Hello from down a rabbit hole!  I have now officially taken ten post-graduate courses in a manual therapy approach to assessing and treating the body called osteopathy.  Specifically, I have focussed on two techniques called visceral and neuromeningeal manipulation (NM).  Visceral manipulation (VM) refers to the use of my hands to treat fascial restrictions around organs that may be causing physical restrictions to blood flow, movement, alignment and posture, while Neuromeningeal manipulation is the act of treating the nerves, membranes and brain itself by means of light touch.

I recently just completed a course called NM4 where I learned all about the role of the cranial nerves and how to affect them with my hands to help my clients.  Your cranial nerves extend out of the base of your brain and branch to provide the electrical wiring to your face, eyes, head and organs.  They are kind of important to your daily life, but largely fly under the radar until they get annoyed for one reason or another.  They can be responsible for headaches, eye pain, ringing in the ears and even referred sensitization and irritation into the body due to their connection to numerous organs through the vagus nerve.

As a person who has woken up with a headache every day for two years since my eye injury, I found this class fascinating.  My empathy for people with head and face pain is substantial so I tried to learn as much as I could from this class to help my clients and hopefully myself.

‍There are twelve cranial nerves:

‍I- Olfactory-smell

II- Optic-vision

III- Oculomotor- eye movement

IV- Trochlear- eye movement

V- Trigeminal- movement & sensation to your face, tongue, nose, ear

VI- Abducent- eye movement

VII- Facial- facial expressions & taste

VIII- Vestibulocochlear- sound & balance

IX- Glossopharyngeal- swallowing, speech, taste

X- Vagus- control heart, lungs & digestion

XI- Accessory- neck muscles

XII- Hypoglossal- tongue muscles

Don’t bother trying to remember them all, but just consider that every movement, sensation and process that happens in your body is somehow connected to your brain and nervous system.  If you have pain or dysfunction in a specific area or system of your body, having someone that understands your electrical wiring in detail can be an invaluable asset to solving your problem.  These cranial nerves are hidden away in your skull and upper neck making them difficult to access, but they do traverse out through the various openings to get to their end destinations and can be affected by both direct and indirect conservative manual treatment.

Some of the nerves are bigger and more accessible than others, but the master chef of the bunch is the fifth one called your Trigeminal nerve.  It is the equivalent of the sciatic nerve from your lower body, but in your head and can be responsible for a lot of face, head and eye issues.  A therapist trained in cranial techniques  can assess and treat the tension in the various branches of this nerve through the skull and in the ear canal.  I have already found these techniques to be helpful with my clients and I continue to refine my ability to very precisely work on people’s heads.  The bones and membranes in your skull and face move a lot more than I would have ever thought possible!

The head can get torsioned in the same way your pelvis and ribcage can get pulled into twisted holding patterns.  Sometimes it is the root cause that keeps throwing off your alignment after a therapist has helped straighten out your back.  The head is a subtle thing to treat, but as I am learning, it is an important piece of the puzzle to treating clients’ resistant pain problems.  When people come in and they complain of issues entirely on one side of the body (i.e. shoulder, hip, ankle), I typically start by looking at the pulls in the head and commonly they have a lot of tension in a membrane that supports the brain on that side called the tentorium.

OK, I’m not going to get into too much detail, but my advice is to be open to trying a therapist that uses cranial work as part of their treatment if you are having chronic issues with pain, alignment or general dysfunction.  Your head controls a lot and some people can treat it without having to cut it open and look inside.  I am now one of them and I continue to be impressed by the outcomes I am getting.  I tend to combine cranial work with dry needling and awareness exercises, but do your homework and find someone you think would be a good fit.  Your options are likely an osteopath, physical therapist or massage therapist with specialized training.  There are a few variations of cranial work, I have done neural manipulation through the Barral Institute.  I would call it the cousin of cranial-sacral therapy, a different but related form of cranial work.

Hope this was helpful!  Let me know if you have any questions in the comments section below!

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