CranioSacral Therapy

“Is there a special chart for CranioSacral Therapy sessions?”

I am not aware of a special chart for CranioSacral Therapy sessions although many practitioners use the standard SOAP note chart. Recently I created the chart shown in this blog. I’ve found it helpful in my practice so I wanted to share it with you.

Another question I’m asked about charting is, “How do you remember what the client worked on during a session if you can’t chart it immediately after the session?”

If I don’t have time to complete a client’s session notes then I spend a few minutes after a session drawing symbols on the client’s chart. The symbols represent certain types of compromise, such as an arrow pointing toward the midline of the body means “medial compression”. While completing the chart I use the symbols as reminders of patterns the client worked with during the session.

I trust that my hands remember the session. Sitting quietly with my eyes closed I listen to my hands as they review the session. This helps me stay in the felt experience rather using my mind to figure it out. Not only do I recall the session but also new insights regarding the client’s strain patterns and corrective processes often arise during these times of reflection.

“If I understand correctly, CranioSacral therapy basically aims to improve the functioning of the central nervous system. Is that right?”

Yes, that is correct.  The central nervous system (CNS), which is comprised of the brain and spinal cord, is encased within three layers of connective tissue.  These layers are part of the craniosacral system (CSS) that forms a somewhat flexible container that is filled with the brain and spinal cord.  If the container is distorted then the contents will also be affected in some way.

When abnormal stress occurs within the CSS layers such as, twists, pulls, bends, overstretch, or compression, then the tissue of the CNS may become distorted.  If the delicate brain or spinal cord undergo structural deformation then the tissue becomes overly stressed.  This stress can alter the way cells work or inhibit their ability to work at all leading to a multitude of dysfunction.

One primary objective of CranioSacral Therapy is to assist the body in decreasing harmful strain within the CSS layers, which in turn helps to alleviate injurious stress of the CNS cells.  As this occurs then the CNS cells can function, adapt or compensate to their optimal ability.

“How is it possible that such light touch used in CranioSacral Therapy (CST) can help the body correct problems?”

Andrew T. Still, D.O., the founder of Osteopathy, said, “The little things are the big things in the science of Osteopathy.” and “It may be that by measurement we can discover a variation one-hundredth of an inch from the normal, which, though infinitely small is nevertheless abnormal.”

Minute strain patterns of the body’s tissues, nerves, or fluids, which are often overlooked, can cause compromise ranging from minor aches or pains to severe disabling pathology.  In CST we are working with tiny areas of compromise. Sometimes dysfunction is due to only one area of compromise, and at other times many areas merge into larger patterns.  The effect of a strain can remain in the area where the strain is located, or it can affect other regions of the body, even the body as a whole.  Each person has their own unique patterns of compromise, and each person has their unique patterns of correction, both of which can be expressed in infinite ways.

In CST it has been shown that using a light and delicate touch aids the corrective process of the client, and helps the practitioner perceive stressful and corrective patterns.  An example may be a cork floating in water.  It requires minimal pressure to feel the cork moving and the smallest amount of force to help the cork move.  If one uses more than minimal pressure to feel the cork then its patterns of motion will be disturbed.

A primary focus of CST is to feel tissue and fluid patterns as they are within the client’s body moment to moment.  To do this a practitioner uses light touch which supports the unique corrective patterns of the client in response to treatment; the practitioner does not determine how to correct but rather supports unique patterns of self-healing as they arise within the client. At the same time light touch helps the practitioner perceive a client’s patterns since the practitioner’s touch is not disturbing the client’s unique expression of strain and correction.

Reference:

Still, A. T., Philosophy and Mechanical Principles of Osteopathy, Hudson-Kimberly Publishing Co., Kansas City, MO., 1902.

The next few blogs will be devoted to answering questions that students ask in CranioSacral Therapy (CST) classes.

Question:  What am I feeling for when I’m working at the cranium or face?

Answer:  It depends on the intent of the technique that you are using at the time.  For instance, when applying decompression of the sphenoid then the intent of the technique, in Upledger CST, is to feel the sphenoid move in the direction of decompression.  The following checklist can be helpful in combination with any CST technique we may use for the skull or face.

1.  Does each bone feel like it has elasticity within itself while responding to the craniosacral rhythm (CSR)? As an example, when the occiput widens and narrows in synchrony with the CSR does it feel like its bony matrix moves easily or does it feel inflexible?  If it feels stiff then techniques such as direction of energy or cranial pumping can help the bone gain pliability within itself.

2.  Does each bone feel as though it has enough mobility within its sutures to move through its normal range without strain? For instance, while a zygomatic bone is moving in synchrony with the CSR is it moving freely or is it jammed into the zygomatic process of the temporal bone, or perhaps into the frontal bone, or the maxilla thus restricting motion?  If restrictions are found then the application of specific techniques, such as zygomatic decompression in this example, can help the bone gain greater freedom and motion.

3.  Are fused bones free to move along with the CSR with the least amount of strain? Fusion can take place due to normal processes, abnormal processes, trauma or surgery, and if fusion has occurred between bones then one focus of CST is to optimize balanced mobility of the affected bones.  As an example, if the sphenoid has fused with the base of the occiput then using Sutherland Sphenobasilar Lesion Patterns and Cranial pumping can be very helpful to optimize mobility.

4. Are the craniosacral system membranes moving freely in response to the CSR? As an example, when the falx cerebri and falx cerebelli move in synchrony with the CSR are they moving easily, freely, evenly, and equally, or do they feel pulled, twisted, stuck, or lacking symmetry of motion?  If they are not moving in a free and balanced way then CST techniques such as frontal and parietal lift, temporal and sphenoid techniques, as well as cranial pumping can help the membranes gain greater ease as they move in synchrony with the CSR.

I find the following quote a helpful reminder when working with the cranium or face.  “Do not look for movement as in other joints of the body.  This is merely a resiliency-a combination of slight yielding or suppleness in the articulation plus the flexibility of live and pliant bone.”

If you have a CST question please feel free to send it to me.

Reference:

Magoun, Harold I., Osteopathy In The Cranial Field, Third Edition, The Journal Printing Company, Kirksville, Missouri, 1976

CranioSacral Therapy (CST) often helps children overcome ear infections, especially when a child’s Eustachian Tube (ET) is blocked or congested.

Ear infections can bring about problems beyond the infection such as ear and jaw pain, tiredness, irritability, fever, headache, crying, restlessness, vomiting and diarrhea. Speech, language or learning impairment may even be related to chronic ear infections and the immune system can become excessively strained over time.

The craniosacral rhythm (CSR) is constantly “massaging” the ET.  One day I followed a child’s ET in synchrony with her CSR.  By the end of the session she felt better and a few days later her ear infection resolved.  So now I use the following sequence along with other CST techniques in a child’s session if she has an ear infection.*

• Visualize the purpose of the technique, which is to help the child decrease ET blockage or congestion, enhance ET drainage, decongest the middle ear, and equalize air pressure between the middle ear and the atmosphere.
• Visualize the ET connecting the middle ear to the back part of the upper throat, about in line with the nostril.
• Visualize the ET moving in synchrony with the CSR. The ET is minutely stretched open and lengthened during the flexion phase, and slightly squeezed and shortened during the extension phase.
• The child should be upright because it places her ET in its optimal drainage position.  Sit facing the child.  Place your finger softly upon the mastoid process of her affected ear and your thumb of the same hand alongside her nostril.  If the child can’t tolerate your finger in her ear then place it upon her mastoid process.  Imagine your thumb and finger are actually resting upon the opposite ends of her ET while sensing her entire ET.  Set the intention to use “0” grams of pressure while following the ET as it moves into positions of release until you feel softening.  Then follow the tissue with “0” grams of pressure in synchrony with the CSR until you feel greater ease of ET CSR motion.

This technique can help to enhance the CSR massage of the ET.  This gentle kneading can un-block the ET and pump substances through the ET, which helps to decongest the middle ear and to relieve excessive pressure from inside the middle ear. As this happens the child’s ear infection can resolve more easily and the middle ear can work normally thus leading to improvements in hearing and other problems caused by an ear infection.

* When working with children it is very important to follow the adaptations of CST for infants and children in the CS I and CST II classes taught by the Upledger Institute. Practice the techniques before working with children in order to refine your touch, to enhance your ability to sense and follow the CSR, and to increase your awareness of tissue patterns and responses to treatment.

Denticulate Ligaments.

Denticulate Ligaments (DLs) are strands of connective tissue that suspend the spinal cord within its membrane sac, which is called the dual tube.

The dural tube is comprised of three layers of membrane surrounding the spinal cord. The membrane layer attached to the surface of the spinal cord is called the pia mater. The layer surrounding the pia mater is called the arachnoid membrane, and the layer surrounding the arachnoid membrane is called the dura mater.

DLs extend from the inner surface of the pia mater, travel through the pia mater, through the arachnoid membrane and then attach to the inner surface of the dura mater.

There are 21 pairs of DLs on the lateral aspects of the spinal cord. The first is attached to the foramen magnum. The last is attached to the conus medullaris, which is the end of the spinal cord at L1, and a small portion of the Filum Terminale (FT) beginning at the conus medullaris. The FT is a band of tissue extending from the conus medullaris to the coccyx that is made of spinal cord glial cells surrounded by pia mater.

DLs and FT shortening, twisting, bending or immobility can place adverse stress upon the spinal cord leading to neurological strain and dysfunction. Conversely, balancing the DLs and FT can decrease spinal cord stress which in turn can enhance neurological function.

DLs are fascinating components of the dural tube that seem, to me, to create a ligamentous suspension system cradling the spinal cord. Very little DL research is available.

These questions arise when I ponder and work the DLs and FT:

1) Since the spinal cord needs to move in its bony container more than the brain tissue does in its container, do the DLs provide protection and flexibility while allowing motion?

2) The dura mater of the dural tube is only one layer thick rather than the two layers within the cranium, so do the DLs create additional tube strength without compromising movement?

3) As the spinal cord moves within the spinal canal do the DLs, like thousands of tiny interlinked bungee cords, help dissipate stress and allow the spinal cord to find its most favorable position?

4) Structures that can affect the spinal cord, such as the occiput, spinal column, sacrum and coccyx, dural tube, adipose tissue within the spinal canal and nerve roots can each have restrictive patterns that in turn can distress the spinal cord. Do the DLs help to protect the spinal cord by balancing, dissipating and fine-tuning tension that is transmitted to the spinal cord?

5) Some theories suggest that there is a down and up flow of cerebrospinal fluid within the dural tube. Since the DLs separate the dural tube into anterior and posterior compartments, could that then organize the flow of cerebrospinal fluid?

I hope you’ll join me next month to explore this suspension system further. I’ll share some ideas on how to feel and work with DLs and the FT.

References:
Cramer, Gregory D., D.C., Ph.D., and Darby, Susan A., Ph.D., Basic and Clinical Anatomy of the Spine, Spinal Cord, and ANS, Second Edition, Elsevier Mosby, St. Louis, Missouri, 2005.

Sills, Franklyn, Craniosacral Biodynamics, Volume Two, North Atlantic Books, Berkeley, California, 2004.

Tubbs, Shane R., M.S., PA-C; Salter, George, Ph.D.; Grabb, M.D.; and Oakes, Jerry W., M.D. ; “The denticulate ligament: anatomy and functional significance”, J. Neurosurg: Spine / Volume 94 / April 2001.

The Hypoglossal Nerve (Cranial Nerve XII) is the primary motor nerve of the tongue. When the tongue does not work properly then difficulty chewing, swallowing, speaking or breathing can occur. One cause of tongue impairment is harmful strain upon the Hypoglossal Nerve as it travels from the brain to the tongue. The opening through which the Hypoglossal Nerve travels is called the Hypoglossal Canal.  It is an important area to assess and mobilize if your client has impaired tongue function or tongue atrophy.

There are two Hypoglossal Nerves, a left and a right. The Hypoglossal Nerves pass through the Hypoglossal Canals (HCs) on their way from the brain to the tongue. The left Hypoglossal Nerve passes through the left Hypoglossal Canal, and the right Hypoglossal Nerve passes through the right Hypoglossal Canal. Adverse strain of the occiput, occipital condyles, craniosacral system membrane layers, foramen magnum, structures of the upper cervical region, or fascia of the occipital cranial base can distort the shape of the HCs. This shape distortion can place harmful stress upon the Hypoglossal Nerves.

The following description is one way to assess and mobilize restrictions of the HCs. However since the occiput has not completed its ossification process until the age of eight, when working with children only use the assessment and mobilization steps #1 through #3, and use the utmost of delicate touch and soft intention.

Throughout this description the client is supine (on their back). The practitioner is seated at the client’s head.

Assess the area of the HCs:
Hand Positions:
Place hands under the occiput, finger tips at the occipito-atlantal junction (where the occiput articulates with C1).

1. Feel the shape of the occiput while using “0″ grams pressure upon the occiput.

Imagine a line drawn through the centerline of the client’s face and cranium from the center of their chin to the center of the top of their head.
Does the occiput feel symmetrical in relationship to this line? Does it feel tilted so that one side is more inferior (towards the feet) than the other side, or twisted so that one side is more anterior (towards the front) than the other side? Does one side or the entire occiput feel flat, or does one side or the entire occiput feel excessively bowed? These shapes indicate probable strain of the intracranial membrane system, occiput, foramen magnum, occipital condyles or the HCs.

2. Feel the occiput and HCs widen and narrow in synchrony with the craniosacral rhythm (CSR) while using “0″ grams pressure.

Is there an equal range of motion during the flexion and extension phases of the CSR? Does the quality of motion feel smooth, unencumbered and balanced; does it feel thick, rigid or lopsided? Imbalance or strain in synchrony with the CSR indicates probable strain of the intracranial membrane system, occiput, foramen magnum, occipital condyles or the HCs.

Mobilize the area of the HCs:

1. Mobilize restrictions of the thoracic inlet area.
Place hands on the upper thoracic area so that the posterior hand rests midline under the C7/T1 area and the anterior hand is upon the collarbones and upper thoracic area. Come to “0″ grams pressure with both hands, and then set the intent for the fascia and structures in this area to move into positions of release. Follow the tissue as is does so until a feeling of softening occurs.

2. Mobilize restrictions of the hyoid area.
Change hand positions so the fingers of one hand are under the posterior neck area. Place the thumb and second finger of the other hand upon the anterior, lateral aspects of the hyoid. Come to “0″ grams pressure with both hands while setting the intent for the fascia and structures in this area to move into positions of release. Follow the tissue as is does so until a feeling of softening occurs.

3. Mobilize restrictions of the tissue in the area of the occipito-atlantal junction and traction release the occiput in a superior direction.

While seated at client’s head, place both hands under the occiput with your fingertips at the occipito-atlantal junction. Soften the feeling in your hands while setting the intent for the client’s tissue to soften under your fingertips. Wait and follow the tissue until a feeling of softening occurs.

Then set the intention to traction the occiput in a superior (towards the top of the head) direction using “0” grams pressure. Follow the tissue until a feeling of softening occurs in a superior direction.

4. Mobilize restrictions of the occiput.

Hands remain under the occiput at “0″ grams pressure. Set the intention for the fascia and structures of the occiput, both inside and outside of the occiput, to move into positions of release. Follow the tissue as it moves into positions of release until a feeling of softening occurs.

5. Mobilize restrictions of the HCs.

Hands remain under the occiput at “0″ grams pressure with a focus upon your fingertips. Imagine that your fingertips are delicately contacting the area of the HCs. Set the intent for the fascia and structures in the area of the HCs to move into positions of release. Follow the tissue with your fingertips as is it does until a feeling of softening occurs under your fingertips.

6. Mobilize restrictions of the Hypoglossal Nerves.

Hands remain under the occiput at “0″ grams pressure with a focus upon your fingertips. This time imagine that your fingertips are resting delicately upon the Hypoglossal Nerves as they pass through the HCs. Set the intent for the Hypoglossal Nerves to move into positions of release. Follow the nerves with your fingertips until a feeling of softening occurs.

7. Use the dynamic fluid motion of the craniosacral system to enhance and integrate correction.

Hands remain under the occiput at “0″ grams pressure. Follow the occiput as it widens and narrows in synchrony with the CSR at “0″ grams pressure. When the occiput arrives at end range of widening and end range of narrowing, apply the intent to encourage the occiput further into its end ranges. The intent to encourage lasts for about one second or less at each end range. Continue to encourage at end ranges until a feeling of softening occurs in both directions. In Upledger CranioSacral Therapy, this is referred to as “Cranial Pumping”.

8. Enhance correction by facilitating integration between the tongue muscles and the occiput.

While seated at the side of your client, slowly slide the palm of one hand under the occiput and gently place the fingers of your other hand at the area of the base of the tongue under the chin. While using “0” grams pressure, set the intent for the tongue, occiput, foramen magnum, HCs, Hypoglossal Nerves, fascia, cervical area, craniosacral system membrane layers and brain tissue to integrate the corrections that have occurred. Wait to feel softening and a feeling of greater connection between your hands.

If you are working with clients who have difficulty chewing, swallowing, speaking or breathing; or babies having difficulty sucking or swallowing; then you may want to try the HC sequence during several sessions to see if it helps. Also, using this sequence periodically can enhance your client’s overall well-being, even if there is no tongue issue, since the occipito-atlantal junction is a common area of tissue restriction, fluid congestion and strain upon the central nervous system.

References:
Moeckel, Eva, D.O., M.R.O., M.S.C.C., and Mitha, Noori, D.O., M.R.O., Textbook Of Pediatric Osteopathy, Churchill Livingston Elsevier, Philadelphia, PA., 2008.

Magoun, Harold I., A.B., D.O., F.A.A.O., Osteopathy In The Cranial Field, Third Edition, The Journal Printing Company, Kirksville, MO., 1966. 1976.

Dr. Upedger and I paused before going into the treatment room. Sammy, who had the left side of his brain removed to stop his constant seizures, was waiting inside with his mom. “Let’s work with Sammy’s stem cells to help him rebuild his missing brain,” Dr. Upledger said without reservation or apprehension. “Since stem cells can create any type of cell in the body, why shouldn’t they make a new brain?” He paused to let this idea sink in. “You know, bone marrow in flat bones is a main site for stem cells, so his head is a perfect place to start. I’ll begin at his head. Will you start with his ribcage?” I nodded, “Yes, sure.”

When we entered the room Sammy was lying on his back upon the treatment table, awkwardly trying to roll from side to side while crying and screaming. His mother, Alicia, introduced herself to Dr. Upledger, her eyes darting to Sammy then to Dr. Upledger, back to Sammy and then to the CD player. “We Can Work It Out” by the Beatles seemed way too loud. Alicia, sensing our concern about the music, said, “Beatles’ songs help Sammy calm down.” Raising his voice a little Dr. Upledger said, “I’d like to work with Sammy’s stem cells to see if they’ll rebuild his brain, OK?” “Sure, I’m open to anything that’ll help Sammy,” Alicia replied, her eyes continuing to fleet between Sammy, me, the CD player, Dr. Upledger, the wall, and back to Sammy.

We drew our chairs alongside the treatment table quietly so that we wouldn’t startle Sammy. Alicia, now singing along with the music to help calm Sammy, sat down, put one hand on his leg and began patting his leg just out of rhythm with the music.

Placing our hands upon Sammy, Dr. Upledger and I focused on sensing Sammy’s brain, body and stem cells. After about five minutes Dr. Upledger began to speak softly as he held Sammy’ head, “Sammy, I’m John and I’d like to help you. Is that OK?” Brief pause. “I’d like to ask stem cells in the bones of your head to go and make new brain parts. Is that OK?” Pause. “Great, thank you Sammy.” Then, “Sammy, you already know Tad, is it OK if he helps stem cells go from your chest into your head?” Pause. “Great, thank you Sammy.” Twenty minutes or more passed. I could see Dr. Upledger’s mouth moving as he talked to Sammy, but I couldn’t hear what he was saying. Sammy was screaming louder, Alicia was patting faster, and she kept turning the volume up on the Beatles who were now blasting out “She Loves You”.

All of a sudden Sammy’s bones and blood began to vibrate as if the New York Symphony and the Mormon Tabernacle Choir were playing and singing the same note. In that moment, like a switch turned, Sammy became still and quiet, his eyes softened and stopped moving all around; Alicia stopped singing and patting his leg, slowly stood, turned, and clicked off the music.

Then, after time passed in this quiet state, Sammy’s body signaled that he had finished his session’s work. Dr. Upledger said, “Great job Sammy, we’ll see you tomorrow, OK? Thank you.” We slowly removed our hands and pushed our chairs slightly back from the table. Dr. Upledger asked Alicia if she had any questions. She was staring at Sammy as he lay quietly on the table and said, “Well, yes, but right now I don’t know what to say, can we talk tomorrow?” Dr. Upledger smiled and nodded, “Yes.”

After two weeks of daily treatment Sammy and Alicia returned home to Iowa. Sammy came back to the clinic with his mom two to three times a year for several years, and he improved with each visit until he could manage at home with local practitioners.

Dr. Upledger is constantly using his intelligence, clinical experience and research to create and perfect his ideas within a CranioSacral Therapy context. He has a remarkable ability to investigate current thinking and research, and then distill the information into practical CST technique.

Dr. Upledger has shown me that each one of us is uniquely creative, insightful and perceptive, and when we embrace these qualities in ourselves to help others then the possibilities for growth, both of our clients and ourselves, is immense.

My infatuation with form began when I was a child and still is a constant wonder and focus in my work as a CranioSacral Therapy practitioner.

My parents owned a small Chinese antique store in Washington, D.C. A tiny repair room crammed full of damaged objects was in the back of the store. Stuff was everywhere: broken statuary made of porcelain, wood or bronze; stained or ripped paintings; tattered silk robes; fragments of jade; pieces of carved ivory, and dented cloisonné vessels. The floor was taken up with pieces of teak furniture and two huge ceramic foo-dogs so large they loomed over me.

I spent hours with these things. Their shape, color, and texture carried me into a realm of wondering. When I held the woman carved of ivory, I wondered about her, not in a specific way like who carved her or what happened to her. I wasn’t trying to create anything, I’d just wonder and wait… accepting anything that arose in my mind’s eye.

Before I knew it her missing hand would spring forth with its delicately pointing finger, or her smooth face would glisten suddenly, as if illuminated by the moon, pastel colors of pale green and poppy yellow emerging upon her gown. I’d pay close attention and hear stories murmered by water flowing over creek stones. At times her voice whispered sounds that I didn’t understand, yet somehow I felt better, as though wrapped in a warm blanket.

Eventually I became an artist making imagined things into objects drawn and sculpted. Yet something was lacking. I didn’t understand what it was until I began to learn and use CranioSacral Therapy. Then I realized what was missing, it was life’s motion.

Movement characterizes life. While practicing CranioSacral Therapy I am awe struck when feeling the life force within each cell which can be expressed as blood coursing within our vessels, oxygen filling our lungs, nerves conveying information, or particles entering and leaving our cells. This majestic motion is the way form makes itself known to me.

So when I work with clients, a state of wonder permeates each second of time. I feel the human being is majestic and our life force unfathomable, yet somehow palpable. I marvel at the depth of motion within each cell and I wonder and wait. As I wait images arise of cells moving freely, fluids energizing and vibrant. Other images may emerge of brain parts twisted, membrane coiled or stuck, nerves stressed, or vessels congested. I may see the entire body crumpled by a snagged string of fascia. A large part of my work is to gently support shapes as they shift and untangle.

I am constantly amazed how form is a gateway into the ordinary, the extraordinary, the glorious and the therapeutic.

Abbreviations:
CoS = Confluence of Sinuses
CST = CranioSacral Therapy
DMM = Dura Mater Membrane
EOP = External Occipital Protuberance
VSS = Venous Sinus System

A toxic and harmful brain environment can develop when normal flow of blood and cerebrospinal fluid leaving the brain is reduced. This can cause a backup of the fluid that is trying to cleanse the brain. If the backup persists then waste and toxic elements can collect, congest, irritate and ensnarl delicate brain cells. Harmful pressure can also arise within the matrix of the brain. Furthermore, the flow of fresh arterial blood and cerebrospinal fluid carrying vital nutrients and oxygen to brain cells can be reduced.

In response brain tissue may undergo abnormal change leading to brain challenge or brain dysfunction. The spectrum of brain change can vary from mild to severe leading to a wide range of issues from occasionally having difficulty concentrating or sleeping, to Parkinson’s disease or Epilepsy.

The tubes through which venous blood and cerebrospinal fluid leave the brain are formed by one of the membrane sheets covering the brain and spinal cord, called the dura mater membrane (DMM). These tubes, referred to as the venous sinus system (VSS), are not veins but rather cavities formed within membrane. These cavities do not have muscular walls like veins, so their shape is dependant upon the form of the DMM.

The DMM is interconnected with the body’s fascial system, therefore fascial strain patterns anywhere in the body can alter VSS shape. Any change in form of the VSS, even very small, can reduce fluid outflow, like a crimp in a garden hose reduces the flow of water traveling through it.

Optimizing VSS structure can aid our clients’ specific issues and general well-being. Therefore it is a good idea to routinely focus directly upon improving VSS shape in order to enhance normal VSS fluid outflow. The following sequence of steps, or a comparable protocol, is designed to do just that.

Client position: supine.

I. Check to be sure there are no contraindications to CST, if so do not apply the following sequence.

II. The following four steps are intended to decrease fascial strain in preparation for VSS mobilization.
A. Mobilize and balance primary fascial strain in the body (VSS can be caused by fascial stress
anywhere in the body).

B. Mobilize and balance the thoracic inlet (This helps to open the channels through which fluid flows to the heart).

C. Mobilize and balance the hyoid (this reinforces steps A and B above).

D. Mobilize and balance the Occipital Cranial Base. This helps to decease strain in the area of the jugular foramina through which pass the internal jugular veins that carry blood and cerebrospinal fluid out of the brain. This can also decreae strain of the sigmoid sinus.

III. The following steps focus upon releasing restrictions of the VSS.

A. Locate your client’s external occipital protuberance (EOP), the small bony “bump” on the back of their head. Some people do not have a prominent EPO, therefore imagine a horizontal line along the back of their head connecting the top of their ears. Then imagine a vertical line in the center back part of their head. Where the two lines intersect is the area of the EOP. This is an important landmark because on the inner surface of the EOP is the confluence of sinuses (CoS), a flowing together of three of sinuses: the superior sagittal sinus, the straight sinus, and the transverse sinuses.

B. Cradle the occiput in your hands so that your palm side knuckles are in line with the top of your client’s ears. This will place the EOP between your fifth knuckles.

1. Focus your intention and wait to feel softening midline from the CoS to the foramen magnum that addresses the occipital sinus.

2. Then focus your intention and wait to feel softening laterally/sideways at inferior/lower occiput to address the marginal sinuses.

C. Change your hand position so your hands cradle the skull with your fingers spanning the distance from occiput to sphenoid. Imagine a line drawn from the confluence of sinuses laterally/sideways and then anteriorly/front-wise to mid-orbit/middle eye area. This line will travel along the occiput, temporal bone and greater wing of sphenoid.

1. Focus your intention to feel softening of the occiput from the CoS laterally/sideways to address the transverse sinuses.

2. Focus your intention in a lateral/sideways and anterior/front-wise direction, along the temporal bones while projecting your intention inward along the petrous portion of the temporal bones. Wait to feel softening which address the superior and inferior petrosal sinuses.

3. Project your intention inward at the greater wings of the sphenoid and wait to feel softening which addresses the cavernous and circular sinuses.

D. Cradle the occiput midline in one hand with the EOP in your palm and your fingers pointing towards the client’s feet. The other hand contacts the parietal bones midline. Bring your parietal hand one-third the distance from the EOP to the bridge of the nose.

1. Focus the intention of your parietal hand towards the foramen magnum to engage the anterior/front part of the straight sinus. Your occipital hand engages the posterior/back part of the straight sinus, which is the CoS. Wait to perceive softening of the straight sinus.

E. Place finger tips along either side of the sagittal suture beginning at the CoS to address the superior and inferior sagittal sinuses. Wait to feel a response of softening under your finger tips then move your hands in an anterior/front-wise direction a little at a time, waiting for softening each time your move your hands, until reaching the bridge of the nose.

IV. End with CV-4 stillpoint induction to help the body integrate corrections that have occurred in response to treatment.

Helping the brain efficiently drain waste and toxic elements by directly working with our client’s VSS can optimize their brain’s performance and increase their overall vitality and health.

Do you notice a difference in your client’s response to CranioSacral Therapy sessions when you incorporate a regular VSS sequence into their sessions?