Season Two Highlights

Summary: Whitney Lowe and Til Luchau review highlights and key take-aways from their busy second season of interviews, conversations, and inquiries into the thinking behind effective hands-on work.

 

Til Luchau:

Welcome to The Thinking Practitioner. Hi, I’m Tim Luchau. When I was looking for a publisher for a book I wanted to put out, I was fortunate to have ended up with two offers, one from a large international media conglomerate and the other from Handspring, a small publishing company run by four great people who love great books and who love our field.

Til Luchau:

To this day, I’m glad I chose to go with them, Handspring, because not only did they help me make the books I wanted to share with you, the AMT series, but the catalog has emerged as one of the leading collections of professional level books written especially for body workers, movement teachers, and all professionals who use movement or touch to help patients achieve wellness.

Whitney Lowe:

And I’m Whitney Lowe and Handspring’s Moved to Learn webinars are free 45 minute broadcasts featuring their authors, including one with you, Til. So, head on over to their website at handspringpublishing.com to check those out. And be sure to use the code TTP at checkout for a discount. And thanks, again, Handspring for supporting and sponsoring the podcast. Good day, sir, how are things in the Rocky Mountains today?

Til Luchau:

Things here are very good, a bright, windy day with a chance to sit with you and look back on this past year of podcasting with you, what a pleasure. How’re you doing?

Whitney Lowe:

It is. I’m doing well. It is reflection day for us, apparently. So, this is coming out in December. And this is a time of year when we all tend to sort of look back over the year and wax over the things that we have done, where we’ve been, the paths that we have taken. So, we’re going to do that a little bit today in our podcast, take a look at some highlights from episodes over the past year, some things that we got out of it and maybe suggest some things for everybody else to take a look at and dive deeper in it as well.

Til Luchau:

Because it surprised me to see how much we’d covered. And so, I think it’s a great exercise just for us to go back and update. But I want to hear your takeaways and how you’re thinking about some of those conversations we had last year. But like you said, maybe it’ll give listeners a shortcut back into some things you’re interested in diving into some more.

Whitney Lowe:

Yeah. Absolutely. And just as we get into this, I want to say also, thank you again to you for hanging out with me over the past year because this is something I look forward to every two weeks to get to dive into some of these conversations and see what I can learn and do. So, I really appreciate your time and desire to keep going with it.

Til Luchau:

That’s touching. And yeah, I feel the same. It’s true that I really enjoy these conversations. And it’s great to be able to bounce ideas off of you. And some of the feedback we’ve received as a people really like it when we disagree. So, I’m-

Whitney Lowe:

What?

Til Luchau:

What? Maybe, yeah, we’ll talk about that.

Whitney Lowe:

It’s a load of crap.

Til Luchau:

I know. But I appreciate being able to do that with you, too, and take these things from different points of view.

Whitney Lowe:

Yeah. Good. All right. So, we agree or disagree on four core takeaways from this year.

Til Luchau:

That’s right.

Whitney Lowe:

Yeah.

Til Luchau:

So, that first episode we did in 2021, Episode 30, was on, we called it Excuses, Excuses, Our Favorite Reasons Not to Blink. And we were talking about what seemed to get in our way at that point, it was New Year’s resolutions or things we wanted to change. What do we do instead of doing those things that we wanted to do for ourselves? Is that how you remember it?

Whitney Lowe:

It is indeed, yeah. I went back and kind of listened and looked over some of the things that we talked about. And I think that was a big thing that I think is a pervasive challenge for a lot of us. And one of the things that I was going to kind of reflect back on as I looked over this, again, is that I was trying to reflect on about some of my processes and focusing on, this was also calling into attention, one of the episodes that we did last year, the one about how we chart our own path and educational processes and thinking about.

Whitney Lowe:

The pandemic has forced us into a lot of unusual types of circumstances. For example, with continuing education courses and so many of the live courses being canceled, people were sort of forced into doing online education things. And many of those are self-directed things that you sort of do on your own time. And there’s a lot of instances and I went to our program where people jump in with great intention and purchase a whole bunch of courses and then we never see him again.

Whitney Lowe:

And I’m guilty of it, too. I’ve got a list of all kinds of things that I have seen. “Oh, wow, this is great. I want to do this,” and jump into this course and sign up for something, and then, it’s like moments later, “Oh, I forgot about that thing.”

Til Luchau:

Well, huge, that’s true. You and I are basically like shoveling content out into the world. And the uptake is healthy but not everyone ends up completing it, because of maybe some of those reasons. That’s not always a bad thing. But I know I spend a lot of time thinking about, I bet you do, too, how do I help people at least in the courses, how do we help them see it through? How do I help them stay engaged?

Til Luchau:

But I appreciated the perspective we took, too, to talk about what got in our way because there’s so many time management strategies or goal achievement strategies and sometimes we celebrate the things that we do instead. It was a nice break as well.

Whitney Lowe:

Yeah, yeah, absolutely.

Til Luchau:

You mentioned how do we chart our path or whatever that was? That was Episode 17, I looked it up.

Whitney Lowe:

Oh, good. Yeah.

Til Luchau:

Back to that one.

Whitney Lowe:

Yeah. So, those were some of the things that came to my attention with us focusing on those kinds of things. And I went back and I was looking at some of the stats that you had mentioned in that episode, as well about the percentage of people that actually follow through on New Year’s resolutions and things like that. And it’s kind of depressing. Yeah.

Til Luchau:

Yes, yes. It’s depressing if our goal is to follow through.

Whitney Lowe:

Yeah, right.

Til Luchau:

It sounds like it’s the spaghetti against the wall effect, too. We try a bunch of things. And the things that stick are done, are ready for this one’s ready for.

Whitney Lowe:

Yeah.

Til Luchau:

So, now that would we do?

Whitney Lowe:

I think in our next episode, we talked about cervicogenic headaches. And that was a fascinating one. I was really interested in this particular episode. I got a lot out of your classification schema on those different headaches. That was a real interesting thing that you shared with us there.

Til Luchau:

Well, that was inspired by Toby Hall, some research he’d done around cervicogenic headaches. And they’re a bit controversial as whether they’re a thing or not in other ways. But there seems to be this class of headaches that respond really well to manual therapy. And one of the key definers is does movement of the neck make it worse? And if it does, at least as a cervicogenic component, you can say to that headache.

Til Luchau:

And since we work a lot with movement and with sensitivity of the tissues around movement and there’s a lot we can often do for that kind of headache. So, yeah, it was a fun deep dive for me as well.

Whitney Lowe:

Yeah. Always good for us to review a lot of these kinds of topics. And for the listeners and practitioners out there too, just as a reminder when you come upon things, and you’re like, “Oh, yeah, I took a class on neck things or I read a bunch of stuff about neck things,” it’s always helpful to go back and do that again. Because as we prepare for these episodes, we’re often well, I’ll speak for myself and imagine that the same is true for you, we’re often going back and reading things that we’ve read before or looking at things that we’ve seen before and looking to see what’s new and different as well.

Whitney Lowe:

And I always get more out of it. Like, “Oh, I read this article years ago and I missed that thing.” And neck and headache pain is such a common thing for people to come see us for it’s a good one to go back and really dive into.

Til Luchau:

That was Episode 31.

Whitney Lowe:

Yeah.

Til Luchau:

So, in Episode 32, I talked to my old friend, mentor and colleague, Art Riggs.

Whitney Lowe:

Yeah.

Til Luchau:

Yeah, about his, just here are some of the stories and the subject was aging and aging well, because he’s probably, I don’t know, 15 years or so older than you and me. And he never ceases to surprise me about how engaged he is, how energetic he is, and yet his attitude toward the numerous challenges that he faces in his own body and in his life is always an inspiration to me.

Whitney Lowe:

Yeah. I listened to this episode and I was really interested in some of the different perspectives that you both shared in there. And the aging thing is one of those things that it’s been more on my radar as of late. When this episode comes out, I’m just a few weeks away from turning 60.

Whitney Lowe:

And so, we’re at some of those ages. And I just kind of felt this was interesting watching a lot of the icons of my youth and that was the rock and roll generation, mainly of the ’60s and ’70s, all these people that were rebellious youth at that time, being old people now old men and old women and dealing with those issues about being old and aging and things like that. It’s brought a lot of things to the forefront about looking at where we are in our lives and how those things affect us, each one of us as we get to those places.

Til Luchau:

We are doing our greatest hits, Whitney, here we are.

Whitney Lowe:

Okay, I remember when.

Til Luchau:

Yeah, yeah. So, then you had a lovely conversation with Drew Freedman, the Boston Bodyworker.

Whitney Lowe:

Yeah, yeah. Drew has been a colleague and friend of mine for a number of years. And I’ve watched him just accomplish some really stellar things with what he’s done with the Boston Bodyworker group there.

Whitney Lowe:

And he’s had some real challenges with his clinic situation as a result of the COVID pandemic as have many. I’ve talked to practitioners all over the country, lots of them have had similar kinds of things, especially when you’re running clinics and being unable to overcome some of the financial challenges that happened. This was during the height of the kind of the winter shutdown, before the vaccines were around, and that sort of thing.

Whitney Lowe:

And just the financial pressures that this whole thing has brought on to all of us. So, it really tests us in many different ways of being able to withstand some of those challenges.

Til Luchau:

That’s right. And just to hear the stories are powerful. But then his, of course, his resilience and his kind of pragmatic attitudes. And here’s what we had to do and how he stayed oriented around the things that still work and the things you still love to do.

Whitney Lowe:

Yeah.

Til Luchau:

It was great.

Whitney Lowe:

Yeah.

Til Luchau:

That was Episode 33.

Whitney Lowe:

In Episode 33. And then in 34, we took a deep dive on thoracic outlet syndrome. One of those interesting conditions that’s one of the things that we highlighted in there is the difficulty of kind of pinning down what this even is just because there’s so many different discussions and perspectives about thoracic outlet syndrome.

Whitney Lowe:

And really, we tried to kind of peel it apart and identify some things, especially some of the different variations on this with potential entrapment of the brachial plexus in numerous locations between the scalenes with cervical ribs, and underneath the pec minor, et cetera. So, we’re kind of peeling apart some of those things to try to get a better idea of what this actually is, because it’s kind of one of the things is not so well defined in our field.

Til Luchau:

Yeah. And yet, I mean, that can be a barrier to understanding any set of symptoms that it’s hard to define. And yeah, thoracic outlet is one of those where, “Oh, my gosh, it can be one of these three symptoms.” And that gives this sense that is predictable and reducible to a set of techniques. And sometimes it is, but many times it’s not. So, it was great to unpack or tease that apart with you what other factors might be there and some actual strategies for that one.

Whitney Lowe:

Yeah. And I think this also highlights just the importance of, like you said to being a little cognizant of the ways in which we try to compartmentalize our understanding of some of these things into discrete conditions and problems that have clearly defined boundaries, because that can get to be a challenge in and of itself.

Til Luchau:

Well, and I am way into the complexity, and not pigeonholing things and understanding that things are often complicated or multi causal or even hard to pin down, but that’s not where I like ending the conversation. Because even in those situations, there’s still things we can do. There’s still things that we can perceive or assess or sense and things we can do that help. So, that’s important for me to bring into. And I think we did that there as well.

Whitney Lowe:

Yeah. And what did we do in 35?

Til Luchau:

Thirty-five, that was fun. We traded geek lists of things that was that inspire our learning, resources that inspire our learning is what we called it after the fact that we got into like, our favorite podcasts, our favorite tech tools, our favorite music even.

Whitney Lowe:

Yeah.

Til Luchau:

I got some great ideas from you and went and checked it out. It was fun just to go through some of mine as well.

Whitney Lowe:

Yeah. Likewise. I got some really good places to go to look at things that something came up for me looking back at this episode and looking over the script about it. I was in a conversation with someone the other day that was talking about book collections, because I have too many books. And in the olden days, a lot of it was they were falling off my bookshelves because I was running out of space in my office. And now, they’re falling off my iPad because I have so many books loaded onto my iPad. It gets heavier and heavier by the day.

Whitney Lowe:

But they were talking like, “Hey, do you really need all these books?” And I said, I heard this great analogy from somebody else. It’s like a really fun wine collection. I may not ever drink all of those bottles completely myself, but knowing that they’re there and knowing that I can go there and find things and sometimes I do just go get one little piece out of this book because I need it right at this time, that’s why I like to kind of gather those things up.

Whitney Lowe:

And we talked in that episode a lot about collectors, who were the collectors that were gathering that kind of stuff and holding on to it? And so, one of my faults about gathering and not letting go of things is just around books and resources.

Til Luchau:

I think I’m there with you. I like the company of books. They are not clutter in my mental landscape. They’re companionship. The more the better in some way.

Whitney Lowe:

Yeah. And I acknowledge a fair degree of the FOMO. For those who know those acronym, F-O-M-O, the fear of missing out.

Til Luchau:

The fear of missing out.

Whitney Lowe:

I have that, if I don’t get this, there’s going to be some gem in there that I wish I had. So, I’ve got that on those kinds of resource.

Til Luchau:

Of course, you read them all. Plus you go to our Episode 30 and pick one of those excuses not to.

Whitney Lowe:

That’s true. Yeah. So, speaking of learning, yes.

Til Luchau:

Thirty-six, you talked to Robin Anderson, that was about research, education, her work with the foundation, her work with her community college, a bunch of things.

Whitney Lowe:

Yes. So, this was an education deep dive. And we were both kind of geeking out on this being educational geeks about this. And one of the things that really kind of came back to me about this episode that is a thing that I think about a great deal and really ponder about is really, and this question has been coming up for years is where are we going in our field and profession with our training programs? Are we going towards the future of traditional degree programs? Will we stay as proprietary educational small microcredentialing programs and things like that?

Whitney Lowe:

And these are some huge questions, I think that will have a great deal to do with steering the direction of where we’re going in the future. And there’s a lot of people who just feel like, we need to increase standards and increase the participation in the traditional academic environment with getting massage therapy, for example, to be a degree program. And I’m not so sold on that idea as I used to be just because of a lot of things that I see changing in the educational landscape.

Whitney Lowe:

So, I think a lot of this is going to happen after I have already hung up my cleats, but I am very interested in trying to look at the future of where those things are going and see what kind of places I’ll participate in the direction somewhere down the road.

Til Luchau:

Yeah.

Whitney Lowe:

So, yeah.

Til Luchau:

That’s quite an image hanging cleats.

Whitney Lowe:

I’m not there yet. But it’s closer than it was.

Til Luchau:

Right.

Whitney Lowe:

I want to ask you just this question, and I’m going to bounce back for a second to our question about your episode about aging with Art and just ask you this. Do you happen to remember a time when you kind of looked around at your world and said, there’s probably more behind me than there is ahead of me?

Til Luchau:

Yeah, for sure. That’s probably my 40th birthday. Who knows? Maybe numerically not, but it sure felt like the crest of a hill in many ways.

Whitney Lowe:

Yeah.

Til Luchau:

I’m just kidding. It came downhill from here.

Whitney Lowe:

I don’t think I really slowed down enough to kind of have that perspective and think about it until I was in my late 40s. Even almost, maybe even to my early 50s, I think I start really thinking along those lines.

Til Luchau:

No, that’s true. There’s different levels of reflection on that perspective and different ways it looks too, on this side of the hill. And you’re coming up to your 60s, this is such a great thing. But my 60s, which was pretty recent, too, was so powerful for me personally. And in spite of being much less of my life likely left and is behind me, it did somehow excite me to be facing it and to realize there’s so much that’s possible, ended up having a conversation. Art Riggs was there. In fact, with many my older friends to talk to me about aging. And we had a like a Zoom birthday party. And it was really helpful and useful.

Whitney Lowe:

Yeah. Well, speaking of getting older and having those kinds of things happen, my shoulders been bothering me a lot. We talked about shoulder pain in Episode 37.

Til Luchau:

I was going to say I got an episode for that. That was Episode 37, Shoulder Pain, Impingement and Rotator Cuff Issues. Do you think what’s going on view fits in that category?

Whitney Lowe:

Not quite. I think I’ve got more bicipital tendon issues. But that could be impingement could be going on there to some degree. So, there could be some impingement problems happening there. But yeah, we talked about terminology issues and looking at some new perspectives around some of those kinds of things with alternative causes of potential shoulder pain, what is the formerly called shoulder impingement syndrome and what are we now looking at with terminology around that? And how does that also change our perspective of what’s going on in there?

Til Luchau:

And the short version is, it seems to be really useful to call the situation for its effects rather than for its presumed cause. So, the pain in your shoulder is a probably a much more accurate description than impinged by tendon, for example, because there can be so many mechanisms involved, and there’s so many debates about that, that when we come into, this is the point we made there, when we come into assuming a mechanism that shapes our approach. And if we come in assuming an effect, then we can probably be even more specific in what we’re doing.

Whitney Lowe:

Yeah. And I also have to believe that this has an impact, too, on the way the client perceives what’s going on with them in terms of talks about, “Oh, I’ve got something pinched in there. I got to spread it apart or something like that.” Just the mindset of what needs to happen there. And so, yeah, I think the words matter. The words in the name matter.

Til Luchau:

Well, and then we went and continued the conversation in 38 and called it Frozen Shoulder, for goodness’ sake, which is one of those terms that brings to mind all sorts of probably unhelpful things. But we talked about that. And we talked about getting some of the questions involved about mechanisms, some of the populations that are most likely affected or factors and how that comes up and some of the thoughts that conventional wisdom about it having a natural history of meaning resolving itself in many cases, does that seem to be the case or not, and then the role of manual therapy of course.

Whitney Lowe:

Yeah. An important distinction, I think, too about this, because this is another one that’s conditions that is so poorly defined and poorly identified in many situations is making some distinctions between those things that are muscular boundaries, restrictions of the shoulder as opposed to a true adhesive capsule situation because that’s oftentimes poorly delineated in many cases.

Til Luchau:

I like how you consider the capsule true.

Whitney Lowe:

Consider it true.

Til Luchau:

Maybe instead of true, you said a true capsular adhesion.

Whitney Lowe:

Yeah.

Til Luchau:

Or sometimes we’ll call it this, like tissue base, we’ll call it real. It’s really stuck. It’s not just that we’re

Whitney Lowe:

Imaginatively stuck.

Til Luchau:

But I actually like flipping that for myself. It’s a good distinction. It’s one I use all the time my work. Is it stuck together on the physical plane or is it more of a subjective experience of being painful to move and so, I don’t, for whatever reason. I really like that distinction, but I challenge myself on my assumptions about which is more real, which I can affect and which I can’t, that kinds of things.

Whitney Lowe:

Yeah. That’s a good point. Yeah. And the word “true” is probably inappropriately used there. We should just call it capsular lesion. I guess, one of the reasons that that word has snuck in there so much is because there’s been so much false description of that is a capsulitis, when it really wasn’t. And so, we talked about all this that’s really is capsulitis. That really is capsular lesion.

Til Luchau:

That’s true. There’s that word again, that’s true, that the debate does get true or false around what is the mechanism and then what is the effect. And it’s a bias that is so pervasive probably ever since Descartes, which is saying there’s the material world and there’s the mental or the outer world, the inner world. And with the outer world, when we share up in quotes, objectively is the true one.

Til Luchau:

And the other one is subjective and cool, too, but not it’s real, which with your psychology background and with mine, I mean, early on that’s not a distinction that is as pronounced in the world of psychology is that would be saying physics or something.

Whitney Lowe:

Yeah.

Til Luchau:

And then bodywork is somewhere here in the middle where people hurt and that can have a physical component, or maybe not, and which one is true.

Whitney Lowe:

Yeah. And I would say all of those things force us in the direction of some interesting critical thinking, which is our segue into Episode 39 discussion you had with Ruth Werner.

Til Luchau:

Smooth, nice. I like how you got me back on track there. Yeah, Ruth and I had we really missed you. I wanted to be there, but the timing didn’t work out. We had a great conversation about thinking critically. And this was, as she, I think she had either just published or was about to publish her article, her extensive article in Massage and Bodywork magazine about that same topic.

Til Luchau:

And she had interviewed me, I think you too and some of the people about in preparation for that article. And we just got started so that I wanted to talk to her. So, I got a chance to interview her in depth in the conversation. And I always like talking to her. That was a good conversation.

Whitney Lowe:

Yeah, yes. And you all got into some really interesting and fascinating stuff. And that kind of segue into also the piece that we ended up doing for the ABMP CE summit on Critical Thinking too. And that was a nice expansion of some of those ideas as well.

Til Luchau:

We got to be on that panel together and each share some perspectives on critical thinking. It was fairly recently. Yeah.

Whitney Lowe:

Yeah. And Cal Cates was on that panel, which segue to our next Episode 40 here.

Til Luchau:

Yup. Cal was there with us. And it was How Not to Fix It. And Cal to talk about death and dying. And I was like, “Okay, let’s do it.”

Whitney Lowe:

It’s an interesting topic we don’t really get into that much, certainly on our podcast and doesn’t get a whole lot of traction I think in our field, but Cal had written this article a while back and had gotten quite some response and feedback from people about looking at those things. And Cal was talking about how this has impacted practice and interactions with clients and things like that and some very fascinating aspects of that.

Til Luchau:

That’s right. No, her article, we do talk about her article, which I think was 2018. And then some of the more recent work around death and dying. It was a fascinating dimension. And that’s the focus of Cal’s work with her group, Healwell, too, to get to hear how they’re doing that in hospitals and hospices and training providers, things like that. Those things we can all consider in our own process of moving forward with life and being with clients who are doing that.

Whitney Lowe:

And this is one of those episodes that I enjoyed a lot, because it really got me out way outside my traditional sort of comfort zone and things that I focus on a lot with my work and the orientation of what I’m usually doing. So, I was out there a good bit in more unfamiliar territory and that always is helpful for pushing the edge of learning more significantly. So, got a lot out of that whole discussion.

Til Luchau:

Me too. And I just want to give Cal and her group a plug, Healwell. They were kind enough to actually formally sponsor us for a few episodes there. But the emotional support or the moral support we give each other is really mutual and appreciate that.

Whitney Lowe:

Yeah, indeed. And then in Episode 41, we went again to another interview episode. This one with Diane Matkowski, the massage mentor. And this was also some fascinating stuff that she’d been getting into at this time, too, with the kicking off the Shoulder Jam and a lot of the other educational ventures that she’s into, and just been a really good I think role model for so many people about seeing a vision, carrying it through and really creating all kinds of opportunities for people. It was an inspiring picture.

Til Luchau:

We called it Going For It because that’s what Diane did. And she’s my buddy, but she’s also just such a big inspiration about how she’ll get an idea and then just make it happen. And she’s building big things as we speak. And in fact, we’re out to get her back. I think it is probably next episode to talk about her next project, The Inside Job series that your teacher on as well.

Whitney Lowe:

Yeah. So, we’re looking forward to another discussion with her about some of those kinds of things. Because these are some of the things that are about the vision that drives us to accomplish the things that we want to accomplish and get to the places that we want to get to. And so many people do wonderful things on a day in day out basis with their clients in the treatment room.

Whitney Lowe:

But a lot of times, it’s really helpful to focus on and think about that bigger vision of why do you go through the difficulties and challenges that work really entails? What is it that’s your mission behind the whole thing? I think it’s really helpful for us all to remember and align with that when we can.

Til Luchau:

That’s right. And then her tagline is success is an inside job, that speaks a lot right there.

Whitney Lowe:

Yes, indeed. Yeah.

Til Luchau:

Cathy Ryan was with us in Episode 42 to talk about Scars and Scar Tissue, something that’s become a specialty for her after the book she wrote for Handspring on the subject. And she was somebody that I went to a time that my wife was going through some treatment that involved a lot of scar recovering, things like that. So, Cathy was a great advisor. To me, she’s awesome. But I went to an interview in my putting together the inflammation series. So, it was fun to close the circle and talk to her a little more and very specifically about working with scar tissue and a massage therapy context.

Whitney Lowe:

Yeah. And this is a topic that I think really needs a lot of kind of updating and looking at some of the newer research and stuff because many of us were taught some sort of formal ideas about scar tissue that haven’t proven to be what we thought they were initially with how its managed, what it is, and what it does. And she was bringing some really good perspectives with newer research and understanding of some of these kinds of concepts and how to work with them on a therapeutic level. That was really helpful, I thought.

Til Luchau:

Yeah, it was. And…

Whitney Lowe:

And then in 43, you had a solo episode interview there. That was interesting as well.

Til Luchau:

That was with Marcela Ot’alora, who is a researcher in the only FDA-approved clinical trial for MDMA and PTSD. So, MDMA is commonly known as the party drug ecstasy. But it turns out that it has a pretty remarkable effect in helping people work through PTSD and trauma.

Til Luchau:

And so, I really wanted to get her on the podcast and talk about the study, and especially how the body is part of that traumatic response is basically their thinking, as I understand it, is that something like MDMA helps take the amygdala offline, basically turns off the part of the brain that’s dealing with threat, so that you can essentially experience and feel and process things that you’re normally keeping out of your consciousness.

Til Luchau:

And so, you get to do that in a context that’s much more benign or agreeable or even pleasant, which has some interesting parallels to our work too, to we’re actually giving people. Sometimes physical experiences that might be intense, but often, it’s in a context that’s agreeable or pleasant, or that we can relax into, and then things are better or different afterwards.

Whitney Lowe:

Yeah. And I think there is a lot of corollary between many of those kinds of experiences and some of the things that happen in our massage sessions. And there’s a lot that we can learn from some of those kinds of explorations for sure.

Til Luchau:

So, that was Episode 45. She talked to about maps and the organization that is seen through her phase three trials and things like that. So, some good conversation. And you got to talk with Doug Nelson in Episode 44. You called it Table Lessons, but you went a few places with him.

Whitney Lowe:

Yes, indeed. So, Table Lessons, this name came, of course, from Doug’s books. He’s got two volumes series called Table Lessons, which is basically stories from his practice of things that he’s encountered. And one of the things that I brought up a lot in there in our discussion and I really liked the way he handled this in his books was, these weren’t a series of kind of lessons of here’s what was wrong and here’s what I did to fix it.

Whitney Lowe:

Most of these stories in the clinical environment left with question marks at the end about what really happened, what were some of these outcomes, where did this go? Because that kind of often is the case in many of our situations that we may not get full resolution on a lot of kinds of things. And each one of these kinds of encounters in the clinical treatment room often leaves us with questions about what did we do, what did we not do, or what did I learn out of this kind of situation?

Whitney Lowe:

And that was a really valuable perspective, I think, to hear him talk about from decades and decades of lots and lots of treatment sessions with probably thousands of clients at this point.

Til Luchau:

Oh, he’s a great spokesperson for that point of view of that questioning and listening perspective.

Whitney Lowe:

Yeah. And another thing that he really brought to the forefront, too, and this is valuable coming from somebody who the point that we were talking was the president of the Massage Therapy Foundation and has been very involved with research for many years looking at the importance of translating that research into our clinical practice, but also keeping in mind that in many instances, what happens in clinical research can often be somewhat fictitious, I don’t know, fictitious is the right word, but constructed environments that aren’t really reflective of what happens with our direct one-to-one interactions with people in the treatment room.

Whitney Lowe:

So, keep that in mind sometimes as you’re reading and looking at research studies that some of these kinds of environments could have different impacts or different results and outcomes, because it’s not really a real treatment environment.

Til Luchau:

The context isn’t always the same as we’re dealing with. And so, the conclusions may or may not be relevant. Of course, you saying, “Yeah, keep that in mind, as you’re reading your research.” I’m saying, I would say put it out of your mind if you stop yourself from reading research because of that, because that’s often one of those reasons we have for not seeing what we can learn from research is like, yeah, that’s research. That’s not really that relevant. True. And maybe there are ways that we can learn something from that, of course.

Whitney Lowe:

Yup, indeed. And we had a fascinating discussion with Robert Schleip in Episode 45.

Til Luchau:

Speaking of research.

Whitney Lowe:

Yup. Speaking of research is based on his book, Fascia in Sport and Movement. And he shared with us some of the new things that he’s discovering working on. And we talked a great deal about what is going on under our hands and what are some of the both misconceptions and concepts and ideas that really tell us about what’s happening with this particular type of approach. Some really fascinating stuff that we learned from him there.

Til Luchau:

He’s been an inspiration and a mentor of mine, as I mentioned before, but his book is titled, like you said, Fascia in Sport and Movement. And yet his background is as a manual therapist. So, I really wanted to connect that. I want to come back and see how what he’s writing about are getting all of the other contributors to that book to write about how that applies to manual therapy.

Til Luchau:

And he accommodated me, but it was also the case that so much of what he’s saying is like, we need to be moving people more. We need to get people over their lack of movement in the right dosage, because he made a couple times in our talk. It’s not like just more movement is better. Somebody who runs every day might have more Achilles tendon issues than someone who just runs three times a week. But the couch potato has even more the other one, he says.

Whitney Lowe:

Yeah.

Til Luchau:

So, there’s a way that keeping our physical body or connective tissues like our fascia healthy through movement and activity is really important. His background as a manual therapist, of course, and the people that he invites him to talk about that in the book is really educational for me.

Whitney Lowe:

Yeah. And I think that had a lot of connections with other things that we were talking about with a couple other episodes emphasizing movement that came up again, both in the episode that I had with Jamie Johnston and Eric Purves, and also in our discussions with Todd Hargrove. He’s been a big movement advocate for so many years. I think we’re seeing and hearing a lot more of that whole concept and idea of movement really needs to become a lot more integrated in what we do with any of our client approaches.

Til Luchau:

Well, at least if we want a shift and symptoms, because often that’s what our clients want. They want less pain or they want to move better. And so, there’s a limit as to what we can do passively with someone on the table. There’s a lot we can do, but there’s a limit too, at least if the goal is to shift someone’s ongoing chronic symptoms. But often that does come down to movement as being the way that’s going to change.

Til Luchau:

And Robert was clear about that. He made the soundbite, of course, from that conversation was that he saw a lot of the debates around whether fascia changed or not as being a North American social media phenomenon. He said that in a world of researchers like of course it changes. Here’s, in fact, we’re learning more about how it does. Maybe not in the plastic, simplistic way a lot of us body workers were taught. There’s change going on all the time with fascia.

Whitney Lowe:

Yeah. And so, in Episode 46, we got into Iliotibial Band Controversies and Approaches, some of the things trying to better understand and dive deep and explore some what’s going on in the IT band. This is one of those speaking of fascial and connective tissues, one of those ones that gets a lot of focus and attention, both because of its size, mechanical role and role that it plays in a lot of other kinds of disorders in the lower extremity, hip and pelvis region.

Til Luchau:

Let’s say roll a few more times as we talk about this ITB, because, again, that’s one of the controversies like, should we roll it or should we roll-

Whitney Lowe:

Yeah, roll in a different way. Yeah.

Til Luchau:

And we do talk about that in that episode and we talk about the ways that I think we each approach it and some of the reasons we might even be an issue in our populace sensitivity there on the outside the leg, its role in balance and stability, across the knee, those kinds of things.

Whitney Lowe:

Yeah, yeah. So, we did some kind of deep dive into physiology of the iliotibial band looking at its physiological makeup and also biomechanically what it’s really designed to be doing and like, can you loosen it in particular and should you be trying to do that.

Til Luchau:

Is that the goal, right?

Whitney Lowe:

Yeah.

Til Luchau:

Yeah. Yup. And that was, even with those considerations and caveats we found hands on things to share, and that was one of those episodes where we put together a handout. You pulled some of your gems out of your treasure chest, and I threw a couple in myself, threw in some gravel to mix it up. And then we put it out as a handout that people can go download for free for that one and a few of the others as well.

Whitney Lowe:

Yeah. So, well, we kind of continued our lower extremity structure and biomechanical approaches in Episode 47 talking about over-pronation, Getting Over Over-Pronation was our title of that episode. That was kind of interesting. You were doing some foot and ankle stuff with course at that time, I believe.

Til Luchau:

That was one of the two month online principles courses about the foot, knee, and leg. But yeah, that over-pronation story. And I enjoyed taking the devil’s advocate and really highlighting the research the questions whether or not over-pronation is a problem. Like if pain or difficulty or performance issues are not really well correlated with arch height. It’s not like if you have a low arch, you have more foot pain, statistically.

Whitney Lowe:

Yeah.

Til Luchau:

So, looking at some of our goals or our assumptions, they’re around when we’re working with an ankle that pronates a lot or doesn’t pronate a lot.

Whitney Lowe:

Yeah. And these are things, too, that are constantly I think, evolving with our understanding better biomechanical, physiological understandings of what’s happening in those tissues and seeing what’s the role of manual therapy in trying to address some of the things because this gets back to the whole movement issue.

Whitney Lowe:

We can do all kinds of work with people’s feet when they’re on the treatment table, and that may or may not change a whole lot of what they’re doing with movement when they actually get out and start moving around a lot. So, we have to look at how do we help support better, more appropriate movement if that’s an unnecessary goal or not.

Til Luchau:

Well, and then if we do take the movement lens, how would that change our tableware because it’s totally changed my table work in the last 10, 15 years to think that movement becomes the goal and are helping someone move more and easier and more comfortably in their own life? What if that’s the goal? Was that the result I want from my table work into something that is so solid is an ankle joint and foot the tarsal bones those kind of relationships. What are some things we can do that actually make movement more possible in the ways we hope it to be?

Whitney Lowe:

Yeah. So, as we talk about controversies and issues that certainly came up we did a rebroadcast in Episode 48 of an episode we had done earlier on Psoas Work. Is it safe and is it necessary?

Til Luchau:

Yeah, we picked that because it was one of our most downloaded episodes from the previous year. And sure enough, this year again it got right up there. People want to hear about the psoas. I think it’s one of those love hate things.

Til Luchau:

And I can be sure that if I want some interesting controversy, all I did was mention psoas on social media and sure enough, people will be everything from it’s the sacred see to the soul to this as a bunch of hooey and you can’t even touch it so why are you talking about it or shouldn’t be even touching it. So, we do talk about that range of perspectives and where we each stand on that in our own approaches toward working with the psoas.

Whitney Lowe:

Yeah, yeah. So, I think it’s not going away anytime soon. It’s probably going to continue to be that. So, if you feel like we only want some interaction with people, go out poke the bear and say psoas on social media.

Til Luchau:

Yes. Psoas work is god or psoas work is baloney, whatever you want to say there got some response.

Whitney Lowe:

Posted in one group, psoas work is god and posted in another group of psoas work is baloney and see what your responses are. So, then where do we go, 49. What do you feel? We should have done this episode with an old overdub of Peter Frampton’s do you feel like I do song or something like that for interoception.

Til Luchau:

Yeah. Well, I got to say background music is on my wish list. I don’t know if we’re going to get it in 2022 but sometime, yeah, so that’s a great way. I’m going to make a note of that.

Whitney Lowe:

Maybe you and I should do some background karaoke to some of these episodes or something. That will make our listener list drive.

Til Luchau:

You do the soundtrack and I’ll do the visual. How about that? I’ll lip syncto your sound. But Episode 49, we talked about interoception. And that was an article, a topic that I picked to write for, for massage and bodywork. And you were kind enough to interview me on that and helped me elucidate or elaborate some of the ideas I had about it.

Til Luchau:

And the article was called Three Questions on Interoception. And I took three common questions that therapist ask for clients like, are you comfortable? How’s the pressure? And can you relax into that? And looked at them from an interocepted point of view? Like what parts of the brain you’re actually asking to come online when you ask those questions and how to actually help get useful answers to those questions and these responses as well.

Til Luchau:

And then, the role of just feeling in general how maybe feeling becomes. If we think of that feeling is like a medium, maybe there’s muscle, there’s connective tissue, there’s movement, but maybe it’s even feeling the perception of sensation that we’re producing with our hands.

Whitney Lowe:

Yeah. And you have talked about this a number of times and I think this is really valuable is for us to kind of zero in on some of those sorts of things when we talk about treatment goals with our clients. What do you want to be feeling when this is complete or how are you determined this is complete? How you feel?

Til Luchau:

That’s how the client feel and also, how are we feeling? What is our interoception’s practitioners play into that? What happens in our bodies as we’re working in and how can we incorporate that and use that?

Whitney Lowe:

Great.

Til Luchau:

Episode 50.

Whitney Lowe:

And so, 50. This was an episode I did, an interview with Jamie Johnston and Eric Purves from the Massage Therapy Development Collective podcast in Canada. We talked about a lot of across the border issues. I think I said collective I meant initiative, Massage Therapy Development Initiative for their podcast there.

Whitney Lowe:

So, this is an interesting exploration of things that we’ve grappled with here in the US and things they’ve grappled with in Canada along similar lines, especially around educational requirements, types of program evaluations, some of the issues around continue education, things like that, always good to have a different lens to look through to look at some of these different issues and see how they’re perceived in these different.

Whitney Lowe:

Because there’s cultural, legislative, systematic things that all influenced the way our professions are perceived in different places. And it’s always good to get outside your own lens of bias and look at that through different glasses.

Til Luchau:

That’s right. And I think most American therapists are aware that a Canadian massage therapist typically has been through a whole lot more formal schooling than their American counterparts, at least in the field of massage therapy.

Til Luchau:

And so, it’s always interesting for me to have those conversations across the border, but then the teaching I’ve done in Canada pushes my technical skill to another level and then looking for ways that we can dialog and talk about our work that are useful and from both perspectives. But that was great. I enjoyed the conversation you had with them and their own dedication toward raising the bar that in a balanced way, that includes not just the technical.

Whitney Lowe:

Yeah. And another important point they brought up in this discussion, too, and I’ve had this discussion with a couple other practitioners is we often make these sort of more generalized statements about massage therapy education being so much more extensive in Canada. And that is not necessarily true.

Til Luchau:

Okay.

Whitney Lowe:

Depends on what province you’re talking about. Because Ontario and British Columbia, that’s probably true. In Alberta and Manitoba, it’s not. So, that’s one of the things that we get kind of sucked into some of those kinds of generalizations, both about education there as well as here in the US as well, yeah, important distinction.

Til Luchau:

I stand corrected and I stand specified. So, thank you for that.

Whitney Lowe:

Yeah. So, in our Episode 51, we had a great conversation with Todd Hargrove on neuroinflammation, which I know topic near and dear to your heart, your focus on inflammation and everything.

Til Luchau:

Yup. And it’s neuroinflammation being a systemic inflammation that affects the functioning of the nerves or might even inflame the nerves themselves. And Todd did have an eloquent blog post on some of the sources of that or effects of that. So, it’s great to get him on the show and have a conversation with him about that and about inflammation in general.

Til Luchau:

And we went a few places together, but I did also enjoy that conversation with him. And again, he’s got a background as a manual therapist or connecting those dots back to what we can do on the table and with our hands in a way that I found really interesting and satisfying.

Whitney Lowe:

Yeah. And for those not familiar with Todd, he’s done some wonderful explorations and put together some really good stuff. He’s got a very fascinating podcast, too. I encourage you to take a listen to that, the Better Movement podcast and some other things that he’s put together in a book he’s published and everything like that. So, a great resource there for expanding your vision about what you’re doing with soft tissue work.

Til Luchau:

Check it out. And that was Episode 51. All these guests were mentioning. I mean, we should just be pointing people to the show notes, because both on your site and on mine, we do list, the resources, we’re talking about how to dive a little deeper with this.

Whitney Lowe:

Yup, absolutely.

Til Luchau:

Then this pretty … We’re almost wrapping up here, Episode 52, I got to talk to you about orthopedic special tasks, which had come up in your conversation with Jamie Johnston and Eric Purves. But we got to really pick your brain about those and the role that you see for those or not.

Whitney Lowe:

Yeah. And this is a really valuable kind of reflective piece for me, because having written a book on orthopedic assessment that was a huge part of what I have spent many, many years teaching. And I’ve really changed perspective, a great deal on how much emphasis we put on those and how much we use them for the whole tissue evaluation process when we’re trying to figure out what might be going on with our clients.

Whitney Lowe:

One of the things that we kind of mentioned and there’s still value in these procedures, and they can be used more effectively. We got some comments that came back from people about this and a few other things that came up in some of the Facebook groups and stuff about these things.

Whitney Lowe:

And I think one of the key themes around is there’s still some significant value in many of these tests for ruling out really serious problems in many instances. They may not be as accurate in really giving us confirmation that something’s there, but they can certainly be helpful, in many instances to rule out more serious types of complaints.

Whitney Lowe:

And the other thing that would really emphasize it came out of that is that they should never be used in a vacuum. Just like I’m just going to go through and do the shoulder test and now I know what’s going on. You’re missing a whole bunch of information, just that kind of narrow vision.

Til Luchau:

Well, it’s an interesting paradox because we want to know what’s happening so that we can do something to help are affected. And these tests hold the promise of giving us some information if I can provoke the movement, or if I feel a difference, or the client feels a difference, then that tells me what to do. But they are out of favor in many ways because of the if-then thinking. If I see this, then I should do that. And that’s not always the case. You did talk about some great ways to balance that tendency. And still find usefulness in them.

Whitney Lowe:

I wanted to share a quote I heard from somebody that somebody had posted on social media the other day, or week or two ago or something in talking about a topic similar to this of when is it necessary that we really try to find out what tissue might be causing certain types of things. And there are instances where pain is not necessarily caused by specific tissue damage. And that’s become a big theme from a lot, especially the pain science community. But that has also, I think, led people away from looking for it when it might potentially be an issue.

Whitney Lowe:

And somebody had put this quote out there because there’s this concept that pain is not necessarily indicative of tissue damage, except when it is. And that’s an important thing to remember is that there are still going to be times when it is and if it’s helpful to figure that out to manage your approach that’s valuable. But just keep in mind, remember that a lot of times, it’s not going to be as clearly identified as we once thought it might be.

Til Luchau:

Well, when a lot of the pain science debates were starting a decade ago ever was, I mean, there were all the accusations of let’s not throw the baby out with the bathwater just because it’s not always the tissue doesn’t mean it’s never the tissue. And I think again, a decade on or whatever span, we’re finding a much more balanced or maybe nuanced perspective on the role that tissue can play in pain or how our thinking in tissue bound ways might actually limit us to be effective there.

Whitney Lowe:

Yeah. So, I like to think that we’re getting back closer to a balance and away from a pendulum swing there. So, that’s a good thing.

Til Luchau:

Isn’t it nice that society is becoming so balanced and so little.

Whitney Lowe:

We are very balanced. Yeah.

Til Luchau:

Yeah.

Whitney Lowe:

We have a little discord and they were very balanced.

Til Luchau:

Oh boy. Yeah. I mean, we’re all learning about that. We’re learning how to deal with discord. I hope that’s what we’re doing. At least we’re getting a crash course in living through this.

Whitney Lowe:

Yes. I’m not sure how much learning this could be. I think you’re more right. They we’re getting a crash course and living with it. But yeah, I’m not convinced about how much learning is really happening.

Til Luchau:

I could tell. In the meantime, lots of grist for our collected mills there.

Whitney Lowe:

Yeah.

Til Luchau:

What did we talk about next?

Whitney Lowe:

Our last episode of the year, content wise, other than this one we’re doing was an interesting deep dive into some more fascial research with Dr. Antonio Stecco from Italy has joined us for a fascinating conversation about these things.

Til Luchau:

Yeah. And his research has been really instrumental and helping define the different layers and mechanisms involved in the fascial effects that we do see what the fascial effects are. He’s come up with some interesting imaging ways. And he’s particularly good at clarifying what can be a very amorphous situation there. So, I was really pleased to have his ear and give him a chance to talk through some of the questions together.

Whitney Lowe:

Yeah, yeah. Great discussion. And as you noted, too, and he spoke about it here, he and his whole family have been working on this for many years. And I’ve just put out a tremendous wealth of information on some really fascinating stuff so if you want to help expand your understanding and build out your library of great resources, they’ve got some wonderful things that they’ve been doing there in this work for a very long time.

Til Luchau:

Yup. All right. So, that was our year and then we have this one. Do you know what our top episodes were out of those 50 something?

Whitney Lowe:

I don’t. And I would have to go back and look at stats, but I’m going to hope that maybe you actually did that.

Til Luchau:

Well, I did that. And let me pull up that page here. The top downloads and just in terms of downloads, it does vary quite a bit, is that really interesting to see like a factor of three, sometimes. Three times more interesting than other times, barely.

Til Luchau:

But Robert Schleip again topped our charts like he did last year. Again, his episode, which was 45, again, was our most downloaded episode. Also high on the charts was Shoulder Pain, Impingement and Rotator Cuff Issues, 34. There’s something about shoulder pain that really gets people’s attention.

Whitney Lowe:

Yeah. Well, I just think it’s, first of all, it’s a common challenge for lots of clients and it’s something where we often don’t see easy results, makes people want to learn more about what’s going on there and try to figure it out because it’s a complex region structurally and functionally.

Til Luchau:

Sure is. So, a bunch of our technical episodes got real high downloads, as well as Todd Hargrove’s and many of the others there along the way. But including our retrospective from last year that our version of this a year ago where we gave an overview of what we’ve been talking about and pointed people back towards specific topics. That was a popular one as well. So, what are you picturing are coming here with?

Whitney Lowe:

I’m looking forward to some new fascinating discussions on all kinds of stuff. And as we always mentioned to folks, let us know if you got ideas of things that you want to hear some more about. Sure in this next year, we’ll do a couple more deep dives on some specific clinical pathological kinds of things. We’ll have some more expansive discussions with people on philosophical perspectives, expand our thinking and understanding of things and hopefully interview some other researchers and people that have published stuff and help you become a more broad thinking practitioner. That is our goal.

Til Luchau:

Thinking practitioner. There it is. Yeah, I’ve got a wish list of people to interview and since I haven’t asked them yet, I can’t even say who it is. But I got some dream conversations that I’ve been longing to have and topics that I want to make sure that I get some time with are the continuing question of how do we actually inspire our clients to take action around their own health. Yeah. Whether it’s to go for a walk or to be interested enough in the session to report back with their feeling or to make healthy choices in their life. What role do we have in that? That’s kind of an ongoing line of inquiry for me.

Whitney Lowe:

Yeah. I will look forward to listening to that episode.

Til Luchau:

It may be an episode, maybe a theme.

Whitney Lowe:

Maybe a theme. Yeah.

Til Luchau:

I’m going to welcome you to your 60s here pretty soon as you have your birthday in a couple of weeks, and then we’ll see how that comes into as the themes like how do we live and age well and work as practitioners. How do we work well as we grow older as well?

Whitney Lowe:

Yeah. That sounds good. Well, I will look forward to another exciting and interesting and engaging year with you. So, I look forward to some of those conversations.

Til Luchau:

True for me, too.

Whitney Lowe:

Yeah. And we would also like to thank all of those people who’ve been hanging around listening, and in particular, thank our sponsors. ABMP in particular is proud to sponsor the Thinking Practitioner podcast. And ABMP membership gives massage therapists and bodyworkers exceptional liability insurance, numerous discounts, and great resources to help you thrive. Like their ABMP podcast, which is available @abmp.com/podcasts or wherever you happen to listen.

Til Luchau:

And even if you’re not a member, you can get free access to Massage and Bodywork Magazine, where you, Whitney and I are frequent contributors. And special offers for thinking practitioner listeners at abmp.com/thinking.

Whitney Lowe:

And we’d like to say thank you to all of our sponsors in particular. If you can, stop by our sites for any handouts, show notes, transcripts and any extras that are over there. You can find that from my site at academyofclinicalmassage.com, and Til, where can people find that from you?

Til Luchau:

Advanced-trainings.com. If there are questions, suggestions, feedback, accolades, complaints, whatever you’d like, miracles, spontaneous remissions, et cetera, write us about those in the email address [email protected] or look for us each on social media, just our names Til Luchau, and your name.

Whitney Lowe:

Today, my name is Whitney Lowe. You can find me over there that way under Whitlowe on Twitter, shorten it that way, because I was only allowed a certain number of characters to put my name.

Til Luchau:

Yes.

Whitney Lowe:

Not true. But anyway. But in general, you can, if you will. This will be a favor for us. Rate us on Apple podcast as it does help other people find the show. And you can hear us on Spotify, Stitcher, Google Podcasts, or wherever else you happen to listen. We do thank you for listening. And I hope you’ve gotten some good things out of that. So, do please share the word and tell a friend. And of course, as always, if you’re unable to find us in any of those locations, you can rub two sticks together on a night with a north wind and a harvest moon and you’ll hear us in the wind.

Til Luchau:

Wow. I haven’t tried that. Is that like research based?

Whitney Lowe:

It is. I’ve done all these things. I want to tell you. That’s right.

Til Luchau:

That’s awesome. Now, you tell our sponsors are kind enough to actually help us cover the cost of doing that but you telling other people is how you help us cover this cost. So, thanks for doing that everybody.

Whitney Lowe:

Absolutely.

Til Luchau:

Thank you, Whitney for another great year. Looking forward to next one.

Whitney Lowe:

Indeed. Me as well. So, we’ll see everybody else in a couple of weeks and have a good late part of the year holiday season and we’ll talk to you soon.

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