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Craniosacral Therapy Introduction Theresa A. Schmidt, DPT,MS,OCS,LMT,CEAS,Chy,DD
www.educise.com Sponsored by: Cross Country Education C2009 Copyright Theresa A. Schmidt
In the efforts to comply with the appropriate boards/associations, I declare that I do have an affiliation with or financial interest in a commercial organization that could pose a conflict of interest with my presentation.
Craniosacral Therapy Introduction By Theresa A. Schmidt, DPT,MS,OCS,LMT,CEAS,CHY,DD
Cross Country Education Leading the Way in Professional Development. www.CrossCountryEducation.com
STRUCTURE & FUNCTION OF FASCIA: Craniosacral Dura
Compartmentalizes and surrounds everything! Maintains posture Supports vessels, organs, muscles, nerves, bones Defines muscle motion
Aids circulation Influences cell metabolism Aligns with mechanical stresses Deposits collagen to rebuild and to heal injuries
Relays and stores information
Electromagnetic transmission agent
COMPOSITION OF FASCIA
Proteins: collagen and elastin
Ground Substance: lubricates and separates
CRANIOSACRAL ANATOMY 8 cranial 14 facial 6 auditory
CRANIUM
Frontal Parietal-2 Occipital Temporal-2 Sphenoid Ethmoid
FACIAL BONES
Zygomatic-2 Maxillae-2 Mandible Nasal-2 Lacrimal-2 Palatine-2 Vomer Inferior conchae-2
ANATOMICAL LINKS Cranial base Core link- spinal dura Sacrococcygeal complex, S2, filum terminale, S4 Meninges, ventricles
CRANIAL BASE
Frontal Sphenoid Ethmoid Temporals Occipital
MENINGES Dura Arachnoid Pia Mater
DURA MATER Falx Cerebri Falx Cerebelli Tentorium Cerebelli
RECIPROCAL TENSION MEMBRANES
Forces across a membrane are transmitted equally through CSF to other membranes, hydraulic system
CEREBROSPINAL FLUID Nourishing fluid produced by choroid plexus circulates through 4 ventricles Fluid mechanics affect membrane tension
VENTRICLES 2 Lateral Ventricles Third Ventricle Fourth Ventricle CSF travels through ducts in the system
EXAMINATION History Structural Assessment Motion Analysis
PALPATION
Craniosacral Rhythm Cranial bones are anchors for dural membranes
THE WHOLE IS GREATER THAN THE SUM OF ITS PARTS!
PRINCIPLES OF CRANIOSACRAL MOTION Craniosacral Rhythm (CSR) Rhythmic inherent physiological motion of 6-12 cycles/ minute
CRANIAL MOTION Flexion / external rotation (widening) Extension / internal rotation (narrowing)
FLEXION: EXTERNAL ROTATION: Transverse diameter increases A-P diameter decreases
SPHENOBASILAR FLEXION: External rotation of paired bones: widening
SPHENOID AND OCCIPUT ROTATE IN OPPOSITE DIRECTIONS: Like a clamshell: Opening into flexion Closing in extension
As sphenoid rotates anteriorly, occiput rotates posteriorly
SPHENOBASILAR EXTENSION Internal rotation of paired bones Narrowing
Sacrum moves in synchrony with sphenoid
DURING SPHENOIDAL FLEXION
Sacrum moves:
Apex anteriorly Base posteriorly
Clamshell opens
FORAMEN MAGNUM Moves superiorly Elevates Tenses the dura
COUNTERNUTATION Craniosacral Flexion “Tail tucks in”
Sutures are not fused in normals! Function as joints
Sutural Joints Contain: Fascia, dural attachments, Sharpeys fibers, nerves, C fibers and blood vessels NOT FUSED!
RESPIRATION Inhalation enhances flexion Exhalation enhances extension
3 DIAPHRAGMS: Tentorium Cerebelli Respiratory Diaphragm Pelvic Diaphragm Depress and flatten during inhalation
CRANIOSACRAL ASSESSMENT
Rate
Amplitude Quality Symmetry of motion
ABNORMAL CSR: Low Rate Coma Decreased
vitality Intracranial lesions
ABNORMAL HIGH RATE Denervation Drug use Hyperkinesis Fever Autism Meningeal restrictions
CRANIOSACRAL THERAPY GOALS
Reduce membrane restrictions Increase mobility in articular restrictions Improve circulation Reduce neural entrapment Reduce abnormal sympathetic tone
PRECAUTION
Appropriate diagnostic workup must be done prior to treatment
CONTRAINDICATIONS
Acute intracranial bleeding Increased intracranial pressure Skull trauma or fracture Arnold-Chiari malformation ANY condition in which motion is contraindicated (Upledger)
PRECAUTIONS
Seizures Internal hardware Psychiatric or psychological disorders Any history of brain trauma or stroke
(Upledger)
INDICATIONS
Acute systemic or local infections Acute sprain and strain Chronic pain Visceral dysfunction Autonomic dysfunction Rheumatoid arthritis Emotional disorders
INDICATIONS
Scoliosis Visual disturbances Auditory problems Cerebral ischemic episodes Potential use in autism, ADD, seizures, headaches, TMJ, chronic conditions
CRANIOSACRAL ASSESSMENT TECHNIQUES
GENERAL & LOCAL LISTENING
CRANIOSACRAL RHYTHM
Upledger: “Accept what you sense as real.” Rhythmic pulse 6-12/min. widening and narrowing Palpate 5 grams of pressure or less, weight of a nickel
PROPRIOCEPTION EXERCISES
Enhance your sensitivity Rub hands briskly Separate slowly What do you feel?
CRANIOSACRAL TECHNIQUES Select clinical interventions: Transverse Plane Releases Cranial & Sacral Releases Craniosacral Balancing
TRANSVERSE PLANE RELEASES Respiratory diaphragm Pelvic floor Thoracic outlet
RESPIRATORY DIAPHRAGAM
PELVIC FLOOR RELEASE
THORACIC OUTLET RELEASE
SELECT CRANIAL RELEASES
Temporal Lift “Ear pull” Frontal Lift Mandibular decompression Craniosacral balancing
TEMPORAL RELEASE
FRONTAL LIFT
MANDIBULAR DECOMPRESSION
CRANIOSACRAL BALANCING
CRANIAL RELEASES CV4: Occiput Cochrane Database of Systematic Reviews study showed inprovement in headaches
CV-4 RELEASE
Integration of Techniques into a Treatment Plan
WWW.EDUCISE.COM Visit for outstanding seminars, DVDs, textbooks, and professional consultations!
References
Arroyo-Morales M, Olea N, Martínez MM, Hidalgo-Lozano A, Ruiz-Rodríguez C, DíazRodríguez L.Psychophysiological effects of massage-myofascial release after exercise: a randomized sham-control study. J Altern Complement Med. 2008 Dec;14(10):1223-9. Arroyo-Morales M, Olea N, Martinez M, Moreno-Lorenzo C, Díaz-Rodríguez L, HidalgoLozano A. Effects of myofascial release after high-intensity exercise: a randomized clinical trial. J Manipulative Physiol Ther. 2008 Mar;31(3):217-23. Barnes, John F., Myofascial Release Rehabilitation Services-Pain and Stress Control Center Paoli, 1990 Barral, Jean-Pierre, and Mercier, Pierre, Visceral Manipulation, Seattle: Eastland Press, 1988 Becker, Robert O., and Selden, Gary, The Body Electric, Electromagnetism and the Foundation of Life. New York, William Morrow and Co., 1985 Bertolucci LF. Muscle Repositioning: a new verifiable approach to neuro-myofascial release? J Bodyw Mov Ther. 2008 Jul;12(3):213-24. Boyd, Robert, Biocranial Therapy, Charlotte: The Biocranial Institute, November 3, 2001 Cantu, Robert I. and Grodin, Alan, Myofascial Manipulation Theory and Clinical Application, Gathersburg: 1992 Cameron, Carrie, Multidimensional Healing, Bloomington: Authorhouse, 2007
Duncan B, McDonough-Means S, Worden K, Schnyer R, Andrews J, Meaney FJ. Effectiveness of osteopathy in the cranial field and myofascial release versus acupuncture as complementary treatment for children with spastic cerebral palsy: a pilot study. J Am Osteopath Assoc. 2008 Oct;108(10):559-70. Eagan TS, Meltzer KR, Standley PR. Importance of strain direction in regulating human fibroblast proliferation and cytokine secretion: a useful in vitro model for soft tissue injury and manual medicine treatments. J Manipulative Physiol Ther. 2007 Oct;30(8):584-92 Gehin, Alain, Atlas of Manipulative Techniques for the Cranium and Face, Seattle, Eastland Press, 1985 Gilchrist, Roger, Craniosacral Therapy and the Energetic Body, Berkeley: North Atlantic Books, 2006 Oschman, James, Energy Medicine in Therapeutics and Human Performance, Philadelphia, Butterworth Heinemann, 2003 Pick, Marc, Anatomy and Physiology of the Cranium Videotape, Sedan, KS: SacroOccipital Research Society International, 1986 Upledger, John and Vredevoogd, Jon, Craniosacral Therapy, Seattle: Eastland Press, 1983 Upledger, John, Somatoemotional Release and Beyond, Palm Beach Gardens, UI Publishing, 1990 Waechter, Randall L. and Sergio, Lauren, Manipulation of the Electromagnetic Spectrum via Fields Projected from Human Hands, A Qi Energy Connection?, Subtle Energies $ Energy Medicine, Vol. 13, No. 3, 2002 Walton A. Efficacy of myofascial release techniques in the treatment of primary Raynaud's phenomenon. J Bodyw Mov Ther. 2008 Jul;12(3):274-80
www.educise.com Sponsored by: Cross Country Education C2009 Copyright Theresa A. Schmidt
In the efforts to comply with the appropriate boards/associations, I declare that I do have an affiliation with or financial interest in a commercial organization that could pose a conflict of interest with my presentation.
Craniosacral Therapy Introduction By Theresa A. Schmidt, DPT,MS,OCS,LMT,CEAS,CHY,DD
Cross Country Education Leading the Way in Professional Development. www.CrossCountryEducation.com
STRUCTURE & FUNCTION OF FASCIA: Craniosacral Dura
Compartmentalizes and surrounds everything! Maintains posture Supports vessels, organs, muscles, nerves, bones Defines muscle motion
Aids circulation Influences cell metabolism Aligns with mechanical stresses Deposits collagen to rebuild and to heal injuries
Relays and stores information
Electromagnetic transmission agent
COMPOSITION OF FASCIA
Proteins: collagen and elastin
Ground Substance: lubricates and separates
CRANIOSACRAL ANATOMY 8 cranial 14 facial 6 auditory
CRANIUM
Frontal Parietal-2 Occipital Temporal-2 Sphenoid Ethmoid
FACIAL BONES
Zygomatic-2 Maxillae-2 Mandible Nasal-2 Lacrimal-2 Palatine-2 Vomer Inferior conchae-2
ANATOMICAL LINKS Cranial base Core link- spinal dura Sacrococcygeal complex, S2, filum terminale, S4 Meninges, ventricles
CRANIAL BASE
Frontal Sphenoid Ethmoid Temporals Occipital
MENINGES Dura Arachnoid Pia Mater
DURA MATER Falx Cerebri Falx Cerebelli Tentorium Cerebelli
RECIPROCAL TENSION MEMBRANES
Forces across a membrane are transmitted equally through CSF to other membranes, hydraulic system
CEREBROSPINAL FLUID Nourishing fluid produced by choroid plexus circulates through 4 ventricles Fluid mechanics affect membrane tension
VENTRICLES 2 Lateral Ventricles Third Ventricle Fourth Ventricle CSF travels through ducts in the system
EXAMINATION History Structural Assessment Motion Analysis
PALPATION
Craniosacral Rhythm Cranial bones are anchors for dural membranes
THE WHOLE IS GREATER THAN THE SUM OF ITS PARTS!
PRINCIPLES OF CRANIOSACRAL MOTION Craniosacral Rhythm (CSR) Rhythmic inherent physiological motion of 6-12 cycles/ minute
CRANIAL MOTION Flexion / external rotation (widening) Extension / internal rotation (narrowing)
FLEXION: EXTERNAL ROTATION: Transverse diameter increases A-P diameter decreases
SPHENOBASILAR FLEXION: External rotation of paired bones: widening
SPHENOID AND OCCIPUT ROTATE IN OPPOSITE DIRECTIONS: Like a clamshell: Opening into flexion Closing in extension
As sphenoid rotates anteriorly, occiput rotates posteriorly
SPHENOBASILAR EXTENSION Internal rotation of paired bones Narrowing
Sacrum moves in synchrony with sphenoid
DURING SPHENOIDAL FLEXION
Sacrum moves:
Apex anteriorly Base posteriorly
Clamshell opens
FORAMEN MAGNUM Moves superiorly Elevates Tenses the dura
COUNTERNUTATION Craniosacral Flexion “Tail tucks in”
Sutures are not fused in normals! Function as joints
Sutural Joints Contain: Fascia, dural attachments, Sharpeys fibers, nerves, C fibers and blood vessels NOT FUSED!
RESPIRATION Inhalation enhances flexion Exhalation enhances extension
3 DIAPHRAGMS: Tentorium Cerebelli Respiratory Diaphragm Pelvic Diaphragm Depress and flatten during inhalation
CRANIOSACRAL ASSESSMENT
Rate
Amplitude Quality Symmetry of motion
ABNORMAL CSR: Low Rate Coma Decreased
vitality Intracranial lesions
ABNORMAL HIGH RATE Denervation Drug use Hyperkinesis Fever Autism Meningeal restrictions
CRANIOSACRAL THERAPY GOALS
Reduce membrane restrictions Increase mobility in articular restrictions Improve circulation Reduce neural entrapment Reduce abnormal sympathetic tone
PRECAUTION
Appropriate diagnostic workup must be done prior to treatment
CONTRAINDICATIONS
Acute intracranial bleeding Increased intracranial pressure Skull trauma or fracture Arnold-Chiari malformation ANY condition in which motion is contraindicated (Upledger)
PRECAUTIONS
Seizures Internal hardware Psychiatric or psychological disorders Any history of brain trauma or stroke
(Upledger)
INDICATIONS
Acute systemic or local infections Acute sprain and strain Chronic pain Visceral dysfunction Autonomic dysfunction Rheumatoid arthritis Emotional disorders
INDICATIONS
Scoliosis Visual disturbances Auditory problems Cerebral ischemic episodes Potential use in autism, ADD, seizures, headaches, TMJ, chronic conditions
CRANIOSACRAL ASSESSMENT TECHNIQUES
GENERAL & LOCAL LISTENING
CRANIOSACRAL RHYTHM
Upledger: “Accept what you sense as real.” Rhythmic pulse 6-12/min. widening and narrowing Palpate 5 grams of pressure or less, weight of a nickel
PROPRIOCEPTION EXERCISES
Enhance your sensitivity Rub hands briskly Separate slowly What do you feel?
CRANIOSACRAL TECHNIQUES Select clinical interventions: Transverse Plane Releases Cranial & Sacral Releases Craniosacral Balancing
TRANSVERSE PLANE RELEASES Respiratory diaphragm Pelvic floor Thoracic outlet
RESPIRATORY DIAPHRAGAM
PELVIC FLOOR RELEASE
THORACIC OUTLET RELEASE
SELECT CRANIAL RELEASES
Temporal Lift “Ear pull” Frontal Lift Mandibular decompression Craniosacral balancing
TEMPORAL RELEASE
FRONTAL LIFT
MANDIBULAR DECOMPRESSION
CRANIOSACRAL BALANCING
CRANIAL RELEASES CV4: Occiput Cochrane Database of Systematic Reviews study showed inprovement in headaches
CV-4 RELEASE
Integration of Techniques into a Treatment Plan
WWW.EDUCISE.COM Visit for outstanding seminars, DVDs, textbooks, and professional consultations!
References
Arroyo-Morales M, Olea N, Martínez MM, Hidalgo-Lozano A, Ruiz-Rodríguez C, DíazRodríguez L.Psychophysiological effects of massage-myofascial release after exercise: a randomized sham-control study. J Altern Complement Med. 2008 Dec;14(10):1223-9. Arroyo-Morales M, Olea N, Martinez M, Moreno-Lorenzo C, Díaz-Rodríguez L, HidalgoLozano A. Effects of myofascial release after high-intensity exercise: a randomized clinical trial. J Manipulative Physiol Ther. 2008 Mar;31(3):217-23. Barnes, John F., Myofascial Release Rehabilitation Services-Pain and Stress Control Center Paoli, 1990 Barral, Jean-Pierre, and Mercier, Pierre, Visceral Manipulation, Seattle: Eastland Press, 1988 Becker, Robert O., and Selden, Gary, The Body Electric, Electromagnetism and the Foundation of Life. New York, William Morrow and Co., 1985 Bertolucci LF. Muscle Repositioning: a new verifiable approach to neuro-myofascial release? J Bodyw Mov Ther. 2008 Jul;12(3):213-24. Boyd, Robert, Biocranial Therapy, Charlotte: The Biocranial Institute, November 3, 2001 Cantu, Robert I. and Grodin, Alan, Myofascial Manipulation Theory and Clinical Application, Gathersburg: 1992 Cameron, Carrie, Multidimensional Healing, Bloomington: Authorhouse, 2007
Duncan B, McDonough-Means S, Worden K, Schnyer R, Andrews J, Meaney FJ. Effectiveness of osteopathy in the cranial field and myofascial release versus acupuncture as complementary treatment for children with spastic cerebral palsy: a pilot study. J Am Osteopath Assoc. 2008 Oct;108(10):559-70. Eagan TS, Meltzer KR, Standley PR. Importance of strain direction in regulating human fibroblast proliferation and cytokine secretion: a useful in vitro model for soft tissue injury and manual medicine treatments. J Manipulative Physiol Ther. 2007 Oct;30(8):584-92 Gehin, Alain, Atlas of Manipulative Techniques for the Cranium and Face, Seattle, Eastland Press, 1985 Gilchrist, Roger, Craniosacral Therapy and the Energetic Body, Berkeley: North Atlantic Books, 2006 Oschman, James, Energy Medicine in Therapeutics and Human Performance, Philadelphia, Butterworth Heinemann, 2003 Pick, Marc, Anatomy and Physiology of the Cranium Videotape, Sedan, KS: SacroOccipital Research Society International, 1986 Upledger, John and Vredevoogd, Jon, Craniosacral Therapy, Seattle: Eastland Press, 1983 Upledger, John, Somatoemotional Release and Beyond, Palm Beach Gardens, UI Publishing, 1990 Waechter, Randall L. and Sergio, Lauren, Manipulation of the Electromagnetic Spectrum via Fields Projected from Human Hands, A Qi Energy Connection?, Subtle Energies $ Energy Medicine, Vol. 13, No. 3, 2002 Walton A. Efficacy of myofascial release techniques in the treatment of primary Raynaud's phenomenon. J Bodyw Mov Ther. 2008 Jul;12(3):274-80
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