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Articles and Research

A Summary of research that supports the existence of the CranioSacral System and the use of Cranial Osteopathy/ Sacral therapy

Four researchers, Frymann (1971), Michael and Retzlaff (1975), and Moskalenko (1980,'96,'98) have all shown that the cranial bones do, indeed, move.

  • Frymann measured skull diameters on living human subjects and showed that the cranial bones exhibit a rhythmic mobility that is different from the breathing rate.

    • (Frymann, V.M. "A Study of the Rhythmic Motions of the Living Cranium", JAOA, Vol. 70, 1971, 928-945.)

  • Michael and Retzlaff measured the cranial bone motion of squirrels. Their findings showed cranial bone motion with a rate of 5-7 cycles/minute that did not corresponded to heart rate or changes in venous pressure.

    • (Michael, D.K., & Retzlaff, E.W., "A Preliminary Study of Cranial Bone Movement in the Squirrel Monkey", JAOA, Vol. 74, 1975, 860-864.)

  • Moskalenko used computer analysis of various physiological measurements to show cranial bone "fluctuations" of 6-14 cycles/minute.

    • (Moskalenko, Y., "Bioengineering Support of the Cranial Osteopathic Treatment", Medical and Biological Engineering and Computing, Vol. 34, Supplement 1, Part 2, 1996, 185-186.)

  • A fifth and sixth researcher, Heifetz and Weiss decided to temporarily increase the pressure inside the heads of two comatose patients. They injected solution into the brain and showing that the cranial bones move and spreading apart in response to the rising internal pressure.

    • (Heifetz, M.D., & Weiss, M., "Detection of Skull Expansion with Increased Intracranial Pressure", Journal of Neurosurgery, Vol. 55, 1981, 811-812.)

"While I was lecturing to the hospital staff in Haifa Israel, it was brought to my attention that by proving cranial sutures are not calcified, we had "reinvented the wheel." I was shown pages 202 and 203, Volume 1, in Anatomica Humana, 1931, written by Professor Guiseppi Sperino. He stated that cranial sutures only calcify before death under pathological circumstances. Apparently, Italian and British anatomists have a long-standing disagreement over this issue." Comments by DR John E.Upledger, D.O., FAAO.

Further research to confirm cranial bone motion:

  • Oleski and Smith measured pre- and post-treatment changes in cranial bone position utilizing x-ray technology. The percentage of subjects with identifiable changes are:

    • 66.6% with the mastoid process

    • 91.6 % for the atlas, sphenoid and temporal bones.

Oleski SL, Smith GH, Crow WT. Radiographic evidence of cranial bone mobility. J Craniomandib Pract. 2002;20(1):34-38.

  • X-ray studies of the relationships between the sphenoid body and the basiocciput were done on 25 patients by Dr. Greenman. He was able to show abnormal relationships between these bones that demonstrated the lesions defined by Sutherland as flexion, extension, torsion, sidebending, vertical strain and lateral strain. No correlation was attempted with clinical symptoms. Therefore, the x-ray findings could represent anatomical variants as well as abnormal findings.

Philip E. Greenman, Roentgen Findings in the CranioSacral Mechanism, D.O. Journal of the American Osteopathic Association, 70:1, September 1970

  • Dr. Thomas applied strain gauges across the surgically exposed sagittal sutures in living cats. He recorded rhythmic motion across the sutures with the cats at rest that differed from cardiovascular and respiratory activity. Externally applied stimuli did not significantly change the sutural activity. The rates of sutural movement averaged 11 cycles per minute.

Parietal Bone Mobility in the Anesthetized Cat, Thomas Adams, Ph.D., et al., Journal of the American Osteopathic Association, Volume 92, Number 5, May 1992

  • Dr. Gilmore performed the Upledger-designed 10-Step CranioSacral Therapy Protocol on 20 learning disabled children once weekly for six weeks. She reports that all 20 learning-disabled children improved from below average to either average or good in their reading skills over the six-week period.


Norma J. Gilmore, Ed.D., Right Brain, Left Brain Asymmetry, ACLD Newsbriefs, July-August 1982
Space Research
Assessment of cranial bone motion carried out by the Russian cosmonaut programs used various types of radiographic (x-ray) and ultrasound equipment. Moskalenko and associates carried out several studies which illustrated cranial bone motion:

  • Moskalenko demonstrated, via NMR tomograms, cranial bone motion between 380 microns to 1 mm, and cranial cavity volume increases by 12-15 mL, with a rhythmicity of 6-14 cycles per minute.

Moskalenko YE, Kravchenko TI, Gaidar BV, et al. Periodic mobility of cranial bones in humans. Human Physiology. 1999;25(1):51-58.
In the mid-1990s NASA carried out research and developed an ultrasound device using pulse-phase locked loop (PPLL) technology with sensitivity to 0.1 m, to more precisely assess intracranial anatomy and physiology.

  • Ballard,et al.carried out a study on two fresh cadavers. Saline was manually pumped into the internal spaces of the brain (ventricles) at a rate of one cycle per second, increasing the Intra-Cranial Pressure (ICP) by 15 mm Hg, and expanding the skull 0.929 mm. These findings were interpreted by the authors as similar to those found by Heisey and Adams, Hiefetz and Weiss, and Frymann.

Ballard RE, Wilson M, Hargens AR, et al. Noninvasive measurement of intracranial volume and pressure using ultrasound. American Institute of Aeronautics and Astronautics Life Sciences and Space Medicine Conference. Book of Abstracts, pp. 76-77, Houston, TX, 3-6 March 1996.
In their summary, the NASA research team stated, "Although the skull is often assumed to be a rigid container with a constant volume, many researchers have demonstrated that the skull moves on the order of a few m in association with changes in intracranial pressure."
Ueno T, Ballard RE, Cantrell JH, et al. Noninvasive estimation of pulsatile intracranial pressure using ultrasound. NASA Technical Memorandum 112195. 1996.
Studies to demonstrate the success of Cranial treatment.

  • A Standardized Craniosacral examination was conducted in a mixed sample of 203 grade school children. The probabilities calculated supported the existence of a positive relationship between elevated total Craniosacral motion restriction scores and the classifications of "not normal", "behavioural problems" and "learning disabled", by school authorities, and of motion coordination problems. There was also a positive relationship between an elevated total Craniosacral motion restriction score and a history of an obstetrically complicated delivery. The total quantitative Craniosacral motion restriction score was most positively related to those children presenting with multiple problems.

Upledger, John E., D.O., FAAO., The relationship of Craniosacral examination findings in grade school children with developmental problems. JAOA Vol 77 pp. 738-54, June 1978.

  • Multiple studies have demonstrated the successful treatment of Otitis Media with cranial osteopathic treatment. These studies showed improvement in health as measured by fewer ear tubes, improved tympanography (a measure of the movement of the ear drum and existence of fluid in the ear), and a significant reduction of the need for antibiotics in children suffering from recurrent ear infections (otitis media). "No adverse reactions were reported" in the study.

The article concluded that: "The results of this study suggest a potential benefit of osteopathic manipulative treatment as adjuvant [in addition to routine pediatric care] therapy in children with recurrent AOM [acute otitis media]; it may prevent or decrease surgical intervention or antibiotic overuse."

    • Mills MV, Henley CE, Barnes LLB, et al. The use of osteopathic manipulative treatment as adjuvant therapy in children with recurrent acute otitis media. Archives of Pediatrics & Adolescent Medicine. 2003;157:861-866.

    • Steele KM, Kukulka G, Ilker CL. Effect of osteopathic manipulative treatment on childhood otitis media outcomes. Poster presented at the American Osteopathic Association 102 Annual Meeting and Scientific Seminar 1997 (Oct) grant # 94-12-400.

    • Degenhardt BF, Kuchera ML. Osteopathic evaluation and manipulative treatment in reducing the morbidity of otitis media: a pilot study. J Amer Osteopath Assoc. 2006;106:327-34.

  • Dr. Frymann further demonstrated the benefit of cranial osteopathic treatment for children with learning problems, children with neurological deficits, and seizure disorders.

    • Frymann VM. Learning difficulties of children viewed in the light of the osteopathic concept. J Am Osteopath Assoc. 1976;76:46-61.

    • Frymann VM, Carney RE, Springall P. Effect of osteopathic medical management on neurologic development in children. J Am Osteopath Assoc. 1992;92:729-744.

    • Frymann VM. The osteopathic approach to the child with a seizure disorder. In King HH. (Ed) Proceedings of international research conference: Osteopathy in Pediatrics at the Osteopathic Center for Children in San Diego, CA 2002. American Academy of Osteopathy, Indianapolis, IN, 2005;89-96.

  • Dr. Frymann evaluated 1,250 newborn infants, focusing on Craniosacral system function. She found that both respiratory and circulatory symptoms correlated to abnormal sphenobasilar synchondrosis torsion accompanied by temporal bone dysfunction and immobility. Frymann states that symptoms abated when CranioSacral Therapy was used to correct the sphenobasilar torsion, and mobilize and balance the temporal bones.

Viola M. Frymann, D.O., Relation of Disturbances of CranioSacral Mechanisms to Symptomatology of Newborns: Study of 1250 Infants, Journal of the American Osteopathic Association/, Volume 65, June 1966

  • The cranial osteopathic treatment of respiratory conditions such as asthma, pneumonia, bronchiolitis, and newborn diaphragm restrictions are described in the chapter on General Pediatrics in the Foundations for Osteopathic Medicine. The authors discuss the applications of cranial osteopathic treatment in gastrointestinal disorders such as colic, gastroesphageal-reflux (GERD), constipation, and diarrhea.

Centers S, Morelli MA, Vallad-Hix C, Seffinger M. General Pediatrics. In Ward RC (Ed.) Foundations for osteopathic medicine, 2/e. Philadelphia; Lippincott, Williams & Wilkins, 2002:305-326.

  • Treating Post Traumatic Stress Disorder in combat soldiers

The Upledger Institute has provided two week intensive treatment for Vietnam veterans suffering from Post Traumatic Stress Disorders diagnosed by the Veteran's Affairs (VA) medical division. These patients received psychological evaluation tests at the times of entry and exit into and out of the program. The intensive treatment was about six-seven hours per day for eight full days, with approximately three-four hours on the first and last days of the program. Patients were initially tested using the Mississippi scale for combat related PTSD, Trauma Symptom Inventory, Quality of Life Questionnaire, Brief Symptom Inventory and Beck Hopelessness Scale as methods for evaluation of trauma. The participants showed the following results obsessive compulsive scores dropped from 86th percentile to 46th, depression from 69th to 27th, anxiety from 79th to 42nd, paranoia from 84th to 62nd. The results obtained strongly suggest that PTSD may be more successfully treated when the therapy includes corrections of the Craniosacral system. and conscious-non-conscious integration.
Upledger, John E., D.O., FAAO., The effects of CranioSacral Therapy on Post Traumatic Stress Disorder symptomology in Vietnam combat veterans. Subtle Energies & Energy Medicine, vol 11, No 2 pp. 123 - 143, April 2000

Since teeth reside within cranial bones and are involved in cranial motion, it is not surprising that cranial osteopathic treatment has been successfully applied in the treatment of dental conditions.

  • Magoun provides several case studies and specific techniques for cranial osteopathic treatment treatment of individuals whose cranial strains involve dental considerations.

    • Magoun HI. Osteopathic approach to dental enigmas. J Am Osteopath Assoc. 1962;62:34-42.

    • Magoun HI. Dental equilibration and osteopathy. J Am Osteopath Assoc. 1975;74:115-125.

    • Magoun HI. The dental search for a common denominator in craniocervical pain and dysfunction. J Am Osteopath Assoc. 1979;78:83-88.

  • Lay continued work in the dental sphere, providing more case studies involving temporal-mandibular joint (TMJ) dysfunction.

    • Lay EM. The osteopathic management of tempormandibular joint dysfunction. In Gelb H. (Ed.) Clinical management of head, neck and TMJ pain and dysfunction; a multidisciplinary approach to diagnosis and treatment. Philadelphia; W.B. Saunders Co, 1985.

  • Baker demonstrated widening of the dental arch of patients receiving cranial osteopathic treatment. Models of upper teeth over a six month period showed overall widening of 0.7 mm between molar teeth. It is common in the practice of orthodontics to move the upper molars up to 2 mm by dental appliances. However, in cases reported by Baker, the changes were brought about only by cranial osteopathic treatment.

    • Baker EG. Alteration in width of maxillary arch and its relation to sutural movement of cranial bones. J Am Osteopath Assoc. 1971;70:559-564.

  • Treatment with cranial osteopathic treatment has been effective in helping normalize function of both the nervous and vascular systems.

  • Huard demonstrates that the "Venous Sinus Technique" (VST) helps restore optimal intracranial blood flow in the area of the cranial base (base of skull). The VST is a commonly applied procedure used in the treatment of congestive headaches and sinus congestion. Huard applied the VST to 39 subjects, with 39 others receiving light touch only, and another group of 39 subjects received no touch at all. Ultrasound technology was used to measure and record blood flow.

    • Huard Y. Influence of the venous sinus technique on cranial hemodynamics. In King HH. (Ed.) Proceedings of international research conference: Osteopathy in Pediatrics at the Osteopathic Center for Children in San Diego, CA 2002. Indianapolis, IN; American Academy of Osteopathy, 2005:32-36.

  • Treatment for Back Pain Sufferers

A study in the New England Journal of Medicine in 1999 compared Osteopathic spinal manipulation with standard care for patients with low back pain. The "osteopathic-treatment group required significantly less medication (analgesics, antiinflammatory agents, and muscle relaxants) and used less physical therapy." The "differences in cost were significant."

This article concludes that: "Given the known and potentially serious adverse effects and costs or nonsteroidal antiinflammatory drug therapy, the achievement of equal outcomes in regard to pain relief, function, and satisfaction, with less use of medication and physical therapy, suggests an important benefit of osteopathic manipulative treatment; this type of treatment deserves careful examination through a formal cost-benefit analysis."
Anderson, Gunnar B.J. et al., "A comparison of Osteopathic Spinal Manipulation with Standard Care for Patients with Low Back Pain," The New England Journal of Medicine, 1999; 341: 1426-1431.

  • Treatment for Children With Spastic Cerebral Palsy

A study published in the journal of Clinical Pediatrics in 2004 compared parental perceptions of 23 children, diagnosed with cerebral palsy, who were treated by osteopathic manipulation as compared to 19 children who were not (the control group). Over a twenty-four week course of therapy, "twenty-one of the 23 parents of the children in the osteopathic group reported improvement in their child during the course of the therapies."

Osteopathic treated group, specific parental comments:

  • "Improved 'dramatically' with walking, runs without holding onto furniture-age 32 months."

  • "Stood for the first time, climbs everywhere-age 34 months."

  • "Running for the first time; chases boys; very coordinated; kicked ball for first time-age 8 years."

  • "No surgery on his hips 'The orthopedist was stunned'-age 12 years."

  • "Able to use skateboard for the first time-age 12 years."

In the control group, however, only 2 of 17 parents reported "general but nonspecific improvement" in any area. "One child reported improvement in speech and in mood and the other reported improvement just in mood." On the other hand, "five children in the control group reported worsening of mood."

Duncan, B. et al., "Parental Perceptions of the Therapeutic Effect from Osteopathic Manipulation or Acupuncture in Children with Spastic Cerebral Palsy," Clinical Pediatrics, May 2004; 349-353

Study shows craniosacral therapy increasingly used by elderly

Web article about CranioSacral therapy

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