Balanced Ligamentous (and Tissue) Tension for the Equine Patient: L2 Module 5


This module is perfect for those who have some clinical experience with equine patients, but want to learn more about assessing and treating the subtleties the body. This will allow you to treat a greater array of patients and assess and treat the body as a whole. It will also teach you how to fine tune your palpation and hands-on abilities, to enable you to locate and treat more globally and specifically through the mechanism of the tissues. 


As a result of COVID 19 and its effects on everyone, we have reviewed our educational strategy. This means that the Level Two Pathway is being delivered online and (where applicable) via blended learning (with consolidated practicums). Under the new format, students may apply to one module at a time, or they can study the online elements of Module 1-7 and then come to the UK for one practicum visit. This would run over 2 weeks plus two days with two weekends in between for respite and revision. Studying in this way, radically reduces flight costs for international students. Successful completion of Modules 1-7 on the Level Two Pathway leads to a Diploma in Functional Osteopathy for the EquinePatient, validated by the ESO.

Total number of study hours (taught online content, 2.5 x practical days, assessments, assignments and self-directed learning and practice): 55 hours
Price:  £725.00 (flexible payment available) 


Below you will see the answer we give when students ask what the difference is between osteopaths and another manual therapists. The benefit of this module, in particular, is highlighted in the example below, because the better your ability to palpate, the greater your ability to extend your scope of differential diagnosis and therefore your working hypothesis. It also means that you’ll have a broader library of techniques that you can call upon to treat a greater range of patients, not just those who can tolerate articulation, stretching and soft tissue treatment. Indirect techniques such as BLT or BTT vastly extend your service offerings and the patients you’ll be able to treat. This is good, both for the patient and also for you. 

This module will teach you how to evaluate a patient’s body in a quiet and listening manner and to connect with the tissues in an unobtrusive way, so that a equine patient can relax in your care. You will be taught BLT and BTT as a both an assessment tool and as a form of treatment to give you the greatest scope of use. It’s a fabulous approach for those who want to connect with their animal patients on a deeper level and be able to treat whole body patterns (as well as local areas). Something that adds real value to the multi-faceted cases. 

It’s also an immensely useful module for those used to using a more standard assessment protocol – such as a vet might use. This is because it will help to enhance not only your skills of palpation, but also the way you can treat. It’s also a useful tool, because when you can listen with yours hands, there will be less need for invasive investigation; at least in the early stages. 


Students can undertake this module as part of the Level Two Pathway which leads to a Diploma in Equine Functional Therapy (Osteopathy), or it can be studied as a standalone CPD module. As such, the prerequisite to this course is to have successfully completed the Level One Pathway (or have evidenced that you hold a qualification that matches our Level One content). Those studying on the Academic Pathway, must already have completed Module 1, 2,3 and 5 of Level Two. This is because each module leads neatly on from one to the another encouraging autonomous thinking, criticality and a self reflective mind in our academic students. All of which are important in the clinical setting. 


This course is for any AOI Level One (or past equivalent) graduate or experienced equine osteopaths. It is also open to physiotherapists/chiropractors and veterinary/animal therapy professionals, who fulfil all Level Two entry criteria. In additional all applicants must have successfully completed Modules 1-5 of this pathway. A conversion course is available for those wishing to enter Level Two modules directly, but have not followed the AOI’s level one programme. Please click HERE for more information. Proof of prior experience and education is essential (without exception). All delegates should provide evidence of insurance, which allows them to study/work on/with animals. 


Please note the following abbreviations: 

BLT means Balanced Ligamentous Tension.

BTT means Balanced Tissue Tension.


  • The history and current theories and understanding behind Balanced Ligamentous Tension;        
  • Stages of BLT and protocol; 
  • Physiological and current hypothesis behind the mechanism of BLT/BTT;
  • Indications and contraindications in practice;
  • Engagement and disengagement (safely);
  • Grounding approaches. Become a more focused practitioner. 
  • Layer palpation – learn to know which tissues you are on and how each compare; 
  • Testing dysfunction via BTT;
  • Determining the main influencer (theory); 
  • Application of BLT techniques to the equine patient; 
  • Incorporating BLT within treatment protocol.

During your 2.5 day practicum in the UK, you will learn the following: 

  • Introduction to the practicum and the course delegates; 
  • General discussion about the course content to date;
  • Working with equine patients in a non-invasive way for the betterment of your assessment and treatment outcome; 
  • Grounding exercises and approaches; 
  • Layer palpation; 
  • Engagement with the patient and the tissues – too much/not enough – when to know the difference; 
  • Finding the lesion, understanding the pattern, choosing the correct layer – to enhance efficacy of assessment and treatment; 
  • Testing for dysfunction and knowing what to do with the information; 
  • Finding and assessing the main influencer and drivers; 
  • Demonstration and application practical of BLT techniques;
  • Demonstration and application practical of BTT techniques. 
  • Incorporating BTT/BLT into treatment protocols. 


Module 5 is likely to be released in the second half of 2021. However, as this module is only open to those on the Level Two Pathway and not as a standalone CPD module for non-osteopaths, it will be released when students are nearing the end of their Module 4 studies. Please note: International students who are wishing to consolidate their Level Two practicums (to reduce travel costs), may do so, but this must be agreed at the start of educational circuit. This means that a student could fulfil the online elements of Modules 1-6 and then come to the UK for all the practicums and module 7, which (in total) will be run over a two week and two day period (with 2 weekend breaks in between). 


Many people ask what the difference is between an osteopath and other manual therapists. One of the core answers is the way we think and what we do with the information that we attain from the horse, owner, and other professionals. For example, an osteopath might come up with the same working hypothesis as another manual therapists, but, if an osteopath concludes that the reason behind the pattern of pathological disease or dysfunction is caused by external factors – such as external stressors instigated by the owner (or its environment), the osteopath will work as hard to change that factor – via education or referral, as they would to treat the symptoms. This is because osteopaths understand the basis of functional medicine, which is, that everything (internally and externally) can cause dis-ease over time. One fine example of this is the cortisol reaction caused by stress and all the physical symptoms that occur as a result (weight gain, heart pathology, diabetes etc.). As such, true osteopaths believe that treating nothing more than the site of pain (or dysfunction) is merely patching up the symptoms, it is not treating the “whole” patient nor the CAUSE of the dis-ease. This module will teach you how to evaluate a patient’s “whole picture” and what to do with the information. At AOI we believe that the greater the depth of your knowledge, the greater the opportunity you will have to become to be a truly osteopathic practitioner.


Students must also have the capacity to come to the UK for the practical sessions and assessments. Without this, no certification will be issued. As such, student require both the time and financial resources to attend the UK based practicum within 24 months of their commencement of the Diploma Pathway to complete modules 1-7. 

2.5 day practical component (must be taken once you have successfully completed the theory element of the course, online. 


Dorset/Hampshire region (New Forest District) UK. There is a chance that in 2022/2023 we may be able to reconvene international practicums in Denmark, USA, NZ and Canada, but this must never be assumed at the present time.


We are happy to take national and international students, but all students MUST be proficient in all aspects of the English language (both written and spoken), so as to ensure that you can make the most of the course and its contents. The AOI will not be held responsible for any language challenges that arise and no refunds will be made on these grounds. As a guide, we typically expect that students to have skills equivalent to IELTS with an overall score of 6.5 (or equivalent).

Our pathway courses are validated by the European School of Osteopathy. For more information on the ESO, go to:

If you are interested in taking Level Two or this module as standalone CPD, please click on the fish to contact us today. Applications are ongoing due to the part-online nature of the content.