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The General Osteopathic Treatment. A Modern Application.

Updated: Jul 11, 2023



From Pascal Grolaux, BSc, DO, MOst. & Tim Sparrow DO BSc.Hons Ost Med . MICO MIO MGOSC


The General Osteopathic Treatment (GOT) was first developed by AT. Still. It was used by the earlier American osteopaths to act on all body parts as they are all in connections to each other. It was then developed and described by JML Litllejohn and brought with him in UK where he founded the British School of Osteopathy in 1917.


Still and Littlejohn philosophy and principles of osteopathy influenced John Wernham’s way of understanding and practicing osteopathy.15 Wernham started studying osteopathy in 1928 and graduated from the BSO in 1947 under the guidance of Littlejohn, dean of the BSO at that time. For over 70 years, he studied, lectured and practiced in accordance with Littlejohn’s teaching. He founded the Maidstone College of Osteopathy in 1985, devoted entirely to the teaching of Littlejohn.


John Wernham is considered to be the father of the Body Adjustment (BA). The BA is an essential integrative method of treatment which represents the Osteopathic General Treatment’s concept of Littlejohn, commonly named the General Osteopathic Treatment (GOT) by European osteopaths.


The general body adjustment already existed in the time of Still before Littlejohn was there but without any specific application. In his 1906 writing, Carl Philip McConnell, DO, described the general treatment as one consisting of passive or active movements using rotation, flexion and extension, but also including soft tissue massage or stretching along with application of heat, cold, pressure or rest, together with specific re-adjustments of body parts and removals of obstruction. In 1922, Mary L. LeClere, MD, DO, partisan of the general treatment, described it as containing diagnosis, relaxation, and specific correction all in one and the same maneuvers. She believed that “as long as there are specific lesions still needing correction, there is some secondary tissue tension along the entire spine that had better be restored to normal each time.


At the present time, the Institute of Classical Osteopathy (ICO) in the UK offers its teaching in osteopathy based on the principles and techniques laid down by Dr. Littlejohn.


As stated by J.F. Kemp, DO, Littlejohn considered that health rests on a three-pillared foundation, i.e., structure adjustment, function adjustment, and the adjustment of the organism to its environment. Littlejohn defined ‘adjustment’ as the law governing and regulating the physical conditions of the organism. Adjustment may be seen as the adjustment/coordination of part to part, organ to organ, tissue to tissue, on the basis of mobility rather than anatomical position. The GOT, which may include ‘specific adjustment’ administered along its course, is given in order to balance these 3 pillars. Adjustment of the structure, i.e., spine and limbs, is given through general and specific treatment and long lever techniques are commonly applied. Adjustment of the function consisted of working on the lungs, the digestive and assimilative organs, as well as on the eliminative organs through the ribs and the osteopathic center. Adjustment of the organism to its environment is also considered on the physical, mental, emotional and spiritual planes.


Wernham applied Littlejohn’s philosophy of the alignment of the spine as the basis of the GOT to the adjustment of the different parts of the body in relation to the postural elements of the body as a whole.


The goals of the GOT are mainly to identify potential somatic dysfunctions, to gain range of motion (direct technique), and to soften the tissues. Indeed, repetitive passive movements are known to improve range of motion and to promote motor function in patients by modulation corticospinal processes. Moreover, passive rhythmic mobilization procedures possibly stimulate the intrafascial mechanoreceptors (mechanobiology) of tissues involved leading to altered proprioceptive input to the central nervous system and therefore tonus regulation of motor units associated with these tissues. An impact on heart rate variability (HRV) and the sympathovagal balance could possibly also be induced by the GOT, as standard OMT like balanced ligamentous and membranous techniques have been shown to influence HRV and the autonomic nervous system activity, increasing parasympathetic activity.


For those who are interested to review the GOT and how to practice it, based to its original concepts and techniques, a course : GOT. Beyond the structural paradigm. The nature of mechanobiology and neuroscience within treatment. is offered by Pascal Grolaux, Bsc, DO, MOst, Dr (Hon) ACoPM to review the fundamentals and principles and bring for the first time scientific concepts of mechanobiology and neuroscience. Demonstrations will also show its effects on the autonomic nervous system modulation through heart rate variability analysis.


Please check our courses section and join us now!

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