resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
TCM & the Caregiving Population: Treatment Considerations & Our Vital Role
Informal caregiving is increasingly a reality for many Americans who find themselves providing unpaid care for a loved one or a family member with a long-term, terminal, or chronic illness.
ICA Goes on the Vaccine Offensive
Have you watched the vaccination documentary, "Vaxxed: From Cover-Up to Catastrophe," by Andrew Wakefield MD, director, and Del Bigtree, producer? This is the documentary Robert DeNiro was pressured to remove from his Tribeca Film Festival.
Treating the Lower Pelvis (Pt. 2): Midline Structures and Fascia
My previous article [October 2016 issue] outlined evaluation and treatment of pelvic issues involving the sacrotuberous ligament and the pubic symphysis. Now let's discuss two case studies that illustrate how to address additional problematic areas of the pelvis.
Gather & Grow
I recently attended a faculty seminar held by one of the acupuncture schools. There was a facilitator who led us through some very interesting experiences. The attendees were a diverse group with varying opinions.
The Large Intestine Official
The large intestine (AKA colon) is the great eliminator, or as J.R. Worsley called it, "The Drainer of the Dregs." Dregs are defined as the remnants of liquid with its sediment left in a container, or the basest, least valuable portion of anything.
Paperwork Done Wrong, Done Right
I was visiting a doctor's office recently and a member of his staff brought a stack of forms to his private office and laid them on the doctor's desk. She informed him he needed to complete the forms for patients and a few third parties.
Correcting Rib Dysfunction: Improve Patients' Pain, Posture and Breathing
As chiropractors, we tend to focus on the spine, and rightly so. Many problems our patients face can be corrected by manipulating the correct spinal level.
VF Works / DMX Works Epilogue: Almost Two Decades Later, the Lawsuits Continue
An article in the March 8, 1999 edition of Dynamic Chiropractic examined whether then-VF Works / Nu-Best Franchising was selling its franchises illegally to doctors of chiropractic.
AOM Residency at NUNM
Imagine you're a recent acupuncture graduate, worried about making enough income as you forge your new career and seek more in-depth training in a particular treatment style.
Advancing the "Whole Organ" Spine Model
Historically, the human spine has been organized by body region utilizing specific anatomical landmarks and transition zones.
Getting Unstuck: Healing From Trauma With TCM, Qigong & Movement
We all come into this world vulnerable, with seeds to grow into our strength. Some of us — through a combination of good fortune (i.e., family and culture we are born into, constitutional inheritance, or ability to learn) grow with minimal interruption from traumatic injuries and experiences.
Latest Cassidy Study on Stroke Risk Published
The latest study to investigate whether a unique association between chiropractic manipulation and risk of cervical artery dissection / stroke exists has yielded similar encouraging findings, with the authors noting "no excess risk of carotid artery stroke after chiropractic care" and no significant risk difference between patients receiving care from a DC or a primary care medical provider.
Spiritual Initiation: Opening Your Higher Healing Abilities
People drawn to the field of acupuncture and Oriental Medicine tend to be those who march to the beat of a different drummer.
The Acupuncture Channel System (Part 2)
The primary channels (main channels) are introduced in chapter 10 of the Ling Shu, these channels are referenced in many chapters throughout the Su Wen and the Ling Shu. The primary channels have become the main channel system used in TCM.
House Calls With Dad
My father was a chiropractor and he did house calls. On Wednesday nights, while my mother attended the weekly women's meeting at the Odd Fellows and Rebekahs hall in our small town, dad loaded up the portable adjusting table, fired up the Pontiac and drove off to treat a few patients in their homes. I went with him.
Reader Beware: Consider the Source
The aftermath of last year's presidential elections brought a running conversation on the role played by "fake news" that was largely presented via social media.
Chiropractic in Texas Is Under Attack
The profession of chiropractic faces an unprecedented challenge in Texas, an attack that is more aggressive, sustained and dangerous than anything previously seen. The medical lobby has launched a coordinated, multi-front assault.
Waist Circumference: A Conversation Starter
New estimates suggest more than two-thirds of Americans are either overweight or obese. The medical significance of this statistic is astounding.
News in Brief
The American Association of Acupuncture and Oriental Medicine (AAAOM) board members recently met with the Korean Customs Service, which is similar to the FDA, to discuss herbal safety and importation issues.
A Brief History of Acupuncture and Oriental Medicine Doctoral Programs
A doctorate in acupuncture and Oriental medicine has been a goal of the profession since its beginnings in the late 1970s. At that time, however, the maturity of the educational institutions and the regulatory environment made it a goal with only a distant completion date.
4 Things Every DC Should Know About Levels of Care & Prevention
As health practitioners, we help people with their health problems and assist them with health promotion and disease prevention.
Near-Infrared Therapy for Diabetic Neuropathy
The pain experienced by people with diabetes is a symptom of diabetic neuropathy. The impact on quality of life is significant. Pain makes walking difficult, sleep troublesome, and eventually contributes to a decrease in social interaction.
May, 2008, Vol. 08, Issue 05
The Controversy of Cranial Bone Movement
By Lisa Johnson Zee; guest author for John Upledger, DO, OMM
Editor's note: Dr. Upledger has asked guest author Lisa Johnson Zee to share her thoughts on cranial bone movement in this month's column.
In anatomy and physiology, I learned that cranial bones fuse in early adulthood or childhood.1 Gray's Anatomy supports the theory that the sutures grow together, creating a solid mass of bone called the calvarium. The fused skull functions as a helmet in which volume or pressure changes in blood, cerebrospinal fluid (CSF) or brain tissue cause corresponding pressure changes in other systems to prevent an increase of intracranial pressure.
However, there is a sizable body of literature that documents a small, rhythmic movement of the cranial bones. The bulk of these studies come from the cranial osteopathy medical field. The following is a synopsis of some of these studies.
Tettambel used force transducers to measure movement between the frontal bone and bilateral mastoid processes of the temporal bone in 30 subjects.2 She recorded three rhythms including the cardiac and respiratory rhythms. She hypothesized that the third pulse, which averaged eight cycles per minute, was the craniosacral rhythm.
Frymann studied the rhythmic changes in the circumference of the head using a U-shaped frame with a differential transducer.3 Changes in the diameter of the skull were measured by the displacement of metal rods. This study is unique because it measured movement in live human subjects. Frymann found a pulsating rhythm between six and eight cycles per minute separate from cardiac and respiratory rates. The amount of displacement was measured between 10 and 30 microns.
Another study by Adams, et al., looked at parietal bone mobility in cats.4 These researchers fastened strain gauges to feline parietal bones to measure movement when injections of artificial CSF were given. The bones moved significantly, varying from 17 to 70 microns. External lateral head compression caused a measurable widening of the sagittal suture with an inward rotation of the parietal bones.
Researchers at the University of Michigan College of Osteopathic Medicine have looked at cranial bone mobility in adult primates.5 Michael and Retzlaff used a direct screw attachment on the right parietal bone and measured movement with a pressure transducer. They also measured blood pressure, heart rate and respiration rate. The parietal bones moved spontaneously in two distinct rhythms, one corresponding to the respiration rate and a second, slower rate of five to seven cycles per minute.
These four studies indicate cranial bones may show a slow, steady, cyclical movement. A relatively new theory for Western medical science, it represents a dramatic shift. Bringing controversial ideas into the status quo of scientific thought is not easy, but the body of literature supporting cranial movement is growing. Although inconclusive, it deserves to be approached with an open mind.
In CranioSacral Therapy (CST), the rhythm of CSF can be palpated at all parts of the body due to the passive action of fascial connective tissue. The rhythm occurs in two distinct phases: flexion (outward movement) and extension (inward movement). In physical therapy terms, flexion is a decreasing measurement of degrees in the angle of the joint. The sphenobasilar joint is where the posterior sphenoid articulates with a ridge on the occipital bone.
When Dr. William Garner Sutherland, the "father of osteopathy," palpated the movement of these bones, he noticed this joint does indeed flex or reduce angle size on the inferior side. The flexion of this angle is accompanied by subtle outward movement in the body, which Sutherland called flexion. Therefore, in CST, the cranium, along with the rest of the body, is in flexion when it widens and in extension when it narrows.
Anatomy of Suture Closure
To discover more about cranial bone motion, let's examine the nature of cranial sutures. If the sutures remain flexible throughout adulthood, some degree of motion is possible when driven by pressure changes in the craniosacral system. If the tissues fuse and become immobile, rhythmic motion is unlikely.
Several studies have examined the nature of the cranial sutures. Retzlaff, et al.,used light and scanning microscopy to examine tissue samples of adult primate sutures.6 They found connective tissue, blood vessels and nerve fibers present in the sutural space. They described a five-layered pattern of fibers and cells containing collagenous bundles. Tissue was reported to be arranged in a wavy pattern. The researchers hypothesized the purpose of the tissue might be to control the elongation of the collagen bundles. They reported no evidence of fusion in the adult primate sutures.
In a separate study, Upledger and Retzlaff examined the sagittal suture in primate skulls.7 They found not only connective tissue, but also a vascular network and neuronal plexuses and receptors in sutural tissue. In one specimen, they were able to trace a single dendrite through the dural membrane into the brain, terminating in the third ventricle containing CSF. Further study of this neural tract may bring answers to how the homeostatic feedback mechanism in the brain's CSF hydraulic system functions.
In the 1920s, Todd and Lyon published two articles examining a timeline of sutural closure in the male human skull.8 These researchers hypothesized that cranial sutures fuse at some point in the human lifetime. They started with 427 specimens, but rejected 81 due to abnormal suture closure or "delayed union." Furthermore, some of the skulls were termed lapsed union, which meant failure of the suture to close due to a concentration of bone along the edge of the articulatory surface. For reasons unclear, they counted these skulls as fused, which biased results toward earlier suture closure. The data they found is as follows:
The authors concluded that the sutures tend to close along this timeline. However, there is a high degree of variability reported. This study also was conducted some 80 years ago. Standards of protocol in scientific research have changed.
Researchers have studied one suture in-depth using different human specimens. Kokich examined one suture in the facial area - the frontozygomatic suture.9 Of his 61 specimens, he found none demonstrated closure until after age 80, and some weren't completely fused even after age 90. He noted that bony interdigitations formed along the suture with advancing age, but did not affect the patency of sutural movement. Kokich, like Retzlaff and Upledger, found clear evidence of collagen fibers within the suture. He stated that frontozygomatic suture remains a functioning "articulation" until late in life.
A conclusive statement about whether and when sutural fusion occurs cannot be made from existing research.10 Clearly the subject remains open for debate. Having palpated the craniosacral rhythm with my own hands, I believe cranial sutures maintain flexibility that might best be called articulation. This flexibility allows the bones to move passively as they are driven by the craniosacral system.
Click here for previous articles by John Upledger, DO, OMM.
Lisa Johnson Zee is a clinical supervisor and instructor in the Communication Disorders and Sciences Program at Southern Illinois University Carbondale. She is certified in CranioSacral Therapy Techniques through The Upledger Institute. Her other interests include complementary and alternative medicine, traumatic brain injury and bilingual Spanish/English therapy.
Join the conversation
Comments are encouraged, but you must follow our User Agreementcomments powered by Disqus
Keep it civil and stay on topic. No profanity, vulgar, racist or hateful comments or personal attacks. Anyone who chooses to exercise poor judgement will be blocked. By posting your comment, you agree to allow MPA Media the right to republish your name and comment in additional MPA Media publications without any notification or payment.