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The Craniosacral System

By Lynn Gerner, DC

Craniosacral therapy, as well as chiropractic care for children, is extremely gentle and is performed using acupressure, massage, light traction, and Activator (instrument) adjustments.

Most of you know by now that a passion and specialty of mine is caring for children. In addition to gentle chiropractic adjustments, Craniosacral therapy is highly effective technique—for breastfeeding function, for neurological development, and for all vital functions of life!

To begin, it will be helpful to talk about some anatomy. I love anatomy! There is a thick, leather-like covering of the spinal cord inside of the veretebral canal called meninges. This thick tissue extends the entire length of the spine— from the top all the way to the bottom. The posterior (back) end is attached to the bottom of the coccyx (tail bone) via a thin strand of fibrous tissue called the “filum teminale.” 

The superior end actually continues past the upper cervical spine (neck) and blends into the periosteum of the skull (the skin around the bones.) This a key detail because any abnormal tension at any point all the way down to the bottom will affect the skull (also called the cranium.) The innermost layer of the meninges is called the dura. 

The skull is made up of eight cranial bones and 14 facial bones that support the brain, eyes, inner ear, and Eustachian tubes. They form the sinuses and jaw (Temporo-mandibular joint or TMJ). A few of these cranial bones contain holes or “foramen” through which the cranial nerves pass. Cranial nerves emerge directly from the brain in contrast to spinal nerves, which emerge from segments of the spinal cord. There are 12 pairs of cranial nerves that are responsible for smell, sight, eye movement, sensation and movement of the face, jaw, and tongue (important for proper nursing,) balance and equilibrium, taste, salivation, swallowing, vocalization, heart function, lung function, and head and shoulder movement.

There is a clear fluid called cerebral spinal fluid (CSF) which flows up and down inside of the spinal column and cranium by a pumping mechanism created by the motion of the sacrum and the cranial bones.

In the adult, this motion is accomplished by the simple act of walking. In the newborn, this motion is established during the birth process as the baby is squeezed through the birth canal. The alignment of the cranial bones and attachments of the dura inside of the skull form a duct system that allows the flow of CSF throughout the brain and cranium. The CSF fluid controls the temperature in the cranial vault. Increased temperature leads to a tendency for seizure activity. The CSF fluid also provides nutrition and waste removal to nervous tissue and acts as a protective chemical and physical barrier for the brain and spinal cord. 

The normal craniosacral rhythm and flow of CSF begins even before birth.

Uterine contractions occur throughout the pregnancy to facilitate fluid and rhythmic impulses in the growing fetus. At the beginning of labor, intra-uterine pressure starts at 10mm Hg and rises above 100mm Hg in the second stage. If the baby is in the normal birth position (head fully tucked when entering the pelvic outlet), the pressure caused by the contracting uterine muscles actually stimulates the normal flow of CSF in the infant’s spinal column. Of course, this process is absent in the event of a C-section, resulting in a decreased or stagnant flow.

Dr. Upledger, the main founder of craniosacral therapy, describes this process: 

“Delivery of the newborn involves passage of the child through a convoluted birth canal. I believe vaginal delivery represents a child’s first craniosacral treatment, spinal mobilization, myoneural system treatment, and sensory stimulation session. In my opinion, all of these serve to prepare the infant for the rapid transition from life inside the womb to the outside world. Nature seldom makes design errors, and I certainly don’t believe the birth canal is one of them.”

The delicate nervous system in infancy is protected not by bone, but by cartilage. In fact, the skull and bones do not fully ossify—become solid—until around 18 years of age. The skull at birth is extremely pliable and should be in a constant state of motion. This allows it to expand and adapt to the rapid growth of the brain for the first three years of life, and as mentioned before, this also functions as a pumping mechanism for the baby’s CSF fluid. Misalignment of the sacrum and/or the upper neck and cranial bones also impedes the normal flow of CSF, causing nerve inflammation, increased pressure in the spinal canal and skull, and greater risk of damage to the brain and nerve tissues.

The brain grows 2.5 to 3 times its birth size in the first year of life, with 90% of the neurological development and synaptic connections completed by the age of six. During the first year of life, each cortical neuron develops 1,000-10,000 connections with other neurons. It sounds hard to believe, but the baby’s developing brain makes almost 9,000 new synaptic connections per second during the first year of life!

There is a covering on most of the major spinal tracts and the cerebrum called a myelin sheath made up mostly of protein and fat. This covering allows the nerve impulse to travel. The nerves of an infant are “naked” and just starting to form this myelin. This is why his motions are awkward and uncoordinated. This is also why those actions become much more purposeful and controlled as he matures.

Partial myelination is completed by the end of the second year of postnatal life, while full myelination is completed after the tenth year. Compression on the brain or nerve pathway caused by bone, muscle, or dura tension, causes significant over-stimulation of the baby’s sensitive system.

Stunted or delayed development at any point in the development of the CNS (central nervous system) will have permanent and far-reaching effects on the functional outcome of the nervous system. By age 6, all of the motor and sensory functions we use as adults have been fully developed.

Damage at any stage prior to the preliminary development of these functions will cause compensatory patterns, that are either learned or naturally occurring, to allow us to interact with our environment to the best of our ability. If corrections are not made early in life, studies have shown that these children will function at a greatly reduced capacity later in life.

Dr. Upledger also speaks to this scenario in Applications of CranioSacral Therapy:

“If both sides of the occipital base (bottom of the skull) are severely compressed, it’s common to see colic; food regurgitation; esophageal reflux; respiratory difficulties, rapid heart rate; and compromised bowel function (constipation or diarrhea). There also may be spasm of the neck muscles. If left untreated, the situation may result in a hyperactive child syndrome and attention deficit disorder.”

Here’s another quote by Major De Jarnette—the founder of the chiropractic Sacral Occipital Technique.

“The only true subluxation you ever see must be in a child prior to the age of seven years. If this subluxation goes uncorrected, it becomes a primary source of stimulus through life, but the tombs of distortion, which form from one traumatic experience to the other, soon bury this primary subluxation under that ‘tomb of distortions.’ The subluxation that all of us worry about occurred some time between birth and the seventh year of life, and the remedy would of course be careful chiropractic care from birth through the seventh year of life.”

Childhood Conditions

A newborn suffering from increased intracranial pressure and abnormal CSF rhythm will often be “colicky,” uncomfortable, have abnormal digestion and excess gas, and have difficulty sleeping.

These children may show only minor symptoms in the first months of life, but later on at the age of 5-6, they often suffer from headaches, postural problems, or diffuse symptoms like sleep disorders, the inability to concentrate, difficulties with coordination, short-term memory loss, anxiety, and hyperactivity (overactive sympathetic nervous system) and lowered immunity.

Problems with nursing are often due to cranial misalignment; especially related to the TMJ (temporal-mandibular joint) or jaw. The inability to open the jaw fully, to turn the neck (due to vertebral misalignment), and/or pressure on the cranial nerves, which control the tongue and muscles for sucking, result in a frustrated baby and mom. Teething will also be much more difficult when the jaw and soft palate cannot expand normally.

Causes of Craniosacral Misalignment

The most common cause is birth!

The sutures and fontanels (soft spots) allow the bones of the cranium to overlap one another during the birth process as they compress while entering the birth canal. This process is called molding. In the event of a longer, more difficult labor, more pressure results in more molding.

Because the sacrum is the other largest structure in the bony skeleton, it also easily rotates out of alignment during birth. Both situations can occur even while the baby is developing in-utero if they are in a compromised position for an extended time.

The cranial bones should resume their normal appearance within one week after birth. Even if there isn’t noticeable physical asymmetry, there can still be misalignment and increased pressure of the internal structures. Craniosacral therapy can restore normal motion, alignment, and function for your healthy growing baby.

It sounds hard to believe, but the baby’s developing brain makes almost 9,000 new synaptic connections per second during the first year of life!

How is It Done?

Craniosacral therapy, as well as chiropractic care for children, is extremely gentle and is performed using acupressure, massage, light traction, and Activator (instrument) adjustments. There is no “twisting” or “popping” of the spine that is often associated with adult adjustments. Not all chiropractors are alike. Make sure to seek a chiropractor who has completed advanced pediatric and specific cranial training as well.

One last serious thought—What is your child’s health worth? What would you do to help your child avoid learning, social, and emotional challenges? It is truly an honor to care for your children. It is incredibly rewarding to see comfort return to a suffering baby (and very tired parents…) and to ultimately increase the lifelong health and potential of one human being who will affect many.