Till Luchau here. We're going to talk about the cranial core sequence in our Headaches and Migraines Advanced Myofascial Techniques course. We're going through the second one of the sequences in that course, in the manual, by the way, they maybe noticed the techniques are labeled with a letter D. There's a story behind that, but it's actually the cranial core sequence.
But just a couple reminders about zoom or online course, thriving and surviving. Avoid multitasking. In this, just do this chill and be and listen. And let the let the social media go, let the housework go, you can just do this. Do stay engaged, though. Keep wiggling, keep moving. Don't be just a brain. Soaking this up, actually find it in your body, we are going to remind you here and there but, and we're actually going to do a little work on ourselves today too. So if you don't have a glove handy, you may want to get one for later in the lecture. also working on yourself, you just do whatever sanitary procedures you want to do, it's fine to wash your hands, whatever.
But stay engaged in your body throughout the call as well. keep changing positions, standing up, moving, lying down, etc. and engage your mind so that you challenge what you're hearing, contextualize what you're hearing, compare what you're hearing, categorize what you're hearing and open, if you want to what you're hearing, find ways that it fits or doesn't with what you know, already, find ways that it might be completely different than any of those categories you have. But really, that's going to help you retain it and learn it and remember it.
And if you got questions you can if you're on the live call, just type them into the zoom chat. We have chat monitors standing by to help you in both English and Spanish, or save them for the question and answer period at the end of the call. And then if you're listening to the recorded course use the Facebook forum for those or there's actually a little comment section at the bottom of the course navigator screen now. You can leave comments right there on the page, questions and comments like wow, this is an awesome lecture, we definitely want those there. I'm kidding you. But seriously, if you have a question about the lecture that you're watching, it's gonna be useful for other people to see that question. So that's another place now to ask those as well.
A preview of our quiz, if you're doing this for credit, there's a little learning quiz at the end of your lesson, the sequence, what kind of techniques are the cranial core, sorry, what kind of headaches are the cranial core sequence techniques indicated for? This is the cranial core sequence. What kind of headaches is this good for? What therapeutic targets would typically be indicated for migraines as distinct from tension headache targets? Therapeutic targets means like the anatomy or the thing you're thinking about, or the media we call it? What is the target tissue or the target process the target that you're thinking about when you're working with migraines? That's different, say than when you're working with a tension headache, which was our featured headache last time. And technique D-04 the orbit points technique? What shift is the practitioner waiting for? You're waiting for something to change or shift or be different. What is it that you're waiting for in that technique? In the maxillary, and zygomatic, fascia technique, which is D-05, where is the practitioner's finger and it'll be multiple choice. You'll see the choices there when you get there, but pay attention. What are we doing in that technique? And that actually is one we're going to do on ourselves. So you'll have some tactile or haptic or kinesthetic learning as well, too. In the mastoid process cradle technique, D-08 what is the practitioner's vector of pressure? Which direction are we pressing or intending? When we're in that technique, that's, that's an important thing.
A couple little examples, maybe more than a couple a few examples of migraine art. This is Joyce Ryan, who very kindly gave permission to use this image featured in the Advanced Myofascial Techniques book and this picture is called Visual Disturbance which is one of the symptoms associated with migraine. I wanted to open with these just to get you in the mood as it were because so much of working with someone with a migraine or neurogenic headache is really understanding the state they're in and having some sort of empathy for what it's like from the inside out of migraine. Whether or not you're working in the moment with someone who's having a migraine or helping them recover from one they just had, or you're working with someone that gets them regularly and your intention is to help reduce their frequency or reduce their intensity to help prevent those. Because these techniques will do all those things, it's still useful to be able to understand what that state is like and actually work from that place of understanding as well.
If you're one of the somewhere between, it depends on where you are in the world, 70 to 98% of people who have never had a migraine, lucky you. But I'm going to help you to, through these pictures and also through some ideas and some concepts, to help you begin to understand what that's like, because again, that's the place you're going to be most effective to work from is an understanding of what it's like inside out. And I am a migraine sufferer. I began to have migraines after a bicycle accident in my teenage years when there was probably some brain injury. And you're saying that explains a lot about Til right there. But one of the things that came was the migraines started immediately and didn't diminish until I was in my first Rolfing series and my Rolfer actually it was my second Rolfing series, when the Rolfer at the time really did some detailed work in my mouth intraoral work, that I could palpably feel were connected to the headache experience, and shifted just from that point forward the frequency, it took a few years for them to diminish. But I learned from that and made up from that self care techniques that allowed me to work on my own migraines when they come up. And then I was able to help members of my family, because it does seem to run in family lines, or people I know and then later my clients who experience migraines.
And so I'll talk I'll share those with you. That's really the kind of basis of this just a little review here too about when you would suspect a migraine. So some of the key signs of migraine or neurogenic headache tends to be focused on one side of the head, while the tension or musculoskeletal headaches tend to be bilateral. The migraines, this is one of the key characteristics you could have, you could have nausea, light, sound sensitivity and or visual disturbance. Now you can have that with a tension headache. Usually it's much milder. And sometimes people get both at once. I think some of mine in the past were probably both tension and neurogenic at the same time. And we'll talk later about what the therapeutic goal is. But I just wanted to help you begin to refresh your memory on what the distinction is.
And this is just, this is a therapeutic working assumption you're making, they say up to half of people are actually misdiagnosed and either don't have migraines until they do or do have migraines until they're not. So it's a difficult thing to definitively say this is a migraine or neurogenic genetic, but because from a strategic point of view as a hands on therapist, we're going to give you the strategic narrative for working in that way. And then the test is: is there a shift? Does it does the work feel meaningful and satisfying and worthwhile to the client? And then does that actually change their symptoms or the experience of the symptoms along the way. So that nausea that comes for many people, not all but many people get nausea along with their headaches, is a is a key and a distinguishing feature of that. So that's a clue to shift gears in a way, shift the way you're thinking about working with it. You work somebody with nausea very differently thqn just a tension headache like you know, throbbing temples or something can be very different with nausea.
Visual disturbances, where there's a there's jagged lines, or flashing lights or blind spots that come in that's, that's a pretty clear indicator that you're dealing with neurogenic component at least to the headache, we'll talk next time about how some cervicogenic headaches also bring some visual disturbance with them too. But even then, it's probably because of the neurological factors involved there as well. So there's lots of amazing art around this. It's amazing and it's terrible. It's amazing. It's terrible because it's reflects probably not a beautiful experience. There's there's beautiful work being made out of this experience. But in I don't know, I've never had anybody say my migraine was beautiful. You know, it's terrible. It's just terrible even if there is bizarre and powerful imagery that comes. I want to go ahead and show you for a second. Someone's video and audio now, a reconstruction of what their migraine is like and it's actually pretty similar to mine when I used to have the stronger migraines. And so I want to just give you a little heads up. If you have a tendency toward migraines, you may want to turn down the volume of this, you may want to even not even look at this, for some people who are really sensitive or prodromal, even looking at some of those pieces of art can be evocative. So really do track your own exposure to this. If you're someone that suffers from migraines, or you think you might be prodromal, you may want to skip this part and see you in a few minutes. But otherwise, yes, sit back, relax. And enjoy.
We're almost done. Okay. That's enough of that. I'd say yeah, that's enough of that. So just take a second to, there's more by the way, and for you know, if you have a migraine, it accelerates from there. It's accompanied in almost all cases, by in most cases, by pain sometimes extremely severe. So if you could just take a second and attend to the impact in your own body and your own head, perhaps, that watching and listening to that had. And if you could just you know tune into that and feel that and then as you feel that and if you're inspired if you could share with us by just writing in the chat. If you were a client if you were a client going to a body worker and you had that experience you had that kind of headache going on with the whining sound if your audio picked that up the throbbing pulsing sound, your headache, the visual disturbances, and garbled noise if you were that client, what kind of touch, approach or work would you like from your hands on practitioner? How would you like them to work with you just chat in some words, just type in some words as you get a sense of that, and chat monitors Feel free to read out those as they come in. And as you're doing that, whether or not you're chatting in your words just keep breathing and feeling and letting your body return to its homeostatic state after that experience.
Ringing was intense, it affected my breathing, made my right eye ache, the light, would want someone to work slowly.
yes, so slowly Yep. Right chat in, there's there's lots of them coming, just give us some more. How would you want your practitioner to be with you? How would you want their touch their approach?
With much presence grace, compassion as possible. Light yet solid connection. Slow loving, attentive, compassionate touch.
Yeah, for my own experience both with my, my own clients and myself. Sometimes it's pressure that feels really good. Sometimes it's the lightest possible touch anymore that are noteworthy?
They're all noteworthy, good to focus. would want cold hands, gentle pressure, dark room, focusing on breath, slow, gentle, no music.
Absolutely. Right. Okay, so there's, you know, there's a few features I mentioned there, the visual disturbance, etc. The sound of the blood in the ear, the pulsing can hear your heartbeat sometimes, that's really interesting. And that led to some of the theories that we have about migraine. But just I'll get to that in a moment.
Just first, a couple more examples of migraine art. This is Cruickshank from the last century or more than a century ago. Talking about that, say the visual disturbance. Someone's singing off key in his other ear as well as the sharp stabbing, burning pain. Here's a hot poker. All of those are key aspects. That stabbing quality probably inspired this gentleman to attempt self treatment for his migraine. He's a Sudanese man who this went around on the internet a few years ago, who actually drove a nail into his own head to try to relieve his migraine pain. And some of us see that and go, yeah, I get that. Yeah, I can see that. Because it's that intense. And if I could just get in there to that place that hurts so bad, I would do just about anything. The good news is that he, we, from what we know he survived, and there's a lot you can do for migraine, especially if you're lucky enough to get a client in your office with a migraine or you can be with somebody in there and experienced there's things you can do. Most of the time, I won't say I've had 100%. I wouldn't say that. But I've had a much, you know, vast majority of time been able to relieve or sometimes eliminate the headache pain.
So it looks like faculty, you're you could check your mute, someone's unmuted there. But let's look at this page in your handout D-01, the cranial core sequence. Let's look at the goals. Now for this collection of tools. No, really, I almost thought about not calling this a sequence, because it is a collection of tools. And you might just do one with somebody with a migraine, you might just need a couple of them. But I put them all together into a toolbox and sequence them as if it was going to be a protocol you follow, you could do that too. I wouldn't try to do them all with someone with an active migraine, I would very carefully follow the client's cues and pick one or two. But let's go ahead. But if the if the goal was prevention, say, or recovery from a recent one, then yeah, I might use all some, you know most of these.
But our goals are really to assess and normalize any sensitivity, or mobility restrictions. So we want to find out, you know where they are and what they're like. That's the assessment part, we want to bring them back to normal that is diminish their intensity and unpleasantness of places that are sensitive, as well as immobile. So it's very similar to our tension headache protocol, except we have a slightly different method and a slightly different therapeutic target. In this case, we're thinking about the inside the head of intercranial, neural and fascial structures as well as the joints of the head itself. So it's the neurofacial structures, the fact that nerves have a fascial component, and they're embedded in fascia as well as the sutures, the deep and some of the deepest synarthroses of the head, the deepest joints in the head, we're thinking about those as well. The word may be the last session in the sequence. Traditionally, it was I'm actually going to add another sequence in two weeks on cervicogenic headaches. But if this was the final session, you could say in a series I would be thinking about ways to bring it back to integration and completion. In our in person workshop. This is the stage we do that in.
The indications for this work are headaches, especially neurogenic, which includes migraine and cluster headaches amongst their main types, or sinus headaches. sinus headaches can really respond to these techniques. So can tension headaches, of course, so can tension headaches, but these are the ones in particular that I would use for the migraines as well as facial or dental trauma or facial pain, like trigeminal neuralgia or Bell's Palsy isn't usually painful, but it can be something that you find ways to, you know, help people with in this way it's it can be also really stubborn. It's a it's a paralysis or a numbness of part of the face, also in probably involving the trigeminal nerve. So these are some techniques you might play with with those people but it's it can be tricky. And dental trauma, or ongoing TMJ or jaw pain this can be these can be helpful techniques as well.
Migraine incidence varies, migraines are mysterious, we're still learning quite a bit about this, but one of the mysteries is why they vary so much around the world. Why that's something about 11 or 12% of people in the US get a migraine at some point in their life. But in Hong Kong, only one and a half percent of people are, according to the different studies, get a migraine, while in Peru is full, almost a third of people get a migraine at some point in their life. Now some of this might be different methods of defining migraine or linguistic differences even but this is, there was an attempt in this study to actually try to correct for those to try to measure the incidence of the same thing throughout the world. And there does seem to be a whole lot more migraines in Peru than anywhere else and a whole lot less amongst East Asians than any other population. Peru has been studied quite a bit to see what migraines are about. And its altitude has been ruled out, altitude does cause headaches, and there's an interesting placebo clinic from Fabricio Benedetti in Italy, at high elevation in the Alps where he's studying, yet people go there often get a headache. So he does a lot of research around placebo, and our contextual ideas for headaches because of that. But it turns out that in Peru that it's when you correct for elevation, it's not the factor why so many people there get headaches.
The best guess we have is genetics, that it seems to run along genetic or racial lines as well. With Asians, East Asians, like people of Chinese heritage living anywhere in the world tend to have very few migraine headaches. Same with people from Africa, people of African heritage living in anywhere in the world have a very low incidence of migraines. While people of European, Northern European descent have a higher incidence, and maybe people of indigenous American origin had even more, perhaps, does seem to be these kind of tendencies.
Where the throbbing or the pulsing I mentioned, was probably part of why since the 1700s, the theory really was that migraines were a result of vasodilation of the blood vessels of the head, expanding and essentially getting so much blood into the cranial vault, that the pressure in there was what caused the headache, the pressure or later as we got more sophisticated to understand, with the advent of brain surgery, that brains are not sensate, the brain tissue itself doesn't have sensation, you don't need to have your brain anesthetized in brain surgery, just the scalp and the bone around it. That's one reason why people are often awake in brain surgeries because the brain itself doesn't feel pain, the meninges of the brain do and the blood vessels vessels, the vasculature, the brain do have stretch receptors and they can feel pain. So the thought was that maybe the blood vessels of the brain are stretching out we can hear the pulse in people with a migraine and there is you know there is some measurable vasodilation in migraines in some people it turns out, but the this is an actual scan.
This one here is actual scan of somebody having a migraine and having some vasodilation in their occipital lobe. But it turns out that the vasodilation only happens for some people, not all migraines. And when it does happen for people, it's later in the migraine cycle. It's not the first thing that comes for most people when it can be measured. Now we can do use brain scanning and actually watch the vasodilation happen. What happens earlier is this synaptic activity This is a depiction of a synapse. The nerves kind of light up in a bizarre way they start what's known as the cortical spreading depression where there's an abnormal kind of flickering or pulsing of their activity that starts in the back in the occipital lobes and moves forward in the brain over time. So here's the time counter showing where this red zone of abnormal synaptic activity starts to move forward in the brain and can be tracked on scanners as well. Now the fact that it starts in the occipital lobe might explain why many people not all but many people will get visual disturbances with the migraine. Some people get visual disturbances without any other symptom without pain, I still occasionally will get those if I'm sleep deprived or another another a couple of the triggers that I'll sometimes will get a little bit of visual disturbance rarely, knock on a big piece of wood, do they progress to pain for me anymore after the tools and management strategies I have, but they're a common signal for a lot of people, not everybody, that a migraine is on its way. And here's some people's art work around those kind of visual disturbances people have.
So that occipital lobe neurological activity can also cause the kind of yawning through brainstem signaling or urination. Again, as the brainstem gets involved neck pain or fatigue, some people will have neck pain as the first signal and that's crossover with the neurogenic idea. Mood changes, light sensitivity, sound sensitivity come in later. Many people have nausea and vomiting. This is a timeline we're going over, and the visual symptoms etc seem to happen pretty early, while the headache often comes later and touch sensitivity comes later. And that can go on from anywhere at this point for four hours to or to 72 hours or three days of this for some people. And there are people who it happens continuously as soon as you start recovering from one, another one starts in. So this can be a rolling migraine as it were, but this represents what's happening at the brain in each of these stages, how there's brain activity in some people way down in the brainstem first and then grows and spreads through the brain. So different brain centers become involved in the symptoms evolve as well.
The pain that comes in, the headache pain, which as you can see, is actually fairly far down the line in this chart, is probably related to the trigeminal cervical nucleus and activity within the trigeminal nerve. This is a depiction of the trigeminal nerve. I'm saying probably, because the symptoms often map well to the trigeminal nerve. This is the zones that the branches of the trigeminal nerve innervates and that working with the trigeminal nerve seems to help people with migraines. But honestly, it's still a big mystery. We honestly don't know a lot about why migraines come or why, you know, some people's migraines, or some people's trigeminals you can say get active and other people's don't.
Here's some other amazing imagery that shows you just how pervasive this trigeminal nerve and its branches are how it we're going to focus now on the ones here, these little branches, here's the ones that seem most relevant to headaches. But also these branch here though, the most inferior branch, the trigeminal is inside your jaw. So like up inside the jaw here, it's a little more difficult to work, we actually do work this zone in our TMJ class. And I'm going to save it for that because it takes a bit more prep and a bit more rapport a bit more easing into it for the client and a very clear communication. But if you have a migraine, yourself, I would certainly recommend applying what we're about to practice today on yourself inside the jaw as well.
So yeah, the trigeminal nerve is a nerve that innervates the whole front of the head, it arises deep below the brain, though that ear technique we did in the last sequence was intending to actually get in there to the roots of the trigeminal nerve and open it up. But its branches spread out over the whole front of the head. And then if that's not complicated enough, the trigeminal nerve system here is in blue. By the way, if there was one picture, in this slideshow with a lot of pictures today that I really want to emphasize or even, you know, commit to memory, it might be this one, because this one really just clearly shows the different nerves involved and their mappings, which gives the promise of knowing how and where to work. And it relates the complexity of the fact that their neurons intermingle and inter communicate within the trigeminal cervical nucleus, which is a little nerve lump down in your brainstem, very low down in the brainstem, you cannot touch it sorry. But there is a lot of inter communication amongst these branches.
This is involved in all headaches of any kind, the trigeminal cervical nucleus seems to have activity going on in every kind of headache. And the fact that the nerves and termin intermingle there explains perhaps why you'll have some referred pain that might start in the back of the head and then move to the eye or seem to be like a tooth pain that ends up giving a whole head headache. This is thought to be like the the clearing house or the crossroads of these different headache phenomena where they talk to each other here as well.
Now the vagus nerve is also part of that nucleus. And that's thought to be we accessed that last time through the ear, that really was us warming up now for the migraine story, because that can be a very powerful way to help diminish that neurological activity that seems to be going on in the brain and is being reflected out into the peripheral nerves or into these cranial nerves, where we can use the vagus to essentially calm the system and calm that the body activity. The vagus is the brain's main communication center with the heart. So the heartbeat does escalate with the viscera. Yeah, as well as with a whole lot of other great stuff, including your pancreas, and your spleen and some different things that help you with immunoregulation and inflammatory reactivity, your gut, which is also involved in that. So that vagus nerve becomes such a key connection between the viscera and the head.
Our strategy, we could say our strategy for each of these approaches last time it was to reduce myofascial tension, or we could say increase myofascial glide. That was one of our key goals last time. This time, it's reducing cranial compression. So actually thinking about taking the pressure off of the head, somehow finding a way to help someone feel less like this, or less like this. This is a common motif you could say in migraine artists, the clamp the migraine clamp there. And this comes not only did I find validation in the art being done by people about their migraines, this comes from my own experience of having a migraine say what's going on what would help, being a body worker myself, again, what could I do to help my own migraine and really the image and the experience and mapping it out to this kind of thing, where there was a kind of opening, or expansion, or coming apart almost of the head. And so that is the you could say, the structural, or anatomical goal I have. There's a parallel neurological or experiential goal, which is to help calm the whole system, calm someone's experience, as well. And comfort, provide some sense of comfort too, in what's often a terrible experience.
So we, I'll do a few more slides before we take our first little movement break. But this one, let's look at the first technique in that sequence, the parietal lift technique, it's really beginning with these bones up on top of the head, the parietal bones are these bones here, at the side of, I can show you a picture. Yep, that's them. And they, they have a shape to them. And you can actually get a hold of them. And you just simply lift them off of the head, lift them off of your clients head, you could use some of Wojtek really clever ways of resting your elbows on the table. And leaning into those to get some of that same effect on yourself right now, you might try that, if I did it, you wouldn't see me I'd be down below level of the camera. But if you rest your elbows on your desk, or table your floor, if you're laying down, and then get a hold of your own parietal bones, it's not sliding down in the temporal fascia like we did last time, it's actually feeling for the bony shapes. For these big corners on the bones here. Yeah, these big handles essentially, on the parietal bones that you can actually get ahold of with your hands if you're doing it yourself, with your fingers on a client, and essentially lift that parietal bone or lift both parietal bones up off of the head, it's a, it can be a very relieving sensation for any of us. Especially if you have this kind of headache going on where there's just a sense of being clamped, or viced, into that headache. So that process of opening up the parietals can be a great way to ease into that.
From there, the sequence goes into the orbit zygoma release technique. And here, it could be a very light touch, I think the picture there. That's probably it was probably my hands, I'm using a bit of pressure, I would say ease into it. And really, you're going to be communicating with your client. That's the key word and is answer to one of the quiz questions, there's a freebie for you, communication. Remember that word, because that's what's gonna be really key with your client to find the right direction, pressure and placement and they're gonna be able to guide you very carefully to the places where you can get a hold of, say, the zygomatic arch on one side and the orbit on the other and actually help someone feel that you're decompressing the orbit or decompressing the eyeball, that you're encouraging those bones to come away from each other. So the zygomatic arch to go inferiorly toward the feet, the upper part of the orbit a part of the frontal bone there to go upwards and to open up the space around the eye.
The eyes are often really involved in migraines, some people like I said, just get an ocular migraine where it's just an eye, it's just a visual symptom. Other people will feel it in their eyes, other people feel it behind their eyes. The eyes have a very strong restraining system, they're held into your head fortunately, by pretty strong stuff, like myofascial units, otherwise known as muscles. And this thick ocular nerve, which is not only is it interesting, because it actually does some processing of information. It's not just a wire, it's actually transmitting and synthesizing information in itself. But it's also got a lot of collagen in it and it acts like a little guy wire or a little restraining cable on the eyeball itself just so they don't pop out. But that might explain why moving the eye can be really relieving or provoking for someone's migraine, that somehow just looking left and right might be actually you know, stimulating sensation in all the myofascia around the ocular control structures or it might actually be pretty mechanical. This is what I imagined on myself, a pulling on my brain by looking really hard in one direction. And that looking really hard just pulls that optic nerve right out of the opposite hemisphere, it can be amazingly relieving. It can be like scratching an itch that there's no way to get to. To get down in there, I'm not going to do with a nail like the Sudanese guy did, I hope, stop me if you ever hear me talk about that. But I am going to use my eyes to look really hard one way, because I can do the same thing I can feel like I get done inside my own head that way. And that's what I'll do with my clients too. If they're on the table, I'll actually have them looking left and right to find the directions that relieve or in the case of a migraine, I don't want to provoke it's usually if someone's in that much pain, but I'll have them play with the edge of it, or tickle the edge of it or just get it present. So we know we're talking to it. That's the gold standard as it were, it's like something that relates to the pain. That's what we're looking for.
So that picture last picture and this one are both cross sections, there's another one, I wanted to point out the the space between the eyes and behind the eyes, all the sinus space, so sinus headaches, either due to infection or pressure there, or even just sensitization of this zone from continuous allergic irritation or something can also respond to these kind of techniques that work very gently with the orbit and the zygoma, say, or the next one we're working with, orbit points. This is someone's picture depiction of their cluster headache, cluster headaches too also tend to cluster in time, but they're often clustered around the eye, one of the eyes. And these techniques can be so helpful for that.
The orbit point technique here on D-04, D-04 there, what I'm feeling for is sensitivity, a pressure on the rim itself feeling for sensation, relevant headache sensation, the notes say, I gently hold those places, and then I wait for a shift in sensitivity. I'm not trying to relax the bone, or relax the muscles per se. I'm waiting for the sensitivity to change for the sensitivity to shift. And often it will. And this is maybe when people ask is this you're doing a trigger point there. Maybe I am. I'm looking for often for tender points. But trigger points are interpreted in so many different ways, I'm reluctant to say this is a trigger point technique, as much as it's finding sensitivity on the actual bony rim of the orbit and waiting for that sensitivity to diminish through some gentle touch there, and especially I mean, someone has migraines can then direct you, because sometimes like I said for myself and other people too firm pressure is really helpful, sometimes not. So you find the right level for your client. But there's lots of nerves and wires and wires and tubes and everything all around the eye of course. And underneath the arch.
This is a cluster headache depiction. Yeah. And this is a sonogram map of the sinuses as well as the hemispheres of the brain. This is actual image medical image that's been colored a bit. But this is a person showing their structures of their eyeballs and their sinus cavities as well as their brain and the layers around all that. Which is what we're working there.
Chris, I know you were having some internet issues, Chris, give me some auditory feedback if you are okay, leading some movement today.
Til, you're gonna need to co-host Chris so he can unmute himself personally,
That's probably a good practice any case.
Thank you got it. Can you all hear me just fine.
Yeah, there we go.
All right. Yeah, let's take a little movement break. And let's all come to standing for this one. So come out of your chairs out of your stools your benches, find your feet.
Give us a second, Chris, just to highlight you and we're still looking for you. Here we go. Okay, you are spotlighted.
Alright, so we got everyone standing. Take a moment, take a moment to feel your feet resting on the floor. And you might do a little experiment of finding your heels for example, if you were to rest into your heels for a moment, feel how the back of your body can kind of fall back into your heels to really ground the back of your body. And even imagine the back of your head could be resting over the backs of your heels. And then play with the opposite. Let yourself rest into the front of your feet. You might scrunch your toes as you fall forward slightly. Imagine letting the front of your face rest out over the front of your feet. So your nose, your jaw, your eyes can hang out over the front of your feet. And just feel what it's like to have that part of your face suspended by the front of your feet. And then then begin to shift from left to right. So find the outside edge of your right foot. For example, let your right ear and the right side of your jaw hanging out over the lateral side of your right foot. And then feel what it's like to transition into the lateral arch of your left foot. And notice that your left ear and the left side of your face, your jaw could could rest, your arm can hang out over the left lateral arch of your foot, and then allow yourself to drift back into center so that you've got the whole perimeter of your foot sort of present in your mind and you're kind of hovering in the middle somewhere.
And we'll use a we use a ball as the analogy of the head. So here's a floating ball, you can kind of picture this. And imagine now your head is floating in that space. Inside the perimeter of your feet, your big toe, your small toe, lateral arches, heels, you're in the middle, you're floating. So just imagine this first floating on the surface of the water just for a moment, and allow your head to float somewhere in the middle. And you might imagine the head is tethered, connected to your feet via some sort of a line. And that could be your spine, of course and your hips. And that gets to float or we migrate oscillate between the connection of the ground and your floating head.
And wonderful, let's now define our head let's take our hands and feel where your jaw is. So just wrap your hand around your jawbone and allow your jaw to rest in your hand for a moment. So soft jaw, slack jaw, you can move, let your head fall to the left slightly, let your jaw hang, move it around, fall to the right, let your jaw fall to the right hanging. And then let the jaw swing back to center. And then take your fingers and find the the outside of your eyes, it might just be like the orbit points that Til was referring to, so feel the shape of the eye socket. with your fingers, you can trace it. And just using a little bit of pressure like little indentations, you're tracing the sphere around your eyes. And that'll give you a little sensation and awareness of that part of your face. Then if you hold the skin above and below the eyes and just gently open your eyes wide with your fingers and look around and try looking up, looking to your right, looking down and looking left. And then take your fingers away and just see if that gives you a greater sense of spaciousness in the front of your face. Just notice that. You got your floating head.
And then take your ears. Hold on to your ears with your thumb and first finger. So you've got your ears. And then I'm going to have you keep the ears where they are. But bring your face forward, let your face open up out in front, you might make a big face, open your eyes wide, and leave your ears behind. So your your face is moving forward as you leave your ears behind is a gentle ear stretch. Make a big smile.
And then now let's go to the back of the head. So let the back of the head get curious about what's behind you. Like it's filling up like a big balloon and let the back of your head begin to reach while your ears stay where they are. And smile with the back of your head. Open up the eyes in the back of your head and see how would you do that? How would you open up your eyes and make a big face in the back of your head? What happens if you let your weight rest into your heels slightly to give you a little more space back there. Wonderful. And then let your head come back to center.
And then now just soften your knees so you drop but leave your ears behind. So you get to do a little dropping, your head gets to hang between your ears. your jaw gets to hang between your ears. And then now if you press the earth down with your legs and press your head up, reach to the top of your head leaving your ears where they are, different stretch. Imagine the top your head can become curious about the sky. They can scan the sky. You might do a little nodding to really scan the whole sky in all directions. Kind of like you're the top of a cone of some sort exploring the sky. And then let your head rest back to neutral and release your ears and come back to the feeling of being a floating ball resting over your feet, suspended.
And from here take a moment to close your eyes or soften your eyes whatever is more comfortable for you. But close eyes or soft eyes feel your floating head and I'm going to have you imagine that you're hearing a very specific small sound off to your right somewhere. It could be the sound of a mouse scratching the wall behind the wall, but it's very specific. And with your eyes closed, your eyes soft, I want you to begin to tune in to the sound the very specific sound off to your right and just notice how you do that. How does your body become really aware of something off to your right with your ears? And imagine you could get a little closer to it like you want to really examine the sound with your right ear and feel how you get there? Does your body fall to the right? Do you shift to the right. Just notice how do you listen to something great specifically, notice what your neck feels like. It's a very small, specific local sound. Feel your, jaw feel your breathing. How do you focus on something off to your right that's very specific?
And then come back to center take a moment to rest. And now imagine the sound is something much bigger like the sound of the ocean, something really large and expansive. It's like filling up the entire right side of your of your senses, and start to tune into a big sound like the ocean or the sound of the wind around you. But it's all happening off to the right. And notice the experience of your face your sense of jaw tension, your breathing. How does your body in its entirety adapt to the sound of something much bigger off to the right? And just notice that. How do you listen to something to the right, that's big, like the ocean. And then come back to center and find your floating head, pause for a moment. And with your eyes closed, feel your head floating.
And then now I'm going to have you imagine you're something like a human periscope. Submarines have a periscope that pops up to to look at the horizon. Animals will come out of their holes in the ground to look around and make sure that they're not about to be lunch or breakfast or dinner. So open your eyes and here's a periscope. And a periscope will scan the horizon. So take a moment to be a periscope or an animal popping out of its hole. And notice what does your body do to create that feeling of being that structure or that animal becoming present with your surroundings? And then let the periscope take in the surroundings. So you could use your eyes you could look left and right. Your head might turn.
But notice where you turn from? How does your head scan the horizon? Where is your movement coming from? Is it just the eyes? Is the neck involved? On your own body as you scan left and right and you're looking around at your surroundings, point your finger on your body where your movement initiates from. Where do you start the turning movement? Where are you doing all your turning from? Just notice where that is. And for me, I'm kind of turning. I'm in a chair right now. So I'm turning from the base of my neck, I can really feel that's where it's all happening. So see what happens if you turn from your heart. So let your gaze come from the heart and express the self out of the eyes. And then let your your periscope come from the hips so your hips now can be part of the movement looking around. You're moving around an imaginary center, but your hips are part of the movement. Let your knees be part of it come from your knees to look left and right. And then come from your foundation come from your ankles and your feet to scan the horizon. And notice that that gives you a bigger feeling of space of possibility. And then once you finish scanning the horizon, come back to your center and come back to rest find your floating head again. And now we're going to play with something a little different. Go ahead and close your eyes for a moment.
We should I should give you like a one minute warning there. Chris .
Thank you. And start by listening to something off to your left this time. And notice how you get there. And then open your eyes. I'll give you a shape. This is you listening to something off to your left. It's very specific, very focused and see how that feels in your body. And then start to get bigger in what you're listening to. So here's something bigger. What happens if you have a much larger space or dimension to listen to? Notice how your body adapts around something much bigger. How do your eyes feel, how does your jaw feel? How is your breathing as you listen to a larger sound, bigger sound. And then come back to center. Take a moment to rest again, finding your feet and finding your floating head. And lastly, find the back of your head, just touch it with your hand for a moment. And allow yourself to breathe up into the back of your head. Find space back there. Imagine the back of your head could take in everything behind you. And then just notice other ways you can find more space back there, try taking your pelvis, try tucking your tail slightly, and then untuck your tail, letting your tail lift up. And notice where you get the most sense of space and dimension and awareness in the back of your head. Where does your body need to be to find all that space? Wonderful.
And then come back into resting and floating head. And take a moment, allow your head to fall forward, resting for a moment. The back your neck could be open. And then from your feet, float your head back up again and finding your center. Thank you guys back to you, Til.
That was awesome. That was awesome. Let's just do that the rest of the class. But actually I have a few more things I want to share too. And for that you're going to want your glove or you're going to want to wash your hands or whatever while you're standing up still. But let's go ahead and look at that maxilla and zygomatic fascia technique. I'll go and get that up on the screen here.
Faculty, how's that look to you? Okay, thank you, right. So in this technique, you're gonna use a cleaner gloved hand to basically feel inside the upper lip. Go ahead and do that. Now, I gotta say that, that moment of touching yourself or guiding your client to do that, too, is a special moment, it really is beginning a kind of interesting relationship between your hand and your head, so do that consciously, you're really going to go ahead and just go inside the upper lip. And then if you go up to the upper pocket of that lip, you'll feel this sensitive there. That's there's a little branches of the trigeminal nerve up there at the upper pocket, outside the teeth, but inside the lip, and then you can follow that around and follow that around to the other side. If you're using your right hand, you'll follow it around to the left side of your face. So you're reaching across your own face.
Now your other hand can be essentially outside of that pressing or moving the fascia around that finger that's on the inside. So my finger's inside between the teeth and the cheek, the outside hand is moving the cheek and the tissue and the nerves in there against the inside finger. So you can work from both inside and outside. The inside finger doesn't need to be that active, usually its presence is plenty, the outside finger can gently encourage and what you're looking for on yourself are little zones of sensitivity, or especially ones that remind you of a headache, or that relieve the headache. And when you find them you just hang out there and breathe and relax and smile. That's the really important part. I'll let you do that in your own time. And I'll let you repeat that on the other side to seem good and reach across and use the other hand get the other side.
But this picture from Man Ray is just really showing us the way the face the mask of the face. We're behind the mask with this technique we really are feeling for the spaces. here inside the oral cavities. This is the mucosa the blue layer here as you explore the sensitivity along that upper up under the zygomatic arch. You're in this space of mucosa and all around your various ligamentous layers connecting the face the structure of the face to the bone underneath and you're between that there's lots of nerves in there including branches of the trigeminal nerve. There's lots of ligaments that connect both the skin to the fascia underneath and then that fascia to deeper layers of fascia. And then essentially, you're between all of those, in a way feeling for sensitivity. Here's another view of the mucosa of that mucous membrane now inside your mouth, and how you're able to follow that pocket around to get in between different structures, there are glands there. So be sensitive, of course, as well as nerves, you're not going to try to rub out every lump you find there of course.
Go ahead, and we'll actually, yeah, let's go ahead and shift now to the maxilla rocking technique. This one's tricky to do on yourself. In this technique, I'm actually I got my both fingers involved, you'll see me do it on the video even better than I'm doing here in the lecture, both fingers on the upper molars, yeah. And then I use a grip on the head to essentially twist the maxilla. to twist that front bone of the skull in different ways, I again, look for a direction that relieves the headache. This has been a really great one for both my own headaches. And in my practice, you can find a direction that seems to twist the head up in a direction using those upper teeth as a handle. Now, for working on yourself, I would suggest that you use your thumbs. And if you're sitting down or lying down your stomach on the floor, you can actually rest your elbows on your desk. And if you get your thumbs on your upper molars there, and your relax your hands on the outside of your face, you can actually use your thumbs to stabilize your maxila. And maybe you can then turn your head a little bit against that stable, maybe you can use your hands to turn the maxilla. But we're looking for that torque and direction and relationship of the upper teeth to the top of the head torquing those left and right, you can also go ahead and get one side there. And go ahead and feel for different passive torques through the head in both directions as you stabilize the upper teeth in one side.
Take your time with that. Because you know, once you find a direction that's interesting or relieving, you're going to hang out with it and breathe. And, you know, we're we're giving you the toolbox. But when you find the right tool, you want to really take the time to use it to full effect. And that basically means add more time to it. And the other side too, stabilizing your upper molars with your thumb. And a counter movement of the head against that is one way to recapitulate this technique on yourself or to guide your client through it as well. We're essentially twisting the maxilla this front bone in relationship to the rest of the head.
This is from the inside out. In our Neck, Jaw and Head workshop we show this picture of a Rowe disimpaction device where the maxilla often in a car accident or facial blow get fractured or broken and this tool is used to pull the maxilla forward back into its normal position. So this work you're doing here you can actually rest your hands on your face and use a kind of pulling motion or pushing to again, play with actually dis-impacting or decompressing your own skull through that gentle traction on the upper molars as well.
While you're there, while you're on your upper molars. Go ahead and shift one thumb over now to the roof of your mouth to the palate. This is one of the supplemental techniques that I've put it into the lecture handout at this point because it's a key technique toward this goal that we have now of decompressing the skull and helping desensitize the migraine sensitivity. But essentially, you're going to be on the hard palate now with one of your thumbs kind of like you're sucking your own thumb. Yeah, right up there, but you're gonna feel the shape the upper dome of your hard palate. And you'll find that if you it's made up of different bones, yeah, and there are glands and nerves that come to that. So again, it's not about scraping that palate or rubbing it smooth. Think about it, instead of being like the keystone in a intricate puzzle. It's the central piece around which everything is constructed within the skull. That's your palate, your palette is right in the middle of it all. And so here being able to actually press on it either with a finger with your client or your thumb works really well on yourself. That's where I am just up on the hard palate.
The pressure, maybe furthering our goal of articular mobility, but it's certainly also furthering our goal of neurofascial desensitization or normalizing the sensation of the nerves there because the palette is very richly innervated with the middle branch of the trigeminal nerve. So you're talking right there to the trigeminal nerve fibers itself when you press on the palate. And I think, honestly, when I do this technique, I'm not looking for nerve fibers, I know they're there. And this was a revelation to me, years after learning that this would help migraines, this pressure on the palate, to understand how much trigeminal innervation there is in the palette, and it was a revelation. But honestly, I think the sensation we're generating, by working that upper branch rather the middle branch of the trigeminal is probably affecting the brain more than it say, you know, working the neuro fascia of the of the nerve trunk itself, probably the sensation we're producing is having an effect on the brain and on the headache, because with most people who have visual disturbances, you can find a place that relieves the pain, if not totally make it go away at least shifts the pain. And the method there I'll talk about and demonstrate on the video. So I'm not going to try to explain the whole method there. You might have to skip around a little bit in the video to go find this technique. It's just one of the supplementals, but do go watch me in the demonstration there. It's a different focus than in the Neck, Jaw and Head workshop where we also work the palette, here, it really is looking for the places that relieve the headache and hanging out there. And it could be that I hang out for 20 minutes, we need to take a little break, you know and drink some water to rehydrate from having the mouth open so long.
But really, it's about hanging out on that palette. And to know where to hang out, I need my client's communication, I need their input, I need them to tell me which direction which way because they'll feel very precisely exactly where it's interesting and where you don't want because you'll also find places on the palate that could provoke some more nausea. Often, people's gag reflex gets heightened during a migraine often so you'll find sometimes even just the lips or tongue will cause a gag reflex. Or you can find zones on the palate that seem to trigger a kind of nausea feeling a gag reflex. So it's not about pushing into those, it's about finding the places and sometimes it's firm pressure have them direct your pressure too that seemed to relieve the headache.
Now the palate's role in headaches is interesting in migraine headaches. This is a little video clip, it does show some surgery. So it does have a bit of surgical gore in it. So heads up there if you if you don't want to see that don't watch this. You can just look away and listen to the narrator let me play a little bit this, this teenager had severe headaches. He also had a difference in position of his upper and lower jaws. And so the treatment was to actually lengthen the length of one jaw and break free the maxilla to reposition his jaws, but the presenting symptom was headaches. So faculty, tell me if I got sound?
The doctors had to len
Was their sound? I started and stopped the screenshare. Yes. Yeah, we're good. Okay, here we go. He said the doctors.
The doctors had to lengthen Roberts jaw by about 14 millimeters. The process began with four cuts in his jaw bone. The first two cuts are made in his maxilla the top of the jaw. The second two cuts are made in his mandible or lower jaw bone. Doctors then separate the bones using a mallet. Once the bones are broken, the dynaform is put into place. The device is anchored to brackets that are temporarily bonded to Robert's teeth. His jaw is then wired shut to set the bones in place. Over the next week Robert will have to help doctors by adjusting the dynaform's length. When 14 millimeters is reached, he will stop the adjustments do allow his jaw to heal.
Alright, so this is his post op checkup check in. And the story according to the TV show he you know it was very effective. His migraines were better his migraines were helped by the basically breaking his mandible free and repositioning it and breaking his jaw and lengthening it. So the teeth meet together. So there's dentists like that. The that cast I showed you, that's actually this one here, the previous slide. That one that one's actually from a dentist that specializes in migraine treatment. He does it by orthodontia. He just corrects the alignment of the teeth and people report their migraines feeling better. There's a lot of potential contributors but certainly the palate that seems to be one of them.
Here's another device that's sold on the internet that you it's a spring essentially that you bite and the pressure on your teeth helps people's migraines just actually holding that there. The pressure there helps relieve people's migraines. Here's one you wear to bed. It's a little bike guard miniature bike guard for migraines, you put it around the teeth that seem to make the most difference and in bed just your bruxism where you're biting down while you're asleep, helps people's headaches, I don't know of any research into the role of the palate, and the and migraines but there's a lot of remedies a lot of treatments that people are using it certainly made a big difference for mine. And it's it's really my go to place for a ocular connected migraine, a migraine that has a visual disturbance or nausea.
But the idea there, this is my this is the because this is the palette as a peacock the idea that as we're getting the helping the palette, unfurl or be spacious, and be beautiful, not be so sensitive and be so reactive. And you can do that through your touch. And honestly, this might be the one technique I do and almost in a whole session with someone with an active migraine, or uncertainly, it's the it's the clearest self care technique you can teach your clients to do is just essentially get their thumb in there, find the places that relieve the headache and hang out, go lie down somewhere, get your thumb and wait. It, I gotta say this has helped me a lot. It's even more effective when someone else does it. It's just one of those things where if conditions are right, you know, if you're able to do that safely, and you're in real time, then if you can do it with someone they can get someone to do with them, it's even more effective to be able to relax into the recipient. But still, it's an amazing first aid approach you can use with yourself for migraines.
Yeah. Okay, so a couple of questions. We got time for question or two, Bethany, what do you think, you got any there you see that we should should catch up at this point?
Um, so we just had a question asking about I wonder how braces will play into this, how it would be different from some of this. In terms of, so any comment on braces?
Yeah, no, there's stories both ways a lot of people get headaches when they get braces. But people report having their migraines go away when they when they have braces too. So I think, you know, some of the headache is just the adapting of the mechanical force the braces are putting on. But some people I mean, that one orthodontist treats his migraine clients with braces, so I think it can go either way. Certainly our work with somebody who has braces, I'm thinking about things being more adaptable, being able to not resist what the braces are asking to do and to be able to adapt out into the head.
You know what I didn't mention, when you're playing with that with yourself. And by the way, at ease, if you still have your thumb in your mouth, you can take it out now. But what I didn't mention is if your thumb is in your mouth, you can get around with your other part of your hand and almost squeeze the maxilla between your inside and outside hands, or with a client, we do that with the outside hand, we'll get that other hand on the essentially the outside of what we got from the inside. And you can feel the maxilla between those two, helping it be adaptable.
Kyle, you're asking about dental trauma, you say you have serious trauma yourself. They start out with a dial at 10. Yep. And your one interoral experience with a therapist was a disaster. Somehow, we got to find you don't have to get this work, maybe it's just not for you. But if there could be a way that you could be in control enough of the situation or ease into it enough that you could begin to work with the protection and the reactivity that we all have around our mouths, then that could be really helpful. And that's the key is really giving our clients control really putting them in charge. And it could honestly be just them working on themselves could be the first step toward this is not like because what we're working with is a nervous system. It's not even so much the tissue directly. The tissue is just a medium for speaking to the nervous system. So that we can speak to the nervous system in lots of ways by just someone imagining something, somebody imagining me working in their mouth by someone relaxing and breathing with the thought of that. So yeah, it's it's like any other traumatic experience. It's all about pacing and dosing. It's all about giving the client control. It's all about taking the time, because taking the time to let that normalize is the therapeutic goal. It is the outcome and you can do that before you even touch someone.
Til, do you want to continue to share that screen? Is there more?
The peacock?
Yeah, you're gonna leave the peacock up?
You got another question or to go to the next technique?
We have a question about love to hear thoughts on working with these techniques on people that have had Botox injected to prevent or block pain signals from migraines. Also, how early after the injections, can they receive this work after approved by the physician?
Well, I'm gonna, I'm gonna go ahead and turn the page, just so that you can look at this picture now because that's what we're about to talk about. The Botox question is really interesting. Botox, if you don't know essentially turns off the muscle through a toxic effect on nerve transmission. It's temporary, it lasts, you know, for some people a month, sometimes longer. And if there is a tension component to someone's headache, whether it be migraine or headache, turning off that muscle can be an amazing sense of relief from the headache. It's like magic, the Botox injection can just take some people's headaches away. It's a mystery. You know, we still don't understand how tension feeds into some people's migraines. It could be that the Botox's effect on the nerve itself as any kind of analgesic effect, it changes the migraine, or it could be that the fact that just essentially releasing in quotes, the tension completely. I mean, like there's no resting tone there with Botox is enough to really shift the migraine. Now, how soon afterwards to do work? I don't really know, I would say, I don't think you know, like any, any tissue incident, we want to give it a chance to heal before we go scraping on it. So it's not about deep pressure on the injection site. So, I think I wouldn't be shy about doing work elsewhere. Even if someone had a Botox injection. I would be listening and watching watching what happens in their body. Yeah, did we hit the high points there, Bethany?
High points for now. Thank you.
Okay. All right.
There's a couple more questions, Til. If you got time.
Yeah. Why don't we go ahead. And yeah, let's, let's see how we do at the end. Because I there's more techniques. Thank you, Larry.
This one here cranial vectors technique, it also makes a first appearance in the Neck, Jaw and Head workshop here. The indirect variation now in D-07 is a variation where it's the same hand positions we use in the Neck, Jaw and Head workshop, but there I'm listening. And I'm feeling for connection, motility, meaning the ability of the head to move itself, as opposed to mobility, that is my ability to move the bones, I'm not trying to move the bones, I'm listening for the movement, that is the body, the head in this case is doing on its own. So the breathing, sorry, the movement might be breath movement, it might be the craniosacral rhythm it might be who knows what, but you're gonna basically get a hold of the head and feel. The method again, I explain better on the video that I'm able to do here, but then this ordering of same side first is number one, number two, and then the diagonals number three and number four, and then finishing across the back across the lambdoidal suture in the back of the occiput. That's traditional. That's the way I was taught it from a couple different sources. It was taught to me as a quote shotgun technique for all of the sutures just a way to get all the sutures adaptable. And it's practiced both as a very direct technique like we do in our neck workshop where we're squeezing, which by the way can really help some people's migraines. Some people want you to do this one with firm pressure and an indirect technique where it's like the images that I'm holding, holding a jellyfish. Really I'm holding a jellyfish and letting it move I'm not inhibiting its movement at all. So that could be the metaphor for this one the indirect approach.
There's William Garner Sutherland doing this technique. He is the originator of the cranial osteopathic approach that became craniosacral therapy etc. And it turns out that Ida Rolf worked with him a bit. Some say as a secretary, other people say she was studying with him. For some part of a year. It's the details aren't clear, but so at some point in the 50s, she spent time with Sutherland and there you can see the influence perhaps of him, but certainly of the osteopathic lineage in the structural integration method, as well.
In this technique I often think about what's going on inside the skull, including the membranes traditionally, this is thought to be what the therapeutic target is in this technique where you're actually feeling the membranous connections within the skull. They are intimate with all of the nerves here the optic nerves and trigeminal roots. So you may be actually having a mechanical effect on the nerve itself. Or it may be that like in this cool illustration from Charles Swenson who's a Rolfer not too far from me here. He's showing us how the tentorium and the falx are thought to be the key structures involved in the craniosacral rhythm, primary respiratory rhythm, it's called in that system where the movement of the skull around the structures is what keeps them vital, and keeps them alive and keeps them normalized in terms of their sensation and hydration, and all those other great things.
So it may be difficult to see over Zoom, but there's a very subtle movement this animation shows of the various bones of the skull around these structures, as well. And so that's the kind of thing we're feeling for you, you may do craniosacral work and which case you have a lot of techniques you could employ here or you may not, in which case, just feel and follow, allow anything to happen that's happening already, that's going to be calming and normalizing just in your perceptive able to help someone calm and go into perceptive mode where they feel what's going on.
That's that's the opposite of a jellyfish. That's like someone that's what my head felt like, before I started getting much work for my migraines would just start to feel like so hard and dense that these techniques really start to help it have a little more adaptability.
This one here on D-08, the mastoid process cradle. It's using my thumbs on the mastoid processes. So if you feel your ear lobes, the mastoid processes are just below those. It's a way for me to essentially use the temporal bones, which is what the mastoid processes are part of, to feel into or lever into the SPS, the sphenobasilar synchondrosis or sphenobasilar juncture in some schools. This is thought to be the primary joint involved in the craniosacral rhythm, the one that is driving the whole engine, the motions of the sphenoid, against the occiput. In that system, it can do all sorts of interesting things that each have their own axes, and they can get into different sorts of relationships that are considered dysfunctional.
In this approach. All I'm doing is I'm squeezing gently the mastoid processes. Yep. So there's my thumbs on her mastoid processes. And I'm squeezing very gently, right up into this zone. This is a plastic skull. So it's hard to see the actual joint there. But it's a medial and a little bit forward. That's the vector of my touch in this one, because I'm thinking about this, sphenobasilar juncture. So it's, this is the juncture here. These are mastoid processes. Yeah, got them colored, they're a little bit for you. So you get a hold of those and you squeeze might be even too strong a word you feel mmediately a little bit forward, which takes you right up into this joint. And maybe why I mentioned doing is that I'm using that temporal bone as a kind of wedge to go between the occiput and the sphenoid. It is a kind of wedge shaped relationship. And by gently pushing that bone, those bones two bones medially and forward, maybe I'm helping that joint have a little more mobility, a little more openness a little and I maybe I can help even normalize its motion, or sensitivity, people will feel a kind of migraine relief when you find the right vector here. And who knows maybe that is this the sphenobasilar junction where affecting this joint right up in here.
The sitting neckwork is our capstone technique on the sequence is the final technique where we gently get someone up and begin to connect it down into the rest of the body. But through in this case, gentle work with the layers of the neck. This is also going to be really relevant to our cervicogenic work in the neck sequence. This is one I learned from Jim Asher years ago, Rolfing instructor Jim Asher, we just anchor the layers of the neck and have someone turn and follow, they might engage the eyes, something that Chris was doing with us in the standing technique too.
Let's wrap it up with just a couple of, this is in your handout, by the way, if you want to fill in the blanks as we go, a couple of the things that people use that have folklore value, and maybe some in some cases, research value. Hands on body work has both folklore value and research oriented evidence that it helps with migraines. A couple of studies, one of just plain old vanilla Swedish massage show that people that got a regular session Swedish massage, I think it was maybe it was once a week for six weeks just from memory had fewer migraines and the migraines were less intense when they did have them. So and that's not the only study. There's a number of studies that show that when you actually get some work and get it regularly, the frequency and intensity of the migraines can diminish.
Another one is an ice pack under the back of the head. That was thought to be the effect on vasoconstriction. It's probably not the vasoconstriction that's causing the headache, but somehow the cold air might help diminish that aspect of the migraine experience. Similarly, an ice cube or ice cream on the roof of the mouth, there's the palate again getting your palate cold. So that suggests to me, you know, the blood vessels aren't down in your palate, but the nerves are that suggests to me that it's maybe a neural mechanism we're affecting through with cold on the roof of the mouth. Some people have a useful relationship with caffeine at the first sign of an aura that seems to be the key, the first sign of a headache. Some people can drink a cup of coffee or my grandmother traveled with nodos all the time in her handbag, that was the way she managed her migraines is to take one of those at the beginning of a migraine, or the big one is learning what your triggers are for your own migraines, helping your client learn that. And sometimes it's the simple questioning that you can do sometimes asking people to think it through with you or to pay attention, foods, etc, can be triggers. Let's talk about some of those.
Stress is probably the number one. Yeah. Fatigue and sleep direct disruption. What happens then is the trigeminal cervical nucleus gets sensitized. When you don't have enough sleep, its sensitivity or activity goes up so does all your nervous system. But it seems to be at that place in particular gets especially affected by sleep. And if you can, there was an interesting study of neck, this is neck pain, but it might relate to headache or migraine pain. The biggest factor in one study's analysis of neck pain relief after hands on and movement and physical therapy based intervention was how much sleep people were getting. The biggest factor wasn't how much therapy did they get or which therapy they get it's like how much sleep were the people getting? How good was their sleep. So just having having someone think about and work with their sleep disruption as hours of sleep can really help someone's migraine diminish, as well as the caffeine can be a trigger for some people, some people get a migraine, especially excessive caffeine or alcohol use, hunger, certain foods, overly bright, or flashing lights can be a trigger for some people, as well through that ocular stimulation perhaps of that occipital lobe in the brain. So to wrap it up, wrap up the lecture and then we can go to some more questions at the end if we're getting right about at the bottom of the hour. And as always, you feel free to leave when you need to. But we'll stay after and I'll take the questions, etc.
It's helpful to know about the difference between the musculoskeletal headaches or the myofascial tension headaches like we did last time and the neurogenic headaches that we talked about this time, because we're going to work with them differently. Hands on manual therapy can help with both kinds. For the musculoskeletal headaches, the goal is reducing the tension or helping the glide, you could say of the tissue layers, the myofascial tissue layers in the neurogenic headaches, like the migraines, the goal I'm suggesting too is reducing cranial compression, I would you know to revise this more fully, I would add in the sensitivity piece, calming the nervous system and helping normalize that sensitivity too is also one of my key goals in the neurogenic headache. But in terms of prevention in the long term is helping someone relax and it's helping the head be adaptable, helping some of the stress levels go down. And that seems to have a huge effect on migraine intensity.
Even we didn't mention hormones. For some people, hormone like a woman's hormonal cycles, either lifetime cycles or monthly cycles can be periods of migraine activity. All of these techniques still apply. There's migraines are multifactorial, there's many different things that set them off, including the genetics, including for some people, hormones, including that whole list of triggers that we had. So anytime we can reduce the impact that one of those triggers is having on the whole, maybe it has the tipping point effect of not letting someone's cumulative triggers get so bad that they actually get the full blown symptom.
Now, next time, we're going to talk about this last one in particular, don't miss that because it's a key, refer to a physician if the pain is persistent, accompanied by other symptoms or came on suddenly. And there's a few other warning signs where it is really important for someone to be under medical care. Even if you can relieve the headache, just you making their headache better doesn't mean that they shouldn't have it evaluated, if they're if it's been going on and is intense and keeps coming back or they have some other symptoms such as fever and we'll talk about this in detail, or came on really quickly, or changed, have them checked out.
All right, my friends. Let's go around and do our faculty pearls it's going to be ask you faculty to stay to the point since I didn't, since I went on. Yeah, but wave at me faculty if you're ready to go, Larry, it looks like you're ready. Why don't you go ahead and begin?
I yeah, one of the things I wanted to mention is some of these that were brought up in some of the thoughts or online things was uh, if you know a migraine client is coming in, you really want to set up your room and be cautious of your room and the smells in the room, you know, if you like candles, or incense, or even sometimes the sheets, if you wash them in something special that triggers migraines, the lights in the room really trigger it if you you know, if you have a lot of windows and things like that, or worse fluorescent lights that you're using, that triggers migraines. So some of those things you want to be aware of just when they're coming in, how they can, how you can work with them. Another thing is, is lying them down might get them nauseous. So if you need to most of these things you can work in a seated position. So do what you need to to help them out.
Thank you. Who's next? Go ahead, Chris. Go ahead and unmute yourself, Chris. And then Yep. Yeah.
There we go. Sorry about that. Just thinking about the whole concept of decompression. And there's there's ways we can help with that, especially around the idea of working with the cranium. One, of course, is touch, you know, a very soft touch is we as practitioners can help develop that soft, sort of non invasive listening touch just by how we occupy our own bodies, in our chair, or in the way we're standing, or using the table for support when you make contact with a client. So being in your body in a very supportive way where you can be soft and kind of listening. And unintentional yourself is very powerful for this kind of work. And then using, I guess the concept of support, like when I put my finger on someone's maxilla, or any bone in the head, in essence, I'm providing a localized place of support. But I need to help my client know that and so verbal cues, like could you allow yourself to rest around my point of contact can be very powerful just to help your your your client actually recognize that they could, they could release something around that support. And, you know, even in the standing exercise of listening to something, you know, where your body is under your head changes the degree to which your head can relax, or be tensioned and compressed if you're engaging muscles to support it excessively. So just just some ideas around that.
That's fantastic. Thank you, Chris. Laureen, go ahead.
Piggybacking on Chris's, talk about how important it is for the practitioner to find ways to be soft in their body, and the idea of support, in order for us to provide support for our clients. In many of these cranial techniques, you've got to really think about what you're doing with your body support. So finding the ways that you're going to be really comfortable seating, finding ways to rest your forearms on the table, rest them against your body, brace them in a way that your body can relax, so that your client's body can relax into the support you're giving them. I'll keep it brief.
Totally true. So true. You are the, you are the message, what you're doing in your body is what you transmit. That's what comes through your hands. Bethany.
Um, yeah, um, so Laureen took my thunder. But agreed, again, this idea of support. And I would say actually, that these techniques, this would be another one where you might be interested in that virtual practice period, because in the last one, we were able to help people find ways to position themselves and work with people very specifically. So I think that it's going to be helpful as we go along. But this would particularly be one especially as you're working in some, perhaps new places for some of you. And the other thing to keep in mind is just that, like in the last section, we were thinking about, by working with myofascial tension, a lot of times we're working with working with like, the outer layers, and now we're thinking of bony touch. So it's that support is even more important because it doesn't mean you're pushing harder. But when you're supported better, you can sense in deeper. So that's all I got.
That's great. No, that's I'm so glad you mentioned that. You're working on bone time and bone touch and bone mode. That's so important. Bruce are you out there somewhere? We're ready for you.
Yeah, I'm out here. I'm gonna touch on the communication component of it and simply embrace your client's experience. You know with that intake and what they're feeling try to get into their body and their sensations as to what their experience is and try to understand the areas that relate to their pain and their experience and work, you know, very consciously with that. Another component is really practice, practice these oral techniques, interoral techniques on yourself, so that you can experience and try different things to see what the sensation actually is inside your mouth. So you might have a little template for what your client might be experiencing. That's it. Thanks, guys.
Thank you, Bruce. Thank you, Bruce. Let's catch up on the chat questions. We're going over a few minutes. That's all right. We'll catch up on the chat questions. And if you have verbal questions, feel free to raise your hand as well. What you got chat monitors? What do you want to make sure we get a chance to answer.
Sure we had a question about if someone has a migraine, especially neurogenic. What about just doing parasympathetic work only?
Yeah. I love that question, Brian. And I love it that you asked it. And I want to just clap. I just want to say yeah, that's it. That's the that's the point of the lecture. Exactly. And then I want to ask, I'm gonna go one more level and say, Okay, how would we do that? How would we do parasympathetic work only? I wonder. Because if any, or what work would we do? That wouldn't be parasympathetic work only? Is the other kind of question. So essentially, that becomes the target. Yeah, I know. I got the new button. I'll get you. But it's, that's the other side of that question is yes, that is the target. We want to shift someone's sympathetic state. Now there are many roads to parasympathetic, Nirvana, you could say, there are many ways to get there. So but yeah, if we shift our thinking from being okay, what about the bones and stuff like that, to what about the parasympathetic nerves then we're on track. Hold that thought, Brian, I want to catch some in the chat and we'll get back to you and we can hear what you have to say about that. What else in the chat should we cover?
Um, Cher talked about stabilizing the sphenoid when working with the maxilla.
Yeah, there's a cool technique on a client, we can grip, very gently grip is too strong word, you can get ahold of wings of the sphenoid and work with the maxilla. That is essentially what we're doing in that the maxilla rocking technique, that upper hand has the the frontal bone or the sphenoid. Yeah, while we rock the maxilla from below. Yeah. So that's for sure. Rocking the maxilla and sphenoid against each other or the occiput. You can essentially do the same thing in back, you can get under the occiput and get the front the head and torsion the head and the occiput through that dimension too. Really rich, really great. It feels like it's almost just ringing the migraine right out of you when they get the right direction. Anymore, Larry, you have some?
Bethany took care of it.
Hey, gang, very good. Okay.
It was one, excuse me. There was one from someone asking about the movements we make with the maxilla they're just micro movements.
Yeah.
And is it? Yep. that is it. Yeah,
Well, I have yet to find a maxilla that, that moves in a macro way. I don't know what that would look like. Maybe though that guy in the surgery video. That's his was moving in a macro way. But yeah, it's it's, uh, you know, they're sutures. So there's a little bit of give and that's all. That's what we're talking about. Yeah. Okay. All right. Brian, you had your hand up first. Let's hear you got another. Iris. We got you in the queue, too. So let's hear from you, Brian, go ahead. And what what did you want to say? Right. What do you want to ask me about?
I brought this up because, you know, based on the experience I've had with migraines my swimming coach has had them, my mom had them really bad for a number of years. You know, I, I questioned some, I mean, I think some of these techniques you have are great. But I question their usefulness, when somebody is having a migraine, they just want to be left alone, and they want this release of pressure. So do I want to be touching people when they're in this state?
That is such a good point. That one's by the way, that one's in the book. That technique is in the book. It's, there's sometimes doing nothing is the best thing. You know, sometimes they do just need time and space. And you're absolutely right is it sometimes anything we do is the wrong thing. And we're not, we're not going to make it better by trying to intervene or manipulate or any of that stuff. And that said, at the right times, this work has been a godsend for me, and for the people, I know, my clients as well. So in the right circumstances, absolutely. But Larry's point about really creating the context for that to happen within the office or wherever it is, is a key part of that you're almost like a context architect for that person to help them have an experience or surrounding cocoon that can where they can have their migraine end, and then you're incidental. You're just the parasympathetic guy.
So how do you convince your clients to come in and try this?
Migraine coupon? Save 25% on your next migraine? I'm sorry? Sorry, I couldn't resist? I don't know. I don't know if we need to convince them.
But they're gonna be afraid to come in and have anybody touch them. That's why I brought up the the craniosacral is you're putting hands, you're trying to, I guess, are you trying to reduce the homunculus? What about working with their hands? Would working their hands affect their face and head?
Well, yeah, yeah. Cuz I honestly think that I'm, I'm thinking about the brain, no matter what I touch. They're all just ways to talk to the brain. So I like that. Now, I, I want to make sure we got time for Iris's question, but what faculty, what do you think about this question of like, what if they're reluctant to come in? Is that okay, is there anything we can or should do about that? And thoughts from you, faculty?
Yeah, I've got some on that. I work with a lot of migraine clients that, I mean, they're actually on disability, government disability because of migraines. And she was reluctant to come in at first, but then once she started coming in, we always had this rule that, you know, if her migraine was so bad, she couldn't drive, you know, not to come in naturally. And then she got so her migraine was so bad, she just called an Uber to drive her over. And she would still come in because it helps so much to dissipate the migraine. So, I mean, it's one of those things, once they come in and find out about it, they're really there. And now I've actually started working training her husband to work with her migraines, because he's working at home now. And so you know, how I can help them and different techniques I show them very, very much out of the books that we're using, and it helps tremendously. So it's not, it's the opportunity to get the work done at the right time is the biggest thing.
So it's it's just touching the body calming the nerve endings, then if we're just lightly touching, like, like progressive compression of the rest of the body. Does that calm?
Yeah. I love it. I'm going to jump in. That's right. I'm gonna jump in and take back over that. But I just want to say, it's yeah, what you said, touching, you said just calming their nervous system. And I always, I think we think about just working parasympathetic or just calming, just can mean it's diminishing. I know that's not what you mean. But that's important to say that actually, that's the key thing we're doing with our hands. In all this work is we are affecting the nervous system, whether it's relieving pain or producing a state of ease or whatever the ultimate target of our effects is you could say experience in the nervous system. And then the tissue is just a medium by which we do that. Thank you, Brian. I'm gonna go into Iris's question when you're ready Iris What you got?
Hey, um, I think in reference to Brian, you don't really need to have a big publicity to get migraines patient come in because a lot of times when you have a migraine you try yourself you know to get some pressure points and if you don't know where they are, you just you know kind of instinctively go somewhere and then it relieves you. So if you can feel that if you find your own spot and it relieves the pressure, if you go to someone that is trained in relieving the migraines, it will just be like huge relief. So I don't think there's a huge question about people not wanting to come in.
People are desperate too you know that people try anything if they have migraines going on. They'll try it. They'll be pain is a great motivator. But you know in the in the episode yeah, that is tricky, but maybe it's not the right thing too. You're right Iris. Your work speaks for itself. Did you have another question?
Yes. When you work on the palate and the craniosacral, they, they say it's really just an extremely light touch zero grams. So it's really just resting, and how much pressure would you put on the pallet?
More, although it is, it's going to be the client's. I'm going to follow the clients directions, I don't have an injunction against pressure on the pallet, like there is in the craniosacral system. It's fun that a cranial, you know, Hugh Milne's group in Switzerland hosted me for many years to go work with them. And they were all very sophisticated, very skilled cranial workers. And the radical thing about what I'm telling them is, guys, it's okay sometimes to use a little more pressure. And that just really, really rocked their world. You know, that idea? It's not right for everybody, I wouldn't say you should use pressure, or because in some points of view, you shouldn't, and I just want to respect those as well. But in this approach, I'm using pressure. I'm letting the client direct me as to how much and it can be a surprising amount that relieves the migraine.
The same thing with the ear pull, they say it's five grams, but when we did the techniques on the last meeting, it was actually really nice to pull the ears. And with more intension.
I won't I won't tell anybody who said that. That's good.
I have one more question if I can. Sure. Um, I have a client and she actually knows that she has a pituitary gland tumor, which is growing? And would you say there is any contra indication of doing any of the work? She's she always says she feels relief when working with her. But you know, just.
If she's under medical care, I would have her check it out with her care team. And you know, they can offer you can offer to communicate with them. They may not need to or want to, but yeah, I would I would get their input on that. I couldn't begin to answer on that. I can't off the top of my head. I can't think of necessarily an automatic like no, but I would want to check it out under that kind of thing for sure.
Okay, thank you.
All right. Well, thank you, everybody, thanks to the faculty. Thanks to all the people that have come in. I know that we have a bunch more questions in the chat. If we did not get to them we're gonna you can please bring them in either into the forum or into your, your small groups, because that's the next step now. We're gonna call it a day and do take your experiences, your wonderings, your uncertainty, your excitement, all that into the next step, which is to really go check out the techniques, meet with your study group, meet with your study pod, come to a virtual practice session, if you would like and try this on yourself, try this with your clients as well. Thanks, everybody. Have a great day, everybody.