Originally published in Body Sense magazine, Spring/Summer 2005.
Copyright 2005. Associated Bodywork and Massage Professionals. All rights reserved.
The beautiful, 18-month-old child named Emma stood in front of me. Her piercing blue eyes held mine in an unblinking stare as she took my hands and placed them on her head. She was telling me to treat her.
Following her wishes, I gently cradled the sides of her head, felt the movement of the bones, and followed their lead. As her cranial bones reorganized themselves, Emma stood and held my gaze. When her skull balanced, she took a deep breath, grinned, and stepped over and hugged her mom, Kristen, who was sitting on the floor with me.
What was I doing to Emma's skull? It's a type of bodywork called craniosacral therapy, an osteopathic discipline now practiced by many bodyworkers. The name refers to the manual approach of evaluating and treating the mobility of bones in the skull and pelvis. While a beneficial therapy for those of any age, craniosacral work seems to be especially beneficial for children.
As is often the case, Emma's mom was my client first. During a session with Kristen, I had asked how her daughter was doing. "Fine," she said. "She's got the language skills of a 22-month-old and the energy of five people. By the way, she's had two ear infections in her first year. Is there anything you can do to help that?"
"Probably," I said. "At least I'd like to check her. I remember your description of her birth. Wasn't there a problem?"
I listened as Kristen recounted the final stages of Emma's birth. She was stuck in the birth canal, and the doctor tried suction. When that didn't work, he had to push the baby back into her mother's uterus and deliver her via C-section. She scored perfectly on her newborn tests, and she's been healthy, except for the ear infections.
The fact there was some difficulty during Emma's birth was enough reason to check her head, but the ear infections were a strong clue that the bones in her skull might not be properly aligned. Sure enough, when I checked, there was a bulge in her skull that matched the location of the suction device. With everyone's consent, we set out on a course of therapy that would change this little girl's well-being.The Cranium and Its Parts
The cranium, or skull, is made up of 22 separate bones. Eight of these bones form the vault that holds the brain. The other 14 bones create the skeletal framework for the face and jaw. The sinuses, eyes, nose, and internal ears are all contained and protected within these bones.
The belief that the cranial bones grow together as we age is a common misconception. In fact, barring some trauma or rare condition, these bones continue to move throughout life. Not only can they move, but ideally they should move in a rhythmic fashion.
We have many rhythms within our bodies. Our heartbeat and breath are two such rhythms. In treating the mobility of the cranial bones, craniosacral therapists work with another, lesser-known rhythm -- one that is produced by the pump in the vault of the skull. The Cranial Pump
The brain and spinal cord float in a fluid similar in chemical content and thickness to blood plasma. This cerebrospinal fluid (CSF) acts as a cushion for the central nervous system. It feeds the brain with nutrients and helps it eliminate waste. Because CSF fills the container from the brain down the spinal canal (the tube holding the spinal cord) to the tailbone, it needs to be circulated. Our bodies have an ingenious way of doing this.
The entire cranial vault and spinal canal are lined with a flexible, strong sack called the dura. This sack is the container for the CSF. As CSF is produced in small cavities in the brain, called ventricles, pressure builds and causes the dural sack to stretch. When the dura is stretched to a specific point, a signal is sent to the brain to stop making fluid, and at the same time, the blood vessels in the cranial vault are told to absorb fluid. When the stretch reduces, another signal tells the brain to make more fluid, and the cycle starts again. When a therapist places her hands on a client's head, she feels a subtle expansion followed by a return, almost as if the head is breathing, but in a much slower rhythm than the respiratory response.Craniosacral Technique
Craniosacral therapists evaluate and help establish normal cranial rhythm and in so doing, balance and align the cranial bones and the sacrum. A trained therapist can detect the rhythm of the cranial pump and how each bone in the skull responds to this rhythm with its own specific movement pattern. She can tell when there's a problem with the balance and mobility of the bones. Treatment involves following the rhythm and encouraging the bones to align using very light pressures -- as little as five grams (basically the pressure of the weight of a nickel). The therapist provides an outside stimulus to assist the body's natural ability to regulate the cranial rhythm and the balance of the bones.Craniosacral Therapy for Children
While craniosacral therapy is beneficial for people of all ages, it's especially helpful for infants and children. And because it's so gentle in its application, infants and toddlers usually respond well.
In an ideal vaginal birth, a child's skull is compressed as it passes through the birth canal. This is a normal, healthy process. It's believed that this compression process actually stimulates the cranial pump and helps to mold the skull. Within 10 days, the baby's cranium becomes symmetrical and well-balanced.
But what about those births that are not "normal"? The caesarean-section delivery, while it may be the measure that reduces risk to both mother and baby, can actually alter the compression process that is so vital to creating balance in the cranial bones. Further, the sudden change in pressure caused during a C-section may actually prevent the cranial rhythm from reaching its full potential.
My client, Nancy, brought her 2-year-old son, David, in for an evaluation. She was concerned about the flat spot on the back left side of his head. He was getting frequent colds and displayed bouts of hyperactivity. His C-section delivery went smoothly, but he had moved little in utero. The doctor speculated that the flat spot was caused by the constant pressure on that area of his head. A vaginal delivery most likely would have created enough pressure to reshape his skull, but because birth circumstances required the
C-section, he was left with the asymmetry.
When I evaluated David, I found a sluggish craniosacral rhythm and several bones on the left side of his head that were still. Through a gentle remolding process over the course of five sessions, David's cranium changed significantly, he's had fewer colds, and he's a calmer, happier, 2-year-old.
Forceps or suction, while perhaps necessary aids during challenging vaginal deliveries, can place stresses on the cranium that may prevent it from normalizing. In my practice, I've seen many children with sinus and ear infections who have asymmetries in the cranium and impaired cranial rhythms -- many were delivered via suction or forceps.
I've been blessed to be able to treat many children during my bodywork career. I've also seen adults who have suffered from chronic headaches, earaches, and sinus infections since childhood. Invariably, when asked, these adults report having had some kind of birth trauma. Craniosacral therapy is effective for people of any age, but I'm finding the earlier I can work with children, the easier it is to help them. Often, it only takes two to three sessions to help them forgo years of problems.
And Emma? She's doing great. Her mom says she hasn't had an earache since we started working together. I'll be checking her again soon and, by then, she'll be 2 years old. I fully expect to hear her say: "Check my head, will you?" Cathy Ulrich, P.T., is a Colorado author and bodyworker with more than 20 years of experience in physical therapy (sports medicine and orthopedics), craniosacral therapy, myofascial release, Rolfing, Rolfing Movement Integration, and visceral manipulation. She can be contacted at firstname.lastname@example.org.