A patient came in with two complaints. Headache. Jaw pressure. She had a concussive injury a while back, and that was the whole list she gave me.
I ran a full evaluation, including our FOCUS protocol with Dr. Aimee Spoelstra even though I don’t usually run that complete neuro workup on adults. I expected massive deficits given her mechanism and post-concussive history. Outside of some visual tracking challenges, there wasn’t much there at all.
Then I went to palpate her cranium. It felt like a brick. No symmetry, quality, amplitude, or rate issues to compare, because everything was symmetrically garbage. Static. Not pumping at all.
That stillness matters. CSF isn’t just fluid moving around. It buffers pH, regulates temperature, delivers nutrients, and clears metabolites and toxins from the cranial system. When it isn’t pumping, none of that is happening. Damadian and Rosa’s work on whiplash and MS points at the same mechanism, cerebrospinal fluid stasis leading to protein leaching and an autoimmune reaction, even though their study was specific to the upper cervical joint.
Here’s the part I actually want you sitting with. Chronic subluxation and chronic pain change the threshold for how the nervous system processes signals from the body. It becomes easy for the brain to dissociate from the body entirely. Stop checking in. Stop noticing what’s happening down there, because the input is too overwhelming to keep processing. That’s the third F after fight and flight. Freeze.
This is why some patients show up massively subluxated and report almost nothing. Their brain isn’t lying to you. It genuinely stopped registering what the body is going through.
I break down what that looks like on the table, why a trauma-informed approach matters even for patients who never bring up trauma, how to know when you’re pushing a patient past what they can metabolically handle, and what it actually looks like when a patient starts waking back up during care.
What we cover: (unchanged)
- Why I ran a full FOCUS neuro workup on an adult post-concussive case
- What a cranium in static mode actually feels like under your hands
- SQAR: symmetry, quality, amplitude, rate, and what it means when nothing is moving
- CSF’s four jobs: nutrient delivery, pH buffering, thermoregulation, metabolite and toxin clearance
- Damadian and Rosa: whiplash, CSF stasis, and the autoimmune connection
- Chronic subluxation, chronic pain, and the shift in nervous system threshold
- Dissociation as the third F: freeze
- Why a quiet patient can be more concerning than a loud one
- Building a trauma-informed approach into every adjustment
- Ragdoll: knowing when you’ve pushed a patient past what they can metabolically handle
- What waking back up looks like: sleep, energy, sensation returning
Your assignment this week: (unchanged)
Pull a case where the cranium feels locked down, where SQAR is flat instead of asymmetric. Look at the actual symptom list the patient gave you on intake. Ask yourself what they might have stopped reporting, not because it isn’t happening, but because they stopped feeling it. Then ask them directly.
Links:
Foundations of Cranial Adjusting: thecranialdoc.com/training
Chapters:
- 0:00 Cold open: “it felt like a vice”
- 0:40 The two-symptom case that didn’t add up
- 2:02 Running the full FOCUS workup on an adult
- 2:24 What the visual tracking findings did and didn’t show
- 2:41 Palpating a cranium that feels like a brick
- 3:07 SQAR and symmetrically garbage
- 3:40 What CSF is actually supposed to be doing
- 4:18 Damadian and Rosa: whiplash, stasis, autoimmune reaction
- 4:58 The symptoms she wasn’t reporting
- 5:19 Chronic subluxation and the nervous system’s threshold
- 5:45 Dissociation as the third F: freeze
- 6:18 Why a quiet patient can be the bigger concern
- 6:53 The disconnect between findings and what patients say
- 7:30 The avatar patient: chronic health challenges
- 7:58 Trauma-informed care: predictable hands, no surprises
- 9:35 Ragdoll: knowing when you’ve pushed too far
- 10:28 What waking back up looks like
- 11:04 This week’s assignment and where to learn more