‘Minimally Invasive Manipulation’ – the secret to gentler and more effective high velocity manipulation

Date: 10/03/2018

Location: The London College of Osteopathic Medicine, London NW1 6QH


What is Minimally Invasive Manipulation (MIM)?

MIM is an umbrella term that describes a group of novel techniques that allow the practitioner to reduce the muscular, neural and psychological barriers to high velocity manipulative techniques, resulting in much less force required to provide the desired result of better joint movement. The understanding is that less force leads to a reduction in treatment reactions, a reduction in the risks associated with high velocity manipulation, an increase in patient comfort, and an improvement in treatment outcome and patient satisfaction.

The techniques, which have been devised by the workshop leader Gavin Burt over 20 years of clinical practice, include the following:

  • Neurological assistance – using movements of the eyes, jaw, shoulder, stomach and toes to remove the need to ask the patient to ‘relax’.
  • Reciprocal inhibition and MET assistance – uses these concepts to encourage greater direction of force, and to remove muscular barriers to accessing joints, thus getting the patient to work with you.
  • Applicator adjustment – uses a mechanical adjusting tool to improve joint movement in those who do not like high velocity adjustments or who are not suited to high velocity techniques.
  • Tissue slackening – using slight adjustments to patient position, once joint bind has been achieved, to allow easier and softer final thrust.
  • Momentum, Vector and Speed – combining these three elements in different ways for different patients.
  • Simple trance – combining simple trance concepts along with touch to induce a more relaxed tissue state.

Workshop Structure

The workshop is over a full weekend, which is structured as follows:


  • Begins with a full discussion of the latest, most up to date thinking regarding how to screen patients for their suitability for High Velocity Adjustments through tests and medical case history taking. The cervical spine, naturally, takes centre stage in this discussion. Attendeees are then encouraged to pair up and practice screening with each other
  • Each and every technique will be explained, presenting the theory and reasoning behind it, before a practical demonstration. Following this attendees will pair up to practice the techniques together, under the watchful eyes of the course tutors
  • The areas covered on Saturday include techniques for the upper and lower cervical spines, the upper and lower costovertebral joints, and the upper and lower thoracic spines


  • A review of the HVT screening from Saturday.
  • Fielding of any questions from the techniques taught on Saturday
  • The areas covered on Sunday include techniques for the cervicodorsal junction, the 1st ribs, the thoracolumbar junction, the lumbar spine, the lumbosacral joint, and the sacroiliac jointsOn both days lunch will not be provided, but “classy” biscuits and tea and coffee will be provided throughout the day!

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