Craniosacral Therapy

Craniosacral Therapy for Concussion Symptoms

There is limited research regarding craniosacral therapy for concussions, but anecdotal data shows positive effects.

In this type of manual therapy, the practitioner applies uses very gentle touch to the head and back, and does not do any rigorous kneading or rubbing that is typical for other types of massage.

Some leading sports physicians now refer concussion patients for craniosacral therapy to help lesson post-concussion symptoms, according to momsTEAM. Dr. Elizabeth Sandel, a nationally recognized brain injury specialist, write that craniosacral therapy "can be effective at treating headaches, as well as neck and back pain that are common with post-concussion syndrome."

A recent article in the Seattle Times profiles craniosacral therapist Lauren Christman: "Craniosacral massage focuses on the head and spine, using a gentle touch, and she often sees people for brain injuries, headaches, trauma, and stress."


Melinda Roland, PT, in Massage Magazine, describes the possible mechanisms for how craniosacral therapy may positively affect post-concussion symptoms.

How to access craniosacral therapy, or cranial manual therapy

A qualified practitioner will be a practicing massage therapist, physical therapist, or occupational therapist who is certified in cranial sacral therapy. Additionally, some osteopaths practice cranial manual therapy, and specialized chiropractors use a Sacral-Occipital Technique (SOT).

When using the search tool, select for a craniosacral therapist. Search tool provided by the International Association of Healthcare Practitioners. 

Scroll down the page for the listings tool. Search tool provided by the Biodynamic Craniosacral Therapy Association of North America.

Search tool provided by International Affiliation of Biodynamic Trainings.

Questions to Ask A Potential Provider

Lauren M. Christman, LMT, CBSI/KMI, CCST has provided questions to ask a potential provider concerning their training and experience. 

Please scroll down for the list of questions.

What to Expect From Craniosacral Session

Please scroll to the bottom of the page for "What to Expect" provided by Lauren M. Christman, LMT, CBSI/KMI, CCST 

How are craniosacral therapists certified?

The text below in this section is from our professional contributor Lauren M. Christman, LMT, CBSI/KMI, CCST, who is a practitioner, author, and teacher, and is currently teaching a Craniosacral Therapy Certification Program in Seattle.

Currently, there is not a unified national credential for CST. Instead, individual schools provide certification programs to prepare students. Most require over 200 hours of training, beyond an initial license to touch (such as massage therapist.) Many practitioners also have a background in massage therapy, physical therapy, occupational therapy or a form of psychological or spiritual counseling. 

Please note: it is possible for someone to have little or no training and still advertise as a CST — if you have an acute or complex condition, it is important and appropriate to inquire about a practitioners training and practice experience.

How Craniosacral Therapy May Help with Concussions and Post-Concussion Syndrome

Craniosacral therapists see the normal cranial system of plates, sutures, and membranes in the skull as having mobility, i.e. the capacity to "breathe."  Head injuries and concussion can adversely this mobility, and also affect the free flow and stable pressure of cerebrospinal fluid (CSF), blood flow, neural conduction and numerous other physiologic functions. (momsTEAM) The gentle manipulations of CST can restore plate, suture and membrane mobility and promote an improved flow of cerebral spinal fluid.

The text below is from our professional contributor Lauren Christman, LMT, CBSI/KMI, CCST :

General description

Craniosacral therapy (CST) is a gentle manual method that supports health and vitality within the client. Though there are several kinds of craniosacral therapy, they all orient to subtle movements in the body, enhance the functioning of the autonomic nervous system and assist in resolving trauma. 

Working with concussion requires all of those attributes. 

Two schools of CST

The classical method of CST is known as ‘biomechanical’ — its focus on mechanical movement requires a keen understanding of the cranial bones, sutures (joints) and membrane system. It tends to have a more problem-solving approach which can be helpful in the case of immediate injury. The other branch of CST is known as ‘biodynamic’ — it focuses of the ‘fluids’ of the body, where our reservoir of inherent health resides. This approach does not orient to symptoms or problem-solving, instead aims to build health from within rather than treating from outside. 

Questions to Ask When Choosing a Craniosacral Therapist

"Questions to Ask" are provided by our professional contributor Lauren M. Christman, LMT, CBSI/KMI, CCST.

Concussion Specific Questions

  • Do you have experience working with acute (recent) concussions?

  • Do you have experience working with post-concussion syndrome?

General Questions

  • Which kind of CST do you practice?

  • Do you combine that method with other skills?

  • How long was your training (are you certified)?

  • How many years have you been in practice?

  • Do you have a particular focus in your practice?

What Can I Expect?

  • If you are a child or elderly, do you have experience with people my age?

  • On average, how long do you work with a client?

  • How do you know when a client is making progress?

  • What can I expect to feel during or between sessions?

  • Will you expect me to do exercises/self-care, of some kind, between sessions?

Coordinating With Other Providers, and Health Insurance

  • Will you communicate with my other health care providers if needed?

  • Do you have other practitioners you can refer to if needed? (Counselors, neurologists, etc.)

  • Do you bill medical insurance? (Depends on state regulations, practitioner involvement, and individual insurance coverage.)

What to Expect From A Craniosacral Therapy Session

"What to expect from a session" is provided by our professional contributor Lauren M. Christman, LMT, CBSI/KMI, CCST.

Craniosacral therapy is generally done on a massage table, though can be adapted to clients in any position (as is done with children). Practitioners will gather information about the client’s health history, current concerns and health goals — this may or may not include an exploration of pain, illnesses, or limited activities. Some practitioners may emphasize physical considerations, while others may focus on emotional or spiritual concerns. Clients remain clothed and usually are encouraged to be mindful of their experience or relax during the session, which can last from an hour or up to 2 hours. 

The touch is usually light and sustained for many minutes, allowing the practitioner to perceive subtle movements in the area or in their overall system. This is characteristic of the work and perhaps most distinguishes it from what people usually consider “massage.”  During the session, clients usually experience a sense of deep relaxation, calm and groundedness. In this restful place, clients might have new insights or an uprising of emotion — this may or may not be explored in the session. In this, some craniosacral practitioners combine CST with counseling skills or work closely in tandem with counselors.

Research

A small pilot study published in 2018 concluded that "Osteopathic cranial manipulative medicine was considered a safe adjunctive treatment option to improve concussion-related symptoms and recovery." A small number of patients with concussion symptoms were given one treatment of osteopathic cranial manipulation. "Five of the Five of the 7 participants who returned for follow-up demonstrated improvement in their overall concussion symptoms based on the Post-Concussion Symptom Scale scores."

A 2017 study, CranioSacral Therapy and Visceral Manipulation: A New Treatment Intervention for Concussion Recovery, found that “Ten sessions of specific CST/VM/NM therapy resulted in statistically greater improvements in pain intensity, ROM, memory, cognition, and sleep in concussed patients.” The study was published in the journal Medical Acupuncture. Read an article about this study, Pro Football Players Testify to Craniosacral Therapy’s Ability to Address Concussion and CTE, published in Massage Magazine.

An August 2017 study of craniosacral therapy with professional football players (NFL and Canadian Football League) showed positive results. The players all had medically diagnosed post-concussion syndrome and showed "statistically greater improvements in pain intensity, orthopedic range of motion, memory, cognition, and sleep" after ten sessions of Craniosacral therapy (CST) combined with Visceral Manipulation (VM) and Neural Manipulation (NM). Ricky Williams, a former NFL running back who also played a season in the Canadian Football League, partnered with the Upledger Institute International on the study.

In a study published in June 2018, participants who received osteopathic cranial manipulation showed “improvement in their overall concussion symptoms based on the Post Concussion Symptom scale scores.