'''Osteopathy in the cranial field''' (abbreviated '''OCF''', also called '''cranial osteopathy''' or '''cranial-sacral osteopathy''') is a method of [[alternative medicine]] used by [[Osteopathy|osteopaths]] who assess and enhance the function of the patient's health by accessing their primary respiratory mechanism and working with various rythms inherent in the connective tissue and fluid systems of the body. Some published work suggests that the involuntary motion palpated by osteopaths using OCF is a function of the cardiovascular system.{{fact}} By working with the whole body, including the [[Skull|cranium]], osteopaths can remove restrictions in the flow of cerebrospinal fluid and other bodily fluids, relieving [[Stress (medicine)|stress]], decreasing [[pain]], and enhancing overall [[health]].<ref>The Sutherland Society [http://www.cranial.org.uk/page2.html General information on Cranial Osteopathy] Retrieved January 24, 2006</ref>
Although well-established,<ref>[http://www.cranialacademy.com/cranial.html The Cranial Academy (US)]</ref> use of cranial techniques
is a contested issue within the osteopathic profession; it is not known what proportion of osteopaths are practitioners. Opponents claim that OCF has been shown to be without scientific basis,<ref>S.E. Hartman, J.M. Norton (2002) Interexaminer reliability and cranial osteopathy. ''Scientific Review of Alternative Medicine.'' 6(1): 23-34 [http://faculty.une.edu/com/shartman/sram.pdf PDF full report]</ref>
<ref>Ferre JC, Chevalier C, Lumineau JP, Barbin JY (1990) Cranial osteopathy, delusion or reality? ''Actualites Odonto-Stomatologiques'' 44: 481-494. PMID 2173359</ref>
<ref>Rogers JS and others (1998) Simultaneous palpation of the craniosacral rate at the head and feet: intrarater and interrater reliability and rate comparisons. ''Physical Therapy'' 78(11): 1175-1185. PMID 9806622</ref>
and some studies that support OCF have been criticized for poor methodology.{{fact}}
== Practice ==
Cranial osteopaths are trained to feel a very subtle, rhythmic shape change that is present throughout the head and body. This is known as the involuntary mechanism, or the cranial rhythm. The movement is very subtle, and it takes practitioners with a very finely developed [[Palpation|sense of touch]] to feel it. This rhythm was first described in the early 1900s by Dr. William G. Sutherland.<ref>[http://www.osteohome.com/MainPages/ocf.html What Is Osteopathy In The Cranial Field (OCF)?] Osteohome website (Accessed 2nd Aug 2006)</ref>
The theory underlying cranial osteopathy is rejected by many osteopaths and orthodox medical doctors because it was previously understood that cranial bones fuse by the end of adolescence. Histological studies have however demonstrated the presence of [[Sharpey's fibres]] between the adjacent bones forming the sutural margins, and it is known that these specialised fibres form only at areas where tissue movement is allowed. It is accepted by most modern osteopaths working in the cranial field that the spheno-basilar symphysis (a large joint in the skull base) does indeed [[Ossification|ossify]] (turn to bone) and the original principles of OCF have thus evolved in light of increasing knowledge. Tuition of OCF refers to movement remaining within the thin bone of the sutures, and that flexibility within living bone occurs, in contrast to dried specimen bones. The brain does pulsate, but some research suggests this is related to the cardiovascular system.<ref>Wirth-Pattullo V, Hayes KW. ''Interrater reliability of craniosacral rate measurements and their relationship with subjects' and examiners' heart and respiratory rate measurements.'' Phys Ther. 1994 Oct;74(10):908-16; discussion 917-20. PMID 8090842</ref>
The same study looked at inter-operator reliability of palpating the 'cranial rhythm' and found there to be little agreement, although modern understandings in the cranial field describe a number of simultaneous rhythms with differing rates, relating to different aspects of function.{{fact}}
How this mechanism is related to health and disease is not established. Many without direct experience of the benefits of treatment dismiss cranial osteopathy as pseudo-science. However, OCF is increasingly being recognised as especially suitable for newborn babies and young children, with particularly good results in the treatment of colic and crying.{{fact}} It is claimed that as their bones have not fully fused and hardened, they are more susceptible to the treatment.{{fact}} All in all, this practice appears to be popular with patients with an increasing demand for experienced practitioners.
==History==
OCF was originated by [[Osteopathic medicine|osteopathic doctor]] [[William Sutherland]] DO (1873-1954), who studied under the founder of osteopathy, [[Andrew Taylor Still]], at the first American School of Osteopathy (now [[Kirksville College of Osteopathic Medicine]]) in 1898-1900. While looking at a disarticulated [[skull]], Sutherland was struck by the idea that the [[Cranial sutures|sutures]] of the [[temporal bone]]s where they meet the [[sphenoid bone]]s were ''"beveled, like the [[gill]]s of a fish, indicating articular mobility for a [[Respiratory system|respiratory]] mechanism."''
<ref>Sutherland A (1962). ''With Thinking Fingers.'' Indianapolis, IN: Cranial Academy, 13.</ref>
The idea that the bones of the skull could move was contrary to contemporary [[Anatomy|anatomical]] belief. Sutherland spent many years attempting to disprove his theory, applying forces to his own cranium and creating significant disturbances in his own physiology, he placed himself at significant risk of never being able to find a path back to health. Through self sacrifice over 50 years of diligent study, Dr. Sutherland discovered the principles of OCF. Research on himself and on his patients led him to conclude that the bones of the skull do move along their sutures, and any hindrance in movement may be associated with a dysfunction.
After confirming the presence of movement between the bones of the skull, Sutherland evolved the idea that the [[Meninges|dural membranes]] act as '[[guy-wire]]s' for the movement of the cranial bones, holding tension for the opposing motion. He used the term ''reciprocal tension membrane system'' (RTM) to describe the three [[Cartesian coordinate system|Cartesian]] axes held in reciprocal tension, or [[tensegrity]], creating the cyclic movement of [[inhalation]] and [[exhalation]] of the cranium. He called this breathing movement the ''primary respiratory mechanism'', and later described its origin as the ''Breath of Life'',
<ref>Sutherland W (1939). ''The Cranial Bowl. Mankato, MN: Self-published. Republished 1986, Indianapolis, IN: Cranial Academy.</ref>
from the Book of [[Genesis]] (2:7). This was an acknowledgment of the [[Vitalism|vital force]] as a fundamental aspect of osteopathic philosophy.
The RTM as described by Sutherland includes the spinal dura, with an attachment to to the [[sacrum]]. In his observation of the cranial mechanism, Sutherland found that the sacrum moves [[Synchronization|synchronously]] with the cranial bones. The mechanical relationship between motion in the sacrum and the [[parietal bone]]s has since been confirmed in experiments using [[electrode]]s measuring [[capacitance]] across parietal sutures of the [[squirrel monkey]].
<ref>Retzlaff EW, Michael DK, Roppel RM. ''Cranial bone mobility.'' J Am Osteopath Assoc. 1975 May;74(9):869-73. PMID 804505</ref>
Sutherland began to teach this work to other osteopaths from about the 1930s, and continued to do so tirelessly until his death. His work was at first largely rejected by the mainstream osteopathic profession as it challenged some closely held beliefs among practitioners of the time. His clinical results were however impressive and he began to attract a small group of osteopathic physicians who studied with him.
In the 1940s the American School of Osteopathy started a post-graduate course called 'Osteopathy in the Cranial Field' directed by Sutherland, and was followed by other schools. This new branch of practice became known as cranial osteopathy. As knowledge of this form of treatment began to spread, Sutherland trained more teachers to meet the demand, notably Drs Viola Frymann, Edna Lay, Howard Lippincott, Anne Wales, Chester Handy and Rollin Becker.
The Cranial Academy was established in the US in 1947, and continues to teach DOs, MDs, and Dentists "an expansion of the general principles of osteopathy"
<ref>[http://www.cranialacademy.org/intro.html The Cranial Academy] Accessed 10th July 2006</ref>
including a special understanding of the central nervous system and primary respiration.
Towards the end of his life Sutherland began to sense a "power" which generated corrections from inside the bodies of his patients without the influence of external forces applied by him as the therapist. Similar to [[Qi]] and [[Prana]], this contact with the Breath of Life changed his entire treatment focus to one of spiritual reverence and subtle touch.
<ref name="therapy13">The Cranial Academy [http://www.cranialacademy.org/cranial.html Osteopathy in the Cranial Field] Retrieved January 24, 2006.</ref>
In [[1953]] Sutherland established the Sutherland Cranial Teaching Foundation as a way of providing a continuity for his teaching.
<ref>[http://www.sctf.com/about/index.html Sutherland Cranial Teaching Foundation] Accessed 10th July 2006</ref>
From 1975 to 1983, osteopathic physician John Upledger neurophysiologist and histologist [[Ernest W. Retzlaff]] worked at [[Michigan State University]] as a clinical researchers and professors. They set up a team of [[anatomy|anatomists]], [[physiology|physiologists]], [[biophysics|biophysicists]], and [[bioengineering|bioengineers]] to investigate the pulse that Upledger had observed and to study further Sutherland's theory of cranial bone movement. Upledger and Retzlaff went on to publish their results, which showed support for both the concept of cranial bone movement and the concept of a cranial rhythm.
<ref name="therapy6">Upledger JE (1977) The reproducibility of craniosacral examination findings: a statistical analysis. ''J Am Osteopath Assoc'' 76(12):890-899. PMID 7899490</ref>
<ref name="therapy7">Upledger JE (1978) The relationship of craniosacral examination findings in grade school children with developmental problems. ''J Am Osteopath Assoc'' 77(10): 760-776. PMID 659282</ref>
<ref name ="therapy8">Upledger JE, Karni Z (1979) Mechano-electric patterns during craniosacral osteopathic diagnosis and treatment. ''J Am Osteopath Assoc'' 78(11):782-791. PMID 582820</ref>
== Biodynamic osteopathy ==
The spiritual approach to the work has come to be known as "[[biodynamic]]" osteopathy and has had further contributions from practitioners such as Becker and Dr James Jealous. The biodynamic approach recognises that embryological forces direct the embryonic cells to create the shape of the body, and places importance on recognition of these [[Morphogenesis|formative]] patterns for maximum therapeutic benefit, as this enhances the ability of the patient to access their health as an expression of the original [[intention]] of their [[existence]].
Biodynamics provides a profound expansion upon OCF.
{{sectstub}}
== The Primary Respiratory Mechanism ==
Craniosacral therapy is originally based on Sutherland's 'Cranial Concept',
<ref>Sutherland, W G. ''The Cranial Bowl.'' Self-published, 1939. Reprinted by the Cranial Academy, 1948.</ref>
which proposed a system known as the ''Primary Respiratory Mechanism'' (PRM). The basis of PRM function has been summarised in the following five [[Phenomenon|phenomena]]:
*Inherent [[motility]] of the [[central nervous system]]
*[[Fluctuation]] of the [[cerebrospinal fluid]]
*Mobility of the intracranial and intraspinal [[Meninges|dural membranes]]
*Mobility of the [[cranial bone]]s
*Mobility of the [[sacrum]] between the [[Ilium (bone)|ilia]]
The effect of the above five on the rest of the body is suggested by Magoun
<ref>Magoun H I (ed.), ''Osteopathy in the Cranial Field.'' The Cranial Academy, 3rd edn, 1976, p. 23.</ref>
as a sixth phenomena.
'''Inherent motility of the central nervous system'''
Still described the inherent motion of the [[brain]] as a "[[Electrical generator|dynamo]]," beginning with the [[cerebellum]],
<ref>Lee R P. ''Interface: Mechanisms of Spirit in Osteopathy.'' Portland, OR: Stillness Press, 2005, pp. 193-8. ISBN 0967585139.</ref>
a century before [[electroencephalography]] (EEG) studies confirmed the presence of this activity.
<ref>Cohen D (1968). ''Magnetoencephalography: Evidence of magnetic fields produced by alpha-rhythm currents.'' Science, 161:784-786</ref>
[[Emanuel Swedenborg]] was the first to [[Emanuel Swedenborg#Discoveries|discover]] inherent motion in the brains of living dogs in the 18th Century. His work has since been verified by human physiologists: according to modern [[Radiology|radiological]] observations the [[Pulsation|pulsatility]] of the central nervous system (CNS) is a function of the cardiac cycle, as described by Bergstrand in 1985 using [[magnetic resonance imaging]].
<ref>Bergstrand G et. al. ''Cardiac gated MR imaging of cerebrospinal fluid flow.'' J Comput Assist Tomogr, 1985 Nov-Dec;9(6):1003-6. PMID 2932480.</ref>
The [[intracranial]] fluid fluctuation can be seen as an interaction between four main components: [[Artery|arterial]] [[blood]], [[capillary]] blood (brain volume), [[venous blood]] and cerebrospinal fluid (CSF).
<ref>Greitz D, Franck A, Nordell B. ''On the pulsatile nature of intracranial and spinal CSF-circulation demonstrated by MR imaging.'' Acta Radiol. 1993 Jul;34(4):321-8. PMID 8318291.</ref>
<ref>Greitz D, Wirestam R, Franck A et. al. ''Pulsatile brain movement and associated hydrodynamics studied by magnetic resonance phase imaging. The Monro-Kellie doctrine revisited.'' Neuroradiology. 1992;34(5):370-80. PMID 1407513.</ref>
The function of such a mechanism is explained by Lee
<ref>p. 197</ref>
as being based on a [[Lever|fulcrum]] created by the root of the cerebellum and its [[hemisphere]]s moving in opposite directions, resulting in an increase in pressure which squeezes the [[third ventricle]]. The pulsation is described as essentially a recurrent expression of the [[embryology|embryological]] development of the brain.
<ref name=Lee2>p. 196-7</ref>
The amplitude and phase of theta rhythms in the cortex of the human brain have been studied using [[magnetic resonance imaging]]. High gamma activity has been found to reflect the activation of a local cortical area and is correlated with the blood oxygen level dependent MRI-signal. The much slower theta rhythm is more distributed across the cortex and is associated with novelty, attention, working memory, and exploratory behavior. The strength of the theta-gamma coupling is correlated with variations in a range of cognitive tasks.
<ref>Canolty R T, Edwards E, Dalal S S, et. al. [http://www.sciencemag.org/cgi/content/short/313/5793/1626 "High Gamma Power Is Phase-Locked to Theta Oscillations in Human Neocortex."] ''Science'' 15 September 2006: Vol. 313. no. 5793, pp. 1626 - 1628</ref>
This suggests a significant physiological role in CNS rhythmical movement.
The motility of the CNS in turn causes a rhythmic fluctuation of the CSF.
'''Fluctuation of the cerebrospinal fluid'''
Sutherland used the term ''"[[Tide]]"'' to describe the inherent [[fluctuation]] of fluids in the Primary Respiratory Mechanism. ''Tide'' alludes to the concept of ebbing and flowing, but also the contrast between waves on the shore having one rhythm, with the longer rate of [[Moon|lunar]] tides below. The Tide incorporates not only fluctuation of the CSF, but of a slow oscillation in all the tissues of the body, including the skull.
Practitioners work with cycles of various rates:
* 10-14 cycles per minute - the original ''"Cranial Rhythmic Impulse"'' (CRI) <ref>Magoun H I (ed.), ''Osteopathy in the Cranial Field.'' The Cranial Academy, 3rd edn, 1976, p. 25.</ref> (also described as 6-14 times per minute) <ref name=Lee2>Lee R P. ''Interface: Mechanisms of Spirit in Osteopathy.'' Portland, OR: Stillness Press, 2005, 198. ISBN 0967585139.</ref>
* 2-3 cycles per minute - the ''"mid-Tide"''
* 6 cycles every 10 minutes - the ''"long Tide"''
Following on from the work of Swedenborg, [[Ludwig Traube (physician)|Traube]] and Hering in the 19th Century observed fluctuations in the arterial rates of dogs (the Traube-Hering wave) at similar rates to those reported by cranial practitioners. In 1960 Lundberg made a continuous recording of intracranial activities of traumatised patients, finding three waves, one of which resembles the CRI.
<ref>Lundberg N. ''Continuous recording and conrold of ventricular fluid pressure in neurosurgical practice.'' Acta Psychiat Neurol Scand, 36:suppl 149, 1960. Quoted in Lee R P. ''Interface: Mechanisms of Spirit in Osteopathy.'' Portland, OR: Stillness Press, 2005, p. 199. ISBN 0967585139.</ref>
Research has not verified a large correlation in rates detected between examiners working simultaneously on a subject, possibly due to the rate being a product of [[entrainment]] between patient and practitioner.
<ref name=Mcpartland1>McPartland JM, Mein EA. ''Entrainment and the cranial rhythmic impulse.'' Altern Ther Health Med. 1997 Jan;3(1):40-5. PMID 8997803</ref>
;Mobility of the intracranial and intraspinal dural membranes
The membranes surrounding the brain and separating the left and right halves and the [[cerebrum]] from the cerebellum are continuous with the spinal dura, and share the same fluctuating rhythm. In 1970 Upledger observed during a [[Surgery|surgical]] procedure on the neck what he described as a slow pulsating movement within the spinal meninges. He attempted to hold the membrane still and found that he could not due to the strength of the action behind the movement.
<ref>Upledger J E, Vredevoogd J. 1983 ''Craniosacral Therapy'' Eastland Press. ISBN 0-939616-01-7</ref>
In craniosacral treatment the membranes act as a fulcrum for [[fascia]]l restrictions throughout the body, and craniosacral therapists may perceive a change in quality as a result of disturbance such as infection or [[Allergy|allergic]] irritation.
;Mobility of the cranial bones
Cranial sutures are often believed to be immobile after [[fusion]], preventing cranial bone movement. This belief arose in the mid-1900s. According to Lee
<ref name=Lee1>Lee R P. ''Interface: Mechanisms of Spirit in Osteopathy.'' Portland, OR: Stillness Press, 2005, 130-33. ISBN 0967585139.</ref>
this belief was misinterpreted from the work of authors hoping to correlate suture closure with the [[Chronology|chronological]] age of a skull in [[Archaeology|archaeological]] specimens. The authors not only found that there was no correlation between suture closure and the chronological age of the individual, but also that most skulls demonstrated no suture closure at all except as structural evidence of pathological [[physical trauma]]. Lee cites many references giving evidence for mobility in human skulls,
<ref name=Lee1/>
and modern anatomy books suggest incomplete fusion of some sutures, for example: ''"Sutural ligaments may effect an almost immovable bond between large areas of bone... but such immobility cannot be effected at narrow edges of bones in the cranial vault,"''
and: ''"When such sutures are tied by sutural ligament and periosteum, almost complete immobility results."''
<ref name=Grays1>Williams P L, Warwick R, Dyson M, Bannister L H. ''Gray's Anatomy.'' Churchill Livingstone, Edinburgh, 37th edn, 1989, p. 468. ISBN 0-443-02588-6</ref>
It is usual in cranial textbooks to say that the motion of the skull is possible during flexion and extension because the sutures are mobile, especially the spenobasilar synchondrosis - the junction between the base of the [[sphenoid]] and the occiput. Positional descriptions of cranial lesions traditionally relate to the relationship between the sphenoid and the occiput at this junction. An alternative theory to SBS motion taught in craniosacral training suggests that sutures are ''"lines of folding"'', like pre-folded marks on cardboard, rather than necessarily being fully open.
<ref>Cook, Andrew, ''An alternative to Spenobasilar Synchondrosis (SBS) Motion.'' Self-published online, Sep 2005. [http://www.hummingbird-one.co.uk/pdf/sbs_simplified.pdf PDF]</ref>
;Mobility of the sacrum between the ilia
Mobility of the [[sacroiliac joint]] is not contested, although the [[Lever|fulcrum]] of craniosacral movement is through the body of the second sacral vertebra or segment (S2). The cranial concept recognises the link between the sacrum and occiput via the spinal dura, which is attached to the [[anterior]] of the sacrum at S2: as the occiput goes into [[extension]] the sacrum [[Nutation|nutates]], and the converse also occurs. The occiput can therefore be influenced by treatment of the sacrum, and vice-versa.
==Criticism==
Practitioners claim that by using cranial techniques on the body, including the head, they can remove restrictions in the connective tissue system and in the flow of cerebrospinal fluid; relieving stress, decreasing pain, and enhancing overall health. [1] [2] [3] Opponents claim that the therapy has been shown to be without scientific basis, [4] [5] [6] [7] and some studies that support the therapy have been criticized for poor methodology. [8]
Sceptics existing both inside and outside the [[Osteopathic medicine|osteopathic]] profession level the following criticisms at craniosacral therapy:
;'Lack of evidence for the existence of "cranial bone movement''
:The scientific evidence for cranial bone movement is insufficient to support the theories claimed by craniosacral practitioners. Scientific research supports the theory that the cranial bones fuse during adolescence, making movement impossible. However, this research only points to fusion of the base of the skull which is not contested in craniosacral therapy and does not address movement in the superior plates. As such, this research plays no part in disproving the type of cranial bone movement as postulated by craniosacral therapy.<ref name="therapy9"> Madeline LA, Elster AD. (1995) Suture closure in the human chondrocranium: CT assessment. ''Radiology'' 196(3):747-756. PMID 7644639</ref>
;Lack of evidence for the existence of the "cranial rhythm"
:While evidence exists for cerebrospinal fluid pulsation, one study states it is caused by the functioning of the [[cardiovascular system]] and not by the workings of the craniosacral system.<ref name="therapy2">Ferre JC, Chevalier C, Lumineau JP, Barbin JY (1990) Cranial osteopathy, delusion or reality? ''Actualites Odonto-Stomatologiques'' 44: 481-494. PMID 2173359</ref>
;Lack of evidence linking "cranial rhythm" to disease
:No research to date has supported the link between the "cranial rhythm" and general health.
;Lack of evidence "cranial rhythm" is detectable by practitioners
:Operator interreliability has been very poor in the studies that have been done. Five studies showed an operator interreliability of zero.<ref name="therapy1">S.E. Hartman, J.M. Norton (2002) Interexaminer reliability and cranial osteopathy. ''Scientific Review of Alternative Medicine.'' 6(1): 23-34 [http://faculty.une.edu/com/shartman/sram.pdf PDF full report]</ref>
:The one study showing some operator interreliability has been criticized as deeply flawed in a report to the British Columbia Office of Health Technology Assessment.<ref name="therapy5">Green C and others (1999) A systematic review and critical appraisal of the scientific evidence on craniosacral therapy. ''BCOHTA'' [http://www.chspr.ubc.ca/bcohta/pdf/bco99-01J_cranio.pdf PDF full report]</ref>
==Training and accreditation==
Osteopathy is protected by statute in both the US and the UK. Cranial osteopathy has no recognised qualification, and any osteopath or osteopathic physician may practice cranial techniques if it is within their scope of competence.
===Training in the US===
{{sectstub}}
===Training in the UK===
{{sectstub}}
== Craniosacral therapy and sacro-occipital technique==
{{main|Craniosacral therapy}}
[[Craniosacral therapy]] is based on the same principles as cranial osteopathy, but practitioners do not have to be qualified osteopaths, and therefore do not always have the same depth of training in the clinical sciences and differential diagnosis. Osteopaths view craniosacral therapy as a simplified therapy derived from OCF first taught by osteopathic physician John Upledger.
In 1983, after years of frustration with the limited penetration of OCF into the osteopathic profession, Dr. Upledger decided to teach cranial osteopathy to non-physicians. He simplified a delivery system for teaching the cranial concept in a manner that was accessible to massage therapists. As a result, the cranial concept is being practiced by significantly more individuals than have ever been educated by the osteopathic profession.
The Cranial Academy claim the differences between cranial osteopathy as practised by osteopathic physicians and craniosacral therapy as practised by craniosacral therapists is often a confusing topic for the public.<ref>[http://cranialacademy.org/cst.html How Does Cranial Osteopathy Differ From Cranio-Sacral Therapy™] The Cranial Academy</ref>
Osteopath and chiropractor M.B. Dejarnette also developed craniopathic techniques as a complete [[chiropractic]] system known as sacro-occipital technique, or simply "S.O.T."<ref>The Sacro Occipital Research Society International, Inc. [http://www.sorsi.com/ SORSI]</ref><ref>Sacral Occipital Technique Organization USA [http://soto-usa.org/]</ref>
== References ==
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==External links==
;Practitioner organisations
* [http://www.cranial.org.uk/ Sutherland society]
;Training organisations (UK)
* [http://www.scc-osteopathy.co.uk/ Sutherland cranial college]
* [http://www.eso.ac.uk/ The European School of Osteopathy]
* [http://www.bso.ac.uk/ British School of Osteopathy]
* [http://www.occ-uk.com/ Osteopathic centre for children]
;Training organisations (US)
* [http://www.cranialacademy.org/ The Cranial Academy]
* [http://www.biodo.com/ The Biodynamics of Osteopathy]
* [http://www.sctf.com/ The Sutherland Cranial Teaching Foundation]
;Other organisations
*[http://www.cranio.org.uk/ UK Forum for Cranial Practitioners] Creating common standards of practice for cranial and craniosacral therapy in the UK
;Advocacy
* [http://www.originalosteopathy.com/osteopathic/index.html Cranial Osteopathy - Myth or Science?]
* [http://www.osteodoc.com/sutherland.htm Image of the dural membranes]
;Criticism
*[http://www.skepdic.com/craniosacral.html The Skeptic's Dictionary]
*[http://www.ptjournal.org/Nov2002/Nov02_Letters.cfm Craniosacral Therapy Is Not Medicine] Hartman, DO and Norton, DO (letter to the editor)
;Biodynamic osteopathy
* [http://www.osteodoc.com/biodynamics.htm Biodynamics]
[[Category:Alternative medicine]]
[[Category:Osteopathy]]
