Cranial Somatic Dysfunction
Practitioners of cranial manipulation typically have studied under an osteopathic physician in the anticipated movements of a normal head which includes the articulation of the base, vault, and face. The practitioner will use their hands to gently free up restrictions (indirect manipulation techniques) in the movement of cranial bones and associated soft tissues and to stimulate the flow of the cerebrospinal fluid, which bathes all the surfaces of the brain and the spinal cord.
Practitioners believe that distortions in the natural rhythms of the central nervous system may result from the trauma of all sorts including birth trauma, childhood injuries, automobile accidents, even psychological trauma. Researchers at Michigan State University’s College of Osteopathic medicine confirmed the theory put forth in the 1930s by William Sutherland, D.O. in the late 1970s by showing cranial bone motion in X-ray films of the skulls of living subjects. Some have espoused the notion that the cranial bones are directly connected to the sacrum mechanically through the dura (outer connective covering of the central nervous system). Anatomically, through the dura mater (the outermost connective tissue layer of the spinal meninges) there is a link from the foramen magnum to the sacrum, but the available movement of the dura from flexion of the spine to extension is 5-9cm, which is a max of 3-4 inches of the excursion. Most practitioners of “craniosacral therapy” believe they can feel this subtle motion which is millimeters of the excursion. What they also talk about is the “craniosacral rhythm” which is thought to occur as cerebrospinal fluid is expressed and removed by the arachnoid villa in the brain. This has never been documented/confirmed in an objective way.
What is true is that the cranial sutures are synovial planar joints which are innervated and do move. Reactivity of the muscles of mastication, facial muscles, and long restrictors such as the sternocleidomastoid, upper trapezius, subcranial oblique muscles, can have a dramatic effect on the movement of the cranial sutures. The joints of the cranium, therefore, can be the source of pain. The muscles may be in spasm, and pain may be referred to as the head from various structures from the upper thoracic region, the cervical spine, the TMJ, and others. The way we think of these joints is similar to any in the spine or appendicular skeleton in that they may exhibit somatic dysfunction. In somatic dysfunction which is found when the altered function of the somatic system which includes all connective tissue elements and their associated neural, lymphatic, and vascular elements may result in pain, loss of mobility, and tissue texture abnormality. When the practitioner objectively identifies visual and palpatory findings of somatic dysfunction of the cranial joints and associated muscles are treated properly the patient’s spasm, mobility of the joints and pain are improved.
If you are suffering from an injury or underlying condition that is causing you discomfort, especially associated with the head, contact Sports and Orthopaedic Therapy Services in Silver Spring, MD today. We will schedule a consult with one of our dedicated physical therapists to determine whether or not cranial manipulation therapy would benefit you!