Abstract
A theoretical model that does not evolve with new information deriving from scientific research, by changing the assumptions from which it was born, becomes a philosophy; the scientist becomes a scholarch. Cranial manual osteopathic medicine is very controversial, although it is commonly practiced, from the clinician to the nonmedical health worker. The article, divided into two parts, reviews the assumptions with which the cranial model was created, highlighting the scientific innovations and new anatomical-physiological reflections. In the first part we will review the synthesis and movement of cerebrospinal fluid (CSF), the movement of the central and peripheral nervous system; we will highlight the mechanical characteristics of the meninges. The aim of the article is to highlight the need to renew the existing cranial model.
Highlights
The osteopathic cranial manipulative medicine (OCMM) was born around 1898, when a student of the American School of Osteopathy observed a disjointed skull in the museum of the same institute and noticed that the temporal bones resembled the gills of fish [1]
The similarity with the gills and the bone shape allowing the articulations of the skull, gave the inspiration for the fundamental principles of OCMM: the primary respiratory mechanism (PRM) and the movement of the cranial bones [1]
The PRM is the theory that would explain the movement of the cranial bones through palpation [2]
Summary
If a stress vector crosses layers with a significant stiffness (bone), the speed of the propagation waves will increase (from the outside to the inside); if the forces are produced from within, such as when the brain and spinal cord move influenced by breathing and heartbeat, the speed of propagation of the pressures created will be slower, as the internal tissues have less stiffness [46]. The cranial rhythm felt by the clinician's palpation derives from the movement of the brain and the spinal cord, which movement would create outward tension waves slower, compared to the real rhythm of breathing and heartbeat, thanks to the viscoelastic property of the meninges that dampen the speed of tension transmission. The pial spinal layer has a great capacity to withstand longitudinal mechanical stresses and their distributions, despite its small thickness (from 0.089 to 1.40 MPa) [49,50]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
