CranioSacral Therapy

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?

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