CranioSacral Therapy

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?

Normal tongue structure and function are crucial during fundamental activities such as chewing, sucking, swallowing, breathing and speaking. Dysfunction of these activities can occur when either the form or position of the tongue is disturbed, if structures attaching to the tongue are compromised, or when the tongue’s sensory or motor nerve pathways are stressed. CranioSacral Therapy can help the body form balanced free motion of the tongue by decreasing dysfunctional biomechanical or neurological strain upon it.

The tongue is suspended from the cranium, soft palate, mandible, and hyoid bone by way of the tongue’s extrinsic muscles. A constant give-and-take relationship exists between these structures such that the tongue affects them and, in turn, they affect the tongue. We can think of it as a kinetic chain of reciprocal influence.

Conditions can arise that challenge the smooth operation of one or more components within the tongue’s kinetic chain. This may lead to dysfunction involving activities in which the tongue is directly involved such as swallowing and speech, or activities that do not directly engage the tongue such as balance or rib-cage motion. Visceral function can even be altered.

When a person’s tongue is unable to function properly the consequences for the individual can be heart wrenchingly difficult. Working with the tongue, its associated structures and the body as a whole, may help alleviate dysfunctional biomechanical strain in such a way that the tongue can establish optimal position, movement and function.

Please look for Tad’s upcoming article on the tongue in the Massage Magazine’s online “Techniques” section, <http://www.massagemag.com/Resources/massage-techniques/>

The myodural bridge (MDB) is a ligament connecting a pair of deep muscles at the base of the skull to membrane surrounding the spinal cord, called dura mater. (Fig. A/B, click on image to enlarge) Harmful stress can be placed upon the delicate tissue of the spinal cord and brain when abnormal MDB tension is transmitted to the dura mater. This stress can cause neurological strain leading to a multitude of dysfunction, such as:
neck pain,
headache,
dizziness and balance problems,
movement disorders,
difficulty controlling eye movement,
visceral dysfunction,
high blood pressure,
chronic fatigue, or
emotional stress.

CranioSacral Therapy can help normalize MDB tension, which can decrease nervous system abnormal strain thereby helping the body heal and gain optimal function.

The area of the MDB is one of complexity, subtlety and sensitivity.  Techniques such as the thoracic inlet release, hyoid release, occipital cranial base release, and dural tube mobilization can help normalize MDB shape and tautness. Using the least amount of pressure needed, while sensing and following the response within the tissue, is an effective way to help the body correct abnormal strain in the MDB, dura mater, craniosacral system, and other tissue or systems.

Please look for Tad’s upcoming article, The Myodural Bridge, Small Size—Large Influence, in the Massage Magazine’s online “Techniques” section, <http://www.massagemag.com/Resources/massage-techniques/>

Mara cautiously walks huddled alongside her mom.  This closeness, and the doll she clutches to herself, gives her a feeling of steadiness. She has low muscle tone that has caused her difficulty speaking, balancing, walking, using her hands, and developing at a typical rate. During Mara’s first CranioSacral Therapy (CST) session a lack of cerebrospinal fluid (CSF) flow seemed to have disrupted the normal availability of vitalizing elements, called neurotrophins, flowing from her spinal cord to the rest of her body.

It is thought that neurotrophins are produced inside nerve cell bodies of spinal cord nerves, and then the neurotrophins stream within peripheral nerves throughout the body.  Hindrance in the accessibility of these enlivening elements can cause cell exhaustion, which in turn could lead to Mara’s muscle weakness.

There was a palpable communication, both bio-chemically and energetically, between Mara’s CSF, neurotrophins, and tissue.  It felt as though CSF was guiding the direction, and determining the amount, of neurotrophins trickling to her muscles, organs, and glands.  Since her CSF flow was very congested, particularly where her peripheral nerves exit the spinal column, her neurotrophins had almost completely lost the support and guidance of CSF.  Because of this CSF compromise Mara’s muscles could not receive their essential amount of vital energy from the spinal cord.

Our session focused on opening the connective tissue pathways by which CSF flows out of the spine, increasing CSF motion, and encouraging her body to receive increased neurotrophin flow.  There were times when you could actually feel her muscles enliven, as though they were turning on for the first time.

The entire experience was surprising, enlightening and very exciting for me, even though I’ve never read anything about a relationship between CSF and neurotrophins to validate what I was feeling.  Yet, client response to CST is one way to judge how precise our perceptions have been.

Mara’s mom reported that after our session Mara’s strength and balance noticeably improved, and the improvement lasted four weeks before the effects of our session began to diminish, but not disappear.  This is an indication to me that Mara had a good response to CST, she could benefit from more CST, and there is a supportive relationship between CSF and neurotrophins in her body.

“Vibrations turn to atoms and atoms generate what we call life; thus it happens that their grouping, by the power of nature’s affinity, forms a living entity.”
Hazrat Inayat Khan

Recently during a session a rhythmic pattern arouse in my perception that felt to me like a slow, very long rumble within the client.  At the same time I felt like nerves from my hands were magically connected to my visual cortex.  I was feeling with my hands but concurrently seeing what my hands were feeling.  Images appeared as though I were watching a luminous slow-motion 3D film of someone tumbling in gelatinous crystal clear liquid.  I watched close-up scenes as the client’s body slowly floated in my vision, each pore, each cell, each miniscule part of her sinking and then rising again as if an invisible wave was moving the viscous fluid which in turn moved her.  What was this rhythmic wave?  Then I recalled coming across an interesting reference months earlier about sound and thought there may be a relationship to our session.

We live amidst a sound emerging from a group of galaxies 250 million light years from Earth called the Perseus Cluster.  “The sound waves coming from it are in the form of a single note…” which is B-flat, and the frequency of these sound waves is 10 million years.

If I’m not mistaken this means that if we were to draw this B-flat frequency in time with its sound waves then the amount of time it would take to draw one sound wave going from the wave’s valley, to its peak, and then to the next valley, would be 10 million years!  By contrast if we were to draw a wave of the craniosacral rhythm, while staying in time with its rhythmic wave, it would take about 9 seconds.

We can sense and work with many biorhythms in CranioSacral Therapy. Some of these rhythms are generated through inner biological processes, such as cerebrospinal fluid seeping, blood oxygenating, lymph cleansing, even elements moving through a cell’s wall will create some form of frequency.

We can also feel and utilize rhythms that arise outside of ourselves since we exist in an environment awash with vibrations.  Some of these outer rhythms merge into our body to become an integral part of us.  For example, waves swooshing upon the shoreline, water trickling from icicles, rainwater flowing from roof to gutter to cistern, and fire crackling can all have an internal effect.

One of the astronomers who discovered the Perseus Cluster sound said it “…may be the key in figuring out how galaxy clusters, the largest structures in the Universe, grow.”  Well then, could this sound be affecting our clients, the world, us?  Is it in some way organizing or at least affecting our growth and can we use this rhythm to help our clients and ourselves?  I wonder.  So I’m inviting this sound wave from the stars to arise more fully in my awareness.  Intuitively it seems there is much to learn from Perseus’s drone as well as other cosmic rhythms from our Milky Way galaxy and parts of the universe.

If you have time perhaps sit for a moment to experience Perseus humming, its low drone singing, dancing and chanting to us from 250 million light years away.

References:
Jenner, Lynn, “Interpreting the ‘Song’ Of a Distant Black Hole”, Goddard Space Flight
Center, http://www.nasa.gov/centers/goddard/universe/black_hole_sound.html,
Page Last Updated: February 23, 2008.
Khan, Hazrat Inayat, The Mysticism Of Sound And Music, Shambala Publications, Inc.,
Boston, Ma., 1991.
Weider, June Leslie, Dr., Song Of The Spine, Sound Healing and Vibrational Therapy, Booksurge Publishing LLC, North Charleston, SC, 2004.

I have used the Pressurestat Model as an explanation of the craniosacral rhythm (CSR) for most of my career as a CranioSacral Therapy practitioner.  Recently in my work my view of this model has changed, and as a consequence newfound awareness has developed.

The Pressurestat Model, which was created by John Upledger, DO, OMM, proposes that: 1) normal drainage of cerebrospinal fluid (CSF) out of the craniosacral system is ongoing, and 2) areas in the brain producing CSF normally do so in an on-and-off sequence, called cycles. These cycles cause a rise and fall in the total amount of CSF and pressure within the craniosacral system, brain and spinal cord.  In turn, these fluid pressure changes generate the CSR.  (1)

It can be helpful to periodically contemplate the models we use in our practice. The process can add greater clarity and nuance to our work, whether our thinking and research changes or re-confirms our concepts, models, or techniques.

The following questions arose for me one day: If CSF change within the craniosacral system is the primary force producing the CSR, then how much fluid per cycle is actually moving the system?  Does this amount of fluid seem to be enough to create the CSR?   Can a small amount of fluid within a container, such as the craniosacral system (CSS), create a large response?

When I divide the average volume of CSF produced daily, which is 650 milliliters, by the model’s average daily cycles, which are 12,960 cycles per day, I get a change in volume of approximately .05 milliliter of new CSF created per cycle, which is about 1/10th teaspoon. (2)

Is this enough fluid to move the craniosacral system, cranial bones, face, spinal column, sacrum, brain, spinal cord, and generate enough on-and-off pressure upon the motor cortex to elicit full body response?

While standing in the kitchen I measure out 1/10th teaspoon of water, place it in my palm and rock it back and forth in my hand. I feel it move, its weight and pressure upon my skin.  As I do this I imagine the entire craniosacral system, brain and spinal cord being moved by this amount of fluid.  Is this enough to move the craniosacral system and related structures?  If not, then what else helps create the CSR?

Perhaps CSF movement is only one oscillation in a combined wave pattern consisting of many oscillations, which is created by merging of the body’s anatomical and physiological oscillations. Then the rhythmic motion we feel as the CSR could be a blend of biological frequencies. Perchance the CSR is not a separate rhythm moving the body, but is part of the body’s collective vibrations. (3)

Try this: place your hands at the thoracic inlet.  Identify some of the structures in the area, such as: clavicles, sternum, upper lungs, thymus, thoracic spine, muscles, Vagus nerve, sympathetic chain, brachiocephalic veins, carotid arteries, spinal cord, dural tube, and trachea.  Each one of these structures and their processes individually produces its own specific oscillation.  These frequencies also unite forming an overall harmonic rhythmic pattern.  What does the overall pattern feel like? What do the individual anatomical and physiological patterns feel like?

Now feel these structures and processes moving in response to another motion, the CSR.  First identify the CSR, and then feel the structures moving in synchrony with the CSR. Are you feeling structure and function move in relationship to another rhythm, one that is moving them?

Is the CSR providing a fundamental pattern that is a primary organizing frequency within an individual?  Is this rhythm shaping one’s existence from the micro level of particles to entire body?  William Sutherland, DO, the creator of Cranial Osteopathy, proposed an elegant relationship between cerebrospinal fluid and vital forces generating life, motion and stillness within the body, which he called “The Breath of Life”. (4)

So, I began with wondering what creates the CSR and have come full circle to still not knowing.  Yet, pondering the CSR has led me to feel, perceive, and use the body’s remarkable harmonic and disharmonic frequencies in new and exciting ways.  Also, I have a clearer intuitive sense of what fits within my view of nature, the human body, and what I sense while working with clients.

In your opinion, what is creating the CSR?  What model do you use to explain the CSR? Does your work change if your model of the CSR changes?  How do you explain the CSR to your clients?

Reference List:
1.  Upledger, John E., D.O., O.M.M., and Vredevoogd, Jon D., M.F.A., 1983, Craniosacral Therapy. Eastland Press, Seattle, Washington.

2. Agamanolis, Dimitri, P., M.D., et al., Neuropathology, An Illustrated Interactive Course For Medical Students and Residents. Chapter Fourteen, Cerebrospinal Fluid. Northeastern Ohio Universities College Of Medicine, http://www.neuropathologyweb.org/chapter14/chapter14CSF.html.

3. Chaitow, Leon, ND, D.O., 1999, Cranial Manipulation Theory and Practice.  Churchill Livingston, London, England.

4.  Sutherland, William, G., D.O., Teachings In The Science Of Osteopathy.  1990, Rudra Press.

Illustration by Tad Wanveer,LMBT, CST-D, Copyright 2008, All Rights Reserved.

Expanding our understanding and application of CranioSacral Therapy is a constant quest.  One way to further our knowledge is by reading books, articles, and presentations written by Osteopathic Physicians and CranioSacral Therapy practitioners.  Knowing where to go to find information can be invaluable. Two fantastic resources for books and products relating to CranioSacral Therapy are:
•    The Upledger Institute, and
•    Pacific Distributing – Books and Bones.

The Upledger Institute has an extensive, and excellent, line of books and products relating to CST (primarily the work of John Upledger, D.O., O.M.M.) as well as other manual therapies, such as: Lymphatic Drainage, Zero Balancing, Healing From The Core, Brain Curriculum, and others.
Contact Information:
The Upledger Institute
http://www.upledger.com/

Christopher Muller, and others at Pacific Distributing – Books and Bones, have a thorough understanding of CST, thoughtfully listen to my questions, help me decide which products will best suite my needs, and provide those products in a timely manner. Christopher has kindly provided the following description of their products as well as contact information.

“We teach and have a private practice so over the years we have found useful tools that may be of benefit to other practitioners and teachers.

We have a wonderful collection of craniosacral, osteopathic books (Sutherland, Becker, Magoun) all of the James Jealous CDs, a great selection of embryology, anatomy, physiology, energy and form, and works on trauma resolution. We are very particular about what we carry as most of our inventory are things that contributed to our own educational process.

We produce the best disarticulated skull in the world.  Each bone is the exact weight, color and feel of the original bone. The specimen we cast from was unusual in that the base and vault can be re-articulated just on sutural contact (no pins, hooks or plugs). We carry a full selection of fetal and adult skulls, sacrums and other anatomical models.”

Contact Information:
Pacific Distributing - Books and Bones
Phone: 951-677-0652
Contact: Christopher Muller

How often do you listen to your craniosacral system?

Rollin E. Becker, D.O. presented the following instructions and mediation as part of a lecture given in 1976 at the Sutherland Cranial Teaching Foundation in Milwaukee, Wisconsin.  The title of this portion of the lecture is “Sitting With Your Mechanism”.

“Now, sit in your chairs with your feet on the floor, straighten your spines, and shift forward slightly so you’re sitting on your pelvic bones and not leaning in your chair at all.  Then, quietly, for a moment, with your eyes closed, think of a potent cerebrospinal fluid expanding and contracting rhythmically.  This is an internal feeling – quietly within yourself try to feel a body of fluid that comes to a still point and expands, comes to a still point and ebbs, comes to a stillpoint and expands, comes to a still point and ebbs, rhythmically every five to ten seconds.  Fuse that feeling with the to-and-fro rocking of the reciprocal tension membrane by focusing on the straight sinus, the fulcrum of the reciprocal tension membrane.  Don’t worry about the ends of the levers, look to the fulcrum.  Focus your attention, not your mental brain but your awareness, on the reciprocal tension membrane at the Sutherland fulcrum.  Quietly.  Quietly.  Still…be still and sense this life in motion.” 1.

Click on Illustration to enlarge.

Notes:
-  “The dural membrane system was called the “reciprocal tension membrane” by Dr. Sutherland.” 2.

-  “The movement of the membranes has a natural point of balance, or a fulcrum, within the straight sinus where the leaves of the falx cerebri and tentorium cerebelli meet.  This natural fulcrum was considered so important by cranial practitioners that it became known as Sutherland’s fulcrum.” 3.

References:
1.  Becker, R.E., Life In Motion, Rudra Press, 1997
2.  Sills, Franklyn, Craniosacral Biodynamics, Volume One, North Atlantic Books, 2001
3.  Ibid.

Illustration by Tad Wanveer, LMBT, CST-D, Copyright 2008, All Rights Reserved

Do your clients wonder how light, delicate touch of 5 grams or less can help decrease restrictions within their body? How do you explain this to them?

I recently devised a fascia model representing collagen, elastin, and restriction of motion, which I hope you find useful.

To make the model you will need the following items:
1.  Pair of scissors,
2.  Business card, and
3.  Rubber band.

Instructions:
1. Use a pair of scissors to cut a business card lengthwise and then cut a small “V” notch towards one end.  The piece of card represents collagen.

2. Have your client hold the piece of card between their thumb and index finger snugly yet softly.  Their grasp of the card represents a restriction.

3.  Place a rubber band around the piece of card so it sits within the “V” cutout.  Ask your client to hold the rubber band with their other hand.  The rubber band represents elastin.

4.  Ask your client to take the slack out of the rubber band slowly in the direction away from the “V” cutout, which means just to the point at which they feel the stretch (elastic quality) of the rubber band.

5.  Have the client continue taking up the slack in the rubber band as the piece of card rotates within their grasp.  The movement of the piece of card represents mobilization of a restriction.  Refer to Figure #1 (click on the image to enlarge)

It may be helpful to demonstrate using the model before the client uses it.  You can show how to apply minimal traction to the rubber band.

Perhaps explain to your client that fascia surrounds all structures in their body.  Actually, every cell is surrounded by fascia; collagen and elastin are two principal components of fascia. Fascia is the substance through which bio-chemical processes and biomechanical force and action occur, therefore normal anatomical structure and physiological function are dependent upon unencumbered balanced mobility of fascia.

Gently engaging the elasticity of the rubber band transmits force throughout the rubber band and paper.  As the paper moves between thumb and finger (restriction releases) continue to take up the slack of the rubber band; this represents following the tissue.

What would happen if there were hundreds, or thousands, perhaps millions, or billions of interlinked models?  Isn’t the fascia interlinked, interconnected, to form a continuous network throughout the entire body?

Does this model demonstrate how minimal force can create change?  Does it suggest how a local change can cause a global change due to the interconnected nature of fascia?

Perhaps if we (CST practitioners) use this model periodically it can help us hone our craft of using the minimal amount of input into a client’s body to aid their self-corrective process.

Harold Magoun’s words regarding palpation reminds us, “To employ other than a skillful and delicate sense of perception is to lose the shades of physiological reaction so necessary for success.  Living cells prefer persuasion to force… One must work with the tissues not against them.” 1

Reference:
1.  Magoun, H., 1966, 1976, Osteopathy In The Cranial Field, The Journal Printing Company, Kirksville, Missouri

Optimal sinus function appears to have a considerable influence on our overall health.

Various functions of our paranasal sinuses continues to be explored with recent research focused on the molecule Nitric Oxide (NO). NO is involved in blood circulation, blood pressure regulation, neural transmission, mitochondrial function, the inflammatory process, weight loss, immune function, digestion, learning and memory. NO is produced in the lining of our blood vessels and paranasal sinuses.

The paranasal sinuses are found in the following bones: maxilla, frontal, ethmoid and sphenoid. CranioSacral Therapy can help maintain the most favorable sinus function by maximizing craniosacral rhythmic motion of the bones and sinuses. “Motion is Health and Stasis is Disease” 1. certainly seems to apply to our sinuses as well as our body as a whole.

1. John E. Upledger, D.O., O.M.M. CranioSacral Therapy and the Reversal of Pathogenic Processes Study Guide. Upledger Institute, Inc. 2005

Note: Illustration by Tad Wanveer, LMBT, CST-D. Copyright 2008, All Rights Reserved.