The Osteopathic Way

Maria T. Gentile, D.O.

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Treatment of Pain and Injury

Cranial Osteopathy or Osteopathy in the Cranial Field (OCF)

Cranial Osteopathy utilizes the practical relationship of the anatomical and physiological mechanisms in the cranium and their interaction with the body as a whole. It includes a comprehensive system of diagnosis and therapeutic procedures for the prevention and treatment of disease and injury.

Cranial Osteopathy (or Osteopathy in the Cranial Field) is a concept first put forth by William Garner Sutherland, D.O. who expanded on an observation already referred to by Andrew Taylor Still, M.D.  Dr. Sutherland determined there is a palpable movement within the body that occurs simultaneously with the motion of the cranial bones. Sutherland proposed a model called the "Primary Respiratory Mechanism" (PRM) to describe the inherent forces that drive this cranial rhythm.  He used this terminology to suggest an essential, vital rhythmic force functioning through the cooperation of a number of physical elements.  These consist of the mutually dependent relationship of five components:

  1. The natural, inherent motion of the brain and spinal cord
  2. Fluctuation of the cerebrospinal fluid
  3. Mobility of the membranes within the cranium and spinal column
  4. Unified motion of the cranial bones
  5. The involuntary motion of the tailbone between the pelvic bones

Cranial Osteopathy uses the primary respiratory mechanism to diagnose and treat problems within the cranium and throughout the entire body.  This natural rhythm of alternating expansion and contraction can be felt from any part of the body by a trained physician.  This is because the the PRM effects every cell, influencing and guiding the physiology of the whole body.  

A thorough understanding of anatomy, physiology and embryology is crucial in order to effectively perform cranial osteopathy.   Therefore, the teaching of this art and science has been limited to D.O.s, M.D.s, and D.M.D.s (dentists) because these practitioners have an extensive medical background.  Hundreds of hours of study and training are required for understanding of this field.  Certification  is given only after 5 years of training and competency testing.

Doctors trained in cranial osteopathy can feel subtle changes in the PRM as it relates to problems in the body.  Even small alterations of an infant skull's natural shape or motion can lead to disorders such as colic, swallowing difficulty, frequent spitting up or developmental delay.  If left untreated, these cranial patterns can lead to a number of problems in adulthood.  Head trauma can also cause altered cranial patterns which can manifest as back pain, headaches, breathing and digestive disorders, joint pains or menstrual disorders.

For many years it was believed that the bones in the cranium fused at an early age and did not move.  However, modern diagnostic imaging has proven the existence of motion in the cranium.  

Cranial osteopathy is a very effective and profound treatment modality that can be safely applied in the treatment of infants, children and adults.


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