Craniosacral Therapy & Fascia: What’s the Connection?

As we have explored the topic of craniosacral therapy over the past months, you may have begun to ask yourself questions about how such a gentle treatment can affect such deep structures. Today, I will introduce the topic of fascia and a few of its interesting phenomena that will help answer this question.

First a little refresher:

With so many different treatment styles focusing on fasia and fascial release, we need to remember that what sets craniosacral therapy apart is the focus on the craniosacral rhythm. No matter what techniques a craniosacral therapist uses during a treatment, we always come back to assessing the craniosacral rhythm and how it is being expressed through the body.

Okay, onto fascia:

So, what is fascia:

Before we can describe how fascia is connected to craniosacral therapy, we need to understand what it is.

If you like watching videos to learn, I recommend this one as a quick introduction. Ignore the sponsor’s promotion at the end.

If you prefer to read, I’ve got you covered too:

Fascia is all the tissue surrounding, winding through, and connecting your skin, muscles, bones, and organs. It is what truly holds us together and allows us to move efficiently. It is made up of a gel-like substance along with protein fibers like collagen and elastin. These substances working together vary between acting more fluid or more rigid depending on your movements.

What does fascia have to do with craniosacral therapy?

Fascia changes in response to pressure over time:

One really amazing characteristic of fascia is its ability to change in response to sustained pressure - this is one of the ways craniosacral therapy works with fascia. Areas of fascia that are more rigid create pain - think of a tight muscle or plantar fasciitis. Through applying targeted and non-harmful pressure (gentle touch or movement) the fascia can soften and become more mobile. When we focus on the expression of the craniosacral rhythm, we can identify patterns of imbalance that affect the fascia all over your body. We use this information to find the areas of tight fascia and then apply gentle pressure to help them release. Between visits, regular and gentle physical movement will help maintain benefits gained from treatment and continue to improve your function and health.

On the other hand, the more your hold your body in a specific shape - say sitting in a chair hunched over - the more rigid your fascia becomes. This makes holding this position easy and relatively effortless, but it makes coming out of that position much harder and possibly painful. Pain will result from being in that position too long as well - our bodies are designed to move and depend on movement to move our fluids around delivering oxygen and nutrients while removing carbon dioxide and metabolic waste products.

Fascia helps us understand where our body is in space and what is happening inside it:

Our fascia is full of stretch receptors (1) and in connection with our muscles, bones, and joints, it helps us understand what position our body parts are in - even if we can’t see them. Fascia also helps us feel what is happening inside our body (interoception). Remember when I mentioned that some people can better feel what is happening during a craniosacral therapy session than others? This is a function of their fascia, and this sensation tends to improve as the health and function of the fascia improves! The more your fascia can glide and allow for movement, the more the stretch receptors will be triggered and the more your brain - fascia connection will be strengthened.

Fascia can be a source of pain:

Have you ever experienced intense pain of an unknown source? Maybe you have gotten imaging and undergone a whole battery of tests only to be told there is nothing wrong with you. Perhaps you have a diagnosis of fibromyalgia or unspecified chronic pain. Maybe you had an injury and have “recovered” but still have pain. There is mounting evidence that many of these conditions might be caused by issues of the fascia that we just can’t see with the imaging tools we have currently (2). Not only is the fascia full of stretch receptors, it is also full of pain receptors! When the fascia is tense and not moving fluidly, this changes how the fascia moves all around it and can trigger pain receptors. When we treat the fascia, many of these conditions can improve over time. This helps us better understand the list of issues craniosacral therapy can help with.

Many unexplained conditions may be tied to our fascia:

Because the focus on fascia is relatively new in mainstream medicine (1), there is a LOT still to be learned. Many scientists suspect that hormonal, mental health, chronic pain, and other complex conditions that don’t seem to play by the established rules may be more connected to our fascial health. We also see direct connections between our autonomous (automatic) nervous system and our fascia! (1,3) Tight, restricted fascia triggers the fight/flight/freeze/fawn response while fluid, mobile fascia triggers our rest/digest/bond response. Tight fascia in our trunk restricts our ability to take a deep breath and further affects our ability to adapt to the stresses of life. Many, many conditions (if not all) have a stress component.

This is one reason why the traditional claims of meditation, yoga, qi-gong, tai-chi, and other systems that incorporate mindfullness with posture and movement have continued to be validated with modern science (5,6,7). When mental focus, deeper breathing, and thoughtful, gentle movements are combined, the whole fascial web and the autonomic nervous system are treated together!

What common craniosacral therapy techniques directly address fascia?

All craniosacral therapy techniques will address fascia - its all connected (4). However, some of our techniques are particularly aimed at addressing larger areas of fascia:

• Diaphragm techniques that address areas where tissues that run from head to toe meet up with tissues that run from side to side specifically focus on fascia in a 3 dimensional way. Whenever your therapist is holding an area of your body sandwiched between their hands, they are likely performing a diaphragm technique.

• Fascial glide creates a gentle and sustained pull into the fascia in areas of restricted movement decompressing areas of fascia.

• Regional positional tissue release involves holding an area of the body and helping it move freely in all three dimensions. This can release fascial restrictions in a whole area quite effectively. If you have ever been on a craniosacral therapy table and it felt like your limb was moving of its own accord while the therapist supported that movement, you have experienced regional positional tissue release.

You may have noticed emotions or memories coming up during a treatment. This is yet another aspect of our fascia that we don’t quite understand. We don’t know how, but fascia seems to hold onto our emotions and memories just as easily as our physical tensions. When emotions are released along with physical tensions, craniosacral therapists call this a somatoemotional release or SER.

I hope this article gives you an even better understanding of craniosacral therapy and helps pique your interest!

To our health,

Danielle

PS - If you are really interested in learning more about fascia and bodywork, this lecture is a fantastic next step!

References:

1. Fede, C., Petrelli, L., Guidolin, D. et al. Evidence of a new hidden neural network into deep fasciae. Sci Rep 11, 12623 (2021). https://doi.org/10.1038/s41598-021-92194-z

2. Kondrup F, Gaudreault N, Venne G. The deep fascia and its role in chronic pain and pathological conditions: A review. Clin Anat. 2022 Jul;35(5):649-659. doi: 10.1002/ca.23882. Epub 2022 Apr 27. PMID: 35417568.

3. Fede C, Petrelli L, Pirri C, Neuhuber W, Tiengo C, Biz C, De Caro R, Schleip R, Stecco C. Innervation of human superficial fascia. Front Neuroanat. 2022 Aug 29;16:981426. doi: 10.3389/fnana.2022.981426. PMID: 36106154; PMCID: PMC9464976.

4. Rowlands E, Pozun A. Osteopathic Manipulative Treatment: Suboccipital Release. 2022 Sep 6. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan–. PMID: 35881731.

5. Casuso-Holgado MJ, Heredia-Rizo AM, Gonzalez-Garcia P, Muñoz-Fernández MJ, Martinez-Calderon J. Mind-body practices for cancer-related symptoms management: an overview of systematic reviews including one hundred twenty-nine meta-analyses. Support Care Cancer. 2022 Dec;30(12):10335-10357. doi: 10.1007/s00520-022-07426-3. Epub 2022 Nov 2. PMID: 36322248.

6. Song R, Grabowska W, Park M, Osypiuk K, Vergara-Diaz GP, Bonato P, Hausdorff JM, Fox M, Sudarsky LR, Macklin E, Wayne PM. The impact of Tai Chi and Qigong mind-body exercises on motor and non-motor function and quality of life in Parkinson's disease: A systematic review and meta-analysis. Parkinsonism Relat Disord. 2017 Aug;41:3-13. doi: 10.1016/j.parkreldis.2017.05.019. Epub 2017 May 25. PMID: 28602515; PMCID: PMC5618798.

7. Zou L, Zhang Y, Sasaki JE, Yeung AS, Yang L, Loprinzi PD, Sun J, Liu S, Yu JJ, Sun S, Mai Y. Wuqinxi Qigong as an Alternative Exercise for Improving Risk Factors Associated with Metabolic Syndrome: A Meta-Analysis of Randomized Controlled Trials. Int J Environ Res Public Health. 2019 Apr 18;16(8):1396. doi: 10.3390/ijerph16081396. PMID: 31003412; PMCID: PMC6517947.