Osteopathy in the Cranial Field
Craniosacral technique (more correctly referred to as Osteopathy in the Cranial Field) was developed by William G. Sutherland. As a medical student in 1899, he was drawn to a disarticulated skull and the beveled articular surfaces of the sphenoid and temporal bone.
It occurred to him that the beveled edges were "like the gills of a fish, indicating articular mobility for a respiratory mechanism." He spent many years trying to dismiss this idea and then set out to disprove it. Years of study, thought, and experimentation eventually led to what we now know as osteopathy in the cranial field.
The term primary respiratory mechanism (PRM) is the basis of this system. It is defined as a model proposed by William G. Sutherland to describe the interdependent functions among the five body components as follows:
- Articular mobility of the cranial bones
- Mobility of the intracranial and intraspinal membranes, also known as reciprocal tension membrane.
- Fluctuation of the CSF
- Inherent mobility of the central nervous system
- Involuntary mobility of the sacrum between the ilium
This motion can be felt throughout the body, but more so at the skull and sacrum. The key articulation for cranial mechanics is the sphenobasilar symphysis, formed by the occiput and sphenoid. The sacrum is then "connected" via the dura that attaches at the foramen magnum (occiput) and at the second sacral segment.
In a state of normal functioning, the midline bones move in flexion and extension while the paired bones move in external and internal rotation, with flexion and external rotation being paired.
Clinical Pearl
I think of craniosacral as a fascinating combination of anatomy and energy. The concept is intriguing and very much appeals to me. There is still a great deal of controversy surrounding the basic principles of this technique, but it has become increasingly popular among manual medicine practitioners. There is also controversy about non-physician practitioners performing this technique, which is exemplified by the distinction between craniosacral therapy (non-physician) and osteopathy in the cranial field (physician).
This technique is nontraumatic and can be used for all ages. It is particularly good for use with the very young and the very old because it is so gentle. However, it is not completely innocuous. The most common side effect is fatigue. Headaches, dizziness, nausea, and vomiting may also occur. Emotional release occurs most frequently with this treatment, and one needs to be prepared to deal with that situation. It should also be used cautiously with head trauma.