAPTER 14

Diagnosis by Evaluation of Craniosacral System

Function and \Vhole Body Response 242 CHAPTER 15

Examination of the Cranial Rhythm in

Long-Standing Coma and Chronic Neurologic Cases 275

Z Karni, j E Upledger, j Mizrahi, L Heller,

E Becker and T Najenson

APPENDIX C

Mechano-Electric Patterns During Craniosacral

Osteopathic Diagnosis and Treatment 282 John E Upledger and Zvi Karni

APPENDIx D

Management of Autogenic Headache

John E Upledger and Jon D Vredevoogd

APPENDIX E

Spontaneous Release by Positioning

Lawrence Hugh Jones

291

300

john E Up/edger, ErneJt W Retz/aff and

The Relationship of Craniosacral Examination

Findings in Grade School Children with

317

john E Up/edger

APPENDIX]

The Reproducibility of Craniosacral

Examination Findings: A Statistical Analysis 345

Forew-ord

Craniosacral therapy, as explained and taught in volume, light on interface, or area of blending, that lies intervention medicine and self

medicine, traditional allopathic-osteopathic

psychophysiologic self In other words, book throws light on

when differentiation between mind and

physics, biology, psychology and medicine

in

In Preface to this book, John "people continue to

they have care in world Why?

recognize the existence of the

significance.' ,

health has

forceful statement about the "'klH'V"' l.'U

�� •• vu.[',v and manipulations of "body electricity" in

of P � "'''·

a number of physiologic correlates that

Since self-regulation almost of intervention u.��.�,

placebo effect in drug for instance), a crucial question is after reality of the"V-spread" data is accepted: Are the phenomena merely result of psychophysiologic self-regulation, conscious or unconscious, the patient?

It is a well that placebo effect, a

physiologic change in a body, is a subdivision

effect (even though the is completely unconscious of having generated it) Much is known about how a patient consciously or unconsciously uses HU�F>',H""

admittedly, much is not known But one thing is certain: without mental imagery, conscious or unconscious, nothing can self-initiated or self-controlled It is known that placebos and self-regulation methods not work with babies and dogs Those creatures do not know what we are talking about In

mechanisms can not self-directed through visualization

inter-vention may handle the same energy in a way, but in both cases we find it to the existence of a non-neurological and non-classical "body to account for results

technique is used the patient not know what is happening, and has no what is "supposed to happen." The described by Upledger (and which are observed by workshop students, including myself) take place without patient's own visualization And since visualization is sine qua non of self-

out as a satisfactory \ "'It'''' ''''''wu'u

strange as described, you try it before it out hand." To me, however, one who long been in this area, it rings a familiar note It

to mind of yogis whom we (The Voluntary

team Foundation) in India in 1974 with a portable psychophysiology lab self regulation adepts who were willing (and to explain, maintained that everything they did "inside and outside the skin," however

correlate, or reflection, more of "nadis," which are

superphysical, but real, substance not yet detected by instruments filaments are constructed, it is said, of "dense prana," and they conduct a more subtle form of

said to be parts structure In any event, ",,,-,.VLUHAj<,

to yogic psychophysiologic phenomena are inside-the-skin

kinetic phenomena which, mediated by "prana" and directed by or unconscious) are found inside and outside the skin Thus, the former are

FOREWORD xiii

"1J,0< ,,1< cases of the latter

" , , .·u that best accounts

touch martial arts (kung fu, medicine, Philippine (Ayurvedic the theoretical characteristics similar to the "vital physical body" (which the "dense physical body" is said to servily obey), and is similar to body" of psychics, reported days in "out of body"

It is interesting to note that in

O • UIU Puthoff and Russell

by word "spirit," then do not use

of matter." If, however, you are not

of as the densest form of uses the old" energy" in a this seem strange? Not to perhaps the most

an effort,

were directly funnelling divine healing power through their hands."

Upledger's problem: how to talk about an intervention method that works though under the of your " how to separate from

in such a way that boundary of frontier does not up

" to use his phrase

a few more words hptnf'p

by therapist in

energy." cntlcs that

is a "directing of

to mind of therapist But to observer and experiencer, and

Upledger and other therapists who are working in many-leveled domain

body are finding refreshing that support the idea of unity in medicine and yoga, body mind, conscious and unconscious

At present state of knowledge and experience, perhaps it is to a monist, remain rational, be undogmatic, be flexible, become intuitive, and con-

are no new Other, more open-minded scientists, however, gave the energy a new name, "bioplasma," because of its apparent plasma-like properties, and started new projects

To start new projects is what we should the "V-spread" or

"direction of energy" the milieu from which it emerges, craniosacral therapy main work has just As Upledger says, book contains a "considerable amount of observation and theory that has not yet stood rigorous scientific "

ELMER PH D The Menninger Foundation

Topeka, Kansas August 1982

Preface

As in any new field of study, the craniosacral concept is changing rapidly This book contains the most recent information available included is a considerable amount of observation and that has not withstood

We your indulgence in matter continued application and observation, practitioner can begin to sort out the fact from the fantasy Time will demonstrate the of craniosacral the other hand, we do

that potentially high-benefit

should be withheld from suffering

of scientific seek to confirm or refute them In other areas of care where the risk to and the potential dangers more formidable, our position on issue would quite different

whom conventional has proved ineffective

continue to suffer even though they have passed through the some of the health care facilities in the world Why? This is so because orthodox

significance Although possibility of such a was over 50

dynamic activity involving skull bones, meningeal membranes, cerebrospinal fluid, the intracranial system, the development the brain, movement body fluids, the of the of total body connective tissues

as influenced by

As our

started to

1

2

therapy

PREFACE

without a complete understanding of how it works or it

It was when applied by these few, but appeared so

that it became known to as a

This obviated the need for an physiology The work did not die

,',,: ,'-\ 1 it as continued to curious about results observed in response to

own interest in the

(Upledger)

I could not carry out

our work, I heard a lecture by my co-author, Jon

is a and an architect The essence of his can following quotation:

Nature makes the best design in nature is for a purpose and is the most

PREFACE

efficient way to accomplish a task We should the way nature does things and try to emulate it, rather than clumsily and egotistically trying to invent our own We cannot improve on natural we need only understand it

3

I a disarticulated human skull and challenged him to explain to me why

various

problems

skull as it was, and to the function of the design of the

On a general level, is for the curious medical biologist or physiologist,

or anyone who has an interest in the integrated mechanical and physiological functions of the human body craniosacral demystifies and provides a straightforward explanation for many observed but unexplained physiological phenomena and clinical <:""£1,.,,

is, anyone in a healing profeSSion who uses as diagnostic or therapeutic tools Included are medical and osteopathic physicians, dentists, chiropractors, physical polarity therapists, movement therapists, psychotherapists, and many, many more Most of the people in have a background

in In this book, we hope to help upon solid

foundation an concept of dynamic anatomical and physiological function

We encourage to improve their palpatory skills I (Upledger) am by vistas which have opened for me since I began to develop my own palpatory skills The is illustrated by the comment a

who recently visited our He heard of

treatment table, gently placed hands upon my and instructed him

to close eyes and At first he felt cardiovascular rhythm, then the breathing rhythm, and then very clearly the craniosacral Spontaneously and theatrically, he "Once you have found it, you'll never let it go."

lowe the of this book to all of my who in

and me to and the things that my hands so often automatically Outstanding among gentle prodders is the who put together into syllabus form my lecture notes and published articles, Sister Anne Brooks, now an osteopathic physician

I am deeply indebted to Stacy F Howell, Ph.D under whose tutelage I completed a three-year fellowship in Biochemistry at Kirksville College

Medicine Dr Howell attempted to teach me

me into a naturalist observer

Louis Hasbrouck, D.O and Anne D.O were both inspirational during

my first experience at a Cranial Academy seminar Later on in my craniosacral development, Herbert C Miller, D.O helped me to trust in my hands intuition l owe all of deal

turn manuscript into something readable Charles Lincoln, D.O (U.K.) was always there to and discuss my presentation concepts and tech­niques A prodigious amount of time was invested in the designing, typesetting,

4

patient devotion to Patricia

Press did round of editing for which we are grateful

Chapter 1 Introduction to the Craniosacral Concept

au.Av�'a uu rr.,nr,'nf" is a

�>�>'VF,>�'U and

vision grounded upon certain therapy in diagnosis treatment

the individual as an integrated totality

Unfortunately, for purposes we must

physiology therapy and discuss various

artificial, linear approach to in reality is an

certain of repetition and techniques

modified, or viewed from different angles at points in

As a starting point, in Chapter 1 we will introduce the

utilize that

anatomical and physiological in Chapter 2, will serve as a

remainder of the book

THE CRANIOSACRAL SYSTEM AND ITS

physiological system anatomic

1 The meningeal membranes

2 osseous structures to which the meningeal

3 other non-osseous connective tissue structures which are intimately

4 The

5 All structures related to production, resorption and containment of cereblrospinal fluid

by,:

1 The nervous system

2 The musculoskeletal system

to, uences and is

5

6 INTRODUCTION TO THE CRANIOSACRAL CONCEPT

5 The endocrine system

6 The

in structure or function of any of these ,,,,,,1-,,,,,,., influence the craniosacral system in structure or

craniosacral will necessarily profound, frequently aeJ,en�r1()US

upon development or function of the nervous system, especially the

system provides the milieu" the development, growth and functional efficiency of the brain and spinal cord from time of embryonic formation until death

WHAT IS CRANIOSACRAL MOTION?

The system is characterized by rhythmic, mobile activity which persists throughout craniosacral motion occurs in man, primates, , , " felines, and probably all or most other It is distinctly different from physiological motions which are to breathing, and

cardiovascular activity as well It may be underlying of, or closely

adequately explained rhythmiC motion can palpated most

on the head With practice development of palpatory skills, it can

be perceived anywhere on the body

The normal rate of craniosacral rhythm in humans is between 6 and 12 cyclesper minute (This is not to confused with Alpha rhythm from the which is

8 12 cyc1esper second.) In pathological

rhythmic rates of less than 6 and more than 12 per minute During summer of 1979, one of your authors (Up ledger) had the privilege

several long-term coma cases Institute for

in -anana, We were motion In cases, coma due to anoxia

most frequently in a of the cranial rhythm to as low as 3 or4 cycles per minute A few coma cases due to drug overdosage resulted in a cranial rhythm above 12 cycles per minute These rhythms were palpated on the patient's head

OBSERVATIONS OF CRANIOSACRAL MOTION

Hyperkinetic children have observed to present with abnormally rapid craniosacral rhythmic rates, as have from acute illnesses with Moribund and patients will present with abnormally low rhythmic rates As the clinical improve, the rhythmic rates move toward the normal

motion is quite stable It does not fluctuate as do the rates the cardiovascular and respiratory systems in response to emotion, rest, etc it appears

to be a reliable criterion for evaluation pathological conditions

Under normal circumstances this rhythmiC activity appears at the sacrum as a gentle rocking motion about a transverse axis located approximately one inch anterior to the second rocking motion of the sacrum

lNTRODUCTION TO THE CRANIOSACRAL CONCEPT 7

of head As head the sacral apex moves in an anterior direction This

of motion is referred to asjlexio1t the The

of flexion is extension During the extension phase, head narrows in its transverse dimension The sacral moves anteriorly while the apex moves pos­teriorly

the flexion phase the

rotates broadens During extension phase,

rotates and seems to narrow slightly A complete rhythmic motion is composed flexion and one extension phase is a neutrol zone or relaxation between the of one phase and the beginning next of each

from extreme range of one and the physiological move into the phase motion (ILLUSTRATION I-I-A)

Time

Neutral zone

Illustration 1·1·A Representation of Craniosacral Motion

incases

Normal

severance to trauma We were also able

in the cranium which were due to cerebral thrombosis and tumor

8 INTRODUCTION TO THE CRANIOSACRAL CONCEPT

centers of the nervous by palpating to determine

of rhythmic motion change in the paravertebral musculature, the

lesion or injury can determined function is

muscles move rhythmically between 20 30 cycles per innervated muscles move physiologically in correspondence with craniosacral rhythm (6 to 12 per minute is

amplitude of rhythm "nU"-,,,-L<"

the patient's resistance is low, and the craniosacral rate, as palpated on

is low; but energy which

membranes rather restrictive and lacks accommodation to

motion per minute (ILLUSTRATION l-l-B) We

Illustration 1-1-B Representation of Craniosacral Motion

Effect of Barriers

situation in cases past involved find this clinical in autism This

a previous physiological problem which

presently involve, nervous system We mean that autism is

meningeal

which can be used to pathological any type which

of physiological motion, as osteopathic musculoskeletal

dysfunction), inflammatory responses, a.U.U",,'HVU;:) trauma with

INTRODUCTION TO THE CRANIOSACRAL CONCEPT 9

you must upon other diagnostic methods exact pathological nature problem Restoration of

motion to the area motion can as a �L'VF.UV"U.""

asymmetry is eliminated and normal physiological motion restored, you may confidently predict problem is being or has been resolved

head-to-toe, laminated connective tissue invests in (between

IUlLla.} all of the somatic visceral structures of the human body Wi th this model

it is apparent any loss of mobility this tissue in any "l.n,p.rltlr

as an aid in of the process which

By some means, probably via nervous system, system is normally kept in constant motion in correspondence with the rhythmic motion By direct connections and common osseous anchorings, extradural and the are interrelated interdependent in terms of their

from examination mobility or restriction is only by

to rate, amplitude, symmetry and quality of the craniosacral motion and its reflection throughout body

While a student at the American of Osteopathy in Missouri

G Sutherland became fascinated by the anatomical human skulL It to him that were deSigned to

skull-one to the other by and impossible only exceptions to this condition of in human skull were said to found in the tiny mobile ossic1es of the ear and at the temporomandibular anatomists Sutherland, as many still teach

that the skull serves protective hematopoetic only.!

Possessing the that all nature's designs are purposeful,

and its sutures HU.U,-",t<;;;,

Sutherland OJ '.<4><I

1 Italian anatomists in the 1900s, however, taught that cranial suture ossification was pathological in the mature human adult teachings therefore contradict the British anatomists, who taught the doctrine of sutural ossification and cranial as a normal condition (AII(Jtomi(J Umalla, Vol 1,

1931, by Professor p 203.)

10 INTRODUCTION TO THE CRANIOSACRAL CONCEPT

cranium the sacrum on

mater which firmly connects

restrictive osseous attachments hpjh>T�'I'>

the dural attachment of the

nV:SlOlOIHe:al motion and vice versa,

developed a model

osseous cranium The sphenoid

the cranium via its

I I'> V""""1_",.", "_u,, v 11 motion patterns

torsions, sidebending

palpating their crania of humans

are influenced The sphenoid bones From a mechanical with the sphenoid as the

of motion at

•• au""uoof the joint as a hypothesize

as well as torsions, stalenena

occur if some flexibility is retained h"'m,�,.,,,

between the sphenoid

strain however, somewhat more

is not, in fact, a

Histologically, the sphenobasilar

maintain some degree

dural membranes are membranes attach circum-

INTRODUCTION TO THE CRANIOSACRAL CONCEPT

stance abnormal functional motion

motion for the bones of the cranium Inevitably,

is the force upon sphenoid?"

moved in response to a circulatory

upon the intracranial system He saw the falx '-'-"" u

1 1

the tentorium cerebelli and the falx cerebelli as parts of a reciprocal tension membrane system which responds to circulatory of the cerebro-

motion, Sutherland believed, was rhythmic tion and expansion of ventricular system of the brain He regarded the brain as primary source the force which drives system and produces motion

difficult to adopt We do not that the tissue has the tensile strength to act as a hydraulic pump which raises fluid pressure within semi-closed hydraulic system although glial cells in vitro are seen

to move rhythmically, their motion is perhaps one-tenth rate that we in

observa-movements for the a rhythmically contracting as for motion It is true that motion of individual

in vitro may be much slower than those same cells in vivo; it may also be faster

We cannot in vitro glial movement into

production by the choroid plexuses within ventricular system the brain is

by

occurs in the sagittal venous sinus

If production of cerebrospinal fluid is hypothetically twice as as resorption, the production is turned on a given period of time it will an upper threshhold pressure When that upper threshhold is the production of

production of fluid is off when fluid production is off, the fluid pressure will drop as a result of the constantly diminishing volume within the h}'draulic system When a lower threshhold is reached, production of

fluid is again turned on and the cerebrospinal fluid within the

fluid pressure is achieved which, in turn, causes the rtl,,·!"tl,m

daries of the hydraulic system

12 INTRODUCTION TO THE CRANIOSACRAL CONCEPT

' r:"CD"'V"'j,U�'nL FLUID PREssuRE CONTROL MECHANISMS

At this time, there appear to at two U"';'-U<\U '''1

1 we now know that sutures constantly move in normal human adults and other and since we have identified collagen elastic fibers as well as nerve within the suture (APPENDIX A), it seems entirely possible that the suture contains a stretch reflex, When suture is gapped open intracranial fluid pressure to a specific dimension, an intrasutural stretch is activated which telegraphs to ventricular

its contents somewhat intracranial fluid pressure is reduced), a message is sent to brain to resume production fluid This

of fluid production will raise fluid pressure and reduce intrasutural compression

With model in mind, we

beltw€�en the suture the system

nerve axons in the monkey,

histological work provides us with

model described

structures necessary to

2 sinus found in Groy's Anotomy (39th BRITISH EDITION),

there is mention of an arachnoid granulation body which projects into the floor straight sinus at its of union with great vein This body contains a sinusoidal plexus of blood which ";>,r''''''''';> ';"'��'h-'-

a ball-valve mechanism mechanism may then control

the vein which, in turn, by

secretion of the cerebrospinal fluid the choroid

drainage of of brain is from the ,,,,,

which empty into great vein

We would hypothesize the presence of these structures as supportive yet another mechanism whereby production of fluid is under homeostatic controL We that it is this

some intrinsic contractile power tissue itself Observation of living human tissue in situ does the rhythmic motion of brain tissue

it seems more reasonable to conclude the ventricular of the

by contraction

Independently, E.A Bunt, M.D., a South African neurosurgeon, has developed

a similar in the area of idiopathic, normotensive

lateral and third of the brain which show approximately a 50% area change during dilation and contraction of the la teral ventricles of brain at a of 6 cycles per minute in a normal patient Dr

r"" r" � is viable

work is in progress in conjunction with Dr, E,W Retzlaff of the Michigan State University Department of B,omechanics

INTRODUcnON TO THE CRANIOSACRAL CONCEPT

BECKER'S MODEL

13

motion was forth by Ph.D., an anatomist and previously a

tonic response of the muscles to the of gravity provide either (1) a stimulus input into the nervous """" .,''''

which produces the cerebrospinal fluid pressure fluctuations, or (2) via fascial

voluntary muscles act directly upon dural membranes, form the of the cerebrospinal hydraulic

c"'cl,,,,", by rhythmically "."

craniosacral motion were

not seem possible that

quadriplegiC,

ua.'u" IJH;J;<.La cases, cranial

u' ", and in cycles per minute

in

ha ter'2 raniosacral once

enninol

aSlc

Most readers of this text have a good background in anatomy and

ever, many terms concepts in

conventional anatomy physiology courses terms have

Thus, upon main body of text, in this chapter we will survey the most important anatomical, physiological and therapeutic terminology used in therapy, as well as the language of anatomical position Many of terms will in detail in later of the book THE CRANIOSACRAL SYSTEM

physiological rhythmic

hydraulic system related to the nervous "v,:rp'TI

autonomic nervous system, neuromusculoskeletal and crine Its boundaries are formed by the membranes, most specifically the dura mater The system's fluid is via choroid which

craniosacral system fluid which passes the choroid is known as cerebrospinal fluid Cerebrospinal fluid is returned into the venous system by the arachnoid villae villae are most in

contents dural is essentially impermeable to the cerebrospinal fluid which it holds Intake and outflow of fluid from system is by means of specialized tissue structures (choroid plexuses and arachnoid villae) which are under homeostatic

These intake and outflow mechanisms qualify the hydraulic system as closed

semi-Homeostatic are self-correcting and

nisms which rely upon loops Biological """",pm"

static which enable to effect

14

THE CRANIOSACRAL CONCEPT: BASIC TERMINOLOGY 15

constant changes in both internal external environments An example of a

m€!ctlanllsrll in human body is production of thyroid hormone gland, which is under of the thyroid stimulating hormone gland The pituitary receives about

not to release more thyroid stimulating hormone into the bloodstream from level thyroid hormone in the blood, is constantly monitored by

Blood sugar, body blood pressure other ties in body are continuously by

activi-As a hydraulic system, boundaries of craniosacral the dural membranes, are given shape fluid pressure within the system and by its more rigid aspects, the bones to which the membrane is firmly lavishly

functionally as "hard in dural membrane hard

indicators in diagnosis and as handles in treatment

is like water It is our that although cerebrospinal fluid is

the movement is of low velOcity and without much force

mechanics as LU'-'Y",U

application of any is transmitted equally in all directions Therefore, when we apply a pressure or force to an area of the boundary of hydraulic the resultant equally via the rp'rPf\rO

We must also keep in mind that hydraulic ",,<:tp'm

MEMBRANES

""<;,PI" is transmitted through relatively

to the more brain substance

the dura mater, the arachnoid membrane and

The mater is the

of the skull It the cerebellum respectively It also the relatively tentorium cerebelli, bilaterally, separate the cerebrum

dura mater which contains the cerebrospinal fluid and thereby hydraulic This is also referred to as dural The arachnoid membrane is thin, and vascularized It is separated from dura pia mater by subdural subarachnoid The arachnoid mem-

arachnoid membrane from the dura mater exteroally, from pia mater arc with This allows a of In(let>enLoen

inter-16 THE CRANIOSACRAL CONCEPT: BASIC TERMINOLOGY

mater is the highly

<.I' <,u"'" It follows all of

delivers blood supply

delicate internal layer of the

Since the meningeal are capable of independent motion, one of the

serve is to allow to rotate bend without or spinal In cases of where this ability is due to

pain is produced during certain spinal movements

DURAL MEMBRANE

boundary of

(osseous) attachments act as anchors by

tensions are transmitted to connective tissues

these common bony moorings between the dura and

is fact that via connective tissues transmit tensions into system By way of dural continuity, tensions are transmitted to distant very hard-to-predict regions of the meningeal membrane system

the vault dura provides a of endosteum which is

Contrary to common belief, vault are in constant motion as they accommodate the ever changing fluid dynamics dural membrane tensions within the craniosacral The sutures or joints the bones meet other not fuse normal no matter what age the

bones and base and condylar parts of the

for cranial vault The in floor between the anterior

and posterior sphenoid body is referred to as the sphenobasilar joint It is a synchondrosis, which means that of somewhat flexible cartilage-

out life

CoRE LINK

This is name to the dural

and the sacrum The name itself suggests function of this

core link of spinal dural membrane is relatively free to move

THE CRANlOSACRAL CONCEPT: BASIC TERMINOLOGY

Occiput

Illustration 2-1 Cranial Base

17

positIOn, the occipital and sacral motions mime each other Unless abnormal restriction to mobility is present within the core link, the membrane transmits tensions imposed upon one of these bones directly to the other

SACROCOCCYGEAL COMPLEX

This refers to the functional unity of these two bones The meningeal mem­branes enter the sacrum from above with the cauda equina All three membranes blend together, and within the sacral canal there is firm bone attachment only at the level of the second segment This is probably why the sacrum seems to rotate about

an axis at this level as it conforms to the motion of the craniosacral system In the sana I canal, the dura blends with the terminal aspect of the pia, the filum terminale The filum terminale exits the sacral canal through the sacral hiatus, which is usually

at the level of the fourth sacral segment The membranes are now quite fibrous, tough and blended together They merge with and thereby contribute to the periosteum of the coccyx From a craniosacral therapy viewpoint, it is therefore

THE CRANIOSACRAL CONCEPT: BASIC TERMINOLOGY

advantageous to Ull.;>aXCL the sacrum and coccyx as a functional unit

VENTRICULAR SYSTEM OF THE BRAIN

This system is composed four

while third and fourth are (ILLUSTRATION 2-2)

cavities within hemispheres

Foramen of the communication hp1,.",·"

via Aquaduct of

fourth ventricle of brain with the subarachnoid space

formed by choroid plexuses within ventricular ""<:j-""",,

pool fluid via the duct system

and fourth with a resultant fluid

TI-IE CRANIOSACRAL CONCEPT: BASIC TERMINOLOGY

MOTION

Motion has a to people are involved in

19

In this craniosacral motion is that motion which the whole body

is very and short in range We of the craniosacral motion as

physiological because it is unconscious

individual's

are necessary for continuation

Non-physiological motion may to abnormal

adaptational result an obstacle or restriction

physiological motion It is a distorted motion pattern is the result of restric­tion Non-physiological motion is also sometimes used to describe extrinsically in­duced motion However, this usage is less common and is not intended

term appears in this book Instead, we use the word movement for extrinsically

motion Passive movement is present when the therapist does the moving and the subject no effort into the movement Active movement of course, opposite

A restriction is an to normal physiological motion within the body inherent energy causes physiological motion is but is

against the restriction Usually, restrictions occur in the connective tissue or can result inflammation, adhesion, somatic dysfunction and neuro-When a restriction dissipates, it is called a A release is

softening of or restriction which

The resistance melts

is always a therapeutically event

driving the physiological motion, symmetry body motion response

of craniosacral and of extrinsic body connective tissues) , and in range quality motion Is it fighting a resistance barrier?

A resistance barrier is a point during the course of a normal motion cycle at which the body motion either and exerts extra effort to pass, or is

to pass at Restrictions to motion and motion barriers can be characterized

as either rigid or Rigid and restrictions bony

one bone cannot move in relation to another because are jammed

20 THE CRANIOSACRAL CONCEPT: BASIC TERMINOLOGY

Elastic barriers and restrictions abnormal membrane tensions which prevent normal physiological motion Abnormal membrane tensions

occur When you encounter a problem treatment, its restriction has an "give" you to gently and directly it

whole body response to craniosacral system is based upon concept

of fascial continuity throughout the body The motion of the body is probably related to the effect the fluctuation of the cerebrospinal fluid upon the nervous system, which in turn tonus of body tissues

PALPATION

Palpation is typically defined as examination touch It is the development of this skill to which this book is largely dedicated Palpation is an art which is grossly neglected in health care profeSSions Even the "body

only one of palpation and thus develop but a small part of

palpators

Most of you have been taught to palpate or touch with your

SUl)O()Se<1 to preferred method the fingertips are

This is

of the hand We, would urge you to palpate your whole hand, arm, stomach or part of your body comes in contact with

body The idea is to "meld" the palpating part of your body with the body you are

"" ''' UH''O' As occurs, palpating part of your body does what

body is doing It becomes synchronized Once and

your own body is Your proprioceptors are those sensory receptors located in the muscles, tendons, and fascia that tell you where the parts of your body are without using your eyes

The to this of pa."P"'UVH '"'''-''' '''''''''''1''0 and non-intrusive

THE CRANIOSACRAL CONCEPT: BASIC TERMINOLOGY 21

your hand The to success in using this type palpation is your quiet, intrusive melding with the patient

non-THere is one other which should

as real information which your sensory receptors you As a

what seems to be without critical evaluation After you develop the palpatory skill to some degree, you will have of time to critically appraise the information which comes into your your senses

in craniosacral therapy are usually non-intrusive indirect In certain situations you may resort to direct treatment techniques applied against resistance barriers, but after the patient's body has demonstrated

Anlndirect technique, as we define is one releases a restriction or "',-,HOJ'LUL""

to motion by encouraging motion in direction of ease (which is usually opposite to the direction of the is sort "unlatching" principle Often, in to open a we must exaggerate the closure same is true

of indirect cranial technique The therapist follows the restricted structure to its limit in the direction toward which it moves with ease, Le., the direction toward which it exhibits the range of motion When structure

extreme position, becomes immovable the structure or limit of its easy range

of motion you simply to move It is motion structure as it attempts to return to neutral that pushes against you As inherent motion of the structure pushing you it will farther in the direction of easy range motion, often called "direction ease." As this

you occurs, follow it, up but without pushing the motion will move against you more, immovable this procedure through several more cycles

of inherent craniosacral motion Ultimately, a tissue softening or release will occur This is therapeutic which you have been waiting The tissue has

In motion testing, which is a primary method used in search for abnormal restriction barriers, the therapist induces the motion; as soon as structure begins

to move in the direction the therapist reverts to the role of monitor purpose is to see how what or restriction the structure moves in response to inducement The purpose is not to see how far

how many the structure can be pushed In the process pushing you may never find the true underlying problem, which may be compounded by

22 THE CRANIOSACRAL CONCEPT: BASIC TERMINOLOGY

causing injury or restriction to develop

We speak of the restoration of autonomic flexibility as a positive therapeutic

of craniosacral therapy Autonomic flexibility is a term used to describe an

in the of the autonomic nervous system to res;polnct autonomic nervous system maintains and helps one survive without the need conscious thought It has two major divisions: the sympathetic and the parasympathetic The dIvision causes the body to

blood pressure, air volume, blood flow to and

which are needed to spring into action The division monitors body functions during times of rest, sleep, food digestion, elimination, etc., when the body is not ready to into action

As stressful situations occur in daily life, the is

not allow opportunity body to spring into energy generated by a sympathetic nervous system Therefore, the of tone or tonic activity of the sympathetic system increases by day as we accumulate more energy from stressful stimuli than is

toward spasticity and the blood flow to be diverted from vital organs to Left

in this condition, the body would not survive very well In order to counteract condition of readiness "fight or flight" instituted the sympathetic hypertonus, the nervous has to act more powerfully to slow the rate, lower blood pressure, processes and reduce the

of the bowels

The stress stimuli keep coming in The balance sheet shows more stress stimuli

parasympathetic rise in order to counteract the

a is reached at which parasympathetic nervous can no cope with nor effectively counteract increased energy in sympathetic system The blood pressure the heart rate increases, and one may develop spastic colitis and peptic or any number of dysfunctions

We call these functional diseases The autonomic has lost flexibility It can no longer effectively with the

the

out

is restoration of autonomic flexibility the autonomic nervous system plays a large role in homeostatic activity body, when autonomic flexibility

is many homeostatic mechanisms are made more effective

There are a number of other words and phrases which it may be useful to define

Fascial continuity is a phrase human body

organs and structures It is largely oriented in a longitudinal direction and is to

THE CRANIOSACRAL CONCEPT: BASIC TERMINOLOGY 23

from any body to any other

The term cross-restricting diaphragms suggests conceptual framework in which

structures We regard these diaphragms as transverse

the and are to its functional integrity

represent areas stress within body fascial

frequent sites of system dysfunction

term neuromusculoskeletal system is meant to that

between nervous system, the muscle system and skeletal

tiona! point is artificial Therefore, we use the word to

A lesion is an area of localized or tissue An osteopathic lesion

is the term used to designate palpable paraspinal areas of tissue texture deviation toward tightness or swollen It a syndrome of dysfunction

cord facilitation, dysfunction and autonomic

somewhat localized at area osteopathic

Somatic dysfunction is a term by some of the osteopathic to replace osteopathic lesion Proponents of the term somatic dysfunction believe it is

osteopathic or is much more than a somatic or body

internal milieu is environment inside the skin of the body, within which all of your molecules, and organs function It everything from interstitial fluid viscosity to hydrogen ion concentration in the urine It also includes physical parameters such as pressure, as within cranial vault,

In our discussion we refer to several

below:

Autism is a of unknown etiology The autistic child is 0V'.W.''' L

preferring to interact with non-living things in the environment The child is quently self-abUSing and will bite its hand and wrist or bang its head, etc Autistic

seldom display emotion other than

They usually will not eye contact or display

we have many autistic children They

are of intelligence, often display motor coordination Since the cause of autism is unknown, there is much disagreement about diagnosis

and been as such by the "system " Our inclination was to

as a convenient diagnosis attached to difficult-to-handle children However, as

in Chapter 15, many of children drama tic ally to

our is that the behavioral

craniosacral dysfunction, hyperkinesis to food and chemical intolerances, and hyperkinesis due to emotional and psychosocial causes

Learning disabilities might be similarly to description of

kinesis above We have a significant number oflearning disabled

have favorably responded to craniosacral therapy alone

24 THE CRANIOSACRAL CONCEPT: BASIC TERMINOLOG Y

are also anatomical terms we have which may require

Cephalad-toward the head

Caudad-toward the tail

Pedad-toward the

of body

Lateral-toward the of body

Medial-toward the center of the body

Asterton-junction parietal, and U'-'_HJj,UU

Bregma-junction of coronal sutures

Inion-external occipital protuberance

Lamda-junction of the occipitoparietal and sagittal sutures

Pterion-junction of the frontal, parietal, sphenoid, and temporal bones

THE CRANIOSACRAL CONCEPT; BASIC TERMINOLOGY 25

Viscera-an organ which is not a muscle or The heart, lungs, etc., are viscera

connective tissues related to a viscera

Thenar eminence-the muscular part the palm of the hand on the thumb side The hypothenar eminence is on the side of the fifth finger

is to enhance the removal of toxic waste substances the body, and to

for and toxic conditions

lymphatic is usually performed in one of two ways, both the patient supine In one therapist places his or palms over soles the patient's feet are intermittently pushed at a rate approximately 180 times per minute with an excursion of5-10 cm the is seen to oscillate is continued 5-10 minutes Alternatively, therapist

the patient's with or hand on the patient's anterior thorax The patient is instructed to breathe slightly more deeply than normal As the patient exhales therapist follows the posterior-caudad motion the

Chapter 3 Craniosacral Motion:

Palpatory Skills

Most of you have spent years the sciences and

upon your rational, reasoning You probably have convinced

information which your hands can give you is unreliable You may consider facts to

be reliable only are printed on a sheet, projected on a screen or

the electronic device In order to use your and

as reliable instruments treatment, you must

to trust and the they can give

Learning to trust your hands is not an easy You must

conscious, critical mind while you palpate for subtle in body you are

You must adopt an empirical attitude so that you may

Although attitude is unpalatable to most it is recommended that you it a short trial you have developed your palpatory skill, you can criticize what you have felt with your hands If you criticize you to

you will never to use your effectively as highly sensitive

instruments which, in fact, they are

has been divided into and right

of developing a conceptual model upon which we can base an understandable explanation

Consider the

the

side of your brain as being the rational, thinking and critical

except in art, music and other creative activities Often, creative studies are regarded as of less value than sciences a result, the left of brain has grown to hyper-critical, self-centered, omniscient, intimidating and almost autonomous On the other hand, the brain

because when an idea begins to emerge from the right of the into the consciousness, left side of brain immediately begins to tell you why that idea

26

CRANIOSACRAL MOTION; PALPATORY SKILLS

is silly and irrational

In to develop the palpatory skills and to

your left brain for a while Allow skills to without

message from your left brain consciousness insists what you are

isn't there, that it is your imagination Ignore this criticism Let your

27

a chance to gain confidence talents information which are suppressed in your brain may you Your right brain has probably intimidated for so it has become shy

the right messages which you consciously may very tentative fleeting them, draw them out, be kind and gentle with your intuition It will develop quickly if it is a chance Once you have followed your

sensations for a while, as an empiricist rather than a scientist,

from your senses We do not mean to that you arrest activity of your left hemisphere we want to give it a rest so that the remainder of you

a to develop

Therefore, we make this plea in beginning: accept what you sense as real Do not rationally to understand it Give yourself a chance to risk

the game trust my hands" is minimal to the potential payoff for those

Remember that the potential of humankind is limited only by its own concept that limitation Relax and let it happen

with the more obvious motions the human body One of these motions with

comfortable If you are not comfortable, stimulus input from your own tense muscles and discomforts will create an input noise level which will with your perception

With the subject lying comfortably supine, the radial pulses Feel obvious of the pulsation in also to rise and fall of the pressure gradient long is diastole? What is the quality of the rise of pulse pressure after diastole? Is it sharp, gradual, How broad is the pressure peak? Is the

rapid, gradual, smooth or Memorize feel of

so that you can reproduce it in your mind you broken physical contact the body You can sing a song after you have heard it a times; similarly, you should be able to reproduce your palpatory perception of the pulse after you have broken contact

wave morphology with

Now palpate carotid pulse waves simultaneously Compare them Are the sloping rises similar? Are the peaks the same? You are now learning to

exist

to remember

of pulses of your subject

28 CRANIOSACRAL MOTION: PALPATORY SKILLS

Illustration 3·1 Diagrammatic Representation of Pulse Wave Morphology: Cardiac, Respiratory or Craniosacral

compare them with another subject's pulses It sometimes helps to draw a graphic representation of the pulse wave morphology to begin to make the connection between palpation and visualization of what you feel (IllUSTRATION 3-1) In the begin­ning, you may be more comfortable at visualizing than you are at palpating, because you have been trained this way Your palpatory perception may seem too intangible

to be trusted

After you have concentrated upon the body pulses at the radial and carotid regions, simply lay your hands over the thorax of the subject and palpate the cardiovascular activity (ILLUSTRATION 3-2)

Illustration 3·2 Palpation of Thorax