Balanced ligamentous tension

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Balanced ligamentous tension (also known as balanced ligamentous tension release, ligamentous articular strain, or simply BLT) is both an indirect and direct technique used in osteopathic manipulative medicine.


The technique was reportedly invented by A.T. Still. It was later described by his students Rebbecca Lippincott and William Garner Sutherland, who greatly expanded it.DEileen L DiGiovanna, Stanley Schiowitz, Dennis J Dowling. An Osteopathic Approach to Diagnosis and Treatment, 2nd Ed.'' Lippincott. 2004.


The technique has many variants. The general prescription is to disengage and exaggerate the diagnosed somatic dysfunction. This is the indirect component. The practitioner then waits for a change is the palpatory quality of the structure being treated, i.e. a change in skin tension, temperature, or muscle tension. This is followed by a balancing stage in which the practitioner slowly bring the joint into the diagnosed dysfunction (the direct component).

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