Volume 2, Issue 7
READE’S REVIEW
Nov/Dec. 2013
JAMES D. READE, D.C., PLLC
CRANIOSACRAL , SOT AND MORE ...
Special points of interest:
• .Introduction to Craniosacral
and SOT
• Quick History
• Anatomy of Cranial /Spinal
Dura
• Cranial Motion
• How Dura/Meningeal Imbalances Occur
• Treatments
Inside this issue:
Craniosacral, SOT and More...
1
A Quick History of SOT and
Craniosacral
1
Anatomy of Cranial and Spinal
Dura
2
Cranial Bone Motion and The
Dura
3
How Does One Get Dural/
Meningeal Imbalances ?
3
Treatments for Dural Imbalances
4
.
What exactly is Craniosacral
Therapy or Sacro-Occipital
Technique (SOT)? These two
systems of healing are gentle
methods that balance the bodies structural and neurological
systems. This is done by correcting abnormal spinal, cranial membrane motion and
restoring normal motion of the
fluid that baths the brain and
spinal cord referred to as cerebrospinal fluid (CSF). The
corrections are directed to the
cranial bone structures, temporomandibular joint, upper
cervical (neck) vertebra, pelvis, the triangular bone located
in the lower back called the
sacrum and sometimes the
coccyx or tailbone. These areas are crucial, because the
spinal membrane also known
as the spinal meninges at-
taches to these structures. By
the way, this is the same membrane that can get infected and
is known as spinal meningitis.
It is also the same membrane
that is pierced when getting an
epidural injection.
When the spinal meninges
arrives at the level of the skull
it attaches along the inside of
the skull/cranial bones. It then
enters the skull and covers the
brain and spreads out in a tentlike structure dividing the
brain into different sections. It
is then referred to as the dura
or dura mater. You may recall
reading about people who
have had trauma to the head
and developed a subdural hematoma. This is simply a
blood clot located below this
membrane.
We will later discuss more of
the anatomy of this membrane
and its importance. Understanding the anatomy can give
you a better appreciation of
the potential influence of this
healing approach.
We will also discuss some of
the preliminary research done
to date. However, more research needs to done to understand the clinical effectiveness
of this gentle treatment.
A QUICK HISTORY OF SOT AND CRANIOSACRAL
In the early 1900’s, while a
student at the American
School of Osteopathy in
Kirksville, Missouri, William
G. Sutherland was fascinated
with the design and jig-saw
like fittings of the human
skull, called sutures. Even
though he was taught that the
human skull and it sutures
fuse and calcify, he thought
the design and patterns of
skull/cranial bone connections
were really designed for subtle
motion. Convinced that this
was the case he experimented
on himself and others and
found with gentle palpation
that rhythmic motion could be
felt.
Major Bertrand DeJarnette,
D.O., D.C., in 1918 went to
Detroit, Michigan to work in
the auto industry. He was severely crippled by an explosion. He found over the several years that both osteopathic and chiropractic treatments provided tremendous
relief. Having an engineering
background and having graduated with an osteopathic and
chiropractic degree went on to
develop Sacro-Occipital Technique.
READE’S REVIEW
Page 2
ANATOMY OF THE CRANIAL AND SPINAL DURA
The dura mater is a tough fibrous layer of tissue that surrounds the brain and has direct
attachments along the inner
lining of the skull/cranial
bones. The middle layer or
arachnoid contains blood vessels, loose connective tissue,
cerebrospinal fluid (CSF) and
nerve tissue. Some of the
nerves come from nerves derived from the upper cervical
region, a nerve from the brain
stem called the trigeminal
nerve and nerves that come
from the neck and upper back
area that wrap around the
blood vessels entering the
skull. This is why chiropractic
treatments can have very
beneficial effects with respect
to headaches. The last layer is
the pia mater and directly surrounds the brain tissue.
The dura can be thought of as
tough saran wrap surrounding
the brain and along the entire
spine. The dura also divides
the brain into different compartments and is tent-like in
structure. The falx cerebri and
tentorium membranes are the
main part of this dural system
and attach to one another.
There are parts that surround
the main nerve to the eyes
called the optic nerve, the pituitary gland and other cranial
nerves that go to the eyes,
ears, vestibular apparatus to
maintain balance/equilibrium
and other cranial nerves that
exit the base of the skull.
The dura also forms spaces in
the brain called ventricles.
One of the main ventricles
contains the choroid plexus
where the CSF is produced.
The CSF does travel along the
entire spinal cord both in the
middle of the spinal cord
called the central canal and
along the periphery. The dura
once it leaves the base of the
skull is then referred to as the
meninges. The meninges acts
as saran wrap around the spinal cord and CSF flows between the meninges and the
spinal cord. Furthermore, the
meninges forms a “sleeve”
around the spinal nerves as
they leave the bony spinal
column. The dura then blends
into the surrounding coating of
the nerve called the epi
neurium. The CSF does flow
into these spinal nerves as
well. It is believed that the
CSF travels the length of most
nerves.
The meninges firmly attaches
to the large opening at the
base of the skull that the spinal
cord passes through and it is
called the foramen magnum. It
also firmly attaches to the
second and third vertebra in
the neck. There are looser
attachments to the vertebra
via the dentate ligaments.
There is a firm attachment
lower in the spine at the level
of the second sacral segment
which is a triangular shaped
bone in the lower back. Finally, it firmly attaches to the
tailbone /coccyx at the filum
terminalis.
The entire dura and meninges
is attached and tension along
any part of this membrane
whether it is in the skull, upper vertebra, sacrum, pelvis or
tailbone can distort this membrane. Think of a nylon stocking, if you pull on a section of
the stocking it distorts along
the length of the stocking. The
meninges and dura act in the
same manner. In the illustration below think of the dura
like a closed pulley system.
This has the potential for affecting brain, cranial and spinal nerve function. It also can
influence blood flow and CSF
flow throughout the brain and
spinal cord.
To help you better understand
we have included a number of
illustrations on this page.
Volume 2, Issue 7
Page 3
CRANIAL BONE MOTION AND THE DURA
The skull consists of 22 bones
which includes the jaw. The
bones are connected together
like a jigsaw puzzle at what
are called cranial sutures. We
were taught in school that
these bones do not move, fuse
and calcify as you age. We
were also taught that the skull
simply was for protection of
the brain. However, this simplistic model of the skull is
being questioned and that
some research suggests that a
lot more is involved with the
brain and cranium.
A basic tenet of SOT and Craniosacral Therapy is that the
bones of the skull do indeed
move slightly, influencing
dural / meningeal tension,
CSF flow, blood flow and
neurological function.
In 1971, Viola Frymann D.O.,
using a transducer found a
rhythmic motion of cranium of
10-14 cycles/minute. Weiss
M. Heifitz M.D. , in the Jour-
nal of Neurosugery 1981,
found skull expansion with
increased intracranial pressure. In the Journal of Human
Physiology 2001, researcher
ME Moskalenko, using NMR
tomograms and transcranial
ultrasound Doppler Echography, found the cranial volume
rhythmically changed 6-14
cycles/min by 12-15 ml. He
found the cranial sutures to
change 380 micrometers to
1millimeter. .He found that
these cycles appear to be
linked to blood supply, oxygen consumption of the brain
tissue and CSF circulation.
Researchers, Michael Retzlaff
and Mitchell F. Roppel in
1976, using light scanning
microscopy to exam primate
sutures found connective tissue, blood vessels, nerve fibers in the sutures and described a pattern of wavy collagen fibers arranged to monitor elongation of these fibers
in the sutures. In 1978, John
Upledger, D.O. found nerve
fibers and nerve receptors
normally found in movable
joint in human suture samples.
In 1987, Upledger and
Metzlaff found not only connective tissue, a vascular network, nerve network and receptors in a primate suture, but
also traced a nerve that went
into the brain and terminated
in the brain where CSF is produced. This discovery suggests that the cranial sutures
have a direct effect on CSF
production. So it theorized
that as the sutures expand they
help slow CSF production and
if the sutures get compressed
they send signals to increase
CSF production. This might
be how the body regulates
CSF pressure and fluid dynamics in the dura.
There is more research, but
more to be done. Certainly this
explains some aspects of craniosacral and SOT treatments.
HOW DOES ONE GET DURAL/MENINGEAL IMBALANCES ?
Lets go back to anatomy to
help explain why we develop
dural tension and imbalance.
The dura/meninges attaches to
a few key areas of the body.
The cranial bones, base of the
skull, upper vertebra, sacrum
and tailbone. These areas can
be influenced by the muscles/
tendons and fascia that attach
to these structures. There are
important jaw muscles that
attach to the bones of the skull
and have direct influence on
cranial motion. Therefore,
potentially having your jaw
open for long periods of time
during dental procedures
could cause problems. Poor
fitting dentures, crowns,
braces and other dental appliances can cause indirect dural
tension by abnormal muscular
function.
The upper neck when misaligned can lead to abnormal
dural tension. Remember the
2nd and 3rd cervical vertebra
have direct dural attachments.
Furthermore, there is a muscle
in the upper cervical area
called the rectus capitis minor
that attaches to the dura. This
area can often lead to tension
type of headaches at the back
of the skull. Muscular imbalances can occur from trauma
like whiplash, poor postural
habits like studying/reading
with hands propping up the
neck or chin, poor supportive
pillow, sleeping on your stomach , poor supportive chair
while at the computer.
Chronic mental stress may
cause you to contract your
neck, upper back, facial and
jaw muscles.
Injuries, falls, poor muscular
balance to your lower back,
hips and tailbone may also
cause dural torue/tension.
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Phone: 480-732-0911
Fax: 480-812-0533
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.Our mission is to help inform and educate the public
about alternative treatments that are less invasive and employ more natural therapeutics. We in no way are suggesting that regular medical treatments should not be sought
and with some conditions we will suggest a referral to the
appropriate specialist.
We wish to provide hope to those people suffering and
especially to those with chronic conditions. It is our purpose to provide you with knowledge that is helpful and
can provide better health.
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TREATMENTS FOR DURAL IMBALANCES
The treatment for dural/
meningeal imbalance is very
gentle. It often involves contacting different bones of the
skull and applying gentle pressure as you breath slowly. The
spots selected help remove the
sutural “jams” and releases the
dural tension. A gentle method
utilizing specialized blocks
helps to remove dural tension
in the lower spinal regions. It
is important to remove the
tension both at the upper and
lower ends of the dura to get a
proper restoration of function.
There is another approach we
use that is called PRY technique. Which stands for pitch,
roll and yaw. This is another
method to check to see if the
upper and lower tension of the
dura is balanced. We usually
have the patient put there head
and pelvis into different positions relative to one another
and check for dural tension.
Again, the corrections are very
gentle.
Zinc deficiencies seem to be
associated with reoccurring
cranial imbalances. It is suspected that zinc is involved in
CSF production.
Realigning the jaw and balancing the surrounding muscles is vitally important. At
times working with a dentist
to balance the jaw and removing improper occlusion is necessary to stabilize the dural
motion.
Some very recent research
performed by Jeffrey Iliff ,
PhD., at the University of
Rochester Medical Center, has
found a very fast and efficient
CSF fluid pathway in the
brain. The CSF has been
shown to enter the brain rapidly and remove amyloid beta
deposits (which leads to Alzheimers) found between the
brain cells into the surrounding veins. So, this gives further reason to ensure there is
proper CSF flow to remove
toxins in the brain and prevent
possible neural degeneration.
There is an interesting YouTube video on this research.
Another factor to consider are
the feet. There are important
reflexes in the joints of the
foot and ankle that influences
muscular activity in the lower
back, shoulders, neck and jaw.
If the feet are not corrected the
dural tension will return due to
poor muscular balance.