Cranial Manipulation and Craniosacral Therapy (CST) made popular by John Upledger, D.O. are different in substantial ways. Craniosacral therapy is based on a refuted hypothesis that the cranial bones have inherent motion (paired bones externally rotate and singular bones flex and extend) based on cerebrospinal fluid expression and removal by the arachnoid villa in the brain. No objective method of evaluation has demonstrated that this occurs, yet CST therapists continue to recommend the effects to their patients, with positive results occasionally in the way that many hands on approaches have on relaxation of tissues.
Cranial Manipulation (as practiced at SP.OR.T.S.) on the other hand is based on the same protocol of assessment that occurs in the muscle energy model that requires the practitioner to evaluate the patients physical structures to identify (ART) Asymmetry of position, fluid retention, atrophy, etc, Range of motion deficits, and Tissue texture abnormality (muscle spasm). Pain (often compensatory in nature) is frequently a byproduct.
Researchers at Michigan State University’s College of Osteopathic medicine confirmed the theory put forth in the 1930’s by William Sutherland, D.O. in the late 1970s by showing cranial bone motion in X-ray films of the skulls of living subjects. 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 movement of the cranial sutures. The joints of the cranium therefore can be the source of pain.
Therapist’s at SP.OR.T.S. assess for somatic dysfunctions of the cranium just like any other part of the body. The concepts of cranial motion developed by CST are still useful in the assessment scheme in the paired bones as asymmetry of motion is one of the components used to determine if somatic dysfunction exists. We use an assessment scheme for identifying somatic dysfunctions (ART) and then treat accordingly. Direct manipulation (usually of higher force in the direction of the restriction) or indirect manipulation (light forces used in the direction opposite to the barrier of movement) can be used to correct the loss of motion. Typically, since there are associated muscle spasms, indirect techniques are usually favored. Indirect techniques include muscle energy procedures, counterstrain, positional release, and others.
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!