While most of us think of lesions as icky, oozing sores,
Osteopaths use the term Lesion to describe trouble spots in the body that have restricted mobility.
The Craniosacral Rhythm
The Craniosacral Rhythm (CSR) is rhythmic expansion and contraction of the cranial bones and an accompanying external/internal rotation of other body parts such as limbs and ilia. The rhythm takes 2.5-5 seconds to expand and 2.5-5 seconds to contract or six to twelve complete cycles per minute.
There are at lease two plausible models to explain the source of this rhythm, but that’s beyond the scope of this blog post.
The CSR was first described by William Sutherland, the granddaddy of Cranial Osteopathy. He noticed that the squamosal suture between the temporal and parietal bones resembled fish gills. He described the flaring of the temporal bones in response to the CSR as “primary respiration”.
Flexion & Extension
Sutherland also observed that the sphenobasilar synchondrosis, viewed inferiorly, flexes when the cranium is expanding and the rest of the body is externally rotating, and extends when the cranium is contracting and the rest of the body is internally rotating. This flexion/extension terminology describing the phases of the CSR is still in use.
These terms may seem contradictory because in Flexion the cranium gets bigger and the body generally externally rotates. In Extension the cranium gets smaller and the rest of the body generally internally rotates. These definitions go against everything we ever learned in structural kinesiology The terms, however, only refer to the sphenobasilar synchondrosis, viewed inferiorly. When we think of it that way it makes sense.
Craniosacral Therapists observe qualities of the CSR (among other things) to make assessments of where and how to treat people.
Flexion & Extension Lesions
Now back to Lesions. When the body spends more time or has a greater movement excursion in the Flexion phase of the CSR we say that the person has a Flexion Lesion. Likewise, when the body spends more time or has a greater movement excursion in the Extension phase of the CSR, we say that the person has an Extension Lesion.
Still with me?
Treating Flexion & Extension Lesions
The standard treatments for Flexion or Extension Lesions have goals of creating balance – getting the Flexion and Extension phases of the CSR to even out.
Now, here’s the part about how my students are brilliant:
In my CST for Pregnancy Birth & Postpartum class each of my students treats three mothers – generally two pregnant women and one postpartum woman. The students and I meet as a group and discuss all of the treatments afterward. These discussions are rich, informative and supportive.
One of my amazing students last week described her treatment for a very pregnant client who (among other things) had a Flexion Lesion. Her intuitive treatment decision was to do nothing to correct the Flexion Lesion because it made sense to her that this mama was opening up as birth was approaching.
Amazingly, another student in the same class described a treatment in which she treated a newly postpartum mama who had an Extension Lesion. This brilliant student also elected not to treat this lesion because she felt it was normal for this woman to be in the process of closing (like the closing of the bones) after opening to give birth.
I am so proud of my students. I think it takes brilliance, confidence and intact intuition to question protocols, stay present and do what’s truly needed in the moment.