THE STORY OF THE MECHANICAL LINK – AN INTERVIEW WITH PAUL CHAUFFOUR D.O.

(Paul Chauffour) – I was one of the first graduates of the Osteopathy course offered to French physiotherapists in 1965, in London, England.  From 1965 to 1969, the courses were given at the BCNO (British College of Naturopathy and Osteopathy) in London.  In 1969, the school moved to Maidstone, in Kent and changed its name to: European School of Osteopathy (E.S.O.).   We were 9 graduates for all of Europe – how things have changed since!

At the time, the director was Thomas G Dummer, a remarkable man, who taught us all he knew with great generosity.  He spoke of the “total lesion”, of the “primary lesion”, but unfortunately never gave us the key to these fundamental questions.  To this day, the answers to these questions are still unclear.

I graduated as a DO Osteopath in 1971, and since diplomas were awarded in alphabetical order, I received diploma number 2 from the ESO!  I practiced physiotherapy from 1965 to 1973 and since then, I have been practicing Osteopathy exclusively.  In 1971, we created the “Association Française de Défense Ostéopathique”, to promote the official regulation of the profession in France.  I was its founding President, and headed this Association for 8 years.  With my former companions, Fernand-Paul Berthenet as General Secretary, the late Bernard Le Balch as Vice-President, Robert Hiriart as Vice-President, what a fine team we were, what  determination, what unwavering faith!

A ministerial order in effect at the time stated that “all treatments using osteopathy, (…) could only be performed by medical doctors”.  Our decision to identify ourselves by putting up our signs of Osteopath DO led to a series of trials for “illegal practice of medicine”, with convictions, generally 1 franc in damages.  Whether it was 1 franc or a million dollars, this was still a conviction.  But we were aware that the future of French and European Osteopathy was at stake, and so we pursued this course.

In 1975, I was offered a teaching position at the E S O.  I was asked to take on the department of Peripheral Osteopathy.  I already had a good deal of experience in this field as I was treating several dancers for peripheral problems.  At the time, there were techniques, but no truly osteopathic precise diagnosis.  I therefore fully committed to this project and completed my knowledge by consulting the writings of James Mennel MD.  I took his work further, in particular his gliding articular tests.  These gliding tests, I turned into tension tests, which are currently known as such and constitute the first “tool” in the Link method.  So I organised peripheral osteopathy with specific tension tests (interphalangeal, knee, etc.), in greater and greater detail.

Around 1977, I went through a period of doubt.  There were a number of questions which I could not answer, in terms of the osteopathic concept, of my practice or my professional commitment.  At a certain time, I even considered no longer practicing osteopathy.  At that time, I discovered a peculiar phenomenon, which to this day has remained just as valuable and interesting.  If we apply tension tests to two lesions simultaneously, for instance a wrist and an elbow, one of the two lesions always yields while the other keeps its lesional resistance.  I repeated this observation hundreds of times with the same result – this is a constant and reproducible reflex:  a lesion yields, the other persists.  I then realised that the tensions tests performed on the periphery could also be applied to the spine.  These tests of the spine allowed me to relate the spine to the periphery, through this “reflex”.  This was to me an extraordinary surprise, a revelation.  I called this reflex “THE INHIBITORY BALANCE TEST”.  This allowed me to prioritize the lesions of the whole body and to finally find a reliable, constant, repetitive and rational way to find the “PRIMARY LESION”.  The inhibitory balance changed my way of working, reassured me and allowed me to further develop my practice, as well as the concept of the Link.  It is now one of the three essential tools (with the tension test and the recoil) that characterize the Mechanical Link method.

In 1979, a new adventure began.  Three French DOs, Maurice Paul Sainte Rose, Jean Pierre Barral and myself were contacted by the Faculty of Medicine of PARIS XIII, by Doctor Didier Feltesse, to teach our respective specialties: structural, visceral and peripheral osteopathy.  I occupied this position for 8 years.  This experience of teaching in a university environment was positive; it allowed me to be more rigorous, more rational and to meet remarkable people who have influenced my career.

Around the same time, I became interested in the different ways to normalize osteopathic lesions.  In the end, only two techniques remained interesting.  Classical structural techniques, such as the lumbar roll or “dog” techniques, are techniques which I no longer use but consider to be perfectly compatible with the practice of the Link.  They present the disadvantage of not being applicable to patients of all ages or to all areas of the body.  The second technique is the technique of chiropractors, the “toggle-recoil”, perfect in some areas of the body (spine, extremities), but presenting disadvantages and contra-indications similar to those of our structural techniques.

I then realized that I could considerably reduce the force of the “toggle-recoil”, transform it, and substantially refine it.  Thus, I progressively created my own specific adjustment, the “RECOIL”.  With Eric Prat, we then improved over several years its specificity, its precision, its efficiency.  My third tool, after the inhibitory balance, was taking shape: the “RECOIL”.  The recoil may be applied to patients of all ages, on all parts of the body without exception, it presents no contra-indications, whatever pathology we are treating in our patient.  It is the only type of specific adjustment that I have used for nearly 30 years.  In addition to my colleagues that also use the Link, others have also adopted it as their principal technique or to complete their current practice.  The recoil is perfectly painless, light; it is said to be: “a breath passing over the structure”.  With the Link, the notion of movement of a structure in relation to another is no longer used.  The recoil is an informational normalization technique that acts on the neurological receptors of the osteopathic lesion.

With the recoil, I now had three tools, which we have kept to this day, i.e. the TENSION TESTS for the diagnosis, the INHIBITORY BALANCE to prioritize the lesions (and thus find the primary lesion and the dominant lesions of the patient), and the RECOID to correct these different lesions in the necessary order.  These three tools have allowed me to design an original method:  THE OSTEOPATHIC MECHANICAL LINK.

I consider classical osteopathic tests as perfectly valuable.  However, the long or short lever articular mobility tests or the listening tests are not compatible with the inhibitory balance.  I therefore had to rethink classical Osteopathy as I knew and deeply respected it, transform all the mobility tests into TENSION TESTS and thus completely reconsider the general examination of the patient – in short, I had to think outside the box.  I modestly hope to have contributed to the evolution of Osteopathy.  A.T. Still, founder of Osteopathy, has showed us the way, and his followers must continue to develop his thinking, his philosophy, his principles, as well as develop its technique.  Tomorrow, Osteopathy will no doubt be different from what it is today, it will go forward in the realm of specificity, of detail, it will push forward our current therapeutic limitations.  All medical specialties will welcome our practice, for the greater good of our patients.

During the period when I was teaching at the Faculty of PARIS VIII, from 1980 to 1988, I met the late Doctor Jean Marie Guillot; he was greatly interested by what constituted the strength and the attraction of my practice: the holistic view of the patient.  We worked together and decided to write a book.  Published in 1985, this book, Le Lien Mécanique Ostéopathique, substrat anatomique de l’homéostasie, remains to this day our reference.  Currently, this book is out of print.

Given the success of this book, we decided to teach the Link.  For ethical reasons, we rapidly put an end to our collaboration (Jean Marie Guillot, as a physician, could not officially teach non-physician osteopaths, i.e., as stated above, illegal medical practitioners).  I then continued teaching the Link outside of any academic structure.  During this period, I was given encouragement by Jean Pierre BARRAL DO.  He tipped the scale in the right direction at a time when I was wondering where to go from there.

I was about to begin a new Link course when, during the week that preceded, a Colleague named Eric PRAT called me, to tell me that he had followed my course a year before.  He was using the method with enthusiasm and was offering to become my assistant if someday I should need one.  I answered that a course was planned for the following week and that if he was available, I would be happy to have him as a collaborating assistant.  He accepted immediately.

Not only has Eric been my assistant from 1988, but very quickly, he proved to be indispensable for the diffusion of the Link concept.  He is now number ONE in our association, he has a creative mind that gave rise to a number of remarkable advances in different fields of the Link, such as the articular diastasis, the architecture of lines of force, in particular those of the cranium, the integration of the nerve lesion, which is a great and essential functional unit, etc.  Since then, Eric and I have organised seminars and courses in France and throughout the world.  It is a great joy and also very satisfying to share the Link method in this way.

With Eric, we then wrote a number of books.  The first book:  Mechanical Link - Theory and Practice (2003), presents the fundamental principles of the method.  With the collaboration of Jacques Michaud, MD DO, we then wrote Mechanical Link : arteries and autonomic nervous system (2009), as well as third book, which was just published, Mechanical Link - osteopathic lesions of bone (2012).  Our intent is to continue to publish books, in particular, on the viscera, the peripheral and cranial nervous system, the vertebral spine, etc. – subjects where the Link presents new elements that may contribute to the progress of the osteopathic approach. 

The seminars and in particular the courses are now presented all over the world.  Our basic trio Eric, Jacques and myself, is now supported by a team of highly competent teachers: Ildiko Somody Neplaz DO, Dominique Moreau DO, Pascal Ferrand DO, Olivier Dusser DO, Claudia Hafen DO, … and others who work with us as assistants or interpreters.  All these colleagues have several years of experience in the practice of the Link, which they share with great enthusiasm; I can never thank them enough.

Our course is currently offered only to graduates of Osteopathy or their equivalent.  We have never considered creating our own School, an academic structure which would be independent from other schools.  What I wish for, is to see the Link integrated in the curriculum of Osteopathic Studies, just like Sutherland’s cranial osteopathy, Mitchell’s Muscle Energy, Jones’ Strain-CounterStrain or Littlejohn’s structural osteopathy.  I do not wish to replace what already exists, however, the Link has now become essential, I am deeply convinced of that.  I want to see the Link have its share, only its share, in this osteopathic world which is permanently moving and evolving.  In addition to the indispensable culture and knowledge that they must have, osteopaths must have a wide range of approaches to draw from, to allow them, depending on their sensibility and personality, to choose a particular orientation, to amalgamate several techniques or design his own methodology.

Doctor Didier Feltesse once told me: “You know, Paul, I think of you every day.  I have my practice, where I enjoy working structurally, but there isn’t a moment in the day where I don’t put in practice what you taught us.  So, I automatically think of you when I do that!”.  This compliment touched me.  I think that many practitioners throughout the world don’t necessarily use the Link in its entirety, although more and more are working with the Link, but take from this method what they are interested in; and with this I feel fulfilled.

We are currently seeing a certain evolution in the practice of osteopathy all over the world.  Rightly or wrongly, patients are also having more and more reservations about traditionally used osteopathic techniques:  manipulations appear dangerous or useless to them whereas some so-called soft techniques, such as cranial techniques, leave them perplexed.  The base of Osteopathy has been established scientifically.  Anatomy, physiology, biomechanics are its foundation.  If we want to be taken seriously by the medical world, it is essential that we rely on this solid foundation that is common to all osteopaths.  Practitioners using the Link find a clear answer to their fundamental questions.  How to find the lesion throughout the body, what clear path to take when addressing a patient, when to stop a treatment, what tool to use to treat a patient in complete safety.  The holistic concept of the Link, in its logic, allows us to do away with ambiguities which have long delayed the growth of Osteopathy.  The practice of our Art deserves its full place in our current and future society, it is up to us to take the proper measures.  The Link is therefore an interesting proposition, in the practice of this magnificent profession that is Osteopathy.