Mechanical Link (in French, Lien Mécanique Ostéopathique or LMO) was developed in the 1970’s and 1980’s by Paul Chauffour, one of the first French osteopaths trained in England, at the European School of Osteopathy (Maidstone)[1]. Paul Chauffour very quickly understood the limitations of a type of osteopathy where diagnosis is largely based on the symptomatic area and where the treatment essentially consists of vertebral manipulations and General Osteopathic Treatment (GOT). This approach did not really offer concrete answers to the many questions brought up when treating patients[2]. What is the total lesion ? How do we find the primary lesion? Where do we begin the osteopathic treatment? What technique to use ? What is the path to follow from the beginning to the end of the osteopathic treatment ? At what point should the osteopathic treatment stop ?
Paul Chauffour
Inspired by texts describing articular techniques used in the 1930’s in the United States[3], Paul Chauffour devised a test based on applying slight tension to a structure to reveal the presence of osteopathic lesion. He then discovered that this tension test, when simultaneously applied to two structures in lesion, resulted in a reflex response of release of the less important lesion. This was a major discovery, giving an order of priority to the different lesions that were found. Finally, inspired from the toggle-recoil, he elaborated a technique that can very easily treat any type of lesion found: the recoil. The association of these three techniques[4], finally resulted in a complete method of diagnosis and treatment: the Osteopathic Mechanical Link.
Armed with these three techniques and with a simple and logical protocol to address the patient, LMO practitioners have rapidly been able to answer the aforementioned questions:
What is the total lesion ?
The tension test allows to rapidly perform a great number of tests[5] and thus, to assess all the structures including those located far from the symptomatic region. The objective of the tests is the diagnosis of the total lesion (the set of lesions found in the patient).
How do we find the primary lesion and where do we begin the osteopathic treatment ?
The inhibitory balance test determines which, among all the lesions previously diagnosed using tension tests, proves to be the most important (the primary lesion). Thus, this primary lesion becomes the first lesion to be treated in this patient.
What technique to use ?
The recoil technique gives a simple, quick and efficient way to treat any osteopathic lesion, wherever it may be located: spine, extremities, cranium, organs, vascular or nervous system, etc. Although other approaches, with their advantages as well as their drawbacks, may be used, the recoil has been so satisfactory that it rapidly stood out as the best technique at our disposal.
What is the path to follow from the beginning to the end of the osteopathic treatment ?
The treatment of the primary lesion presents the secondary beneficial effect of normalising, from a distance, all the adaptive (compensatory) lesions that were related to it. One must therefore simply verify, among the lesions initially found, which ones are still present then, after having prioritised them, treat the new dominant (second lesion) using the recoil. And so on and so forth after each adjustment of a new dominant lesion (third lesion, fourth lesion, …) knowing that this way the number of lesions that remain decreases more and more each time. Because of this thread, the osteopathic treatment of each subjects follows its unique path, both clearly marked for the therapist and perfectly adapted to the needs of the patient.
At what point should the osteopathic treatment stop ?
Following the treatment of the primary lesion and the dominant lesions in the order in which they were revealed, all the lesions originally present end up being corrected directly or indirectly[6]. The disappearance of all the patient’s lesions marks the end of the treatment.
The concepts of the LMO that were succinctly presented here were the subject of a first publication[7] in 1985, which gave rise to questions and interest within the emerging osteopathic community in France. At that time, the difficult context for osteopathy[8] was in the end profitable to the first practitioners of the LMO[9] : despite the prohibition orders in effect , a great number of patients were consulting. It seemed we were on the right path…
Eric Prat
From the 1990’s, a close collaboration between Paul Chauffour and Eric Prat has resulted in an even greater progression of the method, with the discovery of new applications: treatment of the intraosseous lines of force, articular diastases, arteries, filum terminale, encephalon, etc. Later on, thanks to a whole team of enthusiastic practitioners, the LMO rapidly developed internationally and the method is now taught in several countries[10].
These last twenty years were largely dedicated to the publication of several books to promote the LMO[11]. During this time, between the clinical experience acquired in practice and in teaching, our understanding of osteopathic concepts has become progressively more refined and the practice of the LMO has continued to develop. The recent developments of the method and the new perspectives that are offered are the topic of another article.[12]
To conclude and provide context to the situation of the LMO in the current osteopathic landscape, we may present the Mechanical Link as an approach that is:
traditional, with the faithful application of the fundamental concepts of A.T. Still,
modern, with a practice that is updated according to current medical knowledge,
global, with a systematic, « head to toe », examination of the patient,
analytical, with objective and detailed tests of each lesion to be treated,
logical, with a diagnostic procedure that is clear and comprehensible to the medical community.
valid, with reliable and reproducible tests[13],
coherent, with gentle and direct tissue techniques that may be applied to any part of the body and to all patients (from babies to the elderly)
efficient, with rapid and durable results for most presenting complaints in osteopathy, including some issues that are beyond a functional framework.
Even if the LMO may be used in an exclusive way, the method does not exclude other approaches but, on the contrary, may perfectly be reconciled with all practices that respect the principles of osteopathy. Beyond the apparent diversity of techniques, the fundamental concept remains the same for all osteopaths : find it, fix it and leave it alone !
[1] For those interested in the the story of the Mechanical Link, see the article by Hélène Loiselle : interview with Paul Chauffour.
[2] Currently, neither the great diversity of techniques taught in osteopathy, nor the medical reasoning behind decision making, bring truly satisfactory answers to the questions raised here.
[3] Particularly the specific articular mobilisations of Menell (J. Mc.). - Foot Pain. Little, Brown & Cie, edit., Boston, 1969
[4] The tension test, the inhibitory balance test and the recoil ; see corresponding article.
[5] While respecting the normal duration of osteopathic consultation.
[6] Directly : the lesions that were adjusted by recoil ; indirectly : the secondary lesions that spontaneously normalised as a result of the adjustment of dominant lesions.
[7] P. Chauffour, J.M. Guillot, Le Lien Mécanique Ostéopathique, substrat anatomique de l’homéostasie, Editions Maloine, 1985.
[8] We had to resist the pressure from the medical community that was suing osteopaths for illegal practice of medicine. For the record, Paul Chauffour was convicted in court four times for his practice despite the fact that, at the time, he was officially teaching at the osteopathic medical faculty of Bobigny (France).
[9] Medical doctors formally advised patients against getting manipulations from osteopaths, whom they called « dangerous quacks ». Results and safety were key imperatives – both offered by the LMO – in order to be tolerated in the medical landscape.
[10] See ALL THE COURSES on the website lmosteo.com for the different courses given and the colleagues that are actively participating in the development and teaching of the LMO. We take this opportunity to sincerely thank them for their contribution.
[11] See PUBLICATIONS on the website lmosteo.com
[12] See the article entitled Mechanical Link: evolution and perspectives
[13] The following are three studies on the reproducibility of LMO tests :
Reliabilitätsstudie über der Befunderhebung der Wirbelsäule nach der Methode der Lien Mécanique Ostéopathique, Master Thesis zur Erlangung des Grade “Master of Science” in Osteopathie an der Donau Universität Krems – Zentrum für chin. Medizin & Komplementärmedizin. By Claudia Hafen-Bardella, 10.2009
Reliabilitätsstudie über die Befunderhebung der Knochen und Gelenke der Extremitäten nach der Methode des Mechanical Link. By Gina Hafen, 01.2018
Follow-up-Studie über die Reliabilität der Befunderhebung der Wirbelsäule nach der Methode des Mechanical Link. By Laura Kühn, 01.2018
