The Bowen Technique generates a remedial effect through a number of mechanisms. One of the most important of these mechanisms is the correction of spinal dysfunction. The notion here is a simple one: structural integrity of the musculoskeletal system (and its related structures) results in optimum function of the Central Nervous System (CNS). When this occurs there will be symmetry of ‘tension’ or ‘tone’ on either side of the body. When there is dysfunction of the CNS it will be associated with the development of asymmetrical tensions. This idea was first expressed by D.D. Palmer, the founder of Chiropractic, when he said:
Life is the expression of tone. In that sentence is the basic principle of Chiropractic. Tone is the normal degree of nerve tension. Tone is expressed in functions by the normal elasticity, activity, strength and excitability of the various organs (and tissues), as observed in a state of health. Consequently, the cause of disease is any variation of tone.
The ‘targeted’ approach presented in A Textbook of Bowen Technique begins with an assessment of tonal symmetry. This approach should not be viewed as a major change of policy for Bowen therapists – Indeed, I argue that the reason Tom Bowen commenced each and every treatment with moves 1 & 2 of the lower back procedure was so he could make an assessment of tonal symmetry.
The book draws on osteopathic principles and chiropractic theory in order to provide the Bowen therapist with a simple but effective means of identifying the soft tissues associated with spinal dysfunction. Once identified, therapeutic intervention may be targeted to a particular dysfunction.
Chiropractors and osteopaths have long understood the concepts of the vertebral subluxation and dural drag. In the book I explain these and introduce two new theoretical concepts: The first is the notion that dysfunction results from a series of interrelated events that we can view as ‘a cycle of disturbance’. The second is the concept of the ‘Sustaining Muscle Spasm’. These concepts are discussed below.
The Vertebral Subluxation
According to the World Health Organization, a vertebral subluxation is “A lesion or dysfunction in a joint or motion segment in which alignment, movement integrity and/or physiological function are altered, although contact between joint surfaces remains intact. It is essentially a functional entity which influences biomechanical and neural integrity”.
As Bowen therapists, we can simply view the vertebral subluxation as a dysfunctional joint associated with disturbance of the nervous system.
Figure 1: The vertebral subluxation is a dysfunctional joint associated with disturbance of the CNS
The Dural Drag
From a chiropractic perspective, the vertebral subluxation is a significant entity, mainly because it shares a reciprocal relationship with irritation of the nervous system.
On the one hand, the vertebral subluxation may result from irritation within the CNS. In this situation, the CNS irritation disturbs the alignment, movement and function of the spinal segment. On the other hand, biomechanical issues may give rise to the vertebral subluxation, which will then cause irritation of the CNS.
In either case, there is an irritation of the “dura mater”, the outer meningeal layer which encases the CNS. One of the consequences of such irritation is that increased tension is generated in the muscles on one side of the body. This condition of unilateral abnormal tension may be described as a “dural drag” and is evidenced by the presence of a functional short leg. The important thing for the Bowen therapist to remember is that the side of dural drag (the tight side) is the side of the functional short leg.
Figure 2: Illustration of a left-sided dural drag, which presents as a functional short left leg. In this illustration the related subluxation is in the cervical region and is associated with a right-sided sustaining muscle spasm (refer to the next section)
The Sustaining Muscle Spasm
Bowen directed his treatment interventions at resolving abnormal muscle tensions in the body. He specifically determined which muscle tensions needed therapeutic input in order to restore body function. When it comes to restoring function it is important to recognise that some muscle tensions are more significant than others.
As we have just noted, the vertebral subluxation produces a disturbance in some parts of the CNS which then results in a tension state that we have called the dural drag. The asymmetry observed with the dural drag (the functional short leg) is best viewed as a secondary tension since it is a tension state that results from the subluxation. From a Bowen therapy perspective, certain specific and localised muscle tensions may generate and/or sustain the vertebral subluxation. These are the muscle tensions which we shall consider to be primary in nature and it is these localised muscle tensions that require the full attention of the Bowen therapist. I have coined the term “sustaining muscle spasm” (SMS) to describe the particular point of spasm or tension that acts to “hold” the spinal subluxation in place, thus helping to sustain functional asymmetry and the short leg.
The chiropractor attempts to restore function and symmetry by directly influencing the spine and its segments. It should be noted that the Bowen therapist achieves these goals by locating and resolving the sustaining muscle spasm. The overall result of each therapy is to manifest a state of structural integrity of the spine (and other joints) and thereby facilitate optimum function of the central nervous system so that healing and regulation may result.
Figure 3: A sustaining muscle spasm. This illustration shows the concept of a specific, localised muscle tension affecting the spinal segment and sustaining a vertebral subluxation
A Cycle of Disturbance
On a professional level, there is an old argument that debates whether the chicken came before the egg or whether the egg came before the chicken. In relation to the vertebral subluxation, the dural drag and the sustaining muscle spasm, the chiropractor, the osteopath, the massage therapist and many others have long argued their views, each claiming the moral high ground.
Some confidently claim the dural drag is an example of tension arising due to the subluxation, while others would argue that the subluxation is firmly rooted in muscle tension. Yet others are of the opinion that the cause is to be found within the CNS and they view the subluxation and associated tissue tensions as secondary.
We must recognise the complex interrelationships existing between the vertebral subluxation, the sustaining muscle spasm and the dural drag. We need to develop a perspective that views all of these different aspects as interrelated components of one whole unit. If we view things in a holistic way, we can recognise these individual components as parts of an interrelated “cycle of disturbance”, rather than as separate entities. It then becomes far less relevant where we enter that cycle and far more important that we do enter the cycle somewhere and clear the disturbance.
The Cycle of Disturbance from the perspective of a Bowen therapist
As practitioners of Bowen therapy, our interventions are aimed at clearing the sustaining muscle spasm/tension from the area of subluxation. Practice demonstrates that this results in a clearing of the subluxation and of the dural drag. This suggests that the subluxation cannot be sustained without ongoing tension/spasm to maintain it. On a simplified level, the Bowen therapist might view the cycle of disturbance like this:
- Specific, localised muscle spasm or tension is associated with the formation of the vertebral subluxation. Such spasm/tension acts to “hold” the subluxation in place. This particular tension or spasm is termed the sustaining muscle spasm (SMS).
- The resulting vertebral subluxation gives rise to a secondary state of tension, called the dural drag. This dural drag is an expression of functional asymmetry and it can be observed and measured using various assessment methods.
- The dural drag will resolve when the Bowen therapist has found and then effectively released the SMS. Reassessment of the patient will demonstrate that the dural drag has cleared and the subluxation has resolved.
- The resolution of the subluxation leaves the CNS in a state where function is no longer compromised. At this juncture, the body is free to activate its innate regulating and healing mechanisms in order to restore function.
When practiced efficiently, the Textbook Approach allows the Bowen therapist to optimise the function of the CNS through a simple process of locating and correcting relevant spinal dysfunction (the ‘locating’ is carried out using holistic assessment methods described in the book and the correction is achieved with regular Bowen Therapy). In this way, the Bowen Technique may be used to correct significant spinal, pelvic and cranial dysfunction.
Importantly, the same holistic assessment methods can be re-employed post-treatment to verify that a particular treatment was successful.
 World Health Organization, WHO Basic Guidelines in Training and Safety in Chiropractic, Geneva, 2005. p.4.
 Romney Smeeton is adamant that Bowen was primarily focused on identifying and correcting spinal dysfunction. According to Romney, Bowen assessed the spine (and other osseous structures) on every patient and then used his system of soft tissue movements to influence the deeper structures – to restore function to the spine and its segments.
 The SMS is a construct of my imagination. The reader should consider it a concept rather than an absolute reality. In the theory of Chinese medicine, for example, there are many useful concepts, yet most Chinese medicine practitioners do not really believe the body is made up of Five Elements or that the Triple Burner really exists. Yin and Yang exist only as a concept, yet the whole of Chinese medicine is based on these concepts because they are useful. The concept of the SMS is useful for the Bowen therapist because it allows therapy to be targeted to a specific, primary issue.
 In an ideological context, it is interesting to consider the cycle of disturbance as an adaptive mechanism that responds to various trauma, rather than as pathology. These muscle tensions may even exist as a component part of an overall protective mechanism.
 This initial spasm/tension may originate within the musculoskeletal system or from within the CNS in response to many possible factors, for example, mental, emotional, physical or chemical issues.
 Some procedures described in A Textbook of Bowen Technique are significantly different to procedures taught by other schools.