126: Fascia: A Deep Dive (with Dr. Antonio Stecco, Rebroadcast)

In this episode, Til and Whitney dive into strategies for addressing low back pain (LBP) with hands-on work, exploring LBP's prevalence, causes, and treatments. Sharing the insights they've gained from experts such as Nikolai Bogduk, Stewart McGill, Paul Hodges, Lorimer Moseley, Helene Langevin and Antonio Stecco, they lay out the diverse views on both the structural and non-mechanical origins of LBP. Listeners will also learn about therapeutic approaches, the significance of practitioner confidence, and the importance of comprehensive evaluations. Tune in for a fascinating look at how practitioners and clients alike can better understand and work with low back pain. Key Topics: 1. Prevalence of low back pain Over 60-70% of people have episodes of low back pain at some point [01:51]  Leading cause of disability worldwide Huge economic impact 2. Potential evolutionary factors contributing to low back pain Transition to bipedalism and upright posture Differences in spinal curvature and hip mobility between cultures [05:45] 3. Causes and contributors to low back pain - [07:39] Overemphasis on disc and structural issues in the past Importance of comprehensive evaluation beyond just structural issues Role of soft tissue, muscular, and neural factor 4. Influence of practitioner perspective and confidence on outcomes [30:20] Importance of the therapeutic relationship and rapport Unexpected interventions can sometimes be effective [35:53] 5. Personal experiences with low back pain Overuse vs. underuse/immobility as contributors Debates about the significance of posture, load, and context [41:31] Limits of expertise vs. scope of practice for massage therapists Get the full transcript at Til or Whitney's sites!  Whitney Lowe’s site: AcademyOfClinicalMassage.com  Til Luchau’s site: Advanced-Trainings.com  Resources mentioned in this episode: ABMPs’ CE Summit on LBP: live Oct 1, 2024 and free to everyone in the profession: abmp.com/summit Portions also available by recording to ABMP members and next year, to A-T Subscribers  Sponsor Offers:  Books of Discovery: save 15% by entering "thinking" at checkout on booksofdiscovery.com.  ABMP: save $24 on new membership at abmp.com/thinking.  Advanced-Trainings: try a month of the amazing A-T Subscription free by entering “thinking” at checkout at a-t.tv/subscriptions/,. Academy of Clinical Massage: Grab Whitney's valuable Assessment Cheat Sheet for free at: academyofclinicalmassage.com/cheatsheet About Whitney Lowe  | About Til Luchau  |  Email Us: [email protected] (The Thinking Practitioner Podcast is intended for professional practitioners of manual and movement therapies: bodywork, massage therapy, structural integration, chiropractic, myofascial and myotherapy, orthopedic, sports massage, physical therapy, osteopathy, yoga, strength and conditioning, and similar professions. It is not medical or treatment advice.)

Til and Whitney speak with fascial researcher, anatomist, and manual therapy teacher Antonio Stecco MD PhD about his research in to fascial properties, pain, and the effects of hands-on work, in this audience-favorite episode from our archives, where it originally ran as Ep. 53. Key Topics: Introduction to Dr. Antonio Stecco and his background in fascia research The role of the Stecco family in advancing fascia research Differences between superficial fascia and deep fascia The concept of fascial densification vs. fibrosis How manual therapy affects fascial lubrication and gliding The relationship between fascial stiffness/thickness and pain Mechanisms for long-lasting effects of fascial manipulation The importance of restoring proper biomechanics, not just treating pain The role of retinacula in proprioception and joint stability New MRI techniques for imaging fascial properties Molecular structure of hyaluronan in fascia Use of hyaluronidase injections for treating spasticity Resources for learning more about fascial manipulation Get the full transcript at Til or Whitney's sites!  Whitney Lowe’s site: AcademyOfClinicalMassage.com  Til Luchau’s site: Advanced-Trainings.com  Resources discussed in this episode: Dr Stecco’s research and publications (NYU) FM app on the Apple Store and Google Play Dr Stecco’s site: fascialmanipulation.com Papers mentioned in the episode: Gerber et al., “A Systematic Comparison Between Subjects With No Pain and Pain Associated With Active Myofascial Trigger Points.” Langevin, Helene M. et al. “Reduced Thoracolumbar Fascia Shear Strain in Human Chronic Low Back Pain.” BMC Musculoskeletal Disorders 12, no. 1 (December 2011): 203. https://doi.org/10.1186/1471-2474-12-203. Stecco, Antonio at al. “Ultrasonography in Myofascial Neck Pain: Randomized Clinical Trial for Diagnosis and Follow-Up.” Surgical and Radiologic Anatomy 36, no. 3 (April 2014): 243–53. https://doi.org/10.1007/s00276-013-1185-2. Sponsor Offers:  Books of Discovery: save 15% by entering "thinking" at checkout on booksofdiscovery.com.  ABMP: save $24 on new membership at abmp.com/thinking.  Advanced-Trainings: try a month of the amazing A-T Subscription free by entering “thinking” at checkout at a-t.tv/subscriptions/,. Academy of Clinical Massage: Grab Whitney's valuable Assessment Cheat Sheet for free at: academyofclinicalmassage.com/cheatsheet About Whitney Lowe  | About Til Luchau  |  Email Us: [email protected] (The Thinking Practitioner Podcast is intended for professional practitioners of manual and movement therapies: bodywork, massage therapy, structural integration, chiropractic, myofascial and myotherapy, orthopedic, sports massage, physical therapy, osteopathy, yoga, strength and conditioning, and similar professions. It is not medical or treatment advice.)

🎙️ Grief affects everyone: every person, every practitioner, and every client will lose something important to them, whether it’s their youth, ability, dreams, or a loved one. And so, everyone will grieve. In this episode, Whitney interviews Til about how the recent loss of his wife has given him a new perspective on grieving, and being with others in grief: what helps, what’s important to know, and how to move with grief, as we feel what needs to be felt, and do the things that need to be done. 🔍🗣️👥🔊 Key Points in the Podcast Introduction to the podcast and sponsors (0:00-1:20) Til Luchau's personal experience with grief and loss (1:20-5:30) The importance of self-care for caretakers (5:30-8:30)  Lessons learned from the grief process (8:30-14:55)  Balancing work and personal life during grief (14:55-18:00)  The importance of acknowledging grief in client interactions (18:00-21:00)  Understanding the stages and timeline of grief (21:00-23:30)  Strategies for supporting others dealing with loss (23:30-26:30)  The impact of grief on cognitive function (26:30-31:51) Final insights and reflections on grief (31:51-37:00)  Closing remarks and sponsor acknowledgements (37:00-39:00) Resources Episode 66: Beyond "It Depends" Oncology Massage (with Janet Penny, Rebecca Sturgeon, and Loretta Luchau)  Whitney Lowe’s site: AcademyOfClinicalMassage.com  Til Luchau’s site: Advanced-Trainings.com  Sponsor Offers:  Til Luchau’s “ANKLE Issues” livestream course (live Aug 24-25 '24, or later by recording): advanced-trainings.com/workshop/onl2408m/  Books of Discovery: save 15% by entering "thinking" at checkout on booksofdiscovery.com.  ABMP: save $24 on new membership at abmp.com/thinking.  Advanced-Trainings: try a month of the amazing A-T Subscription free by entering “thinking” at checkout at a-t.tv/subscriptions/. Academy of Clinical Massage: Grab Whitney's valuable Assessment Cheat Sheet for free at: academyofclinicalmassage.com/cheatsheet About Whitney Lowe  | About Til Luchau  |  Email Us: [email protected] (The Thinking Practitioner Podcast is intended for professional practitioners of manual and movement therapies: bodywork, massage therapy, structural integration, chiropractic, myofascial and myotherapy, orthopedic, sports massage, physical therapy, osteopathy, yoga, strength and conditioning, and similar professions. It is not medical or treatment advice.)

In this episode Whitney interviews Laurel Beversdorf and Dr. Sarah Court (co-hosts of the Movement Logic Podcast) to talk about movement, exercise, and rehabilitation. They discuss topics such as the misconceptions surrounding strength training and its impact on flexibility and mobility, strength training for women, posture, movement re-education, and the importance of load management, and much more. Check it out now! Watch the video and get the full transcript of their conversation on Til or Whitney's sites:  Til Luchau’s Advanced-Trainings.com  Whitney Lowe’s Academy of Clinical Massage Key Points in the Podcast - Misconceptions about strength training and its impact on flexibility (06:00) - Overcoming resistance to strength training in the yoga community (08:00) - The fear of injury associated with lifting heavy weights (10:00) - The benefits of strength training at home (14:00) - Starting strength training after developing a physical injury (16:00) - The importance of proper technique and strength for manual therapists (18:00) - The scope of practice for manual therapists in recommending exercise (20:00) - The limitations of personal trainer certifications (22:00) - Differentiating between scope of practice and scope of expertise (24:00 - The shift towards loading and strengthening in tendon rehabilitation (32:00) - The impact of posture and load on the body (34:00) - The importance of considering individual goals and abilities in posture (38:00) - The role of elite athletes and their unique movement patterns (40:00) - The social and hierarchical implications of posture (46:00) - How to connect with Laurel Beversdorf and Sarah Court (48:00) Resources: Slouch, Posture Panic in Modern America by Beth Linker Movement Logic Podcast Social Media:  @movementlogictutorials , @laurelbeversdorf, @sarahcourtdpt Sponsor Offers: Books of Discovery: save 15% by entering "thinking" at checkout at booksofdiscovery.com. ABMP: save $24 on new membership at abmp.com/thinking.  Advanced-Trainings: try a month of the amazing A-T Subscription free by entering “thinking” at checkout at a-t.tv/subscriptions/ Academy of Clinical Massage: Grab Whitney's valuable Assessment Cheat Sheet for free at: academyofclinicalmassage.com/cheatsheet About Whitney Lowe  |  About Til Luchau  |  Email Us: [email protected] (The Thinking Practitioner Podcast is intended for professional practitioners of manual and movement therapies: bodywork, massage therapy, structural integration, chiropractic, myofascial and myotherapy, orthopedic, sports massage, physical therapy, osteopathy, yoga, strength and conditioning, and similar professions. It is not medical or treatment advice.)  

In celebration of Til Luchau's upcoming "Ankle Issues" livestreamed course, Til and Whitney pulled one of their favorite ankle-related episodes (#43) out of the archives. Listen in as they geek out on ankle- and foot-related conditions, anatomy, function, biomechanics and more. Topics include:  How the structure of the foot/ankle complex determines function Are we over over-pronation yet?  Plantar fasciitis/fasciosis, bunions, hammertoes, and other things you wouldn’t have thought of as ankle issues. Episode Outline: Structure of the foot/ankle complex Medial side deltoid ligament complex Lateral side ATF, CF, PTF How does structure govern function Distal tibiofibular joint & talocrural joint form mortise & tenon Primary supporting ligaments Mechanics of the region: Talocrural motions: dorsiflexion & plantarflexion Type I and type II limitations Subtalar motions: inversion & eversion Pronation and supination (definitions and confusion) Phases of gait Some common issues/problems Valgus and varus angulations (toes and calcaneal region) “Overpronation” Bunions & hammertoes Plantar fasciitis Tendon overuse (Achilles tendon etc.) Trauma: sprains breaks Nerve entrapments mimicking soft-tissue pathology (i.e. tarsal tunnel syndrome, Baxter’s neuropathy, etc.) Resources and references discussed in this episode: Til Luchau’s “ANKLE Issues” livestream course (live Aug 24-25 '24, or later by recording): advanced-trainings.com/workshop/onl2408m/  Trail Guide to Movement: save 15% by entering "thinking" at checkout on booksofdiscovery.com Whitney Lowe’s site: AcademyOfClinicalMassage.com  Til Luchau’s site: Advanced-Trainings.com  Podcast anatomy image from Advanced Myofascial Techniques, Volume 1. Used under license from Primal Pictures. Sponsor Offers:  Books of Discovery: save 15% by entering "thinking" at checkout on booksofdiscovery.com.  ABMP: save $24 on new membership at abmp.com/thinking.  Advanced-Trainings: try a month of the amazing A-T Subscription free by entering “thinking” at checkout at a-t.tv/subscriptions/,. Academy of Clinical Massage: Grab Whitney's valuable Assessment Cheat Sheet for free at: academyofclinicalmassage.com/cheatsheet About Whitney Lowe  | About Til Luchau  |  Email Us: [email protected] (The Thinking Practitioner Podcast is intended for professional practitioners of manual and movement therapies: bodywork, massage therapy, structural integration, chiropractic, myofascial and myotherapy, orthopedic, sports massage, physical therapy, osteopathy, yoga, strength and conditioning, and similar professions. It is not medical or treatment advice.)

🎙️In this episode Whitney talks with Christian Green about working with athletes and performing artists. They cover some of the unique facets of working with these special populations. There is much more than specialized techniques necessary to work in these environments and Christian shares some unique and interesting perspectives. 🔍🗣️👥🔊 Watch the video and get the full transcript of their conversation on Til or Whitney's sites:  Til Luchau’s Advanced-Trainings.com  Whitney Lowe’s Academy of Clinical Massage Key Points in the Podcast Introduction to the podcast (0:00) Introduction of Christian Green and his background (1:00) Working with performing artists (4:00) Performing Arts Medicine Association (PAMA) (6:00) Challenges in finding performing artists as clients (9:00) Stigma around seeking help in the performing arts community (11:00) Reasons for the stigma (13:00) Collaboration with other healthcare professionals (17:00) Preventive care for athletes and performing artists (19:00) Biomechanical challenges in performing arts (23:00) Importance of education and research in massage therapy (27:00) Advice for new massage therapists interested in working with athletes and performing artists (29:00) Trend lines in acceptance of massage therapy in the athletic and performing arts communities (32:00) Closing thoughts on the essence of bodywork (35:00) Contact information for Christian Green (37:00) Conclusion and call to support the podcast (38:00) Resources: Performing Arts Medicine Association (PAMA) [email protected] Christian's website  Sponsor Offers: Books of Discovery: save 15% by entering "thinking" at checkout at booksofdiscovery.com. ABMP: save $24 on new membership at abmp.com/thinking.  Advanced-Trainings: try a month of the amazing A-T Subscription free by entering “thinking” at checkout at a-t.tv/subscriptions/,. Academy of Clinical Massage: Grab Whitney's valuable Assessment Cheat Sheet for free at: academyofclinicalmassage.com/cheatsheet About Whitney Lowe  |  About Til Luchau  |  Email Us: [email protected] (The Thinking Practitioner Podcast is intended for professional practitioners of manual and movement therapies: bodywork, massage therapy, structural integration, chiropractic, myofascial and myotherapy, orthopedic, sports massage, physical therapy, osteopathy, yoga, strength and conditioning, and similar professions. It is not medical or treatment advice.)            

🎙️ In this episode Whitney discusses a 2024 paper on modern manual therapy teaching and practice. The paper describes traditional manual therapy principles, including clinician-centered assessment, pathoanatomical reasoning, and technique specificity, and their criticisms based on recent research. He then outlines a proposed new framework for manual therapy practice and education. Lowe encourages listeners to read the paper and reflect on how these concepts align with or differ from their current practices, aiming to stimulate critical thinking about the evolution of manual therapy approaches in light of current research and understanding. Watch the video and get the full transcript of their conversation on Til or Whitney's sites:  Til Luchau’s Advanced-Trainings.com  Whitney Lowe’s Academy of Clinical Massage Key Points in the Podcast Introduction to the podcast (0:00-0:30) Discussion of a paper titled "A Modern Way to Teach and Practice Manual Therapy" (0:30-3:50) Overview of traditional manual therapy principles (3:50-9:30) Clinician-centered assessment (4:10-6:50) Pathoanatomical reasoning (6:50-11:00) Technique specificity (11:00-16:00) Proposed new framework for manual therapy (16:00-23:00) Safety in the therapeutic alliance (16:30-18:00) Creating a comfortable environment (18:00-19:30) Efficiency in therapy delivery (19:30-21:00) Communication and context (21:00-22:00) Person-centered care (22:00-23:00 Implications for teaching and practice (23:00-29:00) Challenges in reframing teaching methods (23:30-25:30) Importance of safety, comfort, and person-centered care (25:30-27:30) Questions for practitioners to consider (27:30-29:00) Resources: A Modern Way to Teach and Practice Manual Therapy: https://bit.ly/45tGfHj Sponsor Offers: Books of Discovery: save 15% by entering "thinking" at checkout at booksofdiscovery.com. ABMP: save $24 on new membership at abmp.com/thinking.  Advanced-Trainings: try a month of the amazing A-T Subscription free by entering “thinking” at checkout at a-t.tv/subscriptions/,. Academy of Clinical Massage: Grab Whitney's valuable Assessment Cheat Sheet for free at: academyofclinicalmassage.com/cheatsheet About Whitney Lowe  |  About Til Luchau  |  Email Us: [email protected] (The Thinking Practitioner Podcast is intended for professional practitioners of manual and movement therapies: bodywork, massage therapy, structural integration, chiropractic, myofascial and myotherapy, orthopedic, sports massage, physical therapy, osteopathy, yoga, strength and conditioning, and similar professions. It is not medical or treatment advice.)

🎙️In this episode Whitney and Justin discuss the benefits of a diverse educational background and the value of pursuing additional higher education for clinical massage practitioners. They also delve into some of the key facets of how massage and corrective movement can be used most effectively for pain management. 🔍🗣️👥🔊 Watch the video and get the full transcript of their conversation on Til or Whitney's sites:  Til Luchau’s Advanced-Trainings.com  Whitney Lowe’s Academy of Clinical Massage Key Points in the Podcast Introduction to the podcast (0:00) Background of Justin Solace (2:00) Pursuing a master's degree in kinesiology (6:00) Integrating exercise into massage therapy (10:00) The influence of psychology and motor learning on massage therapy (14:00) The boundaries of massage therapy and exercise recommendations (18:00) The role of massage therapy in pain management (22:00) The importance of validation in pain management (26:00) Balancing work and self-care as a massage therapist (30:00) Creating a supportive work environment for massage therapists (34:00) The future of the massage therapy field (38:00) How to connect with Justin Solace (42:00) Resources: Hybrid Health:  https://hybridpainrelief.com/ Hybrid Health Continuing Education: https://www.facebook.com/Hybridhealtheducation Justin's email: [email protected] Sponsor Offers: Books of Discovery: save 15% by entering "thinking" at checkout at booksofdiscovery.com. ABMP: save $24 on new membership at abmp.com/thinking.  Advanced-Trainings: try a month of the amazing A-T Subscription free by entering “thinking” at checkout at a-t.tv/subscriptions/,. Academy of Clinical Massage: Grab Whitney's valuable Assessment Cheat Sheet for free at: academyofclinicalmassage.com/cheatsheet About Whitney Lowe  |  About Til Luchau  |  Email Us: [email protected] (The Thinking Practitioner Podcast is intended for professional practitioners of manual and movement therapies: bodywork, massage therapy, structural integration, chiropractic, myofascial and myotherapy, orthopedic, sports massage, physical therapy, osteopathy, yoga, strength and conditioning, and similar professions. It is not medical or treatment advice.)

🎙️In this episode, educators, authors, and massage therapists Rachelle Clauson and Nicole Trombley discuss the surprising sensitivity and functional significance of the ankle’s fascial retinaculum. Their conversation with Whitney and Til also ventures into Rachelle’s work on the Fascial Plastination Project, and their hands-on anatomy educational offerings via AnatomySCAPES. 🔍🗣️👥🔊 Watch the video and get the full transcript of their conversation on Til or Whitney's sites:  Til Luchau’s Advanced-Trainings.com  Whitney Lowe’s Academy of Clinical Massage 👉Check out Til Luchau's new Ankle Issues livestreamed and recorded course (first time online!) at a-t.tv/workshop/onl2408m/ Key Points in the Podcast - Introduction to The Thinking Practitioner Podcast - 0:00 - Introduction to guests and their work - 0:50 - Overview of the Fascial Plastination project - 3:50 - Discussion on the retinaculum and its significance for hands-on therapists - 9:58 - The role of the retinacula in proprioception - 13:44 - The connection between structure and neurology in hands-on therapy - 19:58 - Overview of the AnatomySCAPES project - 29:50 - The challenges of teaching anatomy to massage therapists - 34:50 - The importance of revisiting and relearning anatomy - 38:22 - The value of in-person workshops and the accessibility of online resources - 45:01 - How to learn more and connect with the guests - 57:22 Contact and Resources: Website | FB | IG | YouTube | email: [email protected] “Retinacula: Finding our Footing” in Massage & Bodywork magazine, March/April 2024, p66  Fascial Net Plastination Project BODY WORLDS FR:EIA Exhibit:  YouTube lecture from Carla Stecco “Fascia Research and Proprioception: Implication in Sports”  Retinacula Research: Stecco C, Macchi V, Porzionato A, Morra A, Parenti A, Stecco A, Delmas V, De Caro R. The ankle retinacula: morphological evidence of the proprioceptive role of the fascial system. Cells Tissues Organs. 2010;192(3):200-10. doi: 10.1159/000290225. Epub 2010 Feb 27. PMID: 20197652. https://pubmed.ncbi.nlm.nih.gov/20197652 Sponsor Offers: Books of Discovery: save 15% by entering "thinking" at checkout at booksofdiscovery.com. ABMP: save $24 on new membership at abmp.com/thinking.  Advanced-Trainings: try a month of the amazing A-T Subscription free by entering “thinking” at checkout at a-t.tv/subscriptions/,. Academy of Clinical Massage: Grab Whitney's valuable Assessment Cheat Sheet for free at: academyofclinicalmassage.com/cheatsheet About Whitney Lowe  |  About Til Luchau  |  Email Us: [email protected] (The Thinking Practitioner Podcast is intended for professional practitioners of manual and movement therapies: bodywork, massage therapy, structural integration, chiropractic, myofascial and myotherapy, orthopedic, sports massage, physical therapy, osteopathy, yoga, strength and conditioning, and similar professions. It is not medical or treatment advice.)

🎙️In this episode Whitney engages in a wide-ranging discussion with Paula Nutting about the world of massage therapy in Australia and beyond. They compare notes about the professional landscape, education and numerous other topics. We all learn and grow so much when we look at things through the lens of others, so this is a great opportunity to reflect on how we see things and how they may be viewed from other perspectives. Paula also shares extensively about her experience with teaching and learning about Chapman's neurolymphatic reflex points. 🔍🗣️👥🔊 Watch the video and get the full transcript of their conversation on Til or Whitney's sites:  Til Luchau’s Advanced-Trainings.com  Whitney Lowe’s Academy of Clinical Massage Key Points in the Podcast - Introduction to Paula Nutting (2:00) - Paula's background and transition into massage therapy (3:30) - Changes in massage therapy training requirements (7:00) - Integration with other healthcare professions (11:00) - Overview of Chapman's reflexes (14:00) - Pressure and technique used in Chapman's reflexes (16:30) - Application of Chapman's reflexes in different conditions (19:30) - Challenges in understanding the efficacy of different techniques (23:00) - Teaching massage therapy in different environments (27:00) - Unique experiences teaching and learning massage in different countries (32:00) - Outlook for massage therapy in Australia (39:00) - Advice for new practitioners entering the field (42:00) - Where to find more information about Paula Nutting (45:00) Resources: Paula's site Sponsor Offers: Books of Discovery: save 15% by entering "thinking" at checkout at booksofdiscovery.com. ABMP: save $24 on new membership at abmp.com/thinking.  Advanced-Trainings: try a month of the amazing A-T Subscription free by entering “thinking” at checkout at a-t.tv/subscriptions/,. Academy of Clinical Massage: Grab Whitney's valuable Assessment Cheat Sheet for free at: academyofclinicalmassage.com/cheatsheet About Whitney Lowe  |  About Til Luchau  |  Email Us: [email protected] (The Thinking Practitioner Podcast is intended for professional practitioners of manual and movement therapies: bodywork, massage therapy, structural integration, chiropractic, myofascial and myotherapy, orthopedic, sports massage, physical therapy, osteopathy, yoga, strength and conditioning, and similar professions. It is not medical or treatment advice.)