Balanced Ligamentous (and Tissue) Tension – Equine Module Five

Balanced Ligamentous (and Tissue) Tension – Equine

Format: Online intensive theoretical course and a 2.5 day practicum. The online intensive covers all the theoretical components of the course. This is given to the student in advance of the practicum and all aspects must be complete before the student attends the practicum. A live webinar is also run before the practicum to ensure that students are clear about the theory and can have their questions answered. This module forms part of the two-year diploma course.

This module is perfect for those who have 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 also increases the range of indirect techniques in your osteopathic toolkit, so that you have more option. The module will 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. 


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 Balanced Ligamentous Tension (BLT) or Balanced Tissue Tension (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.

The first part of the course is taught online. Students then attend the 2.5 day practicum to consolidate learning and practice the techniques. As such a strong internet connection is important and you will need a laptop or desktop (not tablet or phone) to watch the content.


This module is typically for diploma students in year two, but it can be taken as standalone CPD by professionally qualified equine osteopaths, who have yet to acquire these important clinical skills (practicum space permitting). Practitioners must however, be able to demonstrate a good working knowledge of animal manual therapy, hold suitable insurance and be working in clinical practice.


Price as a standalone CPD event £899.00* (with UK & Denmark practicum ). £1099.00* (with USA/Canadian practicum (*plus taxes where applicable). Price variation is linked to the cost of local insurance requirements.


Please note that AOI will not be held responsible for costs incurred as a result of student/applicant naïveté. As a professional we expect you to do all the necessary research (regarding costs, local regulations, vaccination expectations etc.) BEFORE booking any dual modality course – especially if you are coming into the UK as an international visitor. No refunds will be made.

To attend, you are expected to already have: 

  1. A dependable understanding of equine musculoskeletal anatomy and biomechanical knowledge of the equine model;
  2. A solid and well versed equine musculoskeletal and neurological assessment process;
  3. Ability to competently apply soft tissue, stretching and articulation techniques to the equine patient;
  4. Safe and confident handling with a range of of equine models in a therapeutic manner;
  5. A thorough understanding of osteopathic concepts and an ability to think in an integrated fashion, which encompasses the whole horse;


Please note the following abbreviations: 

BLT means Balanced Ligamentous Tension.

BTT means Balanced Tissue Tension.

Overall Content: 

  • 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, 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. 


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 would like to take this module as standalone CPD, please click on the fish and contact us today.