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Cranial Connections

By Don McCann, MA, LMT, LMHC, CSETT

About the Columnist
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Combining Techniques

Can Produce Quick Relief

Clients often arrive for sessions with challenges and conditions that can make the application of massage techniques almost impossible or intolerable. Some examples of these conditions are headaches, acute neck or back pain, a jammed cranium, osteoporosis, and high levels of emotional stress.

When clients arrive with headaches, it is very important to be able to effectively treat the headaches within the first 10 to 15 minutes. This is true whether the headaches are due to stress, a jammed atlas/occiput relationship, other jammed cranial sutures, cerebral spinal fluid congestion in the cranium, TMJ dysfunction, or a highly charged emotional state.

Clients with acute neck or back pain need to have a shift in their condition early in their session so other therapeutic techniques can be applied to start a long-term recovery process. Sometimes acute neck and back pain will prevent the client from being able to lie supine on the table without supporting the head with a pillow. This works against the structural improvement necessary to release the pain. Neck pain caused by an acute forward head/neck posture often includes a jammed atlas/occiput relationship so cerebral spinal fluid cannot be effectively pumped in and out of the cranium. An acute whiplash injury or acute neck pain with spasms has swelling, inflammation and ischemia pain that prevents deeper structural myofascial work to bring the damaged neck back into alignment. A jammed occiput restricts the motion of the cranium and the sacrum affecting both the neck and lumbar spine.

Combining Techniques - Copyright – Stock Photo / Register Mark Homeostasis is very hard to accomplish when the cranial motion is jammed or restricted. Additional complications with a jammed cranium include a jammed atlas/occiput relationship restricting cerebral spinal flow, causing pressure on the brainstem that can result in severe headaches and limited brain function. Cranial motion imbalances produce structural distortions of the neck and back, and imbalances in the TMJ. These imbalances can also produce vertigo.

Severe osteoporotic curvatures make it extremely difficult for a client to lay supine which is the optimal position on the table to release the forward collapse of the osteoporosis out of the structure. An additional complication of osteoporosis is having to work lighter on tissues especially those over the thoracic area to release the kyphosis and work with lowered pain tolerance.

Often, clients arrive for sessions having gone through extremely stressful situations from life experiences leading up to the massage. These can include stress at work, family situations, or even emotional stress traveling by car to the session. At the extreme end, we have clients with Post Traumatic Stress Disorder (PTSD), family of origin issues, and sexual/emotional/physical abuse.

In my first year of practice, clients with these challenges and conditions led me to look for a quick way to have clients lie comfortably on the table, relieve pain especially with headaches, mobilize the cranium so homeostasis could start to occur throughout the body, and rapidly diminish high levels of emotional stress. This also included developing a rapport with clients creating a trusting and safe healing environment for them regardless of their emotional, psychological and sexual history. I needed a technique that would work quickly and effectively at the beginning of their sessions that would prepare them for deeper therapeutic work.

Chinese medicine provided some answers with the acupuncture points and associated meridians. There is a referral pattern that involves the head, neck shoulders and low back. Additional research into specific trigger points and their pain referral zones related to the musculature of the head, neck and shoulders merged with the Chinese acupressure points and referral zones. The most effective trigger points for releasing the muscles for the head, neck and shoulders were also some of the most important acupuncture points. It became a moot point as to whether the points were acupressure points or trigger points. What was most important was getting results. The results I was looking for were to reduce the pain, inflammation, and swelling, open the energy flow and relax the associated soft tissue producing structural balance. Using a specific sequence of both trigger points and acupuncture points, produced these results and quickly became integrated with my treatments. There was also some structural improvement as the clients were able to relax and lie more comfortably on the table.

For clients who are not able to lie comfortably on the table or clients with severe osteoporosis with heads 10 to 15 inches off the table, it was necessary to develop a sequence using the acupressure/trigger points that would maximize releasing the musculature and balancing the structure. Using structural balance as a standard the most effective sequence, I first worked points that would release the shoulders back. These points are located on the outside of the shoulders. The next points are more medial to release points in muscles that were helping to raise the shoulder and are located in the attachments of the muscles at the superior angle of the scapula. After these points were released, it was obvious the rhomboids were still contracting and contributing to the problem, so releasing points that affect the rhomboids and also lengthen the back of the neck are next in this process. There was still shortening in the back of the neck so the small intestine meridian points midway up the neck are used to effectively lengthen the neck and open blocked energy flows. At this point, the area of the neck and shoulders still creating the most distortion involved the tissues directly under the ridge of the occiput - a series of five bladder meridian points. These tissues connected to the occiput and also directly affected the atlas and axis. They were significantly involved with headaches as the jamming of the atlas/axis almost always produces headaches along with pressure on the brain stem. Blocking the bladder meridians at these points would also produce headaches and the thickened tissue here would severely restrict cranial motion.

By releasing the shoulders back and the stress into the spine and then up the neck, a lot of stress and structural distortion responsible for jamming this area had already been released. Combining an osteopathic cranial atlas/occipital release with the acupressure/trigger point release and myofascial soft tissue release all with one technique was needed. For it to be most effective, it was necessary to modify the atlas/occipital release in several ways. First, the fingers needed to be curled, not held up straight which pushed the head forward, to allow the release of the energy at the trigger points and soften the tissue at the base of the occiput. Using myofascial release on this hardened tissue meant holding it and waiting for the tissue to soften, not trying to force through it. Oftentimes, tissue that had been hardened for years entrapping nerves causing head pain, neck pain and jamming the occiput would only release with constant steady pressure. Patience is the name of the game. As the tissue softens and melts, sometimes after as long as 10 minutes, the energy releases along with the ischemia, inflammation and swelling. When this happens, the head wants to fall back, tipping the chin up which would actually press C1 anteriorly causing a possible jamming of C1. Applying gentle traction towards the top of the head will start lengthening the neck allowing the head to settle without tipping back. This gentle traction will begin stretching the dura and will release the sacrum. At this point, synchronizing a traction and release with the cranial rhythm will free a stuck occiput, stretch the dura, rock the sacrum, expand the cranial motion, increase the cerebral spinal fluid pumping, and reduce structural restrictions in the body caused by imbalances in the cranial motion.

The area at the base of the cranium that was so tight, restricting the cranial motion is also one of the major emotional blocks of the body. Fear, anger, sadness are very often blocked at the base of the occiput pulling into the tissues that affect C1 and into the TMJ. Releasing this area by using the sequence described produced a significant reduction of emotional energy and stress in clients. This is done safely and gently with great results.

Therapists applying this technique can, within 15 minutes, very effectively reduce the majority of client headaches, quickly reduce clients highly charged emotions, quickly reduce acute neck and back pain, change the structure of the client's neck and shoulders so the client can lie comfortably on the table - including severe osteoporosis, and maximize the cranial motion for homeostasis and relaxation.

Deeper and more long lasting myofascial work can be applied for long-term relief of pain and dysfunction.

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