OMM #12
Wed, 08/27/03 2pm
Dr. Chapman
K.Stancoven for Sheila Gartman
Page 1 of 4
Parietal Lift and V-Spread
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Parietal Lift
o Parietal bones receive a great deal of trauma
 Hit the top of your head on something, etc…
o Restrictions in the coronal sutures can cause restrictions in the normal
motion of the SBS
o The Sagittal sinus course is under sagittal suture between the parietal
bones
 The falx cerebri splits below the parietal bones
 Serves as a pathway for the sagittal sinus
o Middle meningeal artery lies under the squamous portion of the
parietal bone
o A large portion of the venous drainage is associated with the parietal
bones including
 Dr. Chapman stated that Netter has a good diagram of the
cranial sinuses
 Sagittal Sinus
 CSF moves from sagittal sinus into the confluence of
sinuses into the lateral sinus
 Lateral Sinuses
 CSF then moves from the lateral sinus into the sigmoid
sinus
 Sigmoid sinus
 CSF moves eventually into the venous system
(eventually into the jugular veins) from the sigmoid
sinus
 Located underneath the temporal bones
o Arachnoid granulations are primarily located in the parasagittal area
o Falx cerebri is attached to the parietals along sagittal sinus
 Pariteal lift aims to relieve the restriction on the falx cerebri
and sagittal sinus
o Any fascial or membranous restriction can cause decreased venous
flow
 Parietal lift improves venous flow out of the head
o Beneficial for patients with headaches or increased anxiety
 Usually better for vertex headaches
 Usually, the pain is directly at the sutures
 Parietal lift also used to augment treatment on the temporal
bones
 Remember, it’s all connected
So…How Do I Do It?
o Contact the parietal bones using a vault like contact (contact only the
parietal bones)
OMM #12
Wed, 08/27/03 2pm
Dr. Chapman
K.Stancoven for Sheila Gartman
Page 2 of 4
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 Similar to vault
 Place fingers on the parietal ridge above the temporal fossa
o Thumbs will bridge the sagittal suture
o Do not cross suture lines of the following sutures:
 Coronal suture
 Squamous suture of temporal bone
 Lamboidal suture
o Treatment modality is based upon gentle disengagement of sutures
o GENTLY compress medially to disengage the parietal bones from the
squamous portion of the temporals and the sphenoid
 Gently bring fingers up
 Remember to keep your fingers off the temporal bone
o Try to encourage external rotation by gently applying pressure with
crossed thumbs just lateral to the sagittal suture
 External rotation = flexion
 Don’t apply any pressure with your thumbs
 Use them as a fulcrum to move the parietal bones into
external rotation
o Lift with a preference in external rotation until the parietal bones are
freed
 Feel gentle release and fingers move up slightly
 Release is subtle, there won’t be any popping or
clicking sounds (like HVLA)
 As if the bones get softer
 Don’t be discouraged if we can’t feel this release on the first
try, it takes some time to perfect
The next slide shows the proper placement and action of your fingers while
performing the Parietal lift
V-Spread
o Is used commonly in conjunction with directing the “tide” of the CSF
 Can be used on any sutures
 Today, we are working with the occipitalmastoid suture
 It is the easiest to feel movement on
 We are applying a direct impulse between your fingers to free
up the suture
o CSF surrounds and permeates within the brain, supplies nutrients to
the neurological system
o Tide is the inherent motion of CSF = CRI
o Therefore, need to review some of the salient premises of the “tide”
Premises of the Tide
o The CSF is in control
o The potency of the Tide is used for diagnosis and correction
OMM #12
Wed, 08/27/03 2pm
Dr. Chapman
K.Stancoven for Sheila Gartman
Page 3 of 4
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o Can be used to assist in creating a directed impulse which is initiated
by very gentle pressure applied to the skull
o The impulse is directed straight through the contents of the skull and
suture
 Described as like bouncing a tennis ball on the floor
o The potency of the tide is amplified in relation to the distance from
which it is directed, much like a wave in the ocean
o If the suture in question (the occipitalmastoid suture) is unrestricted,
the impulse will feel “like waves rolling quietly up a smooth sandy
beach”
 Like a nice in/out motion
 Motion will be smooth if unrestricted
o If the suture is restricted there will be anywhere from a hesitation in
the impulse to “the profound repercussion of a rock bound coast”
 Any restriction will cause the motion to feel like a banging
So…How Do I Do This One?
o For demonstration, we are going to address the Occipitalmastoid
suture
o Diagnose which side feels restricted by gentle palpation
o Apply a V-spread contact with one finger on either side of suture
(Occiput and Mastoid)
 A common mistake is to place the fingers directly on top of the
suture
 Remember to place you fingers on opposite sides of the suture
o Place other hand on opposite frontal eminence
OK, I’m With Ya So Far
o Now, from the V-spread hand direct a fluid impulse to the frontal hand
and locate the point of maximum impulse (PMI)
o Once this is located, reverse the direction by applying 1 or 2 fingers
over that PMI and directing the fluid wave to the restricted suture until
it frees up
 Gently push with your fingers that are on opposite sides of the
occiptalmastoid suture and feel for the wave with your other
hand on the frontal bone
 When you feel the return wave over the frontal bone, move
your hand to the point where the wave feels the strongest - PMI
 Gently push the wave back towards the occiptalmastoid suture
 Repeat until you can access the motion
 Access suture motion
 Does it feel like a banging or thudding wave
o Restricted
 Or is it a nice and smooth wave
o Unrestricted
OMM #12
Wed, 08/27/03 2pm
Dr. Chapman
K.Stancoven for Sheila Gartman
Page 4 of 4
 Gently push with your fingers
o As the OM suture starts to loosen up, spread the two posterior fingers
to assist in freeing up the restriction
 The outcomes that are positive for this treatment
 Nice, soft, release on the suture
 No more tapping on frontal bone
o Nice, slow wave motion is felt
o The last slide shows the correct placement of your hand and fingers
while performing the V-Spread treatment