PT Classroom - Palpating and Treating the Immune System Using CranioSacral Therapy by Tim Hutton, PhD, LMP, CST-D

Tim Hutton, PhD, LMP, CST-D is a Licensed Massage Practitioner in private practice at the Natural Health Clinic in Bellingham, WA. He is a certified CranioSacral Therapist at the Diplomate level (CST-D) and teaches a variety of courses in CranioSacral Therapy for the Upledger Institute International. He holds a PhD in Physics from Rice University and previously worked as a research physicist at MIT. His passion for CranioSacral Therapy arose from his own health challenges. After receiving CranioSacral Therapy and experiencing remarkable improvement in his own health, he began to study the techniques and today he is the developer and Ombudsman for Upledger's CranioSacral Therapy and the Immune Response (CSIR)curriculum.

Palpating and Treating the Immune System Using CranioSacral Therapy

The immune system, which consists of a loose network of 10 to 50 billion cells of various kinds, all acting together and communicating with each other chemically and energetically, can often seem a bit esoteric. Tissue is easy to palpate, and is easily affected by manual therapy. It is less obvious that this is true of the immune system. The immune system, however, is involved in every issue that we treat as manual therapists. If the client is experiencing a symptom, there is some degree of inflammation, and the immune system is involved.

This involvement may be primary, as in the case of an infection or an autoimmune condition, or it may be secondary, in which case simply releasing fascial restrictions may be enough to allow the inflammatory response to completely abate. Most often, the situation is somewhere between these two extremes, however, and simply releasing fascial restrictions does not completely eliminate the inflammation. Thus it is critical that we as manual therapists be able to address this important system of the body.

CranioSacral Therapy (CST), because of its ability to engage specific tissues in the body with great precision, is an ideal modality with which to address the immune system. Using CST it is possible to directly map inflammation in the body, on a micro level. One can tell exactly which tissues are inflamed, what aspects of the immune system are involved in that inflammatory process, and to some extent to what the immune system is reacting, all simply by palpating the movement of the immune system in response to the craniosacral rhythm (CSR).

The CSR is the primary palpation tool used by craniosacral therapists. It consists of a slow (5 to 10 second period) subtle external and internal rotation of the body which occurs as a consequence of the body’s mechanism for controlling cerebral spinal fluid (CSF) pressure. According to the pressurestat model* developed by Dr. John Upledger and Ernest Retzlaff, CSF production is intermittent, while CSF reabsorption is constant. During fluid production the pressure in the cranium rises very slightly, which causes a slight increased stimulation of the motor cortex. This increased stimulation in turn causes a slight global increase in muscle tonus. When this happens, the external rotators overpower the internal ones, causing a slight but easily palpable external rotation of the body. This is the flexion phase of the CSR. When the fluid production shuts off, the CSF pressure drops, the muscles relax slightly, and the body internally rotates. This is the extension phase. Generally speaking, if a particular tissue is moving well in the CSR that implies the tissue is functioning well. If the tissue is not moving well in the CSR, then that indicates that there is a problem.

One of the basic principles of CST is that, ideally, all parts of the body should move freely in the CSR. This includes the immune system. When the muscles pull the body into external rotation during CSR flexion, they externally rotate the entire body and all its tissues, including the loose network of immune cells. The therapist can choose to tune in to the movement of the tissue as a whole, or choose to pay attention to the movement of any of its various components. Therefore placing attention on the network of immune cells allows the therapist to determine how those immune cells are moving in response to the CSR, and thus how the immune system is functioning at a particular location.

As an analogy, consider listening to a symphony orchestra. What one hears depends upon what one chooses to pay attention to. Focusing on the sound of the first violin brings that sound into the foreground slightly, while the sound of the rest of the orchestra retreats into the background, allowing the sound of the first violin to be easily distinguished from that of the rest of the orchestra. Similarly, focusing on a particular tissue allows a therapist to determine how that tissue is moving in response to the CSR.

Under normal circumstances, absent inflammation, the cells of the immune system are not to be found in the interstitial spaces of the tissues of the body, but are instead confined to certain specific pathways (under the skin and mucous membranes, in the blood and the lymph, and in certain specialized immune organs such as the bone marrow, the spleen, and the lymph nodes). This is part of the body’s protection against autoimmune disease. If the immune cells are not routinely exposed to certain of the body’s proteins it is much less likely that the immune cells will adversely react to those proteins.

In this situation, a therapist tuning in to how immune cells in some location in the tissue are moving in response to the CSR will feel no movement, since there are no immune cells in that tissue and thus nothing there to move. The tissue itself may or may not be moving in the CSR (it may or may not be restricted in its own right), but there will be no CSR response from the immune system in that location.

If there is inflammation, however, immune cells release histamine which opens up the capillary beds and allows immune cells to travel out into the surrounding tissue. In this situation, there will be immune cells in the interstitial space, and the therapist will feel those cells moving in response to the CSR.

It is important to distinguish acute inflammation from chronic. Acute inflammation is the body’s normal and appropriate response to trauma, and is characterized by the body rebuilding itself. The inflammation is in the process of resolving itself. Chronic inflammation, on the other hand, is not a normal response, and is characterized by the body simultaneously rebuilding itself and tearing itself apart. The body is caught in a loop and the inflammation is unable to resolve.

In acute inflammation, since it is the body’s normal response, immune cells in the tissue will generally be moving well in response to the CSR. The tissue itself is often restricted, since there is inflammation, but the immune cells will be moving well. In chronic inflammation, the immune cells will not be moving well in the CSR. The tissue will generally be restricted, and the movement of the immune cells will be restricted as well.

Tuning in to the movement, or lack thereof, of immune cells in response to the CSR allows the CST therapist to directly map inflammation in the body, on a micro level. With practice, for example, it is possible to palpate a coronary artery and to distinguish the movement in the CSR of the muscular wall of the artery from that of the endothelial lining, from that of the blood inside the artery, and from that of any immune cells within the lining. Normally there should be no immune cells in the endothelial lining, so their presence there is an indication of inflammation.

Using CST it is possible to determine exactly which tissues of the body are inflamed, whether that inflammation is chronic or acute, which aspects of the immune system are involved in that inflammatory process, and to some extent to what the immune system is reacting, all simply by palpating the movement of the immune cells in response to the CSR. Following the subtle micro-movements of the tissue and of the immune cells will then facilitate the release of conflict within the body and allow the inflammatory condition to gradually begin to resolve.

Chronic inflammation is the major driver of most of the “lifestyle” diseases that are so common today. These diseases include heart disease, obesity, diabetes, digestive disorders, arthritis, and many others. When these diseases occur they do not do so “out of the blue.” Most such disease is preceded by years of chronic inflammation which gradually devitalizes the tissue eventually causing the disease to manifest. By treating underlying low grade chronic inflammation, by whatever means, one can hope to reduce the likelihood of such disease actually occurring. CranioSacral Therapy, with its ability to map inflammation in the body and treat it with precision and specificity, is an ideal vehicle with which to address such issues.


*John E. Upledger, DO, FAAO and Jon D. Vredevoogd, MFA, Craniosacral Therapy, Eastland Press, Seattle, 1983, pp. 11 – 12.

For further information on research and classes in your area, please visit

Last revised: February 21, 2016
by Tim Hutton,PhD, LMP, CST-D

Terms & Conditions

Please review our terms and conditions carefully before utilization of the Site. The information on this Site is for informational purposes only and should in no way replace a conventional visit to an actual live physical therapist or other healthcare professional. It is recommended that you seek professional and medical advise from your physical therapist or physician prior to any form of self treatment.