The Central tendon or Central Chain

The Origin of the Concept of the ?Tendon Central? has never been recorded in the annuals of the osteopathic literature. Instead, as with most osteopathic concepts, it has been and continues to be transferred by the word-of-mouth teaching (which is more properly stated as “oral memetics” 1. ) of osteopathic instructors, who once heard it themselves as students and replicate it more or less rigorously.

Tendon Central Concept (TCC) and other similar concepts are often passed on as an eminent truth, from instructor to students, generation after generation, with no substantiation, context, or historical record ever provided. Without a confirmed and accurate written record, of both the original theory and intended application of such concepts, the chances of this information being transferred incorrectly both then, now, and in the future, or adapted without the knowledge or consent of the original creators, grows exponentially with every person who is charged to teach it.

These exponential replications and eventual shifts in content can result in a pedagogic or memetic ruin, which may end up influencing patient treatment protocols. (Butterfly effect)

The word-of-mouth teaching (oral memetics) requires even stronger feedback and questioning protocols than the written memetics because of the lack of peer review and verification possibilities. In oral memetics there is no “garde fou” or safety barrier, for the students; because the matter is new to them, and if the teacher is not of the questioning type, he is convinced and convincing of what he thinks, he learned, and now replicates that. (Memetic evolution)

This paper offers a first draft of the alleged history of the development of the TCC, by searching back in time. It does not purport to be the definitive version; rather it intends to raise consciousness to an ever-growing problem in Osteopathy, lack of recorded history and self-questioning about own concepts and models. Additionally, least one very similar concept to the TCC, which is now taught at the Colleges of the French Osteopath, Philippe Druelle, is known as the Central Chain. 

This author having been recently become acquainted with both concepts, was struck at their similarities which is what sparked this informal investigation as to their respective origins.

Anyone, wishing to contribute further, or who has original notes, or recordings which could help to document the history of these two theoretical models are welcomed to contact the author of this open letter. – Max Girardin - [email protected]

The ?Tendon Central Concept? appears to be an osteopathic didactic and pedagogic model that was never partially nor completely scientifically validated or even verified on reliability because the number of controllable variables is so huge that it is technically undoable for the whole concept. As far as is known there remains no further scientific support or proof for this concept, excepting the anatomical continuity of the connective tissue and mesenchymal layers, which are continuous in all directions. But even this information is premature, if it is not even known where the concept originated.

As a student at the Institute William Gardner Sutherland, (IWGS), in Antwerp, Belgium, during the early 1980’s, the author was introduced to the TCC by two instructors, Rein Mortier D.O. and Yvan Poppe D.O. 2. They both credited the French Osteopath, René Briend D.O.,3. as being the originator of the concept. 

Between the years 1985 and 1987, the author had the opportunity to study directly from René Briend D.O. , who was teaching at the IWGS in Namur, (Belgium). At that time René Briend D.O. explained the concept of the “Tendon Central” in a similar fashion as was taught by the IWGS instructors at Antwerp. (Thus there was no sign of memetic evolution, solely proper memetic transmission) The noteworthy point being, René Briend D.O. did not reference himself, in fact he did not credit anyone with TCC’s conception. 

The next point of historical significance (known to this author) occurred in 1996 when the instructors of the College Sutherland Belgium, Netherlands and Germany 4. held an extended pedagogic review of the College’s programs and their delivery. Among the participants were Etienne Cloet D.O., Piet Dijs D.O., Rik Keunen D.O., Rob Muts D.O., JeanPaul H?ppner D.O., Prosector, and Max Girardin D.O., Prosector.

Together they engaged in a day long discussion of the TCC including their individual personal views. In addition, R. Muts D.O. gave a visceral perspective, of the concept, JP. H?ppner D.O., Prosector, gave an embryological and anatomical perspective, while M. Girardin D.O., Prosector, gave anatomical, histological, physiological views and also a review of the TC concepts history and different pedagogic versions as far as known, within the IWGS France, Belgium, Netherlands and Germany. 

What became obvious throughout the day’s discussion was that different interpretations were presented, each difference reflecting the respective interests and/or expertise of those who took part in the discussion. Thus the Tendon Central concept, with no recorded history, began taking on the perspective of the person who was at the microphone at the time. In hindsight, it was regretful that no one really tried to determine if René Briend D.O. was in fact the originator of the concept. Thus this author too, was obviously not fundamentally questioning enough at the time. Unfortunately, 14 have years have passed, and Osteopaths, some of who are the holders of the historical record have passed away. 

One topic that all participates agreed upon was that the concept was about form and connected oneness (Holism of the connective system) and that it was clear that if this concept was going to be continued to be taught that there was a need for anatomical and histological consistency in its teaching. However, the intent of the actual concept, as well as its practical application in Osteopathy, remained as didactically proficient towards “wholeness” but speculative. 

Another decade would pass until 2009, when a real burning desire to document the origin of the TCC surfaced. As an invited “international juror” to a non-medical osteopathic college known as the Canadian College of Osteopathy, in Toronto, Canada, 6. the author’s interest in the TCC was ignited for the third time in 25 years. 

The author was assigned as ‘international juror’ over four theses. Six weeks were given to read the submissions. After reading all four theses, it was evident that the students based their osteopathic discussions and foundations, at least in part, on the concept of the ?Central Chain? (CC). A concept that they all stated as a fact and was systematically credited as originating from the school’s founder, Philippe Druelle D.O..

 Unfortunately within each thesis, there was a systematic and distinct general lack of any form of academic rigor; also about this specific theme as each thesis seemed to assume the Druelle’s concept of the CC was a universally accepted osteopathic science fact – and thus they did not bother to neither describe it fully nor cite any peer reviewed articles supporting the concept. Just in each thesis referring to the precedent one from a year earlier ....and so on and highlighting Philippe Druelle as the inventor-discoverer of the CC.

 If these and other thesis writing students, who are destined to become the next generation of teachers continue to accept such concepts as facts, without trying to verify them, without investigating parallel theories, and without demanding references, it will not be long before the intellectual integrity of the entire education and research aspect of osteopathy will be in a state of demise, which I honestly suspect is already the case at least in the Canadian College and its international spin offs. Furthermore this lack of questioning may permeate through to the clinical practice level and in time lead to major clinical errors of judgment or gross negligence as formulated in the courts in repetition and for almost Holy status osteo's. 7.& 8.

Piecing together the partial descriptions of the CC contained with each thesis, the resulting construct strangely resembled the TCC that was introduced to the author in the 1980’s and reinforced by René Briend in 1985-87. Philippe Druelle’s Central Chain concept, as briefly described by the students, has strikingly similar features to the Tendon Central Concept of René Briend D.O.. 

It is not too late for this profession to investigate and record the origins of both the Tendon Central Concept and Central Chain Concept, as both of their respective originators are at the moment both living and practicing. What is required to accomplish this is the candid openness of the contributors and diligent recording by the investigators. Following that, the researchers, and scientists of the profession can test, validate, and/or verify or refute the claims of these concepts. Until then, these concepts must be held out for what they are, theories, conceptual models, or worse copies that have been highjacked under another name for personal glorification, fact is to date they are not founded, nor proven. Failure to do this has serious consequences for the entire profession and does not help our profession on the contrary, personal thought. 9. & 10. & 11.

Prior to the author’s participation as a juror in Toronto, the author made a preliminary casual investigation in the origins of the Tendon Central Concept and/or Central Chain while reading the thesis's for the session and checking the data. It was discovered that there were no formal recordings of this information in any osteopathic literature. Furthermore, the non-published material which included, 

-Consultation of the official pedagogic weekend notes of College Sutherland from 1996 

-Internet verification of times and places, and comments on the theses were non-conclusive and also conflicted in certain cases.

The next step was to conduct a telephone interview with René Briend, (October 2009) the supposed originator of the Tendon Central Concept and to engage in several person-to-person discussion with the Philippe Druelle ( Thesis defense CCO November 2009) and alleged originator of the Central Chain Concept. It should be noted that Druelle was distracted at the time, being in the middle of an international symposium and taken off guard by the questions and the questioner, who he was meeting for the first time. Thus to the author’s perception, Druelle appeared to be skirting the questions posed by the interviewer (the author). Although he tried also in Druelle's native language French, but the skirting and evasive mumbles continued. On the other hand, René Briend, who previously had several personal encounters with the interviewer, offered a non-stop wealth of information, some of which was pertinent, some not. The pertinent information is offered here as part of the historical record. Note:

Telephonic contact with René Briend D.O.: 

First question to René: ()

(René, do you remember the concept of the ‘Tendon Central’ that you used to teach in the seventies, eighties and even beginning of the nineties before you sidetracked entirely into the Biodynamic Osteopathy as you teach today?)

“Yes of course, this concept was very popular in those days in France and Belgium, we used it mainly to demonstrate to the students that the body is one whole, and not like they had learned in physiotherapy school anatomy books: an assembly of a set of organs and limbs. The holistic vision was the most important and most difficult breaking-idea to get over in those days to physiotherapists.” (As most non medical osteopathy students where in those days) Historical note from the author.

Second question to René:

(René, was the concept of the “Tendon Central” your concept? Did you invented it, because your name was given as originator reference too me by my teachers of IWGS in the early eighties, as well from Paris, as from Namur and Antwerpen?)

René laughs and says : “No no, no, I learned it from Philippe Souchard and in fact there is a whole story that I know of because I treated Paul Geny at the end of his life, and he told it to me; in fact it has to do with how Osteopathy arrived in France…

Rene went on for some time, until I had to interrupt him to return to my question. 

Third question to René:

(René, René, stop, stop please I have difficulties to take the notes on everything you say, and it is all very interesting but the question originally was about the “Tendon central concept”, remember? You said you heard from it by Philippe Souchard?)

Ah yes, of course, you know, I know so much about this all, because I lived it and have known the actors myself, and there is so many untruthfulnesses told today, you know Max, not by dishonesty but because they all talk without knowing, they all reproduce hearsays that they did not live or experience it and now with the explosion of osteopathic educations everywhere it is all getting worse… (My response to René was, yes I know René it is the same story with anatomy and histology or physiology I hear so much nonsense everywhere of "Blanc becs" who heard the sound of a bell but don't know where the clapper hangs" . So yes I know René, it is exactly to verify such a thing that I phone you, I have to juror four theses and they all claim the “central chain “ which strangely resembles “le tendon central” concept as being a scientific fact and discovered by Philippe Druelle D.O. .)

Oh yes, Druelle I know him, he is an old student of mine and later he opened colleges in Canada and later even in Germany and Japan I think…

I even went to give a few guest lectures in Canada at his college in the time...

(Yes René, I heard that, but what about Philippe Souchard…?)

Ha yes, Souchard, I heard of ‘the tendon central concept’ directly from him in 1976 or 1977, he was a pupil of Mézière, you know from “the muscular chains?” and of Godelieve Struyf Denis a Belgian osteopath and Mézièriste. You know in the beginning of non medical osteopathy in our regions there was a constant mix up between manual therapists, physiotherapists interested in muscular chains and Osteopaths etc.

Souchard said it was the dressing ‘l’habillement’ of the concept of the central line of gravity of the body which was a theoretical concept from J. M. Littlejohn. (An internet search could not confirm this, it is unclear if the gravity line concept was from C.E. Henry, or J.M Littlejohn (Osteopathic technique) or TH.E. Hall or even J. Wernham who claimed it as latest but under Littlejohn’s name?)

(Thus that is certainly not an novel invention or original discovery from Philippe Druelle D.O. as his students’ state?) (This question was very “tainted” but this author needed a clear yes or no previous to juror the theses presentations.)

No, certainly not, he was a student of ours like you were in your younger days….ha je me rapelle mon cher Max.

(Thanks René, but you should start to write all that stuff down, make a book of it, it is important for the history of non medical osteopathy in our regions ….

the rest of the conversation became personal digging old cows out of the ditch….)

In days surrounding this interview, several local sources were tapped to help further elucidate the history of the concept. Regarding any attempts to verify the concept of the Central tendon/ Central chain.

While admitting it was not an ideal time or place to be discussing the concept of the central tendon/central chain with Philippe Druelle, he did manage to provide this statement. The author readily admits that he had his doubts as to the credibility of Druelle’s concept and went so far as to imply that he was tantamount to accusing Druelle of presumable oral plagiarism, written down by his own students in their thesis. Druelle did give one statement which categorically denied any connection of his Central Chain theory to that of the Tendon Central. He said, “no, the Central Chain is about something completely different, it is specific for the Canadian College of Osteopathy, and has nothing to do with “le tendon central” 

Conclusion

Until now, it was assumed that René Briend was the originator of the Tendon Central Concept. In fact when he was contacted to verify this assumption, he stated that the concept is traceable to John Martin Littlejohn who came up with the “Central line Gravity of the body” “Ligne centrale de gravité du corps".

René Briend heard from the tendon central concept in 1976 -77 by Philippe Souchard , who was a pupil of Mézière and Denis Struyf. It was Denis Struyf who then, as Rene states ?anatomically dressed? the Central line. His exact words in French were – “qui ont ?habillé? la ligne centrale” and thus this dressed central line of gravity became the Tendon Central concept.

Thus, the Tendon Central concept seems to have arisen from the idea of covering, or dressing anatomically the central line of gravity. 

Certainly one is left to wonder whether Philippe Durelle, having been, according to René Briend , a student in Briend’s class was exposed to the Tendon Central Concept during his career. In addition Rene continued a profession relationship with Druelle in the the 1990s as Briend taught different subjects in Philippe’s chain of schools. 

Until both concepts, the Tendon Central and the Central Chain are at least recorded in a place of public accessibility; no one will truly be able to compare them. The responsibility now rests with Philippe Druelle, to put his 25 year old concept imported from france with him or not, in a permanent record. Further, although Rene claims not to be the founder of the Tendon Central Concept, he appears to have a considerable amount of information about the topic. As such, he is implored to commit to a permanent record - the concept the Tendon Central as he understands it. At this point, it is suspected that the majority of the readers do not know many details or even the significance of these two concepts. This is truly a shame and possibly a great loss for the profession. Unless they are recorded, so that they can later be verified, it is strongly suggested that they stop being taught as a fact, as their history, their significance, their value, their applicability, and their authenticity remains in question. If these concepts are clearly stated as a hypothesis or pedagogical example of holistic approach, there is no problem using them as to fulfill that purpose: an example of a view, wild hypothesis or conjectural conceptualisation…

Please consider the consequence to this profession of this type of oral memetics continues unchecked; it is already bad enough with what is possible to check as demonstrated several times in anatomy or visceral theories like Barral's for example...

This remains an open question for the profession hence this open letter:

We clearly have a serious problem between oral transmission, philosophy of Osteopathy and then pseudo scientificism like too many so-called evidence based studies? What do we want and where do we go for the next century?

Your comments and information are welcomed at - [email protected] or trough the website www.morphologicum.org

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I am very sorry but this went over four different IT systems before ending here in the LinkedIn format which is very limited as such the original points of reference where mixed up, I tried to manually restore them but on this old mac there may be errors, if you have questions contact me through Facebook, LinkedIn or mail ...

 1. Meme: a package of culture, knowledge , technology or information with its directly related topics, ready for transmission to the next generation. Memetics: the science that studies how meme’s are packaged, transmitted and the mechanisms and consequences of these. 

 2. Masters in Manual therapy and D.O.'S, held responsibly for the courses on the Thorax and held responsible for the courses on the Myo-fascial chains

 3. Instructor of the Thorax course in which both Mortier and Poppe were students.

 4. Previously known as IWGS Institut William Garner Sutherland

 5. Founded in 1991-92 by, Philippe Druelle, then ungraduated later, DO, originally of France

 6. In fact most of the thesis authors referred frequently to other CCO theses from the precedent years, some authors which in the mean time had become their teachers. Fast turn over of teachers in that system...

 7. Bergmann L. HYPERLINK "https://www.quackwatch.org/11Ind/frymann2.html" Accusation. In the matter of the accusation against Viola M. Frymann, D.O. No. 91-19, Nov 7, 1991. 

 8. HYPERLINK "https://www.quackwatch.org/11Ind/frymann2.html" Stipulation in settlement and decision. In the matter of the accusation against Viola M. Frymann, D.O. June 19, 1992. 

9. In the matter of the petition for termination of probation of Viola Muriel Frymann. OAH No. N-9411102. 

10. Bergmann L. HYPERLINK "https://www.quackwatch.org/11Ind/frymann3.html" Accusation. In the matter of the accusation against Viola M. Frymann, D.O. No. 99-18, Dec 15, 1999. 

 11. HYPERLINK "https://www.quackwatch.org/11Ind/frymann3.html" Stipulation in settlement and decision. In the matter of the accusation against Viola M. Frymann, D.O. July 21, 2000. 

 The interview was conducted in French and has been translated here, to English, by the author. 

 Litterally : des non-vérités affirmées aujourd’hui.

 Mézièriste : the name given to the therapists that used the method of Mézières to treat their patients.