(A Three Part Series on the Philosophy, Science, and Art of Cranial Care) In Part 1 of this series, I discussed the importance of cranial motion and its effect on health. From affecting the master endocrine glands (setting up major biochemical imbalances in the body), to the disturbance of the neurological impulse, and the effects on the cranial nerve nuclei, cranial conditions can dramatically alter body function. From strokes to seizures, allergies to endocrine disorders, cranial conditions can have far reaching effects. Causes of cranial conditions vary, but they may be a result of: The birth process Injuries or traumas to the head, jaw, and face Dental conditions Mental emotional stress Nutritional deficiencies and Any spinal/sacroiliac subluxa- tion Regardless of the cause, the treatment of cranial conditions begins with an examination of the patient to determine or evaluate cranial faults. So, let's begin by examining the most important patient you have, "YOU". In Part 1, we provided some guidelines for evaluating the cranium. We said that the first thing a doctor must do is simply TO OBSERVE the patient. So, doctors, look in the mirror and tell me what you see. I mean, really look at the symmetry of your face, skull, and anterior cervical spine. This is not a beauty contest, this is an examination that, if you do not perform on yourself, you are going to be one sorry doctor. So, look at the structure of your cranium. What do you see? Use the the following test to evaluate yourself: Test to Assess Cranial Distortions. If you answer Yes to, at least, ten of the questions below, you probably suffer from major cranial faults. Check for folds, furrows, and skin wrinkles that only appear on one side of you face; do you have any? Does one eye appear larger/smaller then the other? Does your nose or jaw deviate to the left or the right? Does your jaw neckline look symmetrical? Does one cheek look higher/lower or more/less prominent then the other? When you smile, is your smile symmetrical or is it lopsided? Does you skull tip inferior or anterior on one side? How about the skull? Does your forehead appear more prominent on one side then the other? How about your skin? Does it look youthless, rather than youthful? Do you feel sharp mentally, or have you seen better days? Can you concentrate, focus, and figure things out easily? Do you have energy or weight loss problems? Do you suffer from headaches, facial pain, or problems with equilibrium? How about digestive, allergy, or immune weaknesses? Did you ever have braces, recon structive dental work (bridges, crowns, implants)? Do you suffer from, or are you on any medications for, depression, anxiety, etc. l~~l Do you suffer from any condition affecting your sense of smell, taste, or hearing? Do you have a problem with your eyesight? Do you clench your teeth often? I 1 Were you a forceps baby? Or a difficult delivery? So. how did you score? If you said yes to at least 10 or more questions or, in some cases, only 5 questions, then it would behoove you to seek a cran-iopath. The next step is to examine your immediate family. Listen, if your parents are still alive, then you may save them and youself from a CVA, or senility. Or, it might be your lovely spouse or significant other that you save from being plagued with headaches, allergies, or endocrine and digestive disturbances. Or your children, from suffering with sinus problems, headaches or seizures. Whoever they are, they need your help, and you better deliver, because there is nothing worse then sickness and disease in your own household, and your not being able to stop it. What a hopeless feeling that is. Now that you have a few candidates from your immediate family, or yourself, palpation is the next step. With the patient, or yourself, in a supine position, palpate with the pads of your fingertips the following sutures and landmarks of the cranium. Frontal Parietal (Coronal) Suture Parietal Parietal (Saggital) Suture Frontal Sphenoidal Suture Squamosal Suture (Suture between the temporal and parietal bones) Occipito Parietal (Lambdoidal) Suture Sphenotemporal Suture It would be helpful for you to take out an anatomy book that diagrams these sutures and landmarks as you palpate. You could also purchase a plastic/live skull and palpate sutures on the model/live skulls, since the sutures feel very much like those of a patient. The following landmarks are also essential to palpate: Pterion: the point where the frontal, parietal, sphenoid and temporal bones articulate with one another. This point bellows out when you clench your jaw. Asterion: where the temporal, occiput and parietal bones articu late with one another. Bregma: where the frontal bone and the two parietals articulate with one another. Lambda: where the occiput and two parietals articulate. Inion: the external occipital pro- tuberance. into which the ligamen- turn nuchac attaches. When palpating sutures, palpate with the tips of your lingers, hands relaxed with you and the patient in a comfortable position. Gently palpate each suture. At'first you may not even be on the suture line but, eventually, each will be found; so. be patient. Note sutures that are painful to the patient. How do they feel? Does the suture feel swollen? Does the surrounding tissue feel taut and tight? Does it feel stringy? Does the suture feel compressed, ridged, or does it feel separated? Feel with your fingers, be patient and practice, while always visualizing in your mind. Now. determine which sutures meet the above criteria, and follow these simple steps on cervical cranial sutural release. THE CERVICAL CRANIAL SUTURAL PROCEDURE Please note that all pelvic problems must be stabilized first. Cervical Techniques With the patient's head turned to the right, take your right hand, using a flat hand contact: contact the left temporal, parietal, frontal area. Now, using your left hand, encircle the anterior transverse processes on the right, as your left thumb tip contacts the left cervical area. Check from Cl-C7. from spinous process (ligamentum nuchae) to the transverse process for taught and tender areas. Please note that the fingers of your left hand should be in contact with the anterior transverse process tips of C1-C7, based on the level you are palpating. Goad and manipulate all sensitive neuromuscular junctions. Also, palpate, especially, around the suboccipital. atlanto-axial, and atlanto-occipital areas. Repeat on the opposite side. Now, with the head in a neutral position, palpate the lateral and anterior cervical musculature. To expose the right anterior, and lateral musculature and, also, to challenge the tissues, have the patient turn his/her head to the left, and vice versa. Then, work all lateral, and anterior cervical muscles, especially, the hyoid musculature. At this point, you are ready to unravel the trapezius. With the patient's head in the center, make a bilateral four-finger contact to the sides of the SP'S from T2-C5. Palpate for pain, and tightness. When found, deeply massage the muscles in a circular fashion, until they are completely relaxed. Now. traction the occiput with a 4 finger contact to the suboccipital ridge, pulling superiorly on inspiration/exhalation for 4-5 respiratory cycles. These cervical areas should be checked with the patient in the seated position, as well. In this case you would sit or stand behind the seated patient, working any of the cervical musculature that was nodulated, stringy, painful or spastic. Encircling the frontal bone with your indifferent hand may be required for support. Once these are complete, you can now advance to any area in the cervical spine requiring spinal manipulation. Now, you are ready for the sutural stretch technique. Sutural Stretch Technique The purpose of this technique is to release any muscular stress causing sutural duress. When stretching the sutures on the left, rotate the patient's head to the right. Contact the patient's left mastoid furrow with your left thenar pad. With your right hand, using your right thenar, palm, finger tips, and pads, stretch all the sutures on the left side of the cranium such as the coronal, squamosal. occipital mastoid, spheno-temporal, parieto-occipital, frontal and zygomatical sutures. Also, palpate and stretch the major muscles such as the temporalis, frontalis, occipitalis and auricularis muscles. Repeat on the opposite side. Once this is complete you are ready to utilize the sutural correction technique Sutural Correction Technique The purpose of this technique is to find any painful suture that still exists, bilaterally. For example, if the coronal suture was painful on the left, you contact both the left and right coronal sutures with the same number of fingers at the same locations, bilaterally. Hold the contact with 3-5 pounds of pressure, and instruct the patient, or yourself, to breathe in and, then, exhale deeply through the nose, not the mouth. After 5-8 respiratory cycles, the patient should experience less pain, and your palpation should yield less sutural duress. If there are no changes, try again and, then, move on to the next painful suture, and the next, until all are covered. Then, go back to the sutures that you could not correct and try to release them once more. There you have it. The total process should take less then 10 minutes, depending on the severity and chronicity of the cranial condition. Cranial correction is the same as spinal correction; it may take 15-20 visits or more, depending on the case. In Part 3. I will discuss advanced cranial techniques that utilize cranial motion, and CSF fluctuation to correct cranial faults; also, temporo-mandibular joint dysfunction, and its effect on the cranial sacral mechanism. I will also give you the procedural codes that make it worth your time to perform this specialized technique. Until then may your health, family, practice and Finances nourish. Dr. James Cima has been teaching, and writing on this subject for 20 years. Dr. Cima also teaches seminars and has created a software package for the doctors to help them assess their patients' needs. For more information, call toll free 1-877-627-2770 or fax 561-624-3871, or e-mail Dr. Cima at [email protected]. o
