Used with permission. Image by Salvatore Vuono at FreeDigitalPhotos.net. Note: When last visited, Vuono’s portfolio was no longer on Free Digital Photos; however, this photo is still being classified as public domain.
Craniosacral therapy is a gentle treatment approach that works with the natural, self-correcting mechanism of the body and the craniosacral system to detect and release restrictions in mobility and enhance the function of the craniosacral system.
The craniosacral system includes the membranes and fluids that surround and protect the brain, spinal cord, and nerves. Restrictions in the rhythmical movement of the craniosacral system can cause sensory, motor or neurological dysfunction.
The techniques of Craniosacral Therapy were developed by osteopathic physician John E. Upledger, founder of the Upledger Institute. Dr. Upledger based his method on the research of Dr. William Sutherland, another osteopath, who is considered the father of craniosacral therapy.
Sutherland observed that, contrary to general belief, the bones of the skull do not fuse completely in early childhood. This means that through very gentle touch, they can be moved, and consequently, the tissues attached to them can be moved. Furthermore, early in his career, Dr. Upledger realized that the membranes surrounding the brain and spinal cord move in a rhythm, different from respiration or the heartbeat. He developed a technique to palpate and manipulate this craniosacral rhythm.
“Dr. John” taught this technique internationally and widely published his research on the efficacy of the treatment protocol. His research is continuing under the auspices of the Institute and the many students and teachers who continue to scientifically validate the usefulness of CST in treating a variety of complaints.
So what is the technique? Using pressure of about five grams, the therapist is able to palpate or feel the rhythm of the craniosacral fluid moving through the tissues of her clients and uses her evaluation of the flow and restrictions to focus treatment on the causes of dysfunction rather than only on the symptoms. She used the bones, mostly in the head and spine, to manipulate the tissues and fluid that affect the whole body.
The client lies on the heated treatment table and usually remains clothed. It may seem like not much is happening because the touch is so light and the therapist does not move around a lot. Many clients go to sleep, and that is fine. The sense of relaxation may continue for several days as the body continues to heal itself and achieve a greater state of balance. Clients often claim their pain is alleviated for longer periods and their mood is improved. The effects are subtle and tend to build with treatment.
The therapy has been used successfully to treat such disorders as headaches, neck and back pain, TMJ, fibromyalgia, motor coordination difficulties, vertigo, edema, neuropathy and nerve compression syndromes. It is also good for chronic conditions that may have an emotional component such as fibromyalgia, attention deficit disorder, anxiety and depression, and even learning problems.
Craniosacral Therapy also has a strong component that focuses on mobilization of the fascia, the continuous sheet of connective tissue that surrounds the organs, muscles, bones, nerves, vessels and other structures of the body. This three-dimensional fascia runs head to toe, front to back and exterior to interior in the body.
Release of fascial restrictions in one part of the body can affect painful tissues in other parts of the body and cause them to also release. The craniosacral system an be used as an indicator of fascial restriction, and then a gentle myofascial release technique can be used to normalize muscle tone, decrease pain, decrease swelling and increase soft tissue and joint mobility. The benefits are usually immediate. For this reason, CST is considered to be a deep tissue modality even though the client does not disrobe and even though the pressure is only 5 grams.
People of all ages, from babies to grandparents, can benefits from craniosacral therapy. In fact, unless there is a high-risk condition affecting the brain or spinal cord, like an aneurysm or tumor, most people can benefit from CST. Recent research even suggests it is helpful for people with traumatic head injury or autism. In any event, your therapist will obtain a medical history before doing a treatment and may ask you to get doctor’s approval if anything seems contraindicated.
A deep tissue massage is slow work and often focuses on one part of the body for the full session.
Deep tissue massage does not have to be painful. That is a misconception that we at Tapestry Life Resources and Hands On Massage Therapy are trying to dispel.
In fact, if, on a scale of one to ten, your massage goes past the pain threshold of a six or seven, the work is ineffective and probably doing more harm than good. That is because the muscles contract against the pain, instead of lengthening and relaxing.
In general, massage techniques that are used for Swedish or relaxation massage can be used effectively for deeper work. The aim in both is to loosen adhesions, stretch and mobilize connective tissue, and improve circulation and lymph flow. In fact, a good Swedish massage can be the first line of defense against injury since healthy, flexible tissues are less likely to get hurt in the first place.
What separates deep tissue massage from Swedish massage is the depth of the pressure and the speed of the massage. The rule is that the deeper you go, the slower you go. Thus, if you are really having trouble with an area of your body, you may only have time in an hour massage to get that area worked. A full-body massage that is all deep work lasts at least 90 minutes and could last two hours. A look at the way muscles are layered may explain why.
In order to reach the deeper muscles, the massage therapist must first release the superficial muscles. To do this, the therapist may use fingers, hands, fists, knuckles, forearms, elbows, or various massage tools. This can take some time before the superficial muscles are relaxed enough for the deeper muscles to be reached. Less oil or cream is used so that there is less slip as greater pressure is slowly applied. Heat, cold, and sprays may also be used.
Superficial and deep muscles of the back Grey’s Anatomy
Let’s use the back muscles for an example. The superficial muscles of the back act on the upper limb. The intermediate muscles act on the ribs and thorax; the deepest muscles of the back are responsible for keeping the body erect.
If trigger points are found, the therapist may strip, friction or compress these to gain a release. Trigger points are taut bands of muscle fiber that do not relax and that keep the muscle in a shortened state. They are usually more painful than the surrounding muscle tissue, and they refer pain to other parts of the body. Trigger point therapy, also called neuromuscular therapy, is often combined with deep tissue massage. Its focus is these taut bands, and although trigger points can hurt as they are released, the therapist should not push beyond the pain threshold of a six or seven.
A true deep tissue massage focuses on the spreading and lengthening of the connective tissue sheath. Deep tissue techniques are based on the work of Ida Rolf who developed a technique called Structural Integration. Her principles have been widely adapted into other connective tissue massage therapies.
Beneath the skin and connecting every part of the body is a fibrous sheet of connective tissue called fascia. The fascia surrounds the bones, muscles, and organs. Indeed, although it is is basically a single sheet of mesh, it wraps individual tissue fibers as well as the whole structure (ie, individual muscle fibers and the whole muscle). Thus, connective tissue health is essential to painless movement. If the surrounding fascia is restricted, so is the muscle. Denser connective tissue forms the tendons and ligaments.
Connective tissue is unique in that it is elastic, which allows it to be elongated. However, the therapist must employ precise levels of palpation, pressure and energy to effectively make changes in the tissue. Simply massaging, kneading or compressing the fascia does not change or elongate the connective tissue. Fascia and muscle are different types of tissue, and they require different approaches. Your therapist will be trained to apply these techniques.
The fascial layers are worked one at a time, progressing from superficial to deep just as with the muscle layers. The superficial layers must lengthen and become more elastic and supple before going to the next, deeper layer.
Often the reason deep tissue massage hurts is that the therapist may be trying to achieve releases too quickly. While it is appropriate to work at your pain threshold, the therapist should not exceed your threshold. If she does, it is up to you to tell her so. Furthermore, you may have to decide to forego a full-body massage and ask that the therapist concentrate on one troublesome area so she is not rushed. Alternately, you could schedule a longer massage appointment.
Finally, you need to drink water and take a hot bath in Epsom salts or apple cider vinegar when you get home. You always hear this after a massage, but do you do it? The water flushes toxins and helps keep the connective tissues hydrated so they can heal. The heat of the bath and the properties of the salts or vinegar also remove toxins and help relax the body more fully. Stretching or other exercises may also be helpful.
Deep work does not have to be painful if your therapist is knowledgeable and if you communicate with her about your pain level, You should be willing to limit your massage to a trouble area, to schedule a longer massage session, and/or to return for a follow-up visit to achieve the best results with minimal pain. Finally, you need to practice self-care and follow your therapist’s advice about proper hydration and post-massage detoxifying.
I recently took a new Craniosacral Therapy class from the Upledger Institute on unwinding the meridians. We studied the rudiments of Traditional Chinese Medicine in massage school, and there was a good bit of TCM on the NC Board of Massage and Bodywork Therapy licensing exam, which I took in 2007. (Wow! Have I been doing massage that long?)
We also took Touch for Health Level 1 in massage school as the owner of the now closed Whole You School of Massage and Bodywork, Cheryl Shew, believed it was one of the best classes to prepare us for the massage exam. It is based on TCM and applied kinesiology and is an incredibly effective method for balancing meridians and toning muscles.
After I finished massage school, I took the Levels, 2, 3, and 4 Touch for Health classes, and my teachers, Larry and Arlene Green, offer refreshers and online “get together” frequently. When I began the Unwinding Meridians class, I suspected my TFH books and charts might come in handy, I was right. Much of the material I had previously learned was applicable to the new technique.
I realized I needed to brush up on things though, and it actually got me excited. The more something in the class triggered previous knowledge, the more confident I felt that this is a modality I can use.
So what is it that got me so pumped? Well first of all, I could actually feel the craniosacral rhythm/energy movement when I put my fingers on the acupuncture points. As with traditional craniosacral therapy, the touch is light and less like acupressure or Shiatsu massage.
Before I tried the work on a client, I made sure to look up the acupuncture points for a problem I know she has. I could feel the rhythm shifting and changing even more strongly, maybe because I was working on a real problem. She shared my excitement.
Using craniosacral therapy to unwind the meridians can help with the emotions as well. In Traditional Chinese Medicine, each meridian is associated with organs, emotions, seasons, colors, and a whole wealth of other correspondences. If a client has several points that need to unwind along the same meridian, you can sometime discover old trauma that is the source of chronic pain that seems to have no cause by asking questions related to the meridian correspondences. The inner physician knows and will often lead you to the truth you may be avoiding.
Unwinding the Meridians with Craniosacral Therapy is now a tool in my toolbox. I hope the more that I use it, the better I will get at help clients become pain-free and enjoy life more.
One of my favorite and most frequently used oils is tea tree oil. It’s been called a first-aid kit in a bottle, and I’ve certainly found it to be true.
The melaleuca alternafloria plant is found in New South Wales, Australia, and it yeilds beautiful flowers like the pink and white ones above. However, it is the leaves that contain the healing oils.
The indigenous Aborigines of the area use the leaves of the plant for healing. One way they do so is to crush the leaves and inhale the odor to relieve coughs and sinus stuffiness. Inhalation is the way I most often use tea tree oil myself although I use the distilled essential oil rather than the leaves.
Another way the Aborigines used the plant was to make an infusion from the leaves, which they drank. In fact, that is how the plant got its name. Captain James Cook observed the natives drinking the infusion and gave the plant the name tea tree. You should avoid drinking the essential oil, however.
Research done in the 1920’s found that essential oil from the melaleuca plant was eleven times more potent than the leading antimicrobial of the time. That means it is still powerful antiseptic, a good thing to know in these days of super-bugs tat are resistant to antibiotics. Plus, tea tree oil doesn’t contain the toxicity of manufactured antiseptics.
Tea tree oil can be used to treat cuts and scrapes, burns, blisters, cankers and cold sores, and a variety of skin conditions such as dandruff, acne, athlete’s foot, and Candidiasis.
It is often found in cleaning solutions such as household cleaners, soaps, hand sanitizers, shampoos, toothpastes and mouthwashes; in antibacterial and antifungal ointments; in baby wipes; and in makeup and skin care products. It has even been used to treat the bacterial and fungal infections of pet fish!
It is good for keeping insects away. It makes a great natural mosquito repellent. One of my clients recommends it for treatment of lice. It is much safer than the OTC remedies, and it works.
One of my favorite uses is in the inhalation oil recipe below. It is relatively inexpensive and is an oil no medicine chest or first-aid kit should be without.
Safety caution: Tea Tree oil is generally used externally. You may need to dilute it with a carrier oil if you have sensitive skin. Furthermore, you should not put it on your pets. If they lick it, it could make them sick. It has been reported to be fatal for cats.
Recipes using tea tree oil
Chief Two-Trees Infusion Oils for Sinus Congestion and Headaches
• 3 drops Eucalyptus EO
• 3 drops Peppermint EO
• 3 drops Tea Tree EO
Boil a cup of water and remove it from the stove. While it is still steaming, add the oils. Immediately cover the cup and head with a towel and inhale for 3 minutes. Keep your eyes closed.
Nail Fungus
• 4 tsps. apple cider vinegar
• 1/8 C. distilled water
• 6 drops tea tree EO
• 10 drops lavender EO
Mix well and apply to nails with a polish brush or cotton. Store in a glass bottle.
Disinfectant/Spray for Mold
• 2 tsps. tea tree EO
• 2 C. distilled water
Put in spray bottle and spray on problem area. Do not rinse.
Skin Care/Vaginal Ointment
• 1 T. aloe vera gel
• 6 drops tea tree
Mix tea tree and aloe vera gel together. Apply to affected area
According to WebMD, “The piriformis muscle is a flat, band-like muscle located in the buttocks near the top of the hip joint. This muscle is important in lower body movement because it stabilizes the hip joint and lifts and rotates the thigh away from the body. This enables us to walk, shift our weight from one foot to another, and maintain balance. It is also used in sports that involve lifting and rotating the thighs – in short, in almost every motion of the hips and legs.”
Piriformis
The piriformis is prone to trigger points, and if it becomes taut enough, it can press on the sciatic nerve, which usually runs underneath it but sometimes can run through it. Trigger points in the piriformis or an entrapped sciatic nerve can refer pain all the way down the leg. A tight piriformis may also torque the low back causing lumbar area pain as well. It’s a small muscle, but it can cause tremendous problems if it becomes taut or irritated.
Any number of things can cause the piriformis to become taut. Chief among these is sitting in one position for too long. If you have a job that requires sitting at a desk all day, chances are you know what a tight piriformis feels like. Likewise, activities that require climbing or repetitive motions like running, especially over uneven ground, can cause piriformis pain.
Massage is one of the best cures for piriformis pain, especially if you don’t wait until it becomes chronic. You can also use self-care strategies like rolling and pressing a tennis ball over the site or using a SacroWedgy®.
There a a number of good stretches for the piriformis as well. One is to lie on your back and to bend the knees. Cross the right leg over the left at the knee. Clasp your hands behind the bottom knee and pull both legs toward the chest. You should feel the stretch in the buttocks of the crossed leg. Repeat on the other side.
A variation of the above stretch is to sit in an chair, crossing your legs with one ankle over the knee of the other leg. Keeping your back straight, lean forward until you feel the stretch.
Another stretch is to kneel on the floor on hands and knees. Tuck the right knee under the body so that knee is in line with the left shoulder and straighten the left leg. Press the hips to the right until a gentle pull is felt in the right buttock. Repeat on the other side.
You don’t have to suffer with piriformis pain. Massage and self-care can keep you moving and help you avoid more serious problems like sciatic nerve entrapment.
I received an email this week from a new client who has been suffering from a headache lasting a week. I remembered reading a series in Massage and Bodywork Magazine, a publication of the Associated Massage and Bodywork Professionals (AMBP)), by Til Luchau. I pulled them out and reread them. Then I did a little more research online.
Luchau divides headaches into two broad categories: tension and musculoskeletal headaches in one category and migraine and other vascular headaches in the other. I’d add a third category: sinus headache. TMJ headaches might be a fourth category, and the general protocols for TMJ jaw pain often relieve the headaches as well. However, these headaches might be better categorized as a subset of TMJ dysfunction.
Luchau provides a chart for musculoskeletal/tension and migraine/vascular symptoms in his first article. My other research differs a bit on some points, but is in general consistent with Luchau. Understanding the symptoms is important because slightly different massage techniques are used for each type of headache. The image below offers a capsule version with hunger and eyestrain headaches omitted in the discussion that follows.
Common types of headaches
Tension headaches often arise when the muscles on the shoulders, back of the neck, under the occiput (posterior inferior cranium), and scalp become tight and pull on the scalp and the lining (dura mater) under the skull. Clenching the teeth is also a tension response and can cause headache even if TMJ dysfunction is not present.
Usually, tension headaches occur on both sides of the head, but if the musculature on one side of the body is tighter than the other, the pain may be worse on that side. It may also be worse in the back of the head, but depending on which muscles are hypertonic, it can be located almost anywhere. The pain is often a dull ache, but it may be more severe. It sometimes feels like squeezing or tightness in the head. Physical activity usually does not exacerbate it.
According to Luchau, the hands-on goal of working with tension headaches is to reduce the myofascial tension.
Sinus headaches are caused when the mucous membranes that line the four air-filled sinus cavities become irritated and swollen. The sinuses produce more mucus as a response, and the mucus that normally serves to moisten the air and soothe the sinuses becomes thicker and adds congestion that further blocks the sinus passages often creating a vacuum within them.
The pain is usually felt as pressure and/or tenderness just behind the eyes, cheeks, and forehead or near the upper teeth or temple regions. The pain may worsen if you lie down although lying down may reduce the pain of tension and migraine headaches. Bending over usually makes sinus headache worse. Your face may be noticeably swollen from a sinus headache.
If the cause of a sinus headache is infection, massage is contraindicated, and you should see a doctor immediately. Otherwise, massage with a hands-on goal of stimulating lymphatic drainage and relieving blocks caused by swelling and congestion may help.
Migraines are believed to be caused when the blood vessels inside the head dilate. Many migraine remedies include vasoconstrictors for this reason. However, according to Lachau, new research may point to another cause.
“Recent research suggests that migraines start as waves of nerve cell hyperactivity sweeping across the brain; the spreading waves in turn activate pain-signaling neurons in the brain stem. The root cause of these neuro-electrical ‘brain storms’ of abnormally increased activity is unknown. The hyperactivity is followed by inhibited nerve cell excitability; the cells seem to be worn out, and this exhaustion may explain difficulty speaking or thinking clearly after migraines” (Luchau, Sept./Oct. 2010).
The pounding or throbbing, sometimes stabbing, pain of a migraine is usually focused on one side of the head. It is frequently preceded by an “aura” or visual disturbance and is accompanied by nausea and sensitivity to light, sound, and odors. Physical activity can make it worse.
Most migraine sufferers have ideas about the triggers that cause their headaches and the symptoms that signal one is starting. They may also know that the massage protocols that work on tensions headaches often have little lasting effect on a migraine. Luchau’s hands-on goal of migraine massage is to reduce cranial compression, and I would agree that even if the migraine is initially triggered by muscular tension or sinus blockage, by the time it is a full-blown migraine, work on the cranium and the cranial fascia is necessary to relieve it.
Sometimes it is hard to tell what kind of headache it is. Generally, a look at the location and quality of the pain and at the response to activity and sensory input can help identify the type of headache you have. However, if you have a sudden, severe headache with no history of migraine headache or a dull headache that will not respond to treatment, you need to see your doctor immediately. Headaches can be a symptom of severe and even life-threatening conditions, stroke for example, and should not be ignored.
The massage protocol for a tension headache will include release of tight neck, shoulder and chest muscles and general relaxation strokes. Luchau’s first article emphasized release of the superficial and deep fascia of the scalp and a concentration of the suboccipital regions. I would add trigger point therapy of specific muscles likely to contribute to headache pain. Indeed, numerous research studies have cited the efficacy of massage, including specific pain-relieving modalities and more general relaxation type massage which tends to improve overall structural alignment and release endorphins into the body, as greatly relieving symptoms of tension headaches and even preventing headache recurrence when massage is received regularly.
Sinus massage with use of lymphatic drainage therapy is effective for relieving the pressure in the sinuses. (See my recent newsletter article on Sinus Massage.) The Lymph Drainage Therapy technique is slow and precise, and it uses feather-light strokes to move the lymph out of the head and into the nodes. It may also include the use of aromatherapy to further open the sinus passages.
Migraine headaches respond well to Craniosacral Therapy, especially intraoral work. CST allows the therapist to decompress the bones of the cranium and balance the blood flow. It also allows for structural realignment. Luchau’s technique uses a little more pressure than CST, but it is similar. (Trigger point therapy is often not as effective on migraines and on tension headaches.)
According to Luchau, the effect of this cranial work may be to reduce the pressure on the trigeminal nerve or to affect the hypothalamus and pituitary glands which may be responsible for the “brainstorm” of nerve cell hyperactivity mentioned in the quote above (Luchau, Nov./Dec. 2010).
Regular massage may also increase serotonin levels in migraine sufferers and thus prevent recurrence. Serotonin is a neurotransmitter and low serotonin levels have been indicated in migraine sufferers. Low serotonin also causes depression, seasonal affective disorder, addictions and eating disorders.
Two other modalities that seem to reduce headache pain are Myofascial Release and Reiki. Myofascial Release used gentle, light traction and stretching to release the fascia, which is a single sheath of connective tissue that covers the muscles, bones, organs, and even the cells (everything!) inside your body. Craniosacral therapy and lymph drainage therapy always incorporate myofascial release as do other modalities, but it can be used as a “stand-alone” modality. Reiki is one of a number of energy modalities that can be used to work on the subtle energy body. In many cases, this gentle therapy alone can relieve the headache.
Massage has been proven in study after study to decrease the severity and frequency of headaches. When you see your therapist, be sure to tell her the following to help her determine the best therapy protocol for your specific needs:
Where your pain is located
How long you’ve had the pain and if it comes and goes
How often you have headaches in general
If you’ve seen a physician and if so, what is the diagnosis
What precipitated the headache if you know
What is the quality of the pain (dull, throbbing, stabbing)
How movement and sensory stimulus affect the pain levels
What you have done to relieve it, such as taking pain relievers or using cold compresses, before coming to her
Headaches do not have to be a fact of life. Self-care and regular massage can be of great help in preventing them and relieving them when they do occur.
I incorporated Touch for Health into a Swedish massage today. It is the second time I’ve done so for this client. It is so easy to balance muscles with Touch for Health, and for the second time the muscle testing affirmed what I was feeling and intuiting about which muscles needed specific work.
My client is from out west and tells me that many therapists, chiropractors and alternative/complementary health providers out there use muscle testing. Not so here in the South.
I am gratified that this client called me and asked about TFH. I offered to incorporate TFH into her massage sessions free so that I could practice working with anatomical order rather than meridian order and also could practice with a client on the table rather than standing. I’m am more convinced than ever to use TFH on my clients who have chronic pain issues. I don’t use it as often as I would like because some of the tests are difficult to perform on a draped client. Getting to practice helps me to discover the best ways to keep the client comfortable while I check to muscle.
I am fortuante to have so many regular clients who don’t mind letting me try new techniques or different ways of solving their issues. I invite comments from anyone else who uses muscle testing with their clients on the table.
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