Introduction to Biodynamic Craniosacral Therapy
Life expresses itself as motion. At a deep level of our physiological functioning all healthy, living tissues subtly "breathe" with the motion of life - a phenomenon that produces rhythmic impulses which can be palpated by sensitive hands. The presence of these subtle rhythms in the body was discovered by osteopath Dr William Sutherland over 100 years ago, after he had a remarkable insight while examining the specialized articulations of cranial bones. Contrary to popular belief Dr Sutherland realized that cranial sutures were, in fact, designed to express small degrees of motion. He undertook many years of research during which he demonstrated the existence of this motion and eventually concluded it is essentially produced by the body's inherent life force, which he referred to as the "Breath of Life." Furthermore, Dr Sutherland discovered that the motion of cranial bones he first discovered is closely connected to subtle movements that involve a network of interrelated tissues and fluids at the core of the body; including cerebrospinal fluid (the 'sap in the tree'), the central nervous system, the membranes that surround the central nervous system and the sacrum. 
The "Breath of Life" 
The Breath of Life produces a series of subtle rhythms that may be palpated in the body and which make up an integrated physiological system. At least three subtle rhythms have been identified in this "primary respiratory system", each having a different rate and producing rhythms within rhythms. These three "tides" are referred to as: 
  • the cranial rhythmic impulse; a more superficial rhythm expressed at an average rate of 8-12 cycles per minute, 
  • the mid-tide; a tidal rhythm that carries ordering forces into the body expressed at a slower rate of approximately 2.5 cycles per minute and 
  • the long tide; a deep and slow rhythmic impulse expressed about once every 100 seconds. The long tide is considered to be the first stirring of life and motion as the Breath of Life emerges from a deeper ground of stillness at the center of our being. 
Essential ordering principle 
In the biodynamic approach of craniosacral work the subtle rhythms produced by the Breath of Life are regarded as expressions of health that carry an essential ordering principle for both body and mind. Dr Sutherland realized the important role played by the fluids in the body (particularly cerebrospinal fluid) in helping to disseminate these ordering forces throughout the body. 
The essential ordering principle carried in the rhythms of the Breath of Life acts as a blueprint for health which is present from the time of our early embryological development and is the fundamental factor that maintains balance in our form and function. Thus, the ability of cells and tissues to express their primary respiratory motion is a critical factor in determining our state of health - when these rhythms are expressed in fullness and balance, health and well-being naturally follow. 

Inertial patterning 
During the course of our lives our bodies become patterned, shaped and conditioned according to how we¹re able to deal with any stresses or traumas. If stresses or traumas are overwhelming, they become locked in the body as sites of inertia - until such a time as we are able to access resources that allow them to be processed and released. These sites of inertia effect the natural rhythmical movements of the Breath of Life and so hinder the ability of our essential blueprint for health to manifest at a cellular level. 
Common causes of inertia are physical injuries, emotional and psychological stresses, birth trauma and toxicity. Due to an accumulation of these stresses, tissues can become imprinted with the memory of unresolved experiences and so act like video tape which may keep replaying whenever stimulated. 

A gentle facilitation 
The emphasis in Biodynamic Craniosacral Therapy is to help resolve the trapped forces that underlie and govern patterns of disease and fragmentation in both body and mind. This involves the practitioner "listening through the hands" to the body's subtle rhythms and any patterns of inertia or congestion. Through the development of subtle palpatory skills the practitioner can read the story of the body, identify places where issues are held and then follow the natural priorities for healing as directed by the patient¹s own physiology. 
The intention of treatment is to facilitate the expression of the Breath of Life and so enhance the body's own self-healing and self-regulating capabilities. This is done in a non-invasive way as the practitioner subtly and gently encourages the conditions that allow for the reemergence of primary respiratory motion. Furthermore, the practitioner's deep and clear quality of presence can become a reflective mirror for the patient and an invaluable cue for their potential for change. 
A holistic approach 
Biodynamic Craniosacral Therapy takes a whole-person approach to healing and the inter-connections of mind, body and spirit are deeply acknowledged. It is an effective form of treatment for a wide range of illnesses helping to create the optimal conditions for health, encouraging vitality and facilitating a sense of well-being. It is suitable for people of all ages including babies, children and the elderly, and can be effective in acute or chronic cases. 

"Worms will not eat living wood where the vital sap is flowing; rust will not hinder the opening of a gate when the hinges are used each day. 

Movement gives health and life. 

Stagnation brings disease and death."


- proverb in traditional Chinese Medicine 






The Potential Impact of Orthodontia on Whole-Body Health
While the craniosacral system is comprised of the membranes and fluid that surround the brain and spinal cord, its numerous osseous relations can impact the body in far-reaching ways. For instance, I was a professor of biomechanics at Michigan State University in 1976, when I first witnessed the effects of orthodontia on the spinal alignment of the vertebral bones.
The patient was a 16-year-old girl who had begun to develop scoliosis about two years earlier. 
Her father, an English professor at the university, told me her orthopedic surgeon wanted to implant corrective rods for the scoliosis, which had been measured at 38 degrees in the thoracic curve. At his request, I began to see his daughter weekly. 
Over a period of six weeks, we were able to reduce the curve to 18 degrees using a combination of CranioSacral Therapy, Myofascial Release, osteopathic spinal manipulation and Therapeutic Imagery. At that point, I continued to try to help improve her condition. After four or five unsuccessful attempts, however, I realized that each time I balanced her occipital bone it was off balance the following week.
Clearly, I had not located the underlying cause of the occipital bone problem. The occipital bone had to be relieved of its abnormal transverse tilt and its restriction to motion, which were both compromising craniosacral system function. The sphenoid bone remained transversely tilted in the opposite direction from the occiput.
Ultimately, I discovered the hard palate was preventing the sphenoid bone from maintaining the corrections. Could it be that the orthodontic braces the patient had been wearing for about three years were contributing to her scoliosis? The answer proved to be "yes." At my request, the orthodontist removed the braces from the patient's mouth. Subsequently, her scoliotic curve was able to correct to less than five degrees and there was no recurrence of scoliosis over the next five years. I continued to see her every six months or so until she married and left home.
Please allow me to explain the biomechanics of how such an event could occur in a 16-year-old girl. The paired maxillary bones are influenced via the pterygoid wings of the sphenoid bone with which they articulate bilaterally. The maxillary bones move in concert with the sphenoid bone via these articulations. Actually, the distance between the second upper molars on each side fluctuates about two millimeters at a rate of 8-12 cycles per minute in accordance with the craniosacral rhythm. The sphenoid bone is one of the prime movers of the craniosacral system. When the bone's mobility is restricted, the craniosacral system tries very hard to compensate for the dysfunction, but it's seldom fully successful.
When an orthodontic appliance is put on the upper teeth and it crosses the midline between the two anteromedially located incisors, the motion of the maxillary bones induced by the sphenoid bone is inhibited and sometimes totally restricted. When they are first applied, the braces also might entrap one of the maxilla in an external position and the other in an internal position. In CranioSacral Therapy, the motions of the maxillae in response to the sphenoid bone are called internal and external rotations, because the maxillae appear to rotate about individual axes generally directed in anterior-posterior directions.
The distance across the hard palate is measured using the biting surfaces of the second molars as reference points. The usual mean distance variation between these teeth in response to internal and external rotations of the maxillae is two millimeters. In the case of my scoliosis patient, the braces locked the left maxilla in external rotation while locking the right maxilla in internal rotation. The abnormal positional locking of the maxillae caused the sphenoid bone to eventually yield to these abnormal forces after attempting to correct the problem and then adapt to it. Having ultimately failed in these attempts, the sphenoid was forced into a transversely oriented tilt, with its left side tilted in a superior direction and its right side in an inferior direction.
Next, the occiput had to compensate for the sphenoid tilt. In order to do this, the occiput had to tilt in the opposite direction, right side superior and left side inferior. This occipital tilt placed an increased traction on the right side of the dural tube as it ran through the sinal/vertebral canal. It also allowed less tension or increased slack on the left side of the dural tube.
We have found over and over again that the sacrum mimics the occiput unless there is a significant restriction of the dural tube somewhere between the occiput and the sacrum. In the case of our patient, the sacrum was mimicking the occiput. The right upper pole of the sacrum was higher; the left was abnormally lower. Hence, the sacral base, which is the upper transverse boundary of the sacrum, presented a tilted foundation for the spinal column to rest upon. Because of this un-level sacral base with the right side high and the left side low, the 5thlumbar vertebra had to angle off to the left, creating a "leaning-tower" dynamic. In order to correct this, the remaining lumbar vertebrae formed a scoliotic curve so the thoracolumbar junction crossed the midline center of gravity.
Now we had the upper lumbar coming diagonally across the midline center of gravity from the left, thus sending the lower thoracic vertebra off diagonally to the right. This curve needed to come back to the midline center of gravity at about the cervico-thoracic juncture in order to maintain body balance. The compensatory lumbar and thoracic spinal curves form the classic "S" curve of scoliosis. In the neck, we also might have a compensatory curve that involves most of the cervical spinal vertebrae. Clearly, the balance for the neck is skewed as the upper thoracic vertebral column comes to the midline center of gravity.
Sometimes this whole compensation in the neck occurs from a sharp displacement of the two lower cervical vertebrae atop the 1st thoracic vertebrae. This acute compensation at the lower cervical vertebrae often is painful and frequently results in brachialgia or dysfunction of the arms and hands, all due to nerve-root compression. It seems reasonable to me that the powerful nerve reflexes that strive to keep the eyes horizontal with the horizon might require this compensation at the cervicothoracic junction.
This is but one example of how orthodontia can affect the craniosacral-neuromusculoskeletal relationship to impact the whole body. To learn more, read "Surviving Orthodontics: A Bodyworker's Exploration into Orthodontics and CranioSacral Therapy," by Nancy Burke, CMT, CST. 




Considering CranioSacral Therapy in Difficult Situations

When a baby is unable to nurse or nurses so poorly that he causes pain to his mother, he presents a true challenge. A mother who experiences pain or who perceives that her baby is not breastfeeding effectively is a mother who is at risk of prematurely weaning this baby (Riordan and Auerbach 1999).
After working through all of the usual avenues of information and resources that can help in this kind of situation, some Leaders have found a new therapy, called CranioSacral Therapy (CST), can be helpful. CST is a light-touch manual therapy used to encourage the body's self-correcting mechanisms. Generally using about five grams of pressure, or about the weight of a small coin, the practitioner evaluates the body's craniosacral system. This system plays a vital role in maintaining the environment in which the central nervous system functions. It consists of the membranes and fluid that surround and protect the brain and spinal cord as well as the attached bones-including the skull, face, and jaw, which make up the cranium, and the tailbone area, or sacrum.
Since the brain and spinal cord are contained within the central nervous system, the craniosacral system has powerful influence over a wide variety of bodily functions (The Upledger Institute 2001). The extremely light touch used in this therapy means that at no time should CST treatment cause damage.
Doctors of osteopathy, chiropractors, and others are trained in cranial osteopathy. There are many different types of health care professionals who have taken CST courses including medical doctors, nurses, doctors of oriental medicine, osteopaths, psychologists, massage therapists, dentists, physical therapists, acupuncturists, chiropractors, occupational therapists, and some lactation consultants.
Babies who seem unable or unwilling to nurse at birth and babies who are unable to nurse properly may benefit from CST. A thorough evaluation by a health care professional should be done to determine possible causes of the problem. These may include birth injuries, congenital or neurological problems, illness, or the lingering effects of drugs used before the baby's birth. The history may reveal that a baby was deeply suctioned, fed artificially (with tubes or artificial nipples), or experienced other interventions that could cause oral aversion (Healow and Hugh 2000). It is crucial to investigate all aspects of the infant's health when determining the cause of breastfeeding problems.
If none of these factors seems to be the cause of the problem, then circumstances surrounding the birth may be the cause. Even a normal birth can cause trauma to the baby's head or spine. If the birth history includes a precipitate (very fast) birth, a cesarean birth, the use of a vacuum extractor or forceps, an unusual presentation, or a baby with a large head, this may indicate that birth trauma has occurred. These kinds of events during the birth can result in undue pressure placed upon cranial nerves, particularly those that control the mouth. The three nerves of the cranium that affect breastfeeding are the glossopharyngeal nerve (which controls the muscles of the pharynx), the vagus nerve (which controls the muscles of the soft palate), and the hypoglossal nerve (which controls the tongue muscle). Compression of any or all of these nerves can cause dysfunctional nursing (Hewitt 1999).
Craniosacral Therapy can also be beneficial for babies who do not open their mouths widely enough to latch on effectively, and for babies described as "arching or hypertonic." These types of babies are difficult to nurse. They cause pain or trauma to the mother, and often grow poorly due to inadequate milk transfer at the breast. When babies do not open their mouth widely to latch-on, it is often possible to remedy the situation by assisting the mother with proper positioning and latch-on (Eastman 2000). If the use of proper techniques does not help, a Leader may want to suggest that the mother consider looking into CST.
Arching or hypertonic babies are considered "tight." The behavior seems to be a temporary condition that improves over time rather than permanent neurological impairment. The breastfeeding relationship often suffers or is ended early due to the difficulty of nursing these babies. The behavior is considered by some to be a sign of difficulties with the nervous system, possibly caused by pressure on the nerves that occurred during the birth. CST is often dramatically effective in reducing the hypertonic behavior and encouraging the baby to nurse more efficiently by relieving pressure on nerves caused by the malposition of the cranial bones (Hewitt 1999).
The routine use of epidurals, mothers birthing in a supine position, the use of vacuum extraction and forceps, and the high rate of cesarean birth, may cause babies to be at risk for craniosacral problems. Of course, it's necessary for babies' skulls to mold, enabling them to pass through the birth canal. The skulls do correct themselves after the birth, although many can use assistance in achieving a well-balanced, optimal shape. A CST practitioner will gently examine the baby's head for overlapping cranial sutures, unevenness (one side of the head not matching the other), and "missing" or unusually large or small "soft spots." The techniques used in CST to encourage the body to correct itself are also evaluative techniques that inform and guide the practitioner (The Upledger Institute 2001).
CranioSacral Therapy is an option when traditional techniques for correcting latch-on problems are not completely successful. It is common for babies to need continued treatments over a period of weeks, even when the initial CST work greatly improves the situation. If basic issues such as positioning, latch-on, and milk supply have not been properly addressed, adjunct treatments like CST are unlikely to help. It is important to remember that even after CST treatments, mothers and babies may need additional breastfeeding help.

 

Cranial Care for Infants and Children
Reprinted from Mother to Mother, Dec/Jan '89/90
How often have you heard remarks like these? "Martha will grow out of it." "All babies get colic." "Ignore Johnny. He's just trying to get your attention." "Mary's not trying hard enough in school." "Billie's hyperactive." "Ear infections are an inevitable part of childhood."


We are part of a society that delights in generalizations, almost unconsciously categorizing, labeling and pigeonholing everything we run into in life. Doctors, in particular, have been taught to name diseases, rather than treat individuals. And, while this too is a generalization, it is an unfortunate by-product of our educational process for doctors.

The difficulty is that naming a problem does nothing to alleviate it. And labels are very destructive when applied to human beings. When applied to children, the results can be devastating. This can be clearly seen in the medical approach to a myriad of childhood problems, like those referred to in the introduction, that have a common source. Most medical therapy is directed toward suppression of symptoms, not correction of the underlying cause.

A simple example of this approach is the myriad of children who become caught up in the cycle of ear infections leading to treatment with antibiotic and decongestant therapy, resulting in continuous rounds of antibiotic/recurrent infection/antibiotic. For many children, as the infections continue and the immune system becomes more and more depressed by the antibiotics they are given, the eventual result is a surgery, with the placement of tubes in the ears. Both of these therapies are now being called into serious question by current medical information. According to the December, 1987 issue of Healthfacts, the publication of the Center for Medical Consumers:

  1. 70% of children treated with either antibiotics alone or antibiotics combined with decongestants still had fluid in the ear after four weeks of treatment.
  2. Antibiotics benefited some children: twice as many children (30%) who had antibiotic treatment were better at four weeks than those given the placebo only (l4%).
  3. However, half of these antibiotic-treated children whose fluid was successfully eliminated at four weeks experienced a recurrence within 3 months.
  4. And, finally, one expert cited feels that "Once you put in the tubes, you may render the ears more susceptible to trouble thereafter. After the tubes are extruded [the eardrum heals around the tubes and pushes them out - in an average of 6-9 months], the child is more likely to need them again."


Another example of controversial medical treatment is the prescribing of Ritalin for children who have been labeled as "hyperactive." There has been much in the news lately about parents being coerced into giving their children this powerful drug by the school systems. The argument is that the children are too disruptive in the classroom without medication. Yet now the medical community itself is at odds over the benefit of this powerful drug. However, it is still listed as the treatment of choice in the medical texts. And, the average doctor wants to help; after all, that's her job and what she was trained to do. Therefore, he or she prescribes what is currently believed to be the best available therapeutic agent.

What I want you to consider is an entirely different concept of "disease," that of dysfunction. In America, we adhere to the notion that a given problem is caused by a particular organism. However, hyperactivity clearly does not fit that model. In fact, there are a myriad of childhood conditions which have a common biomechanical defect, a disarrangement in the craniosacral mechanism. These conditions are on a continuous spectrum from commonly accepted irritations of childhood (for example, the incessantly crying baby who demands to be rocked and nursed constantly) through mild problems (ear infections, temper tantrums) to severe (autism). In those cases where the problem can be "diagnosed," symptomatic treatment is rendered, with varying degrees of success, while nothing is done about the underlying biomechanical insult. Treating that basic defect is the premise of cranial care for infants and children.

I am constantly astounded by the wide range of conditions which are accessible to cranial treatment. In my office, I regularly see children with wide-ranging problems and with truly astounding results. Let me share a few case studies with you to illustrate the diversity:

Case 1: A newborn, adopted child was brought to me at 5 weeks of age. She was born prematurely to an alcoholic, crack and cocaine addicted mother and was given multiple antibiotics at birth. She was constantly fussy, didn't sleep more than 2 hours at a time, and was very hypertonic. She would regularly arch back on her heels and the back of her head, pulling back into total rigidity. She had been assessed by the adoption agency's doctor, who recommended continuing physiotherapy. It was felt that the hypertonicity was secondary to neurologic damage from the mother's cocaine and crack addiction and alcohol consumption. A series of cranial adjustments eliminated the hypertonicity.

Case 2: Another case involved a 3-year old with severe irritability, who couldn't stand to have his hair brushed, who was easily upset to the point of tantrums, disrupting the entire family. In fact, the family had sought help from a family therapist, but were unable to have the evaluation until after the first three cranial treatments. At that time the therapist could find no trace of the problem behavior. It had spontaneously corrected. In fact, his mother reports that after the first couple of months of therapy, his preschool teacher asked, "What have you done? He's a different child."

Case 3: A 3 1/2-year-old who was having fits of inconsolability, quite different from his ordinary self, and who wanted to be rocked and suckled incessantly for comfort. He had had dental work on his front teeth resulting in the facial bones being jammed up into the cranium. Relieving the jamming allowed him to return to his usual disposition.
Case 4: A newborn infant referred in by the midwife because the child had had a dif-ficult delivery. The shoulders had gotten stuck in the birth canal. The mother reported the baby seemed uncomfortable when she was awake, that she was very startlable when sleeping, jerking awake and wanting to be walked or rocked for comfort. On examination, the baby's limbs were very stiff and tense and her face looked pinched together between the eyes. A minimal course of three cranial treatments resulted in a relaxed, comfortable baby.
As you can see, the variety of conditions and scope of effectiveness of cranial care is quite astonishing. However, it becomes less remarkable when you consider that the craniosacral mechanism nourishes and supports the proper functioning of the nervous system. After all, the entire body is controlled by the nervous system, and every organ, gland, bone and muscle is dependent upon nervous transmission for its proper functioning. Therefore, the craniosacral mechanism is basic to the body's ability to function, and restrictions in the cranium, sacrum and/or dural tube can result in far distant effects. As already noted, these effects are as diverse as lack of coordination, hyperactivity, chronic ear infections, generalized irritability and autism.

Reasonable questions at this point might be: "Just what is involved in cranial care? How is it accomplished? Is it invasive? Will it hurt my child?" All parents are understandably concerned about any treatment their children are going to undergo, and particularly so if that treatment is somewhat unfamiliar.

Simply put, cranial therapy is the manual correction of any restriction of motion in the body's craniosacral rhythm. It is totally non-invasive and is accomplished with fingertip pressure. The amount of pressure used on newborns is approximately equal to the amount of force required to hold a nickel on the end of your finger. To make this process more meaningful, let me describe the anatomy and physiology of the craniosacral system and its rhythmic pulsation.

The body has a number of intrinsic rhythms. We're all familiar with the heartbeat. Well, that is the driving force of the cardiovascular rhythm. Anywhere you can feel the pulse, you are palpating the cardiovascular rhythm. Another familiar rhythm is the respiratory motion, driven by the expansion and contraction of the diaphragm. A third, intrinsic rhythm of the body, and one quite independent of the other two, is the craniosacral rhythm. It is generated by the cyclic production and reabsorption of the cerebrospinal fluid. It, too, can be palpated anywhere on the body, although it is very subtle.

The cerebrospinal fluid pump is composed of the cranium at the top, the sacrum at the bottom and the dural tube (enclosed in the spinal column and enclosing the spinal cord) in between. The entire mechanism can be visualized as a semi-closed hydraulic system where restrictions (or trauma) are transmitted from one site to another via fluid pressure. A complex system of membranes in the cranium divides the brain into its functional parts, supporting and shaping it. Without the membranes, the brain would simply be a gelatinous, formless mass. So, distortions and abnormal forces transmitted through the membranes alter the brain's structure and the interconnections between the neurons. The cerebrospinal fluid is channeled through this same membranous system, nourishing the tissue. The constant supply of fresh cerebrospinal fluid washes away stagnant metabolic waste products and, via hormonal factors in the fluid, enables the nervous system to coordinate itself via biochemical communication.

The brain's membranous system is continuous with the dural tube that encloses the spinal cord, the sheath that encloses every peripheral nerve and the dura inside the sacrum. Furthermore, it is continuous with the scalp, extending through the sutures of the skull to cover the cranial bones both internally and externally. The continuity of the system promotes ease of correction.

Corrections are accomplished with the fingertips, using the bones as handles to untwist the craniosacral membranes. Some adjustments are accomplished using the soft palate as a lever to move the individual cranial bones. But, again, force is never used. Only gentle pressure, beneath the body's resistance level, is required to make the corrections. There can be slight discomfort, particularly if the distortion is severe. In fact, the tension in the membranes creates specific point tenderness, which is one of the indications of the need for correction. So, some babies will cry when the adjustments are first made. However, one of the indications that all the corrections have been made is a state of total relaxation, almost bliss, that comes over the child. Seeing a child reach that point is one of the greatest rewards in my practice.

You might now be wondering: What disarranges the system? Often, the initiating factor is the birthing process. In all of my newborn examinations, I have found only a handful of children with normal craniosacral mechanics. The multiplicity of factors attending even a normal birth makes this less startling than it might at first appear. The important question is: How severe is the restriction? When is it essential that it be corrected as early as possible to prevent future developmental complications? The rule of thumb is: The more difficult the delivery, the greater the intervention employed, the greater the likelihood that there will be significant, possibly multiple restrictions. Dr. Upledger's research has indicated a positive degree of statistical correlation between restriction in the craniosacral rhythm and a history of an obstetrically complicated delivery. His criteria for classifying a delivery as obstetrically complicated include one or more of the following: 1) Cesarean section, 2) high forceps delivery, 3) induction of labor for reasons other than convenience, 4) fetal distress in utero, 5) breech delivery, 6) prolonged labor, 7) precipitous labor, 8) toxemia of pregnancy and 9) severe trauma during pregnancy which resulted in pelvic fracture. (Craniosacral Therapy, Upledger and Vredevoogd, 1983, Eastland Press, pp. 336 and 343).


In my practice, without exception, both Cesarean section children and children born extremely rapidly have needed extensive care. This is because the normal process of labor and delivery stimulates the normal development of the craniosacral mechanism. It primes the pump. With Cesarean sections, particularly those which were "scheduled" and where the mother never labored, the cranium has a peculiar lack of resilience. Rather than feeling like pliable, living tissue, the skull has the consistency of a plastic billiard ball. One four-year-old that I saw was extremely bright, but had been labeled as a "difficult" child. He didn't want to be touched or held; he was very opinionated and inflexible and had a monumental temper. His cranium was totally inflexible and rigid. Cranial therapy resulted in a marked change. He became more approachable and affectionate, with a much more equable disposition.

In cases of extremely rapid birth, more serious problems develop. The cranium isn't rhythmically and gradually molded. Instead of being gradually overlapped (as is normal during delivery), the bones jam together with great force and fail to come apart post-partum. These babies are often inconsolable, wanting to be nursed and rocked in an attempt to put some motion into a system that is locked down into immobility.

Another key factor in disarranging the cranial system is trauma. While we might expect severe blows to cause problems, sometimes relatively minor trauma can cause severe distortion. In one case, I treated a three-year-old who had a facial distortion. His mother had stumbled while holding him and bumped his head into the corner of a house. The examining doctor at that time found no skull fracture. But, as he grew up, his face was extremely distorted. On ear was actually behind the other; his mouth was twisted; and his eyes were not on the same level. In addition, he salivated excessively and constantly, and he couldn't swallow, indicating irritability of the cranial nerves. He also had asthma. After treatment, all of these problems resolved and he's a handsome and mellow little boy, with a much greater attention span. His mother monitors his behavior as an indication of when he needs occasional follow-up care.

In summary, what clues should parents look for to determine whether their child needs attention? All children with severe neurological deficits should be treated cranially. While cranial care may not totally correct the deficit, the quality of function improves dramatically. Children with cerebral palsy and autism, in particular, benefit from cranial treatments. Dr. Upledger has seen much of the self-abusive behavior in autism, such as head-banging and hand- or wrist-biting either abate entirely or greatly reduce its severity. The improvement is spontaneous; and he postulates that long-standing, internal head pain has been relieved by cranial decompression. He believes that the child may have been blocking uncontrollable, external pain. (Ibid., p. 263) In children with cerebral palsy, I have seen a marked decrease in spasticity and improved coordination, speech and motor skills.


For less severe problems, there are a wide range of behaviors to look for, depending upon the child's age and the severity of the restriction. In a newborn, hyperirritability of any kind should be a warning sign. The child who cries excessively, is excessively wakeful, who is very startlable and jerky, who wants to nurse incessantly, or who has suckling difficulties should be checked as soon as possible. In the older infant, incessant rocking, thumb sucking, head banging, recurrent ear infections, ear and hair pulling should be noticed. The child who fights and cries over hair combing or washing is a likely candidate as well. As children get older and enter school, the school authorities are likely to label them as "problem" children or "behavior problems." Popular terminology presently includes "attention deficit disorder," "learning disabilities," "dyslexia" and "hyperactivity."

Personally, I feel very strongly about applying labels of this sort to children. So much harm is done to the child's sense of self-worth by ignorance. Very young children tend to act out our expectations of them. And, older children begin to feel defeated by the school system and begin to regard themselves as failures. So much good can be accomplished by viewing children with understanding and compassion. Put yourself in their place. If you were born with a congenital cranial restriction and had never known anything but stress, tension and pain, how would you know what is "normal"? Children can't express that something "hurts" if they've never been pain-free. So, they use what tools they have: they kick and scream; or they are disruptive; or they don't want to be touched in sensitive areas. Just how crabby are you when you have a severe headache? Let's give our children the most positive start we can, giving them every opportunity to be the best that they can be. That's my commitment to children.

Colic
The new millenium has begun; and we at the RFHC hope that it finds you well and happy. We were well-prepared for Y2K, and had all of our systems up-graded well in advance.

A most interesting research article came across my desk which has already changed the way pediatrics is being practiced in Denmark. The question is: Will the American medical community take notice -- for the benefit of the children.

The University of Southern Denmark published the results of an important follow-up study on infantile colic in the Journal of Manipulative and Physiologic Therapeutics (JMPT, Oct 99). JMPT is a peer-reviewed journal of the highest caliber and the study’s design conformed to the randomized, controlled trial model so beloved of the medical profession.

It was a follow-up to a 1985 study which surveyed the results in 316 infants who had moderate to severe colic and who were brought in for chiropractic care to 50 clinics in Denmark. The results were impressive: 1. A dramatic reduction (>50%) in colic symptoms after the first treatment; 2. An overall success rate of 94% (colic stopped in 60% and improved in 34%) after an average of 3 treatments over the course of 2 weeks, with no adverse side effects.

In the new study (consisting of 50 infants between the ages of 2 and 10 weeks), the goal was to compare chiropractic manipulation to the most common medical treatment -- dimethicone. The results again were impressive! Dimethicone treated infants did no better than what was predicted for the “placebo” effect. The chiropractic results were a 67% reduction after 12 days. (The results are skewed downward due to the study design: 9 of the 25 babies in the medical group dropped out because of a worsening of symptoms during the course of treatment. The drop outs were excluded from the final analysis of the results. Therefore the 67% difference is even more impressive than it first appears.)

Why is this study important? It represents the best scientific documentation to date that infants benefit substantially from spinal manipulation. Infantile colic is common; it affects approximately 20% of newborns and can be very destructive to family life. The most accepted definition is “Unexplainable and uncontrollable crying in babies from 0 to 3 months old, more than 3 hours a day, more than 3 days a week for 3 weeks of more, usually in the afternoon and eveninig hours.” A variety of causes for colic have been suggested, and discarded, when no research showed no differences between colicky and non-colicky infants. Likewise, a variety of medical interventions (drugs) have been tried and discarded (often due to serious side effects).

Now, in a head-to-head comparison, chiropractic manipulation has been shown to be safe and effective for the relief of infantile colic. In Denmark, pediatricians have already begun referring babies for chiropractic manipulation. Will the American medical profession pay heed?

If you would like to read the full details on these studies, a copy of the review article can be found in our reception area -- in the blue binder entitled “Kid’s Health.” The article is in The Chiropractic Report, November 1999, page 1. When next you are in the office, take a few minutes to read it. I think you’ll be impressed. If you need a copy for friends or relatives, please send a self-addressed, stamped envelope, and we will provide you a copy by return mail.



Health Risks from Acetaminophen 
INFANT TYLENOL IS 3-1/2 TIMES STRONGER THAN CHILDREN'S STRENGTH TYLENOL

Early in July Associated Press performed an important public service. They released a story which highlighted a serious public health problem. Parents, in particular, need to take note of this information.

Acetaminophen (Tylenol the most familiar brand) is extremely dangerous. When I was in school, our instructor in drug toxicology (who was a pharmacist and had practiced at LA County General Hospital) pointed out that acetaminophen was the leading cause of death by accidental poisoning in the pediatric population. What made the statistic even more startling was that the drug was almost always administered by the parents - with the intention of helping their child.

Acetaminophen poisoning is insidious. It destroys the liver, so they symptoms include: mild nausea, lack of appetite' diminished urination, lassitude, vomiting, and diarrhea. Late stage includes jaundice and kidney failure. The liver damage is irreversible and death occurs two weeks after poisoning, unless a transplant can be performed.

Recently, Johnson and Johnson has formulated a new grape flavored, infants' Tylenol. Unfortunately, it is 3-1/2 times more concentrated than the children's strength product. You must adjust the dosage downward to avoid overdosing your child. It is counterintuitive to many people to think of an infants' formula as being stronger than a children's formula.

These are not the first problems Johnson & Johnson has had with their acetaminophen products. And, children are not the only people at risk. Recently, a man on the East Coast (New York City, I believe) suffered complete liver destruction and survived only because of a liver transplant. He took acetaminophen daily and had 1 alcoholic drink every evening. The combination proved deadly to his liver.

Another man's liver was destroyed after exposure to lawn chemicals (pesticides) together with acetaminophen.

So, how can you protect yourself and your family?

> Keep a written log of when the dose was administered and how much was given. Keep this information with the bottle so that it is readily available.

> If you are using acetaminophen for any reason, avoid alcohol and dry cleaning agents. (All are liver toxic).

> If you are an adult who is not aspiring sensitive, an aspirin-based analgesic may be a better choice.

> Do not give aspirin to children under the age of 18 or to the elderly who have viral infections and high fevers. The danger is Reyes Syndrome which destroys the organs, including the liver. Acetaminophen was originally marketed as an alternative to aspirin for this situation.

The bottom line: All drugs have side effects and dangers. Be careful whenever you use pharmaceutical products. A fever is not a disease, it is evidence that the body's immune system is working properly. There are safe, natural methods of reducing a fever when it is absolutely necessary. For further information, send a manila envelope (suitable for 8-1/2" x 11") enclosures, with three stamps, to the RFHC and request our publication "The Ten Most Common Childhood Illnesses and What to Do About Them." It contains a wealth of information on safe and effective home care, as well as guidelines for when a visit to the doctor is mandatory.

Cranial Surgery for Infants
Recently, a parent of one of my pediatric cranial patients shared with me an article published in the February, 1996 issue of The Wall Street Journal (WSJ). I found the information so outrageous and alarming that I needed to share it with everyone. The headline reads "Some Physicians Do Unnecessary Surgery On Heads of Infants." It seems that neurosurgeons are removing infants' skulls, "remodeling" the bone, and reattaching the skull to correct what is a simple, functional problem - positional molding.

In 1992, the United States and a number of other countries adopted the recommendation that babies sleep on their backs to reduce the occurrence of Sudden Infant Death Syndrome (SIDS). In every country where this recommendation has been publicized, doctors are now seeing an epidemic of misshapen infant heads, specifically, flattening in the back. The director of pediatric surgery at St. Louis Children's Hospital reports a 400% increase in these cases since 1992. The result has been an "epidemic", (per WSJ) of misdiagnosis of craniosynostosis - a condition where the sutures fuse prematurely, resulting in deformity and increased intracranial pressure. Craniosynostosis is a serious condition, but it is extremely rare. Perhaps only 1 in 3,000 babies have some form of it; the type which results in posterior flattening is even rarer, perhaps 1 in 100,000. There is some ambiguity in the statistics, since specialists now believe that the statistics, too, are based in inaccurate diagnosis.

Literally hundreds of babies are having their skulls sawed off, reshaped and reattached. The best result: a scar from ear to ear. A few babies have died during surgery and others have been left permanently disabled. However, even with a "good" result, the emotional cost of this procedure is high. Now that I have seen several of these children in my practice, I have seen other, undocumented side effects. After surgery, adhesions form in the dura which affect the pelvic biomechanics. As a result, these children have an awkward, stiff gait and a lack of coordination. Correcting the biomechanical defect is almost impossible due to the continuing effect of the scar tissue.

An alternative medical procedure involves the children wearing helmets for 23 hours a day. The problem with this approach is the immobilization of the cranial structures. The intent is purely cosmetic - to force the head to round.

A far simpler and better solution is available. It is a relatively simple matter to restore the alignment and, more importantly, the functional integrity, of the cranium in infants. The cranial vault functions as a hydrostatic pump, moving in a rhythmic manner to pump cerebrospinal fluid through the ventricular system of the brain. An infant's brain more than doubles in size during the first 18 months of life. During this developmental period, important neurological interconnections are being made as the brain matures. You can observe the changes in a baby's increasing motor skills. Adequate cerebrospinal fluid circulation provides important communication between brain cells as they migrate, myelinate and interconnect. Immobilizing or surgically impairing this system can adversely affect cognitive and neurologic function. Dr. John Upledger, a world-famous cranial osteopath traces autism to immobilization of the cranial vault. (Craniosacral Therapy), Upledger & Vredevoogd, Eastland Press 1983).

Most cases of skull modeling respond well to precise cranial adjustment. Adjusting the skull is a simple matter of fingertip pressure, usually inside the mouth, freeing the sutural lock. Many serious conditions respond to cranial adjusting, including strabismus, autism and traumatic deformation of the cranium. Even genetically impaired children function more fully with cranial adjusting, although the genetic defect can never be erased. Premature infants who have been on a respirator for weeks to months also have cranial distortions which impair eyesight and balance. However, those distortions occur inside the mouth and are therefore harder to visualize. I have corrected many such cases in my practice.

If cranial surgery is recommended for your child (or any child you know), I strongly urge a consultation first with a pediatric cranial chiropractor, such as myself, to determine if there isn't a less invasive, more humane method to achieve a better result.



ADHD
Ritalin is the fastest growing abused drub in the US!
I attended a valuable seminar on Attention Deficit Hyperactivity Disorder (ADHD). Dr. Mary Ann Block, has written No More Ritalin, Treating ADHD Without Drugs, A Mother 's Journey, A Physician's Approach. I was interested in her therapeutic approach, since at the RHFC, we have had a great deal of success with this condition.

The seminar was valuable to me for another reason as well. It's another case of "What Do Statistics Really Mean?"

Remember the war on drugs? And all the election hoopla about President Clinton's poor example to America's youth? Well, whatever your feelings about the President, this may be one time where he was unfairly accused.

Teen drug use has risen 105% from 1992 to 1996. During the same period, prescriptions for Ritalin have risen 150%. Currently, 2 million children are on Ritalin.

Do you realize that Ritalin is a cocaine analog? That, in fact, the tablets when ground up and inhaled, give the exact same high as cocaine? Well, the kids do. Ritalin is the fastest growing abused drug today. And most of it is obtained through legal prescriptions!

Furthermore, an 8-year study by Russell Barkeley, PhD, et al., American Academy of Child and Adolescent Psychiatry, July 1990, concluded that the current therapeutic gold standard-special education resources, greater use of mental health services and medications-had an 80% failure rate when outcomes were studied. After 8 years on drugs and in therapy, 80% of the children still had symptoms. In addition, 60% had progressed to more serious psychiatric disorders which led to them being institutionalized in either a psychiatric hospital or a prison.

For those of you who do not want your children on Ritalin, I think this data offers you a potent counter-argument with the school administrators and teachers who so often pressure parents to medicate their children.

In fact, ADHD is a complex disorder that includes cranial dysfunction, food allergies and bowel dysbiosis. Which factors affect which child can only be determined by the proper diagnosis and testing.

At RFHC, we have been working successfully with ADHD for many years. The key has always been fitting the therapeutic program to the individual's needs.
 



Case Profiles
Case Profile (Pediatrics)
We brought our 3-1/2 year old daughter to Dr. Richards in June 1993. She had numerous problems interfering with her development. Her walk was very awkward; she could not run; and she did no jumping or climbing. For the most part, she was physically inactive. She had a cleft in her soft palate which contributed to her very limited speech. Most everything she tried to say sounded like "ma ma." She wore glasses for the correction of farsightedness and had difficulty keeping her eyes from turning in (strabismus). We had been told that the only correction for this was surgery. The most frustrating thing for us was the fact that she was unresponsive much of the time, showing little or no emotion. Most often, she was irritable and minimally cooperative. This made speech therapy less than successful.

Our daughter recently turned 5. Looking at her today, it's hard to believe she's the same child. She now runs, hops, jumps and climbs, In fact, after her first visit to Dr. Richards, she tried jumping for the first time. It seems that now she rarely slows down to a walk. She still wears glasses, but her left lens has been changed to a weaker prescription. As long as she has her regular adjustments, her eyes remain straight. Surgery for strabismus is no longer being discussed. The most significant change has been in her personality. She giggles, laughs and smiles much of the time. She has been making good progress in speech therapy. She talks about everything. Although she is still shy, she responds to people in a positive way. Most importantly, she now enjoys life. --L and TA

This is one of those instances where nervous system coordination was being seriously impaired by what appeared to be a "simple defect. " The cleft palate resulted in torsion, misalignment and fixation in both the frontal and temporal bones. Since the vestibular system exists within the temporal bone, balance is affected. The emotional centers of the brain are immediately behind the frontal bone and frontal bone fixations have been documented to produce emotional distress - including depression, changeability, irritability, lack of concentration, etc. The best part of treating one of my "favorite patients," though, is the big smile and the hugs! --Dr. Richards

Case Profile (Pediatrics, Cranial, Allergies)
"I had heard about Dr. Richards from a friend of mine. My son, C, had a very aggressive relationship with his brother and his father. The fighting was more than just your typical quarreling. After discussing our options, my husband and I decided to take C to Dr. Richards while my husband and I went to a family therapist.

"After about three weeks, my husband and I had noticed a change. C. was fighting a lot less with his brother, his relationship with his dad was improving and he was more mellow. And that was after we stopped going to the family therapist. Dr. Richards and the entire staff were very good with C. and now I hope to take my other son for treatment too. --TC

This is simply another example of a situation where cranial distortions and food allergies result in difficult behavior. Children are very direct and they don't have a lot of ways to express their pain. Helping them become pain-free is quite a privilege. --Dr. Richards

Case Profile (Pediatrics, Cranial, Nutrition)
"In December of 1990, my husband and I visited Pitesch, Romania. Our visit was inspired by a segment on the TV show "20/20", which reported on the treatment and care of infants and children in Romania. When we first saw A and L, they were two weeks old and less than four pounds each. They were born two months premature and had suffered a trauma birth. (A and L are fraternal twins.)

"After a considerable amount of red tape, A and L were adopted at the age of four months by my family. From the time they were born until the day we were able to take them home, A and L were wrapped tightly in swaddling clothes that allowed little or no body movement. A had a severe heart murmur and L had severe colic and strabismus in one of her eyes. A's heart condition eventually became more normal but he seemed unusually quiet. He had no head movement and at first we thought he might be deaf or blind. We eventually brought him to a chiropractic doctor. After just one treatment, A was able to move his head. My husband and I were referred to a chiropractor in San Fernando Valley. The doctor was treating A and L and they were responding very well to the treatments. L's strabismus was clearing and A was able to move more. But the commute to San Fernando Valley was just too great. Then we were referred to the Richards Family Health Center.

"Dr. Richards has been treating A and L for over three months and both are steadily improving. In addition to their treatments, Dr. Richards has addressed their nutritional needs. Both A and L have benefited from the supplements and Bach Flowers we've obtained at the Richards Family Health Center. As a result, L's digestive system has now normalized. A's mobility and alertness has increased. I've noticed that when or L miss their treatment, A. becomes HYPO-active while L becomes HYPER-active. I'm confident that with their treatments and lots of TLC, both A and L will continue to improve. --RS

It is wonderfully rewarding to watch the twins blossom as we continue working with them. L is steadily catching up to her age level. A's deficit is more marked, but it warms my heart to see him hold his head up and look all around. --Dr. Richards

Case Profile ( Pediactrics, NOT)
"School was pretty frustrating for S. He is very artistic - a gifted artist and musician - but reading and study skills were very challenging. In fact, the school system had categorized him as a "marginal" student. S's learning difficulties were structural - at four, he had been hit on the left forehead with a baseball bat. After that incident, he was more emotional than others his age, had difficulty sitting still and trouble learning to read and write. Private tutoring in reading in first grade helped him compensate, but reading was a struggle. And dealing with the school authorities was an endless battle.

"When S was approximately 12 years old, treatment was begun with Neural
Organizational Technique. At first, the treatments were exhausting. It would be very difficult for him to perform the necessary tests, and he would need to sleep after every session. However, the results soon spoke for themselves. He went from a D average in junior high school, to placement in honors classes in high school. He graduated from high school at 16 by passing the State proficiency exam. Now, at 19, he's earned his certification as an Emergency Medical Technician, and is in training to become a fireman." --Aunt of SIS

"I would not have been able to achieve what I've accomplished so far without my NOT treatments. Life would have continued to be overwhelmingly difficult. --SIS

Case Profile (Pediactrics, NET)
"J has always had difficulty allowing anybody to touch his head, especially his eyes. During a regular chiropractic visit, Dr. Richards needed to make an adjustment on his eye muscles, but J was very adamant that he didn't want her to touch his face.

"At Dr. Richards request, I allowed J to have an NET treatment. Immediately J's anxiety about his eyes being touched went away. Interestingly enough, after the treatment, the area around his eyes no longer needed to be adjusted. --Mother of JT
 

Contactos: Telemóvel: + 351 962 426 564 | Morada: Quinta da Beloura, Sintra | Email: geral@integrativeosteopathy.pt