S.A.T. - Specific Adjusting Technique

S.A.T. is a major influence on the treatment philosophy at Still Point so this section provides an overview of this osteopathic concept.


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What is S.A.T.? 

Foundations of S.A.T. (Tom Dummer)

Alison’s Story



What is S.A.T. ?

James: The concept of Specific Adjusting Technique (S.A.T.) started as an accident of fate. The story goes that one day back in the 1950’s Parnall Bradbury (osteopath) found himself to be the only practitioner on duty during a flu epidemic. The clinic was for people of limited means and despite the epidemic, there were still almost forty patients to be seen. There was only time to find a key lesion and make a single adjustment on each patient, but the clinical results were astounding especially in those patients who had been adjusted in the atypical areas of the spine (the upper cervicals and the pelvis). 

S.A.T. as a model of minimal treatment had been born. This method of adjusting one segment at a time effectively gives the body back to itself with very little interference from the practitioner and so is true to Andrew Taylor Still’s (founding father of osteopathy) fundamental precept of ‘find it, fix it, leave it alone’.

Bradbury later developed the concept of ‘positionsl lesions’ which are traumatically induced mobility restrictions affecting primarily the atypical areas of the spine, which require precise adjustment which reverses the force vectors holding the lesion. Through his attention to details and precision, Bradbury observed remarkable changes in the body mechanics of his patients and in the resolution of their pain patterns when treating in this manner. He also went on to publish a paper which describes how specific adjustment of the upper cervicals coincides with a clear rise in blood sugar and adrenaline levels which may contribute to it’s profound healing effect. 

The S.A.T. concept is a major influence on the treatment philosophy at Still Point Osteopathy. It was a large part of my fathers practice life and passed on to me through his mentorship. He in turn developed the knowledge and skill by working with Tom Dummer in the 1990’s. Tom was a wonderful osteopath who developed S.A.T. from its infancy in the days of Bradbury. Tom was the principal of the European School of Osteopathy (ESO), and friend and mentor of my father who wrote this piece about his influence and the evolution of S.A.T…


Tom Dummer

CliffTom Dummer was born on October 23rd 1915.  After a busy life as an osteopath he died on May 17th 1998, just two years after I graduated; a great and sad loss for myself and the profession. 

I met Tom when I was a student at the European School of Osteopathy (ESO), of which he was a co-founder.  Tom was still teaching at the age of 80 then, albeit only occasionally; passing on his innate knowledge in his ‘master classes’. I was very privileged to be able to call Tom a friend.  He took me under his wing during the second year of the four year course, and gave me much advice and tuition.  He is still my spiritual guide in my work to this day. Many people have noticed and commented on his photograph in my treatment room.

His first contact with osteopathy was in 1942 when his hands were diagnosed with rheumatism, which was interfering with his playing piano.  He spent many years working as a jazz musician. He became well after receiving osteopathy treatment from an American-trained osteopath and naturopath named Harry Clements. This started him on the herbal medicine pathway in his twenties. 

He would study while playing piano in a night club by propping his books up on the piano. Some years later he became further interested in osteopathy after visiting an osteopath for a back problem, which set him on a path to a completely new career. 

In his lifetime, he wrote a number of books. He wrote one comparing osteopathy, chiropractic, and naturopathy.  He wrote another comparing Tibetan medicine and osteopathy after his experience of meeting and treating the Dalai Lama some years earlier, which led to his interest in Buddhism. 

His book on Tibetan Buddhism describes the basic principles as well as some of the pitfalls on the Dharma road to enlightenment. This book was a collection of his notes from Tibetan Buddhist lectures and teachings accumulated over his life. It is a well known book for people studying in the field.


Osteopathy (and S.A.T.) according to Tom Dummer

CliffOsteopathy is more than the fixing of back problems in a musculoskeletal way. It has a wide scope as described in more books - his two volumes of A Textbook of Osteopathy. Tom stated that osteopathy stood in the middle of views held by allopathic medicine and naturopathic medicine, but that it had its own philosophy. It is global in its approach to patients and is based on a sound osteopathic assessment and evaluation of the patient as a whole. All osteopathic work should follow the principles and philosophies laid down by A.T. Still and while variations on treatment styles may occur and evolve, these precepts are not negotiable for change. 

There were four phases in the evolution of osteopathy, according to Tom Dummer. Structural, functional, then cranial with the fourth phase being a holistic return to the source approach to osteopathy, as advocated by A.T. Still. This is described as the osteopathic middle way, encompassing all technique approaches in a minimalist way.

During the evolution of this phase, Parnell-Bradbury, Tom’s friend and a chiropractor, was rediscovering a minimal approach to treatment by specific structural adjustment. This was the forerunner of Tom Dummer’s Specific Adjusting Technique (SAT) which he was developing at the ESO.  

SAT utilizes the previous knowledge of various stages of osteopathy to develop a technique that was based in a mechanical but applied in a functional/cranial way. SAT is, in the words of Tom Dummer, a “clinical practice which offers a light, almost ‘feather touch,’ painless and distinctly non-traumatic treatment”.

He felt that in this way osteopathy had turned full circle and returned to the original principles of A.T. Still. Tom Dummer states that the principles of osteopathy are: the artery is primary (circulation of all body fluids), structure governs function, and the body as a functional unit that can auto-regulate. This relates to the interfacing of the inner and outer forms of the body and it is because of the interrelation between the structure (outer), and the function (inner), that osteopathy works. Put another way, the outer form is under voluntary control while the inner forms are more subjective and subject to involuntary systems of response.

The classic structural-mechanical approach works primarily with the outer form while the more functional approaches, including cranial, bioenergetics and fluidic, work more directly on the inner form. In a holistic way, the inner form approach works with the voluntary (mechanical) system as well. A.T. Still’s original principles worked on both levels of form, this was therefore the 'return to source' embracing all modalities of treatment. As in all opposites in life there is a tendency to find a centre and move around that centre.

Tom Dummer stated that A.T. Still presented the human body in three aspects: Mind, Function, and Structure. Still saw the body as a complex system of “connected oneness” that worked under the three concepts of mechanistic, vitalistic, and spiritual This is presented in modern literature as mechanical or structural, physiological or functional, and spiritual. Still’s work then translates as Matter, Motion, and Mind: Matter being the physical portion of the body; Motion being the action of the combined spirit and mind (as in brain); and Mind being the spirit or soul. These are represented in modern literature as Body, Body-Mind, and Spirit.

Tom Dummer wrote a book on SAT, describing how this technique approach combines with Body-Mind-Spirit in Matter, Movement and Mind to define how these are used in treatment and how SAT is the choice of treatment for Mind at the unconscious level.  Tom used this framework for spinal lesion patterns and saw these three components as Structure, Function, and Mind. This is a complete view of his philosophy as it incorporates elements of body types and Tibetan medicine, as well as Buddhist terms of the elements ie osteopathy as the perfect complement to Tibetan medicine.

SAT is now taught at Post Graduate level as a part of an MSC osteopathy course. Tom helped and encouraged me in so many ways in the short time I knew him. I was privileged to be asked to do the first editing of his volumes A Textbook of Osteopathy. He encouraged me to look at SAT independently from a 'students' perspective and I studied SAT for my final dissertation during my four year degree course in osteopathy. 

He encouraged both myself and everyone to "be a student every working day of your life". Always reflect on what you learn. Understand how you can use the knowledge gained. In this sense knowledge is always expansive, individual and creative.

SAT not only became my preferred model of treatment - it is my belief system and encompasses my whole life - in the sense of Mind and how bioenergetics have an infinite and universal connexion.  Both with and within all living things - and beyond the horizons of our comprehension, knowledge and understanding.


Alison's Story

Cliff: After many years treating multiple trauma presentations in my practice - I have been inspired to dedicate this page on SAT to Alison. She has given a commitment to treatment beyond the normal. Her course of SAT treatment has allowed the possibilty of many changes to her overall health and she now continues to work toward a much more 'integrated self' through her own efforts and her new exercise regime. 

Her appreciation of the changes to her overall well being resulted in her wish to 'spread the word' of SAT - and educate people as to the possibities of change with this treatment approach. It is a unique approach for those individuals who have experienced gross trauma at some time in their lives. This may be directly related to one's childbirth itself or a high speed car crash. It may be a fall down the stairs, a clash of heads playing one sport or another, a fall in the street, a fall off a horse, a slip on ice - or even a trip up a kerb or a bang to the head from some other obscure source. The possibilities are endless in the 'high speed world' we live in - exposing all of us to both physical and emotional trauma of many different kinds. Over the years, trauma to the spine has a knock on effect to other parts of the body. This has a cumulative effect over time and may manifest in multiple issues on physical, organic and emotional levels or all of these. Common amongst these are conditions such as IBS, asthma or a number of different anxiety states (for a more comprehensive list see the Symptomology list). These problems are often treated as illnesses in their own right rather than as the effect of an underlying structural problem in the spine. Unless the underlying problem is addressed, the resulting effects and varied symptomotology will just continue to manifest further problems. 

SAT was developed by Tom Dummer - he had a wide interest in holistic and naturopathic medicine. Tom developed SAT as a method for treating the effects of whiplash and other traumas. An invaluable and insightful approach to human health beyond the ordinary. A spectrum of conditions which manifest over time - and other forms of treatment including the medical approach, having little or nothing to offer. This high speed world we both live and engage in demand an in depth knowledge and understanding to whiplash and the gross effects of trauma, both physical and emotional. The individual affected by force vectors entering the body in a specific incident and in a specific way. Held within and writing its own set of instructions into the nervous system - from then on dictating how we function as human beings.



Alison’s Perspective of her own Unique Symptomology relating to her Untreated Whiplash Injuries before receiving a course of SAT


Here is a list of the symptoms which I experienced which may also be familiar to many of you and may point towards you being a suitable candidate for SAT treatment: 

Muscle Tension and Torsion


Inability to Correct or Improve the Condition by either Exercise or Therapy




Difficulty Sitting


Difficulty Walking


You feel Imbalanced/out of Alignment from left to right and top to bottom




Please read about my journey through SAT treatment and how it has changed my life. 



Alison’s Story 

For the last year, I have been receiving SAT (Specific Adjustment Technique) treatment from Cliff. The effects of this treatment have been utterly life changing and I wanted to share my story in the hope that it will inspire and help others, and that in the long term, SAT will become a more widely recognised treatment. 

I first met Cliff in 2013 through my osteopath in the north of Scotland where I live. I was 30 at the time and had suffered since my teenage years from growing amounts of tension, torsion and pain in my back, which had gradually referred throughout my whole body. I did not know the reason for the tension and discomfort but I knew it was gradually getting worse. The muscular torsion in my body was at the forefront of my mind all day long as I was constantly trying to combat it to go about my day in more comfort. My head was so twisted to the left that I was driving with one eye on the road and my body looked completely twisted and out of line with one shoulder higher than the other and one hip higher than the other. I was so twisted that I could not even sit in a chair normally and was constantly shuffling and ill at ease, which, when doing this every minute of every day for years on end, was exhausting. I appeared to people as though I had a nervous disposition and was socially ill at ease. I could not even lie in bed at night and relax; every muscle in my body was under tension and in order to sleep, I had to completely wear myself out just so that I would fall asleep through sheer exhaustion as soon as my head hit the pillow, rather than lie there rigid for hours on end. There was no escape, and I was utterly exhausted from the daily battle of trying to correct this. I had the best will in the world to fight the muscular pulling sensations in my body with exercises, relaxation techniques etc, but it was futile. After 10 years of seeing several physiotherapists, chiropractors, osteopaths, sports massage therapists and Alexander technique specialists both in the NHS and privately, and spending literally thousands of pounds, only to find that the tension and pain always returned a few days later, I was desperate to try anything new that might work.

I had been put forward by my osteopath as someone who might benefit from seeing an osteopath friend of his who was visiting him here in Scotland. The idea was that Cliff was training my osteopath in a technique called SAT (Specific Adjustment Technique) which was specifically for people who had suffered a trauma to the upper spine. This can occur at birth (so you are often not even aware of anything being wrong because it has just always been this way for you) but it can also be due to a fall, impact or a car crash. In any case, such trauma cannot be treated effectively through conventional osteopathic or chiropractic treatment. It is often not apparent that you have damaged your spine at the time of the impact. You dust yourself down and any minor injuries you may have sustained will heal, but underneath, the trauma has affected your body on a deeper level; in your spine and central nervous system. Health problems which are not normally associated with damaging your spine will gradually creep in over the years. Such problems are then often treated in isolation as problems in their own right rather than as an effect of the trauma to the spine - which by this point may well be long forgotten about in the past and so no connection is ever made.

This is exactly what had happened to me. Although I believe my trauma may be traced back to birth, I believe that an accident further exacerbated the problem in my spine when I was 11, so my body was racked with over 20 years of compensations which my body had made in order to allow it to function as best as it could. (It is probably worth noting at this point that my injury had gone untreated for a very long time and so I was quite a severe case; not everyone’s journey through SAT will be as intense, difficult and will take as long as mine has.)

The idea was that Cliff would do the first major manipulation and then my osteopath would continue the treatment over the coming months. I would be lying if I said that this was a small adjustment to my upper spine and I went home and slept for most of the next two days! A few days later, I woke up feeling very relaxed, I got out of bed and my entire right side of my body had dropped dramatically and was now hanging there with no tension whatsoever! I looked in the mirror and was so shocked by what I saw and felt that I burst into tears and my legs turned to jelly I was so overwhelmed!  It had been years since I had felt no stress or tension in my body; it felt amazing although the impact of such a drastic change was hugely disconcerting. To say that this was a life changing moment would be an understatement. 

"I knew at this point that this treatment was different and much more effective

than everything else I had ever tried."

The treatment continued with my own osteopath, however, over time, my own osteopath decided not to pursue the use of the SAT technique and treatment fizzled out. I did feel much better by this point, but what I did not realise at the time was that unless my body was strengthened and realigned with Pilates after the initial adjustments, the old tension patterns and the related pain would just reappear. 

The symptoms did continue to improve for about a year but then very gradually, tension did begin to creep back in and my overall health began to deteriorate once more. After another couple of years, the symptoms had worsened to the point that it was now affecting my ability to walk as well as having severely aggravated my asthma. I could not even walk up a couple of steps without needing my inhaler and I even wheezed sat in a chair; it had become debilitating and affected my daily routine. At it’s worst, my feet had become contorted to the point that even standing up was painful and every day became a struggle to do even simple tasks. Sitting in a car to drive had become impossible. I had also been diagnosed by the NHS as having IBS and problems with waterworks. At this point, I was exhausted and I was doing the bare necessities in life just to survive from one day to the next.

I was however, at a point in my life where my lifestyle had become much less stressful and I decided that now was the time to put my life on hold in order to get this sorted. I had always made a mental note of Cliff’s SAT treatment from three years ago, and I had kept it on hold in the back of my mind for a time in my life when I could commit to going down to the Lake District to see the process through with himself from start to finish. I first embarked on almost six months of relentless daily foam rolling to loosen off some of the concrete-like muscle fascia which pervaded my body. I then got back in contact with Cliff and finally began this journey for real in April 2016!

For the next five months I embarked on a round trip journey of over 700 miles every three weeks from the North of Scotland to the Lake District to receive treatment from Cliff. Because I had received SAT treatment before, I had every faith that my efforts would bear fruit as I was going to get the entire course of treatment this time, and I had no quarms about taking on such a project! It was a huge commitment to make, not only in terms of time and effort (the trip took a whole weekend every three weeks), but financially too. I remembered the life changing release which the initial SAT adjustment from Cliff had brought three years ago, and over the coming weeks, my faith in the procedure itself grew more and more as the treatment never failed to deliver even more astounding tangible improvements; I was constantly spurred onwards to stick with it. Cliff methodically made adjustments down my spine and used cranial work to calm my nervous system. I followed every bit of advice Cliff offered; especially not exercising after treatment and not dabbling in other treatments at the same time. He explained SAT to be almost like a resetting of the nervous system (and this is exactly what it felt like), so that my body could learn to unravel the hundreds of compensations down my spine and in the muscles and ligaments throughout my body which had been taken on in order to survive since the original trauma. 

Everyday I would get (and still do get) an enormous debilitating shivering sensation through my body, like my nerves were awakening for the first time. It winded me and sometimes was so strong that it knocked me to my knees! But it was never frightening and often made me giggle because the sensation was so intense and felt so positive! Whenever, my body was beginning to fall into old muscular holding patterns, it seemed to stop dead in its tracks and reset in this way. It felt like my body had been enabled to know how to best heal itself and I grew confident that my body knew instinctively which particular pain/tension to address next. I had to learn to go with the flow without interfering too much, to really listen to my body and when I felt it moving and resetting, I just had to sit down for a while and enjoy the sensations!

Over the next 5 months, after each session, more aches and pains disappeared. I used the Necksaviour and the Sacro Wedgy (recommended by Cliff) at the end of every day to help and make sure my body was going to bed in a good state to heal overnight. I had ultimate faith in the procedure and in Cliff. I had improved so much by this point, that I managed to walk up a 2000ft mountain and an 11 mile walk; six months previously I could not even walk a few metres without being in pain!

"This is the extent to which SAT can change lives if you fully believe and embrace it."

At this point, Cliff recommended that I start doing Pilates to help strengthen and realign my body; this, I believe was the vital part of my ‘rehabilitation’ which had been missing three years ago. I found myself a Body Control Pilates teacher and although I have to say that it has been a huge commitment each day, it very much has taken over from where the original SAT treatment left off. It began with just half an hour a day of exercises but now - eight months down the line since the end of the initial SAT treatment – it has increased to two hours a day. I also supplement this with at least an hour of body scan meditation to allow my body to be in a relaxed state to begin and end the day, and to develop awareness and the skill of 'feeling into' my body with a view to calming my nervous system down and releasing pain and tension should I need to do so. I cannot stress enough how strongly I believe that the combination of SAT, Pilates and Meditation is vital to calming, healing and reconnecting mind and body in order to ultimately get the most out this treatment (please click to download my 'S.A.T' leaflet SAT .docx in which I offer some practical advice on how to succeed quickly and effectively in realigning and strengthening your body). It is also possible to strengthen and realign the body after S.A.T treatment through Hanna Somatics rather than Pilates. I believe this could be equally effective in some cases.

To date, my feet are now much less contorted and my ability to walk has improved dramatically. In the last few months I have climbed another couple of mountains and am now able to cycle much longer distances. I am about to cycle around two islands off the west coast of Scotland too! These are things I have never been able to do without a huge amount of distress. In addition to the obvious structural and mobility improvements, my asthma has reduced massively (from taking 250mg of the strongest prescribed inhaler twice a day down to 125mg once every ten days or so!) My allergy problems (which were a daily hindrance) have significantly improved, my digestion and waterworks have returned to normal, my skin is clearer, my libido has increased dramatically and I also have lost a stone even though I am probably eating more than I ever have! Although some of these improvements can be slightly attributed to a distinct change in lifestyle, working hours and a huge decrease in stress which occurred just before I met Cliff in 2016, for the most part, these improvements have been due to SAT and the Pilates which followed. I do notice that whenever I am stressed, my body does try to fall back into the old holding patterns and compensations, however, I believe the Pilates will strengthen my body sufficiently to eventually combat this.

I am currently just over a year into my journey and although I probably have at least another year in front of me, I see tiny movements in the right direction every day. The whole journey through SAT can be a long one, but together with the results from the Pilates it is all very encouraging; in fact there are very few things I have ever done which deliver such regular positive feedback to spur you on! 

"I completely embraced the SAT process and it has completely changed my life."

Every day, I feel my bodystarting to move in different ways, I feel it getting stronger and straighter and this allows me to live a much happier and fulfilling life both in terms of everyday activities like sitting in a chair comfortably and driving without being in severe pain (tasks which other people take for granted), but also the ability to follow an active outdoor lifestyle. I have had this problem for most of my life and so I do not actually know what a ‘normal’ body feels like…so therefore I do not really know how much more improvement is obtainable! However, I am enjoying the journey, and the pain free, new found freedom which every day brings! 


I have made some tremendous achievements on this journey which have been accompanied with overwhelming tears of joy, excitement and awe at what SAT can achieve. However, although I have always had reassuring signs from my body that the treatment was working, there have been times where I have had to dig deep to keep going just because the journey ahead seemed such a long – and often lonely – one, especially living so far away from the one person who knew what was going on in my body! Trying to unravel the multitude of problems in my body has been like peeling an onion; there has been layer after layer of problems to resolve. At these times, Cliff has always been there to remind me that SAT will work, I will achieve my goals and that it just needs time. He has engaged with my constant updates, sharing of high emotions when there have been huge leaps forward and spurring me on every step of the way! I still see Cliff every 8-12 weeks or so for follow up treatment and everything is moving in the right direction.

Given the degree to which SAT has improved my life, I have become passionate about spreading awareness of it, as I believe there are thousands of people who are suffering in the same way and for the same reason I was, merely because whiplash injuries are not diagnosed, treated, and most of all, not understood. 

I am only part way through my journey and will update this story with further significant improvements as they occur! Please read on for a more detailed insight into the specific symptoms which I experienced.


May 2017


UPDATE June 2017 

Since writing my story, there have been some huge improvements in my fitness levels and strength. Whilst on holiday, I cycled over 100km in four days including one extremely challenging hill climb of 15% gradient which would have never in my wildest dreams have been possible even a few weeks ago! I am now running up hills without even being out of breath! A year ago I struggled to even walk from the house to the car and was starting to not want to go out because walking was so awkward and painful. Now, my stamina levels during exercise have increased greatly and I am no longer feeling depleted of energy which is incredibly liberating. In fact, I am - for the first time in my life - actually wanting to exercise because it feels so easy! I am continuing with my Pilates program although in a more relaxed manner these days (usually four days a week) and the muscles around my pelvis and buttocks are continuing to strengthen and realign to make walking feel much more balanced from one leg to the other. I have also noticed that my allergy problems (most notably the incessant runny nose first thing in a morning and last thing at night) have vanished completely! Again, this is something which has troubled me since being an infant!

The journey continues...


UPDATE November 2017  

Back in June, I found out that I was pregnant with my first child! Whilst this was planned, we never thought it would happen so immediately! To date, the pregnancy has been very easy and straightforward with absolutely no sickness or aches and pains. I am thoroughly delighted and astounded by how well my body is coping with the physical strains of pregnancy. I am currently 24 weeks pregnant and feel physically very strong. I also have no doubt that I would not have fell pregnant so easily - if at all - in the state my body was in prior to SAT treatment.

In September, I also achieved something which I had written off ever achieving again - climbing a Munro (a mountain over 3000ft in Scotland)! Here I am at the summit of Ben Wyvis (1046m) whilst five months pregnant!









Two weeks later, I set out on a further mission: to climb THREE Munros in one day! Here I am at the top of the Glen Shee Munros in the Cairngorms! Both walks incorporated not only a climb to height of over 3000ft but also a 14km long walk on each occasion.

Prior to SAT treatment: I had climbed a total of five Munros in my life. Each one brought me to tears I was in so much pain, and incapacitated me for a good week afterwards. As a result, three and a half years ago, I gave up on this ambition of climbing hills because my body simply would not allow me anymore.

Following SAT treatment: I climbed four Munros in the space of two weeks whilst also being five months pregnant! At the end of both climbs I felt just a little fatigued as any normal person would be after a whole day walking up mountains.

What better testament to the effectiveness of SAT treatment to turn around someone's overall health, wellbeing and fitness?

I hope that the above symptoms and the content of My Story resonate with you and that SAT is the correct mode of treatment for you. I wish you the very best of luck in your recovery and hope that it delivers the life changing results it has to me. I have also compiled a leaflet with advice on how to get the most out of SAT treatment - ask Cliff if you would like a copy or print from the links below.





If you are thinking of going through a course of SAT treatment, or your treatment is already underway, please read this leaflet created by Alison to learn how to receive the greatest results:


SAT .docx (click to Download)

SAT LEAFLET PDF.pdf (Foldable leaflet PDF - print back to back)