The Basis of Chiropractic Craniopathy
O. Nelson DeCamp, D.C.
Chiropractic Craniopathy began its development in the 1920's by M.B. Dejarnette, D.C., D.O. as Sacro Occipital Technique. It is based on Osteopathic Cranial Technique developed by W.O. Sutherland, D.O.. The Cranial-sacral respiratory phenomenon and its dysfunction was recognized in 1899 by Sutherland. He developed the applicable corrective technique and in 1939 published this in a small text "The Cranial Bowl".
An excellent expanded text, "Osteopathy in the Cranial Field", was written by H.I. Magoun, D.O. in 1966. During the period of craniopathy that these texts were the basis of Osteopathic Craniopathy, the emphasis was on the cranium and its correction. Not much was written or practiced relating to the causes and involvements of cranial dysfunction from the pelvic complex or patterns of postural compensations. Therefore, due to many de-compensational adverse reactions to cranial corrections and decreased osteopathic involvement and interest in spinal manipulation, Osteopathic craniopathic development and practice waned.
In 1983, John E. Upledger, D.O., produced the text "Craniosacral Therapy". In this text, the previous Osteopathic manipulative cranial procedures were eliminated. Passive light touch and cranial rhythmic impulse energy balancing was developed so as to not upset patterns of compensational dysfunction which previously created adverse reactions in patients. This is presently being taught mainly to non-primary health care providers.
M.B. Dejarnette, D.C./D.O. had experienced craniopathic care as a student and was an avid proponent of the concepts. In personal conversations with him he stated, "I had experienced reactions to cranial corrections personally and was bound and determined to find a system of analysis and treatment to eliminate the reactions to cranial adjustments. Correcting the cranial function and releasing stress on the central nervous system is the ultimate goal in health."
Dejarnette devoted his professional life to the development of Sacro Occipital technique. He produced yearly texts and taught seminars throughout the country from the late twenties til his last text in 1984. In 1968 he felt he had developed his system of analytic objective indicators for sacrum to occiput corrections, based on the cranial sacral respiratory system, to release cranial stress and began teaching craniopathy to the chiropractic profession. This included producing yearly cranial texts until 1980 and teaching until his death in 1992. His work continues to be taught by Sacro Occipital Research Society International (SORSI) that he founded to carry on his work.
Review of the Cranial Sacral Respiratory Function
The Brain is highly vulnerable to disturbance of the blood/CSF supply. The central nervous system, brain/spinal cord, use Oxygen and glycogen, and needed metabolic constituents, at a ratio of 7 to 3 to the other cells of the body. Anoxia lasting only seconds can cause neurological damage. Although the brain constitutes only 2% of the total weight of the body, it receives about 15% of the cardiac output and its oxygen is about 20% of that of the total body. Total blood flow to the brain is about 750-1000 ml/min. and flow per unit of mass of gray matter is about four times that of white matter. This blood flow feeds the CSF, which transports nutrients and oxygen to the brain cells and removes intercellular metabolic waste and is instrumental in maintaining the steady state of the nervous system.
Craniopathy is concerned with two physiological phenomena relating to the moving or pumping of the CSF through the central nervous system from the cranium to sacrum and back. These two phenomena are the cranial rhythmic impulse (CRI) and diaphragmatic - inter/intra cranial bone motion. The CRI is a very light impulse motion that develops in the fetus along with the cardiac impulse and persists through life with a normal rhythm of 8-12 cycles per minute. Although no specific impulse mechanism has been discovered or adequately explained, a couple have been hypothesized.
The CRI motion may be described as a flexion/extension torsional sensation along an axis from the left occipital/temporal suture to the right sphenomaxillary suture. There is a reciprocating temporal bone action with one temporal moving in external rotation and one in internal rotation thereby producing a clockwise eddying flow of CSF through the brain and spinal cord tissues.
This CRI pumping motion is not of high volume nor is its frequency variable sufficiently to maintain the flow of CSF needed for life's extremes of metabolic demands on the central nervous system.
The second phenomena, diaphragmatic - inter/intra cranial bone motion, relates its motion cycle to that of the diaphragm on inhalation/exhalation at an average of 16-18 cycles per minute. This pumping motion is much greater then that of the CRI and can vary in volume and frequency as needed for the metabolic demands and cooling of the CNS.
On inhalation, the diaphragm contracts expanding the lung volume from inferior while skeletal muscles contract to elevate the rib cage in circumference. Some important primary muscles elevating the rib cage are the scalenus, sternocleidomastoideus (SCM), and trapezius.
The resultant contracture of these muscles on inhalation is extension of the occiput on the spine and flexion of the occipital/sphenoid junction (sphenobasilar) of the cranium. This in turn places the internal membranes, the falx cerebri from anterior to posterior and tentorium laterally, into an extension state.
If there is postural compensatory sub-occipital muscular imbalance, sutural fixation from trauma or stress, or dental bite imbalance, the distortion of cranial CRI and diaphragmatic pumping motion is impaired. The resultant impairment of blood and CSF flow can significantly affect the neurological cellular metabolic status. This then can cause additional compensatory patterns throughout the body to maintain the CNS. Many chiropractic spinal/pelvic problems can not be corrected sufficiently to the satisfaction of Dr. and patient because they are now compensatory to a cranial distortion or dysfunction which now requires correction.
Dejarnette developed SOT and Chiropractic Craniopathy as the analysis and treatment of the cranial sacral respiratory/CNS system that is an addition to any chiropractic technique. It greatly enhances all chiropractic techniques and is essential for those interested in expanding their practice in services, numbers, and retention by including 80% of the nervous system not usually treated.