The cranial concepts were fathered by William Garner Sutherland, DO (1873-1954) who graduated from the American School of Osteopathy (known today as A.T Still University) in 1890. Sutherland was a direct student of the doctor who developed the field of osteopathy, Andrew Taylor Still, MD, DO, (1828-1917). Sutherland devoted his career to investigating his idea about cranial mobility, which he conceived while analyzing a mounted skull during his former year as a student.

After years of self-guided research and experimentation, Sutherland discovered an inherent rhythmic presence of motility within the central nervous system, which he defined as the primary respiratory mechanism of the body. Detectable by the sensory receptors in our fingertips, this rhythmic motion involves an expansion (coiling) and contraction (uncoiling) of the brain, cerebellum and spinal chord. Sutherland postulated that this movement is driven by capillaries along the lateral ventricular walls known as the choroid plexus; the 'functional mechanism' which interchanges the cerebrospinal fluid from the arterial blood into the lateral ventricles. The cerebrospinal fluid fluctuates within the subarachnoid space to provide buoyancy for the central nervous system. Sutherland revealed that the purpose of cranial bone articulation is to accommodate for the movement of the primary respiratory mechanism. Furthermore, misalignments of cranial bones cause restrictions, which impinge upon the intracranial venous flow and affect the sufficient interchange of cerebrospinal fluid needed for normal fluctuations to occur within the subarachnoid space. Stagnation of cerebrospinal fluid could then cause implications within other systems of the body and eventually lead to pathology. 

Cranial bones have dural membrane attachment points which connect to the C2, C3, ligamentum nuchae, S2 and the coccyx. Because of this, cranial lesions can directly and indirectly affect other regions of the body. 

Cranial techniques are used locate and release restrictions. Once a restriction has been released, the motility of the central nervous system and fluctuations of cerebrospinal fluid can return to normal function, as can all other affected areas of the body.