Does structural and cranial really differ that much?

Some say that Structural osteopaths feel they relate better to chiropractors and physiotherapist than they do to cranial practitioners.

My view is that it is the principles (what make osteopathy what osteopathy is) rather than the techniques used that should hold us together. But who applies these principles nowadays? I meet more and more osteopaths who don't. For me, the problem comes from the schooling of osteopathy. Personally, i came out qualified not understanding the relevance of the principles, its only after I left and didn't have the stress of knowing everything medical/orthopedic (tissue specific diagnosis) that they started to sink in. If only the osteopathic concept were taught more thoroughly, and better applied in clinic, perhaps the osteopathic community would glue a bit more.

Treating the low back for low back pain (or treating the tissues causing pain) is indeed physiotherapy (nothing against physios, they're great at that). Treating the biomechanical cause of this low back pain is osteopathy. That should be common ground for all osteopaths.

Then, some may want to go a step further and look at the external (lifestyle and diet), psychological, emotional, and more spiritual components/causes... Being even more holistic, why not?

Treatments: 276

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Permalink Reply by Roger Kingston on January 19, 2012 at 11:54pm

I think so!

Permalink Reply by Rikamortis on January 20, 2012 at 12:04am
Hi Roger I wrote a very similar post in the
"Addicted to the crack discussion"
I would completely agree with your observations


Roger Kingston said:

I think so!

Permalink Reply by Michael Lingard on January 20, 2012 at 1:37am

An interesting viewpoint on this question arises from the work of Rudolf Steiner and Anthroposophical medicine; he observed the cranium was a total representation of the whole body. The lower limbs: the mandible (cf tmj & hip joint, lower teeth, toe nails), upper limbs: maxillae (upper teeth, finger nails), both regions representing the limb system; the rhythmic system composed of heart & lungs : the nasal structures & middle cranium whilst the head system corresponded to the cranial vault. Many will have observed the close relationship of hip joint & opposing TMJ dysfunction. Mr John Wernham always claimed cranial treatment was simply part and parcel of osteopathic treatment and its separation off as a different therapy was no more valid than separating off facial treatment etc. as a therapy of its own. (Oh that's been done!)

Permalink Reply by Roger Kingston on January 20, 2012 at 2:16am

Mr John Wernham always claimed cranial treatment was simply part and parcel of osteopathic treatment and its separation off as a different therapy was no more valid ...................

I think you'll find if you research what Suherland and Becker actually did in their practices was to use a lot of body techniques based on balanced ligamentous tension - they were never exclusive to the cranium or sacrum. This is something new!

Permalink Reply by indikate on January 20, 2012 at 8:56am

Afferently "structural" and "cranial" are perhaps levels of perception

Efferently (what is done to the patient) they appear quite different. This difference in approach is based on  different perceptual analysis

Philosophically they can be similar or not depending on interpretation of the principles of osteopathy

Permalink Reply by Small Fry on January 20, 2012 at 10:15am

If reassurance is itself of therapeutic benefit (it is), then what better reassurance than competent and effective therapy?  I would accept that many treatment rationales are invalid, but I would not accept they all are.  Apart from anything else, this is not a good admission to make in public.  Perhaps some personal reflection and CPD would be called for at that stage.

It has been said time and time again that acute problems get better on their own.  After all, 'of limited duration' is the definition of acute.  If we think it is mainly charisma that has solved the case we are probably deluded even about our own charisma.

Treatment lacking in osteopathic rationale is one cause of chronicity in my view, so our 'managed chronics' could actually be degenerating even faster.  The challenge worthy of our paycheck is to manage acute problems well to prevent chronicity, and treat chronic cases to try and actually get them better.


Roger Kingston said:

I guess after 18 years in this game I've been about a bit and have had my feet in both cranial and structural camps. My observation is that on the whole low back pain is incredibly difficult to diagnose, xrays and scans will give one perspective, but to actually formulate a treatment plan that works!

So many of the explanations out there for the different approaches do not hold water scientifically or rationally. But my observations are in NON pathological low back pain if:

1: The patient likes you

2: They listen to and act upon advice given

3: You make contact with "the inner corrective mechanisms" by physical contact

4: You provide psychological reassurance

Then that patient will usually get better irregardless of what technique you use.

Explain that in terms of structure and tissue biomechanics!

Permalink Reply by Small Fry on January 20, 2012 at 12:43pm

Where we are going with the therapy and the pathway this is likely to follow is more important than how we go about it.  If I need to paint a wall it may not matter too much if I use a brush or roller, but I should have some idea of the colour and how it matches the furnishings, curtains, and intended use of the room.

With cranial it is possible to hide a lack of potency behind a convincing story.  With structural work it is equally possible to hide a lack of vision behind an impressive skill.  In my experience though, lack of vision is the main problem, not lack of skill.  If the rationale for structural adjustment is confusing and debatable, then cranial takes this obscurity to another level, bordering on opaque.  That's not to say it lacks validity, but I'm darned if I understand it.

Practitioners turn to cranial for a number of reasons.  But for many I fear it becomes just another (highly sophisticated) way of clearing restrictions and blockages (cf. loosening all the tight bits) without a sense of broader significance.  It may still lack any depth of vision about the picture of health they are aiming for or the reasons those obstructions have come about.  In which case it can be just as much a form of palliation as cracking up all the junctions.

The only thing is that the chronic effect of palliating with a deep and primal technique is a deep and primal discombobulation, rather than simply turning one stiff shoulder into two stiff shoulders and a stiff neck.

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