Balanced Ligamentous Tension [M4]

Location: Hawkwood College, STROUD
Duration: 4¼ days
Price: £1150 (non-residential) £1400 (residential*)
Entry criteria: Open to any qualified osteopath
Next delivery: 16—20 May 2019 (see below for alternative dates)
Leader: Susan Turner

This course is the perfect bridge between so-called 'structural' and 'cranial' osteopathy and offers a unique opportunity to fine-tune your palpatory and therapeutic skills in a supportive environment.

The diagnostic and treatment principle explored here was learned by William Sutherland under the hands of AT Still when he was a student. In his words “Dr Still has taken my hand into his and allowed me to feel the lesion as it exaggerated and then as the ligaments pulled the bones back into place”. WG Sutherland, in turn, taught Anne Wales DO who passed it on to members of our faculty.

We will explore, often with astonishment, what WG Sutherland meant by “Using the powers within the patient’s body”, applying the therapeutic principle of balanced tension in every part of the body.  We will explore how we may use the skeleton as a ‘handle’ to enhance the spatial and circulatory environment of the vital organs, and how the lymphatics may be enlivened through moving the fascia.  

Many osteopaths have found that their cranial palpation improves after taking this course as does their confidence, effectiveness and enjoyment in practice. It was working in this way with the joints of the body that led WG Sutherland develop and apply the same principle on a much finer scale working with the membranous articular mechanism of the cranium.

This approach is rooted in the origins of osteopathy, and may provide a foundation for the participant to extend the boundaries of what he or she believed was possible through osteopathy.

Alternative Dates

Hawkwood College
16 - 20 May 2019 £1150 (non-residential)
£1400 (residential**)
Hawkwood College
7 - 11 May 2020 £1150* (non-residential)
£1400* (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.

What our students say...
"This course has revolutionised my treatment of the shoulder."

"...did more to broaden my scope as an osteopath than any other course I have taken. After taking the course I was suddenly able to treat conditions like ankle sprains, meniscus tears and rotator cuff injuries with such efficacy that I was putting the resident physio out of business! The course demystifies the process of cranial work and gives very practical, specific techniques for releasing virtually every joint in the body, from head to toe.I have taken the course several times, and learned something new each time.Don’t pass up this opportunity to learn a valuable new way of working."

"Words cannot describe! Inspirational and a credit to SCCO! I hope I get to experience the gentle yet awesome teaching approach again."

"Thank you to all the tutors for an outstanding course. That is the best course I have ever been on! I will probably repeat it next year and other courses will just have to wait. I brought so much with me back home!"


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