CranioSacral Therapy and Neurolymphatic Drainage: Exploring Overlapping Modalities

by Valerie Carsey, LMT

Massage modalities often overlap in technique, drawing from diverse theories and methodologies. This is particularly true for CranioSacral cranial holds and Neurolymphatic Drainage holds.

Understanding CranioSacral Therapy

CranioSacral Therapy (CST) is based on the theory that practitioners can work with the craniosacral rhythm—the rate at which spinal fluid is produced then dispersed from the head. This rhythm can be felt anywhere on the body and is used to influence and release tension in the fascia, the soft tissue that wraps around bones, muscles, and organs, especially along the dural tube (the tissue that wraps around the spine and inside the skull). According to the Upledger Institute, conditions that can benefit from CST include:

• Migraines and headaches
• Chronic pain
• Motor-coordination impairments
• Central nervous system disorders
• Orthopedic problems
• Traumatic brain injuries and concussions
• Alzheimer’s disease
• Spinal cord injuries
• Scoliosis
• Issues related to conception, pregnancy, and birth
• Pediatric challenges
• Learning differences, ADD, ADHD
• Autism and sensory processing issues
• Chronic fatigue
• Emotional difficulties, depression
• Stress and tension-related problems
• Fibromyalgia and other connective-tissue disorders
• Temporomandibular joint syndrome (TMJ) and dental challenges
• Immune disorders
• Post-traumatic stress disorder (PTSD)
• Post-surgical dysfunction
• Sleep challenges

Many of these conditions are related to the brain and central nervous system (CNS).

Understanding Neurolymphatic Drainage

Neurolymphatic Drainage focuses on the glymphatic system, a recently discovered network of deep lymphatic vessels in the head. The circulatory system includes the vascular (blood) system (a closed loop starting and ending at the heart) and the lymphatic system, which helps with immune system support and fluid balance in tissues. The lymphatic system is an open system, moving fluid through muscle flexion and filtering it through lymphoid organs such as lymph nodes, adenoids, tonsils, thymus, spleen, appendix, Peyer’s patches in the small intestine, and red bone marrow. While manual lymphatic drainage massage can affect superficial lymph nodes, deeper lymph nodes are primarily influenced by active movement and exercise.

The glymphatic system operates differently. The theory is it regulates interstitial fluid movement, waste clearance, and brain immunity. The glymphatic system works primarily during sleep, which is crucial for clearing toxins from the brain. Conditions suitable for Neurolymphatic Drainage also include central nervous system conditions beyond the acute stage.

The Overlap

The glymphatic system theory suggests it interacts with spinal fluid. Evidence shows cerebrospinal fluid (CSF) enters the periarterial space and mixes with interstitial fluid, potentially serving as a waste removal system. Key aspects of the glymphatic system include:

1. Fluid transport direction, starting with CSF entry at the periarterial space and exiting with “dirty” interstitial fluid along perivenous spaces.
2. The removal of metabolic waste, such as amyloid-β, via the glymphatic system.
3. Fluid transport depending on polarized expression of the water channel aquaporin 4 (AQP4) in the vascular end feet of astrocytes.
4. Increased fluid transport and CSF entry into the neuropil during sleep, enhancing metabolic waste clearance.

Both CranioSacral Therapy and Neurolymphatic Drainage deal with fluids in the head. CranioSacral Therapy also involves releasing fascia tissue. Additionally, the CranioSacral rhythm operates at a rate of 6-12 cycles of cerebral spinal fluid manufacturing and dispersing in the head per minute and Lymphatic flow moves at a rate of 10-12 beats per minute. These are very similar rhythms.

Practical Application

The NeuroLymphatic Drainage routine typically starts with manual lymphatic drainage of the abdomen, followed by holds over the diaphragm and heart. The head holds are similar to CranioSacral cranial holds but are more time-based than tissue release-focused.

CranioSacral Therapy usually begins with holds on the lower abdomen/tailbone, diaphragm, heart, and hyoid (in the neck) before moving to the head. The order of holds differs from Neurolymphatic Drainage. The torso holds correspond to chakra points on the body, adding another layer of overlap with different methodologies. CranioSacral Therapy teaches that these are the “horizontal planes” of the body, where tissues run horizontally instead of longitudinally (from head to toe).

In practice, I often blend the two methodologies based on the goals of the session. For instance, I might start with abdominal lymphatic drainage and follow up with CranioSacral holds to release tissues.

Clients typically describe feeling light and relieved, “like a weight has been lifted off their head,” but not light-headed after these head holds.

Edited by AI

References

– The Glymphatic System: A Novel Component of Fundamental Neurobiology, Lauren M. Hablitz and Maiken Nedergaard, J Neurosci. 2021 Sep 15; 41(37): 7698-7711 10.1523/JNEUROSCI.0619-21.2021

-Hablitz LM, Nedergaard M. The Glymphatic System: A Novel Component of Fundamental Neurobiology. J Neurosci. 2021 Sep 15;41(37):7698-7711. doi: 10.1523/JNEUROSCI.0619-21.2021. PMID: 34526407; PMCID: PMC8603752.