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Old brain

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I have a theory, that yawning cleans the brain.

Yawning increases the cerebrospinal fluid circulation and fluctuates the csf pressure.

You can see my theory here...

http://www.members.shaw.ca/hilaryking/Oldbrain1.htm

I've been trying to prove my theory and the biggest question or seemingly most controversial is the aspect of the movement of skull bones.

In particular the movement of the temporal bones by the pulling of the muscles connected to the styloid processes of the temporal bones, which may also be aided by the digastric muscle connected to the digastric groove.

What do you think ? do the bones move and control the pressure and volume of the cranial vault?
 

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I think you can get some subtle movements based on experiences with cranial surgery on mice. I am not sure though that you could get enough movement to change the pressure or volume significantly. The movement of the occipital and temporal bones however, might be enough to cause the change. Intersting question none the less.
 

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Originally posted by Old brain
I have a theory, that yawning cleans the brain.

Yawning increases the cerebrospinal fluid circulation and fluctuates the csf pressure.

You can see my theory here...

http://www.members.shaw.ca/hilaryking/Oldbrain1.htm

I've been trying to prove my theory and the biggest question or seemingly most controversial is the aspect of the movement of skull bones.

In particular the movement of the temporal bones by the pulling of the muscles connected to the styloid processes of the temporal bones, which may also be aided by the digastric muscle connected to the digastric groove.

What do you think ? do the bones move and control the pressure and volume of the cranial vault?
A substantial fraction of the defense offered in your link is what I'll politely describe as "questionable." To offer one example of many, the thyroid gland is not a mechanical lever. ;)
 
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hermione

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Craniosacral theory sure says yes, it's all based on the subtle movements of the bones in the skull, and how the dural attachments then affect the sacrum and the rest of the body. At first I thought it was crazy, as I'm usually a big skeptic. But look into some of the ideas behind it, and try out the vault hold. I swear you can feel it move!! The field was first reported by William Sutherland, its really pretty interesting.
 

Buster Douglas

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If they don't then it'd suck to be these guys. :p

"Physicians who wish to pursue the field of Cranial Osteopathy must train an additional five years in practice to be certified in this area of expertise."
 

Goofyone

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My little guess as to why we both yawn and stretch.

I think the nerve fibers in the skeletal muscles get a little hyperexcitable over time (maybe some asynchrony between the ATP pumps and leaky channels) leading to the urge to contract our muscles with an action potential. This resets things.

Sort of how scratching an itch makes the itch go away (unless you have some kind of inflammation which keeps your nerve endings stimulated).
 
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Dr JPH

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Originally posted by DireWolf
No they don't. Maybe in one's imagination.

Cranial bone movement has been proven as measured by laser-Doppler blood flowmetry. These findings have been published and repeated in circles other than the osteopathic community as well. Infrared cranial bone markers have also been used in some studies.

It is no longer commonly argued whether cranial bones move or not. In fact, it is widely accepted in the neurological and osteopathic communities particularly that they DO move.

What is more of a question is HOW, WHY and HOW MUCH.

Below I listed a few of the many studies that are readily accessible to anyone wishing to learn more about a scientifically proven phenomenon.

Lenahan BJ , Nelson KE , Sergueef N , and Glonek T
Understanding the cranial rhythmic impulse; JAOA: The Journal of the American Osteopathic Association 2002 Aug;102(8):438


Nelson KE , Sergueef N , Lipinski CM , Chapman AR , and Glonek T
Cranial rhythmic impulse related to the Traube-Hering-Mayer oscillation: comparing laser-Doppler flowmetry and palpation. JAOA: The Journal of the American Osteopathic Association 2001 Mar;101(3):163-173, quiz 201


Myers R
Measurement of small rhythmic motions around the human cranium 'in vivo'. Australian Journal of Osteopathy 1998;9(2):6-13

Zanakis MF , Morgan M , Storch I , Bele M , Carpentieri A , Germano J , and O'Shaughnessy P
Detailed study of cranial bone motion in man. JAOA: The Journal of the American Osteopathic Association 1996 Sep;96(9):552

Zanakis MF , Zaza W , Zhao H , Morgan R , and Schatzer M
Objective measurement of the cranial rhythmic impulse in children. JAOA: The Journal of the American Osteopathic Association 1996 Sep;96(9):552
 

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I don't believe that cranial bones move at all. You cited an impressive list of articles but they are all from the osteopathic community which makes them fundamentally biased towards acceptance of cranial manipulation.
 

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What I think is more fascinating is why do other animals yawn. I catch at least one (of my many) snakes yawning almost daily. I've seen rats, mice and even monkey's yawn before.

WHAT IS IT WITH YAWNING!?
 

bigmuny

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Cranial bones do not move, and cranial sacral therapy is nonsense. It amazes me at school to hear a anatomy phd tell you that bones are fused and do not move, and then go to omt lab two hours later and have an omt guy tell you that they do. As for the articles cited, note that the jaoa(much to my chagrin, outrage, and embarassment) is a crap propaganda rag of a journal(and i grit my teeth and read every edition), and much of the stuff published in it is of highly dubious quality. I did a literature search on cst, and the first articles that came up invalidated the notion that a "cranial pulse/rhythm" is palpable(found zero interrater reliability). Do a pubmed, medline search for yourselves.
 

Homunculus

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Originally posted by JPHazelton
Cranial bone movement has been proven as measured by laser-Doppler blood flowmetry. These findings have been published and repeated in circles other than the osteopathic community as well. Infrared cranial bone markers have also been used in some studies.

It is no longer commonly argued whether cranial bones move or not. In fact, it is widely accepted in the neurological and osteopathic communities particularly that they DO move.

What is more of a question is HOW, WHY and HOW MUCH.

maybe so, but the "cranial rhythm" we're taught to monitor has very little inter-examiner consistency. if it is a measurable, "doppler-able" movement, then wouldn't the rate of ebb and flow be measurable, and therefore testable? i didn't look at your articles, but the last time i heard no study was able to show examiner consistency in measuring this phenomena. get the top 10 cranial-sacral gurus together, and have them determine the rate while the doppler does and see if they jive. it would be an interesting study.
 
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Dr JPH

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Originally posted by BamaAlum
I don't believe that cranial bones move at all. You cited an impressive list of articles but they are all from the osteopathic community which makes them fundamentally biased towards acceptance of cranial manipulation.

Prior bias does not influence Doppler or Infrared machinery. I don't think these devices really care whether the bones move or not.
 

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Originally posted by Homunculus
maybe so, but the "cranial rhythm" we're taught to monitor has very little inter-examiner consistency. if it is a measurable, "doppler-able" movement, then wouldn't the rate of ebb and flow be measurable, and therefore testable? i didn't look at your articles, but the last time i heard no study was able to show examiner consistency in measuring this phenomena. get the top 10 cranial-sacral gurus together, and have them determine the rate while the doppler does and see if they jive. it would be an interesting study.

You raise an important point with the inter-examiner reliability. Right now there are a great number of OMT studies being done to test inter-examiner reliability in palpating everything from ankles to paraspinal musculature and its connection to sympathetic function.

Unfortunately, due to the relatively small number of craniosacral practitioners and the large bias AGAINST this field, it is difficult to find funding for these sorts of tests.

The craniosacral community has put much of its effort towards proving that there is indeed a palpable movement of the cranial bones. Once this is sufficiently done (not for people li ke me, but for many of the skeptics) then we can hope to see more studies on inter-examiner reliability.

Also, the studies on inter-examiner reliability that HAVE been done to this point have not used only practitioners who have training in craniosacral therapy. Or, they have used ridiculously small numbers of examiners in their studies (as few as 2) as to completely nullify and findings, whether they are supportive or non supportive of the original purpose of the study.

More research is needed, but funding is the issue. Personally, I don't think that valuable research money should be shunted towards validating craniosacral movement, but rather showing clinical benefits of such treatments.
 

bigmuny

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Originally posted by JPHazelton
Prior bias does not influence Doppler or Infrared machinery. I don't think these devices really care whether the bones move or not.

Even if this were true, which I doubt, it does not mean that movement is palpable, and more importantly it does not mean manipulating them does a thing(which it does not, because they don't move).
 

Homunculus

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Originally posted by JPHazelton
You raise an important point with the inter-examiner reliability. Right now there are a great number of OMT studies being done to test inter-examiner reliability in palpating everything from ankles to paraspinal musculature and its connection to sympathetic function.

Unfortunately, due to the relatively small number of craniosacral practitioners and the large bias AGAINST this field, it is difficult to find funding for these sorts of tests.

The craniosacral community has put much of its effort towards proving that there is indeed a palpable movement of the cranial bones. Once this is sufficiently done (not for people li ke me, but for many of the skeptics) then we can hope to see more studies on inter-examiner reliability.

Also, the studies on inter-examiner reliability that HAVE been done to this point have not used only practitioners who have training in craniosacral therapy. Or, they have used ridiculously small numbers of examiners in their studies (as few as 2) as to completely nullify and findings, whether they are supportive or non supportive of the original purpose of the study.

More research is needed, but funding is the issue. Personally, I don't think that valuable research money should be shunted towards validating craniosacral movement, but rather showing clinical benefits of such treatments.

i don't think funding is that much of an issue. how costly is it to get a randomized patient group and cranial manipulators to determine their cranial rhythm? it's not like you're funding a clinical trial of a medication or expensive experimental treatment. OMT is cheap, and time is plentiful. if the cranial community really wanted to do something like this, they could. i think it has more to do with their fearing the results than the expense of doing it.
 

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Prior bias does not influence Doppler or Infrared machinery. I don't think these devices really care whether the bones move or not.

Of course the machines aren't biased. However, the study must be constructed to test appropriate variables, data from the machines must be interpreted properly and the study must be scrutinized by the journal's editors to determine if the study was valid and significant. Any of the above have the potential for biased analysis especially from individuals with vested interest in the success of the study(ie editors who practice cranial)
 

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Originally posted by BamaAlum
Of course the machines aren't biased. However, the study must be constructed to test appropriate variables, data from the machines must be interpreted properly and the study must be scrutinized by the journal's editors to determine if the study was valid and significant. Any of the above have the potential for biased analysis especially from individuals with vested interest in the success of the study(ie editors who practice cranial)

The journal editors for the JAOA, where many of the articles are published, are most likely non-biased regarding craniosacral therapy. As has been shown in this thread and is apparent in a good portion of the osteopathic community, if there is one thing that even "hardcore" OMT DOs doubt, its craniosacral motion and treatment. It's not like these articles are being published in the Sutherland journal or something.

Would the same studies have more validity if published in JAMA or NEJM? Maybe this would make some people feel better about them, but I don't see how it would increase the validity of their findings. JAOA is a strong, peer reviewed source.

And another comment on the machinery used to test such motion, although there is an operator component involved, it would not be to the degree that it would skew results in favor of intended findings. I can't take an EKG from a patient and interpret it any way I choose, nor can I look at a chest Xray and see a pneumothorax if one is not present. Doppler and infrared are the same thing...the machinery produces data which, of course, is going to be interpreted by researchers, but when it produces numbers and values that are standardized...well, I just don't see how it can be fooled with to yield positive results if none exist. If someone knows more about this machinery, please let me know. I will do some research myself.
 

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As an aside...for those of you who are adamantly denying the movement of cranial bones, have you attempted to feel the CRI? Were you able to feel something or not? Did you feel something and intepret it is something OTHER than the CRI? Just curious. Thanks.
 

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Didn't feel a damn thing. Maybe it's because I forgot to bring my incense, candles, and magic healing toad named gunther.
 

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Originally posted by DireWolf
Didn't feel a damn thing. Maybe it's because I forgot to bring my incense, candles, and magic healing toad named gunther.

Cute.

Since the I cited resources arguing that there is indeed a measurable cranial movement, I would like someone to provide citations of studies that DISprove the cranial motion. There are plenty of them that I am aware of. THEN, I would like that person to explain to me why they believe the studies DISproving the existence of CRI are valid and non-biased whereas the studies I cited are apparently so flawed.

I have no problems with people not buying into an aspect of osteopathy because they don't have the tactile ability to perceive it...that's fine. I have no problem with people having an opinion as to whether or not cranial bones move...if it weren't for differing opinions, conversation would be nothing. But bring something to the table. If we're having a professional discussion, then let's make it that. If you've got an opinion, throw it out there...but be able to back it up. I've done so with references. And I have felt, treated, and been treated with craniosacral osteopathic medicine. I will soon be certified in craniosacral therapy as well.

Don't come to the playground and complain that my ball has no air in it...where's your ball?
 

DireWolf

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I don't think cranial warrants a "professional" discussion. I consider it an "unprofessional" practice, an embarrassment to the osteopathic community, and an entity that threatens the credibility of our profession. I don't have time to post research that disproves something that has so little credible research to back it up in the first place.

If people want to do cranial on friends/family in their free time, more power to them. However, the fact that it is taught in a professional school as a proven tool is absurd. I can't believe that something so anecdotal is included in national licensing examinations. This should be against the law.
 
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I don't know much about cranial movement but I think JPHazelton has a very valid point.

I see him referring to many resources to back himself up. Other people either
1)challenges the validity of those resources
2)says "I don't think so," "I don't consider it," or "I don't have time" such as Direwolf did.

If Direwolf didn't have time to research what he had to talk about, then maybe not talking about it at all could have saved him even more time.

I'm curious about this. Does anyone really not have any citation of studies that disprove cranial motion?
 

DireWolf

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Originally posted by Jinyaoysiu
I don't know much about cranial movement but I think JPHazelton has a very valid point.

I see him referring to many resources to back himself up. Other people either
1)challenges the validity of those resources
2)says "I don't think so," "I don't consider it," or "I don't have time" such as Direwolf did.

If Direwolf didn't have time to research what he had to talk about, then maybe not talking about it at all could have saved him even more time.

I'm curious about this. Does anyone really not have any citation of studies that disprove cranial motion?

First you need to prove something before you can disprove it.
 

Old brain

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I did a little searching earlier about the movements of skull bones and this is what I came up with...

"The serrated sutures promote expansion and contraction of the skull during respiration (flexion extension). Examples are the maxillary/malar and the malar zygomatic sutures. The squamosal sutures allow for rotation (external/internal) respiratory motion, as in the temporal sphenoidal suture.

There also are key pivot points in cranial sutures, allowing opposing motions, expansion and rotation to operate in an efficient and synchronized fashion. An excellent example of this would be the pivot point in the occipital mastoid suture that allows for temporal (a paired bone) external internal flexion and extension." ...

"This cranial movement is thought to be inherent, rhythmic and spontaneous, and to have a direct influence on dural tissue and cerebral spinal fluid movement."

I got that from here...

http://www.chiroweb.com/archives/14/10/12.html
****************
and this...

Radiographic Evidence
of Cranial Bone Mobility

This study concludes that cranial bone mobility can be documented and measured on x-ray.

Table 1
Measures Atlas Mastoid Malar Spehnoid Temporal
Average degree of change
2.58 1.66 1.25 2.42 1.75
Percentage w/change
91.6 66.6 81.8 91.6 91.6
Range of degree of change
0-6 0-6 0-4 0-8 0-5

The percentage of people with change shows movement of the skull bones is common.

Kragt, et al,(1) showed that movement was possible at the sutures in a macerated human skull, and Retzlaff, et al,(2) documented that the cranial sutures do not fuse with age.

To see the whole study....

http://www.icnr.com/craniojournal/c...onemobility.htm

*********************

and this...

Here are more studies:

Cranial Bone and Sutural Mobility Studies
Cranial sutures play a critical role in calvarial morphogenesis. Opperman et. al., (1993,1995), demonstrated that the traditional model of cranial suture morphogenesis invoking biomechanical tensional forces (not unlike the analogy of "tectonic plates" abutting against one another) arising in the cranial base is an incomplete explanation. It was established that when calvarial rudiments encompassing the coronal sutures of neonatal rats were transplanted into adult hosts, the sutures developed normally, and if the donor dura mater was included, the sutures remained patent. In the absence of dura mater, sutural obliteration eventually ensued. It was felt that growth factors in the dura mater (e.g.TGF-b) participated in a regulatory cascade (e.g. cell signal) that permitted the calvarial sutures to be major bone growth centers during the expansion of the neonatal skull.

Oudhof (1982) demonstrated that as the skull develops, the tissue of the coronal and sagittal sutures assume a specific structure which is nearly identical to a gomphosis classification of a joint. These sutures then may be regarded as a type of "multi-gomphosis". This arrangement permits the suture to resist mechanical forces exerted against it. The differentiation of connective tissue fibers and its resemblance to a gomphosis, suggests that the suture can resist forces in directions that widen and those that narrow the suture.

Wagemans, et. al. (1988) citing the work of Bjork has demonstrated that sutural growth normally ceases at age 17 years in males. However, if growth ceases, the suture does not necessarily close immediately. Citing Chopra and Kokich, Wagemans notes that the frontozygomatic and zygomaticomaxillary sutures of pigtail macaque monkeys remain patent until at least 20 years of age. In humans this observation is consistent that the analogous sutures do not fuse until the seventh decade.

Pritchard, et.al. (1956), in a classic study on suture development used fetal animal or newborn human subjects. Their proposal that viable sutures may permit slight movement is limited to this population of subjects. Interestingly, Pritchard is noted to have remarked: "obliteration of sutures and synostoses of the adjoining bones, if it happens at all, occurs usually after all growth has ceased, but in man and most laboratory animals sutures may never completely close".

Retzlaff, et. al., (1979), performed gross and microscopic analysis of sagittal and parietotemporal sutures in 17 cadavers ranging in age from 7 to 78 years. The authors reported no evidence of sutural obliteration by ossification in any of the samples they studied.

Verhulst et. al., (1997), citing the classic studies of Todd and Lyon of the 1920's, noted that suture closure exhibits a definite periodicity, the most extreme activity occurs between twenty-six and thirty years. Additional periods of activity occur in the fifties and the late seventies. Todd and Lyon, found that the degree of closure of some of the cranial sutures demonstrated fluctuations during the fourth, fifth and sixth decades. The squamous suture is the latest suture to close with ossification starting around the age of 63 years, and a second pulse at the age of 78years.

A study by Michael and Retzlaff (1975) while at Michigan State University, utilizing a pressure transducer surgically affixed to the parietal bones of squirrel monkeys (Saimiri sciureus), demonstrated parietal bone displacement with some of the displacement patterns corresponding to respiratory frequency and another pattern of 5-7 cycles per minute that corresponded to neither heart rate nor changes in central venous pressure.

In the classic study on living human subjects performed by Frymann (1971), wherein she developed a non-invasive apparatus for mechanically measuring the changes in cranial diameter. The apparatus consisted of a "U" shaped frame with a differential transformer placed laterally on each side of the subject's skull. Cranial motion was recorded simultaneously with thoracic respiration. On the basis of extensive recordings, Frymann was able to conclude that a rhythmic pattern to cranial mobility exists that is different than that of thoracic respiration.

Retzlaff, et. al., (1982), demonstrated the presence of nerve and vascular tissue imbedded within cranial sutures. They also were able to trace nerve endings from the sagittal sinus through the falx cerebri and third ventricle to the superior cervical ganglion in primates and mammals. The argument could be made, that what purpose would nature design a cranial suture with a neurovascular bundle imbedded within it, if not to provide some type of vascular nutrient supply and sensory capability to the suture.

Cohen (1993), in his work discussing the correlates of craniosynostosis, clearly believed that all cranial sutures eventually fuse, and his work was directed to explore the reasons why some sutures prematurely close in conditions such as craniosynostosis. He concludes that sutural initiation may take place by overlapping of sutures, in which case results in a beveled suture. Or it may occur by end to end approximation, which creates a non-beveled, end-to end type of suture. All end-to-end types of sutures reside in the midline (e.g. metopic and sagittal). It is felt that biomechanical forces on either side of the developing suture tend to be equal in magnitude. This point of view does not take into account the work of Opperman (1993, 1995), that as alluded to above, also indicates that local dural tissue growth factors (e.g. TGF-b) play an etiological role in cranial sutural morphogenesis, as well as biomechanical tensional forces as the calvarial plates abut up against one another.

Moskolenko (1980, 1996,1998), utilizing a variety of technologies (e.g. reoencephalography, reoplethysmography, and electroplethysmography) combined with a computer analysis, was able to demonstrate cranial bone motion ("fluctuations") at a frequency of 6-14 cycles per minute.

I found that here...

http://www.osteodoc.com/research.html

I don't think theese people are making it up, there are likely more studies that agree with them.

The bones don't move much, but it doesn't take much movement to affect the volume of the cranial vault.

Next time you yawn you might hear a "crack" type sound, it doesn't happen every time you yawn, but once in a while you will hear that cracking sound, it almost sounds like its between the ears at the top of the back of the neck.(not the eustacian tubes) This cracking sound could be the movement of your temporal bone(s). You can live in denial or hear it for yourself by simply paying attention when you yawn.
 

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Originally posted by DireWolf
First you need to prove something before you can disprove it.

Thats idiotic. If something is "proved" then it is truth, which can never be disproved.

What you are suggesting is not how science works. Side A doesnt prove something then tell side B to disprove it. Side A and B argue their sides until a conclusion is reached. For me the jury is still out on Cranial Ost. as to wether the physician can elicit any changes or if the movement is even palpable. But it seems clear that there is a possibility that the bones do in fact move and you have shown me nothing to think otherwise.
 

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Originally posted by JPHazelton
As an aside...for those of you who are adamantly denying the movement of cranial bones, have you attempted to feel the CRI? Were you able to feel something or not? Did you feel something and intepret it is something OTHER than the CRI? Just curious. Thanks.
I don't know whether the bones move or not, but I have tried my heart out to feel a CRI. I can pretty clearly feel a movement occuring along w/ breathing, but I chalked it up to slight pulls on skin and fascia during inhaling/exhaling.

Like JP, I really don't care that they figure out how much the bones move. What I want to know is whether it works, and if it's any better than placebo therapeutic touch.

When the OPP instructor at my school introduced us to cranial, he started out with explaining basically all of the current reasearch that's been done. He himself admitted that there has been no interexaminer reliability. Also, the movements that they came up with were VERY, VERY, VERY small movements--on the order of hundreds or even thousandths of a millimeter. I'm no mechanical engineer, but I'd bet that the flexion of bone itself and or the laxity in the recording machinery could easily account for that kind of motion. Even thick metal flexes a tiny bit and warps w/ temperature changes.

What bothers me way more than whether the bones move a couple hundreths of a millimeter (which I wouldn't be surprised at all to find out) is how a person could even begin to rationalize how this is going to treat a disease. With these amounts of motion, daily strain put on the body through walking and running, I would think, would have way more influence on circulation of CSF, much like it does on venous return, than would OCF. In fact, this is what has bothered me about all of OMM the whole time: we know that visceral structures and somatic ones influence each other through the nervous system, but I find it to be quite a leap of logic to say that just by jiggling a few bones around that you're going to un-cirrhose a liver, un-hypertrophy a heart, or calm a flare-up of IBS.

For musculoskeletal conditions, I have no doubts that OMM works, and works well. But I'm much more skeptical about it's general health benefits and disease-reducing capabilities. I've heard a lot of impressive anecdotal evidence and I don't doubt the sincerity of those that believe it works, but I just don't think we can tell whether or not we're fooling ourselves without doing some good reasearch with large sample sizes. And YES, I think it's VERY important for us to publish research and have it scrutinized by JAMA, NEJM, et. al. because it's the ONLY way that the scientific world is going to buy it. If it's good research, it should hold up to scrutiny and there should be nothing to worry about.

Finally, I have to agree with DireWolf that the likes of cranio-sacral therapy should probably not be taught at Osteopathic schools, except as basic introduction as we do with herbs, acupuncture, etc. The only reason we should even be shown this is so we can communicate with our patients about it when questions arise.

As for the licensing exam, I have to agree with DireWolf again and say that there is absolutely no reason on earth why this stuff should be tested. Same with OMM as it relates to internal disease. For musculoskeletal conditions, great. As a pain reliever along with disease, great. But we shouldn't be tested on unproven therapy. I think this is the stuff that makes the COMLEX lose a little credibility in the eyes of allopathic PDs. Its only saving grace is that there are at least 600 questions that don't relate directly to systems OMM and cranial.
 

Homunculus

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Originally posted by Goofyone
I don't know whether the bones move or not, but I have tried my heart out to feel a CRI. I can pretty clearly feel a movement occuring along w/ breathing, but I chalked it up to slight pulls on skin and fascia during inhaling/exhaling.

Like JP, I really don't care that they figure out how much the bones move. What I want to know is whether it works, and if it's any better than placebo therapeutic touch.

When the OPP instructor at my school introduced us to cranial, he started out with explaining basically all of the current reasearch that's been done. He himself admitted that there has been no interexaminer reliability. Also, the movements that they came up with were VERY, VERY, VERY small movements--on the order of hundreds or even thousandths of a millimeter. I'm no mechanical engineer, but I'd bet that the flexion of bone itself and or the laxity in the recording machinery could easily account for that kind of motion. Even thick metal flexes a tiny bit and warps w/ temperature changes.

What bothers me way more than whether the bones move a couple hundreths of a millimeter (which I wouldn't be surprised at all to find out) is how a person could even begin to rationalize how this is going to treat a disease. With these amounts of motion, daily strain put on the body through walking and running, I would think, would have way more influence on circulation of CSF, much like it does on venous return, than would OCF. In fact, this is what has bothered me about all of OMM the whole time: we know that visceral structures and somatic ones influence each other through the nervous system, but I find it to be quite a leap of logic to say that just by jiggling a few bones around that you're going to un-cirrhose a liver, un-hypertrophy a heart, or calm a flare-up of IBS.

For musculoskeletal conditions, I have no doubts that OMM works, and works well. But I'm much more skeptical about it's general health benefits and disease-reducing capabilities. I've heard a lot of impressive anecdotal evidence and I don't doubt the sincerity of those that believe it works, but I just don't think we can tell whether or not we're fooling ourselves without doing some good reasearch with large sample sizes. And YES, I think it's VERY important for us to publish research and have it scrutinized by JAMA, NEJM, et. al. because it's the ONLY way that the scientific world is going to buy it. If it's good research, it should hold up to scrutiny and there should be nothing to worry about.

Finally, I have to agree with DireWolf that the likes of crania-sacral therapy should probably not be taught at Osteopathic schools, except as basic introduction as we do with herbs, acupuncture, etc. The only reason we should even be shown this is so we can communicate with our patients about it when questions arise.

As for the licensing exam, I have to agree with DireWolf and say that there is absolutely no reason on earth why this stuff should be tested. Same with OMM as it relates to internal disease. For musculoskeletal conditions, great. As a pain reliever along with disease, great. But we shouldn't be tested on unproven therapy. I think this is the stuff that makes the COMLEX lose a little credibility in the eyes of allopathic PDs. Its only saving grace is that there are at least 600 questions that don't relate directly to systems OMM and cranial.

great post.
 

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Would the same studies have more validity if published in JAMA or NEJM? Maybe this would make some people feel better about them, but I don't see how it would increase the validity of their findings. JAOA is a strong, peer reviewed source.

You're saying that the quality of studies published in JAMA and NEJm are similar to the quality of studies published in JAOA? Puh-lease.

Casey

Oh..wait. This post violates my policy of going into forums I know nothing about and making posts. Oops.
 

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at some point, someone had a map that showed the earth was flat and that was all the evidence needed for a misconception that lasted quite a longtime. maybe the new vertical MRImachines will help clear up alot of the mystery about OMM/OMT...

regardless of evidence, my opinion is that the cranial bones are stucked, but i don't have evidence for my claim so i guess its not too valid
 
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What gets me is that we are supposed to be competent at feeling this damn CRI after like a month of practicing. I never felt jack, and I don't know any classmates that honestly did besides our hippie wannabe treehugging PDF hopefuls!! Its crazy, and to teach techniques like the V-spread is absurd. To think one can feel some sort of energy bouncing back and forth from the occipitomastoid suture through the freaking corpus callosum, through the frontal bone on the contralater side. It sounds like witchcraft yet they continue to force it down our throats. How about we save that stuff for the manip club meetings and for the manip residents? This is truly the only stuff about our proffession that enbarrasses me to no end!!
 

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Yes, I am gonna chime in.

I wanted this stuff to be true, I wanted it to make sense. It doesn't. Not a single ounce.

Supposedly osteopathic CS practitioners can alter cranial movements with the slightest of touch...yet headbands, baseball caps, cowboy hats, hard hats, helmets, or violent sneezes don't alter or change this most holy of rhythms. When I sleep at night, the constant pressure of my huge noggin doesn't somehow alter my occiput-sphenoid flexion/extension rhythm?? And what are the consequences??? Nothing. I would hope we are more sturdy than that!
Hazelton wants me to DISPROVE...uh, common sense does that. This is an area that not only needs proof, but need validity and reliability studies.

Having craniosacral therapy on the boards, all THREE steps was the biggest embarassment of Osteopathy I have witnessed on a professional level. MEDICAL BOARD TEST QUESTIONS that can't even be supported by scientific peer reviewed data. Sad. Why not test reflexology??

While I think the therapy is an interesting side not, in NOWAY do I think it should be part of the normal curriculum...nor do I think you need to practice this NONSENSE to be a great DO.
 

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Good posts from Goofyone, PACtoDOC, and Freeeedom!

I agree, there's no way CS should be in curriculum or on the boards (is it really on all three steps?!!!). It's amazing that the COMLEX is as widely accepted in the MD-world as it is considering CS is on it. If the shoe were on the other foot, I'd be chuckling everytime I saw this self fulfilling prophecy. In some ways I feel sorry for the OTM folks b/c I can see half of them don't buy it either but they have to teach it b/c this crap is on the boards. Unfortunately, I don't expect CS to exit from the boards anytime soon b/c there's too many old goats who contribute lots of money to their respective OTM depts and the AOA, expecting CS to be taught as fact and part of the medical education. The nearly broke AOA is hardly in a position to step on those people's toes and risk losing more funding. Plus a lot of those "un-biased" board members of the AOA toss their weight around the JAOA review board; they'll see to it that their brand of research promotes CS, lest they risk losing a nice supplement to their income.
 

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Originally posted by ajgoins
Good posts from Goofyone, PACtoDOC, and Freeeedom!

Hey, come one now. I want credit for my initial assault on cranial for the boards. :D
 

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Forgive me 'o wolfy-one. I did not mean to skimp on thy mighty wisdom. :)
 

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The sutures themselves will be con-verted to an interdigitating structure which
contains periosteum; therefore, growth
will continue as long as the suture per-
sists. The sutures will fuse according to
the following:metopic suture: 6 years
sagittal suture: early 30s
coronal suture: age 40
lambdoidal suture: age 50

You can pat yourselves on the back and say case closed, but I still think the sutures stay open because they continue to move, maybe 100th of a mm, maybe 1/10, maybe a millimeter.

With my theory, I provided a reason for why the movement might exist.

I think it warrents further study.

Here's a little experiment you might try

This might be done the best the first time its tried so read it through before you try it for best results. According to my theory the yawn manipulates the skull bones, so if the bones shift from the yawn action, they will be shifted and a second attempt may be unable to shift them because they are already in the shifted position.

I want for you to listen for the sound of the bones moving so first
open the jaw wide and hold it in that position so that it is not moving and you don't confuse any sounds that the jaw might make because its not moving.

Second take a deep breath through the mouth as deep as you can and listen while you are breathing in, listen intently for a sound like a "crack"

It may not be the most scientific of methods but I cannot think of any other reason for the cracking sound other than the movement of the skull bones. When the jaw is open wide before the deep breath, there is no sound from the eustacian tubes. during the deep breath.

The sound, if you hear it is a clue to expanding our paradigm you can ignore it or dissmiss it, but you can't un-hear it after youv'e heard it.
 

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Anyone know if after blunt force trauma to the head, does the skull just crack and crush at the site of impact or does it bust open along supposedly open suture lines?
 

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Im just picturing everyone sitting at their computer doing this little experiment and how silly they all look.
 

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I like DOs and all, but the idea that FUSED BONES move is ****ing stupid.

By the way, you can't prove a negative so trying to disprove something doesn't work. It's like trying to prove Jesus never existed; you can't do it. All you can do is fail to prove something and assume the opposite.
 

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Originally posted by JKDMed
I like DOs and all, but the idea that FUSED BONES move is ****ing stupid.

By the way, you can't prove a negative so trying to disprove something doesn't work. It's like trying to prove Jesus never existed; you can't do it. All you can do is fail to prove something and assume the opposite.

Hey the idea is that they might not actually be fused. No one is saying fused bones move. Also in science we try not to assume things. If you fail to prove something it could be that you had a bad method, or that it is something else. Not always the opposite.
 

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I know how hypothesis testing works. Yes, confounds and mistakes may lead to a failure to prove an alternative hypothesis, but ****ing up isn't a null hypothesis. You either reject the null hypothesis and use your theory as an explanation or you fail to reject it and assume that your theory is incorrect.

Reaching a conclusion would assume that confounds and errors have been addressed.

I also think it's pretty certain that the bones fuse.

http://www.eurekalert.org/pub_releases/2003-04/sumc-sru040903.php
 

Homunculus

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Originally posted by bigmuny
Anyone know if after blunt force trauma to the head, does the skull just crack and crush at the site of impact or does it bust open along supposedly open suture lines?

the skull acts as a hollow sphere in terms of physics and blunt force and penetrating trauma.
 

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Originally posted by Homunculus
the skull acts as a hollow sphere in terms of physics and blunt force and penetrating trauma.

I'm not sure what this means though. You would think that if the sutures in the skull were not fused, and a strong force were to be applied to the skull then it would open along it's weakest points(the areas that are not fused)
 

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Bottom line is that even if the bones are not fused, to expect a medical student with hardly any time on their hands to become experts at feeling something move a 100th of a mm is crazy!! Its hard enough to feel a liver and spleen that are unarguably large and certainly THERE. It is even harder to do a fundoscopic eye exam. But this cranial crap makes me laugh. Our instructors walk around the room saying flexion..........extension......... I would give up my first year's paycheck out of residency if two DO faculty could palpate the CRI on 2 different people and come up with the same exact rate and intervals. The only study they presented us with prior to cranial was a 10 patient study with all kinds of statistical problems. I mean lets cut the BS. Lets have some experts in thi supposed field get together and show us that they are actually feeling the same thing. The proof is in the pudding!!!
And by some miracle lets say you can actually feel a CRI and proove it exists, you still then have to proove all the hogwash about techniques like V-spread actually do something to it. I am embarrassed to tell someone that I am feeling the tide of the CSF through the skull, skin, and two cerebral hemispheres!! Hell I can't even feel some of the transverse processes in some people's L-spine!!! :laugh:
 

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Originally posted by bigmuny
I'm not sure what this means though. You would think that if the sutures in the skull were not fused, and a strong force were to be applied to the skull then it would open along it's weakest points(the areas that are not fused)

As preface, please dont assume from my posts that I agree at all with Cranial Osteopathy. I havent even learned it yet, but even when i do i doubt itll change my mind.

However, with that said, I like to debate so... When you consider rigid structures, like a skull, when sufficient force is applied the object will break at the point where pressure is applied. Only if intra cranial pressure is increased beyond a certain threshold will it break at the weak points. but as with an egg and a skull, if there are weak points, the force needed to crack the surface is usually significantly less than the force needed to raise the pressure within to "explosive proportions".

Also isnt it possible that the suture points are stronger than or just as strong as the bone itself? This often occurs with avulsion fractures where the tendon is stronger than its boney attachment. Maybe there is something holding the sutures together that allows movement?...ok now im reaching.
 

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Also to argue with myself...

How do you feel cranial bones move under the scalp? when it seems as if you cannot get a firm grip on the skull itself. What i mean is that the scalp is very mobile iand it would seem that it would impair any effort to move the bones or sense them moving. I agree that this is crap, but i am open to the idea that the bones might not be fused. Not like that makes much of a difference.
 
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