Contraindications/Modifications for CST Therapy

OCBR - No Full Platform until age 13, modified Platform on Down’s Syndrome and other conditions
where ligamentous laxity exists. (Rheumatoid Arthritis and other inflammatory Conditions, Vertebral
Artery conditions, Frail Patients) Patient who has experienced whiplash might need x-rays and physician
approval before doing Full Platform.

CV4 – not performed until age 9

Decompression Techniques Only – Under age 9

Temporal Decompression - Ear pull lateral only under 9 years of age

CST

 Recent brain hemorrhage/aneurysm or stroke. Refer to an advanced therapist, or

proceed after the client's physician verifies there is no more bleeding and gives you the
go-ahead.
 Recent spinal tap or puncture in the Craniosacral system. Refer to an advanced
therapist, or proceed after the client's physician verifies there is no more leaking of spinal
fluid and gives you the go-ahead.
 Arnold Chiari Malformation. This is an incomplete foramen magnum in which the
inferior poles of the cerebellar hemispheres and the medulla protrude and may herniate
through the foramen magnum. Refer to an advanced therapist, or proceed after the client's
physician gives the go-ahead. If you do proceed, do so with the lightest pressure possible.
If you do any dural tube work, set the intention to work in a way that causes no inferior
strain. In other words, don't do anything that places more strain - or shifts the fluid
pressure to place more strain - on the foramen magnum, brainstem and dural tube. You
might even choose to avoid certain techniques altogether that directly engage the area of
the malformation, such as occipital cranial base techniques.
 Recent fracture of skull bones, vertebral column or ribs or surgeries in these
structures. Just proceed cautiously and refer to an advanced therapist if you have any
concern.
 Open cavity head wound or closed head injury
 Acute Meningitis
 Heart attack in acute phase
 Infection where cause is suspected to be tick bite. Lyme disease can present with
increased intracranial pressure leading to headache.
 Brain Tumor depends on patient’s specific circumstances.

Article from Dr. Upledger about this issue:

http://www.massagetoday.com/mpacms/mt/article.php?id=13387
A few precautionary reminders:
• thoracic inlet prior to OCB and cranial techniques
• leave temporal bones in synchrony
• follow compression with decompression
• do not treat infants below the age of two unless you have taken the pediatric course/s.