Do skull bones move?

  • yes

    Votes: 165 33.4%
  • no

    Votes: 269 54.5%
  • undecided

    Votes: 60 12.1%

  • Total voters
    494
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Dr JPH

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Just because you can't feel them move doesn't mean they don't move.

Millions of people believe in God and has never seen him (or her).
 

oceandocDO

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Just because you can't feel them move doesn't mean they don't move.

Millions of people believe in God and has never seen him (or her).

Is this sarcasm? Your argument is the precise reason why cranial should be dropped from contemporary medical education... cranial is religion, not science.
 

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Originally posted by oceandocDO
Is this sarcasm? Your argument is the precise reason why cranial should be dropped from contemporary medical education... cranial is religion, not science.

I am not saying that cranial is religion in any sense. You missed the context in which I was comparing the two.

There are millions of people who believe in God or a god. There is no proof that such a being exists, yet there are all of these people who live their lives by such a being (I am not one of them).

Cranial osteopathy is believed in and practiced by many osteopaths in this country. There is no proof that it does work (although there are studies in the works) and there are no studies that prove that it doesn't work.

For each study cited that "proves" that cranial bones don't move, I could zcite studies that show they do.

So my intial comparison was that just because we cannot prove something does not mean its value should be discredited.
 

DOnut

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Originally posted by JPHazelton
I am not saying that cranial is religion in any sense. You missed the context in which I was comparing the two.

There are millions of people who believe in God or a god. There is no proof that such a being exists, yet there are all of these people who live their lives by such a being (I am not one of them).

Cranial osteopathy is believed in and practiced by many osteopaths in this country. There is no proof that it does work (although there are studies in the works) and there are no studies that prove that it doesn't work.

For each study cited that "proves" that cranial bones don't move, I could zcite studies that show they do.

So my intial comparison was that just because we cannot prove something does not mean its value should be discredited.


Oh, well that cleared it up. :rolleyes:
 

oceandocDO

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People believe in UFOs too, some have "evidence" they exist, others have "evidence" they don?t. You could have used that analogy.

I just thought it was funny that you used religion as the analogy because many in the cranial field equate it exactly to that, some don?t deny it either.

I have no problem with any physician exploring the boundaries of medicine. There's more MDs out there who practice alternative therapies than DOs certainly, but to manually force a brand of medicine, which has yet to be proven in the slightest scientific fashion, on medical students does a few things:

1) It cheapens the rest of OMM, as many students lump cranial into the general OMM basket, hence they wind up abandoning it all after they're bewildered how cranial works... and is forced upon them. As a result, the rest of OMM, which can be very efficacious, is tainted, if not poisoned, by this other modality.

2) It threatens the credibility of osteopathic medicine, for mainstream medicine, which is what D.O.s must prescribe to if they want to continue having full practice rights, etc, is based on evidence, not theory.

Cranial osteopathy is believed in and practiced by many osteopaths in this country

Actually, it's not. I would put money that there's no more than 250 D.O.s out of 50,000 that use cranial commonly in their practice. If you go to Colorado Springs for convocation, sure, you'll have everyone preaching it, but the GREAT majority of D.O.s today don?t subscribe to it. It's kept alive by the AAO, and the AAO does not define modern osteopathic medicine, as much as they'd like to...

Overall, the problem with teaching cranial is in the school of thought that's required to learn it. For your entire medical training, you're taught to question everything.... your patients, your treatment regimens, your colleagues consults on your patients, etc. Always ask "why?". "Why" is in my blood. Yet, when you come to cranial, you're suddenly taught to stop asking "why" and just accept it... "it works because we say it works".... that just doesn?t hold enough water for me, and I am a religious person.

I say make cranial an elective for graduates... the AAO can still offer all the courses for your certification, and it can hence remain as part of the profession for those who wish, but lets do our homework with good, non-bias research, or else stop elevating this quasi-art/religion to science...
 

Old brain

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http://www.cranialsubluxations.com/interior_view_of_base_of_skull.htm

fair use, educational

INSKULL-lines_copy1.jpg
 
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stomper627

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Boy you can do an internet search and find people out there that believe anything....
Heres a good site.....
http://www.ruinsofmars.com/
I wonder if the Promise Keepers were cranial believers.....
Old brain....you can sit there and find all the info on the net that you can....it doesnt make it credible....
great post ocean...
stomper
 

Dr JPH

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You can try to DIScredit the cranial theory all you want and it doesn't make it NOT so.

Bring some evidence that cranial bones DON'T move...I'm still waiting for that. None of you on that side of the argument seem to be able to do that.
 

Maxip

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That's the precise problem with beliefs like this... people who believe in them will always ultimately resort to placing the burden of evidence on the non-believers. It's NOT the place of rational researchers and physicians to discredit your ridiculous beliefs; it's your problem to prove it. The fact that independent studies prove that there is no consistency between the measurements of "cranial rhythms" from quacktitioner to quacktitioner should at least BEGIN to demonstrate that you may need to re-check your beliefs. Not to mention the fact that no form of acceptable medicine has gone unchallenged and unimproved for 80+ years. Your theory relies on smoke and mirrors and confusing terminology. And God help you if you try to use this crap as a substitute for real medicine...
 

Maxip

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Oh, and for the love of all that's holy, PLEASE do not compare yourself to the ingenuitive minds of the past whose theories were not accepted initially. You had your day of fun in 1925 and nothing came of it.
 

Dr JPH

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What about the Doppler studies? Apparently NASA approved equipment doesn't mean much to you guys, either.
 

Dr JPH

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Oh that's right...those studies were published in osteopathic journals...so they're not true...what was I thinking.
 

Old brain

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Although the skull is often assumed to be a rigid container with a constant volume, sensitive measurements indicate that the skull expands with increases in ICP (Heisey and Adams; 1993, Heifetz and Weiss, 1981). Recent work in our laboratory has investigated the use of ultrasound to measure non-invasively these slight changes in intracranial volume that occur with changes in ICP. A new instrument based on a pulsed phase-lock loop concept has been developed to measure the ultrasonic phase velocity accurately in condensed matter (Yost and Cantrell, 1992). The instrument transmits a 500kHz ultrasonic tone burst through the cranium via a transducer placed on the head. The ultrasonic wave passes through the cranial cavity, reflects off the inner surface of the opposite side of the skull, and is received by the same transducer. The device then uses a phase comparison technique to quantify distance across the skull. Sensitivity of this method for measurement of intracranial distance (ICD) equals approximately 0.1?m.

from here...

http://spacephysiology.arc.nasa.gov/abstracts/abstracts_96.html#abst1

sound pretty sensitive compared to the large gaps of movement what is that a micrometer? a thousanth of a millimeter?
 

Maxip

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Sounds convincing... at first. Two things to consider: first of all, there is no material, even alloys, that experience absolutely 0 molecular movement, meaning that even the toughest polymers will expand and contract. Therefore, its not crazy to suggest that a biological material, such as bone, will experience SOME movement. Second of all, it seems nearly impossible that CSF would cause these changes. The brain is relatively soft and it would distort so much easier than the skull in response to increased cranial pressure. This study looks at cranial movements in differing head positions, making it more likely that if there is any real movement, it would be due to differential pressure exerted by muscles in the different positions.

At any rate, this study does nothing to speak to the idea that individual bones in the skull move around and that the application of a minute amount of pressure will move them and cause a change in intracranial pressure.

And for JPHazleton... yes, the fact that your articles appear in osteopathic journals DOES bug me because I'm willing to bet that the researchers who carried out these experiments had some vested interest in cranial theory. If there was significant evidence to support the theory, than I have to believe that the rest of the scientific world would want to explore it (unless everyone except for the all-enlightened DO is against proper healing).
 

DOnut

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Ok, this is the best evidence of skull bone motion I have seen. It doesn't mean that you can feel it, but I am more convinced that there is SOME movement. Check out the link. I also just copy pasted the article.


http://spacephysiology.arc.nasa.gov...s_96.html#abst1



Ballard RE, M Wilson, DE Watenpaugh, AR Hargens, LM Shuer, J Cantrell, and WT Yost. Noninvasive measurement of intracranial volume and pressure using ultrasound. American Institute of Aeronautics and Astronautics Life Sciences and Space Medicine Conference, Book of Abstracts, pp. 76-77, Houston, TX, 3-6 March 1996.

Space motion sickness and headaches are a significant problem among astronauts during spaceflight. Seventy-three percent of Shuttle astronauts exhibit symptoms of space motion sickness (Jennings et al., 1993), which may persist through the first three days of flight and have an adverse effect on crew performance and mission progress. Although the etiology of space motion sickness still remains unclear, the symptoms may result, in part, from alterations of intracranial circulation and pressure. In a Joint NASA/NIH Workshop on Research in the Microgravity Environment (20-21 January 1994), intracranial pressure (ICP) was identified as one of the most important parameters to investigate for problems of astronauts in space and for several diseases of patients on Earth. However, current techniques for monitoring ICP are invasive and thus impractical for use in space.

On Earth, abnormally-elevated ICP occurs in 50-75% of patients with severe head trauma (Miller et al., 1992). In cases where ICP increases to values above 20 mmHg, a 95% mortality rate has been observed. Secondary brain injury due to head trauma can therefore be greatly reduced by the prompt detection and treatment of elevated ICP. A noninvasive technique for monitoring ICP would aid not only the initial assessment of increasing ICP, but could also monitor the efficacy of treatment over an extended period of time without the high risk of infection and cost associated with invasive techniques.

Although the skull is often assumed to be a rigid container with a constant volume, sensitive measurements indicate that the skull expands with increases in ICP (Heisey and Adams; 1993, Heifetz and Weiss, 1981). Recent work in our laboratory has investigated the use of ultrasound to measure non-invasively these slight changes in intracranial volume that occur with changes in ICP. A new instrument based on a pulsed phase-lock loop concept has been developed to measure the ultrasonic phase velocity accurately in condensed matter (Yost and Cantrell, 1992). The instrument transmits a 500kHz ultrasonic tone burst through the cranium via a transducer placed on the head. The ultrasonic wave passes through the cranial cavity, reflects off the inner surface of the opposite side of the skull, and is received by the same transducer. The device then uses a phase comparison technique to quantify distance across the skull. Sensitivity of this method for measurement of intracranial distance (ICD) equals approximately 0.1?m.

We used the noninvasive ultrasound technique to measure distance from the forehead skin surface to the occipital bone during acute head-down tilt (HDT). We hypothesized that this distance would increase with recumbency and HDT relative to head-up position due to elevation of ICP. Seven healthy subjects (ages 26-53) underwent the following tilt angles: 90? upright, 30?, 0?, -6?, -10?, -6?, 0?, 30? and 90?. Each angle was maintained for 1 min. Average path length from forehead to occipital bone increased 1.038 ? 0.207 mm (mean ? standard error) at 10? HDT relative to 90? upright values (Torikoshi et al., 1995). When the protocol was repeated using external compression over the ultrasound transducer to minimize changes in cutaneous and subcutaneous tissues during tilt, maximum ICD increase was 0.166 ? 0.038 mm. Application of external compression greatly reduces, but probably did not totally eliminate, cutaneous pooling between the transducer and frontal bone. Therefore, we have since developed technique and hardware modifications to eliminate extracranial tissue contributions to ICD measurements.

To establish the relationship between intracranial diameter and known changes in ICP, we studied two fresh cadavera (< 24 hrs. post-mortem), one female (age 83) and one male (age 93). Causes of death were not ICP-related. A ventricular cannula was inserted into a frontal horn of the lateral ventricle through a burr hole in the frontal bone. Direct ICP measurements were made via a fiber-optic, transducer-tipped catheter (Camino Laboratories, San Diego, CA) inserted into the subdural space through a separate burr hole. An ultrasound transducer was then secured with an elastic band to the side of the head. ICD was continuously monitored while ICP was altered in a stepwise fashion by infusion/removal of saline from the lateral ventricle. Changes in ICD, or distance from one side of the skull to the other, were calculated over the last 10 sec at each pressure level. In both cadavera, ICD increased linearly (ICD = 0.003(ICP) - 0.016, r=0.91) with graded elevation of ICP, such that an ICP change of 15 mmHg caused a skull expansion of 0.029 mm. Magnitudes of cranial expansion observed in these cadavera were similar to those reported in the literature for cats (Heisey and Adams, 1993) and our results supported qualitative findings of Hiefetz and Weiss (1981) in humans. Although only two cadavera were studied, these results clearly indicate that the ultrasound technique is capable of measuring the small changes in ICD resulting from changes (positive and negative) in ICP.

As stated previously, we have developed a new technique for quantifying changes in distance across the skull irrespective of changes in skin thickness. To evaluate the technique, four subjects underwent a tilt protocol similar to that outlined above. Briefly, subjects were secured in the upright posture to a tilt table, and an ultrasound transducer was secured to the side of the head using an elastic bandage. ICD was continuously monitored for one minute of each tilt angle: 90? HUT, -10? HDT, and 90? HUT (tilting from upright to -10? is estimated to increase ICP approximately 15 mmHg; Murthy et al., 1992). The change in ICD measured with our modified technique averaged 0.025 ? 0.008 mm at 10? HDT relative to upright values. Magnitudes of skull expansion observed in this pilot study agree well with results of our cadaver study. While further hardware developments are necessary to optimize the technique, our investigations to date support pulsed phase-lock loop ultrasound as a viable technique for measuring changes in intracranial dimensions and for monitoring ICP on Earth and in space.

ACKNOWLEDGEMENTS

We thank Karen Hutchinson, David Chang, and Dr. Gary Heit for technical assistance. Supported by NASA Ames Commercial Technology Office grant 307-51-12-12 and NASA grants 199-26-12-34 and 199-14-12-04.

REFERENCES


Heisey and Adams, Neurosurg. 33:869-877, 1993.
Hiefetz and Weiss, J. Neurosurg. 55:811-2, 1981.
Jennings et al., Aviat. Space Environ. Med. 64:423(27), 1993.
Miller et al., J Neurotrauma 9:S317-26, 1992.
Murthy et al., Physiologist 35:S184-5, 1992.
Torikoshi et al., J. Grav. Physiol., in press, 1995.
Yost and Cantrell, J. Acoust. Soc. Am. 91:1456-68, 1992.
 
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DOSouthpaw

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Something that disturbs me is all of these drug studies in MD journals....it seems like they would be biased toward drugs because they have such a vested interest in them... lol

:oops:
 

Maxip

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Originally posted by DOSouthpaw
Something that disturbs me is all of these drug studies in MD journals....it seems like they would be biased toward drugs because they have such a vested interest in them... lol

:oops:

Wow.

Maybe because drugs actually help people?
 

Cowboy DO

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Not sure about the journals, but if the information is comming straight from the drug company then it is without a doubt biased even though what they might give you looks, feels and even smells like a peer reviewed, objective, journal article.
 

Maxip

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Originally posted by Cowboy DO
Not sure about the journals, but if the information is comming straight from the drug company then it is without a doubt biased even though what they might give you looks, feels and even smells like a peer reviewed, objective, journal article.

OK, this has breached a new level of ridiculousness. So, I am supposed to be convinced that cranial theory is NOT crap because journals like JAMA and NEJM have published articles comparing/evaluating drug treatments? Please tell me that this is NOT what you're all insinuating. Please...
 

Maxip

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Originally posted by Old brain
Here's an intersesting instrument...

The TechnologyThe ICP monitor uses ultrasonics to gauge
intracranial pressure. The instrument measures
minute changes in distance from one side of the
cranium to the other using a constant-frequency
pulsed phase-locked loop.

http://www.teccenter.org/assets/pdf/intracranial_pressure.pdf

You guys really love that constant-frequency pulsed phase-locked loop doo-hicky, dontcha?

Oooooh, sounds scientific!
 

Cowboy DO

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Originally posted by Maxip
OK, this has breached a new level of ridiculousness. So, I am supposed to be convinced that cranial theory is NOT crap because journals like JAMA and NEJM have published articles comparing/evaluating drug treatments? Please tell me that this is NOT what you're all insinuating. Please...

Its not at all, I'm not even talking about cranial I don?t even know where you got that idea from. I'm talking about drugs and I'm just saying that sometimes the kind of information you get is dependent on the source. which one of the posters hinted at and you so nonchalantly tossed aside as crap. You need to take a pill...preferably of the "chill" inclanation.
 

DOSouthpaw

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I was just poking fun at all of the "We can't take the cranial research seriously because it's in DO journals because DOs have a vested interest."

With that argument then you can't take drug studies seriously because they are in MD journals and MDs have a vested interest.


Or what about nursing studies that are in nursing journals for that matter??? Can we take those seriously because if it's in a nursing journal and it's about nursing then there has to be bias...


Lord forgive all of the vets out there who dare to publish anything about animals in a vet journal because all those people care about is manipulating the public through their biased artcles on animal care...


That's it, I'm done! lol:laugh:
 

Maxip

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Originally posted by DOSouthpaw
I was just poking fun at all of the "We can't take the cranial research seriously because it's in DO journals because DOs have a vested interest."

With that argument then you can't take drug studies seriously because they are in MD journals and MDs have a vested interest.


Or what about nursing studies that are in nursing journals for that matter??? Can we take those seriously because if it's in a nursing journal and it's about nursing then there has to be bias...


Lord forgive all of the vets out there who dare to publish anything about animals in a vet journal because all those people care about is manipulating the public through their biased artcles on animal care...


That's it, I'm done! lol:laugh:

One difference though. Drugs WORK. Articles in MD journals aren't trying to prove any crazy ideas, they're just trying to evaluate actual, observable results. So far, your theory hasn't been able to do that. Cranial theory is being propagated by the same type of people who preached phrenology 100 years ago.

That's it, I'm done! lol :laugh:
 

lolablue

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well i apologize because i did not take the time to read everyone's response to this post but i just thought i would put my two cents in...
i am not a med student - yet - i start at pcsom in the fall so i haven't had gross yet... anywho, i would have to say, based on common sense and what i do know about the human body and physics thus far my answer is YES, of course they move at least some, even if it's only a minuscule amount. why? well because it seems to me that every structure in the human body no matter how solid or "stable" it may seem to be still can cause an effect upon, or is affected by the other structures in the body or the environment, especially those structures that surround it. although the skull protects the brain, underneath it however is cerebral sinus fluid and major sinuses and veins to drain it in addition to all the layers of tissue (pia mater etc.) it would seem to mean that if the skull - which DOES HAVE JOINTS would need to allow some movement in order to endure pressure not only from the outside but inside, otherwise, when you were hit in the head hard enough, your entire cranium would just shatter... just like buildings composed of entirely concrete and steel...... even they have to sway with certain weights and pressures applied or they would completely crumble on impact. i'm not saying your skull moves even enough for our naked eye to observe, but i would just think that it would have to "give way" just a little.
 
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Why do subdural hematomas or hydrocephaly cause so many problems?

I bet its NOT because the skull can compensate by moving out of the way.
 

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I'm as open minded as they come, but even if skull bones move, how is it physiologically beneficial? I never found the explanations from the cranial gurus very convincing when they tried to elaborate on why cranial works on a systemic level. One person even tried telling me cranial would treat a UTI!!
 

Maxip

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Originally posted by xxyyzz
I'm as open minded as they come, but even if skull bones move, how is it physiologically beneficial? I never found the explanations from the cranial gurus very convincing when they tried to elaborate on why cranial works on a systemic level. One person even tried telling me cranial would treat a UTI!!

THANK YOU!
 

DOSouthpaw

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y'all need to check out Miriam Mills, MD's study on Cranial and Otitis Media. It was published in an AMA sponsored journal as well. I'm sure that someone on here has a link to it. It showed that Cranial was beneficial in children with Otitis Media. Sure it was a pilot study, but more will come.
 

DOSouthpaw

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Hey LolaBlue how about stopping by the Ho and picking me up a Super Ho Combo with a Diet Coke on your way to Pikevegas....I'm starving for one of those.

:horns:
 

BamaAlum

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I've actually read that article and it says that OMM was used INCLUDING Cranial. How can one deduce that it was the cranial that produced the effects and not the other OMM techniques when they weren't independently evaluated?
 

DOSouthpaw

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I know Dr. Mills and she does a ton of cranial. Since she was the one doing the manipulating I would imagine most of it was cranial. Of course, if the key lesion is not in the cranium, then doing cranial won't help at all.

Also, the fact that an AMA sponsored journal allowed an article that included cranial manipulation in it to be published is quite a feat in itself. Although a lot of MDs we have here in town don't have problems with cranial; it's the DOs from the Lost Generation that always complain. lol
 

lolablue

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Originally posted by DOSouthpaw
Hey LolaBlue how about stopping by the Ho and picking me up a Super Ho Combo with a Diet Coke on your way to Pikevegas....I'm starving for one of those.

:horns:

lol the ho is awesome! they have the best veggie burgers! i will be coming home (which is only like 30 minutes from pikeville) next weekend!
 

DOSouthpaw

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What really rocks there is the Girl Scout Thin Mint Shakes. MMMMMM....



Those babies will really make your cranial bones move (just to keep this on topic lol)


:hardy:
 

Doc Oc

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Doesn't everything move? I mean, it's hard to believe that any piece of matter doesn't move at all. It's been awhile since physics, but I thought that absolute zero is defined as such because that is when all motion stops. I also think of a broken bone, which must move before it snaps, and if you were to slow-motion it, some movement that you can't see must be happening before you can see the results. I know that there is a force acting upon it, but there are forces acting upon the skull bones during cranial treatments. It's not that I'm a huge cranial advocate, I just have a hard time proving to myself that skull bones, unlike the rest of the matter on the earth, do not move.
 

Cowboy DO

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We are talking about the bones moving relative to each other. Of course your skull bones will move...backwards for instance, if i were to say hit you in the frontal bone with a dodge ball. However this is not a good argument for the bones movement with respect to each other.
 

Doc Oc

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That's not what I mean (and please don't throw a dodgeball at me ;) ) I mean, how could they not move relative to eachother when a force is put on them by someone's hands? There is space in the sutures, maybe not a lot, but there's some room to move. Whether or not the bones can move relative to one another when someone puts their hands on them isn't what confuses me about cranial. I'm confused about how little room there is for them to move, and how someone can tell if something moves a millimeter or so. The most I can do when asked to put my hands on someone's head is just describe what I feel in terms of one side feeling warmer, or feeling more of something on one side, whether its motion or whatever. I have never been able to feel the position and movement of the sphenobasilar suture. How many osteopathic students feel what they are supposed to be feeling when doing cranial?
 

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Originally posted by Doc Oc
How many osteopathic students feel what they are supposed to be feeling when doing cranial?

Not many. It takes time, patience and practice. Things many students aren't willing to sacrafice for the sake of OPP class (at least not at PCOM).

Those of us who can feel the movement and can use it will be able to offer it to our patients in the future, or at least have a basic understanding so that we can refer to someone who is more highly trained in the skill.

I also think the inability for most people to palpate the movement leads to a great deal of the discrediting of OCF, which is understandable. Not sure I believe in aliens...I've never seen one. But it I had, I think my doubts would be dispelled.
 

PACtoDOC

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Originally posted by JPHazelton
What about the Doppler studies? Apparently NASA approved equipment doesn't mean much to you guys, either.

Nasa also runs commercials for Tempurpedic mattresses and my back still hurts after buying one!!!
 

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Originally posted by PACtoDOC
Nasa also runs commercials for Tempurpedic mattresses and my back still hurts after buying one!!!

Your friends must not be good at OMT.
 

PACtoDOC

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Please JP, lets not try and place OMM as "holier than thou". I have had faculty work on my back for 2 years and it just isn't getting any better. You cannot always make structural defects better. I have 2 dessicated disks that are not going to reinflate simply with OMM, so lets be serious here. You are starting to sound like my chiro buddies!
 
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