Osteopathic/ Chiropractic / Cranio-sacral

[Guest guest]

Hi all,

 

I was wondering if anyone knows the major differences between Osteopathic

medicine and Chiropractic medicine as far as visceral / bone/joint

manipulation?

 

Do chiropractors practice cranio-sacral-like PRM techniques? Although it's

not part of the general curriculum in school, is there a branch of

chiropractic that uses these techniques?

 

Is Cranio-sacral technique taught by the Upledger Institute partial or

complete of the Physical Respiratory Mechanism (PRM) course that is taught

in Osteopathic College?

If not, what is left out of the Cranio-sacral course?

 

Thanks in advance,

K.

 

 

 

[Guest guest]

I can't answer your questions about distinction, but I do know that

many DCs practice Major DeJarnette's Sacral Occipital Tehnique. If

you can make it through the book (SOT 1984 is typed in ALL CAPS !), or

find a good teacher, category differentiation and pelvic blocking is

fairly easy to learn and effective for anyone doing physical med.

 

Chinese Medicine , " "

<johnkokko wrote:

>

> Hi all,

>

> I was wondering if anyone knows the major differences between

Osteopathic

> medicine and Chiropractic medicine as far as visceral / bone/joint

> manipulation?

>

> Do chiropractors practice cranio-sacral-like PRM techniques?

Although it's

> not part of the general curriculum in school, is there a branch of

> chiropractic that uses these techniques?

>

> Is Cranio-sacral technique taught by the Upledger Institute partial or

> complete of the Physical Respiratory Mechanism (PRM) course that is

taught

> in Osteopathic College?

> If not, what is left out of the Cranio-sacral course?

>

> Thanks in advance,

> K.

>

>

>

[Guest guest]

Chiropractic is different from osteopathic medicine in many ways. The

largest difference probably stems from the basic premise they adhere to.

Chiropractic tends towards interference in nerve or mental impulse as a root

cause of dis-ease, while osteopathic tends towards interference in blood and

fluid flow.

 

 

 

Chiropractors spend much more of their education and clinical years honing

their skills in spinal adjustments. Osteopaths seem to spend more time

learning traditional AMA standards of medicine (drugs, surgery, etc.). Some

DO's do specialize in adjustments but most do not - the same can be said for

cranio-sacral.

 

 

 

Upledger's cranio-sacral technique came about from his education as a DO but

he took it one step further, refined it and made it its own modality for

people who wanted to specialize in cranial and visceral manipulation. DO's

do not get exposed to in much depth unless they go on to specialize in it.

Cranio-sacral can be learned and practiced by anyone with a license that

allows them to lay their hands on people.

 

 

 

There is pretty much only one chiropractic specialty that deals with the

cranio-sacral mechanism and that is SOT (Sacro Occipital Technique). It is

a complete system but does have some ideas that seem counter to Upledger's.

 

 

 

 

There is controversy on what the cranio-sacral rhythm is and what is

responsible for it - sacral movement, cranial movement, respiration,

cardiovascular and ventricular (brain ventricles and CSF flow/production).

A very good review article was recently published exploring all these

aspects. Although many experts disagree on the specifics, they do all have

clear evidence of its relationship to health.

 

 

 

This is my understanding of it.

 

 

 

Brian

 

 

 

 

 

 

[Guest guest]

Hi Brian -

 

" A very good review article was recently published exploring all these aspects. "

 

Interesting post. Resource/ reference for the above article?

 

Thanks!

 

________________________________

Hugo Ramiro

http://middlemedicine.wordpress.com

http://www.chinesemedicaltherapies.org

 

 

 

 

 

________________________________

Brian Harasha <bharasha

Chinese Medicine

Friday, 24 October, 2008 18:07:19

Re:Osteopathic/ Chiropractic / Cranio-sacral

 

 

Chiropractic is different from osteopathic medicine in many ways. The

largest difference probably stems from the basic premise they adhere to.

Chiropractic tends towards interference in nerve or mental impulse as a root

cause of dis-ease, while osteopathic tends towards interference in blood and

fluid flow.

 

Chiropractors spend much more of their education and clinical years honing

their skills in spinal adjustments. Osteopaths seem to spend more time

learning traditional AMA standards of medicine (drugs, surgery, etc.). Some

DO's do specialize in adjustments but most do not - the same can be said for

cranio-sacral.

 

Upledger's cranio-sacral technique came about from his education as a DO but

he took it one step further, refined it and made it its own modality for

people who wanted to specialize in cranial and visceral manipulation. DO's

do not get exposed to in much depth unless they go on to specialize in it.

Cranio-sacral can be learned and practiced by anyone with a license that

allows them to lay their hands on people.

 

There is pretty much only one chiropractic specialty that deals with the

cranio-sacral mechanism and that is SOT (Sacro Occipital Technique). It is

a complete system but does have some ideas that seem counter to Upledger's.

 

There is controversy on what the cranio-sacral rhythm is and what is

responsible for it - sacral movement, cranial movement, respiration,

cardiovascular and ventricular (brain ventricles and CSF flow/production) .

A very good review article was recently published exploring all these

aspects. Although many experts disagree on the specifics, they do all have

clear evidence of its relationship to health.

 

This is my understanding of it.

 

Brian

 

 

[Guest guest]

Koko

The osteopathic model is a complete medical model that in many ways is

similar to CM in its holistic view of the world. It is not just a

blood and fluid model but contains many more models as they relate to

manual therapy. It includes spiritual, nutritional, chemical, surgical

and other allopathic methods as the founder was an MD. CranioSacral is

a word coined by Upledger and has been designed to teach non medically

trained people. It includes very little true cranial diagnosis which

is a major limitation compared to the osteopathic approaches with are

numerous from suture based to circulatory and several other. Upledger

did not develop visceral work most of which tat is taught via his

institute was developed in France, although visceral work has always

been part of the osteopathic skill set. Cranial therapy is part of the

field of osteopathy and depending on which DO school you go to you can

get quite a bit of manual therapy training (or very little training,

it also depends on your interest) including all the major approaches:

high velocity, muscle energy, myofascial release, fluid circulatory

approaches, counterstrain, functional techniques, visceral, and

cranial being the most common. The major difference in the

" chiropractic " model and osteopathy is the concept of chiropractic

subluxation and it so-called neural effects.

Hope this helps

 

 

 

400 29th St. Suite 419

Oakland Ca 94609

 

 

 

alonmarcus

 

 

 

 

 

 

 

 

[Guest guest]

Alon, Brian,

 

Thanks for the feedback.

 

Other than your book - Alon and being in a DO program,

where can one get this type of manual training ( " high velocity, muscle

energy, myofascial release, fluid circulatory

approaches, counterstrain, functional techniques, visceral, and cranial " )

 

Thanks,

K.

 

 

 

 

On Sat, Oct 25, 2008 at 9:34 PM, alon marcus <alonmarcus wrote:

 

> Koko

> The osteopathic model is a complete medical model that in many ways is

> similar to CM in its holistic view of the world. It is not just a

> blood and fluid model but contains many more models as they relate to

> manual therapy. It includes spiritual, nutritional, chemical, surgical

> and other allopathic methods as the founder was an MD. CranioSacral is

> a word coined by Upledger and has been designed to teach non medically

> trained people. It includes very little true cranial diagnosis which

> is a major limitation compared to the osteopathic approaches with are

> numerous from suture based to circulatory and several other. Upledger

> did not develop visceral work most of which tat is taught via his

> institute was developed in France, although visceral work has always

> been part of the osteopathic skill set. Cranial therapy is part of the

> field of osteopathy and depending on which DO school you go to you can

> get quite a bit of manual therapy training (or very little training,

> it also depends on your interest) including all the major approaches:

> high velocity, muscle energy, myofascial release, fluid circulatory

> approaches, counterstrain, functional techniques, visceral, and

> cranial being the most common. The major difference in the

> " chiropractic " model and osteopathy is the concept of chiropractic

> subluxation and it so-called neural effects.

> Hope this helps

>

>

>

> 400 29th St. Suite 419

> Oakland Ca 94609

>

>

>

> alonmarcus <alonmarcus%40wans.net>

>

>

[Guest guest]

The Upledger Institute offers most of those courses and they are offered

worldwide. www.upledger.com

 

The Milne Institute offers heart centered /visionary cranial sacral therapy

courses www.milneinstitute.com

 

Judith

 

 

 

 

: johnkokko:

Sat, 25 Oct 2008 22:28:39 -0700Re: Re:Osteopathic/ Chiropractic /

Cranio-sacral

 

 

 

 

Alon, Brian,Thanks for the feedback.Other than your book - Alon and being in a

DO program,where can one get this type of manual training ( " high velocity,

muscleenergy, myofascial release, fluid circulatoryapproaches, counterstrain,

functional techniques, visceral, and cranial " )Thanks,K.On Sat, Oct 25, 2008 at

9:34 PM, alon marcus <alonmarcus wrote:> Koko> The osteopathic model

is a complete medical model that in many ways is> similar to CM in its holistic

view of the world. It is not just a> blood and fluid model but contains many

more models as they relate to> manual therapy. It includes spiritual,

nutritional, chemical, surgical> and other allopathic methods as the founder was

an MD. CranioSacral is> a word coined by Upledger and has been designed to teach

non medically> trained people. It includes very little true cranial diagnosis

which> is a major limitation compared to the osteopathic approaches with are>

numerous from suture based to circulatory and several other. Upledger> did not

develop visceral work most of which tat is taught via his> institute was

developed in France, although visceral work has always> been part of the

osteopathic skill set. Cranial therapy is part of the> field of osteopathy and

depending on which DO school you go to you can> get quite a bit of manual

therapy training (or very little training,> it also depends on your interest)

including all the major approaches:> high velocity, muscle energy, myofascial

release, fluid circulatory> approaches, counterstrain, functional techniques,

visceral, and> cranial being the most common. The major difference in the>

" chiropractic " model and osteopathy is the concept of chiropractic> subluxation

and it so-called neural effects.> Hope this helps>> >> 400 29th

St. Suite 419> Oakland Ca 94609> >>

> alonmarcus <alonmarcus%40wans.net>>>

 

[Guest guest]

I have not found the review article but here is something related:

 

 

 

 

 

 

<http://www.sciencedirect.com.biblioproxy.uqtr.ca/science?_ob=ArticleURL & _udi=B6\

T9D-4PMJ9VW-4 & _user=1072221 & _coverDate=02%2F29%2F2008 & _alid=802540351 & _rdoc=4 & _f\

mt=high & _orig=search & _cdi=5112 & _sort=d & _docanchor= & view=c & _ct=94 & _acct=C00005129\

1 & _version=1 & _urlVersion=0 & _userid=1072221 & md5=e488b665e7adfafe8e1ae5ffc2df7eb6>

The respiratory modulation of intracranial cerebrospinal fluid pulsation

observed on dynamic echo planar images

Magnetic Resonance Imaging, Volume 26, Issue 2, February 2008, Pages 198-205

Yi-Hsuan Kao, Wan-Yuo Guo, Adrain Jy-Kang Liou, Yi-Hui Hsiao, Chih-Che Chou

 

 

 

Abstract

 

Pressure changes in cerebrospinal fluid (CSF) that occur with respiration

rhythms have been studied in animals and humans for more than 100 years. This

phenomenon has been recently validated in vivo on MR images by applying spectral

analysis to signal–time curves at selected regions of interest. However,

selecting regions of interest requires knowledge of physiology and anatomy, and

manual selection is time consuming. We postulate that CSF pulsation is passively

modulated by intra-thoracic pressure that is secondary to respiration, and this

pulsation can be observed as a flow-related enhancement on MR images. To

investigate the spatiotemporal patterns of respiratory rhythms in human brains,

we conducted a study on MR scanning of 12 healthy volunteers who performed

normal-breathing and breath-holding experiments during scanning. Spectral

analysis, spectroscopic images, independent component analysis and signal

measurements in selected regions were applied to dynamic MR images acquired from

these volunteers. Through independent component analysis, respiratory rhythms

were found at the vicinity of ventricles and CSF areas in nine subjects in

normal-breathing experiments. In breath-holding experiments, respiratory rhythm

suppression and vessel dilation were observed in 8 and 10 subjects,

respectively. Information obtained from this study further elucidates the

respiratory modulation of CSF in vivo.

 

Conclusion

 

In this study, we validated our postulate that CSF pulsation is passively

modulated by intra-thoracic rhythmic pressure changes secondary to respiration.

We found that (1) cardiac rhythms appear at pixels in the vicinity of

intracranial vessels, choroid plexus, ventricle, CSF spaces and sagittal sinus;

(2) respiratory rhythms appear at pixels in the vicinity of ventricle, CSF

spaces and sagittal sinus; (3) breath holding induces vessel dilation; (4)

respiration- modulated CSF pulsation at ventricle and CSF space is temporarily

suppressed by breath-holding; and (5) opposite amplitudes of the same

physiological signal–time curves are found at different pixels. This

study shows that it is feasible to conduct an in vivo evaluation of the

physiological modulation of CSF pulsation.

 

 

 

 

 

Also, here is a good summary with links if you are interested in reading more:

http://www.cranialacademy.org/pdf/PRMresearch.pdf

 

 

 

 

 

 

[Guest guest]

I have taught courses, you can get some training vie upledger although

i do not like their course that much, you can take the Michigen state

courses they have manual therapy courses that you can take, CEU like,

you can take courses via the Academy of osteopathy, and you can take

courses from people like Bear in Wa, Mitchell in Mi etc.

 

 

400 29th St. Suite 419

Oakland Ca 94609

 

 

 

alonmarcus

 

 

 

 

 

 

 

 

[Guest guest]

Brian

this study does not support the osteopathic ideas of the primary

respiratory mechanisms which are not part of thoracic motions or heart

beating.

Interesting!

 

 

 

400 29th St. Suite 419

Oakland Ca 94609

 

 

 

alonmarcus

 

 

 

 

 

 

 

 

[Guest guest]

Alon,

Thanks. When are you teaching a course in Manual therapy for

acupuncturists?

 

K.

 

 

 

On Sun, Oct 26, 2008 at 8:42 PM, alon marcus <alonmarcus wrote:

 

> I have taught courses, you can get some training vie upledger although

> i do not like their course that much, you can take the Michigen state

> courses they have manual therapy courses that you can take, CEU like,

> you can take courses via the Academy of osteopathy, and you can take

> courses from people like Bear in Wa, Mitchell in Mi etc.

>

>

> 400 29th St. Suite 419

> Oakland Ca 94609

>

>

>

> alonmarcus <alonmarcus%40wans.net>

>

>

[Guest guest]

Thanks, Brian, for that link.

 

Alon Marcus' reply: does the osteopathic model delve that much into the

rest of the body's system? I once read some books, including one, I

think, by Sutherland, finding it quite impressive. It wouldn't be at all

unreasonable to find whatever mechanisms directly govern the CSF rhythms

to also be in some ways, if indirectly, influencable by the other, also

autonomic rhythms. That relates to the article on referred pain, one of

whose main points was that nerve fibers and connections, especially in

the CNS, are so dense and closely packed, and the brain itself so much

more plastic in its functional organization than thought up to recently,

that cross-talk and other sorts of seemingly disparate interrelations

are hardly surprising.

 

Having once taken a weekend Upledger seminar in CS therapy, the one

thing that I've retained is an appreciation that the CS rhythm is a

physiological given. And it is the one aspect I occasionally apply

(along with, for instance, a more regular use of monitoring the pulse),

to help evaluate stabilization of overall patient state during

treatments. It seems to come to mind in cases involving headaches,

head-neck-upper back tension, and low-back, especially lumbar-sacral issues.

 

A rationale is given in Jeffrey Yuen's portrayal of the dynamics in the

(Doaist) structural metaphor of the whole body as three bony cavities

--- the pelvis, the thorax, and the skull (the palaces of the three

treasures: jing, qi and shen). The sacral and cranial junctures

correspond to the two major articulations that hold, flexibly, these

three bone-structures together. And the du/governing channel, with

obvious correlation to osteopathic (and chiropractic) theory, has a

major area of utility in regulating that structure.

 

 

[Guest guest]

Correction: message sent a moment ago was labeled

Re: What is our Medicine,

 

but should have been in the thread:

Re: Osteopathic / Chiropractic -- Cranial Sacral

[Guest guest]

I never organize them, if people are interested they need to organize

 

 

 

 

 

 

 

 

 

 

[Guest guest]

Alon,

 

I can organize one. What would you want to teach?

How many weekends in the Bay area?

 

If anyone is interested, please contact me at johnkokko

Thanks for being open to teaching, Alon.

 

K.

 

 

 

On Mon, Oct 27, 2008 at 10:05 AM, Alon Marcus <alonmarcus wrote:

 

> I never organize them, if people are interested they need to organize

>

>

>

>

>

>

>

>

>

>

[Guest guest]

I would suggest a basic muscle energy course since it can build the best

foundations as far as manual therapy. Should be about 5 weekends

 

 

 

 

 

 

 

 

 

 

[Guest guest]

Some historical perspective following up on parts of this discussion.

 

Brian Harasha initially responded (Fri, 24 Oct 2008 17:07:19 –0500):

>> Osteopaths seem to spend more time learning traditional AMA

standards of medicine (drugs, surgery, etc.). Some DO's do specialize in

adjustments but most do not - the same can be said for cranio-sacral.

 

Osteopaths cut a deal with the AMA/allopathic movement a Century or so

ago. They go through MD training, then specialize. Similar to

psychiatrists. A friend who roomed with me six months back when I was in

TCM school at PCOM, San Diego, ca. 1990, was doing an OD internship with

one Viola Frymann (Freimann?), a major lineage holder of mainline

osteopathy. Her specialty, what my friend was into, and also is

practiced mainly by a local well-known and respected OD in the Palo Alto

area was dealing with childhood, i.e. developmental problems involving

the CNS.

 

In a later message, Brian cited the 2008 study by Kao et al:

>> The respiratory modulation of intracranial cerebrospinal fluid

pulsation observed on dynamic echo planar images

…Pressure changes in cerebrospinal fluid (CSF) that occur with

respiration rhythms have been studied in animals and humans for more

than 100 years. This phenomenon has been recently validated in vivo on

MR images…

 

and Alon added:

>> this study does not support the osteopathic ideas of the primary

respiratory mechanisms which are not part of thoracic motions or heart

beating.

 

I revisited a book my osteopath friend recommended back then, roughly

when I had taken a weekend intro to Upledger CS. Namely " Osteopathy in

the Cranial Field " , by Harold Ives Magoun, OD, which presented the

research and treatment principles and techniques developed by William

Garner Sutherland, one of the fathers of osteopathy. (Book first

published in 1966, covering Sutherland's work apparently in the

1920's-1930's)

 

Some relevant passages from Chapter II " The Primary Respiratory Mechanism " :

 

" Osteopathy in the cranial field is primarily concerned with two

physiological phenomena: the motion present in the cranial sutures and a

rhythmic impulse within the cranium, distinct from any previously known

pulsation, as they relate to a basic physiological complex considered to

be responsible for many of the essentials of homeostasis. "

 

Interesting " homeostasis " was apparently a significant concept back then.

 

" …[F]irst recognized by the late W G Sutherland, D.O….1939…his findings

in a small volume named 'The Cranial Bowl' … involves the entire body

as a unit of physiological function under the name of the Primary

Respiratory Mechanism,… which includes…:

A. The inherent motility of the brain and spinal cord.

B. The fluctuation of the cerebrospinal fluid.

…

E. The involuntary mobility of the sacrum between the ilia.

And, one might well add, the effect of all these phenomena throughout

the entire body by way of all possible channels. "

Clearly the seeds of a " cranial-sacral' notion. Interesting " holistic "

characterization. The author was unlikely to have been aware of the

jingluo, but I suspect that if he had, would have readily admitted the

CM view under " all possible channels. "

Finally:

" There is much in the literature to corroborate cerebral movement. "

Indeed, as recent at 2008. And, back in Sutherland's and Magoun's day:

" Four definite motions [in the brain] have been observed at operation:

[cited from a 1957 study]

1. A pulsation which is synchronous with cardiac contractions.

2. A pulsation which coincides with respiratory pressure changes

associated with inhalation and exhalation.

3. A wave not related to either heart rate or respiration but one which

constantly maintains its own cycle. "

4. An undulating pulsation which has not been identified. "

Obviously an instance of Kao et al's acknowledged study in this area

going back 100 years.

Somewhere else in there was also mention that all organs pulsate, in one

way or another. As in the curious notion Stephen Change put forth, that

the kidneys (shen) pulsate, not unlike the heart.

Le plus change, le plus meme…

[Guest guest]

Chris

There is a rumor that Stills' first clinic was rented from the chinese

laundry, which may have exposed him to some ideas. I heard this from a

DO friend but have not seen this anywhere else. Who knows? He

definitely saw health as a multifactorial interaction between spirit,

emotions, environment, nutrition and structure. At the same time he

was an MD so having DOs go through regular medical training is keeping

with the founder.

What surprised me about the study is that they looked at respiratory

(lung) activity as it relates to cranial motion. The Primary

Respiratory Mechanism is not thought to relate to lung or heart

movement. As far as training you get some manual therapy at med school

at all DO institutions. Manipulation is part of their boards, however;

many DOs are not interested and never been interested in it, the only

reason they went to a DO school is o get a regular medical license. As

i said before depending on interest and school you can got lots of

training at medschool. They do have a subspecialty in " Osteopathy " its

called neuromusculoskeletal medicine and osteopathic manipulative

medicine.

For information on the training go to

www.com.msu.edu/omm/sir_postdocneuromstsds1.pdf

 

 

 

 

 

 

400 29th St. Suite 419

Oakland Ca 94609

 

 

 

alonmarcus

 

 

 

 

 

 

 

 

[Guest guest]

Alon,

 

I've been reading your book. You cover a large expanse of musculoskeletal

techniques and integrative therapies.

I also saw that for the Michigan state University College of Osteopathic

medicine continuing education program,

http://www.com.msu.edu/cme/courses.html

the required text for most of the manual therapy classes is

http://www.amazon.com/s/ref=nb_ss_gw?url=search-alias%3Daps & field-keywords=green\

man+manual+medicine & x=0 & y=0

 

Since these courses are open only to D.Os, M.Ds, DDS and P.Ts,

aside from the courses that you'll be teaching (which I'm looking forward

to) are there any other ones available for L.Acs?

 

K.

 

 

On Sat, Nov 1, 2008 at 1:44 PM, alon marcus <alonmarcus wrote:

 

> Chris

> There is a rumor that Stills' first clinic was rented from the chinese

> laundry, which may have exposed him to some ideas. I heard this from a

> DO friend but have not seen this anywhere else. Who knows? He

> definitely saw health as a multifactorial interaction between spirit,

> emotions, environment, nutrition and structure. At the same time he

> was an MD so having DOs go through regular medical training is keeping

> with the founder.

> What surprised me about the study is that they looked at respiratory

> (lung) activity as it relates to cranial motion. The Primary

> Respiratory Mechanism is not thought to relate to lung or heart

> movement. As far as training you get some manual therapy at med school

> at all DO institutions. Manipulation is part of their boards, however;

> many DOs are not interested and never been interested in it, the only

> reason they went to a DO school is o get a regular medical license. As

> i said before depending on interest and school you can got lots of

> training at medschool. They do have a subspecialty in " Osteopathy " its

> called neuromusculoskeletal medicine and osteopathic manipulative

> medicine.

> For information on the training go to

> www.com.msu.edu/omm/sir_postdocneuromstsds1.pdf

>

>

>

> 400 29th St. Suite 419

> Oakland Ca 94609

>

>

>

> alonmarcus <alonmarcus%40wans.net>

>

>

[Guest guest]

Bear in Wa allows LAcs, also academy classes

 

 

400 29th St. Suite 419

Oakland Ca 94609

 

 

 

alonmarcus