Open Source Cranio

Tag: Flexion

  • Cranio Sacral Therapist and Student Newsletter 20

    January  18 – 2007

    Questions and comments for this issue:

    + Talking during treatment.
    + How the face reflects the cranial rhythm.
    + Why is the ventricular system so important?

    Hello,

    Let me just put my Hula Hoop down for a second
    so I can talk to you.  You don’t Hula?
    Why, it’s the latest re-fad.  You know, a fad
    that makes a comeback.

    In America, “hip hooping” classes, videos and
    Hoopster clothing lines are springing up across
    the country. Beyonce and Charlize Theron are huge
    fans.  They are always pestering me to join them
    at hip hooping class.

    I can see I’m wasting my time talking to you
    about this.  You just want to hear about cranio.

    Fair enough, let’s get on with the mailbag.

    ***QUESTION***

    Dear John,

    Thank you for your newsletters they are wonderful.

    Here is my question.
    I would like to get some of my patients more
    involved in their process when we are working
    together but I don’t want to do a full somato-
    emotional release type thing with them.
    Do you have any suggestions for an intermediary
    type approach I could do?

    Thanks again.
    PR.
    California.

    MY COMMENTS:

    Okey dokey.  Here’s something you can do.

    Once the person is on the table and you are
    settling in and chit chatting and generally
    entraining with them.

    No, not entertaining them, I said ENTRAINING
    with them. Now take that clown suit off and lets
    get back to the session.

    Tell the person that you are going to do
    something a bit different this week.  Keep your
    tone light.

    Take up a contact that allows you a good sense
    of the whole cranio sacral system.  Ask the person
    to close their eyes and begin to see themselves
    shrinking on the inside until they are small
    enough to walk around, inside the structures of
    their body.

    Whenever you are talking with a patient choose
    your words carefully.  I used the word ‘see’ on
    purpose.   ‘I want you to see yourself shrinking
    on the inside until you are small enough to be
    able to walk around inside the structure of your
    body.’

    Don’t say visualise or imagine as I have found
    these words can short circuit the process before
    it even gets started.

    Why?

    Well, because some people are convinced they
    have no imagination and others have tried
    visualisation before and are, ‘just no good at
    it.’

    Start off with a relatively restriction free
    area.  Ask the person to describe what it looks
    like.  Get them to describe the area in as much
    detail as possible.  Encourage them to tell you
    what they see, even though they may be inhibited
    by their lack of anatomical knowledge.

    They can shrink themselves to whatever size
    they need to be to pass between structures or see
    something in detail.  Ask them if everything looks
    okay in the area.  If it is, move on to another
    area, one where you sense a restriction, though
    you don’t need to tell them you think it is
    restricted.

    If they tell you that everything is NOT okay in
    an area, ask them to describe what it is that
    looks unnatural.  Encourage them to be as specific
    as possible.  You may need to move your hands
    closer to the area they are describing.

    Ask them what needs to happen for the area to
    return to a more natural state.

    Wait for their answer.

    If they are having difficulty seeing a way to
    correct the situation you can suggest solutions to
    them using the symbols they have communicated to
    you. Make full use of their size in the area.

    They can climb in between bones and push them
    apart.  They can pull and push things with their
    hands in very specific ways. You can suggest
    little tools that may help them, but avoid
    frightening tools like hammers and saws etc.

    You can suggest light beam machines to warm
    cold areas.  Ice guns for cold.  Muscle oil
    aerosol cans for tight or stiff muscles and so on.

    All the time you will be monitoring and
    following the changes they are making on the
    inside with your hands.

    This is generally an enjoyable technique for
    you and the person.  It seldom has a huge
    emotional aspect and is particularly good with
    patients who are very out of touch with their
    feelings.

    Most people don’t find it threatening and are
    amused by what they find in their bodies. They can
    be surprised at the clarity of the images they
    see. This is because the following of your hands
    enables the person to see more clearly the
    restriction in their bodies.

    This technique is a very useful way to involve
    the person and use their attention as an extension
    of yours, to check things out and correct them
    from the inside.

    As you get more experience with it you will get
    a sense of who this technique is appropriate for.
    It is a good introduction for other forms of
    therapeutic conversation which you may intend to
    use in future treatment sessions with the person.

    ***QUESTION***

    Dear John,
    I am currently studying the face and the way it
    moves with the cranial rhythm.  Frankly I find it
    confusing and hard to remember.

    I’m hopping you have some little analogy or trick
    for making it a bit clearer.

    Yours Sincerely.

    KS.
    Canada.

    MY COMMENTS:

    Before I get into the face I need to quickly
    run through flexion and extension in the cranium.

    Think of the cranium as a balloon.

    During extension the balloon narrows and
    elongates and during flexion it expands and
    becomes squat.  Long and thin in extension, short
    and squat in flexion.

    To understand the way the face moves with the
    cranial rhythm, take the balloon and add a small
    box.  Attach it to the balloon roughly where the
    face hangs off the cranium.

    Now, lets look at how the box moves with the
    balloon.

    In extension the balloon will become long and
    thin.  The box will arc inferiorly and narrow as
    the whole balloon elongates

    During flexion the balloon will become short
    and squat.  The box will arc superiorly and
    broaden as the balloon shortens and broadens.

    So what does this feel like in practice?

    Sit at the head of the person.  With their
    permission, place your hands on their face, thumbs
    on their forehead and fingers on their mandible.

    During flexion you will feel your thumbs and
    fingers move closer together while in extension
    they will move further apart.

    Once you get this overall movement you can work
    out the specifics of each bone relatively easily.

    Here are some other things to consider.  The
    mandible and the frontal bone moving towards each
    other in flexion could put stress on the bones of
    the face but this compressive movement is
    naturally absorbed by the orbits.

    This makes the orbits particularly vulnerable
    to any restriction patterns present in the face or
    cranium, especially the posterior aspect of the
    orbit.

    Certain bones of the face are designed to
    reduce the amplitude of the movement of some of
    the larger bones they articulate with. These bones
    are the palatines, the zygomae, the vomer and the
    ethmoid.

    You can think of them like ‘washers’ between
    two larger bones.  William Sutherland called these
    bones the ‘speed reducers’ but they do not
    actually reduce the frequency of the rhythm, they
    reduce the amount of movement or amplitude.  So a
    40 micron movement of the frontal can be reduced
    to a 10 micron movement in the Zygomae. [Remember
    a sheet of writing paper is 100 microns thick.]

    ***QUESTION***

    Hi John,
    I am being repeatedly told that the ventricles are
    very important but I am not sure why.  I have
    asked this question of my tutors repeatedly but
    never got a satisfactory answer.

    I would be grateful to hear your explanation.
    Thanking you in anticipation.
    PB
    South Africa

    MY COMMENTS:

    It may be easier for you to think of the whole
    system in terms of plumbing, which it is in a way.
    It’s a very important and significant plumbing
    system.

    The ventricular system, is a collection of
    cavities and canals deep within the brain and
    spinal cord. It consists of 4 ventricles connected
    by various channels.  It always looks to me like a
    model of a space ship.  Think Star Trek.

    The four ventricles are made up of the 2
    lateral Ventricles located within the two cerebral
    hemispheres, each of which connect via an inter-
    ventricular foramen to the 3rd ventricle which is
    located between the two thalami of the brain.

    The 3rd ventricle connects inferiorly through
    the cerebral aqueduct (or aqueduct of Sylvius as
    you will see it in some books) to the 4th
    ventricle which is located between the cerebellum,
    posteriorly and the pons and medulla, anteriorly.

    The 4th ventricle continues inferiorly as the
    central canal passing down the centre of the
    spinal cord.

    The whole ventricular System is filled with
    Cerebrospinal Fluid.

    So that’s the plumbing.  Now let’s look at
    inlet and outlet valves.

    The INLET valves are located in the roof of
    each of the four ventricles and are called Choroid
    Plexi.  These are filter like structures through
    which cerebrospinal fluid is formed as a filtrate
    from arterial blood.  Arterial blood enters the
    choroid plexi from the cerebral arteries; then
    blood cells, proteins and other large particles
    are filtered out.  The pure colourless fluid that
    filters through this choroid plexi into the
    ventricular system is cerebrospinal fluid.

    I will get to the outlet valves in a minute.
    First I want to focus on something that is very
    easy to get confused about.
    We know that the membrane system contains
    cerebrospinal fluid, right?

    Just nod.

    And now we have a good idea of how
    cerebrospinal fluid enters the ventricular system.
    And we also know the ventricular system is
    contained within the membrane system.  The thing
    is the ventricular system is, for the most part,
    closed.
    So how does cerebrospinal fluid get out of the
    ventricular system into the membrane system?

    Very good question.  It all happens in the 4th
    ventricle.  In the posterior and lateral walls of
    the 4th ventricle there are three foramina,  – the
    foramen of Magendie which is in the middle
    posteriorly and the 2 foramina of Luschka,
    bilaterally.

    It is through these 3 foramina that
    cerebrospinal fluid passes out into the sub-
    arachnoid space where it circulates around the
    brain and spinal Cord.

    Now back to the OUTLET valves.
    Cerebrospinal fluid is eventually returned to
    the blood via the Arachnoid Villi which protrude
    from the sub-arachnoid space through to the
    superior sagittal sinus of the Brain.  It re-joins
    the venous blood which then drains from the venous
    sinuses via the internal jugular Vein to be
    returned to the heart.

    So that’s the plumbing, the general flow and
    the inlet and outlet valves.   The significance is
    that this system is in continuous use which means
    it has to be in working order all the time.  If
    any one of the valves or canals of foramina are
    not working properly the effects are serious.

    Just think of the person having a spinal tap.
    Only a tiny amount of cerebrospinal fluid is
    removed yet the person will have to lie horizontal
    for 24 hours to avoid severe headaches.

    Also if there is a problem in this system it’s
    not like you can just shut it down while repairs
    are made.

    So that’s it for this issue.

    Cheerio for now.

    Till the next time.

    Your Mate,

    John D.

  • How does opposed motion relate to flexion/extension?

    + How does opposed motion relate to flexion/extension? – October 05

    Hey JD,
    Enjoying your Q and A’s.
    Here’s my Q.
    How does opposed motion relate to
    flexion/extension?

    Thanks
    B.F. London.

    >>>MY COMMENTS:

    Glad you’re enjoying the NL, B.F.
    I’m guessing you do a lot of text messaging on
    your ph.
    Here’s my C’s.

    When you first learned cranio sacral, you were
    probably told how the cranio sacral system moves
    in flexion and extension.   ‘In flexion, the
    parietals flex and extend around a medial axis
    running along the sagittal suture.’ and so on . .

    That’s called the similar motion model.  The
    main characteristic of which is that everything
    moves symmetrically around the midline of the
    body.

    What you will have found in practice is that
    some people just don’t flex and extend in
    symmetrical way.

    The fact is that no person fits into the
    theoretical models of flexion and extension all
    the time.  Some never.  No person’s head moves in
    the same way from one day to the next.

    It is important to learn flexion and extension
    in the beginning so that you can refine your
    palpatory skills to really be able to perceive
    flexion and extension in all its nuances.

    With the opposite motion model flexion and
    extension are felt asymmetrically.  When one
    parietal is moving into flexion the other one will
    be going into extension.  This creates an
    asymmetrical peddling motion within the whole
    cranium.

    The frontal bone will move anterior and
    inferior on one side (flexion) while the other
    side moves superior and posterior (extension).

    The squamous portion of the occiput will flare
    and move inferior and slightly posterior as it
    tucks under (flexion) on one side while the other
    side is narrowing and moving superiorly
    (extension).

    The sphenoid torsions around its body.  One
    greater wing will nose dive  (flexion) while the
    other side will be arching superiorly.

    It’s probably easier to get a mental visual of
    it all if you think of the membranous balloon
    lining the cranium, filling on one side while it
    empties on the other.  This will help you make
    sense of what the bones are doing.

    Trying to figure out every bone movement in the
    opposed motion model will do your head in.

    Not recommended.

    Get the idea of the way the membranes move and
    the bones will follow.

    You’ve probably felt this motion already and
    may have put it down to your inability to feel
    flexion extension correctly.

    Well you were right, there is a motion like
    that and it’s called opposed motion.

    Some days our system will move in similar
    motion flexion and extension and on other days it
    will have this opposed motion feeling.

    Hope that was of H.

  • ‘Am I making it up?’

    + What I feel with my hands, am I making it up? – September 05

    Mr Dalton.
    I feel I am at a crossroads in my craniosacral
    training. I have been studying CST for six months.

    I have listened carefully to my trainers.
    I have read books on CST. I understand the fluid
    mechanics of what is happening, in theory.

    When I tune into the system I begin to feel things.

    Then I begin to wonder am I feeling the rhythm
    because I expect to feel it. I wonder if I am
    not imagining the whole thing. What I feel with
    my hands is so tenuous that I could very well
    be making it up.

    My trainers say that the feeling will become
    clearer with time and practice.

    It has been six months now. While I can feel more
    than I could at the beginning it is nowhere
    as clear as I expected.

    I understand that with your experience and in
    your position you have a strong vested interest
    in ‘believing’ in what you do.

    I would appreciate it if you could answer me as
    honestly as possible.

    Do we make it up?

    Regards.

    M.S.

    Somerset.

    >>>MY COMMENTS

    Let me tell you right now, it’s not going
    to get any easier.. . .

    What you are looking for is a kind of certainty.

    Where you put your hands on someone’s body and
    it lights up like a Christmas tree and you can
    see EVERYTHING, every restriction pattern,
    every cause.

    And the road to health for that person looking
    like a well lit highway.

    And all this without that awful squirmy feeling
    like you are groping around in the dark not really
    sure of anything.

    I feel for you, but it’s never going to
    happen. There is something about this work that
    always keeps you at the limit of yourself.

    I’ll explain.

    When you started to learn six months ago and you
    heard about flexion and extension, it probably
    all made sense.

    Then you put your hands on someone and you tried
    to feel it and all you could feel was NOTHING!

    And it felt awful.

    You trusted your trainers and you persevered.

    As time passed you learned new things like feeling
    lesion patterns in the sphenoid or some such
    and when you tried to feel them, all you could
    feel was NOTHING!

    And it felt awful.

    You looked forward to the day when you wouldn’t
    feel that awful feeling.

    You didn’t notice two important things.

    1) Your palpatory skill was improving and
    changing. You were actually feeling more. When
    you were struggling to feel whether the sphenoid
    had a flexion or extension lesion, you failed to
    notice that you were feeling flexion and extension
    with relative ease.

    2) The awful feeling wasn’t changing. It was the
    same awful feeling six month ago that you are
    feeling now.

    As good as your palpatory skills get,
    as good as your diagnostic skills get,
    as good as you perceptive skills get,
    you will still have that voice in the back of
    your head wondering, ‘Am I making this up?’

    Outstanding cranio sacral therapists haven’t
    eradicated uncertainty, they have mastered it.

    It’s not like you get it sorted and never have
    to deal with it again. It’s something that goes
    on every time you treat someone. It’s one of the
    most difficult aspects of cranio sacral work.

    I know all this because I went/go through it myself
    and I have seen ALL the people I have trained go
    through it in one way or another.

    Here’s what I suggest: put the question on hold for
    another six months. Make a deal with yourself that
    for the next six months you are not going to ask
    yourself that question. For the next six months
    you are just going to take it that what you are
    feeling is true. It’s not forever, its just for six
    months.

    I’m not talking about kidding yourself.
    You need to understand what you are trying to do.
    You haven’t been conditioned to think in the way
    that you’re trying to think when you do cranial work.

    Your neuronal pathways are formed in a different way.

    Continually asking yourself if you are making it
    up won’t allow new neuronal pathways to form.

    We are not MRI machines. This is science, but not as we
    know it, Jim.

    Asking if we are making it up is a question from
    another approach.

    Because we are not machines we have the capacity
    to go far beyond our own expectations and pull miracles
    out of the bag. It also means we have the capacity to
    have an off day and get it wrong.

    To answer your very specific question.

    Do we make it up?

    Sometimes.

    Mostly in the beginning of training.

    With experience, 1-2 years minimum, you can begin to
    discern when you are making it up? You can spot it
    and in time it too becomes another thing to note,
    along with the multitude of other things you are
    registering as you work.

    ‘The rhythm is changing, I wonder what that means?

    The patient is feeling sadness, I wonder what that
    means? Now they are angry, I wonder what that means?
    I just made that bit up, I wonder what that means?
    Now they are about to release this bit, I wonder what
    that means? The sadness is still there. .’ and so on.

    Have a good look at what I’ve written. Talk it out with
    people who know you and care about you. Cranio sacral
    therapy may not be the thing for you. It doesn’t suit
    everyone. There are lots of modalities that offer
    much more of the certainty you are looking for.

    Having said that, I encourage you to persevere.
    The rewards far outweigh the difficulties.

    And the weird thing is as you become familiar with
    and master uncertainty, it permeates your whole life
    and it becomes more . . well . . fluid.