Craniosacral Therapy and Osteopathy

Therapies > Craniosacral Therapy and Osteopathy

The theory and practice of Craniosacral Therapy are rooted in the rich fabric of Manual Osteopathy, and in particular, Cranial Osteopathy as discovered and developed by William Sutherland D.O. The following summary of the history and concepts of Osteopathy will provide some insight into the connection between the two modalities.


Traditional Osteopathy is a natural healing system that has existed for over 100 years, and was the brainchild of A. T. Still,  a 19th century medical doctor disillusioned with the trend of allopathic medicine toward the use of prescription drugs while ignoring the power of touch to diagnose and treat.  Over the years he developed a manual therapy which married a profound knowledge of anatomy and the laws of physics with sensitive touch and the art of Listening.

A.T. Still founded his new therapeutic system on four principals:

  1. Structure and function are interdependent: if a structural unit (bone, muscle, nerve, organ, etc.) has shifted from its ideal position and loses mobility, it cannot function  properly.
  2. Proper circulation to and from a structure is essential to maintaining its health.
  3. The body is a functional unit, which means that everything in the body is interrelated and affects everything else.
  4. We are endowed with a system of auto regulation: the body is constantly trying to correct imbalances and dysfunctions at all levels and has the inner resources necessary to accomplish this.  It just needs a little help sometimes.

One of A.T. Still’s students, William Sutherland, made a remarkable contribution to Osteopathy in the first half of the 20th century. For many years the practice of Osteopathy involved the direct correction of joint and muscle strain using firm manual pressure or a high-velocity adjustment.  Sutherland showed that these corrections could be made in a much more gentle way using the body’s internal forces. It started with his discovery that the cranial sutures (the joints between the cranial bones) were designed to express small degrees of motion, which was contrary to popular scientific belief that the skull fuses solid.  He undertook many years of experimentation which led him to conclude that not only did the cranial bones move but they move precisely to accommodate a rhythmic expansion/ contraction of the brain which efficiently pumps cerebrospinal fluid (CSF) throughout the central nervous system. Sutherland eventually concluded that this rhythmic motion is essentially produced by the body’s inherent Life Force which permeates the CSF with the “Breath of Life”. He realized that at a deep physiological level all healthy living cells “breathe” with the rhythmic motion of life (expansion/contraction), a phenomenon that can be felt with sensitive hands anywhere on the body.  Sutherland called this motion the Primary Respiratory Mechanism or PRM. The palpation of this motion can be used as an assessment to determine where there are problematic imbalances in the body.  Even more importantly, when stimulated by the skilled hands of the therapist, the inherent power or Potency of the PRM can trigger a healing response in the tissues that lead to the correction of these imbalances. The Primary Respiratory Mechanism was the heart of Sutherland’s Cranial Concept and had five main components: 1) the fluctuation of cerebrospinal fluid, 2) the motility (inherent motion generated by the PRM) of the brain and spinal cord, 3) the function of the Reciprocal Tension Membrane (more commonly known as the dural membranes), 4) the mobility of the cranial bones and 5) the synchronous motion of the sacrum with the cranial mechanism.

Sutherland called his contribution Cranial Osteopathy and although he enjoyed great clinical success over many years in treating difficult problems, his ideas were not accepted by his colleagues until the 1940’s, several years before his death.  Although his followers continued to practice manual Osteopathy using the biodynamic forces of the patient’s body,  the vast majority of Osteopaths in the U.S. preferred a more mechanical and medical approach. Meanwhile Osteopathy had spread to the UK, France, and several other countries and in each location it developed in slightly different ways. For example, in France a numbers of Osteopaths, particularly  J.P. Barral, developed a method of treating the body’s organs which Barral coined Visceral Manipulation.

Presently, the manual practice of Osteopathy, as distinguished from the medical practice of most D.O.’s in the U.S., is a synthesis of several modalities, including:

-Visceral Manipulation: treatment of body organs

-Cranial Osteopathy: treatment of cranial bones, dural membranes and ventricles

-Strain/Counterstain and Positional release: treatment of tender points

-Osteo-Articular Technique, which utilizes a high velocity/ low amplitude thrust to adjust the joints. (chiropractic adjustments are usually described as high amplitude/ high velocity)

-Muscle Energy: fatigues muscles which are maintaining joint dysfunction

-Myofascial Release: normalizes strains in the muscle/fascia matrix

How Osteopathy Works

In Osteopathy the healing process only begins when the therapist is able to interact with the patient’s Inner Healer, the system of auto regulation that A.T. Still referred to. This is done by engaging in a unique dialogue through touch with the patient’s tissues. The entry point into the body is the rhythmic motion that Sutherland discovered and called the Primary Respiratory Mechanism (PRM) to emphasize its importance and distinction from other respiratory rhythms in the body.  Craniosacral therapists usually refer to it as the Craniosacral Rhythm.  When engaged during the therapeutic process this rhythm transforms into a corrective force.  When the body absorbs trauma from falls, accidents, repetitive strains or psycho-emotional stress the PRM becomes affected. This can be perceived by the therapist as a weakened and unbalanced rhythm. This compromised state will manifest as myofascial restrictions and muscular pain, reduced joint mobility, impaired circulation of blood and other fluids, and neurological dysfunction. The PRM is able to reflect any specific strain or trauma absorbed by the individual and also has the potential to resolve the imbalance with the proper support and guidance of the therapist.  Through engaged listening, the therapist is able to witness how the Potency of the biodynamic forces is able to reorganize the body matrix toward normality.  The successful treatment of a particular area culminates with a very palpable release and softening of the tissue strain with a subsequent realignment and relaxation of the body. The patient then enters a state of calm and stillness called the Stillpoint, during which time healing forces circulate in the body to integrate the therapeutic changes that have occurred, promoting greater vitality and Health. Profound shifts can and usually do occur at the mental/emotional/spiritual levels as part of the transformational process.

The goals of treatment can be summarized as: improve vitality, increase mobility, optimize posture and restore balance. This applies to any specific structure being treated as well as to the person as a whole. The therapeutic aim is to treat the root causes of what ails the patient and this usually leads to good results for a wide variety of conditions. Patients are often delighted to find improvements in unexpected areas of their health.

During the early 1970’s, Osteopathic Physician John Upledger observed the movement of the spinal dura during a surgical procedure, an event which led to his studying Cranial Osteopathy which up until that time had only been practiced by a select group of Osteopaths who were part of the Cranial Academy established by Dr. Sutherland. Upledger felt it was important to expand accessibility to this powerful healing tool and did so by re-packaging it as Craniosacral Therapy and offering the training to other health professionals.

Osteopathy and Craniosacral Therapy are safe and gentle enough to be used on people of all ages, including newborns, and are an effective treatment for a wide variety of conditions: headaches of all kinds, neck and back ache, knee, hip, ankle and shoulder disorders, dizziness, neuralgias, digestive and eliminative problems,TMJ dysfunction and injuries caused by whiplash and falls. Using a precise quality of touch and intention, the therapist is able to affect any tissue of the body, whether it is a cranial bone, a nerve or vascular structure, a spinal joint or an organ. A single therapy session usually lasts one hour and begins with an assessment which includes postural and mobility testing, and evaluation of the PRM in several areas of the body.   The treatment part addresses several areas within the body depending on the patient’s complaints as well as the skill of the therapist to determine the root causes of those complaints. Significant improvement is experienced by a majority (75-80 %) of people after 3-4 sessions. Osteopathy and Craniosacral Therapy do not use treatment formulas – two persons suffering from headaches may receive vastly different treatments – and is characterized by the intelligent application of mechanical principals blended with a sound knowledge of anatomy and physiology.  There is an old saying in Osteopathy that we treat the person, not the disease.  By focusing on the Health continually trying to express itself within the person, the therapist is best able to find and remove the impediments that prevent the full expression of that Health. I like to think that this work is a process of helping the whole person – body, mind and spirit – find it’s way home.