Introduction to CranioStructural Integration (CSI)

Acute or chronic pain is the most frequent complaint of presenting patients in many offices. The pain generally involves some combination of TMJ, neck, shoulder and arm, low back, sacroiliac joint, gluteal region or sciatica. Many of these symptoms can be attributed to chronic global neuromusculoskeletal compensation patterns related to chronic sutural restrictions and compensatory patterns of the sphenobasilar synchondrosis (SBS). Release of these patterns generally results in marked improvement, if not total elimination of many of the above pain symptoms.

Common, perhaps universal, patterns of postural compensation and neuromuscular imbalance have been described by many authors, including Drs. Gordon Zink {Common Compensatory Patterns (CCP)}, Willard Carver (The Typical), G. Dallas Hancock {Primary Compensatory Patterns (PCP)}, and others. An explanation for these patterns can be found in the craniosacral concepts developed by Dr. William Garner Sutherland and described with remarkable clarity by Dr. Harold Magoun, Sr. in Osteopathy in the Cranial Field (1976).

Dr. Hancock has identified cranial compensation patterns that appear to be maintaining the somatic compensation patterns of the Primary Compensatory Patterns and has developed effective techniques to release them. These unique cranial techniques, CranioStructural Integration, are the core of the CSI - I and CSI - II workshops.

In this and other writings the somatic compensatory patterns will arbitrarily be referred to as Somatic Primary Patterns (SPP) and the cranial compensatory patterns as Cranial Primary Patterns (CPP). Cranial compensation involves SBS strain patterns, sutural restrictions and the coordinating action of the reciprocal tension membrane.

How is CranioStructural Integration different?

CranioStructural Integration (CSI) shares with other cranial therapies the craniosacral concepts developed by William Garner Sutherland. His concepts are the underpinning of all craniosacral techniques. CranioStructural Integration differs from traditional osteopathic craniosacral technique and other craniosacral therapies in several important ways.

First, CSI treatment procedures have been developed by Dr. Hancock to remove specific restricted patterns of cranial movement (Cranial Primary Patterns or CPP) which are related to, and maintain, specific chronic global postural / neuromuscular compensation patterns (Primary Compensatory Patterns or PCP). Most CSI procedures used to ‘unlock' restricted cranial motion are unique, and based on cranial biomechanics rather than traditional cranial techniques. Each of the identified CPP can be eliminated by CSI cranial procedures, thereby releasing the related PCP.

Secondly, the objective of CSI treatment is to eliminate universal chronic neuromuscular Primary Compensatory Patterns by establishing a substantially increased, symmetrical range of motion of the osseous components of the cranial mechanism. Simply establishing motion - even balanced motion - of all of the SBS patterns does not release the Primary Cranial Patterns. In fact, CSI treatment may begin where other cranial therapies leave off. For example, if an SBS torsion strain pattern is present, normal balanced left and right torsion movement is restored prior to performing the CSI torsion releases.

Third, the CSI treatment approach is generally more structural in nature, and utilizes direct rather than indirect cranial techniques. However, sufficient force is frequently applied in the direction of greatest mobility / least restriction (indirect technique) to unlock sutural restrictions and lengthen soft tissue holding elements prior to applying force against the restriction barrier (direct technique). (CSI utilizes the fronto-occipital hold for most releases.) Treatment may require alternating between the directions of mobility and restriction until the desired degree of cranial movement has been achieved in both directions.

Fourth, the amount of force applied in CSI treatment is generally greater than the amount usually used in most craniosacral therapies or traditional osteopathic cranial techniques. The objective in CSI techniques is to create permanent changes to the cranial mechanism by lengthening the cranial soft tissue holding elements (e.g., fascia, sutural ligaments (periosteum), reciprocal tension membranes, etc.). These changes to the cranial mechanism are necessary for the release of Cranial Primary Patterns and the Somatic Primary Patterns, which together make up the Primary Compensatory Patterns.

Fifth, CSI is an outcome-oriented therapy. Diagnostic techniques used in CSI include the usual palpation and visual evaluations. In addition, manual muscle testing and various reflex techniques from applied kinesiology are used extensively for both diagnostic evaluation and confirmation of treatment outcomes. Validation of predicted treatment objectives - by muscle tests and other measures - is expected.

Despite these differences, CSI shares the broad holistic treatment objectives of traditional osteopathic craniosacral and other craniosacral therapies. CSI also recognizes, and addresses in treatment, other interrelationships between components of the craniosacral mechanism and neuromusculoskeletal compensation patterns occurring elsewhere in the body.

CranioStructural Integration I (CSI - I) Workshop

The first objective of the CSI - I workshop is to establish the theoretical framework, based on CranioSomatic concepts, within which both the cranial and somatic components of Primary Compensatory Patterns can be analyzed. Both sutural restrictions and strain patterns of the sphenobasilar synchondrosis (SBS) produce specific global changes to somatic posture and neuromuscular function. This will be demonstrated. Likewise, it will be demonstrated that changes in somatic posture and neuromuscular function produce changes in the position and function of cranial components. Manual muscle testing, therapy localization, and challenge techniques from applied kinesiology will be used to correlate these relationships, and to establish examination procedures which will be used throughout CSI - I and CSI - II for detecting / evaluating the cranial and somatic components of Primary Compensation Patterns.

The second objective of CSI - I is to identify Primary Compensatory Patterns. Workshop participants are introduced to these patterns through an examination exercise conducted by each participant on a partner. This examination consists of neuromuscular evaluation using manual muscle testing, postural evaluation, range of motion (ROM), and palpation. The deviations from normal posture and neuromuscular function found in this examination generally identify some of the cranial (CPP) and somatic (SPP) components of Primary Compensatory Patterns.

The third, and prime, objective of CSI - I is to release the Primary Compensatory Patterns. During CSI - I, and the first part of CSI - II, participants will learn to release the compensation patterns identified in the examination and many other components of Primary Compensatory Patterns. They will learn to identify each pattern, apply the appropriate treatment technique found on the CranioStructural Integration protocol, and confirm that the pattern has been released.

These corrections should hold from visit to visit, and generally should not need to be repeated barring head trauma. The release of these chronic Primary musculoskeletal compensation patterns results in increased ROM, improved athletic performance, and a reduction in pain and other symptoms. Patients will generally voluntarily acknowledge these changes.

Click here for CSI course outline

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CranioStructural Integration II (CSI - II) Workshop

The first objective of CSI - II is to finish the release of Primary Compensation Patterns begun in CSI - I workshop. This is accomplished by completing the procedures listed on the CranioStructural Integration protocol. At the completion of the protocol, each participant will repeat the examination performed on his/her partner in CSI - I workshop and record the new results. This reexamination will provide the participant with an opportunity to verify that none of the compensation patterns previously released by the CSI techniques has returned. The exercise will also increase the practitioner’s skills and build confidence in the techniques.

The second objective of CSI - II is to provide participants with the knowledge and skills to identify functional compensation patterns, and treatment strategies for releasing them. After all of the Primary Compensatory Patterns have been released, practitioners should evaluate patients for functional compensation patterns on each subsequent visit and should perform appropriate treatment procedures to release them. Additional analytical and treatment procedures will be presented in CSI - II to treat functional compensation patterns.

The various systems of the body (skeletal, muscular, and neurological, etc.) form a single functioning unit. Changes to any component of these systems may result in global compensation patterns involving all systems. For example, abnormal position and function of any joint, including the bones of the skull, knees, hands and feet, fingers and toes, sacroiliac joints, etc., can result in neuromuscular imbalances, postural distortion, sutural restrictions, and SBS strain patterns. It will be demonstrated that when a suture is jammed or a finger joint is compressed longitudinally, specific predictable patterns of neuromuscular inhibition occur immediately.

Participants will use manual muscle testing, therapy localization, and challenge to identify patterns of inhibited neuromuscular function. These patterns will indicate the sutures and/or other joints requiring treatment and the type of treatment needed to release the functional patterns. Acupuncture points and acupuncture meridians will also be used in evaluating sutural restrictions, SBS strain patterns, and other joint problems requiring treatment.

The third objective of CSI - II is to teach participants how to evaluate the somatic effects of various items in the immediate environment and identify the resulting functional compensations. Pain patterns and other symptomatic complaints will be discussed along with recommendations for resolving the problems. Six groups of environmental factors adversely affecting posture and neuromuscular function will be covered (see workshop outline).

Another source of functional compensations is habituated patterns of repetitive motion. In chronic cases, the condition may be diagnosed as a Repetitive Movement Disorder (RMD). In less severe cases, facilitated neural pathways may be the perpetuating factor in recurring or chronic aches and pains that are annoying, but not disabling.

Facilitated Pathways Intervention (FPI) is a very effective treatment for RMDs and other recurring pain symptoms. This unique cranial technique will be briefly demonstrated at the end of the CSI workshop.

(Click here for the CSI course outline)

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CranioStructural Integration I & II

Workshop Outline *

NOTE: These two workshops are taught as a pair, so the outline is continuous.

Teaching Methods: Lecture with audiovisual support; Demonstrations with teaching aids; Interactive student activities; Discussions; Question & Answer sessions.

Introduction to CranioSomatic concepts

· Cranial dysfunctions affecting somatic function

· Somatic dysfunctions affecting cranial function

Introduction to CranioStructural Integration (CSI)

· History / development of CSI

· Defining characteristics of CSI

· Objectives

Posture

· Definition

· ‘Ideal’ Characteristics

· Evaluation methods

Postural compensation patterns

· A brief history of postural research

· Commonly recognized patterns of musculoskeletal compensation

Correlation of postural patterns to cranial patterns

· Postural flexion and extension

· Postural internal and external rotation

· Postural adduction and abduction

Primary Compensatory Patterns (PCP)

· Cranial Primary Patterns (CPP)

· Somatic Primary Patterns (SPP)

‘Primary’ versus ‘Functional’ patterns

· Definitions and characteristics

· Evaluation

· Treatment

CranioStructural Integration concepts

· Releasing Primary Compensatory Patterns with CSI

· Contact considerations & intended results

Evaluation methods used in CSI

· AK techniques (Manual Muscle Testing, Therapy Localization, Challenge)

· Range of Motion (ROM)

· Palpation

Evaluation and treatment procedures

· Demonstration: Evaluation of Cranial Primary Patterns (CPP) & Somatic Primary Patterns (SPP)

· Overview of the CSI protocol (40+ techniques, arranged in 6 ‘sessions’)

· Treatment procedure for each CSI technique (pre-treatment evaluation; corrective action; post-treatment verification that pattern released)

Teaching Methods: Instruction with demonstration for each technique; Intensive Hands-on practice (students evaluate and treat each other on all techniques); Feedback / Q & A

CSI Techniques (Hands-on)

· Evaluation of CPP & SPP (postural and neuromuscular)

· SBS releases (CSI sessions # 1 & # 2)

- Master Release^SM concepts

- SBS releases for A/P axis

- SBS releases for transverse axes

· Intraoral & facial releases (CSI session # 3)

CSI - II

· Vault releases and combination releases (CSI session # 4)

· SBS and vault releases (CSI session # 5)

· Post-treatment evaluation of CPP, SPP, and other released patterns

· Integrating sutural releases with CSI (sutural clearing procedures)

Functional Compensations

· Recognizing functional compensations and compensatory patterns

· Evaluation procedures

· Treatment techniques (cranial and non-cranial)

Environmental factors in functional compensations (CSI session # 6)

· Eyeglasses, dental appliances, etc.

· Footwear (orthotics, shoe inserts, and heel lifts, shoe characteristics)

· Ergonomic factors (chairs, computer workstations, etc.)

· Magnets and electronic devices (cell phones, headsets, key pads)

· Fragrances and other airborne chemicals

· Restrictive clothing (tight jeans, bands in socks, etc.)

Facilitated Patterns and functional compensations

· Lecture & Demonstration: Primitive reflexes and compensations

· Demonstration of Facilitated Pathways Intervention (FPI)

Brief review of CSI concepts and treatment protocols

· Establishing a treatment plan

· Comprehensive evaluation protocol

· Individualized therapeutic objectives and treatment plan

· Using the technique protocols

· Closing each session

* Hancock CranioSomatic Institute reserves the right to modify workshop content without prior

notice.

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