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Cranial Sacral Therapy

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by Wayne Still

Dr. William Sutherland

Among the many benefits of being a practitioner of bodywork are the opportunities to add more skills to our basic skill set and to experience their benefits. The most recent skill I have learned is cranial sacral therapy. Cranial sacral therapy was originally developed by an osteopath named William Sutherland  in the first half of the last century. Through his observations and palpations he came to realize that the plates of the skull could and would move at the sutures where they join. From there he learned that all the bones of the skull were movable and responded to the breath. This was in direct contrast to the conventional wisdom of the time which was that the cranial bones became fused and immobile after birth. The work was taken up and popularized by the late Dr John Upledger in the latter part of the century. He noted that there was a force inside the cranium which caused the bones to move in a detectable rhythm. This rhythm he found could be detected and manipulated in all parts of the body if a person had a sufficiently sensitive touch. 

The name implies that there is a connection between the cranium and the sacrum and that this connection has a therapeutic potential. The connection is of course the spinal column and spinal cord. The spinal cord has a wrapping called the dura which is continuous with the membranes surrounding the brain. The same rhythm that was detected in the cranium could be followed down the spine and along the nerves branching off the spine. It turned out that there was a pump in the base of the skull which was pumping cerebrospinal fluid (CSF) throughout the cranium and the dura. The reciprocal movement of the CSF was the rhythm being felt. Like the other inherent movements of the body in the viscera this natural movement can be used to effect changes in the body’s structure where there is an imbalance in the natural tensions which the body uses to keep its form and function.

The tensions are found mainly in the fascial system which Dr Ida Rolf called the organ of form. So imbalances affect the ability of the body to function at its optimal level. There are many reasons for the body to be out of balance but the imbalance always manifests itself as a shortening of the fascia or connective tissue in the affected area. The body is compensating for a trauma of some sort and the shortening is a brace or support while the the trauma is being healed. However, and counter intuitively, when the healing is complete the bracing remains, creating an adhesion. This means that the loss of range of motion associated with the shortened tissue may become chronic with associated discomfort. But the body is trying to release the adhesion, and this can be detected as a subtle movement associated with the adhesion. By following the movement a practitioner can help the body to release the adhesion with little pressure or discomfort to the client. This is where a therapy such as cranial sacral comes in.

The skill set I learned in my basic training involved using directed pressure to release adhesions and restore length to connective tissue. This was an effective approach but could at times be quite uncomfortable for the client. Therapies such as cranial sacral use a very light touch to encourage the restoration of the natural rhythms in the body and in so doing eliminate the adhesion which was causing the problem. While the touch is light the effect can be quite profound as I learned at the end of my second cranial sacral workshop in March. I have been trying for many years to restore normal movement to my neck but was always stopped by a blockage deep in the base of my skull. At the end of the workshop the blockage released. A deep release such as that has profound effects throughout the body as previously chronically shortened tissue is allowed to regain length and normal function. Another step along the long path of healing was taken.     

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Dr. Kegel

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by Wayne Still

Dr. Arnold Kegel

Once upon a time, not so long ago, in a land not so far away there lived a gynaecologist named Dr Arnold Kegel. Dr Kegel noticed that as some of his patients aged they experienced increasing problems with incontinence. The problems were exacerbated if the patient was overweight, had given birth or had abdominal surgery. Dr Kegel also noticed that the condition was related to the strength of the pelvic floor. Women with a weakened or compromised pelvic floor had more of a problem. He deduced that if a woman exercised her pelvic floor to strengthen it, the problem of incontinence could be alleviated or eliminated. This observation led to subsequent study of the pelvic floor and how it related to a persons general health and wellbeing. A Google search of Dr Kegel will take you to a Wikipedia page with lots of information on the pelvic floor and the exercise Dr Kegel developed to strengthen the pelvic floor and which to this day bears his name. In this column I will give you an overview of the pelvic floor and why it is of such importance.

The pelvic floor is made up of three muscles, the pubococcygeus, usually referred to as the “PC”, the levatorani and the ileococcygeus, (these names will be on the test!!!). The muscles form a sling or hammock at the bottom of the abdominal and pelvic basin to hold the associated organs in place. They are attached to the coccyx and hip bones posteriorly and the pubic bone anteriorly. The pelvic floor is kite shaped, longer and narrower in men, shorter and wider in women. Its integrity is compromised by the rectum and uterus in women and by the rectum in men. The strength of the pelvic floor is important to all movements in the hips and legs, its elastic nature gives spring to walking, running, jumping etc. The extra opening in women’s pelvic floors is one reason why women athletes are not able to compete at the highest levels with men. Besides contributing to incontinence in both men and women a weak pelvic floor is also associated with various sexual dysfunctions in both sexes. Strengthening the pelvic floor will help women to achieve stronger and more frequent orgasms while helping to prevent premature ejaculation in men. A strong pelvic floor will make the birthing process easier and speed post partum recovery.

All of us do the Kegel exercise several times a day in the course of normal elimination of wastes from our bodies. The contraction of the pelvic floor at the end of urination and defecation is a Kegel whether we are aware of it or not. In fact if you want to consciously experience a Kegel, just stop urination mid flow. However do not do this regularly as it will lead to urine retention. Once you have isolated the feeling of voluntarily contracting the muscles of the pelvic floor you are set to incorporate Kegel exercises into your daily routine. There are some things to keep in mind while doing them. The contraction should be confined to the pelvic floor, butt clenching doesn’t count. For women the anal and vaginal sphincters should be relaxed, for men the anal sphincter should be relaxed and the testicles descended. Get into the habit of doing your Kegel exercises at certain cues such as at red lights or while in line. It is an invisible exercise, no one knows you are doing them. I like to tell my clients that you don’t have to go to the gym to do them. Do them in reps of 20-30 and experiment with holding them for 3-4 seconds. The feeling is enjoyable and the benefits enormous.

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Joint Capsules and Bursas

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by Wayne Still

The mammalian body is a marvellous piece of architecture capable of feats of strength and movement. If we look at the methods of movement a useful analogy is to think of ropes and pulleys. The ropes are muscles. The pulleys are joints which articulate with the pull of the muscles providing the flexibility we need to make movements necessary for our lives. Just as ropes need to be flexible to be useful so must muscles be limber. Pulleys need to be lubricated in order to turn smoothly. Joints, especially the ball and socket joints such as found at the shoulder and hip need lubrication in order to articulate with a minimum of effort and maximum range of motion. If ropes rub against each other while doing their job they will fray and wear out. Similarly if muscles or their attachments to bones rub against each other damage can result. Nature has provided our bodies with adaptations to facilitate movement while ensuring that the movement happens efficiently and without harm to themselves.

Joints are lubricated with a material called synovial fluid. It has the appearance of egg white and the consistency of egg yolk. Synovial fluid is kept within the joint itself by a fibrous membrane forming a cuff around the entirety of the joint. The cuff is known as the joint capsule. It has functions besides keeping the synovial fluid inside the joint; it helps to keep range of motion within the joints appropriate range as well as helping to hold the joint together. When subjected to injury or other stressors the capsule has a tendency to contract along its margins forming pleats. These contractures can limit the range of motion of the joint. The cascading effect of the limitation is that associated muscles are not able to move in their full range and become painful. One of the more commonly known examples of this is the frozen shoulder where the joint capsule becomes increasingly thickened and contracted to the point where normal range of motion is severely limited and painful. Fortunately tissue that contracts can also be persuaded to return to its original form. This is accomplished by working around the margin of the joint capsule gently opening the pleats. This restores the tissue to its original length and allows the joint to move in its full range. Additional work is usually needed to bring the associated muscles back to their happy place. Sometimes we get lucky and this can be accomplished in one session, other times it can take several visits to the area to completely resolve the issue.

Bursas are found throughout the body, there are more than six hundred of them. If there is the opportunity for a bone to rub through the skin a bursa will stop that from happening. Similarly they cushion bones that might otherwise rub on each other or tendons that go over bones. They are similar to joint capsules in that they are made of the same fibrous material. Only in this case the material is formed into a sack filled with synovial fluid to provide the necessary cushioning effect. They are subject to the same stresses as joint capsules and respond in the same way by contracting around the margins and adhering to the underlying structure restricting normal glide. Again range of motion is reduced and more effort is required to move the affected body part. Using the same methods as are used to release adhesions in joint capsules, bursas can be released and returned to their normal function. It is quite impressive to see the amount of change in range of motion that simply releasing a bursa can achieve. Not to mention the greater comfort the owner of the bursa will feel.

I have been fortunate in the past year to have learned about these structures and how to treat them. This knowledge has allowed me to become more precise in my work thereby achieving better results for my clients.

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The Original Still Technique

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by Wayne Still    

Andrew Taylor Still

In the early 1800s, in what would now be called ethnic cleansing, the British moved troublesome Scottish clans from their territories in the highlands and dispersed them to the colonies. My great, great grandfather, a member of the Still clan, settled in the Muskoka region of Ontario. I am a direct descendent of that diaspora. Another descendent of the diaspora was Andrew Taylor Still who was born in Lee County Virginia in the late 1820s. He was a surgeon in the civil war where he became very familiar with human anatomy. He took a particular interest in the connective tissue which composes most of our body. When the war was over he went on to bring into being the modality of Osteopathy. The traditional discipline of the Bone Setters was his starting point and he became known as the “Lightning Bone Setter”. Since then Osteopathy has grown into both a medical science with schools and hospitals in different parts of the world as well as a method of restoring range and freedom of movement to the human body.

Dr Ida P Rolf, the founder of Structural Integration also known as Rolfing®, was interested in the nature and qualities of connective tissue. She studied the writings of A T Still, some of her work was based on those studies. From her own observations and experience she developed the ten series recipe as a teaching tool based on manipulating connective tissue. By following the recipe a practitioner can bring a clients body into a more harmonious relationship with gravity so gravity becomes a supportive force for the body, not something to fight against. Connective tissue has a characteristic that when stressed it becomes shorter, restricting its range of motion and taking the body out of balance. By releasing the restriction we  can restore range of motion which helps to restore balance in the body. In my basic training the techniques we were taught to accomplish this used considerable force. The techniques were effective but at times resulted in a painful experience for the client.

Some seven years ago I began to learn a complimentary modality known as Visceral Manipulation. This is the work of French Osteopath Jean-Pierre Barral. In VM we learn to find and release restrictions using much gentler but equally effective methods to release the same restrictions. The main difference is that we learn to listen to the body and allow the body to tell us in which direction we should move the tissue in order for it to release. Generally this involves taking the tissue to a first barrier in a gentle stretch. It is at the first barrier that change can most easily occur when we follow the direction indicated by the body. Pressure used is minimal and we are sometimes accused of not doing anything!! During my most recent training in VM I learned the original Still technique.

The original Still technique uses the power of the first barrier to bring about change. In this method the tissue is not stretched to a first barrier but the tissue associated with the restriction is compressed, using bilateral pressure, to a first barrier. The tissue is held at that first barrier until a change is detected and its direction followed. When that movement ends the compressive force is released in the reverse direction to which it was applied. The tissue is then subjected to a quick circular movement ending the manipulation. I have found the technique to be effective in releasing soft tissue restrictions as well as restoring range of motion to joints. There is a ten second video showing A T Still demonstrating the technique on a mans shoulder joint. He compresses the ball of the humerus into its socket, makes a subtle movement with his hands then swings the mans arm in a wide circle. Lightning bone setter indeed.

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Temple Grandin and Me

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by Wayne Still

You may have heard of Temple Grandin. She is a professor of animal science and welfare at the University of Colorado. Half the animals managed in commercial stockyards pass through handling facilities which she designed. The design encourages animals to pass through the facility on their own accord with a minimum of stress. She is also possibly the worlds most famous person on the autistic spectrum having had a movie made of her story. Her explanation of the mechanics of autism makes it fairly easy to understand. The brain is made of grey matter and white matter. Grey matter is where intelligence resides. White matter is where the intelligence is translated into communication and action. Think of white matter as a switchboard with many connections going to various parts of the persons being. Now imagine that some of those connections are missing or are connected to the wrong part of the person. Speech, general comprehension, understanding social cues, physical actions can all be affected to the personal detriment of the individual so affected. Temple Grandin is an outstanding example of someone who, with proper training was able to overcome the difficulties associated with autism. As with many others on the spectrum she has a gift, in her case the ability to empathize with animals. She combined this with a skill in designing animal handling facilities which has lead to her fame.

So what does all that have to do with me? A couple of columns ago I alluded to having had social problems in my life. This is particularly true when it comes to interpersonal interactions and communication. Comments I considered to be innocuous were misinterpreted and offence taken sometimes leading to alienation. Social cues which could have lead to a deeper friendship were missed. Relationships which seemed promising dwindled and ended rather than becoming deeper. I became more and more of a loner, happy enough on my own but not very comfortable in social situations where I had to make small talk or engage in conversation with strangers. All these things I was able to recognize as being detrimental to my sense of well being but always thought they were unique to me.

A couple of months ago I read an article on Aspergers Syndrome describing symptoms and life experiences of those with the syndrome. That sounds like me I thought!!! Yes, it was a bit of a downer to think that, in fact, I have a neurological disorder but on the other hand I learned that I am in good company. Einstein, Mozart, Newton, Steve Jobs and a lot of the geeks working in Silicone Valley were or are thought to be Aspies. Apparently the lack of connectedness allows the intelligence to focus on a topic of interest with laser like intensity which allows for great creativity.

Over the holiday period I had time to do some in depth research on the subject. I read quite a bit and was eventually lead to You-Tube and the many videos posted there by people on the spectrum describing their life challenges. Almost all had difficult childhoods being friendless and bullied, my experience too. Many described being overwhelmed by visual and auditory stimuli making “normal” life difficult or impossible. Thankfully I don’t have that problem but I do prefer quiet music to the head banging variety. Interestingly enough when I lived in India and China I found the crowds to be quite stimulating in a good way. But that reinforces the fact that everyone on the spectrum experiences it in their own way. It was often stated that when you meet one person with autism you have met one person with autism.

I am now a septuagenarian and in all have lived a pretty good life as a high functioning, borderline Aspie. At least now I have a better idea of why some situations in my life went as sideways as they did.Temple Grandin has become a role model showing how far a person on the spectrum can go.

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Inguinal Hernia

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by Wayne Still

Comfrey Root Powder for Poultice

One of the most common physical afflictions to beset the human body is the inguinal hernia. It is far more common in men than women particularly if the man is sedentary and overweight. Usually dealt with by surgery, there are about 750,000 procedures done in the US each year with a 10-15% failure rate.

An inguinal hernia occurs when there is a tear in the membranes and muscles of the abdominal wall which allows a section of the small intestine to protrude through the abdominal wall. The inguinal area is located just superior and lateral to the pubic bone. A hernia is not life threatening except in the case where the intestine actually protrudes through the skin when it is known as a strangulated hernia and emergency surgery is needed. Without surgical intervention to replace the intestine and repair the abdominal wall the digestive system becomes blocked. Obviously not a good thing.

Late in 2015 I was getting back into swimming after not having done much of the sport for about four decades. I was in a coached program and at one point we were taught the butterfly kick. One evening after a couple of practices of this I felt a softness in my inguinal region which was soon followed by a palpable bulge. To my horror I realized that I had developed a hernia and I am neither sedentary or overweight. A quick check online confirmed my suspicion along with the information I have relayed in the first paragraph. Now I am not a fan of surgical interventions except in exceptional circumstances. I see the negative after effects of surgical scar tissue in my bodywork practice on a regular basis so was not too inclined to go that route. In any event a MD at a walk in clinic told me it would be six months to year before I could have the procedure. So I started to do more research on non surgical treatments for the problem.

What came up immediately on Dr Google was the use of comfrey root poultices along with a bunch of horror stories about botched surgeries. Also encouraging reports of people who were able to deal with a hernia without surgery. I found a source of comfrey root, bought a coffee grinder to make it into a powder, then learned how to make and apply the poultice. This involves making a pad from 4×4 cotton sponges, mixing the powdered comfrey root with enough water to make a paste roughly the consistency of brownie dough. The mixture is applied to the pad and taped to the area where the hernia is happening leaving it on for 8-10 hours. After the first painful removal I learned to shave the area as I am a rather hairy beast. I continued to apply the poultices pretty much on a nightly basis sleeping with my amethyst bio mat over the poultice for several months. In the summer I was able to source fresh comfrey from a friends farm so was able to use the leaves as well as the roots in the mix. I was also getting weekly acupuncture and cold laser treatments to the area. In addition to all this I would spend an hour or so in the evening on my slant board with the intestine pushed back into place doing Kegel exercises that extended into the abdominal area to strengthen the muscles of the abdominal wall so as to facilitate the healing of the tear. Skiing, swimming and cycling activities were suspended for the duration of the winter.

Over the course of several months I felt the area of the hernia become solid again although the loop of intestine continued to come through the wall. The encouraging part was that the loop gradually got smaller and harder. There is smooth muscle tissue in the intestinal wall which was strengthening and shortening the loop. I did not ever have a lot of discomfort from the hernia but I now go for days with out feeling anything out of the ordinary in the area fourteen months after the initial occurrence. During the summer I was able to pursue all the activities I enjoy so I am quite satisfied with the healing regime I chose. As I continue the exercise regime I described above I am confident that eventually the hernia will completely heal.

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Form and Function

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by Wayne Still
siIn the  fall of 1970 the great love of my life, Kathleen, joined me in Istanbul, Turkey. We were on our way to India and the adventures that lay in store for us. We spent our days in Istanbul wandering the streets, exploring the museums and markets of that ancient city. One day we came upon a group of old men who were hanging around a large building. What made this group of old men remarkable was that they were all permanently bent forward at the waist at about a sixty degree angle, their backs were flat.

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Continuing Education

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by Wayne Still
backIn our basic training we are taught the important fundamentals of our craft. They stand us in good stead as we begin to practice, we get quite remarkable results following the ten series recipe Dr. Rolf left us. But Dr. Rolf also left us with the admonition that “Where you think it is it ain’t”. This was to encourage us to look further for the cause of an imbalance than where a pain may be manifesting. She taught us to see the body as an interconnected whole piece. So a pain in the neck may be more related to a problem in the knee than any disfunction in the neck itself. In the ten series we work on all parts of the body, finding and eliminating the adhesions formed in the connective tissue that create imbalances in the body. Over time we find the basic skills we learned, while effective for the most part, are not always adequate to deal with the complexities we are presented with.

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C-1, The First Cervical Vertebra

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by Wayne Still

B.J. Palmer

B.J. Palmer – the first to develop a therapy based on the upper cervical vertebrae

C-1 is the first cervical vertebra making it the first vertebra in the spinal column. It is also known as the atlas, named after Atlas, the mythical figure who carries the world on his shoulders. Like Atlas, the atlas vertebra supports the human skull. It is also the point of entry for the spinal cord into the spinal column as it leaves the medulla oblongata at the base of the brain. In addition, important nerves, arteries and veins pass through C-1 and its partner on which it turns, C-2. This is a very important piece of human anatomy, its maintenance is crucial to the optimal functioning of the spine and hence the whole body. Continue reading →

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