Craniopathy is the study of the musculoskeletal system of the skull and cerebrospinal fluid, CSF flow, as well as intracranial pressure, (ICP)and compliance in the brain and cord. Cranioathy was founded by Dr. Donald Sutherland, an osteopath. Osteopathy was founded in Kirksville, Missouri in 1865 by Andrew Taylor Still, a former civil war doctor.

Chiropractic was founded just downstream on the Mississippi from Kirksville, in Davenport, Iowa in 1895. It was founded by DD Palmer. Although some say he shared notes and ideas with Taylor and Sutherland the two disciplines remained distinct and never collaborated. Most osteopaths have since moved away from its founding principle and become more like medical doctors. How craniopathy ended up as a corrective discipline in chiropractic has many different stories, but chiropractors have a long history of using it. Today it is mostly practiced by chiropractors who practice Applied Kinesiology (AK) and Sacro Occipital Technique(SOT)which are different treatment methods within the chiropractic profession.

Craniosacral Primary Respiratory Rhythm

The primary premise of craniopathy is that there is a fundamental rhythm in the body called the craniosacral primary respiratory rhythm or CS-PRR that is important to the health of the brain and cord. The rhythm is composed of three sources of waves.

The first source of waves comes from the nervous system. The nervous system produces electrical waves which we measure with EEGs in the brain, ECG’s for the heart, and EMGs for skeletal muscles.

The second source of waves comes from the heart and respiration, which together create cardiorespiratory waves that are transmitted to the brain. The pumping of the heart and blood vessels create ripples in the water surrounding the arteries in the brain. Because of its pressure affect on the heart and blood vessels in the ribcage, respiration, increases the ripples in the arteries like wind on water.

Respiratory waves are further transmitted to the brain via vertebral veins in the spine called the VVP. The VVP is connected to the brain and like the cranial veins, the veins of the VVP have no valves.

The third source of waves comes from musculoskeletal forces. The first source of musculoskeletal stress comes from inhalation and exhalation via muscles which cause flexion and extension of the base of the skull and the rest of the spine including its base, the sacrum. Technically, the respiratory affect on motion in the axial skeleton is called nutation.

The accessory muscles of respiration pull down on the base of the skull causing a strain that bends it downward in the direction of flexion. Respiration also causes the ribs to lift and the ribcage to expand. In addition, it causes the thoracic spine to straighten.

Respiration also causes the diaphragm to plunge downward pushing the abdominal organs deeper into the pelvis. The downward movement of the organs and the change in the throacic spine causes the lumbar spine to straighten and the sacrum of the pelvis to move into more of a flexion position. Exhalation relaxes the strain and reverses the above. This cycle continues with every breath throughout life.

As a child matures additional muculoskeletal stresses come from holding the head upright, chewing, standing and walking. Bipedal motion causes fluid shifts in the cranial veins which again have no valves.

Upright MR angiograms continue to confirm Dr. Sutherland’s theory of the craniosacral primary respiratory rhythm. Radiologists refer to the respiratory waves in the brain as B waves or volume waves. Because the vertebral veins, which have no valves, transmit respiratory waves to the brain it causes cerebrospinal fluid (CSF) pressure in the brain (and cord) to rise and fall. In other words, brain pressure goes up and down with each breath. The brain beats just like the heart. In radiology it’s called compliance. Compliance is a good thing in the brain. It helps move things along.

Craniopathic Correction of the Base of the Skull

The goal of craniopathy is to restore balance in the musculoskeletal system of the skull by reducing mechanical strains. It is believed that by removing hindrances and restoring mechanical cranial function CSF flow is restored to normal as well. Craniopaths use a large variety of hand techniques to work the skull. The adjustive techniques use the facial zone, the cranial vault, and the base of the skull.

Sutherland successfully used cranial molding on children with craniosynostosis type deformations. Cranial molding is easy to accomplish in infants and young children while the sutures are still open.

Humans are susceptible to certain design flaws in the base of the skull that can cause the brain to get compressed and squeezed down into the foramen magnum. This is called an Arnold-Chiari malformation. The child below died of SIDs due to cranial deformation.

Of all the moves in craniopathy the most fundamental is the sphenobasilar release. Other important maneuvers involve the atlanto-occipital joint known as the AO joint in chiropractic parlance.

Craniopathic Circulatory Techniques

Additionally, crainopathy includes circulatory techniques to improve venous drainage in the brain. The basic theory of the craniosacral primary respiratory rhythm and the corrective maneuvers and circulatory techniques of craniopathy are all very intersting in light of our current understanding of CCSVI. Brain scans continue to confirm long held craniopathic concepts. Upright MR angiograms and venograms are further confirming those tenets.