In Reciprocal Tension

How does the body maintain its shape strength and stability when moving? Have you been curious why a patient presented with a headache after a fall on the pelvis or back ache after a car accident? Did you know that between them, the tentorium and falx are connected to every bone in the neurocranium?

Inspired by Sutherland's observations, we start to look at the body from the perspective of the spaces he described and how they are contained and connected. By developing our sense of these spaces within and around the body through practicals, palpation and exercises, we can start to understand how the body might organise itself in response to the different forces, stresses and strains it encounters. We discover how we as osteopaths can engage with the intelligent connective tissue matrix in treatment.


You must have attended Module 2: Osteopathy in the Cranial Field.

Course Content

  • Introduction to the concept of Reciprocal Tension, the distinction between the Reciprocal Tension Membrane, and reciprocal tension as a principle at work within the membranes of the whole body. The concept of fulcrums & the idea of a self adjusting suspensory 'fulcrum' for forces within the RTM (known as Sutherland's fulcrum).
  • Reciprocal tension systems in the body as a whole, a presentation of anatomical dissections highlighting the fascial relationships in the whole body, the interrelationships of the 4 diaphragms. Practical: The role of reciprocal tension in diagnosis and treatment using the principal of balanced membranous tension and engaging the therapeutic forces of the body's physiology.
  • Anatomy and clinical importance of the meninges: continuity of pia arachnoid and dura from occiput to sacrum (the core link), and into the cranial and peripheral nerves. Practical exploring the quality, individual layers and continuity of the meninges from brain to bony cranium. Treatment of dura using BMT.
  • The venous sinuses, structure and importance of involuntary motion for function. Practical: Viola Fryman venous sinus drainage technique
  • Embryology of the dura. Practical: palpation and treatment of dural reflections of falx, tent and anterior dural girdle in relation to the notochord.
  • Physiology of fascia: Extracellular matrix (ECM) as an intelligent organ, its relationship to neuro-endocrine-immune systems and homeostasis. Insights from Still and Sutherland to modern scientific understanding. Practical: exploring the innate wisdom of the ECM, and the how the membranous tissues respond to the fluctuation of the tide as expressed in involuntary motion
  • Reciprocal tension in the endocrine system and what that means in terms of therapeutic intervention for hormone related imbalances.
  • Tensegrity within the connective tissue systems of the body
  • Reciprocal tension and the 5 phenomena. How do the concepts covered in the course enhance our application and understanding of familiar treatment approaches such as CV4, potency within the CSF and CNS, BMT of sutures?

Course Format

Our faculty share their latest research and development discoveries in short lectures and presentations which are followed by group practicals and tutorials with a 1:4 tutor to student ratio. In your tutor groups, you will be encouraged to explore different aspects of the material through worksheets, discussions palpation exercises and hands on practicals. You will be given individual guidance from your tutor and will be invited to discuss your learning with colleagues in a friendly and mutually supportive environment. Excellent course notes are provided.

Course Details

3 day residential course. This course is run approximately once every 2 years in the UK. Please see our Course Schedule page for details.  

Dates & Prices

15 - 17 February 2019 £895 (non-residential)
£995 (residential [shared])

Accommodation at Hawkwood is in shared rooms, a limited number of singles are available at a supplement and allocated on a first-come-first-served basis.


Do I need any previous experience to do this course?

Yes, you must have taken the SCCO 40 hour course Osteopathy in the Cranial Field. 

How will this course benefit my practice?

This course will enhance your understanding of whole body homeostasis, and how this can be disrupted by trauma of any sort. It will help you develop your palpation using your whole body as a sensory organ, deepen your understanding of the whole body response to an area of dysfunction, strain or injury, and will enable you to treat more complex musculoskeletal problems.

Will I have to do any pre course study?

There will be some precourse reading sent out, but this is not onerous.

Is the course assessed?

All courses are assessed in a very open and student centered way. You will be encouraged to reflect on your own progress each day in discussion with your tutor.

What next?

Join the SCCO Mentoring Scheme: an opportunity to work with and share learning experiences with like minded and experienced colleagues.

You could choose to write an assignment: The SCCO membership pathway requires 3 written case study assignments. Writing this assignment is an excellent way of reviewing and consolidating your learning from the course.

Refresher Day Bring your questions and experiences or difficulties to share with your colleagues and experienced tutors on a refresher day. An excellent way of consolidating your learning from the course.

Other courses: The Neurocranium and Sacrum: Living Bone links very well with this course, exploring the unique qualities of bone as a connective tissue, and its role in the biotensegrity function of the connective tissues. Or choose another modular course to continue your journey on the SCCO membership pathway.

What our students say

Marvellous tutors who are so expert and so generous in their support of our learning

Great up-to-date research to support the theories and the osteopathic principles, together with the insights that just kept unfolding!

The course exceeded all my expectations in a freedom to enjoy learning about cranial osteopathy.

The whole course dynamic was great. The flow between structured, well presented and researched lectures, to the well controlled and directed practicals - all fantastic!

Everyone connected so well!

Such a safe environment created by the tutors to learn and share. Their presence, clarity and kindness were fantastic - everyone felt accommodated.