Balanced Ligamentous (and Tissue) Tension for the Equine Patient – Level Two Module 5


Module 2 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.

This page contains of lot of information. All of which you MUST read if you are serious about applying. This shortcut list is just for ease, for those seeking quick answers to key questions:

  • The module covers the theory and practical associated with BLT and BTT;
  • It is a Level Two module and you must have completed modules 1, 2, 3 and 4 to apply for this course, to ensure a degree of competency and skill;
  • It is open to osteopaths and non-osteopaths with the necessary skills and qualifications;
  • It includes an online element AND a 2.5 day practicum in the UK;
  • You must complete ALL aspects to be given a completion certificate;
  • There will be assessments – theory and practical;
  • You will need to come to the UK for the practicum;
  • It costs £725 for all online content, assessments and 2.5 days of high quality practical plus certification for successful candidates. Flexible payment options are available for this module only.

As a result of COVID 19 and its effects on everyone, we have reviewed our educational strategy. This means that the Level II pathway, will be delivered online and (where applicable) via dual modality (with practicums).  Under the new format, students may apply to one module at a time or they can study the online elements of all compulsory elements and then come to the UK for one consolidated practicum, which would run over 2 weeks plus two days with two weekends in between for respite and revision. This radically reduces flight costs for international  students. Successful completion of the compulsory Level II pathway leads to a Diploma in Osteopathic Approach to the Equine Patient, internally validated by the ESO.

Why study Module 5? 

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.

Prerequisites to Module 5

SStudents can undertake this module as part of the Compulsory Level II Pathway which leads to a Diploma in Osteopathic Approach to the Equine Patient. As such, the prerequisite to this course is to have successfully completed the Level I Pathway (or have evidenced that you are already of Level I standard) and that you have completed Module 1, 2, 3 and 4 at Level II. This is because each module leads neatly on from one to the another encouraging autonomous thinking, criticality and a self reflective mind. All of which are important in the clinical setting. We also reiterate at this stage of learning, that any student who attends this course, must have maintained their anatomical knowledge. This is to ensure accuracy of technique and thus, safety of all those you treat. If you cannot recall your equine anatomy easily, we would urge you to do so in advance of this module.

Who can apply for Module 5?

This course is for any AOI level I (or past equivalent) graduate or experienced equine osteopaths. It is also open to physiotherapists/chiropractors and veterinary/animal therapy professionals, who fulfil all level II 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 II 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. 

Application Notice

If you apply for this module in the Level II Pathway, informing us that you are up to the required standard, and during the course your grades, theoretical knowledge and/or technical skills indicate that you are not, we will require that you  put your learning on hold and undertake the appropriate Level I or Level II modules before continuing. This is simply to guide the student accordingly, so successful completion is more likely. No refunds will be made for the modules that you have or are completing at the time. As such, please ensure that you apply for the right level and do not “up-sell” yourself, to bypass Level I. Doing so could be costly and is not professional. We will always do our very best to support your journey, but we do expect all applicants to be open and honest about their level of competence.

Indicative content– online and via a live practicum

Please note the following abbreviations:

  • BLT means Balanced Ligamentous Tension
  • BTT means Balanced Tissue Tension.

  • Grounding and balancing – how to stay grounded whilst your patient moves
  • How to engage with your equine patient but not to intrude
  • Layer palpation. How to determine in which layer the dysfunction originates
  • Testing dysfunction using subtle tissue tension
  • Which dysfunction is the main influencer? – subtle assessment to support effective treatment
  • History of and current theories and understanding of BLT/BTT
  • Application of BLT and BTT techniques to the equine patient
  • High practical content with demonstrations and technique sessions
  • Excellent student to horse ratio (1 between every 2-3 students)
  • Excellent tutor to student ratio (maximum 1:9 students)

Total number of study hours (taught online content, 2.5 x practical days, assessments, assignments and self-directed learning and practice):  56 hours
Price:  £725.00 (flexible payment available)

Module structure, online format and internet requirements:

This course will be delivered online, via our platform AND via a face to face teaching practicum in the UK – unless student numbers dictate otherwise. Students will also be made a part of the online community via Facebook where Facebook LIVE drop-ins will take place for questions. For our generic AOI group page click HERE.  Because this module will be partly delivered online, students must be able to ensure internet connectivity. AOI will not be held responsible for internet failure or that of poor signal, so if you lose connectivity, you will only be able to watch the replay of any live events. Students MUST assume that we will be teaching the practicum in the UK, unless they have been offered other alternatives.

When is Module 5 likely to be released? 

Module 5 is likely to be released in the second half of 2021. However, this module also makes up the COMPULSORY element of the Level Two Pathway (for those wanting to achieve Diploma status). This module is only open to those on the Level Two Pathway. As such, 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 II 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). 

What is the difference between osteopaths & other manual therapists?

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 would 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 (from within or from without) can cause dis-ease. 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. That’s why an osteopath would likely approach such a case with direct and indirect techniques that offer treatment to the whole horse. Not just the most obvious dysfunction.

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.

Practical session requirements:

Students must 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 module commencement. Diploma Pathway students will be given first refusal on practical dates (these are students who are paying for the full Diploma over 12 months). Please, note that if you pay a module at a time, you may not get the dates of your choice if the course is busy, because limited numbers per practical event do apply. As such, if dates are vital to your plans and you want to take the Diploma, we would encourage you to sign up for the full Diploma circuit from day one. Especially for international students who want to book the practicums for all diploma modules in one visit.

Students are also responsible for the necessary acquisition of any visas that they need to enter the UK and we urge all students to visit the UK government website BEFORE booking on this module, to make yourself fully aware of any additional costs, travel restrictions, COVID testing requirements or quarantine periods that may be enforced as a result of your travel to the UK. We also suggest that you acquire suitable travel insurance to suit your needs. 

Please note: The course does not cover the cost of travel, food or accommodation. It includes only light refreshments on the day of the practicum and the teaching content itself. Please dress appropriately and brings layers and an all weather coat if you are not used to the cooler (wetter) British weather.

AOI will not be held responsible for costs incurred as a result of student naïveté. As a professional we expect you to do all the necessary research BEFORE booking any dual modality course – especially if you are coming into the UK as an international visitor.


Those who successfully complete this module will be awarded a digital AOI Certificate of Completion. Students who go on to complete ALL compulsory modules of Level II successfully, will be issued with a Diploma in Functional Osteopathy the Equine Patient internally validated by European School of Osteopathy.

Online component

Your online lectures will cover the following topics:

  • 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.

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

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.
  • Plus assessments

Location of the practicum:

Dorset/Hampshire region (New Forest District) UK. There is a chance that if student numbers in any given country exceed 18, that we will consider sending the teaching team out, instead of bringing the students to us. BUT this must never be assumed at the start of a cohort, as we cannot know, until we confirm student numbers (which can vary year on year) if this is possible. If this option becomes available in any given country, you will be informed. Please do not keep asking us.

Bookings for Practicums

AOI cannot be held responsible for any losses made as a result of accommodation, transportation or flight bookings (or any associated costs – such as visas). As such, we recommend that bookings are only made, where a full refund option is available or where you, the student, is willing to uphold any lost fees/charges. We also recommend that you take out suitable insurance for the duration of your visit to cover all eventualities. This is because we are living in exceptional times where (sadly) nothing can be guaranteed. Further information about travel can be found below.

International Students – English Proficiency

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.

Further information: If you would like to be considered for this module (Level Two Pathway), please contact us on so that we can contact you directly or send you an application form.