The Sacro Occipital Technique is a popular chiropractic technique deployed to check and adjust subluxations from the occiput (the next area) to the sacrum (at the base of the spine). Right from pregnancy and infancy, this technique can be delivered across the lifespan and altered to suit the age and strength of the individual under care.
While several papers have looked at various elements of the Sacro Occipital Technique (SOT), a new study has taken aim at primary cranial analysis for all three categories of SOT. We know these three categories to be the primary cranial sacral respiratory mechanism which allows for the movement of cerebrospinal fluid in working with the body’s natural breath mechanism, the way the body maintains weight-bearing function (the ligaments and the sacroiliac joint as we work against gravity), and lumbar subluxation.
The study was a retrospective analysis of 85 patients who had undergone chiropractic care and had cranial analysis and adjustments. Published in the Asia Pacific Chiropractic Journal, the paper gives unique insight into key factors that the author found to be significant in caring for these patients.
The first factor to note right off the bat is that the study’s participants were not selected on the basis of symptoms or any specific examination finding (like subluxation location or pain scores for example). Rather, the similarities noted included three factors: examination for lateral head tilt, zygomatic ranges of motion, and comparative facial analysis. 
The foundations of the study
Before we delve into the study, we need to look at these key terms. A lateral head tilt is the orientation of our head to one side. In an ideal posture, our spine and head would be in a straight line when looking from front to back or vice versa. But with a lateral head tilt, a persons head moves or tilts to the side without their knowledge.
Then there’s the zygomatic range of motion. The zygomatic bones sit on either side of the face. They are diamond-shaped bones that form the most obvious part of the cheek and work up the sides of the eye sockets. They are also called cheekbones or malar bones, and to be honest, most people don’t think of them too often (unless they’re applying makeup). However, these bones are vital in tooth deployment and adapt throughout the life span, undertaking important functions in line with cranial sutures. Respiration and brain growth as well as the stressors of life can impact these under-appreciated bone structures.
The third element is the facial analysis. Far from being a cosmetic element, there are important things that facial appearance can tell us about the structure and function of a person’s cranium and thus the function of their “cranial soft tissue, sensory organs and functional spaces.” 
What the study found
When looking at this cohort of people, the study’s author looked at the three foundations above and made some noteworthy connections. Of the 85 patients, 80 of them had a lateral head tilt indicated by one lower ear, and 71 of these had limitations on craniofacial ranges of motion pertaining to the zygomatic bone on one side of the body. The other nine lateral head tilt patients had contralateral zygomatic bone range of motion limitations – that is, ROM limitations applying to both sides of the face.
Of the 80 lateral head tilt patients, 67 of them had facial analysis findings on one side of the face. The 13 who didn’t have one sided abnormal facial analysis findings, had abnormal findings applying to both sides of the face. The chiropractor was specifically looking at the lower superciliary arch, the cheekbones and the distance from the maxillary / zygomatic suture to the zygomatic arch of the temporal bone.
In line with this, the paper advocates for cranial adjusting targeting five areas of structure and function:
- Sutural release,
- Platysma Stretch,
- Maxillary Spread,
- Maxillary Straddle, and
- Zygoma adjustment
Full details are provided in the paper referenced below. While the retrospective study created some interesting connections, and gave rise to an informative paper giving chiropractors practical and actionable guidance on what may assist them in patient care, further research is certainly warranted.
We look forward to seeing what emerges.
- Getzoff H. A primary cranial analysis and adjustment method for all three Sacro Occipital Technique (SOT) Categories: A retrospective study of 85 patients. Asia-Pac Chiropr J. 2023;4.2. URLnet/Papers-Issue-4-2/#GetzoffCranial