Understanding Craniosacral Work

Do you suffer from headaches, TMJ pain, or a stiff neck? Do you have unresolved issues from a whiplash injury (recent or years ago)? Are you stressed out and find it hard to sleep well? Read on! This article will explain craniosacral work, a gentle bodywork modality that could bring you significant relief.

What’s In a Name

The word “craniosacral” comes from the top and bottom ends of the craniosacral system. The top end is the cranium (skull) and the bottom end is the sacrum, the triangular-shaped bone at the base of the spine. The cranium itself is made up of 21 bones (excluding the tiny bones of the inner ear); some of these are paired bones – meaning there is one on each side of the head – and some are single bones that reside on the midline. The sacrum leads into the coccyx (tailbone), and is wedged between other pelvic bones, which craniosacral work can also address. In fact, a craniosacral approach can be applied to any area of the body.

Equally important to the craniosacral system are membranes and fluid. The membrane layer of the craniosacral system includes the periosteum that “shrink-wraps” all these bones, the falx and tentorium that help house and support the brain, and the dural tube – which is like a stocking around the spinal cord anchored at the top and bottom ends of the bony system. The fluid layer is the cerebrospinal fluid, which bathes the brain and spinal cord and also acts as a shock absorber.

History

Craniosacral work as a form of bodywork came out of cranial osteopathy, which was developed by William G. Sutherland, D.O. in the early part of the 20th century and draws on the work of osteopathy’s founder, A.T. Still M.D. As an osteopathic student Sutherland had an epiphany of realization about the cranial bones: they are able to move minute amounts. In other words, the adult head is not a solid block of bone, but rather a complex system of relationships between bones that all move in relation to the flow of cerebrospinal fluid.

Sutherland’s work stayed in the osteopathic field for the most part until the 1980s. Eventually some osteopaths began to teach manual therapists outside the osteopathic world, and variations on cranial osteopathy are now taught to chiropractors and bodyworkers. Cranial osteopathy still exists, but there are not many osteopaths who specialize in manual medicine these days.

Problems of the Craniosacral System

Common problems of the craniosacral system include – among many others - headaches, sacroiliac joint pain, temporomandibular joint (TMJ) pain and dysfunction, ringing in the ears, teeth grinding, whiplash, and the inability to deeply relax/sleep. What causes these problems?

The cranial bones are meant to move in precise and balanced ways, but they are part of a delicate balance that can be disrupted. Many problems stem back to physical impacts – falls, whiplash injuries, blows to the head, birth trauma – that leave paired bones out of balance or a feeling of one part of the cranium being “jammed up.” You can also have issues in the craniosacral system as a result of scoliosis, poor posture, extended dental work (orthodontics, or uncomfortable jaw positions during dental procedures), high stress levels, and trauma.

The various cranial nerves (affecting the facial muscles, vision, hearing, etc., as well as digestion and relaxation vs. fight/flight) in many cases pass through small holes in the cranial bones, or between cranial bones. So an imbalanced cranial system can put pressure on these nerves, just as nerves exiting the spinal cord can be impinged as they exit the spine. The nerves can also be flared up from unresolved trauma or chronic stress where the body remains in a fight/flight mode of sympathetic nervous system activation, unable to drop into the parasympathetic system that brings relaxation and deactivation.

Craniosacral Touch

Craniosacral work tends to be gentle. This is because the cranial system is easily impacted – think of a sea anemone that retracts as soon as it is touched, or touch-sensitive plants that close their fronds when you touch them. The body’s intelligence understands the delicacy of the head and nervous system and prefers an approach that lets it take the lead. For this reason, many techniques used in craniosacral work are what we call “indirect” technique. Direct technique (e.g., most massage, most chiropractic) says “I’m going to make this muscle longer” or “I’m going to put this bone where it should be.” Direct technique can be very effective, but it is often rejected by the craniosacral system as interference. In contrast, indirect technique is like asking the body “Shall we dance? You show me where you are troubled and I’ll support you in change, you show me where you are healthy and I’ll support health.”

One of the results is that the body will accept this touch and allow the nervous system to deeply re-regulate. Have you ever had a massage but not felt relaxed afterwards? Some people’s nervous systems are so charged that standard forms of therapeutic touch – such as massage or chiropractic – are seen as more stressful input into an already overloaded system. Because craniosacral touch asks the body to lead, it is not perceived as unwanted stimulus, so tension in the nervous system can begin to discharge. You could say that craniosacral work is like an induced meditation. As the practitioner becomes aware of the craniosacral rhythm – one of the deepest and slowest rhythms in the body, more primary than the heartbeat and breath – there is an entrainment effect whereby the client also drops into this deep layer and profound relaxation occurs.

Craniosacral work obviously requires a particular type of quiet space and light touch. While it is touch, it is listening touch:  the practitioner’s hands have to “listen” to the body – I think of them as little satellite dishes, receiving signals – and not override its subtle expressions. To learn to be effective with craniosacral work, a practitioner has to learn to quiet down internally, to sense subtly, and to be aware of how his or her “energy” meets the client’s “energy.” When I taught indirect work at a massage school on Maui, I would tell my students that to “listen” well you have to be patient and allow yourself to be aware of minute, almost imperceptible changes – the pace and level of drama can be like watching snow melt, but it is fascinating when you are in touch with its rhythms.

What  is the practitioner “listening” for with his or her hands? We are listening for the very deep and slow movement of the cerebrospinal fluid, which has a rhythmic flow through the craniosacral system. Like any fluid movement – a stream, a river – it can have a healthy flow or areas of eddying or stagnancy. We are also listening for the positioning and movement of the cranial bones, whether they can express their normal movement or have areas that feel jammed in a strain pattern. And then we are also listening for “still points” where motion stops and the system resets in a profound and nourishing stillness, and for releases where patterns are freed from the inside out and motion and potency return.

Finding a Craniosacral Practitioner

There is no one school or certification program for craniosacral work. As mentioned above, this work came out of the field of osteopathy, so for medical-level care you can see if there is an osteopath practicing the traditional work in your area. You will also find bodyworkers (e.g., massage therapists, Rolfers®, Hellerworkers), acupuncturists, naturopaths, and chiropractors who have studied craniosacral therapy, some a little and some a lot. Ask practitioners about their training, and choose someone who has done many classes and made this one of his/her primary modalities.