Craniosacral Therapy in Dogs

Chris Bates  M.Ost, DipAO, EEBW, BHSAI

With a more holistic trend in canine healthcare developing across the world, owners are seeking out practitioners with more diverse skill sets. Craniosacral Therapy or Cranial Osteopathy for dogs (and other animals) has seen a rise in popularity. It is important to have an understanding of how different modalities are intended to work, what they are best utilised for and who to ask. This article aims to demystify the somewhat poorly understood world of Cranial Therapy and better inform as to why it could be a key to helping your dog.

The History of Cranial Therapy

Cranial Osteopathy was developed by American Osteopath William Garner Sutherland (1873–1954), who, in the early twentieth century, began exploring the idea that the bones of the skull might possess subtle physiological movement. Initially influenced by the anatomical form and articulation of the temporal bones which he described as having an appearance akin the gills of a fish when disarticulated. 

Sutherland spent decades investigating what he described as the “primary respiratory mechanism” and developed gentle techniques intended to influence the mobility and function of the cranium and its associated tissues. These ideas were quite controversial as many of his contemporary physicians from both the Osteopathic fraternity and the allopathic medical world were of the opinion that the cranial sutures were fused by adulthood.

Craniosacral Therapy was a concurrent development drawing on the work of Sutherland eventually but had come about through entirely separate observations. American Osteopathic Physician John Upledger (1932 - 2012) had observed a perplexing phenomenon during a spinal surgery. As described in the book Your inner Physician and you (Upledger, 2017), Upledger had observed a subtle movement of the spinal cord when becoming frustrated trying to hold the meninges during a surgical intervention. Initially perplexed as this had not been taught to him as a common occurrence, he did further study and developed his work in a similar vein to Sutherland. From here on we will refer to the practice of Cranial Therapy to describe either the Sutherland or Upledger approaches for ease.

How Cranial Therapy is Applied

Regardless of the historical concept (Osteopathy or Craniosacral), Cranial Therapy is a very gentle intervention that uses direct contact and what is often described as a “Listening hand”. The practitioner uses very light touch to assess the animal and can judge severity of restrictions in motility, imbalances and the rhythm of the intrinsic movement. 

Many teachers of Cranial approaches (certainly mine) would say that we simply follow the movement palpated and wait for the system to adjust itself. Some might wonder why the body isn't simply adjusting itself to correction all the time then, but it is. As we know from Osteopathy, the body is always adjusting and changing to try and reach the most agreeable state of homeostasis. 

However, there can be patterns the body takes to attempt to reach homeostasis that are formed on input it received from a trauma or difficulty that are now unnecessary. The forces that the practitioner applies are acting as a fulcrum for the body to pivot to a more energy efficient and less disruptive pattern.

Hand placement can be directly on the cranium, holding the sacrum or providing a fulcrum elsewhere on the body as well. The terminology of “cranial” therapy or “craniosacral” refers to the intrinsic motility of the central nervous system rather than the location of the practitioner's hands.

In the canine patient, the practitioner may need to take breaks throughout the session as the intervention can take longer sustained touch which some dogs might find confusing or intrusive. Practitioners should also remain aware that some dogs may not like sustained touch to their head in particular. 

However, a well trained cranial practitioner will also be able to apply their intervention further from the point of tissue distress such as a spinal location or at the sacrum allowing for the dog to feel more comfortable. This works on the principle of levers and fulcrums about which you can learn on the courses at the London College of Animal Osteopathy.

The Models of Cranial Therapy

As Cranial therapy has developed, different models of action have been proposed. It can be useful to understand the proposed mechanisms from different models even if your training or preference is for one in particular.

The 5 Phenomenon Model

This is the model most associated with William Garner Sutherland D.O. which use these 5 components: fluctuation of the cerebrospinal fluid (CSF), an inherent motility of the central nervous system, mobility of the intracranial and spinal membranes, mobility between the cranial bones themselves and involuntary movement at the sacrum. These components create the primary respiratory mechanism or PRM which is a slow wave-like fluctuation. Disturbance within any one of these 5 phenomena can create alterations throughout the others and create symptoms body wide.

Biodynamic Osteopathy

With foundations in the work of W. G. Sutherland, this understanding of Osteopathy was expanded upon by James Jealous D.O. who proposed the body to be a continuous fluid network. Practitioners palpate different “tides” within the fluid pulsations and assess their restrictions.

Fascial Model

Some practitioners use a very similar set of palpation and intervention techniques but do so with the intention of interacting with the fascial and membranous tissues. Structures such as the falx cerebri and tentorum which support and protect lobes of the brain, the meningeal tissues, and the more peripheral fascia all form interconnected pathways which can fall foul of trauma and dysfunction.

When it is Used in the Treatment of Dogs

All dogs are different just as we are as humans. Different approaches in Osteopathy are vital to ensuring we can assess and treat a range of dog personalities and physiologies. Much of the time, cranial Osteopathy is interested in the more profound symptoms of the central nervous system and the viscera, often dealing with the functions of the autonomic nervous system. This means that when cranial Osteopathy is indicated, the practitioner will very likely be working under Veterinary supervision or referral. Of course there will be benefit to cranial Osteopathy forming part of the routine maintenance of the dog too.

In puppies, birth trauma is something that can easily be overlooked. Cranial Osteopathy is often used in human babies due to its very gentle application. The forces on the infant dog’s body and cranium during the birth process can create malpositioning of cranial plates and compressions to structures like sinuses. We must also remember that unlike most human gestations, the puppy is in the womb with a number of other foetuses. This could impact the forces upon them too especially if the mother is carrying a large litter.

When we consider the descriptions of the cranial Osteopathy models above, we can easily see why headache might be a reason to use this approach. Animals can be incredibly resilient at times and noticing headaches in dogs is not the easiest thing to do. However, there are signs to look out for. Dogs suffering with headaches may exhibit some of the following:

Head Pressing

Dogs may press their head into walls, bedding or their owners. They do this in an effort to relieve the pressure of the head pain.

Flinching

A dog that flinches away or even becomes aggressive when their head is touched may be feeling pain in the area. This might also show when putting on collars, leads, or when fussing them around the head and neck.

Postural Changes

Bowing or tilting the head to one side.

Loss of Appetite

Refusing food or eating less.

Light and Sound Aversion

Many dogs are averse to loud sounds anyway, but if you notice a dog’s reactions to light and sound have changed, this could be a signal for investigation.

Some dogs may be averse to the more intense forms of manual therapy. Even gentle joint articulation of soft tissue massage might trigger unwanted reactions. Dogs with a history of trauma such as rescue dogs may not feel comfortable having their limbs moved around and would better suit lower intensity interventions. 

It might be the case that a practitioner uses the cranial approach to treatment until the dog feels comfortable enough with them to allow other techniques too. In fact, the cranial Osteopathic approach has often been linked with somatoemotional releases and so a cranial application could potentially allow the dog to process the trauma from their previous owner or abuse more readily.

Some Osteopaths will work with older dogs or those with pre-existing conditions that mean joint manipulation or heavy soft tissue mobilisation are contraindicated. Just like humans, dogs can suffer bone density issues and muscle atrophy with age. Veterinary advice may also be to avoid certain techniques following surgeries or acute injuries. Cranial Osteopathy can provide symptomatic relief, owner reassurance and act as a great monitor of the dog’s progression while other techniques and interventions are contraindicated.

Spreading the word

Cranial Osteopathy is clearly a useful tool in the Osteopath’s kit. It is an approach that is almost unique to Osteopathy and so we should be proud of it and utilise it to its fullest. The best way of doing this is actually to help people understand it better. By educating the veterinary profession about cranial Osteopathy, they can better understand when to refer and how useful it can be when they might have normally thought physical therapies were contraindicated. Helping owners to understand the principles of cranial Osteopathy can enhance public awareness and potentially more interest in the benefits for their animals.

To learn more about Osteopathy and all the wonderful applications it has, explore the International Diploma in Canine Osteopathy at the London College of Animal Osteopathy