Introduction to SOT

Cranial AdjustmentI am pleased that you are interested in the Richards Family Health Center for your health care needs. Many years ago, while I was still in chiropractic school, I made a decision to be something more than a "manual aspirin." I did not want to be treating acute conditions only for pain relief. My interests lay in the realm of addressing the underlying problem so that in the long run the person would be healthier, more stable and have fewer symptoms overall (including less pain).

Therefore, I found myself drawn to Sacro-Occipital Technique (SOT) which takes a comprehensive view of how the body responds to trauma, including the various stages that the structure and the neurology of the body go through as it attempts to adapt to abnormal biomechanics. To simplify the discussion of these complex issues, Dr. DeJarnette (the founder of SOT) established a category system (Category I, Category II, and Category III).

Mastering SOT and becoming proficient in the pain patterns associated with the various categories (as well as the impact of the diverse neurologic impairments) is extremely technical and complex. In fact, it is such a complex specialty that less than 5 percent of all doctors of chiropractic are proficient SOT specialists. How that translates in the treatment room is that oftentimes the work that I am doing looks like "magic." It is similar to taking a cell phone into the Amazon to people who are unfamiliar with electricity. There is a body of information concerning biomechanics, structural anatomy, and neurology that underlies each and every procedure done in this office.

It is not possible to explain all of the procedures during each office visit. Therefore, this section is an effort to help you understand the category system and how it relates to your body as a whole.

I hope that your perusal of this information will lead to a greater understanding of the amazing body with which we have all been gifted. Again, thank you for your confidence in us, and I look forward to meeting you.

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Category I Complex

Category I is the underlying meningeal (dural) twist that a person develops as a result of the birthing process. The Category I Complex is obscured by any superimposed trauma which may have occurred during your lifetime. Once the traumas are resolved, your specific Category I pattern will become apparent.

The twist in the dura results in a variety of dysfunctions as a result of the impact on the nervous system. It can include cranial lesions, but they are not always present. Since the central nervous system controls the physiology of all the visceral organs, the most common symptom of Category I Complex is organ dysfunction. Some common organ problems found with Category I Complex include, but are not limited to: gall bladder disease, digestive upset (including ulcers), reproductive dysfunction (including impotence and painful intercourse), respiratory problems (including asthma) and cardiac rhythm problems of all kinds.

During the course of your lifetime, you will be either an active or an inactive Category I. An inactive Category I has no visceral interference, no cranial lesions and no subluxation of the sacroiliac joint. The person who is an inactive Category I has no need for chiropractic adjustments.

An active Category I is a different story. It is very important that it be corrected as soon as possible to prevent the development of visceral distress, dysfunction and disease. You will be able to tell that your Category I Complex has reactivated when the primary indicator of the Category I Complex (heel tension) returns. You will have heel tension (either right or left) which will remain constant throughout your lifetime when you are in an active Category I state. You can test yourself by sitting down and cocking your foot against a solid object (a modified calf stretch). If one side is tighter than the other, you have heel tension and need to call the office for an appointment.

Remaining vigilant with regard to developing heel tension allows you to take charge of your own health and become proactive, rather than waiting for a crisis.

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Cranial AdjustmentCranial adjusting is one of the most rewarding parts of chiropractic practice. It's pretty obvious why cranial work (even though performed very gently) is so powerful and dynamic. After all, 80 % of the nervous system is contained inside the cranial vault. All of the "higher" mental processes (consciousness) and the controls for the "lower" (movement, blood pressure, heart beat, balance, etc.) are protected by the cranial structures.

The cranial system is actually a complex of interactions among the neurons, the bony structures, the dural membranes, the vascular supply and the cerebrospinal circulation. In the brain, more than anywhere else in the body, structure determines function. This is largely due to the uniqueness of the brain's anatomical composition. The brain is a gelatinous mass whose shape conforms to its container. Therefore, distortions in the bones of the cranium actually change the spatial inter-relationships of neurons which need to integrate and communicate with each other. Furthermore, the membranes are attached to the bones and contain both the blood supply and the cerebrospinal fluid (CSF). Distortion in the bones makes the membranes twist and alters the fluid flow within them. Have you ever twisted a garden hose? The effect is similar, although not always as extreme.

Changes in blood supply can lead to lack of nutrients and oxygen, while disturbances in CSF alter the brain's ability to intercommunicate. Studies have shown that in the CSF is a wealth of hormones and neurotransmitters which create the brain's internal environment.

A wide variety of medical conditions respond well to cranial manipulation: essential hypertension, strabismus and cerebral palsy (these two are only alterable in small infants), attention deficit disorder, dyslexia, strokes, depression, autism, and a variety of mental handicaps. However, all of us can benefit from increased mental clarity and acuity. Eliminating cranial distortions allows each individual's brain to function at its optimum.

Too many children's sense of self-worth is damaged by being labeled and/or medicated in order to fit in to the school system. Cranial adjusting is of special benefit to such children.

If you would like more information concerning cranial work in infants and children,
[see Cranial Care for Infants and Children] or call and arrange for consultation and examination with the doctor. There are those of you reading this article who will wonder if you are a candidate for cranial therapy. I strongly urge those of you wondering, to call and make an appointment today. It may make an important difference in the quality of your life.

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Cranial Care for Infants and Children


Category I Cranial Complex

A Category I Cranial Complex is the distortion pattern in the cranial vault which develops as a result of the Category I (see Category I Complex above) meningeal twist.

The distinguishing features of the Category I Cranial Complex are specific rotations and fixations of individual bones of the cranial vault (usually multiple).

There are four major bones which comprise the cranial vault: frontal, temporal, parietal, and occipital. The three that are commonly subluxated in the Category I Cranial Complex are the frontal, temporal and occipital bones. Each of these bones overlays a specific portion of the nervous system, and the symptoms that develop are a result of which part of the nervous system is affected. For example, the frontal bones overlay the prefrontal lobes (the centers for personality and emotion). Frontal subluxations commonly result in depression, anxiety, or other emotional states. The occipital lobe overlays the cerebellum, as well as the visual cortex. Visual disturbances and/or problems with coordination and body position are often seen in this condition. Likewise, the temporal bones contain the middle ear which regulates the body's equilibrium.

In addition, the brain stem is impacted by these disarrangements. Since the brain stem controls all autonomic functions (including heart rate, blood pressure, respiratory mechanism, etc.), there are a wide variety of health conditions that have a cranial component including asthma, SIDS, constipation, megacolon and pyloric stenosis. These conditions are most often seen in infants and small children who develop a Category I Cranial Complex during the birthing process. In adults, cardiac arrhythmias, vision disturbances (including loss of visual acuity) and disturbances of equilibrium are some of the more common symptom patterns associated with the Category I Cranial Complex.

Fortunately, in infants and small children this matter is easily corrected. Instituting normal cranial rhythm in infants corrects a multitude of ills and improves their future health.

In adults where the pattern has persisted for a long time, the correction takes much longer. The bones need to remodel to the new, correct anatomical relationships. However, the pattern does improve over time. It simply requires an extended course of treatment.

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Category II Cranial Complex

As the Category II Complex (see Category II Complex above) continues to decompensate, some people will develop a Category II Cranial Complex. This is a further attempt by the body to stabilize the nervous system with relation to gravity.

Within the cranial vault are paired bones which are called the temporal bones. Another description of these bones would be "the cranial pelvis." The temporal bones are the flying buttresses of the cranial support system. If you observe the interior construction of the skull, you will notice that the petrous portion of the temporal bone abuts the sphenobasilar junction in the center of the skull, immediately behind the pituitary fossa. This area is the keystone of the skull and, when the body is no longer able to relate to gravity, the skull begins to collapse in on itself at this point. To halt this collapse, the temporal bones buckle. In essence, the petrous portion of the bone jams up against the sphenobasilar junction and becomes immobilized. This supports the skull but has other "serious" consequences for function.

Some of the consequences include: a) chronic ear infection; b) tinnitus; c) vertigo and loss of balance; d) bizarre pituitary dysfunctions; and e) headaches and cognitive dysfunction.

As part of the stabilization process, both the pelvis and the cranial bones are adjusted on each visit. Bone is living tissue and is in a constant state of change. As the correction is repeated, the bones remodel and assume their proper shape, maintaining the correction. Once stabilized, only trauma can distort the Category II mechanism.

In young children, the Category II Cranial Complex can exist independently, as a result of birthing trauma. Although the consequences are the same, the correction is made by addressing the cranium only - without the need to address the pelvis.

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Category III Cranial Complex

The Category III Cranial Complex is a dysfunction in the craniosacral respiratory mechanism. The long-term implications of this lesion include essential hypertension, as well as disc herniation.

A brief discussion of the anatomy and physiology of the craniosacral mechanism is essential to understanding the Category III Cranial Complex. The central nervous system (brain and spinal cord) exists within a fluid-filled sac known as the meningeal system (or the dura). That dural sac is filled with cerebrospinal fluid which circulates through the body at a rate of eight to twelve times per minute under conditions of normal health.

The pumping mechanism is maintained by rhythmic expansion and contraction of the cranial vault and the sacral well. Cerebrospinal fluid (CSF) is excreted by the choroid plexus which is found inside the ventricles of the brain. The choroid plexus is an extension of the vascular tree. As this fluid is produced, the cranium expands to accommodate the increased fluid pressure. At the limiting point, the stretch receptors in the sagittal suture of the skull (between the two parietal bones) are activated. The activation of the stretch receptors turns off production of cerebrospinal fluid and the body begins to reabsorb the excess fluid via arachnoid villi which drain the CSF back into the sagittal sinus (cerebral veins). As reabsorption occurs, the cranium decreases in diameter as the cranial vault settles back together. Pressure receptors within the sagittal sutures are activated and the choroid plexus turns back on and the cycle begins again.

This system is essential to the integrity of the central nervous system. The cerebrospinal fluid bathes the neurons with both nutrients and neurotransmitter chemicals which facilitate inter-neuronic communication. This intrinsic rhythm is so important that, when the mechanism becomes jammed, the body immediately compensates by establishing an ectopic rhythm using the body's musculoskeletal system. In most instances, the psoas muscle in front of the spine begins rhythmic contractions to artificially pump the cerebrospinal fluid. In a small number of instances (perhaps five percent or so), the anterior cervical muscles come into play to accomplish this same purpose. This compensatory muscle activity has long-term effects on the body:
A. Due to overuse, the muscles fatigue easily and muscle spasm and pain either in the neck or low back, are common.
B. At the level of the spine where the muscle contraction occurs, the disc degenerates and disc herniation is the eventual result.
C. Due to the relatively inefficient nature of the compensation, the blood pressure rises in an effort to maintain adequate circulation and oxygenation of the brain tissue. The body's first priority is adequate intracranial blood pressure to maintain the life of the brain cells. For example, in a giraffe's peripheral circulation the systolic blood pressure runs around 450 mm Hg. However, the intracranial blood pressure in a giraffe is exactly the same as ours.
D. In infants and children, this particular lesion results in strabismus (crossed eyes).

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Case Profiles

Head Injury Profile
I was referred to Dr. Richards by a friend who said she had gotten help from an incredible doctor where no other had helped her before. I had lost hope that anyone could help me and was desperate. I had a terrible accident in 1998. I fell onto my head on a cement landing from 10 feet up and then over the edge onto a tree stump on my forehead. I had an HMO at the time and saw a chiropractor, neurologist, an orthopedic surgeon and my primary care doctor and they all kept pushing me to another doctor. I spent 3 months vomiting and have severe vertigo (where the world spins like you are horribly drunk).

On my first visit to Dr. Richards, she did a thorough evaluation of me physically and determined almost immediately that I had no blood flow to my left brain and was still in severe shock. She did her magic with some adjustments to my neck and cranium and I felt the warm sensation of blood flowing to my brain and the left side of my head and face. My left eye had not been able to center since the accident and it now was able to focus and look straight ahead! I cried in relief as the dizziness left. I was then given an NVD treatment to stabilize me and deal with the shock. I spent the next 2 years getting treatments to stabilize the rest of my spine and pelvis due to injuries from the fall. It is now 2004 and I am now able to function in an almost normal way. I have a condition that football players get from being hit in the head too many times called Post Concussive Syndrome. It makes it difficult to live a "normal" life and my physical and mental activities are very limited compared to my life before the accident.

I believe that Dr. Richards saved my life. With her help and continued treatment I can get relief where no other doctor could or would help me. The migraine headaches and visual disturbances are kept at a minimum because she can take the pressure off my head with her cranial treatments, and the rest of my spine and body stay health and well-adjusted thanks to her. I owe her my life. CSW

CSW is an amazing person. She accomplishes an amazing amount in life and never lets her losses stop her. I'll never forget the first time I saw her, weaving down my hallway, leaning over her walker, barely able to walk. Seeing her now, you would have a hard time believing it's the same person. One day, when Dr. Cockburn (the thermography expert) was in our office, we took a pre- and post-adjustment thermographic picture of CSW, which clearly shows restoration of blood flow to the head and brain. The red and yellow colors indicate blood flow; blue indicates lack of blood and cold tissues. --Dr Richards

Case Profile (Pediatrics)
We brought our 3-1/2 year old daughter to Dr. Richards in June 1993. She had numerous problems interfering with her development. Her walk was very awkward; she could not run; and she did no jumping or climbing. For the most part, she was physically inactive. She had a cleft in her soft palate which contributed to her very limited speech. Most everything she tried to say sounded like "ma ma." She wore glasses for the correction of farsightedness and had difficulty keeping her eyes from turning in (strabismus). We had been told that the only correction for this was surgery. The most frustrating thing for us was the fact that she was unresponsive much of the time, showing little or no emotion. Most often, she was irritable and minimally cooperative. This made speech therapy less than successful.

Our daughter recently turned 5. Looking at her today, it's hard to believe she's the same child. She now runs, hops, jumps and climbs, In fact, after her first visit to Dr. Richards, she tried jumping for the first time. It seems that now she rarely slows down to a walk. She still wears glasses, but her left lens has been changed to a weaker prescription. As long as she has her regular adjustments, her eyes remain straight. Surgery for strabismus is no longer being discussed. The most significant change has been in her personality. She giggles, laughs and smiles much of the time. She has been making good progress in speech therapy. She talks about everything. Although she is still shy, she responds to people in a positive way. Most importantly, she now enjoys life. --L and TA

This is one of those instances where nervous system coordination was being seriously impaired by what appeared to be a "simple defect. " The cleft palate resulted in torsion, misalignment and fixation in both the frontal and temporal bones. Since the vestibular system exists within the temporal bone, balance is affected. The emotional centers of the brain are immediately behind the frontal bone and frontal bone fixations have been documented to produce emotional distress - including depression, changeability, irritability, lack of concentration, etc. The best part of treating one of my "favorite patients," though, is the big smile and the hugs! --Dr. Richards

Case Profile (Pediatrics, Cranial, Nutrition)
"In December of 1990, my husband and I visited Pitesch, Romania. Our visit was inspired by a segment on the TV show "20/20", which reported on the treatment and care of infants and children in Romania. When we first saw A. and L., they were two weeks old and less than four pounds each. They were born two months premature and had suffered a trauma birth. (A and L are fraternal twins.)

"After a considerable amount of red tape, A. and L. were adopted at the age of four months by my family. From the time they were born until the day we were able to take them home, A. and L. were wrapped tightly in swaddling clothes that allowed little or no body movement. A. had a severe heart murmur and L. had severe colic and strabismus in one of her eyes. A.'s heart condition eventually became more normal but he seemed unusually quiet. He had no head movement and at first we thought he might be deaf or blind. We eventually brought him to a chiropractic doctor. After just one treatment, A. was able to move his head. My husband and I were referred to a chiropractor in San Fernando Valley. The doctor was treating A. and L and they were responding very well to the treatments. L's strabismus was clearing and A. was able to move more. But the commute to San Fernando Valley was just too great. Then we were referred to the Richards Family Health Center.

"Dr. Richards has been treating A. and L for over three months and both are steadily improving. In addition to their treatments, Dr. Richards has addressed their nutritional needs. Both A. and L have benefited from the supplements and Bach Flowers we've obtained at the Richards Family Health Center. As a result, L.'s digestive system has now normalized. A.'s mobility and alertness has increased. I've noticed that when A. or L. miss their treatment, A. becomes HYPO-active while L. becomes HYPER-active. I'm confident that with their treatments and lots of TLC, both A. and L. will continue to improve. --RS

It is wonderfully rewarding to watch the twins blossom as we continue working with them. L. is steadily catching up to her age level. A.'s deficit is more marked, but it warms my heart to see him hold his head up and look all around. --Dr. Richards

Case Profile (Allergies, Cranial)
"I had heard about Dr. Richards from a friend of mine. My son, C., had a very aggressive relationship with his brother and his father. The fighting was more than just your typical quarreling. After discussing our options, my husband and I decided to take C. to Dr. Richards while my husband and I went to a family therapist.

"After about three weeks, my husband and I had noticed a change. C. was fighting a lot less with his brother, his relationship with his dad was improving and he was more mellow. And that was AFTER we stopped going to the family therapist. Dr. Richards and the entire staff were very good with C. and now I hope to take my other son for treatment too." --TC

This is simply another example of a situation where cranial distortions and food allergies result in difficult behavior. Children are very direct and they don't have a lot of ways to express their pain. Helping them become pain-free is quite a privilege. --Dr. Richards