Steven, I am curious about the early days of working with the heel lift and observing the patients transition to balanced pelvic tension, and tent equilibrium. I am imaging it was trial and error and a wait see approach with the earliest patients. I am curious what your thoughts are on how much the body may adjust and shift just from the work done on the table to bring balance across the pelvis, before assessing and prescribing a heel lift? In various physical medicine practices i hear practitioners talk about how patients don’t need a lift because the majority of the treatment performed on the table should be enough to stabilize there posture. I don’t subscribe to this theory, although I do see that various treatments can shift the postural balance - and of course there are the times when the lift is needed to provide the additional resources.

fbd

howdy brother-
some of what you are asking i shared in the WBI class-  class 5.  some i did not share. 

*i am pondering why are you are asking these questions.  what is it that you really want to know?  what are the hidden questions behind your questions?  is it that you are still not solid with the WBI evaluation procedures as i teach them, and trying to feel your way justify your own evolution in it and not being totally ok with it?  i have found that this sort of question is not a casual sort of inquiry… for me to kick back and reminisce… yet that’s what i will do and perhaps your real questions or concerns will be addressed

i will start from an end perspective… that i am still very much in awe of the process, and in awe of the Grace that guided me through the Journey of discovery with it, which was relatively short.  it began with the recognition that the conventional method of heel lift prescription was not helping my patients.  so based upon clinical failure, my first reaction was to passionately tear everyone’s heel lifts out and throw them away! (we all know practitioners reacting like that!) yet that did not help.  so i read everything i could read about heel lifts and the conventions by which they are prescribed… off and on for a period of almost 2 years (there isn’t that much of a literature but i was slow) and deduced at the end of it that not only were the conventions non-therapeutic, but that they were arbitrary, irrational, and lacked any scientific basis whatsoever!  and still a huge percent of patients were not healing after they got off the table and walked away.  and there’s this piece where as a carpenter and former engineering student and scientist that i knew that the WBI was crucial yet did not know where to put the plumb line and level to determine it!  so i began to play with the idea of computer plates, and evaluating people on the table looking for Breath and Flow as i changed heel lifts, and i used aura readers and my own evolving energy sense to say that maybe i should use the field balance as my criterion.  these were blessedly short lived, as several of my osteopathic mentors sat with me, probably in the late 80’s and together we just kind of brainstormed the idea of reading balanced ligamentous tension across the femurs to hip joints to s/i’s as we translated the pelvis from side to side.  and that was pretty much intact from the moment of inception!  that element itself has not changed.  only my appreciation of it and perceptions of fine mechanical and mysofascial dances has evolved perhaps.  and my appreciation of how much of a whole body-mind-spirit phenomenon and health requirement it represented.  as a tool, like Breath and Flow, it really has not changed much… and has been very very adequate as it was from the beginning.  only exceptions to the rules and appreciation of how the whole body is in its weight bearing dance with WBI… and truly how it is one of the most highly prioritized health requirements with which we are forced to comply!  realize that when we feel the asymmetrical ligamentous shift across the pelvis as it collapses the system is already in decompensation and cannot self correct anymore. 
using the leaflets of the tent came out of the years with dr jealous and the people who applied that work to the study of eyes and eye prescriptions.  realizing that the Breath expressed across all four leaflets of the tent was an extremely sensitive and accurate measure of WBI too, using it for that purpose was obvious.
and the whole of the WBI work-  all three elements has become and remains one of the greatest contributions we make to support the healing journeys of our patients… the difference in a chronic pain patient, who has tried and done almost everything, between healing and not healing!  it’s that simple, and despite all of the criticism of heel lifts and hypothetical ideas about what works or not, i have never seen any other approach provide anything that works from the basic balanced ligamentous tension model.  and nearly all of them are working on the table and not in weight bearing. 
so i will address your other questions directly…

I am curious what your thoughts are on how much the body may adjust and shift just from the work done on the table to bring balance across the pelvis, before assessing and prescribing a heel lift?

you already know my belief around this! do you see me doing a bunch of table work before i prescribe a lift or do i prescribe the lift, walk away, and let the body reorganize itself based upon WBI before i treat?

In various physical medicine practices i hear practitioners talk about how patients don’t need a lift because the majority of the treatment performed on the table should be enough to stabilize there posture.

talk is cheap.  let them prove it.  the patient is either in WBI or not! it is cut and dried!

I don’t subscribe to this theory

,
first of it is not a theory, it is an opinion without any real clinical basis in my experience.  and second good because that would place you outside of my CIrcle!

although I do see that various treatments can shift the postural balance

interesting. i have never seen any of them ever change WBI expressed by the balanced ligamentous tension… ever!  table work without foundation support is analogous to fixing a roof before fixing the foundation.  it may work for a little while but it never addresses the source of the problem and eventually will fail!  why do you think i have evolved to work the way i do?  because it is the only thing that has really ever worked at the root of the problem!

- and of course there are the times when the lift is needed to provide the additional resources.

this is my current last word on the subject.  i do what i do and what i teach, from a long process of response to clinical failure.  i approach clinical practice from a algorithm that represents the difference between people healing… or not healing, over maybe a total of 50,000 treatments (probably more by now but i don’t work as much as i used to).  i have tried almost everything; studied many systems; evaluated patients being treated by many many other people, and thus formed opinions about what works and what doesn’t… based upon the health of my patients… and on hypotheses and theories and mental stuff. 
we cannot help everyone… but we can continue to help more and more people.  the WBI work is not about accessory resources!  it is as fundamental to the health of the being as iare Midline and Breath! 
if you have seen a single case where table work, truly changed WBI (and not their compensatory strategy) based upon balanced ligamentous tension, ii want to know about it, because it would be an exception to 20 years of clinical experience.
if you are not satisfied with your proficiency with this procedure, just continue to work harder with it.  trust me when i say that it is important, and try not to allow your mind to create ways of convincing you that it is not as useful as table work, or can be substituted with something else.  this piece os fundamental to what i do; what i teach, nad what the AOC represents in working with physical and spiritual law.
i just a very challenging conversation with a patient- one of those situations where the patient is not compliant; does not follow up, and then when they do not get better, call to yell at you, cursing you because they are not better. 
so, to summarize… did i address your questions… ??????

I love the heel lift by the way. It is astoundingly profound, complex, simple in the literal sense of placing a piece of rubber under one foot and the results are transformative. 

You definitely did answer my question and there is one little side note. What I am thinking to be clearer, or looking at is lets say there is a patient, when they walk into the room there in WBI and evaluation of posture and ligamentous tension is not plum - a 9mm heel lift is needed on the Right foot which brings balanced ligamentous tension.  Next, on the table the treatments include: midline breath is restored, the coils are coiling, a compression of snake, Blanket,  the diaphragms were not breathing and a pelvic spread and TAHD spread are performed and finally bilateral fibular lift which now brings breath and flow up and down the deep core fascia which was lacking.

Now, when they get off the table and recheck the ligamentous tension are you saying they will still be at a 9mm lift? Where i am going with this is the lift changes patterns of a lifetime and with that the fascia unwinds, the brain alters its proprioception based on the neurooccular reflex holding the body into a pattern that brings the eyes flush to the horizon - with that comes unwinding of more fascia and muscle - breath and flow has access to places in the being it did not before.

A lot of the work we do on the table directly and indirectly affects the tissue and the architecture that holds and contains the body, I am wondering if the work performed with in the AOC’s algorithm can unwind some of the same tissues that unwind with the heel lift? For example the patient treated above in the mock - they were at a 9mm before going on the table, then all those procedures were performed, is it possible that when they get off the table they could be at a 7mm lift, if not right after maybe 72 hours later when bets can be restated?

Thank You, i am enjoying our dialogue over the last week

thanks- me too!
hmmm.  god question, however think about how i answer that question in my clinical work: i essentially never do table healing when i prescribe a heel lift… with the exception of when i do an I/S revision first, however only very rarely do i do any Sacred Count work until after they had the chance to “settle in” with the lift.  you used the word transformational… i would use the word transmutational perhaps. 
if in your example i was Called to evaluate and treat Midline and Breath on the same first visit, i may check the lift at the end of the visit and adjust it accordingly… but like i said i do not like to introduce too many changes at once:  sometimes i will not prescribe a lift when i have done a big I/S revision and the body is still shifting; and like i said i would not normally choose, except under very unique circumstances, to do any healing work on the table when i have prescribed a heal lift, wanting the body to have its own space to work with the corrections with the resources it has, without my muddying the waters and potentially desynchronizing the system.
all that you say reinforces (in my mind) the need to jack up the foundation first, then step back and let the system rework itself before we begin to perform our interventions.