BLT techniques based on Anne Wales’ original concept

Dr Julie Fendall had the privilege of participating in one of Dr William Garner Sutherland’s study groups alongside Dr Anne Wales, who became a key mentor and source of inspiration in her exploration of the membranous articular mechanism.

She attended numerous courses led by Dr Wales and worked closely with her over an extended period, gaining deep clinical and theoretical insight.

During these years, Dr Fendall began exploring the work of Professor Donald Ingber on tensegrity, seeking to better understand how osteopathy — particularly Balanced Ligamentous Tension (BLT) techniques — can influence the body as a whole, restore health, and support long-term wellbeing.

BLT techniques are a unique and valuable tool for osteopaths: they are gentle, non-invasive, pain-free, and can be applied safely across a wide range of clinical situations.

Course Overview

This course is primarily practical and is designed for osteopaths who wish to develop a refined, effective, and patient-friendly manual approach to treating:

• articular dysfunctions
• axial system conditions
• peripheral issues

Throughout the course, Dr Fendall will share her clinical experience, insights, and practical applications, providing participants with tools that can be immediately integrated into their daily practice.

Programme

Monday 9 november

Introductory remarks. Osteopathic principles . Tensegrity and mechano-transduction. Fluid exchange and its importance during the osteopathic treatment. General Principles of Balanced Ligamentous Tension.

Practice:

• General principles: palpation, quality of contact and treatment approach
• The interphalangeal joints of the hand.

Anatomy, physiology and embryology of the upper extremity

Practice:

• Treatment of the metacarpophalangeal joint
• Treatment of the carpometacarpal joint
• Palmar fascia spread technique
• Still’s Wrist Technique
• Superior and inferior radioulnar joint
• The interosseous membrane
• The fluid pump technique to the forearm
• Treatment of the elbow
• Treatment of the glenohumeral joint
• Treatment of the scapulothoracic joint
• Treatment of the clavicle

Anatomy and physiological functions of the knee and hip

Practice:

• Tibiofibular interosseous membrane
• BLT for the knee in seated position
• Treatment of the tibiofemoral and patellofemoral joint
• BLT for the hips in seated position
• Psoas tendon release
• Balancing the femur and the acetabulum in supine and sidelying position

 Tuesday 10 November

Anatomy, embryology and physiology of the pelvis and spine

Practice:

• Lap techniques
• Psoas inhibition
• Treatment of the sacroiliac joints
• Treatment of the lumbar spine
• Pelvic lift in supine position
• BLT for the lumbar vertebrae in supine position

Anatomy and physiology of the diaphragm and ribs

Practice:

• BLT for the thoracic spine in supine position
• Thoracic functional curves
• Treatment of the thoracolumbar junction
• Diaphragm lift in supine and seated position
• Rotation of the liver

Guidelines for the treatment of the ribs

• Treatment of the first and second rib
• Anterior cervical fascial lift
• Treatment of the thoracic inlet
• BLT for the ribs from 3rd to 10th
• Treatment of the floating ribs 11th and 12th
• Treatment of the lumbocostal arches
• Treatment of the arcuate ligaments
• The CV4 technique

Wednesday 11 November

Anatomy and physiology of the cervical spine, atlanto-occipital joint, C1 and C2

Practice:

• BLT for the atlanto-occipital and atlanto-axial joint
• BLT for the cervical spine and cervicothoracic junction
• Treatment of the sacral sag in sitting position
• Sacroiliac joint Nut & Bolt technique in standing position
• BLT for the sacroiliac joint in sitting position

Anatomy and physiology of the ankle and foot

Practice:

• Hind foot: BLT for the talocrural, talocalcaneal (Boot Jack), transverse tarsal, calcaneocuboid and talonavicular (Chopard’s joint) joints
• Mid foot: BLT for the transverse arch (cuneiforms, cuboid and navicular), tarsometatarsal joints, tarsophalangeal joints and interphalangeal joints
• Full treatment; global approach to the body from head to toe; group work