What I Look for During a Cranial Assessment

People sometimes assume a cranial exam is just pressing on the skull. In practice, I’m watching for several different kinds of findings at once, and none of them means much in isolation.

Symmetry

I look at eye level, facial symmetry, and head position. Some asymmetry is completely normal — very few faces or skulls are perfectly symmetrical. What I’m interested in is whether a pattern of asymmetry connects to a person’s history or presentation.

Movement and range of motion

I assess how the head, neck and jaw move, looking for restrictions or asymmetries in that movement compared to what I’d expect.

Muscle response

Using muscle testing, I check how a muscle responds when I apply a contact to a specific cranial area. A change in that response is one data point — not a stand-alone diagnosis — that helps me decide where to focus.

History-linked findings

A history of head injury, dental work, orthodontics, or facial trauma shapes what I pay closer attention to during the physical exam. The history and the exam inform each other.