Balanced Ligamentous Tension [M4]

Location: Hawkwood College, STROUD
Duration: 4¼ days
Price: £1370 (non-residential) £1520 (residential*)
Entry criteria: Open to any qualified osteopath
Next delivery: 16—20 May 2018 (see below for alternative dates)
Leader: Susan Turner

W.G. Sutherland's Approach to the Body as a Whole Using the Principle of Balanced Ligamentous Tension - An essential aspect of our everyday osteopathic practice is treating peripheral and spinal joint strains and sprains. This large but relatively little known body of knowledge described by W. G. Sutherland gives us a precise, gentle and effective way to treat all the joints of the body.

Why does a traumatised joint (such as a sprained ankle) remain vulnerable to injury long after the original injury has healed?

Using the principle of Balanced Ligamentous Tension osteopaths are able to feel the directional forces imposed on the ligaments in traumatic joint injuries. Once you have learned to apply these principles you will be able to understand exactly how a joint was strained, even if this was many years ago. By engaging the self correcting forces of the body to rebalance the ligaments the joint can return itself to a balanced state of health. This makes it much less vulnerable to re-injury.

Our lineage back to Still:
'Dr Still has taken my hand into his...'
Members of the SCCO faculty learned these techniques directly from Dr Anne Wales. Dr Wales learned them from Sutherland and this takes our lineage directly back to A.T. Still.

Course Content

  • Balanced ligamentous tension principle for spine ribs and pelvis
  • Balanced ligamentous tension principle for peripheral joints
  • The anterior fascia
  • Lymphatic circulation
  • Introduction to the treatment of internal organs

Course Format

The course consists of a well balanced mixture of short lectures or workshops followed by practical sessions. You will work in small groups of 1 tutor to 4 students, giving you almost individual tuition in the practicals. Time is set aside at the end of each day for individual reflection and discussion with your tutor. Excellent course notes are provided.

Next steps

Use this approach: There is no better way of learning to use these techniques in practice than to use them on your patients. Do not be discouraged if it does not work perfectly first time, practice makes perfect. Keep your course file in your treatment room, and refresh your memory as you apply these principles. 

Mentoring scheme: The mentoring scheme has opportunities for joining study groups, or you could form your own study group with a few friends to practice the techniques. You may also want to observe an osteopath using this approach in practice.

Repeat the course: You might want to consider repeating this course. There is a lot to be covered on this course and it is difficult to remember it all afterwards. Good course notes are provided. We recommend students take this course more than once to enable them to work with increasing depth, precision and effectiveness.

Alternative Dates

Hawkwood College
16 - 20 May 2019 £1370 (non-residential)
£1520 (residential**)
Hawkwood College
7 - 11 May 2020 £1370* (non-residential)
£1520* (residential**)

* Price unconfirmed, subject to increase
** Residential 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 have to take Osteopathy in the Cranial Field before taking this course?

No, this course is open to anyone. It is particularly suitable for new graduates who want to learn this approach to treatment.

How will I remember all the different techniques?

This course covers almost every joint in the body, and there is a lot to remember. But excellent course notes are included, and it is a good idea to keep these at hand in your treatment room and refer to them regularly.

Do I have to be a model for other students during this course?

Yes, as on every SCCO course every student is expected to be a model. It is a useful learning experience to feel the treatment from the patients perspective. Our experienced faculty monitor practicals closely to ensure that the techniques are correctly done.

Osteopathic Practice Standards & CPD

Learning Outcomes & Assessment Criteria
On completion of this course you should be able to:
To achieve the learning outcome you must demonstrate the ability to:
1 The student shall demonstrate a good knowledge of the ligamentous , fascial and lymphatic anatomy of the whole body in relation to the particular architecture of each structure engaged with. Articulate, analyse and interpret examination findings with reference to the ligamentous , fascial and lymphatic anatomy in a practical setting and show that they can offer an informed explanation of the functional significance of their findings.
2 The student shall demonstrate therapeutic effectiveness and understanding in the application of the principle of Balanced Ligamentous Tension. This includes an awareness of the sequential stages of the BLT process, ie:
i) Motion testing to discern the manner in which the tissues are strained.
ii) “Exaggeration” of the strain to the approximate point of balance ie the point where all opposing forces within the strained joint balance each other out and are therefore in a ‘neutral’ field within which the potency for spontaneous resolution of the strain is poised for action.
iii) Engagement/ matching of the tissue pattern and tone to the degree where the involuntary action of the ligaments begins to actively explore for the refinement of the point of balanced ligamentous tension.
iv) Staying present and supportive to the poised stillness of the potency of the balance point.
v) Noting the moment when the fulcrum shifts and the resolution phase begins wherein the ligaments ’take over’ and guide the joint towards its ideal positional relationship.
vi) Noting the completion of the process, positionally and qualitatively as a return of alignment, three-dimensionality and improved fluid interchange and vitality. Motion testing if necessary.
3 The student shall demonstrate the inner discipline of remaining physically and energetically well-grounded to provide a stable fulcrum around which the patient’s involuntary mechanism feels supported enough to activate and complete a BLT therapeutic cycle by its inherent action. This sometimes includes the principle of steadily ‘holding the bolt while the patient turns the nut’, eg as in application to the hip joint , ribs and clavicle. The student should be able to express an understanding of the concept of Reciprocal Tension and make the case for its application to multiple systems in both a theoretical and practical setting.
4 The student shall demonstrate the ability to give clear and unambiguous instructions to the patient, especially when patient postural cooperation is required. This should include an awareness of the need for patient consent.  
5 The student shall demonstrate an understanding of osteopathic principles especially the interrelationship of anatomy and physiology, including the reciprocal effect of ‘container’ and ‘contents’. It also includes the ability to discern the physiological importance of each structure addressed within the context of the body as a whole. Construct, implement and monitor osteopathic management plans for your patients and adapt them in response to clinical evidence and patient needs over time.
Student Learning
Type of LearningLearning ActivityNLH*
Scheduled Learning Hours Lectures 13
Practical classes 13
Scheduled online activities  
Guided Learning Directed reading & research  
Reflective portfolio development  
Peer assisted learning 4
Independent Learning Unguided reading from defined reading list  
Assessment preparation  
Tutor defined project / Dissertation activity  
Autonomous Learning Reading from non-specific sources  
Reflection on clinical experiences 4
Placement Clinical observations  

* Notional Learning Hours

CPD Requirements: Mapping to the OPS
OPS Theme OPS Mapping
  1 2 3 4 5
Communication & Patient Partnership        
Knowledge, Skill & Performance  
Safety & Quality in Practice
CPD Standards  
CPD activities are relevant to the full range of osteopathic practice See above mapping exercise        
Objective activities have contributed to practice Peer review/Observation        
Case-based discussion activity        
Seek to ensure that CPD activities benefit patients Communication/Consent activity        
Maintain CPD documentation Certificate of attendance/Overview document provided to student