Craniosacral Therapy 10 step protocol

The 10 step protocol was taught by Dr. John Upledger at the very first seminar CS1 (cranial sacral one). It is taught to this day (refined) and serves as the basic foundation of Upledger Craniosacral Therapy (CST). The purpose is to provide a new practitioner a template / guideline of the technique and sequence in order to provide a methodological approach that targets many of the higher-powered areas of the body.

Applying gentle hands-on Craniosacral Therapy (CST) techniques to the patient’s body in order to facilitate improvement in lymphatic fluid, cerebro spinal fluid (CSF) and blood flow, stimulating improvement in symptoms and reversal of many health-related conditions.  Physiological correction in the physical body is achieved through a skilled touch, releasing the body’s holding patterns, while connecting the mind body complex, improving function and diminishing pain.

The 10 step is a reproducible manual touch on the body approach that helps the practitioner provide CST in a gentle, time tested, therapeutic manner, allowing for both the therapist and patient to benefit.  The more ten step protocols are done by the therapist the more experience is gained with every patient. For the patient, it is an effective method of facilitating the body to start achieving physiological and physical improvement. As the Craniosacral Therapy practitioner gains experience, almost always there is a deviation from the original technique approach of the 10-step protocol.

Advanced Craniosacral Therapy

As more advanced CST training is undertaken by the practitioner, the more knowledge of this healing art is gained. Simply put, a practitioner’s more advanced skill set is acquired through classroom hours and patient practice. Incorporating more techniques learned in CS2, SER1, SER2, ADV1, ADV2, etc., allows for a more impactful, more therapeutically valuable approach.

Dr. Kaminsky

Dr. Kaminsky holds a Chiropractic License since the year 2000 and has been providing Craniosacral Therapy since 2015. He has taken many seminars to the highest level of Advanced. He also implements Myofascial Release, SER (somato emotional release) Vagus Nerve toning techniques, and other methods.

Focused Care

CST is a gentle therapy. It is a light touch technique illuminating from the practitioner’s hands on to the body in specific ways, resulting in a positive therapeutic response in the patient.

The therapeutic response of the patient is called by many names: release, energetic breakthrough, therapeutic pulse, healing response, letting-go, energy release, tissue softening, somato emotional release, closure, pain / symptom relief, relaxation, etc.

Most importantly the delivery of care to a patient must be accompanied with love, confidence, gratitude and the patient’s best interest in mind.

10 Step Protocol for Pain Relief

  1. Still Point
  2. Diaphragm Releases
    – Pelvic
    – Respiratory
    – Thoracic Inlet
    – Hyoid
    – Occipital Cranial Base – cranial treatment
  3. Frontal Lift – cranial treatment
  4. Parietal Lift – cranial treatment
  5. Sphenobasilar Compression-Decompression – cranial treatment
  6. Temporal Techniques – cranial treatment
    – Temporal Wobble – cranial treatment
    – Finger with Ear – cranial treatment
  7. Temporal Decompression – cranial treatment
  8. TMJ Compression and Decompression
  9. Dural Tube Evaluation
  10. Still Point (CV-4)

Many of the therapeutic points of contact, hands-on craniosacral therapy correlates to the major chakras of the Energetic Human Anatomy. Dr. Kaminsky incorporates his knowledge of energy bodywork for maximum response and healing of the body.

Still Point Induction

Part of the 10-step protocol is the Still Point, first recorded electronically by Dr. Upledger’s assistant Dr. Zvi Karni. As the still point is induced, the patient will experience positive physiological changes. During the still point everything relaxes. Pain diminishes, somatic (muscular) dysfunction may spontaneously correct, occasionally with a noticeable relaxation, Breathing becomes effortless and smooth, and any muscle tensions seem to melt away.

The still point may last a few seconds to a few minutes. When it is over, the craniosacral system will resume its rhythm usually with a better symmetry and a larger amplitude.

A still point is an intended temporary suspension and recalibration of the craniosacral rhythmic flow, a pause and restart in the mechanism.

After the practitioner has induced your still point, upon the restart there are noticeable changes in the quality and range of motion at the arms, feet, head and other parts of the body being worked on. If the excursions into internal and external rotations are now restored to equality, and left-right symmetry of motion is improved, nothing further is required. If in the practitioner’s judgment the motion is not satisfactory, a repeat in the still point procedure with another turn may be repeated. Each repetition of facilitating a still point, will bring the abnormality (symptoms and lack of range of motion) closer to the norm and benefit the patient.

Not more than ten still point repetitions during the same treatment session is required. There are no side-effects, other than extreme relaxation and sleepiness, which will occur. However, the still point is contraindicated in cases of intracranial hemorrhage and cranial aneurysm, where changes in intracranial fluid pressure might prove detrimental to the patient.

For the practitioner of craniosacral therapy, the technique described for induction of a still point using the patient’s head or feet can be applied anywhere on the body with an intended effect. It is a question of determining the direction of greatest ease and range of physiological craniosacral motion. The practitioner follows this motion to its physiological end point and resists its return. After the still point is induced, and then restarted an improved craniosacral system activity is resumed, the therapist monitors and evaluates the new physiological motion patterns.

The still point is most often induced from the head and secondarily from the sacrum. Techniques applied to these anatomical parts are usually somewhat more rapidly effective than when applied to other parts of the body. The goal is simply to improve the activity of the craniosacral system.


The still point achieved by application of the technique to the patient’s occiput is traditionally called a “CV-4” technique. CV-4 means compression of the 4th ventricle in the head. Dr. Sutherland, the originator of this technique (Sutherland 1939), believed that he was compressing the 4th ventricle of the brain and thus affecting all of the vital nerve centers located in and about the walls of this ventricle.

The occipital squama provides an accommodation to changing intracranial fluid pressures. The CV-4 technique significantly reduces the ability of these squama to accommodate. The intracranial hydraulic fluid pressure is therefore increased and redirected along all other available pathways when the motion of occipital squama is extrinsically restricted. Thus, the CV-4 technique promotes fluid movement and hence, activation of dormant fluid pathways leading into the body.. The enhancement of fluid movement is always beneficial except in cases of abnormal intracranial pressure, aneurysm or hemorrhage.

The CV-4 technique positively affects diaphragm activity and autonomic control of respiration and seems to relax the sympathetic nervous system tone to a significant degree. Autonomic functional improvement is always expected as a result of still point induction.

Clinically, this technique is beneficial in cases where a lymphatic pump technique is indicated (Magoun 1978). It can significantly lower fever by as much as 4 degrees Fahrenheit in 30-60 minutes. It relaxes all connective tissues of the body and therefore benefits acute and chronic musculoskeletal spasm, tightness and strain. It is effective in degenerative arthritic processes, in both cerebral and pulmonary congestion, in regulating labor and as a means of reducing dependent edema. As well as significantly reduce pain.

The CV-4 technique is, quite simply, an excellent “shotgun” technique for a multitude of problems as it enhances tissue and fluid movement and restores flexibility of the autonomic response.


To facilitate the still point, your therapist will cup your head with his hands and lightly hold them there. Feeling for the movement of the head. As the patient’s occiput narrows in the extension phase of the craniosacral system cycle, this movement is followed by the thenar eminences of the therapist’s hands. As the subject’s occiput attempts to widen during the flexion phase of the cranial cycle, the practitioner’s hands become immobile resisting this widening phase of the mechanism. As extension phase narrowing of the subject’s occiput recurs, the practitioner will follow the narrowing of the subject’s occiput. Then the occipital broadening of the flexion phase of craniosacral system motion is again resisted. This procedure is repeated until the cranial rhythm becomes reduced then ultimately stops, temporarily but completely.

When this stop occurs in the cranial Rhythm, the still point has been induced. The still point will continue for a variable number of seconds or minutes. The patient’s respiration will change, and light perspiration will often appear on the forehead. A noticeable relaxation of the body will occur.

Within a few minutes, you will notice that the patient’s occiput once again attempts to broaden into the flexion phase of the craniosacral system’s rhythmic cycle. When you feel a concerted strong motion bilaterally, we follow this broadening and evaluate for amplitude and symmetry of craniosacral motion.


When inducing a still point through the sacrum, the therapist’s hand is applied to the sacrum. Follow the sacral motion into either the flexion or extension face, whichever seems to present the greater excursion. The therapist will resist the attempt by the patient’s sacrum to return to neutral through several cycles until the inherent motion of the craniosacral system ceases. The still point has been induced

Several factors might be considered in selecting where on a patient’s body the still point should be induced. Selection may be based upon convenience when, e.g., the therapist is already holding the sacrum or the feet and does not wish to disturb the patient’s body by changing position. It may also be based upon a desire to monitor the effect of the induced still point upon a given body part. Manual contact with painful body parts is unnecessary since, with practice, still points may be induced almost anywhere on the patient’s body, thereby affecting the pain symptoms at a different area of the body. The motion may be palpated in a restricted body region when the therapist desires to evaluate the effect of a still point upon the restriction in that area. The most convenient method of monitoring this effect is to have your hands upon the area in question during the procedure.

The induction of a still point from the body extremities when, e.g., one is attempting to evaluate and treat an uncooperative child, is an excellent means of obtaining cooperation. The still point experience is a pleasant one for the patient. The child soon learns to associate your touch with the pleasant experience of the still point. Cooperation ensues from this association and the stage is set for a mutually beneficial therapeutic process. It is beneficial to the therapist, both in terms of satisfaction and therapeutic value to the patient. Once cooperation and Trust has been achieved, more specific and efficacious treatment can be used with the 10 Step Protocol.

The Still Point is an excellent way to conclude the 10 step protocol. Many patients feel ultimate relaxation and at this time the nervous system integrates, processes and allows for the feeling of lightness.

Each craniosacral therapy session builds upon the previous session and ultimately healing, and health is achieved.

Beyond the Basics

Beyond the basic teachings, there are advanced methods of craniosacral therapy such as Cranial Pumping, Mouth Work, SER (somato emotional release), Myofascial Release, Arcing, Therapeutic Dialoguing, Positional Release and many other techniques incorporated by Dr. Kaminsky in your session.

Dr. Kaminsky is a licensed Chiropractor and advanced Craniosacral Therapy practitioner.

About Dr. Kaminsky & Craniosacral Therapy

Dr. Kaminsky is a 1999 graduate of the University of Bridgeport College of Chiropractic. He is licensed to practice in NY and has completed close to three thousand hours of professional continuing education since becoming licensed in March of 2000.

The primary approach used in his office is Craniosacral Therapy (CST) which is a method focusing on the cranium (head) and sacrum (a large bone at the base of the spine) scientifically proven to control life sustaining fluid flow throughout the body.

Craniosacral Therapy is a gentle, non-invasive, hands-on manual therapy approach that brings about healing via the fluidity of the body. The existence of the Craniosacral System was first discovered by Osteopath Dr. William Sutherland in the early 1900’s, calling it Cranial Osteopathy.  And later rediscovered, validated, and developed by Dr. John Upledger in the late 70’s early 80’s, who renamed it Craniosacral Therapy after doing five years of research at the Michigan State University, School of Medicine. In 1983 Dr. John, as he was fondly called, established a teaching institute in Palm Beach, Florida, to teach this cranial sacral method to all healthcare providers. The Upledger Institute is still very active today.

The craniosacral mechanism pumps fluid which is produced in the brain, called cerebro-spinal fluid (CSF), through the fascial network of the body, the purpose of which is to lubricate joints, muscles, organs, all cells and all tissues. It is the driving life force for your body’s systems to function properly, CSF also carries healing properties to bodily traumas, injuries and past surgeries.

The proper function of your cranial sacral mechanism, via CSF flow, maintains the normal tone of your muscles, provide nutrients to your organs, and keeps you out of pain. It sustains human life and allows your nervous system to stay responsive to challenges of daily living and your mind-body life experiences. The better your craniosacral mechanism functions, the better the flow of this life sustaining fluid, the better your body can handle physical and emotional stress. The uninhibited flow of this fluid throughout your body allows you to thrive, opposite of survival mode.

CSF is part of the Autonomic Nervous System (ANS) brain and spinal cord), which is physically encapsulated within the dural membranes of the spine and head.

One of the functions inside of your brain is to automatically generate energetic rhythmic impulses that function to pump CSF throughout your body, regulating your peripheral nerves, nervous system and organ systems, which in turn, sustain your function (physiology) and life. It is an important force that maintains everything functioning in your body. This is what we call the Craniosacral System, or Craniosacral Mechanism. It is the hydraulic, energetic and rejuvenating system of your body.

This measurable life force of moving fluid is palpable to a trained craniosacral therapist, like the heart rhythm, pulse rhythm, breathing rate, that can all be felt, so too can the Cranial Sacral Rhythm (CSR) be palpated and measured. It is the foundational diagnostic tool in real-time used to evaluate your current state of well-being (or lack thereof), and potential for health improvement and healing.

Compromises of your rhythmic impulse, correlates to CSF flow restrictions in the system which the body is unable to self-correct or overcome on its own. This is the reason why over time we develop pain, dis-ease, symptoms, conditions, mind-body disconnect and basically all human physical and psychological ailments.

When the fluid isn’t flowing optimally, your bodily rejuvenation is affected, and this is where the skill of an experienced craniosacral therapist becomes valuable. By placing his or her hands on your body, most commonly on your head and sacrum, for diagnostic purposes, the practitioner can detect, feel, evaluate, and rate the SSQAR (strength, symmetry, quality, amplitude, rate) of the rhythm; then bring forth correction of any limitations with subsequent experienced hand placements on different parts the body during a session.

A craniosacral therapist helps your rhythm reset, restore and renew allowing for healing to take place of the mind-body connection, musculoskeletal tightness and spasms, neurological deficits, autoimmune issues, organ function, many common conditions, and of course pain. Through a practitioners properly focused and attuned touch, your body is facilitated to release channels of fluid stagnation and flow restriction, which ultimately breakthrough, overcome and improve CSR and the function of vital fluid flow.

Dr. Alex Kaminsky is an advanced practitioner of Craniosacral therapy, having studied up to advanced levels including SER and pediatric courses. He has built a solid foundation with many years of experience, treating babies, children and adults.

To learn more, visit the other pages on this website. Call to schedule your appointment with Dr. Kaminsky.