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Uncle Sam Needs You
Scrutiny into the Department of Veterans Affairs (DVA) continues to grow after efforts to reform the DVA by the former Secretary of Veterans Affairs, Eric Shinseki, were deemed "a stunning period of dysfunction" by Senate Minority Leader Mitch McConnell (R-Ky.).
History of Animal Acupuncture: Part II
In Part I of this article, I had gone back to 1969 and tried to describe the atmosphere and events of that year that engulfed many of the younger generation, some who were all the core members of the National Acupuncture Association.
The Truth About Herbs
I appreciate the effort and research put into the article written in the June issue of Acupuncture Today regarding pesticides and Chinese herbs.
The Science Behind Happiness
Are you happy right now? Whether yes or no, there are a myriad of reasons why you feel that way. A whole academic discipline has developed to find out what causes or obstructs happiness, and how to amplify it.
The Spirit of the Point
After receiving a large amount of positive feedback on my San Zhen Protocols series, I have decided to focus this article on some relevant clinical aspects of acupuncture therapy prior to moving on to San Zhen Protocols III.
Medicalization and Mindfulness
The past several years have seen a veritable explosion of research on mindfulness. Research abstracts we've published in each issue of Health Insights Today under the heading "Mind-Body News" have increasingly reported on studies about mindfulness interventions.
Thoracolumbar Syndrome: The Great Mimic
The thoracolumbar junction is a common area of joint dysfunction. The most obvious cause is dysfunctional breathing or lack of diaphragmatic breathing. Treating this breathing problem will ultimately be the long-term cure for the syndrome.
Thoughts to Live By
When speaking to your patients about their health make sure to ponder the following points and have them assess if they are making themselves even more sick by the thoughts they have about life. Are these some of the traits and thoughts that your patients might have?
Help Secure Our Future by Sharing It
The National Board of Chiropractic Examiners (NBCE) conducts one of the most comprehensive surveys of the U.S. chiropractic profession every 4-5 years.
A Commonly Missed Spinal Fixation: The Upper Lumbar Spine (Part 1)
When we think of lower back pain, we tend to think in terms of the lower lumbar spine and the SI joint. These joints and their discs are obviously important. However, we tend to miss fixations that occur just above – in the upper lumbar spine. Three questions come to mind: 1) Why is the upper lumbar spine so important? 2) Why do we miss the fixations here? 3) How can we adjust them?
A Glimpse Into China's Top Brain Hospital
The sounds of the city pass through the open window are overwhelming the microphone - car horns, construction machinery - and then there's the family at the adjacent bed talking loudly on cell phones, yet you can still hear the faint beep of our patients monitoring equipment.
When Big Pharma Meets Chinese Medicine
Earlier this year, Bayer made a media splash with their decision to buy the Dihon Pharmaceutical Group Co., a Chinese TCM manufacturer.
MPA Media Wins Seven Publishing Awards
MPA Media, publisher of Acupuncture Today, among other titles, has been recognized for editorial and design excellence with an unprecendented seven publishing awards by the ASBPE, the nation's largest organization for business-to-business publications.
News in Brief
NBCE Launches Computer-Based Testing Era; California Chiropractors Get Expanded DOT Exam Privileges; New Jeff Hays Documentary.
Improving Our Political Effectiveness
The November 2014 elections are right around the corner; members of Congress, governors and state legislators are all running. Now is a good time to talk frankly about our overall political involvement.
Get Ready For AOM Day
This year, AOM Day 2014 falls on Friday, (October 24th). This is a great opportunity to make your AOM Day celebration or event even bigger by extending it throughout the weekend!
Rethinking GMO: Less Panic, More Context
Some of you may have noticed that after writing parts 1 and 2 of “Genetic Modification of Organisms for Human Consumption” a while back [Nov. 15, 2013 and Jan. 1, 2014 issues], part 3 never appeared.
If You Get a Request for Records, Respond!
In our previous two articles, we discussed two of the main reasons for denial when chiropractic records are reviewed by Medicare contractors.
Let the Patient Tell Their Story
Often when a patient presents with an injury, they want to tell their story. People by nature like to talk about themselves, particularly when they're worried about their health.
A Healthy Dose of Failure is Vital to Your Success
As an acupuncturist I tend to see people after they have already suffered for years and "tried everything." They are so desperate for some relief that they want to know everything about how to get better, right now.
Healing Community Trauma in Israel and Palestine
It's the beginning of August and Israel and Hamas have just agreed to a 72-hour ceasefire after a month of brutal fighting. In the last four weeks, 1,830 Palestinians and 67 Israelis have been killed.
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.
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