About the development of Sutherland’s cranial sacral approach

The history of Osteopathy and where Sutherland’s cranial sacral approach originated

Our bodies have a bony skeleton that supports us; this is held together with ligaments, tendons, muscles and connective tissues, and has joints of different varieties between the bones to allow for movement. Inside and around the skeleton you will find the softer tissues of the body, like the brain, nerves, blood and lymph vessels, plus muscles and organs. All of this is contained, supported, surrounded and kept alive by the connective tissues network. The connective tissues transmit the circulatory vessels enabling nourishment of the tissues, and also holds our body together in one tidy package!

In all bodies, it is the connective tissue which does the vital job of keeping everything where it should be, supporting the nerves, and allowing the blood and lymph circulation to do its job of keeping the tissues clean, well nourished with oxygen and nutrients, and consequently the body vital, healthy, supple and free of pain.

Of course, things can and do go wrong sometimes in life! The strains, sprains, impacts and bruising to the tissues after a fall or accident, the inflammation and congestion from an illness, or the binding action of scar tissue following surgery or trauma, can all serve to upset the tension, alignment, mobility and drainage of the connective tissues. This causes twists in nerves, blood and lymph vessels, supported by the connective tissues, and strains and misalignments in organs and joints. When the abnormal stress and strain in the connective tissues fails to properly resolve, the nerves become irritated, the blood and lymph vessels become kinked, or compressed,- visualise the effect on the flow through a garden hose,- so slowing down circulation and repair. The organs and joints then become sore and function less well, due to the position they are being held in by their twisted and unbalanced ligaments, and tissue repair is hampered by congestion and reduced circulation.
Eventually if this state continues, degenerative changes will occur. This means early wear and tear in joints, contractures of muscles and connective tissues, chronic inflammatory states, the likelihood of problems and dysfunctions in organs, all sorts of aches and pains, suppression of the immune system, and the general exhaustion physically and mentally that comes with a body that’s only running on 2 or 3 cylinders!

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Foundation of Osteopathy in 1874

It was in order to help those people suffering with these types of problems, that Dr Andrew Taylor Still founded Osteopathy in 1874. Dr Still based his newfound approach upon the keen observations of structural anatomy, and the ‘functional’ anatomy and physiology outlined above. He developed pioneering hands-on treatment approaches to deal with these health and mobility problems found in his patients. He utilised his skills in the successful treatment of many serious complaints in his patients, as well as the more general aches and pains suffered by most, at one time or another in life.
Still’s theories centred round the vital importance of removing any strains or sprains in the body that were interfering with nerve and blood flow, – and hence tissue repair, the natural alignment of body structures, the smooth movement of joints muscles and organs, and the proper function of the immune system.

Development of the Cranial sacral approach in 1920’s

In the 1920’s, Dr William Garner Sutherland, a student of Still, took these concepts a stage further and developed his Cranial sacral approach to treatment . In addition to the strict observance of Dr Still’s existing principles of treatment, he also noted that there was a rhythmic micro- movement in the connective tissues and central nervous system, which in healthy subjects, was continuous and even, but became altered or restricted in times following a trauma, stress or during infection or inflammation. This he was able to palpate manually by using a soft but firm contact on his patients skull, body and limbs. He noted that along with this alteration in the body tissues micro-motion, there developed many health and mobility problems, giving a state of ‘dis-ease’ to the individual.
These problems of restricted micro-motion furthermore, were not always associated just with the presence of pronounced biomechanical strains to the large joints of the body, but rather to the least mobile and naturally tightest bony unions i.e. the ‘sutures’ of the human skull. Dr Sutherland made his observations concerning the ‘sutures’ associated with his experimental dissection of the bony plates of the skull, which he managed to prize apart quite easily. [Controversially, some medical texts state that the sutures are fused in the skulls of adults, this however is not so. The junctions between the bony plates are very close, but the bones remain separate.]

The ‘sutures’ are the joints between the bones of the skull, their structure is different from other joints in the body, and allows only very small but precise increments of ‘give’ between the bones. This ‘give’ is very important in allowing the correct functioning of the Central Nervous system and the nerves, including their protective sheaths, and associated blood vessels. Plus the general dynamic balance of the body through its connective tissue, and hence the individuals’ entire structural integrity. Jamming, or congestion of these suture,s could cause problems with the function of specific nerves, or more general symptoms relating to congestion of circulation through the brain, or even more general symptoms resulting from the disturbed connective tissue balance affecting the proper support of musculo-skeletal and organ systems.
Sutherland discovered that these restrictions of the sutures, and alterations to the micro-motion of the body, were not responsive to the existing manipulative approaches already developed by Still and others.

With the encouragement of A.T, Still, and following much experimentation, some of it on himself, and after 20yrs of work on the concept, WG Sutherland developed a number of techniques to remedy the problems that arose as a result of this jamming and disturbance of normal sutural and deep body tissue micro-motion.
The term involuntary motion was coined, to describe the normal tissue micro-motion, as it was not something that the individual patient was consciously in control of, but occurred naturally in their body, subtly and behind the scenes, doing its job unnoticed, unless and until it became disrupted by trauma, toxins, scarring, stress or infection.

Sutherland felt that this involuntary motion was responsible for supplying the body in a coordinated way, through the connective tissue and the nerve pathways, with extra levels of nutrition, oxygen, lubrication and hormone circulation at the deeper levels of tissue function.

Today we still feel that this assumption was sound, the more recent scientific work on the ‘trophic’, or nutritive function of nerves and the micro-tubular structure of connective tissue etc, would tend to support Sutherland’s original theories.
The consequences of the skilled use of Dr Sutherland’s newly developed techniques, was amazing. Many patients who found that standard manipulative treatment had not provided an acceptable resolution for them, remarked that they were helped beyond belief, by this new Cranial sacral approach to therapy.
Many of these problems had caused them pain, restriction and debilitation for some time, often several years. In Sutherlands’ skilful hands, over a period of time, following his treatment program, even these long-term chronic debilitating problems responded!

Sutherland’s work gained a small but dedicated following of physicians, it is thanks to these people that we received our training in Sutherland’s approach, which started in 1974. Whilst attending the ‘BSO’ and part way through our training we became exposed to the Cranial approach and started to study Sutherland’s work. It is something we have continued to do ever since. It is as a result of the invaluable help of Sutherland’s original students, that we are able to put his methods to work in our practice, and in our teaching of other practitioners following on.