Richard A. Feely, D.O., FAAO, FCA, FAAMA
Cranial osteopathy, also known as osteopathy in the cranial field, was developed as a natural extension of Dr. Andrew Taylor Still's – the founder of the osteopathic profession – philosophical and therapeutic approaches to health through manipulation. William Gardner Sutherland D.O. was the founder of cranial osteopathy, utilizing the body's inherent forces to overcome membranous articular restrictions principally in the head and spine with secondary effects throughout the rest of the body.
A cranial osteopath is an osteopathic physician and surgeon in the United States. In other countries, the osteopathic physician has a limited license. He or she diagnoses the patient holistically, body, mind and spirit with particular detail to the musculoskeletal system and the cranial sacral mechanism in particular. The cranial sacral mechanism is a dynamic force within the living human body. It is the Qi or energy of the central nervous system and is reflected throughout the rest of the body.
Cranial osteopathy is a sub-specialty within osteopathic manipulative medicine. It has a unique defined body of knowledge, educational requirements and specific diagnostic treatment procedures that are part and parcel of a complete osteopathic manipulative medicine specialist practice. Diligent study of anatomy, physiology and pathology is required to become a cranial osteopath. True system of preventive medicine, treating the whole person, not just the disease.
Osteopathic medical schools teach courses in all branches of medicine and surgery in the United States and various manipulative techniques. It takes four years of training in osteopathic medical schools in the United States. Most D.O.'s seek additional training in cranial osteopathy after graduation. Most osteopathic medical schools in the United States involve two hundred to three hundred hours of osteopathic manipulative diagnostic and treatment education
The Cranial Academy
The professional organization representing D.O.'s who practice cranial osteopathy, The Cranial Academy, requires a 40 hours basic course just for membership and after that most osteopathic physicians have an additional 100 to 200 hours of training in osteopathic manipulative medicine related to the cranial field. In addition, The Cranial Academy offers competency testing and fellowship certification for D.O's receiving national prominence.
Cranial osteopaths were originally labeled as quacks for identifying that the bones of the skull were slightly mobile and that this mobility allowed for membranous articular strains that could cause dysfunction and pain. Today, scientist and many M.D's through the use of high-tech diagnostic equipment agree that there is a motion present in the cranium.
There are many other therapies and therapist out there that claim to be cranial osteopaths. But only physicians (M.D's. D.O.'s and dentists) can be trained by The Cranial Academy, the national organization recognized by the American Academy of Osteopathy and the American Osteopathic Association (AOA) as the professional organization in this field.
Cranial osteopathy cannot be effectively learned via the Internet or reading books. It is a psychomotor skill be best taught with hands on guidance. It must be practiced on living human heads with a skilled trained practitioners providing guidance, experience, knowledge, skill and information to the student.
The Rhythmic Impulse
The body has a self healing mechanisms. One of these mechanisms is the third pulse of the body that emanates from the central nervous system. This inherent motility of the brain and spinal cord occurs with the initial inspiration of the breath of life at birth. This primary respiratory mechanism called the cranial rhythmic impulse which is associated with a very slight coiling and uncoiling of the spinal cord and the central nervous system. The bones of the head and the central nervous system become slightly wider and shorter from front to back in the inspiration or flexion phase of the sphenobasilar synchondrosis. In the exhalation phase, the primary phase, the primary respiratory mechanism moves in just opposite direction. The head and central nervous system becomes longer and slightly wider. This amount of movement is in the millimeter range. One measurement placed it within hundredths of an inch. But this varies according to where one measures the motion, at which suture.
The fluctuation of the cerebral spinal fluid occurs with the motion of the billions of glial cells in the central nervous system and this movement occurs in the relatively closed container of the cranium. As the brain and spinal cord change shape and go through the cycle of inhalation and exhalation/flexion and extension, the cerebral spinal fluid fluctuates back and forth within the spaces of the brain and spinal cord. This helps push the cerebral spinal fluid through the small channels around the nerved down the spinal cord and exiting the central nervous system into the peripheral nervous system. The motion of the membranes of the head called the dura mater that surround the bones and house the vessels in the skull. The dura membranes appear as the three attached sickle shaped membranes forming a tripod to support the brain and skull.
They are called the falx cerebri and the tentorum cerebelli with a small slip dividing the left and right half of the cerebellum. They limit and control the slight motion of the bones of the head effecting the whole fasat mechanism involving the cranium to the sacrum. The dura membranes are firmly attached at the foramen magnum, second and third cervical vertebra and the sacral segment. The 26 bones of the head are in slight rhythmic motion along with the cerebral spinal fluid, the central nervous system, the dural membranes and the sacrum. These cranial bones are architecturally designed to fit together with various grooves and gear-like articulation with each other. The sutures are comprised on connective tissues, membranes and blood vessels with elastic tissue identified microscopically. Since the dura is firmly attached at the base of the skull and the sacrum, motion of the cranial mechanism is transmitted into the sacrum. The cranium and the sacrum work together in a flexion and extension phases. This constant rhythmic motion moves the sacrum into nutation and antinutation.