The Therapeutic Value of the Craniosacral System

By John Upledger, D.o. , O.M.M.

The very existence of the cardiovascular and respiratory rhythm is not disputed today. But for eons, the debate raged on in medical communities, in cultures around the globe, concerning the reality of these systems. Even today, treatment of afflictions associated with these systems and especially health maintenance are remarkedly varied, as diverse as the numerous disciplines found throughout the world and their individual practitioners.

For nearly 15 years I’ve been a chief proponent of the use of the Craniosacral System as another rhythm to help evaluate the proper functioning of the body … and to help solve problems of pain and dysfunction. I’ve been dedicated to teaching the therapeutic value of the Craniosacral System to all healthcare professionals, physicians and non-physicians, including massage therapists, physical therapies, occupational therapists, chiropractors, psychiatrists, psychologists, nurses and even dentists.

If it seems odd that so many different practices can derive benefit from an understanding of this System, an explanation of how is functions may be helpful.

The Craniosacral System is a physiological system that exists in humans as well as those animals possessing a brain and spinal cord. Its formation begins in the womb and continues to function until death. When there is an imbalance in your Craniosacral System, your brain and spinal cord suffer. These organs are the core of your being. Without them senses, emotions and motor functions would be incapable of working effectively.

Craniosacral Therapy is a method of examination and treatment which has been devised to correct problems which affect this very important and vital system.

We call it “Craniosacral” because it involves all of the bones of your skull, face and mouth which make up the “Cranium” and it extends by a system of hydraulics and membranes to the lower end of your spine or your sacrum. Trauma or other things which affect the lower end of your spine such as a fall on your “tailbone” can have adverse effect on the “Cranial” or head end of the Craniosacral System. The whole system and the body parts which effect it must be evaluated and treated in order to improve the conditions or the environment in which the brain and spinal cord must do their job.

We elected to use the word “Therapy” rather than examination and treatment because “therapy” implies a softer approach with more of a cooperative effect between the client and the therapist. It implies a mutual effort towards helping the Craniosacral System to work efficiently rather than the more mechanical approach which would evaluate what’s wrong and fix it without the help of the person who happens to own the Craniosacral System.

The positive effect of Craniosacral Therapy relies to a large extent upon the client’s normal self-corrective physiological activities. It relies upon the hydraulic forces inherent within the system to contribute a great deal towards the corrective process. The CranioSacral Therapist more or less removes obstacles which the normal self-correcting physiological forces have been unable to overcome. The therapist seldom dictates how the correction should be made, but rather assists the body in its own natural self-corrective activities within the CranioSacral System. Therefore when certain rules which enforce a gentle approach by the therapist are followed, there can be no serious error or side-effect because the CranioSacral System itself decides how the correction should be made. The therapist simply removes obstacles, activates and empowers.

How is it Done?

CranioSacral Therapy is a gentle non-invasive manipulative technique. Seldom are pressures applied by the therapist which exceed five grams or the equivalent weight of a nickel. Examination is done by testing for movements in various parts of the System.

Oftentimes when movement testing is done, the test has removed the restricting obstacle. The System is then able to complete its self-correction.

Experienced clinicians are able to palpate the CranioSacral motion anywhere on a patient’s body. Valuable examination information can be gained very quickly by palpating the CranioSacral motion for rate, amplitude, symmetry and quality.

The parts of the CranioSacral System which can be easily palpated by the hands of the therapist are the bones of the skull, sacrum and coccyx because they attach to the membranes which enclose the cerebrospinal fluid. This cerebrospinal fluid is filtered out of the blood in a dynamic feedback loop. The system then acts like any semi-closed hydraulic system with pressures building as the amount of fluid increases, forcing the fluid to move up and down the spinal cord. When the fluid moves the membranes containing the fluid moves, normally at a rate of six to twelve cycles per minute.

All of the other bones of the spine and pelvis are used in CranioSacral Therapy, but because of their less direct effect upon the hydraulic system, more expertise on the part of the therapist is required for their effective use. The same is true of the jaws and the temporomandibular joints.

Low amplitude of the CranioSacral Rhythm indicates a low level of vitality within the patient. That is, the patient’s resistance is low and hence the susceptibility to disease is high.

Occasionally, the CranioSacral rate, as palpated on the head, is twice normal and the amplitude is low. But the energy internally which is attempting to drive the cranial system seems quite high. I subjectively interpret this finding as indicative that the boundary or meningeal membranes of the CranioSacral System is quite restrictive and lacks accommodation to CranioSacral motion. Therefore the rate has doubled while the amplitude is reduced by approximately 50%. This condition continues a normal range of motion per minute. We often find this situation in cases if inflammatory problems which presently involve or have involved the meninges and/or the central nervous system.

Lack of symmetry of the CranioSacral rhythmical motion throughout the body is used to localize pathological problems. The problems may be of any type which cause loss of physiological motion. That is, they may be problems of the musculoskeletal system (somatic dysfunction), inflammatory responses, adhesions, trauma with cicatrix, surgical scars, vascular accidents, etc. The asymmetry of motion will not tell you what the problem is but it will tell you where the problem is located. Once located, you must relay upon other evaluative methods to determine the exact pathological nature of the problem you have found.

Restoration of symmetrical Craniosacral motion to the area of restricted motion is used as a prognostic tool. As the asymmetry is eliminated and normal physiological motion is restored the problem is being or has been resolved.

One may consider the body fascia to be a slightly mobile, continuous from head to toe sheath of connective tissue which invests in its pockets all of the somatic and visceral structures of the human body. With this model in mind, it is apparent that any loss of mobility of this tissue in any specific area can be used as an aid in the location of the disease process which has caused the lack of mobility. By some means, probably via the nervous system, this fascia system is kept in constant motion in correspondence with the CranioSacral rhythmical motion. By direct connections and by common osseous anchorings the extradural fascia and the meninges are interrelated and interdependent in terms of their motion. Therefore the examiner is only limited by his or her palpatory skill and anatomical knowledge as to how much information can be obtained from the examination.

Abnormalities of structure and/or function of the nervous system, the musculoskeletal system, the blood vascular system, the lymphatic system, the endocrine system, and the respiratory system may influence the CranioSacral System.

Where did the CranioSacral System and its Therapy Come From?

In the early 1900’s William G. Sutherland, an Osteopathic student in Kirksville, Missouri was struck by the idea that the bones of the skull were designed as they were in order to provide the opportunity for movement in relation to one another. Sutherland graduated and practiced as an Osteopath in Minnesota. For over 20 years he thought about the prospect of movable bones in the adult human being. He did makeshift experiments on himself with helmet-like devices which could impose variable controlled and sustained pressures on different parts of the head. His wife described personality changes that he displayed in response to different pressure applications. He described various head pains and problems with coordination, etc which related to the various pressures. In the early 1930’s Dr. Sutherland published his first article about his work and ideas under a pseudonym in the Minnesota Osteopathic Journal. He also developed a system of examination and treatment for the bones of the skull. He had some success with patients and developed a small cadre of Osteopaths who studied the cranial work with him.

Sutherland’s system became known as Cranial Osteopathy. Because little was known about how it really worked, and because the results with patients seemed at times to be miraculous, Sutherland’s system acquired an esoteric and cultist reputation.

This reputation and the system known as the Cranial Osteopathy became an embarrassment to the Osteopathic Medical profession which was trying to establish itself as an acceptable science.

In 1970 under specific circumstances during a surgery on a patient’s neck, I was privileged to view first hand the rhythmical movements of the membranous boundary of the hydraulic system which I later researched scientifically. This system became known as the CranioSacral System.

After first seeing the CranioSacral System in action, two years had elapsed before anyone could shed any light on what I had seen. None of my colleagues nor any of the medical books had an explanation for the observation that the outer layer of the meningeal membrane (called the Dura Mater) in the neck visibly moved in and out rhythmically at about 10 cycles per minute when the bones were removed to expose these membranes to the naked eye. The observations had to mean that pressure inside of the membrane sack was rhythmically fluctuating. In 1972, I attended a seminar which explained Sutherland’s ideas and taught some of his techniques of evaluation and treatment. Coupling my tactile sensitivity with scientific background, I quickly understood how a hydraulic system might work inside of a membrane sack which was encased inside of the skull and the canal of the spinal column.

I used the techniques with success and in 1975 was asked to join the faculty of The Osteopathic College at Michigan State University as a clinician-researcher in the Department of Biomechanics. Part of the charge of this research department was to either scientifically support or to debunk once and for all the embarrassment to the Osteopathic profession which was known as Cranial Osteopathy.

At Michigan I led a multidisciplinary research team made up of anatomists, physiologists, biophysicists and bio-engineers through the maze of research which first established the scientific basis for a CranioSacral System. We explained the function of the system in scientific and practical terms and showed how the system could be used to evaluate and treat poorly understood malfunctions involving the brain, the spinal cord and a myriad of other health problems such as chronic pain, lowered vitality and recurrent infections.

CranioSacral Therapy focuses on problem solving. It was enhance your client’s general health, improve their resistance to disease, improve their brain and spinal cord function, reduce accumulated stress and work with the patient’s own natural mechanisms to enhance effectiveness.

As you improve your level of expertise in palpation, you will enhance your ability to evaluate and treat a myriad of problems which before may have seemed well beyond your understanding and experience.

For more information on the brain and spinal cord, visit the Brain and Spinal Cord website.

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