By Alexa Linton

Equine Sports Therapist

Exploring the function of these potent puzzle pieces and the far-reaching impact of a cranial imbalance on your horse. 

The equine skull has thirty-four bones, while the human skull is made up of twenty-two bones of which eight are cranial bones and fourteen are facial bones. That is quite a number of bones making up our noggins and those of our horses. But what do they all do? That’s a great question with a complex answer. 

Various sources describe the role of these bones as ranging from the rather basic functions of protecting the brain from damage and concussive forces, and providing the necessary nooks and crannies to move blood, lymph, and nerves to and from the brain tissue, to exponentially more complex functions. The latter include helping to facilitate the movement of cerebrospinal fluid; adapting to changes due to injury or embryological factors; ensuring in part the health of the spinal cord and accompanying structures; and generally supporting the production and maintenance of the life force that keeps us moving with energy through our days.

As I head into my second year of osteopathy training for humans, I am continually flabbergasted by what these bones actually get up to in a given day. Not very long ago, my knowledge of the cranial bones was limited to a vague recollection of the location of the sutures along the bone lines of my skeleton Hallowe’en costume, and the knowledge that getting hit in the head could be detrimental.

Even my five-year kinesiology degree didn’t give these bones much focus. But, when I started working with horses as an equine sports therapist, it soon became clear that many horses are dealing with imbalances in their cranial bones, often stemming from trauma to the head such as hitting their head on a trailer or stall, pulling back when tied, an issue from birth, or, in many cases, dental imbalances. I also started to realize that the overwhelming tendency for a horse with issues in their cranial bones is to also present with lethargy, anxiety, abnormal spookiness, head tossing, behavioural changes, poor circulation, or excessive discomfort in their structural system. It struck me as odd that the state of these bones, the majority of which much of the medical community believe to be fused, could have such an impact on health and well-being. More surprising still was the powerful and often immediate effect subtle balancing techniques seemed to have on these symptoms. 

These in-the-field, unintentional “experiments” on horses were a part of what led me back to school for osteopathy, the foundation of cranial work, in a quest for further understanding. Osteopathy, as defined by Osteopathy BC, is “a safe and effective approach to health care which works in combination with the individual’s own homeostatic mechanisms to help restore homeostasis and optimal health. It understands the relationship between structure and function within the body and that all aspects of the body must work together to maintain health.” It is also the foundation of cranial work as we know it today.

William Sutherland, considered the father of cranial work, was an osteopath, a student of the father of osteopathy Andrew Taylor Still, an innovative thinker, and an adventurer into the cranial field. His discoveries about the movement of the cranial bones are still valid today. He referred to the tiny movement of these bones as motility, which later in his research became further understood as primary respiration, to attempt to explain a rhythm present that represents life itself and is separate from respiration and heart rate. When these bones move in this rhythm it is imperceptible, measured in microns, and unseen to the human eye. In fact, the skills of palpation have to be well-honed to even feel them move at all. It has taken me over a year of focused schooling to gain trust in my hands and what they feel on the cranium. In Sutherland’s research, he began to realize that these bones moved without an apparent “mover,” and that this natural movement promoted a healthy life force and overall well-being. Conversely, a restriction to this movement, depending on the bones affected, could produce a range of symptoms that extended far beyond the cranium itself. To this day, osteopaths continue to argue about what creates this inherent movement, which is more than likely another reason why much of the medical community is challenged by the concept of cranial motility.

For the purpose of this article, let’s imagine that in a healthy body the cranial bones move in minute amounts. Let’s also imagine that this movement supports healthy circulation, movement of the cerebrospinal fluid, brain function and protection, the well-being of the spinal cord and the surrounding dura, and much more. What happens when there is an impact to the cranial bones or a change at the level of the sutures? Depending on the bone(s) affected, symptoms in both horses and humans can range from headaches, dizziness and tension, to lethargy, migraines and confusion.

I was inspired to write this article by two recent cases. 

The first involves a dear friend who was involved in a horse accident and was traumatically impacted at the nasal-maxilla bone level in the centre of her face. This is a zone that can be highly affecting as it protects the midline bones including the ethmoid and sphenoid, which are integral to healthy brain function and the primary respiratory mechanism (also referred to as the cranio-sacral rhythm). As is common with this type of centreline impact, she experienced vertigo, lethargy, and pain a concerning amount of time. Happily, she is getting great care and will be working with both a talented osteopath and a medical specialist to regain the harmony of her cranium and vitality levels, but it will take time to regain her equilibrium. Her injury has driven home an awareness of how debilitating a cranial injury can be, particularly one affecting the central structures of the cranium, and how important it is to receive support both medically and therapeutically to recalibrate the intricate harmony of these bones and the structures they support. 

The second case involves a horse I work with regularly, who had a mysterious accident in his pasture that resulted in a substantial growth of bone and scar tissue between his eyes and down his nasal bone. Amazingly, he doesn’t present with any noticeable pain, but he does show excess eye watering on one side and after one of our treatments will often have a big sinus clearing. He has also shown noticeable reduction in the size of his bump over a course of treatments using gentle cranial work. Luckily for this fellow, his impact was out of the main danger zone of the brain, but was over an area full of sinuses and responsible for drainage, which could have an impact in the future although not as connected to his overall function. He’s also very lucky to have an owner who is committed to getting him back to his best and is open to this type of work. And happily, he is a fan of treatment!

For me, these two cases highlight the need for more understanding in this area so that both horses and people are able to receive support if needed, and their symptoms arising from a potential cranial issue are recognized and worked with effectively. Typically, I find myself working cranially with more than three-quarters of my equine and human clients. 

Other important factors that can shift the harmony of these bones are dental imbalances, birth (both giving birth and being born), a poorly-fitting or ill-used bit, tight facilitated muscles in the neck (which attach onto important cranial bones), a tight nuchal ligament in the neck, the balance of the hyoid bone, the balance of the upper cervical vertebrae (which connect to the occiputal bone at the base of the skull), and issues along the spine, sacrum, or pelvis. Over the years, I have found that issues are more common in horses who have a tendency to pull back, are orally fixated, tend to “giraffe” or set their neck under saddle, and hold a great deal of tension or discomfort in their muscle or fascial systems. I have also noticed a strong connection between “head shy” horses and cranial imbalances.

To increase your awareness, pay attention to subtleties. Observe your horse’s head for lack of symmetry, and notice how he responds to your approach and your touch on both sides of his cranium. Photo: Devot Gillott

How do we help? 

Awareness is half the battle. You may have suspected that your horse suffers from headaches, noticed odd or unpredictable behaviour such as abnormal spookiness, lethargy, or one-sidedness, or felt that he just hasn’t been quite the same since he hit his head on the trailer a year ago. You may have wondered why your horse experiences head shyness, especially on one side. Take a little time to pay attention to the subtleties.

Start at a distance. Notice whether his forehead is the same size on each side of the midline. Does he respond to you in the same way on both sides of his cranium? Observe any asymmetries and his response to your request to touch his cranium. If your horse is open to it (and many are not), gently palpate the muscles of his jaw, under and behind the jaw, around the ears and eyes, and at the poll. Does he move away from your touch, or enjoy it? Is one side easier than the other? Do both sides feel symmetrical in tension and receptivity? All these are clues as to what is going on for your horse and the health of his cranium. Next, check his neck. Is he able to rotate towards you easily and without reaction or strain? Is it the same on both sides? Can he rotate back towards his ribs in a side bend without turning his head? Can he touch his chest with his nose (flex between the occiput and the first cervical vertebrae)? All of these clues share a little about his level of tension and let us know if he might need some further support. 

Because it is so difficult to feel what is happening in the cranial bones without a great deal of practice, your assessment may lead you to seek the help of a certified equine sports therapist, osteopath, or a craniosacral therapist experienced in working with horses. Because horses can initially be resistant to cranial work, and because it has the potential to resurface trauma during the healing process, any therapist you choose should be well-versed with horse behaviour. 

If you have been affected by a cranial injury, such as a concussion or whiplash, consider adding osteopathy or craniosacral therapy to your self-care practice. Even a long-time injury can still be impacting your well-being. You can also work with your horse on opening up and relaxing the muscles in the neck and over the spine, and cultivating relaxation in all of your work together. I love TTouch, gentle massage, myofascial release, and straightness training for this purpose. From the beginning of my 12-year career as an equine sports therapist, I have actively promoted the addition of wellness tools to the horse person’s toolkit. Consider working with a professional to learn gentle techniques to promote a healthy, happy cranium in your horse and in yourself. Don’t hesitate to reach out to for referrals to resources, great therapists in your area, questions or comments. 

More by Alexa Linton

Main article photo: Shutterstock/Mariait