Introduction

The existence of a Primary Respiratory Mechanism (PRM) was formulated by Sutherland and his early disciples. This mechanism is described as the fundamental breathing of living tissues, making all parts of the body oscillate at a rythm slower than that of the heart and thoracic breathing. Until now, no research, clinical or fundamental, was able to pinpoint its physiological basis, and even osteopaths disagree on its existence and clinical relevance.  We are thus confronted with a paradox whereby some osteopaths feel and experience remarkable clinical results with it, some do not, and research contests its very existence.  This issue is becoming crucial as craniosacral osteopathy, and its derivated approaches (such as myofascial release) are becoming more and more popular with the public, not only as patient care but also as a professionnal training, of short duration, totally separate from general osteopathy.

This seminar hopes to clarify this confusing situation through discussion and practical exercises of the many issues at stake.  It is the author’s belief that the paradoxes of craniosacral osteopathy are resolved by the practice of osteopathic self treatment, where the PRM, its various frequencies, its clinical use, are directly experienced. The seminar will offer basic training in this self treatment, leaving participants with an approach they can use for themselves and their patients. Through various exercices, the PRM and the spontaneous motilities we most often barely feel,  will become subjective certainties and remarkable therapeutic tools in all pathological conditions. 

A full documentation, with an extensive bibliography, drawn from the medical literature will be given to students

Day One

Revisiting osteopathic foundations and principles

• The roots of osteopathic technique : bone setting and magnetic healing.   Considered through AT Still’s technique and his early treatments, then through his first students, in whom bone setting and magnetic healing became, respectively, structural and functional techniques.
• The roots of osteopathic principles : iatromechanism and vitalism, as understood from the books of AT Still and his early students. Their evolution into contemporary biomechanical and biodynamic osteopathy
• Original osteopathic medicine : from the treatment of lethal infectious diseases (AT Still) to cancer (JM Littlejohn’s monograph). What limits our present use of osteopathy to musculoskeletal dysfunctions as opposed to what the pioneers did with it ?

Day Two

Several points of view on the PRM 

• The PRM in the osteopathic tradition
• The PRM in contemporary medical literature. An exhaustive review of PRM-like rythms as measured in the EEG, ECG, EMG, Cardiovascular, Digestive, Immunological, Hormonal, Cellular, Biochemical etc.  systems and levels.  Critical analysis on the traditional concept of the PRM in view of its modern physiology.
• Calcium waves as the most likely modus operandi of all known types of motility
• The PRM in History   From C. Galien to G. Baglivi, E. Swedenborg and how Sutherland read these ancient authors, leading to the formulation of craniosacral therapy.  The limits of contemporary craniosacral osteopathy as a function of the reduction operated by Sutherland on the wider definition of motility given by the Ancients
• The PRM and spontaneous tissue motility from the point of view of modern physics : the Virtual and the Real
• Reflexion on the theological foundations of general osteopathy/craniosacral osteopathy in the writings of Still and Sutherland. Can osteopathy function without them ? If yes, how can they be replaced and still be effective?

Day Three

The difficulty of perceiving the PRM, leading to the lack of consensus about its very existence

• Why can’t we feel the PRM easily ? Why do research protocols consistently fail to show its existence or its objectivity when measured by several operators ? Exercises and questions
• How to use the concept of the PRM in agreement with the osteopathic and medical tradition, modern medical literature and our limited ability to perceive it.  Exercises.
• Myofascial release in view of osteopathic tradition and contemporary physiology : the novel roles of connective tissue and the meninges, particularly in the fast developping field of stem cell physiology
• Mechanotransduction : from mechanics to chemistry. Our ability to modulate the relationship between cellular mechanics and chemistry will be evoked as the general operative mode of osteopathy in future, if our profession can hope to stay relevant in the high tech medical revolution taking place at present.

Practice, indications and contraindications of myofascial release

• Establishing a minimal model of what we are seeking when we listen to tissue : spontaneous therapeutic motions
• The Three Links, mechanical, fluid and neuronal, as an economical  and exhaustive osteopathic treatment model. Any pathology can be broken down to its mechanical, fluid or neuronal elements amenable to manual treatment.  Clinical examples will be discussed in most spheres of human pathology

• Are there specific indications of craniosacral osteopathy vs. standard osteopathy ?
• Contraindications of craniosacral, drawn from the literature and personal experience
• Contraindications from the point of view of the practitionner : why do osteopaths get often tired practicing a technique reputed to bring harmony and balance to the patient ?