CRANIAL TECHNIQUE OSTEOPATHIQUE PRESENTATION p1 INTRODUCTION - - - PowerPoint PPT Presentation

CRANIAL TECHNIQUE OSTEOPATHIQUE

PRESENTATION

INTRODUCTION

• The life appears by the movement. Since the cell that we see under the

microscope, to the animated bodies them also of a certain dynamism. These organic movements create in their turn various functions of the human body, the unit expressing

• ur life.
• Each function is expressed on its organic level, by a movement which is clean for it.

There is thus, for each structure, at every moment, a variable and different state.

• It is the same at the cranial level, whose plasticity is allowed by all. This unit is

made up by the various bones of the vault and the base. And the sutures which connect them, present each one, of the particular movements, but with a synergy of the unit.

• The plasticity of the bones, united with these micro - movements constitute the

dynamics of this system.

• Historically our predecessors had perceived it perfectly, since in many parts of the

world, I met traditional practitioners who use more or less elaborate cranial techniques.

• But this is at the end of century XVIIIº, that in the U.S.A. and then in Europe, these

techniques were explained, classified, improved and gradually codified.

• Like any articulation, that of skull must be free between the two parts which

constitute it.

• In the contrary case, it then occurs a modification of its operation which can result

in a deterioration in its dynamics. If it occurs an additional constraint, this articulation cannot then answer these new functional requirements, : the conditions with the installation of a pathology will be met, where this restriction of mobility appeared. p1

• It is known that this barrier requires to be solicited by the function to appear.
• From where the name of functional barrier.
• Posing his hands on skull, the therapist will perceive these barriers, which will

enable him to then restore by its action a normal mobility where he had perceived this restriction of mobility.

• How does it perceive it? Simply with its five directions which is the most natural

means for decoding the messages of abnormal operation of the human body.

• On the one hand, it sensitively records deteriorations of the function, which can

be sometimes also visible and, on the other hand, it questions each articulation manually : examination of mobility, tests of tissue resistance, rebound at the end of the movement signing the state of conjunctive tissue, etc ......This manual approach renewed at the end of the processing will enable him to realize also of its effectiveness.

• The Greek philosopher Aristóteles “the man is intelligent because it has a

hand”.

• The history of humanity also teaches us that in its evolution “l’homo habilis” (the

man with tools) has preceded “l’homo sapiens” (the man who thinks).

• Let us draw the conclusions from them during practicing soft handling of which

each one, appropriate to the cranial articular level considered, will involve the elimination thus of this functional barrier. Recovered lost freedom, the function will be restored where beforehand a functional deterioration, had allowed the installation

• f pathology.

p2

BASIC PRINCIPLES

• ANATOMY
• and
• BIOMECHANICS

p4

BASIC FOR THE CRANIAL TECHNIQUE

• The training of the cranial techniques has like the

anatomy basic which provides the structural substratum

• f it and biomechanics which then makes it possible to

understand some operation.

• The control of these techniques then will be acquired

thanks to a progressive proprioceptive refinement, so much with regard to the plasticity of the bones that of the sutural movements.

• These are two former qualities which will give the

dynamics of the cranial mechanism.

p5

THE PROPRIOCEPTION

• Like any direction, the proprioception is

born from the receivers of tact, is transmitted to the cerebral zones which make the analysis

• f it, according to the elements beforehand

perceived which are the only references. What thus requires a tactile education for any activity not carried on before. What is the case in cranial technique here, because the movements are only of a few microns.

PROPRIOCEPTION (continuation)

• One cannot teach perception, because.
• it is not interpretable in words,
• It is personal and function of its reference frame, tactile

for the touch.

• It is interpreted according to the state of the therapist.
• One can thus only make live an experiment.
• - It is that you teaches thanks to perception that you

have some during the experiment.

• - This practice is thus the ideal way, personal, regularly

developed, by each attentive expert with what occurs.

ANATOMY

• To understand cranial dynamics, made plasticity on

the one hand, and micro-movements on the level

• f the sutures on the other hand, we must initially

point out some elements of the cranial anatomy.

• Firstly that the cranial system is composed of three

subsystems having a different dynamics, because of their embryologic origin and nonidentical histological constitution:

• 1º - the base of skull of cartilaginous origin.
• 2º - the vault of membranous origin.
• 3º - the face of the variable origins according to the

bones.

The Base of the Skull

• The base of skull, of cartilaginous origin is traversed by tension fields which show us its

capacities of strength to the various constraints. In the same way they indicate the vectors of action to us of as our techniques. It is considered, in cranial dynamics, like the motive fluid

• f this one.

p17

The Vault of the Skull

• It is membranous origin,

which explains its greater flexibility, plasticity, and its little transmission of the constraints to the whole of the system.

• Therefore she is considered,

like adaptation, inside the cranial mechanism.

• It especially consists of bone

pairs.

THE FACE

• Unlike the two others subsystems which we have just seen, the face which is

made up of many bones which are juxtaposed or intricate.

• Moreover they are:
• Not subjected to the reciprocal membrane of tension,
• Animated by a number impressing of small muscles,
• Not always subjected to the synergy of the whole of skull,
• And can be mobile, independently of the cranial rhythm which we will study

front.

• For that it is considered, like the subsystem expressive of the cranial system.

– IN SHORT

– The Driving BASE – The Adaptation VAULT – The Expressive FACE

IN CONNECTION WITH CEREBRAL BLOOD CIRCULATION

• It seems important to us to initially point
• ut the particular anatomy of the brain, since

although representing less than 5% of the body weight its operation can require more than 20% of the totality of glucose and the

• xygen, that brings to him this blood

circulation.

• However, arterial circulation does not

resemble that of the other bodies, according to Professor Lazorthes, world specialist on the

• matter. The brain does not have only one

pedicle like the other internal organs, but blood is brought to him by 4 large arteries. Two internal carotids and the two vertebral arteries. p10

ARTERIES OF THE BASE OF THE BRAIN

p10

ARTERIAL CIRCULATION

pp7,9

Arterial circulation. Internal sight

p9

PHYSIOLOGY OF CEREBRAL ARTERIAL CIRCULATION

• “The distribution of the cerebral vessels

to separate territories anastomosis imposes the concept of blood currents juxtaposed, and relatively autonomous, though heard well functional”.

• ( Professor Lazorthes )

p10

Dependence between circulation and cranial mini- movement

• The examination of the vascular prints left on the inner face of the

bones of the skull (in the skull), in particular by the meningeal arteries, shows that their tree structure is done in range, opening towards the back lasting phylogenesis, in relation to occipital rotation

• n its transverse axis.
• It is the same of the venous prints as leave on the occipital one and

the parietal ones, the higher longitudinal sines, the right and left sines right and sigmoid. As well as other vessels, morphologically less important.

• Experiments led to the United States of America established in the

facts that the practice of the cranial osteopathic techniques increased cranial circulation, as well on the level of the arterial contribution as of the venous current.

p12

VENOUS CIRCULATION

• We have that the prints of the venous sines on the face

endocranial were important, with, links privileged on the level of the vault.

• It is important maintaining to also underline that these

venous sinus restore this face endocranial, between the two layer of insertion of the external dura mater on these same bones.

• One then understands easily how much the mini

movements of bones, joints to the sutural separation will instigate the venous sinus, which we point out it to you do not have a valve.

pp12,13

Endocranial Venous Circulation

p14

SPECIFIC ANATOMY The cranial sutures

• Although you know all the anatomy of skull, there are

elements specific to the cranial osteopathic technique which you are unaware of.

• In cranial technique, we attach an importance more

particular to the suture, which are mini - surfaces slip allowing the changes in form of limps cranial as a whole.

• Indeed, these sutures are bevelled, that is to say on the

level of the external table: They look at then towards

• utside is with depend on the internal table, looking

towards the interior.

pp18,19,20,21

SPECIFIC ANATOMY Membranes of reciprocal tension

• As well the tent of the brain, as its

scythe, the unit constituting a star with three regularly separated branches fits on the bones of the vault (occipital - temporal) that base (Sphenoid).

• They thus represent an internal

system equilibrator as much as a system which distributes in a synergistic way, the constraints which the unit undergoes.

• We call them for that

“Membranes of reciprocal tension”. pp70, 71

Anatomical elements of the sutures

external bevel internal bevel free nerve ending membrane of the reciprocal tension venous sinus artery p29

Anatomy of the cranial articulation

• Like shown joint diagram, it is made up by the same elements as any other

articulation of the human body, whose elements are driven by forces, as well internal as external, and balanced permanently.

• It thus presents:
• slip surfaces (bevelled and squamous sutures), of separation (notched

sutures), juxtaposed (harmonic).

• a periosteum of recovery
• ligaments of recall, consisted by the bifurcation of the insertion of try

and the forgery and their fixations on each sutural bank.

• a free nerve ending in sutural space, like showed it in 1992 the study of

the department of anatomy of the University of Michigan.

• sutural arteries and veins
• proprioceptors located at the sutural level.
• (Bunt - South Africa 1996),

pp28,29

Differencies of cranial sutures

p29

with all bevels of skull

• This figure shows you the unit
• f it. External bevels are

illustrated in “hatched”, internal bevels in white.

• It is absolutely necessary to

know them to understand the particular movement of each various bones of skull. p19

BEVELS and PIVOTS

• * You have notice on the preceding figure, that on the level of each suture it exists

an inversion on the level of bevels, which indicates that a part moves contrary to the

• ther. What means that between the two parts going in opposite direction, there is a

pivot, that I show you on the parietal bone that I have in hand.

• When we meet two pivots by one line, we obtains an axis then. It is what I show you

here on the former edge and the posterior edge of the parietal one.

• It is this axis which determines the movement that this bone carries out.
• As the skull resembles a ball overall, structure which has six degrees of freedom, the

bones which are with the periphery will have possibilities of movement in the three plans of space. I.e. that they thus will have three axes of movement each one, although their displacement is major in a principal direction, there less in the others. Except the parietal ones which is made of a more flexible curved blade.

BEVELS, PIVOTS, AXIS OF MOVEMENT (Example: Temporal)

• The lines link the 2 pivots located at

the changes of bevels.

• They are the axes of movement.

p65

THE BONE OF THE CENTRAL AND PERIPHERAL LINE

• For the cranial motion study, we divide the constituent bones the skull, into two

distinct unit.

• A - A central line, constituted by the odd bones of the median part of the
• base. Of back ahead:
• occiput , - sphenoid - frontal ,- ethmoid, - vomer, mandible
• B – the peripheral bones , pairs , and which understands of back ahead,

following bones:

• parietals, - temporals, - maxillaries, - palatines, zygomatics, lacrymals, –

nasals.

• This division is arbitrary, since the skull functions in synergy. But it makes it

possible to better understand the biomechanical role of each element in the work

• f synergy of the unit.

• In cranial technique, one gives an major importance to the articulation

between the basilar apophysis of the occipital bone, located at his former part, and the posterior part of the sphenoid.

• This articulation is named Spheno-Basilar Symphysis (SBS).
• As you can notice it already, these two articular involved surfaces, on

these two bones are irregular and rough, allowing a movement in successive drive partial and variable in cogwheel of part of a bone with the other.

THE BONE OF THE CENTRAL LINE: SPHENO-BASILAR SYMPHYSIS p40

Biomechanics of the cranial movement

• It is on the level of this spheno - basilar symphysis, that in cranial
• steopathy, one considers that the cranial movement begins. We are now

ready to study the characteristics of them. p39

Displacements of the two articular banks

• Two articular surfaces (nonhyaline) of the cranial articulation, move,

because of the layout of their slip surfaces, each one like a cogwheel in comparison with the other, in a system of gears.

• The cranial movement is a movement which proceeds according to a cycle of two

alternative phases, which are:

• the flexion, which is achieved in the bones of the line of centers (odd bones)

around their transverse axis, at the same time as the external rotation of the bones of the periphery (even bones) around an axis obliques which is specific to each one of

• them. We will study them then. It is the active phase of the movement.
• During this phase an expansion of the cranial mechanism occurs, which produces an
• pening of all the suture of skull.
• the extension or phase of relaxation, phase during which the bones of the

central line return to their position first, at the same time as the bones of the periphery carries out an internal rotation, each one around the axis which is clean for him: I.e. that they turn over to their initial position by using the potential energy accumulated by conjunctive tissue will intra and periarticular at the end of the final stage inflection, during the compression generated by the kinetic energy.

• It is the passive phase or phase of relaxation of the movement.

BIOMECHANICS OF THE CRANIAL MOVEMENT

p39

MOVEMENT OF FLEXION

• The active part of this movement (flexion - external rotation) is not uniform,

but proceeds according to three phases:

• 1º - ascending phase, which enables us to perceive the beginning of the

movement and to have perception of it.

• 2º - maximum unfolding. It is especially during this phase that the

therapeutist will be able to influence and modify the movement.

• 3º - end of the movement. It is during this phase that the resistance of the

conjunctive fabrics appears which with their elasticity and their plasticity slow down the movement, stores the potential energy which, restored causes the return to the neutral point of the unit.

Flexion Movement

p41

Flexion Movement of the bone of the central line

pp40,41

Occipital Movement

• Its principal movement of flexion-extension (but it can like all the other bones,

to move around a vertical axis or of an axis antero - Posterior) is carried out around a transverse axis located at the intersection of two secant plans during passing by stalemate the former edge of the foramen magnum and by the higher edge of its basilar apophysis. pp42,43

Sphenoidal Movement

• Its principal movement
• ccurs around a transverse axis,

but in two successive phases:

• initially the body and mow large

wings move in bottom and in front of the axis passing within the body sphenoid.

• Once this movement of the

achieved body, the large wings continue theirs, always in bottom, ahead and outwards, around a second transverse axis passing between their roots. pp44,45

Movement of Spheno-Basilar Synchondrosis

• This articulation is regarded as the

engine of the cranial movement, because it is of it that share its dynamics.

• Two elements in articular contact are

located in contrary direction, like the gears of two cogwheels.

• It is this displacement which involves

the other bones at the time of the cranial movement, its dynamics being increased by plasticity inherent in biological materials. pp46,47

Frontal Movement

• In cranial technique the frontal bone is regarded as being formed of two
• parts. Indeed, in addition to the metopic suture gives to its convexity an

additional plasticity between its two parts, the osseous blades located between the three pillars (two lateral and one central) confer they to him also an additional plasticity.

• The principal movement of the front-end processor is carried out

especially around a central axis, bringing its edge postero - superior behind and in bottom, whereas the eyebrow arcades advance while being raised.

• But the elements underlined above form at the same time, a light

depression of the metopic suture, as well as an antero-external rise the external orbital apophyses.

• This is supported, by the push ahead, in top and apart from the superior

part of the large wing in its second time as we come to see it in the preceding slide. pp48,49

Diagram of the movement of the frontal bone

p49

Ethmoidal Movement

• The ethmoide present of the tension fields which transform the horizontal forces

into vertical forces and reciprocally.

• These movements are induced by the constraints which its central structure

undergoes, whereas at the same time its side masses, under the action of the external rotation of maxillaries, take part in the expansion side of the face.

• Its transverse axis of rotation is located, on the upper part of the vertical blade.
• The flexion, around this axis, is induced by the part former of the sphenoid, which

involves its posterior part in bottom and ahead, whereas its former part rises and moves back.

• This movement corresponds perfectly to that of the ethmoidal of the front-end

processor in which the horizontal blade of the ethmoid is placed.

• It is it should be noted that as well the plasticity of the bone as the fronto-

ethmoidal union, allows small lateral movements. They will allow small movements of adaptation and compensation.

pp50,51

Diagram of ethmoidal movement

p51

The movement of Vomer

• Lamellar bone, whose oblique tension fields in bottom

and ahead, balance on the one hand the vertical forces, and on the other hand literally in bottom the bimaxillary vault.

• This double role obliges it to adapt constantly in torsion,

this double constraint.

• Its transverse axis is located, in its central part, between

the most marked tension fields.

• Its movement of flexion is induced by the lower part of

the body of the sphenoid, i.e. that its upper part moves in bottom and ahead, whereas its lower part goes in bottom and behind. What corresponds perfectly to the described movements share the palatine apophyses of the maxillaries and by the horizontal blades of the palatine

• nes.

pp52,53

Diagram of the movement of Vomer

p53

Movement of the peripheral bone : Cranial Vault

• It is formed:
• I - the pair bones of membranous origin

like parietal bones ,

• II - the pair bones (Temporals) and impair bones (Occipital, Frontal,

Sphenoid) of mixed origins : – - membranes by their squamous part,

• cartilaginous by their basilar part.
• Its curved and plastic general aspect, with the well marked tension fields

gives him its flexible resistance.

• Its accommodating dynamics results, in addition to the effect of its plasticity,
• f the important movements permitted by sutures of the various type

(notched, bevelled, by juxtaposition, etc….) which allows between them these mini - displacements.

• Located at the periphery of the cranial cavity, these bones present all of the

axes of movement having different obliquenesses

• We will speak - to simplify the demonstration - about only one axis of

movement, knowing pertinently that at each moment of the same movement, its axis being differently directed, and that these successive axes will describe in space a particular figure for each one of them, called cardioid. p55

Biomechanical characteristics of the Vault

• The coronal, lambdoidal, occipito-temporal sutures, present on their course of

the changes of bevels, who form the pivots around of which will be held the movements of each bone of the vault.

• Indeed, these pivots succeed two to two determined axes of the movements
• f parietal and their articulations as well with the front-end processor as the
• ccipital one.
• The movements of the even bones of the periphery proceeding around
• blique axes, each one in varied plans, constitute, at the time of their phase
• f expansion, which one calls external rotation.
• Their phase of relaxation or the opposite movement constitutes internal

rotation then.

• Let us see one by one, the dynamics of each one.

pp55,56

Biomechanics of the temporal bones

The axis of the temporal bone passes - roughly by the petrous pyramid, and like this one, described a cardioid during its general movement. Nevertheless this bone, presents six pivots, joined together in two groups of three, which form two almost perpendicular secant plans then. Thanks to those it will carry out, according to the particular drawing of the various types of sutures, of the small movements particular to the level of each pivot, who will allow on the one hand to have a discriminative movement, and on the other hand to adapt this one to the small losses of mobility being able to exist that and there. Their perception - that we have focusing - will be the diagnostic key which will involve the choice of the specific techniques which will restore the movement general of the temporal one. Let us examine initially, the movement complete general of the temporal bone, which understands four sequences well distinctly (cf. drawing herewith) starting from its neutral point: lowering, external rotation, extreme rotation, internal rotation. pp58,59

Diagram of Temporal Movement

p59

Movement of three pivots of Temporal base

• Petro-Basilar Pivot :
• Articular involved surfaces are grooves, convex at the base of occipital (full

rail), and convex (hollow rail) on the petrous part which is articulated with it. Its axis is transverse.

• It produced there a movement of slip, which allows the widening of skull.
• Petro-Jugular Pivot
• Two articular surfaces form the internal part of the posterior torn hole. There

would exist, according to certain anatomists, sometimes a small meniscus.

• The movement is carried out around two transverse axes (external rotation)

and vertical (time rotation on the level of occipital) and anti - time on the level

• f the temporal one.
• Spheno-Petrous Pivot
• It is a movement of circumduction of the sphenoid around clinoid insertion of

the spheno-petrous ligament (ligament de Grüber).

• This movement allows to balance the structures of the cavernous sinus and

the torn anterior hole. pp60,61

Movement of the three pivots of Temporal vault

• Condylo–Squamo–Mastoidal Pivot :
• Located between the occipital bone, and the posterior part of mastoid, on the

level of its change of bevel (supero - internal, and infero - external).

• The temporal one carries out an external rotation movement on its transverse

axis, at the same time as this former pivot, around a vertical axis, while separating from the occipital one.

• Hinge-Mastoid Pivot (H.M.) :
• Between the parietal one, and the temporal one, on the level of the small change
• f internal - external - internal bevel, squamous edge of temporal (entomion). This

small setback in external bevel within a general internal bevel on the squamous edge

• f temporal, induced movement in veiled wheel, which makes it possible the axis of

the bone to drop and increase then its external rotation.

• We call this as it is extreme rotation
• Spheno-squamous Pivot.
• Between the edge posterior of the large wing of the sphenoid and the former edge
• f the squamous temporal, with the change of bevel of these two bones with their

lower edges. The sphenoid is driven on its three axes. pp60,61

Parietal Movement

• Its 2 coronal and lambdoidal sutures comprise each one, two bevels, one

side which is internal, the other medial which is external.

• With the change of bevels of each suture the point pivot is. The 2 points

pivots of the coronal and lambdoidal sutures, succeed, determine the axis of movement of each of the two parietal ones.

• On the level of the squamous sutures with the temporal one, the parietal

present one on the major part of this one an external bevel, except in the very small zone of the H.M pivot. Or it is reversed., i.e. internal.

pp64,65

EACH PARIETAL PART LOCATION

• The movement of parietal can thus be summarized thus.

During external rotation (synchronous of the flexion of the

• dd bones):
• the antero-internal angle and the side part of the coronal

suture precedented and expressed.

• the medial part of the coronal suture is depressed and

moved back, like it does bregma.

• The interparietal suture is depressed, moved back, and its

two banks separate, especially on its posterior part.

• Lambda is inserted and separated its two banks.
• parietal (whereas the occipital part moves back)
• The lambdoidal suture is inserted, and separates in its medial

part, but advances, while expressing itself in its lateral part.

• Its temporal suture is exteriorized (open).

pp64,65

The drawing of the parietal bones

p65

MOVEMENTS OF THE FACIAL BONES

• Sphenoid, temporal and the front bone transmits

their movement to the maxillary which, under their joint action, transfers this dynamics to all the bones which are articulated with it, i.e. all the other bones from the face.

• It is the moment of the sutural opening.
• Whereas the frontal slope is accentuated, the whole of

the face widens, swells. The eyes open. The mandible unobtrusive while dropping.

• The schema here after you indicate the general

movement of each facial bone. We will specify the distinct characteristics of them, by a specific study of each one of them.

pp66,67

DIAGRAM OF GLOBAL MOVEMENT OF FACIAL BONES

p67

Movement of maxillo-palatino-vomerian complex

• This unit, as we wrote, receives any wave of dispersion coming from the direct

cranial shocks, because of convergence in its centre of the tension fields of cranial architecture.

• After longtime, by Felizet, Benninghoff, etc... pillars and beams and its

continuum in the dural membrane, is well described by Arbuckle.

• We know as this unit, by its dynamic flexibility, must answer the intrinsic

possibilities of its osseous environment, i.e. with the mechanical constraints as well

• f the front-end processor as of the sphenoid.
• It will have to thus be able to adapt these situations by the following

movements : torsion spheno-maxillary, shearing spheno-maxillary, disimpaction spheno-maxillary at the same time as : latero-flexion fronto-maxillary, separation fronto-maxillary, or shearing antero-posterior fronto-maxillary.

pp68,69

Diagram of movement of maxillo-palatino-vomerian unit

p69

The maxillary movement

• Its axis of external-internal rotation is carried out around an oblique

axis, passing by the frontal apophysis in top, and by the angle antero

• external (either the node) of the tuberosity of the maxillary in

bottom.

• Synchronous with the flexion of the sphenoid, the maxillary moves

as if it were suspended with its frontal apophysis. It thus will occupy a more frontal plan, whereas its suture inter maxillary drops, moves behind and that the bone seems to separate from its counterpart subsequently.

• The posterior edge of the rising apophysis moves laterally, so that

it is located in a plan more coronal and its anterior face drives antero-laterally.

• It should be noted that the palatine apophysis of the maxillary

carries out a movement parallel and identical to that of the parietal bone corresponding.

• At the time of the flexion the two maxillary give to the vault of the

palate a more Romance form to the Gothic warhead which represents their form during the extension.

pp70,71

Diagram of the maxillary movement

p71

The movement of the palatine

• Its constitution shows perfectly its biomechanical role within the cranial

movement.

• Formed by two flexible orthogonal plans which meet, while forming a

tension field antero - posterior reinforced, it will give flexibility where the cranial system transform the vertical forces into vertical forces and vice versa.

• Its movement, follows on the one hand the movement of the apophyses

pterygoid against which its pyramidal apophysis presses, and in addition moves back while following the movement induced by the palatine apophysis

• f the maxillary, on which presses its former edge.
• Moreover, it will compensate for by flexibility of its vertical plan the slightly
• blique movement behind and apart from the apophyses pterygoid.

pp72,73

Diagram of the palatine movement

p73

Movement of Zygomatic

• Of dense structure and resistance, it is articulated with the maxillary, the

front-end processor and the temporal one

• Its axis of oblique movement, goes from a point located slightly under the

glabellar one at the gonion, i.e. that at the time of the flexion, the zygoma, rolls antero-laterally, involving its edge orbítal outside, widening the diameter

• f the orbit.
• Its frontal apophysis follows the external orbital apophysis, ahead and
• utside, whereas its temporal apophysis moves infero - laterally.

pp74,75

Nasal Bone Movement

• Articulated with the spine nasal of the front-end processor, it will follow

the movements of them.

• Its axis, goes from its higher edge to its lower edge, through the body
• bliquely in bottom, ahead and outwards.
• Its movement at the time of the flexion makes it turn around this axis, its

central part is depressed whereas her periphery is raised, while being expressed. pp74,75

Lacrymal Bone Movement

• Size of a nail, this lamellate

bone downwards carries out a small movement, before and outside, which increases very slightly the concavity of its inner face.

mobility of right lacrymal mobility pp74,75

Mandibular Movement

• Suspended part of the articulation Temporo - Mandibular, this bone is

dependent on temporal by its lateral ligaments, and mandibular stylus, like by its meniscus.

• Its movement will thus follow that of the temporal part with which it is most

intimate, i.e. its mandibular fossa.

• We know that in external rotation, this part of the temporal one which is located

under its axis of rotation, drops, moves back, and goes slightly outside.

• It will be movement that will achieve the mandible, which moreover will tend to

widen, because of the possibilities structural still existing on the level of its symphysis menton. p77

MOVEMENT OF THE MEMBRANES OF RECIPROCAL TENSION

• We will limit our study of the tension, transverse partition separating the

cranial volume in two stages, and of the forgery, partition medio - sagital, separating the two cerebral hemispheres, with their purely biomechanical role.

• Indeed, their lateral insertions are divided into two layers anchoring each
• ne, either with a sutural bank, or with the lip of an osseous gutter which

shelters a venous sinus..In addition their medial insertions form, on the level of the right sine, a point of balance, a fulcrum flexible and variable, which makes that the whole of these membranes creates an internal system equilibrator for the structure of cranium, where the tension fields of this one are continued with that one by unifying them and by distributing the efforts undergone by the whole

• f the system.
• The diagrams of the next pages, show these tension fields, which can

become lines of stress, as well as the displacement of the tension as well as scythe at the time of the movement of flexion of the cranial mechanism.

pp78,79

DIAGRAM OF THE MEMBRANES OF RECIPROCAL TENSION

Fiber of stress of the dura mater according to B.E. Arbuckle pp80,81

MOVEMENT OF THE MEMBRANES OF RECIPROCAL TENSION p80

CRANIAL ADAPTIVE MODES

GENESIS OF THE CRANIAL ADAPTATION

• The human being does not preserve all its life its potential of functional
• freedom. Gradually the age comes to deteriorate of it the structure which

generates it. Hypermobile points, even fixed settle that and there, because of certain postural attitudes, of abnormal operations, small traumas, gestures imperfectly carried out, muscular tensions and/or fascial, which is born of its emotional reactions in front of the events.

• This loss of partial freedom will create restrictions of local operation that

and there, of the muscular and facial tensions, more or less permanent which makes affect its diagram of general operation at the same time as to mark it

• f a special character in its gestural expression.
• It is a biological law, which the human being seeks to express the best

possible life which is in him, whatever the acquired restrictions, by printed typical diagrams which maintain operation with the maximum of it remaining possibilities. pp83,84

GENESIS OF THE CRANIAL ADAPTATION. TORSION

• As we showed in addition, the first stage of this adaptation will be done in

torsion, because this position enables him to preserve the totality of its potential of operation, even will increase it temporarily, for two reasons.

• Initially because the continuum fascial which crosses our body, enables us

to grow ourselves and to unroll us starting from a point fixes (ground) while keeping our balance. The example of the person who stretches herself in torsion to go to unscrew an electric bulb that it touched very right before the famous good.

• Then, because this position allows us to store by this movement an

energy (potential energy) that the body will restore in the form of kinetic energy by leaving this position. The examples make abundance in the sport : preparatory torsion with the reverse with the tennis or the recovery of stolen to football, etc… The body understood it well. It tries to prevent the fall, will try to control it while seeking by and in its torsion an additional kinetic energy.

• TORSION IS THE FIRST STAGE OF OUR ADAPTATION.
• pp84,85

GENESIS OF THE CRANIAL ADAPTATION. Rotation / Lateral Flexion

• But if it proves to be insufficient, the body will increase its internal stress, by

creating itself a fixed point from which will be born a new balance from which it is then ready to take up its duty. Unfortunately it will be also accompanied by a functional limitation, the most limited possible.

• Always the same biological law of functional survival.
• The skull, to the image any other subsystem of the human being, will follow the

same laws. It will be put successively initially in torsion to continue to function quasi normally. But if that proves to be insufficient, it will then create this less mobile zone of accommodation. This one can also settle following a trauma whose wave of dispersion exceeded the possibilities of the cranial system, it will be an adaptation in Rotation - Flexion - Lateral.

• This cranial zone by losing part of its biomechanical potential, in parallel

produce a constraint on endocranial circulation with like consequence a deterioration of the sugar and oxygen contribution whose brain is fond of delicacies.

• Always the same biological law, our being adopts the best solution for its
• peration, in term of permanence and survival.

pp84,85

GENESIS OF THE CRANIAL ADAPTATION.

• ther adaptations
• Other adaptations can occur, but they make following constraints which

have occurred during the time native, postnatal, or very early in the life, and are not field of the general adaptation of the system.

• We find them in certain small children, teenagers or adults. We will detail

the most frequent diagrams here of them. They are at the level of spheno - basilar synchondrosis (SBS). The principal ones are:

• * Horizontal displacements,
• * Vertical displacements,
• * Compressive stresses

pp86,87

ADAPTATION: THE CRANIUM IN TORSION

• At the time of the movement of flexion, the bones of the central line, carry
• ut each one a movement around their transverse axis, whereas those of the

periphery using the oblique axes which are clean for them, are put in external rotation.

• Because of its central position, Spheno-Basilar Synchondrosis (SBS) sees

converging all the sutures of the base in its direction, like as much rays. One understands easily that a blocking on one or more sutures of the base modifies this movement of flexion - external rotation, around this new fixed

• point. It creates for itself a hinge, which constrained the cranial unit to use an

additional axis to carry out its movement. This new axis antero - posterior implies that the movement is also made in torsion, i.e. that parts former and posterior of skull move in direction opposite one of the other.

• Who is more the plastic deformation of skull reveals an additional

component passive, tiny, around the vertical axes, in opposite direction.

• We qualify this torsion of right-hand side or left according to the side of the

large most raised wing, in the direction of the vertex (and very slightly turned towards the opposite side). pp86.87

DIAGRAM OF TORSION

p89

CRANIUM IN ROTATION / LATERAL FLEXION

• When the constraint exceeds at the cranial level the possibilities of torsion,

that involves a diagram different of adaptation which will give a new possibility of dispersion, by adding an additional compensation in the third dimension of space. But to be established it creates on the other hand, a zone of functional restriction.

• It is the lateral rotation flexion, which is characterized by a movement of:
• flexion around the transverse axes,
• of lateral slope of all skull on a side around a antero-posterior axis.
• of rotation, in opposed direction, of the halves former and posterior, around

two vertical axes passing by the body of the sphenoid and the occipital one.

• It is named by the side of the opening of the symphysis spheno - basilar (SBS).

pp92,93

DIAGRAM OF ROTATION LATERAL FLEXION

• Horizontal

.

p93

DIAGRAM OF ROTATION LATERAL FLEXION

• Three

parts p95

ADAPTATION : LATERAL DISPLACEMENT

• Just as the other diagrams as we have just seen, that of lateral

displacement is established very early during the cranial development, and under pressure exceeding its capacities of adaptation (flexibility and plasticity). But in this case, this constraint is lateral.

• The anterior and posterior parts of skull, on the level of the bones of the

line of centers of the base move in the same direction, at the time of the phase of expansion: – the sphenoid and the bones which are moved by it turn around a vertical axis passing by its body, – the occipital one and its satellites move in the same direction, around an axis passing by its body.

• What seems to open the spheno-basilar synchondrosis (SBS) on the side
• pposed within the meaning of torsion, It is this side which gives its name to

this displacement.

• During the tests of evaluation, as in the preceding cases, if the cranial

mechanism is free, it must be able to adapt to this movement induced by the fingers of the practitioner. pp106,107

DIAGRAM OF LATERAL DISPLACEMENT

p107

• ALGORYTHME CRÂNIEN
• Bevel

Pivot Movement vascular and nervous pathway

CRANIAL TECHNIQUE

• PATHOMECANIQUE

p111

THE LESION of CRANIAL OSTEOPATHY

• Tissue changes, induced either by biomechanical disturbances, or by the

not compensated variations of vascularization or of hormonal information that it conveys to their target, and/or of nervous information, result in an accepted loss, causes deterioration of its plasticity and its normal elasticity. What changes the tissue dynamics of fabrics conjunctive, then creating a fixed point in its centre.

• It is this new fixed point which constitutes the osteopathic lesion.
• We insist on the fact that “not fixes” does not mean “not motionless”, but

not fixes compared to specific intrinsic dynamics to each tissue, i.e. an

• peration decreased compared to its normal driving possibilities.

p113

PHYSICAL CHARACTERISTICS OF LESION OSTEOPATHY

• Tissue Change of state:

– Less plasticity. – Less elasticity,

• Decreased Mobility,
• Loss of the final elasticity of the movement, with articular stop “Net”.

(abrupt, without any flexibility).

• Pain expressing the tissue suffering (especially when one touches there)
• Each bone having at least two articulations, this change will be transmitted

at least to two articulations, which will generate on the level of this second articulation, an articular synchronization. p114

OSTEOPATHY DIAGNOSIS

• We see immediately that these four characteristics will give us the signs
• f the lesion osteopathic, completely accessible to our hands:
• Tissue change,
• Reduced mobility, with abrupt stop at the end of the normal

movement.

• Pain (when it is touched)
• Synchronization.
• It is obvious that the access osteopathic of the cranial field will follow the

same process imperatively: even diagnostic approach, even search of the

• bjective physical signs signing the lesion, and finally, even rationalization

relating to the choice of the therapeutic techniques.

DIAGNOSTIC PROCESS

• In four distinct stages.
• 1º - tissue Test of resistance (evaluates the change of State or of

nature).

• 2º - active Test evaluating the flexibility at the end of the movement.
• 3º - Palpation of the faded zones tissue (large, hard and painful
• when one touches there).
• 4º - Tests of the proximal articulations, to measure the assignment of it
• It is obvious that the cranial access osteopathic of the fields will follow here

also the same diagnostic approach, same search of the physical signs

• bjective which sign the lesion, and then same rationalization at the time of

the decision of the election of the choice of therapeutic technique. p114

THERAPEUTIC DEDUCTION

• Establishment of a therapeutic protocol.
• With the specific techniques best adapted according to this evaluation.
• And for each technique, the definition of its methods:

– Contact point, – Direction of the gestural application, – gestural Method, privileging:

• The speed,
• The strength,
• Moment of the greatest action,
• When to let itself slow down.

p117

Of the lesion at the diagnosis

Osteopathic lesion

Less elasticity (rebound) Tissue change (plasticity and elasticity) Alteration of mobility Tissue palpation zone

Osteopathic Diagnosis

Active proximal articulation test Synchronization Pain in touch Resistant test

p116

THE REDUCTION OF THE CRANIAL LESION (I)

• Once perceived the lesional barrier, we evaluate its characteristics
• f them. What then enables us to choose his mode of suitable

reduction.

• Three possibilities are offered then to us:
• 1 - To be located against the barrier, to rest against this one, without increasing

the force of support, and to wait for its own release.

• It is the technique of induction.
• 2 - Our gesture penetrates little by little in the lesion
• (that we represent in the shape of a triangle of operation weakened within the

range of the articular movement), the gestural reiteration creating thanks to its dynamics, a resolution partial of the amplitude of the triangle of weakened

• peration, is a progressive retreat of this barrier.
• It is a technique of progressive reduction.

p117

THE REDUCTION OF THE CRANIAL LESION (II)

• 3 - The thrust. Gestural acceleration in contact with the barrier,

surprises this one and, its elimination by its own dissolution causes some.

• It is certain that in this last case, the gestural choice which

makes it possible to vary as well the mass as the velocity, allows a perfect adequacy the tissue on which one acts, as on their state.

• We always carry out this gestural choice, in perfect agreement

with another criterion, that of the nervous organization maintaining the lesion. It is there that for us one of the important differences between structural lesion and functional lesion is located.

p117

THE REDUCTION OF THE CRANIAL LESION (III)

• steopathic

lesion induction progressive reduction

APPLICATION TO THE CRANIAL LESION (I)

• The cranial articulation such as we defined it before, like its
• utlined biomechanics the next pages, show us the identity of the
• peration of the cranial system with the other body articular

systems.

• We then understand easily osteopathic adequacy with the

model, like its lesional similarity.

• The approach of the expert osteopath will be thus identical.
• Its diagnostic step consisting with the identification of the

accused systems, their lesions, to collect the physical signs of them, that its reasoning will then enable him to classify, to treat on a hierarchical basis.

• It will be able to then choose the therapeutic sequence as well

as it will implement, than the techniques which it will practice according to qualities of the barrier and accused tissue.

p118

APPLICATION TO THE CRANIAL LESION (II)

• Within this framework, a major knowledge of the anatomy will be
• ne of the essential bases leading to the diagnostic step.
• It is it which allows according to the complaints, of the functional

and tissue changes, to attach the physical signs, either with the interested subsystem, or to understand some in the direction etymologic of the term, the implication of the regulating subsystems located remotely.

• Of course, biomechanics is the other theoretical base more than
• essential. It gives a direction, an explanation so that our hands

perceive, and as well allows us to induce a test evaluating its dysfunction, that an impulse qualifying the quality of the barrier, even its insufficiency.

• p118

APPLICATION TO THE CRANIAL LESION (III)

• The lesional characteristics are identical:
• Tissue Change, with reduction in its plasticity given by

the change of final rebound, whereas its elasticity appears in the neutral phase of the movement at the time of the return to the neutral point.

• Less Mobility,
• Tissue Pain sometimes,
• Articular Synchronization, being able to modify the usual

relation with the other bones.

• And their diagnosis will be made by it by the usual

method.

• Tissue Palpation of the suture,
• Tissue Resistance, which will qualify and quantify the

barrier (final rebound)

• active Test at the functional level.
• Tests using the movements of cranial adaptation, which

underline the restrictions sutures.

p118

CRANIAL TECHNIQUE

• THERAPEUTIC
• TOOLS

p119

ATTITUDE OF THE THERAPEUTIST IN CRANIAL TECHNIQUE

• The expert should not present any fixed point to the

level of his hands at the time of the reception of the head

• f the patient, so that the cranial movement of this last of

anything is not changed or is limited by this contact.

• This total freedom of skull in the hands of the expert,

removing the usual interface between patient and expert, at least will make it possible this last to have a possibility

• f perception, wide until its abdominal center.
• In order to be unified with its patient, and to perceive

the totality of the movements of it, it will gum any possible interface between him and its patient, creating a different interface of action, moved away from the relational center(feet on the ground, sitting on the chair, back of the hand against the coating of the table, etc…).

p121

CONCEPT OF INTERFACE

• The wind meets the sail to make it possible the boat to advance. It is on this level

that it transmits its energy to him.

• Each interface requires an absolute intimacy of contact, of inter - penetration, for a

faithful transmission of energy in a perfectly proportioned action.

• Energy is the wave, at the same time as it prints its force and its movement to it.
• In the therapeutic action, the hand of the practitioner is melted in an intimate way

with the segment which it will animate, transmitting to him the energy produced by its

• movement. The practitioner not to break this union between his/her hand and the skull
• f the patient, will create an interface between him/her and the table of processing.
• In other words, between the back of its hand and the surface of contact on

which it is driven.

• The error would be to create this interface between the palm of the hand and the

skull which it animates: energy would be dispersed there partly.

• In order to avoid it, the practitioner increases very slightly the contact of his hand

against the table, which indirectly perfect the unit created between the palm of its hand and skull of the patient.

p122

DIAGRAM OF THE CONCEPT OF INTERFACE

pp123, 124

CONCEPT OF FULCRUM

• We conceive it with the wide direction that gives him the

Héritage dictionary of “point of balance, equilibrium, position, element or action through which, around which, or by the means of which, of the vital potentials are tested”, so much our action joins together all these aspects of them.

• The therapist will create a new pressure point, exactly with

the interface of the energy which he provides and of the structure that he wants to animate, making it possible to focus

• f it the action with precision there or it wishes either to

appreciate the existence of a functional freedom or not, or to help it later to be recreated.

• In order to act that on tissue interested, its contact will be

placed at the adequate depth, by using as well the density and the presence of its hand, that by prolonging its perception at the adequate level.

pp124, 125