It is not uncommon to find faulty alignment and biomechanics within the cranium in conditions such as head and neck pain, jaw and orofacial pain and even upper extremity pain and impairment. According to The Integrated Systems Model (Lee & Lee), the cranium is considered to be the ‘driver’ (the villain) whenever correcting its alignment and biomechanics improves the symptom (i.e. the victim – headache, TMJ pain etc) and the meaningful task (i.e. movement of the head, neck, jaw or upper limb) (see a complete lecture here). The assumption here is that the bones of the cranium move and that this movement can be felt by the human hand and that the alignment and movement pattern of cranium can be changed. Clinical experience trumps the scientific research in this area since there are no systems yet available that can accurately measure what the human hand can feel.
Touch is one of the primary senses used by physiotherapists in daily practice. We use touch to feel the presence of movement or lack thereof in the joints of the body as well as many of its other systems. Touch has been described as the human brain’s “exquisite capacity” to detect, localize and classify sensations that we receive from our hands (Toerebjork et al.). This exquisite capacity can be used to feel more than just joint movement or muscle tissue; it can be used to feel things not yet measurable by science, things such as the rhythm of motion of the bones of the cranium.
Determining exactly what is causing the cranium to twist or move incorrectly requires that the therapist ‘listen to’ a pattern of motion that craniosacral therapists have recognized for over a century. Since scientists have not been able to measure this clinically proposed cranial rhythm many feel it does not exist. However Brian Weiss notes that “truths really do not need research support. They exist above and beyond scientific confirmation, because science is constrained by the limitations of its measuring devices. It cannot prove what it cannot yet measure. When the appropriate tools are developed, the truths will be there, waiting to be discovered’.
According to clinical craniosacral theory, the cranial rhythm is produced by the pulsation and flow of the cerebral spinal fluid which is produced by the ventricles of the brain. This rhythm is unique much like the rhythm our heart produces when it pumps blood to our organs. When external muscles attaching to the cranium become tight or tense, or when tension increases in the internal membranes of the cranium (the cerebral falx, cerebellar tentorium and spinal dura) this inherent normal rhythm is disturbed and this change in motion is easily detected by the experienced hand.
Both craniosacral therapy and treating cranial drivers according to The Integrated Systems Model require gentle touch that listens and is responsive to minute changes in tension, tone and thus the rhythm/motion of the cranium. While the two approaches may use different language to explain the underlying mechanisms, the end result is that through touch the nervous system can be changed and many acute and chronic headaches, neck, jaw and upper extremity pain alleviated.craniosacral, neck, physiotherapy, surrey