Cranial Sacral Therapy: What is it and how can it help?

Cranial Sacral Therapy

Cranial Sacral Therapy (CST) is a method of assessing misalignments in the body by observing restrictions in the flow of cerebrospinal fluid. This is the fluid surrounding the brain and spine, which is responsible for carrying nutrients from the bloodstream and eliminating waste. It also functions as a protective encasement of the central nervous system (CNS). 

The ebb and flow of cerebral fluid can be restricted due to impingement of a nerve, or lack of blood flow. Nerves travel between and beneath bones, muscles, and fascia (connective tissues), so misalignment can occur anywhere along their route and the results can be: decreased range of motion or function, decreased sensation, or pain and discomfort. 

Some underlying neurological conditions will have an impact as well and can also be treated with CST.

Listening Stations and Assessment

Regarding Cranial Sacral Therapy in osteopathy, practitioners are trained to observe subtle movements across the cranium and throughout the skeletal system. They can detect minute differences in the way cranial bones expand and contract, and in the direction they rotate as the client breathes. 

Although the eight cranial bones “fuse” together during the first two years of life, those sutures are not inflexible. The connective tissue between them allows for a subtle range of motion. These bones follow a measurable pattern of motion based on breath, and the interchange of blood and cerebral fluid.

The motion of the skull is not arbitrary. Restrictions in movement can mean there is an impingement, or even a lesion. When observing restrictions between cranial bones and along key points called “listening stations,” osteopaths can determine whether other symptoms in the body have a source in the central nervous system.

For example, if someone is suffering from numbness or tingling in their fingers, CST can be employed to discover how far down the neck, shoulder, or arm the nerve is being affected. If someone is experiencing migraines, the osteopath may discover a restriction in the vertebrae of the neck or even between the cranial bones.

The practitioner begins by watching the primary respiration—that is, the client’s natural inhale and exhale while they lie prone. The bones of the body expand and relax at 6-9 seconds intervals, based on that breath. Restrictions can also be observed in different types of motion, i.e., walking, sitting.

The osteopath employs certain holds to detect the internal and external rotation of these points:

8 Listening Stations

  1. Heel of feet
  2. Dorsum of feet
  3. Anterior femurs
  4. Bilateral ASIS (Anterior Superior Iliac Spine)
  5. Shoulders
  6. Vault hold 1- hold occipital cradle,  and frontalis 
  7. Vault hold 2- ears between middle fingers, and hands are on the temporalis
  8. Vault hold 3- hold occiput, temporalis, frontalis, and sphenoid

Fine-tuned Adjustments

When a restriction is located, an osteopath is able to provide gentle, hands-on adjustments. If the area moves too much or too fast, they will stabilize it. If it doesn’t move or it is restricts you, they will mobilize it. 

Adjustments can be performed anywhere along the spine, on the bones of the cranium, and between which there are joints. The sutures of the cranium are designed to accommodate the imperceptible movement of cerebral fluid as well as to cushion the brain on impact. Movement between the cranial bones can be detected during the various vault hold assessments. 

Common disorders in the (CNS) include subluxations, lesions, and external or internal rotation dysfunction.

Subluxation- misalignments or dislocations of the spinal bones, putting pressure or impingement on the nerves that innervate them (go through them).

Lesions- restrictions in the fascia, bone, joint, or muscle, such as: open wounds and scar tissue; torn muscle/tendon/fascia; inflamed tissues; growths; cysts; and tumors.

Rotation Dysfunction- Over flexibility in the joints one way or the other.

The practitioner needs formal education in Cranial Sacral Therapies and should also be trained in involuntary mechanisms such as lymphatic drainage and other techniques involving Cranial Sacral Therapy Rhythm. There is a surprising amount of dysfunctions that can be treated at the cranial bone fusion sites, including: 

Treating Cranial Bone Fusion

Headaches and Migraines

Chronic Neck and Back Pain.

Traumatic Brain Injury and Concussion

Stress and Tension-Related Disorders

Motor and Coordination Impairments

Brain and Spinal Cord Injuries

Chronic Fatigue

Infant and Childhood Disorders

TMJ Syndrome



Central Nervous System Disorders

Learning Disabilities


Post-Traumatic Stress Disorder

Orthopedic problems

and many other conditions.

Cranial Sacral Therapy (CST) can relieve chronic pain and tension and offer a renewed range of motion and blood flow through the brain, spine, and entire body. Often, the effects will be immediate. 

For the best results, clients should follow their treatment plan and return to their osteopathic practitioner to be sure the adjustments have made a lasting difference.

For more information on craniosacral therapies, consult your healthcare practitioner. They can advise you on any contraindications to the practice as well as direct you to complementary techniques.

Manual Osteopathic College of Canada; 2020 Involuntary Mechanisms

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