Level 1 Workshop The 14-Step Protocol for Facilitated Self-Correction

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1 Level 1 Workshop The 14-Step Protocol for Facilitated Self-Correction A Rick Vrenios Seminar

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ectively provide a full Craniosacral Therapy session. History & Development of Craniosacral Therapy The father of Craniosacral Therapy is considered to be Dr. William Sutherland.

3 Welcome! Course Objective In this 12-hour intensive, we are going to learn the essential principles, techniques, anatomy and physiology necessary to support the extensive hands-on learning to safely and eff ectively provide a full Craniosacral Therapy session. History & Development of Craniosacral Therapy The father of Craniosacral Therapy is considered to be Dr. William Sutherland. In its early stages, CST was considered to be in the domain of Osteopathic and Chiropractic Medicine. * Commonly accepted in the medical community was the idea that the bones of the cranium were fused and immobile. * In 1929, Dr. William Sutherland fi rst introduced his fi ndings that there was a rhythmic motion in the body that changed the shape of the head. This remains a highly controversial concept. * Core to Sutherland s work was the assumption that the bones of the skull were moveable, and the Sphenoid bone was the cornerstone of the system. The movement within the system was palpable by trained hands. He called this motion, Primary Respiration * Sutherland researched a theory that immobility in the joints between the plates of the cranium would produce a variety of negative physical, mental, and emotional conditions, using a specialized helmet while his wife observed his behaviors and took notes. * In the 1970 s, researchers from Michigan State University s College of Osteopathic Medicine continued Sutherland s research and off ered additional discoveries, including: > Evidence showing movement between the cranial bones was in fact possible. > The Cerebrospinal Fluid is the driving force in the nourishment and function of the brain and spinal tissue. * Dr. John Upledger was a part of the Michigan State Research Team noticed that the tiny movement of CSF through the system was a persistant fl ow from the cranial vault, down the spinal column, and back to the cranial vault. * Craniosacral Therapy is now practiced world-wide as subtle, yet highly eff ective modality that relieves the symptoms of many health conditions from headaches to autism. 1

4 Benefits & Contraindications Benefits / Applications of Craniosacral Therapy Craniosacral Therapy (CST) uses gentle touch to evaluate and enhance the functioning of the Central Nervous System (and therefore, the entire body) by releasing restrictions within the system. CST works in partnership with the client s body and its innate healing wisdom by encouraging the body to fi nd its path to self-correction. In more advanced training, we learn to utilize more direct interventions for those cases in which the body is unable to self-correct. According to Dr. John Upledger, CST can be an eff ective complimentary therapy for a wide variety of medical problems: > Migraine Headaches > Chronic Neck and Back Pain > Motor-Coordination Impairments > Colic > Autism > Central Nervous System Disorders > Orthopedic Problems > Traumatic Brain and Spinal Cord Injuries > Scoliosis > Infantile Disorders > Learning Disabilities > Chronic Fatigue Syndrome > Emotional Diffi culties > Stress and Tension-Related Problems > Fibromyalgia & other Connective-Tissue Disorders > Temporomandibular Joint Syndrome > Neurovascular or Immune Disorders > Post-Traumatic Stress Disorder (PTSD) > Post-Surgical Dysfunction > General Pain > Slipped Disks in the Spine > Dizziness / Vertigo > Irritable Bowel Syndrome/Digestive Problems > Depression Contraindications for Craniosacral Therapy There are very few conditions in which CST is not recommended. > Accute intercranial hemorrhage (stroke) > Intracranial aneurysm > Recent skull, spinal, or rib fracture (caution) > Recent Concussion > Herniation of the medulla oblongata > Caution for Spina Bifi da (no O/A release) > Pregnancy in the third trimester (can induce labor) > Recent spinal tap (confi rm no leakage) > Recent cranial, pelvic or spinal surgery (caution) The therapy has little, if any, serious, irreversible or long lasting side eff ects (Upledger). However, it is best to avoid any condition in which a slight change in cranial pressure may worsen the client s condition. When in doubt, don t 2

Heart Rate: Where can you feel the heart beat? Respiration: Where can you feel the respiration?

5 Finding the Rhythm Sinking Through the Many Body Rhythms The physical body has several innate rhythms and each has its own loudness and tempo. Key: The key to fi nding the subtle rhythm of the CSF is fi nd and connect with the loudest, fastest rhythms and then look for the next deeper layer and the next. Heart Rate: Where can you feel the heart beat? Respiration: Where can you feel the respiration? THINK ABOUT THIS: Each rhythm can be felt throughout the body because of its infl uence on the fascial layer. Finding CSF Rhythm: To fi nd the CSF rhythm, we want to sink deeper into a movement that is even slower than respiration. As the fl uid fl ows into the cranial vault, the slight pressure change creates an expansion. This is called FLEXION. As the fl uid fl ows away from the cranial vault toward the sacrum, the pressure change allows for a contraction. This is called EXTENSION. Flexion and extension are relative to your position. Practice: Find it on yourself! Practice: Find it on a partner at the Head using the CV4 hand position shown in the pictures to the right (also try the alternate hand position). Practice: Find the rhythm in the lateral and medial rotation of the feet. Why do the feet rotate with the movement of CSF? 3

6 Cerebrospinal System Anatomy Cerebrospinal System The system includes: - Cranium - Brain - Dura Mater - Pia Mater - Dural Tube - Spinal Cord - Spine and the sacrum - Cerebrospinal Fluid Layers of Tissue Around the Brain Cerebrospinal Fluid CSF is clear, colorless ﬂuid that bathes the entire surface of the central nervous system. CSF is contained within a system of cavities in the brain called ventricles. Healthy ﬂuid volume: ml (4-5 oz) total. CSF ﬂows between the brain and sacrum and back at 6-12 cycles per minute. 4

Cerebrospinal Fluid Functions of Cerebrospinal Fluid Protection Buoyancy Excretion of Waste Products Endocrine Medium for the Brain Production of CSF CSF is produced mainly by a structure called the

The third ventricle and fourth ventricle are connected to each other by the cerebral aqueduct (also called the Aqueduct of Sylvius).

Total production of CSF is about 400-500 ml/day (about a pint).

7 Cerebrospinal Fluid Functions of Cerebrospinal Fluid Protection Buoyancy Excretion of Waste Products Endocrine Medium for the Brain Production of CSF CSF is produced mainly by a structure called the Choroid Plexus in the Lateral, Third and Fourth Ventricles. CSF ﬂows from the Lateral to the Third ventricle through the Foramen of Monro). The third ventricle and fourth ventricle are connected to each other by the cerebral aqueduct (also called the Aqueduct of Sylvius). CSF then ﬂows into the subarachnoid space through the foramina of Luschka (there are two of these) and the foramen of Magendie (only one of these). Total production of CSF is about ml/day (about a pint). CSF Absorption Absorption of the CSF into the blood stream takes place in the superior sagittal sinus through structures called arachnoid villi. When the CSF pressure is greater than the venous pressure, CSF will ﬂow into the blood stream. However, the arachnoid villi act as one way valves...if the CSF pressure is less than the venous pressure, the arachnoid villi will NOT let blood pass into the ventricular system. The ABCs of CSF As your sensitivity increases in perceiving the ﬂow of CSF, there are three essential factors to look for in the movement of the ﬂuid through the Cranialsacral System. A B C 5

The 4 Major Diaphragms Gateways or Restriction Points To better understand the technique, the Craniosacral System is the full extension from the cranium to the sacrum.

The Dural Tube is a the case that surrounds the spinal tissues through the vertebral column, and is the pathway for the ﬂow of Cerebral Spinal Fluid.

8 The 4 Major Diaphragms Gateways or Restriction Points To better understand the technique, the Craniosacral System is the full extension from the cranium to the sacrum. Restrictions anywhere along this path will have a negative inﬂuence on the function of the brain and the spinal tissues. The Dural Tube is a the case that surrounds the spinal tissues through the vertebral column, and is the pathway for the ﬂow of Cerebral Spinal Fluid. Along that pathway, from the cranium to the sacrum, there are four natural diaphragms that have a direct aﬀect on the ﬂow of CSF through the system. The ﬁrst half of the CST session is designed to release tension at these diaphragms so as to free any restrictions at the gateways through which the ﬂuid can move. Facilitated Self-Correction What does this mean? What do we look for to know self-correction is occurring or complete? How do we help facilitate this change with CST? 6

Step #1 - Establishing the Craniosacral Rhythm Applying the Proper Pressure Remember, we as facilitators assist the body in its need to correct what it cannot do for itself.

Light pressure is the key to successful work.

Step 1a - CV4 Position Step 1 oﬀer three major beneﬁts: a) Connect with, and evaluate the CSF Rhythm. b) Aid the client in relaxing more deeply.

The client s mastoid process rests on your thumbs to engage the 4th Ventricle (CV4). Look for the CSF Rhythm: 1) Amplitude: Does the ﬂow feel strong or weak?

9 Step #1 - Establishing the Craniosacral Rhythm Applying the Proper Pressure Remember, we as facilitators assist the body in its need to correct what it cannot do for itself. We do not want to be intrusive and we are focused in allowing the body to move as it will. Using heavy pressures will put the body in a defensive mode. Light pressure is the key to successful work. The type of pressure we will use throughout this etiquette is equivalent to approximately 5 grams, or the weight of a nickel on your ﬁnger. Step 1a - CV4 Position Step 1 oﬀer three major beneﬁts: a) Connect with, and evaluate the CSF Rhythm. b) Aid the client in relaxing more deeply. c) Potentially induce a Still Point in the system. Lay the ﬁngers of one hand over the ﬁngers of the other and bring the thumbs together. The client s mastoid process rests on your thumbs to engage the 4th Ventricle (CV4). Look for the CSF Rhythm: 1) Amplitude: Does the ﬂow feel strong or weak? 2) Balance: Does it feel equal on both sides? 3) Cycles: How many cycles per minute? 4) Quality: Does it feel smooth or rough? Step 1b - Evaluating the Feet PQ Cup the heels in your palms and allow the lateral sides of client s foot to lightly touch your forearms. As the sacrum enters into FLEXION, the feel will roll outward slightly. Check again to notice the Amplitude, Balance, Cycles, and Quality of the CSF Movement. It is possible for the qualities at the feet to be diﬀerent from those at the head! 7

Anterior Torso Realignment Step 2 - Pelvic Diaphragm The dural tube attaches inside the sacrum, making the sacrum a natural handle for the dural tube.

Lower Hand: Slides underneath the body and position it perpendicular to, and directly under, the sacrum.

Look for the CSF Rhythm: 1) Amplitude: Does the ﬂow feel strong or weak? 2) Balance: Does it feel equal on both sides?

5) Motion: Sliding, rotation, reversing, repelling, sinking, vibrating, pulsating, heat, etc.

The diaphragm is a muscle that splits the tension between the upper and lower segments of the tube.

10 Anterior Torso Realignment Step 2 - Pelvic Diaphragm The dural tube attaches inside the sacrum, making the sacrum a natural handle for the dural tube. This position is both for assessment of the state of health in this area, and it guides the body toward self-correction. Stand at the side of the table. Lower Hand: Slides underneath the body and position it perpendicular to, and directly under, the sacrum. Upper Hand: Place the pinky ﬁngers at the superior edge of the pubic bone (client can establish boundary with their hand). Look for the CSF Rhythm: 1) Amplitude: Does the ﬂow feel strong or weak? 2) Balance: Does it feel equal on both sides? 3) Cycles: How many cycles per minute? 4) Quality: Does it feel smooth or rough? 5) Motion: Sliding, rotation, reversing, repelling, sinking, vibrating, pulsating, heat, etc. Step 3 - Respiratory Diaphragm This point represents the middle of the dural tube. The diaphragm is a muscle that splits the tension between the upper and lower segments of the tube. From the side of the table: Lower Hand: Slides underneath the body and position it under the 12th Thoracic and the upper Lumbar Vertebrae. Upper Hand: Spread ﬁngers to make contact with the Xiphoid Process and the medial edge of the ribs. Look for the CSF Rhythm: 1) Amplitude: Does the ﬂow feel strong or weak? 2) Balance: Does it feel equal on both sides? 3) Cycles: How many cycles per minute? 4) Quality: Does it feel smooth or rough? 5) Motion: Sliding, rotation, reversing, repelling, sinking, etc. 8

Sacral Realignment Step 4a - Realigning the Sacrum There are three major steps to this process.

Standing at the side of the table, bend the client s knee (far side of the table).

Position your hand directly on the sacrum, then roll their body back down - their sacrum resting on your palm. Straighten the knee.

If the motion pulls to the right or left, is rough, is stuck, wobbles, this is a sign of dysfunction, and the next steps will help

Lower hand still under the sacrum, position your elbow into one hip bone and reach across to the opposite hip bone with your hand.

11 Sacral Realignment Step 4a - Realigning the Sacrum There are three major steps to this process. First is to position your lower hand underneath the sacrum. Standing at the side of the table, bend the client s knee (far side of the table). Grasp the client s hip to roll the body toward you. Position your hand directly on the sacrum, then roll their body back down - their sacrum resting on your palm. Straighten the knee. Feel for the CSF Rhythm here and motion of the sacrum. If the motion pulls to the right or left, is rough, is stuck, wobbles, this is a sign of dysfunction, and the next steps will help reset the motion. Step 4b - ASIS Compression This step compresses both ASIS to release the SI Joint and the sacrum. Lower hand still under the sacrum, position your elbow into one hip bone and reach across to the opposite hip bone with your hand. Gently squeeze between your elbow and palm to free the joint. You will feel the sacrum sink into your lower hand. 3 Step 4c - Sacral Release Lower hand stays under the sacrum. The upper hand slides under the lumbar area. The two hands make a T shape. Oﬀer gentle traction along the spine by pulling the sacrum down the lumbar spine upward. Gently release the tension and repeat. Step 4D - Release your upper hand, lean back to stretch the sacrum with one hand. 9

Upper Torso Realignment Step 5 - Thoracic Realignment Place the lower hand under the 7th cervical vertebrae and allow the palm to cradle the upper thoracic

Contact your palm with the upper chest and sense the movement here. Releasing tension here opens the ﬂow of blood to the brain.

LIGHTLY touch the hyoid bone with the upper hand s thumb on one side and a ﬁnger on the other. The hyoid bone is just under the mandible in the throat.

5 5 5 Step 7 - Occiput-Atlas Realignment Form a 90-degree angle with your ﬁngers in relation to your palm.

12 Upper Torso Realignment Step 5 - Thoracic Realignment Place the lower hand under the 7th cervical vertebrae and allow the palm to cradle the upper thoracic vertebrae. The upper hand forms a V with the thumb and opposing ﬁngers. Rest your thumb and ﬁngers on the medial edge of the clavicles. Contact your palm with the upper chest and sense the movement here. Releasing tension here opens the ﬂow of blood to the brain. Step 6 - The Hyoid Bone Place the lower hand on the upper cervical vertebrae (almost straight down from the chin). LIGHTLY touch the hyoid bone with the upper hand s thumb on one side and a ﬁnger on the other. The hyoid bone is just under the mandible in the throat. The edge of your ﬁngers rests on the underside of the mandible Step 7 - Occiput-Atlas Realignment Form a 90-degree angle with your ﬁngers in relation to your palm. A slight valley should be formed in the middle of the palm. The 1st and 2nd digit of each hand should press into the Atlas so that the ﬁngers appear to be pushing through the neck, toward the ceiling. Simultaneously the 3rd and 4th digit gently tractions the occiput toward you as the Atlas continues to move toward the ceiling. This action will continue as the head gently falls toward the table and comes to a complete rest. 10

13 Bones of the Cranium The cranium is comprised of 8 cranial bones. Like pieces of a puzzle, all the bones are connected at joints called sutures. The cornerstone of the cranium is the Sphenoid Bone because each of the other 7 bones connect to the Sphenoid. Parietal Bone Frontal Bone Sphenoid Bone Nasal Bone Temporal Bone Maxilla Zygoma Mandible Occiput Bone Parietal Bone (Not a Cranial Bone) Parietal Bone Parietal Bone Frontal Bone Sphenoid Bone Occiput Bone Temporal Bone Zygoma Maxilla Nasal Bone Mandible (Not a Cranial Bone) 11 Zygoma

The Cranial Vault Step 8 - The Frontal Bone 55 5 5 The key to this hand placement is locking the 3rd digit of each hand on the lateral

Digit # 1 and 2 are on the top of the forehead pulling the frontal bone up as the 3rd digit applies a gentle pressure towards the

The feeling of pulling a brick attached to rubber bands through mud has been my favorite way to relate the feeling you might

A B C 6 5 D Step 9 - The Parietal Bones A) Lightly place hands on the Parietal Bones, and connect with the CSF Rhythm.

Resist the initial FLEXION for a few moments before allowing the ﬁlling. B) Lightly rest your hands on the client s shoulders.

14 The Cranial Vault Step 8 - The Frontal Bone The key to this hand placement is locking the 3rd digit of each hand on the lateral edge of the eyebrows while the thumbs are at midline on the forehead. Digit # 1 and 2 are on the top of the forehead pulling the frontal bone up as the 3rd digit applies a gentle pressure towards the midline and lifting with the other ﬁngers. The feeling of pulling a brick attached to rubber bands through mud has been my favorite way to relate the feeling you might experience as this release occurs. A B C 6 5 D Step 9 - The Parietal Bones A) Lightly place hands on the Parietal Bones, and connect with the CSF Rhythm. When you feel EXTENSION, encourage the motion with a gentle compression toward the midline. Resist the initial FLEXION for a few moments before allowing the ﬁlling. B) Lightly rest your hands on the client s shoulders. Extend your perception throughout the client s body to sense the rhythm and ﬂow for several cycles. C) Lightly place hands on the Parietal Bones, and connect with the CSF Rhythm. When you feel FLEXION, encourage the motion with a gentle lift, pulling the the parietals toward you. As the ﬂow moves into EXTENSION, resist the Parietals settling back. D) Lightly rest your ﬁngertips at the top of the Parietal Bones and sense the ABCs of the rhythm for several cycles. 12

The Sphenoid Realignment Step 10a - Sphenoid Compression The Sphenoid bone is a cornerstone of the system as it hinges with the Occiput when the system goes from ﬂexion to extension.

15 The Sphenoid Realignment Step 10a - Sphenoid Compression The Sphenoid bone is a cornerstone of the system as it hinges with the Occiput when the system goes from ﬂexion to extension. Since we have released the Occiput earlier in position 7, this will complete the realignment. The thumbs will initiate the compression of the sphenoid bone. They will gently traction the bone down toward the table. This bone may not evenly release on both sides. CLINICAL NOTE: this type of uneven movement of the sphenoid is common but be patient and don t force any movement that will resist or cause discomfort for the client. Follow the movement until it bottoms out and stay with it for about 30 seconds making sure the Sphenoid doesn t spring back to the start position. This ends the compression stage of the realignment. Step 10b - Sphenoid Decompression 3 To decompress just reverse direction (see step 2 above) and gently encourage the Sphenoid to backtrack through the original downward movement. Use your thumbs to gently guide the Sphenoid upward toward the ceiling. The sensation you may feel will be similar to the frontal lift. The movement may not be even and should be encouraged without force or discomfort to the client. 13

The Temporal Bone Shift Step 11a - Mastoid Correction Place your ﬁngers on the Mastoid Process and sense the CSF Rhythm. NOTE: This is the only time that the hands move outward during EXTENSION.

Then, allow the movement to ﬂow freely, sensing with both hands. Step 11b - Mastoid Correction Place your middle ﬁnger on the ﬂap of each ear.

The hands will rotate forward in FLEXION and back toward you in EXTENSION.

Stay with the motion. Often the client will sink a layer deeper into relaxation.

16 The Temporal Bone Shift Step 11a - Mastoid Correction Place your ﬁngers on the Mastoid Process and sense the CSF Rhythm. NOTE: This is the only time that the hands move outward during EXTENSION. Use your hands to move the Temporal Bone out of sync by holding one hand ﬁrm when the FLEXION movement is felt. Alternate hands resisting the movement. Then, allow the movement to ﬂow freely, sensing with both hands. Step 11b - Mastoid Correction Place your middle ﬁnger on the ﬂap of each ear. Position the thumbs on the forehead, pointing toward the eyes. The remaining ﬁngers rest lightly along the side of the head. The middle ﬁnger will be the pivot point for this step. The hands will rotate forward in FLEXION and back toward you in EXTENSION. Follow the ﬂow for several cycles R To bring your hands out of sync, use a light pressure to resist one side in either FLEXION or EXTENSION. Your hands will be rocking in diﬀerent directions. Stay with the motion. Often the client will sink a layer deeper into relaxation. When ready, bring the motion of your hands into unison again, following the ﬂow of the ﬂuid, so the motion is back in sync. Step 11c - Ear Pull Place your 1st and 2nd ﬁnger of both hands under the ears, just superior to the ear lobes. The thumb should rest above the ﬁngers. Oﬀer a gentle pulling in a 45-degree angle toward the FLOOR. Continue slowly and gently as you sense the release in this area Take your time and get the release done right. When there is no client discomfort associated with the pull, the realignment is done.

Allow either side to move at its own rate, without excessive force, and if the jaw wobbles, stops or seems sluggish, be patient; it will complete its movement.

17 The TMJ Realignment Step 12a - TMJ Superior Realignment Several problems in TMJ Dysorder can be helped by this very simple realignment. The hands are placed below the chin line (visual) along the side of the head with the thumbs pointing up from the table. The superior realignment phase is a gentle pulling of the hands toward you. Allow either side to move at its own rate, without excessive force, and if the jaw wobbles, stops or seems sluggish, be patient; it will complete its movement. When the jaw no longer seems to want to move, without exerting excessive force or wants to spring back to its original position, then the superior realignment is complete. Step 12b - TMJ Inferior Realignment Without removing your hands, start the inferior realignment. This movement is opposite that of the superior movement. Allow the same movement as in the superior phase. Be patient and follow the natural movement all the way down without letting the jaw spring back to its original position. 15

B) Hold one end of the tube (either cranium or sacrum) while allowing the other end to move unimpeded with the rhythm.

18 The Dural Tube Step 13 - Stretching the Dural Tube Place one hand under the cranial vault (close to the Foramen Magnum (dural tube attachment). The other hand is directly under the sacrum (also a dural tube attachment). A) Connect with and sense the CSF Rhythm for several cycles. B) Hold one end of the tube (either cranium or sacrum) while allowing the other end to move unimpeded with the rhythm. This is stretching the tube and help to release any restrictions it may have inside the spinal column. C) Repeat the previous step for the opposite end of the dural tube. D) Continuing in the same hand hold, feel for the FLEXION phase at the cranial end of the tube. Hold the cranium to resist the ﬂow into EXTENSION. Then, repeat for the sacrum. Hold the sacrum in full FLEXION to resist the ﬂow into EXTENSION. The Dural Tube should be fully stretched from both directions. This is called Threading the Dural Tube through the Spinal Column. Step 14 - Final Balancing & Closing Using the CV4 position, from Step 1, connect with the CSF Rhythm. When the cycle goes into extension, hold the hands in full extension (the hands will be the closest together when extension occurs) and don t allow the ﬂexion phase to begin. If done properly you will put the client into a still point whereby the system will shut down. Allow the rhythm to begin again for 5 or 6 cycles and stop it once again in the same manner as explained above. Do this two more times and when the cycle is stable once again, slowly remove your hands and come oﬀ the client s head. Spend some time with the client to answer any questions they may have and reassure them that this therapy is going to make them feel a bit diﬀerent. Allow the client to lay still for a minute or two, and help them get up and oﬀ the table. 16

19 Thank You! The Health Beneﬁts of CV4 The ﬁnal position to be used in the etiquette is the CV-4 technique. This was developed directly by Dr. Sutherland (Sutherland 1939) and means compression of the 4th ventricle. Here the 4th ventricle refers to the brain. Sutherland believed that the 4th ventricle of the brain aﬀected all of the vital nerve centers located in this ventricle. The impact of this technique includes the following: 1. Lowering fever by up to 4 degrees F in Minutes 2. Relaxes connective tissues and relieves chronic musculoskeletal lesions 3. Eﬀective against degenerative arthritic processes 4. Regulating labor 5. Reducing dependent edema 6. Relaxes the client to a new level of peacefulness 7. Brings a balancing closure to the etiquette 17

20 Seven Wisdoms Institute PO Box 4086 Wheaton, IL

The Upledger Institute

The Upledger Institute 11211 Prosperity Farms Rd D325 Palm Beach Gardens, FL 33410-3487 800 233-5880 l 561 622-4334 l 561 622-4771 (fax) The Upledger Institute International is a proud member of the International