SACRO OCCIPITAL TECHNIQUE (SOT)

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SOT was developed by Dr. M. B. DeJarnette, DC, DO, beginning in the 1920’s. Dr. DeJarnette was inspired to go beyond simple spinal adjusting and developed methods of correcting the Cranium, Pelvis, Extremities and Organs. This study brought about a system of adjusting patterns in the body, not just single body parts. The most significant pattern was the relationship between the sacrum and occiput (which became the name of the technique). His definitive works, the 1984 Sacro Occipital Technique Manual, 1981 Chiropractic Manipulative Reflex Technique, and the 1979-80 Cranial Technique Manual are the culminations of 60 years of research and patient care.  In these manuals he narrowed down patterns of whole body imbalance into distinct categories, allowing the chiropractor to determine the mode of care necessary for a specific patient presentation. SOT was the original source of inspiration for many other related chiropractic techniques, including AK, and over time generated some of the most innovative and effective health care systems the profession has known.

An important distinction of SOT is the use of indicators. Each adjustment has a sign or signal that we use to know when and where to adjust. For example, muscle tension at the knee may indicate the pelvis needs correction. Connective tissue fibers at the base of the skull (called occipital fibers) may indicate the level of vertebral subluxation in the back or spine in need of adjustment. This also tells us on the next visit if the correction has been completely or marginally effective. From these indicators, we design a different adjustment set on each visit, listening to the body each time. It takes study to master this method of care, but it makes for an effective, precise adjustment without relying exclusively on x-rays.

SOT is concerned with optimal function of the “cranial sacral respiratory mechanism”. This is a wavelike oscillation in the covering of the brain and spinal cord. Although quite subtle, this motion is essential for the normal functioning of all components of the nervous system from the brain and spinal cord, to the rest of the body. It has cyclic expansion and contraction phases similar to ordinary respiration–breathing air in and out–and although they are separate systems, synchronized diaphragmatic breathing can be used to assist and normalize cranial sacral respiratory action.

There is an emphasis on cranial bone manipulation, the majority of which are philosophically based on the osteopathic cranial techniques of Dr. William Garner Sutherland.  SOT cranial techniques are used to enhance craniospinal meningeal dynamics, cranial suture mobility, and temporomandibular balance as well as a multitude of related conditions. They incorporate any cranial technique that can safely affect the patient’s anatomy or physiology including manual osteopathic cranial manipulation and craniosacral therapy. Techniques that reduce “twisting,” “torque,” or balance tension in the craniospinal meningeal system may be used. SOT cranial techniques allow for many options while using specific indicators to evaluate the effectiveness of these cranial treatments.
 

Fixed patterns of distortion in the myofascia (soft tissue) and associated subluxations of the vertebra, ribs, extremities, viscera and cranium can persist over time. The fascia often reflects a historical record of the patient’s entire life experience. SOT includes various soft tissue treatments that augment SOT osseous manipulation and treatment.  Many forms of appropriate soft tissue manipulation and treatment fall into the SOT treatment protocol. The purpose is to correct abnormal spinal mechanics and any associated nerve problems that result in back pain, headaches, and dizziness, arm and leg pains.

DeJarnette developed the use of pelvic blocks or wedges to affect these pelvic and whole body distortions in an extremely non-traumatic manner.  He developed a series of treatments using these blocks to affect the patient by using gravity as the slow force of correction.  SOT orthopedic block placements may be applied under the pelvis, rib cage, lumbars, thoracics, knees, and in various directional positions depending on the indicators.

Due to the non-traumatic nature of treatment offered by the pelvic blocks, SOT for the pregnant woman allows treatment of sacroiliac sprains, common in the last trimester, with little if any contraindications.  There are no abrupt movements, twisting, nor strong forces generated to the pelvis or lumbar regions.  SOT pediatric care is a complete method of care spanning neonatal through the early teens.  Obviously, the treatment varies during the age of the child but incorporated are a myriad of SOT and SOT cranial techniques modified for use in a very gentle yet effective manner.  All cranial techniques can be part of the SOT protocol and these can relate to conditions such as, ADHD, otitis media, craniosynostosis, birth trauma, and many others.

THE BASIS OF CHIROPRACTIC CRANIOPATHY

O. Nelson DeCamp, D.C.

Diplomate Craniopath

Diplomate Chiropractic Neurologist

Chiropractic Craniopathy began its development in the 1920’s by M.B. DeJarnette, DC, DO as Sacro Occipital Technique. It is based on Osteopathic Cranial Technique developed by W.O Sutherland, DO.  The cranial-sacral respiratory phenomenon and its dysfunction was recognized in 1899 by Sutherland. He developed the applicable corrective technique and in 1939 published this in a small text, “The Cranial Bowl”.

An excellent expanded text, “Osteopathy in the Cranial Field”, was written by H.I. Magoun, DO in 1966. During the developmental period of Osteopathic Craniopathy in which these texts expressed the basis of the method, the emphasis was on the cranium and its correction. Not much was written or practiced relating to the causes and involvements of cranial dysfunction from the pelvic complex or patterns of postural compensations. Therefore, due to many de-compensational adverse reactions to cranial corrections and decreased osteopathic involvement and interest in spinal manipulation, Osteopathic craniopathic development and practice waned.

In 1983, John E. Upledger, DO produced the text, “Craniosacral Therapy”. In this text, the previous Osteopathic manipulative cranial procedures were eliminated. Passive light touch and cranial rhythmic impulse energy balancing was developed and introduced so as to not upset patterns of compensational dysfunction which previously created adverse reactions in patients. This method is presently being taught to a wide range of health care providers and body workers.

M.B. DeJarnette, DC, DO had experienced craniopathic care as a student and was an avid proponent of the concepts. In personal communication with him he stated, “I had experienced reactions to cranial corrections personally and was bound and determined to find a system of analysis and treatment to eliminate the reactions to cranial adjustments. Correcting the cranial function and releasing stress on the central nervous system is the ultimate goal in health.”

DeJarnette devoted his professional life to the development of Sacro Occipital Technique. He produced yearly texts and taught seminars throughout the country from the late twenties until his last text in 1984. In 1968 he felt he had developed his system of analytic objective indicators for sacrum to occiput correction, based on the cranial sacral respiratory system to release cranial stress, and began teaching craniopathy to the chiropractic profession. This included producing yearly cranial texts until 1980 and teaching until his death in 1992. His work continues to be taught by Sacro Occipital Research Society International (SORSI) that he founded to carry on his work.

Review of the Cranial Sacral Respiratory Function

The brain is highly vulnerable to disturbance of the blood and cerebral spinal fluid (CSF) supply. Although the brain constitutes only 2% of the total weight of the body, it receives about 15% of the cardiac output and uses about 20% of the oxygen of the whole body. This generous blood flow feeds the CSF, which transports nutrients and oxygen to the brain cells, removes intercellular metabolic waste, and is instrumental in maintaining the steady state of the nervous system.

Craniopathy is concerned with two physiological phenomena relating to the moving or pumping of the CSF through the central nervous system from the cranium to sacrum and back. These two phenomena are the cranial rhythmic impulse (CRI) and diaphragmatic – inter/ intra cranial bone motion. The CRI is a very light impulse motion that develops in the fetus along with the cardiac impulse and persists through life with a normal rhythm of 8-12 cycles per minute. Although no specific impulse mechanism has been discovered or adequately explained, a few have been hypothesized.

The CRI motion may be described as a flexion/ extension torsional sensation along an axis from the left occipital/temporal suture to the right sphenomaxillary suture. There is a reciprocating temporal bone action with one temporal moving in external rotation and one in internal rotation thereby producing a clockwise eddying flow of CSF through the brain and spinal cord tissues. This CRI pumping motion is neither of high volume nor its frequency variable sufficiently to maintain the flow of CSF needed for life’s extremes of metabolic demands on the central nervous system.

The second phenomenon, diaphragmatic – inter/ intra cranial bone motion, relates its motion cycle to that of the diaphragm on inhalation/ exhalation at an average of 16-18 cycles per minute. This pumping motion is much greater than that of the CRI and can vary in volume and frequency as needed for the metabolic demands and cooling of the CNS. On inhalation, the diaphragm contracts expanding the lung volume downward while skeletal muscles contract to elevate the rib cage in circumference. Some important primary muscles elevating the rib cage are the scalenes, sternocleidomastoid (SCM), and trapezius. The resultant contracture of these muscles on inhalation is extension of the occiput on the spine and flexion of the occiput/ sphenoid junction (sphenobasilar) of the cranium. This in turn places the internal membranes, the falx cerebri from anterior to posterior and tentorium laterally, into an extension state.

If there is postural compensatory sub-occipital muscular imbalance, sutural fixation from trauma or stress, or dental bite imbalance, the distortion of cranial CRI and diaphragmatic pumping motion is impaired. The resultant impairment of blood and CSF flow can significantly affect the neurological cellular metabolic status. This then can cause additional compensatory patterns throughout the body to maintain the CNS. Many chiropractic spinal/ pelvic problems cannot be corrected sufficiently to the satisfaction of doctor and patient because they are now compensatory to a cranial distortion or dysfunction which requires correction.

DeJarnette developed SOT and Chiropractic Craniopathy as the analysis and treatment of the cranial sacral respiratory/ CNS system that is an addition to any chiropractic technique. It greatly enhances all chiropractic techniques and is essential for those doctors interested in expanding their ability to handle difficult cases by including the 80% of the nervous system not usually treated.