172: Lateral Hip Pain: Stop Blaming the Bursa (with Whitney Lowe & Til Luchau)

🎙 Menopause, Pain, and Bodywork (with Ruth Werner) What if midlife achiness isn’t simply aging—and isn’t necessarily an injury that needs fixing? Menopause can affect far more than temperature. As hormones shift, sleep, mood, cognition, bone and cardiovascular health, pain, and tissue tolerance may all change. Yet most hands-on practitioners received little or no training about what this means for the people on their tables—or for practitioners going through menopause themselves. Pathology specialist Ruth Werner joins Til and Whitney to separate what we know from what we merely assume. They explore why hot flashes remain surprisingly mysterious, how declining estrogen may intersect with inflammation and musculoskeletal pain, and whether naming a “musculoskeletal syndrome of menopause” improves recognition or risks turning menopause into a catch-all explanation for midlife symptoms. Most importantly, they bring the conversation into the treatment room: adjusting expectations, avoiding unnecessary overwork, accounting for medications and longer-term health changes, and recognizing that listening and thoughtful support may be as valuable as anything we do with our hands. They also make room for menopause as more than loss or disruption—for many, it can be a passage into greater maturity, clarity, creativity, and freedom from others’ expectations. ✨ We talk about: • Why menopause is a normal transition, not a disease—and why its effects can still be profoundly disruptive • Perimenopause versus menopause, and why the transition can affect decades of a person’s life • What may be happening during a hot flash—and how much remains unknown • The difficult overlap between menopause, aging, pain, and injury • Estrogen’s possible roles in inflammation and musculoskeletal health • The promise and limitations of the term “musculoskeletal syndrome of menopause” • Practical session considerations: temperature, osteoporosis, cardiovascular health, medications, and tissue sensitivity • Why changing our expectations may matter more than trying to “correct” hormonal effects • Listening, validation, and the therapeutic alliance when clients feel dismissed elsewhere • Menopause as a potentially powerful, creative, and liberating stage of life. 🎓 Continue with the complete course: This episode offers a useful overview and key takeaways. Ruth’s complete 85-minute course, Menopause for Bodyworkers, goes deeper into the physiology, symptoms, treatment options, research, and hands-on implications. It includes the full presentation and discussion, course handout, quiz, and one continuing-education credit. Purchase it individually—or access it at no additional cost with an Advanced-Trainings subscription—at https://advanced-trainings.com. ✨ Resources: • Ruth Werner’s courses, writing, and resources: https://ruthwerner.com • I Have a Client Who… Pathology Conversations with Ruth Werner: https://ruthwerner.com/podcast/ • Vonda Wright and colleagues, “The Musculoskeletal Syndrome of Menopause”: https://doi.org/10.1080/13697137.2024.2380363 • Advanced-Trainings courses and subscription library: https://advanced-trainings.com 🌱 Sponsor Offers: • Jane – Try it free for one month with code THINKING1MO at https://a-t.tv/jane • ABMP – Save on new membership at https://abmp.com/thinking • Books of Discovery – Save 15% with code thinking at https://booksofdiscovery.com • Advanced-Trainings – Try one month free of the A-T Subscription with code thinking at https://a-t.tv/subscriptions • Academy of Clinical Massage – Grab Whitney's free Assessment Cheat Sheet at https://academyofclinicalmassage.com/cheatsheet ✨ Watch the video / connect with us: • YouTube: https://www.youtube.com/@AdvancedTrainings/podcasts • Whitney Lowe – https://academyofclinicalmassage.com | https://facebook.com/WhitneyLowe | https://twitter.com/whitneylowe • Til Luchau – https://advanced-trainings.com | https://facebook.com/advancedtrainings | https://instagram.com/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, physical therapy, osteopathy, and similar professions. It is not medical or treatment advice. Rolfing® is a registered service mark of the Dr. Ida Rolf Institute®.

🎙 Clinical Reasoning, or Clinical Improvisation? (with Whitney Lowe & Til Luchau) Every good protocol, recipe, or routine is designed to be outgrown. The trouble is that almost nobody tells you when. Protocols are how most of us learned: a sequence, a recipe, a named technique for a named condition. They reduce cognitive load when you’re new, they keep you and your client safe, and they let you know what to do next. And then, at some point, they start to get in the way — because real clients are complicated, and they rarely arrive looking like the textbook. Whitney and Til work through what they’re calling the protocol paradox: why structure is essential early on, why it has to loosen for real clinical skill to develop, and how to tell which side of that line you’re standing on. They get practical about it too — how to catch the moment a routine is running you instead of the other way around, what to do when the technique you were taught doesn’t work or makes things worse, and why every hunch and every thing you feel under your fingers counts as assessment data. Along the way: a young Rolfer told that moving arm work earlier in the series “speaks of hubris”; a Sufi sect that shook their left foot for generations because the founder had a sticky sandal; Ida Rolf’s cook-versus-chef distinction; Whitney and Til comparing notes on the difference between detective work and flower arranging; and how AI tutors might finally solve continuing education’s oldest problem — the 20-year-old new grad sitting next to the nurse with 20 years in. ✨ We talk about: • What protocols actually do for beginners — cognitive load, safety guardrails, and a sense of belonging • A practical test for whether you’ve outgrown one: habit, protocol, or an actual reason for this person? • What to do when the neck technique you learned doesn’t work — or causes a reaction • Assessment as an ongoing loop, not an intake ritual: “it’s all assessment” • Symptom chasing vs. detective work — and why the leg that hurts often isn’t where the story starts • Til’s reframe: a flower arrangement of what the client brings you, rather than a Jenga tower of stacked reasoning • Technique narratives that outlived the physiology that was supposed to explain them • Stories from the Rolf legacy: orthodoxy vs. reform, and the principles-based experiment that didn’t survive contact with beginners • The massage school that turned down an experienced teacher for being too experienced • Clinical reasoning — or clinical improvisation? Two names for the same advanced skill • The confidence paradox: you need enough certainty to act, and enough openness to be wrong • Scales, Coltrane, and why “improvisation” never meant winging it • Newtonian and quantum, both true at once — the physics analogy for holding two models at the same time • Culture and structure: Swiss students who needed the notebook first (and then shuffled its pages), shakuhachi players with no tradition of improvising, and Singapore buying its way back to innovation • A clinical reasoning skill to try this week. ✨ And tell us what happened: when you paused at that moment of not-knowing, what came next? Email us — we’d love to hear it. ✨ Resources: • Dr. Ida Rolf Institute: https://rolf.org • Ida Rolf’s Ten Series — the “recipe,” and the decades of debate about it • Esalen Institute — “get out of your head and come to your senses”: https://www.esalen.org • Cognitive load theory and what it means for hands-on teaching • Paul St. John and the neuromuscular therapy community • Trail Guide to the Body, 7th edition (Books of Discovery): https://booksofdiscovery.com • Whitney’s Socratic AI tutors and personalized learning paths: https://academyofclinicalmassage.com • Til’s trainings, CAMT certification, and subscription library: https://advanced-trainings.com 🌱 Sponsor Offers: • Jane – Try it free for one month with code THINKING1MO at https://a-t.tv/jane • ABMP – Save on new membership at https://abmp.com/thinking • Books of Discovery – Save 15% with code thinking at https://booksofdiscovery.com • Advanced-Trainings – Try one month free of the A-T Subscription with code thinking at https://a-t.tv/subscriptions • Academy of Clinical Massage – Grab Whitney’s free Assessment Cheat Sheet at https://academyofclinicalmassage.com/cheatsheet ✨ Watch the video / connect with us: • YouTube: https://www.youtube.com/@AdvancedTrainings/podcasts • Whitney Lowe – https://academyofclinicalmassage.com | https://facebook.com/WhitneyLowe | https://twitter.com/whitneylowe • Til Luchau – https://advanced-trainings.com | https://facebook.com/advancedtrainings | https://instagram.com/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, physical therapy, osteopathy, and similar professions. It is not medical or treatment advice. Rolfing® is a registered service mark of the Dr. Ida Rolf Institute®.

🎙 Becoming Friends with Movement (with Nuria Bowart) 📌 Save the date: early December 2026 in Boulder, Colorado — as a result of their discussion here, Til and Nuria are teaching a collaborative workshop for bodyworkers, hands-on and moving, both. Details to come at https://advanced-trainings.com Tell Nuria you’re “not really a mover” and she won’t argue. She’ll just say: maybe you’ve forgotten. Most of us learned to work on bodies that hold still. Nuria Bowart — dancer, movement artist, Certified Rolfer, and a Mestra in Capoeira — lives at the opposite pole, where the body is always moving, listening, and playing. Til sits down with her to explore a deceptively simple question: how can those of us who work with our hands become better friends with movement — not as one more thing we prescribe, but as listening, relationship, play, and a way of being more at home in ourselves? Along the way they get into Fascial Intelligence, the Axis Syllabus, Contact Improvisation, and Capoeira — and what each one teaches about touch, agency, aging, and befriending the unknown. ✨ We talk about: • Why “maybe you’ve just forgotten” is Nuria’s answer to anyone who doesn’t think of themselves as a mover • Fascia as a constellation of intelligences — and listening as the core point of access • What changes when we start with the body’s design and options, instead of fixing • What Contact Improvisation reveals about weight, gravity, and arriving together in the present moment • Capoeira as a healing art: play, risk, vulnerability, and responding creatively to danger • Aging as a “mystery school” — and movement as the micronutrient of longevity • A simple practice for the week: finding the moment you don’t know what to do, and staying there to listen ✨ Resources: • Nuria’s website: https://www.nuriabowart.com • Nuria on Instagram: https://www.instagram.com/nuriabowart • Berkeley Capoeira Collective: https://berkeleycapoeira.com • The Field Center, Vermont • The Axis Syllabus: https://www.axissyllabus.net | US events: https://axissyllab.us • Axis Syllabus literature and texts: https://www.axissyllabusforum.org/literature • Axis Syllabus socials: https://www.instagram.com/axissyllab.us | https://www.facebook.com/AxisSyllabusResearchMeshwork • Frey Faust, founder of the Axis Syllabus • Bonnie Bainbridge Cohen & Body-Mind Centering; Sensing, Feeling, and Action (Contact Quarterly) • Nita Little & the Institute for the Study of Somatic Communication — hear her in episode 140 of The Thinking Practitioner 🌱 Sponsor Offers: • Jane – Try it free for one month with code THINKING1MO at https://a-t.tv/jane • ABMP – Save on new membership at https://abmp.com/thinking • Books of Discovery – Save 15% with code thinking at https://booksofdiscovery.com • Advanced-Trainings – Try one month free of the A-T Subscription with code thinking at https://a-t.tv/subscriptions • Academy of Clinical Massage – Grab Whitney’s free Assessment Cheat Sheet at https://academyofclinicalmassage.com/cheatsheet ✨ Watch the video / connect with us: • YouTube: https://www.youtube.com/@AdvancedTrainings/podcasts • Whitney Lowe – https://academyofclinicalmassage.com | https://facebook.com/WhitneyLowe | https://twitter.com/whitneylowe • Til Luchau – https://advanced-trainings.com | https://facebook.com/advancedtrainings | https://instagram.com/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, physical therapy, osteopathy, and similar professions. It is not medical or treatment advice. Rolfing® is a registered service mark of the Dr. Ida Rolf Institute®.

🎙 The Affection Question (with Kory Floyd) How many of your clients come to you, week after week, not just for their shoulder or their low back — but because yours may be the one space in their life where they feel truly touched, attended to, and seen? Roughly 40% of people report not getting enough affection in their lives. And research suggests that for our older clients, that number is likely even higher. To explore what that means for our work, Til sits down with Dr. Kory Floyd — professor and chair of human development at Washington State University, and one of the world’s leading researchers on affection and human connection. He created Affection Exchange Theory, wrote The Loneliness Cure along with more than a dozen other books, and makes a striking case that affection isn’t a luxury or a nicety — it’s a biological need with measurable consequences for our health. Drawing on his own recent experiences of loss and loneliness, Til turns toward something that sits underneath almost everything we do as bodyworkers but that we rarely name out loud: the simple, profound human need to be touched, cared for, and connected to. ✨ We talk about: • Affection deprivation — the gap between the affection we need and what we actually receive, and why roughly 40% of people report not getting enough • Why age (not gender, education, or geography) is the strongest predictor — and what that means for our older clients • How deprivation erodes our sense of safety, fueling hypervigilance, poor sleep, and a weakened immune response • Why — to the body — professional touch and intimate touch aren’t so different, as long as it feels safe • What lives inside the therapeutic “boundary”: validation, normalizing, listening, attunement, and a felt sense of being seen • Transference, counter-transference, and the difference between "genuine" affection and what Kory calls being “affection-adjacent” • Being “touched out” — and why the giver of affection may benefit even more than the receiver • Each person’s range of tolerance, why too much touch can also be aversive, and why attunement matters more than quantity • Touch as the first sense to develop and the last to fade — and why it’s the most essential to our survival • Boundaries that keep the heart open, and why our table may be the one place a client truly feels heard ✨ Resources: • Kory Floyd’s book, The Loneliness Cure • Learn more about his research at koryfloyd.com 🌱 Sponsor Offers: • Jane – Try it free for one month with code THINKING1MO at a-t.tv/jane • ABMP – Save on new membership at abmp.com/thinking • Books of Discovery – Save 15% with code thinking at booksofdiscovery.com • Advanced-Trainings – Try one month free of the A-T Subscription with code thinking at a-t.tv/subscriptions • Academy of Clinical Massage – Grab Whitney’s free Assessment Cheat Sheet at academyofclinicalmassage.com/cheatsheet ✨ Watch the video / connect with us: • YouTube: youtube.com/@AdvancedTrainings/podcasts • Whitney Lowe – academyofclinicalmassage.com | facebook.com/WhitneyLowe | twitter.com/whitneylowe • Til Luchau – advanced-trainings.com | facebook.com/advancedtrainings | instagram.com/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, physical therapy, osteopathy, and similar professions. It is not medical or treatment advice.

🎙 How to Bend Time (with Til Luchau & Whitney Lowe) There’s a moment in many good sessions when the clock stops mattering — breathing deepens, your hands settle, and time itself seems to change. Til recently wrote about this as “bending time,” and here he and Whitney explore it as a practical, therapeutic part of hands-on work. They get into how time perception is tied to body state, attention, and interoception; how the practitioner’s own state sets the tempo; and how to work slowly without losing focus, while still respecting the real limits of a 30-, 60-, or 90-minute session. ✨ Topics: • What that timeless shift feels like from the practitioner’s side • Why the practitioner often enters the state first — and how the client entrains to it • Timelessness vs. clock-watching: why it’s not the same as zoning out or falling asleep • Interoception, age, and “clock speed”: why our sense of duration is so elastic • Meeting clients at their rhythm before inviting a shift (follow, follow, lead) • Jan Sultan’s “most important move in Rolfing” — keeping the big-picture overview • Landing the plane: giving clients a heads-up to ease the transition out • Slow doesn’t mean vague: clearer attention, better timing, realistic plans • Presence and compassion as part of skill — and the people hardest to love • A this-week experiment: pause and feel your own body before you touch ✨ Resources: • Til Luchau, “Bending Time: The Therapeutic Power of Timelessness,” Massage & Bodywork magazine (Somatic Edge column) — https://www.abmp.com/massage-and-bodywork-magazine/issues/summer-2026/bending-time • Marc Wittmann, “The Inner Experience of Time,” Philosophical Transactions of the Royal Society B (2009) • E. P. Thompson, “Time, Work-Discipline, and Industrial Capitalism,” Past & Present (1967) • Fantastic Voyage (1966) — the “miniature journey inside the body” film referenced in the episode 🌱 Sponsor Offers: • Jane – Try the Jane practice management app free for one month with code THINKING1MO at https://a-t.tv/jane • Deep Roots Massage & Bodywork – Save 10% on continuing education with code THINKING at https://deeprootsmb.com • ABMP – Save $24 on new membership at https://abmp.com/thinking • Books of Discovery – Save 15% with code thinking at https://booksofdiscovery.com/ • Advanced-Trainings – Try one month free of the A-T Subscription with code thinking at https://a-t.tv/subscriptions/ • Academy of Clinical Massage – Grab Whitney’s free Assessment Cheat Sheet at https://academyofclinicalmassage.com/cheatsheet ✨ Watch the video / connect with us: • Whitney Lowe – https://academyofclinicalmassage.com | https://facebook.com/WhitneyLowe | https://twitter.com/whitneylowe | https://www.youtube.com/@whitlowe • Til Luchau – https://advanced-trainings.com | https://facebook.com/advancedtrainings | https://instagram.com/til.luchau | https://www.youtube.com/@AdvancedTrainings/podcasts 📧 Email us: [email protected] The Thinking Practitioner Podcast is intended for professional practitioners of manual and movement therapies — bodywork, massage therapy, structural integration, physical therapy, osteopathy, and similar professions. It is not medical or treatment advice. Rolfing® is a registered trademark of the Dr. Ida Rolf Institute.

🎙 Recognizing & Touching Trauma (with Dr. Peter Levine) By popular demand! Originally aired as Episode 108, Til’s conversation with Dr. Peter Levine quickly became one of our most listened-to episodes ever — and it’s easy to hear why. The developer of Somatic Experiencing®, bestselling author of Waking the Tiger, and student of Ida Rolf shares how trauma lives in the body, how hands-on practitioners can recognize it, and how we can be most helpful when it shows up on our tables. Whether you missed it the first time or you’re ready for a second listen, this one rewards a revisit. ✨ Topics: • How bodyworkers can recognize trauma as it’s held in the body — bracing, breath holding, and the “snapshot” of past responses • The vagus nerve and gut-brain feedback loops: why 80% of its fibers carry signals from body to brain, and how to send the “all clear” • What wild animals and NASA astronauts taught Dr. Levine about resilience and bouncing back • Why pushing too hard backfires: “talking to the shoulders” with patient, supportive touch instead of forcing change • Dr. Levine’s evolving view that Ida Rolf was “largely correct” about fascia — and how nervous system and tissue work fit together • The four women who shaped his work: Charlotte Selver, Magda Proskauer, Ida Rolf, and Mira Rothenberg • Trauma as “what happens in the absence of an empathetic other” — and how practitioners create relative safety • Scope of practice: where bodyworkers’ trauma work ends and psychotherapy begins • Healing rituals, shamanic traditions, and why community matters in trauma recovery • Practitioner self-care, burnout, and Dr. Levine’s end-of-day river ritual ✨ Resources: • Somatic Experiencing® International — trainings and practitioner directory: https://www.somaticexperiencing.com • Peter A. Levine, Waking the Tiger: Healing Trauma • Peter A. Levine, An Autobiography of Trauma: A Healing Journey • Mira Rothenberg, Children with Emerald Eyes 🌱 Sponsor Offers: • Jane – Try the Jane practice management app free for one month with code THINKING1MO at https://a-t.tv/jane • Deep Roots Massage & Bodywork – Save 10% on continuing education with code THINKING at https://deeprootsmb.com • ABMP – Save $24 on new membership at https://abmp.com/thinking • Books of Discovery – Save 15% with code thinking at https://booksofdiscovery.com/ • Advanced-Trainings – Try one month free of the A-T Subscription with code thinking at https://a-t.tv/subscriptions/ • Academy of Clinical Massage – Grab Whitney’s free Assessment Cheat Sheet at https://academyofclinicalmassage.com/cheatsheet ✨ Watch the video / connect with us: • Whitney Lowe – https://academyofclinicalmassage.com | https://facebook.com/WhitneyLowe | https://twitter.com/whitneylowe | https://www.youtube.com/@whitlowe • Til Luchau – https://advanced-trainings.com | https://facebook.com/advancedtrainings | https://instagram.com/til.luchau | https://www.youtube.com/@AdvancedTrainings/podcasts 📧 Email us: [email protected] The Thinking Practitioner Podcast is intended for professional practitioners of manual and movement therapies — bodywork, massage therapy, structural integration, physical therapy, osteopathy, and similar professions. It is not medical or treatment advice. Rolfing® is a registered trademark of the Dr. Ida Rolf Institute.

🎙 Lateral Hip Pain: Stop Blaming the Bursa (with Whitney Lowe & Til Luchau) Til and Whitney unpack why the old “trochanteric bursitis” diagnosis is almost always wrong—and what that means for your hands-on treatment. ✨ Topics discussed include: • The shift from bursitis to tendinopathy: only about 8% of lateral hip cases involve true bursitis; the majority are gluteus medius/minimus tendinopathies compressed under the IT band • Why women are affected at a 4:1 ratio—declining estrogen, wider pelvis geometry, and IT band bowstringing • Why direct deep pressure on the greater trochanter can backfire—neural sprouting, pain prediction, and the GPR83 pathway • Smarter treatment: targeting gluteus maximus and TFL to reduce IT band compression, rather than trying to “loosen” the band itself • Simple assessment tools: the 30-second single leg stance, the shoelace test, and the bilateral night pain pattern • Stretching caution: why aggressive IT band stretching increases the very compression you’re trying to relieve 🌱 Sponsor Offers: • Jane App — Practice management built for health and wellness practitioners. Thinking Practitioner listeners get a free first month; enter code THINKING1MO at checkout: https://a-t.tv/jane • Deep Roots Massage & Bodywork — Carefully crafted, small hands-on CE workshops in Keene, NH. Save 10% with code THINKING: https://deeprootsmb.com • ABMP — Associated Bodywork & Massage Professionals. Thinking Practitioner listeners save at https://www.abmp.com/thinking • Books of Discovery — Explore their collection at https://www.booksofdiscovery.com and save 15% with code THINKING • Advanced-Trainings — Try one month free of Til Luchau’s A-T Subscription with code THINKING: https://a-t.tv/subscriptions/ • Academy of Clinical Massage — Grab Whitney’s free Assessment Cheat Sheet: https://academyofclinicalmassage.com/cheatsheet ✨ Watch the video / connect with us: • Whitney Lowe – https://academyofclinicalmassage.com | https://facebook.com/WhitneyLowe | https://twitter.com/whitneylowe | https://www.youtube.com/@whitlowe  • Til Luchau – https://advanced-trainings.com | https://facebook.com/advancedtrainings | https://instagram.com/til.luchau | https://www.youtube.com/@AdvancedTrainings/podcasts  📧 Email us: [email protected] The Thinking Practitioner Podcast is intended for professional practitioners of manual and movement therapies — bodywork, massage therapy, structural integration, physical therapy, osteopathy, and similar professions. It is not medical or treatment advice.

🎙 The Most Skipped Step in Assessment and Why It Matters Most  What if the most important part of your assessment never involves touching your client? In this solo episode, Whitney dives deep into the client history — the most critical yet frequently overlooked component of manual therapy assessment. While many practitioners rush straight into orthopedic testing or treat only where it hurts, the subjective intake holds the primary keys to understanding why a client is in pain, not just where. Whitney walks through the OPQRST history-taking framework — a structured clinical checklist covering Onset, Provocation/Palliation, Quality, Referral/Radiation, Severity, and Timing. Along the way, he shares vivid clinical examples showing how tuning your ears and brain to a client’s story can dramatically refine your physical assessment, catch crucial red flags, and help you design safer, more targeted treatment plans. ✨ Topics discussed include: • The assessment illusion — why jumping straight to orthopedic tests or treating where it hurts undermines true clinical reasoning. • O is for Onset — distinguishing acute biomechanical tissue overloads (like sudden eccentric muscle strains) from chronic, nociplastic pain conditions driven by systemic inflammation or cumulative load. • P is for Provocation & Palliation — reading structural mechanical patterns, such as differentiating discogenic spine pain from facet-related pain and the “shopping cart sign.” • Q is for Quality — why you should let clients describe pain in their own words, and what neuropathic “electrical shocks” reveal versus deep, arthritic joint aches. • R is for Referral & Radiation — tracking diffuse trigger point patterns versus localized entrapments, plus a modern clinical look at lateral hip pain: bursitis versus abductor tendon compression. • S is for Severity & Functional Impact — shifting clinical focus from arbitrary 1–10 pain scales to objective functional indicators like sudden muscle inhibition or a joint giving way. • T is for Timing — deciphering the difference between early-morning stiffness that eases with movement and late-afternoon postural fatigue from a desk job. • Hands vs. head — why your ears and brain are just as important as your hands, and how this framework makes you more effective in less table time. ✨ Resources: • The OPQRST Clinical Assessment Protocol. Learn more in the Academy’s Orthopedic Medical Massage Specialist Program. 🌱 Sponsor Offers: • Jane App — Practice management built for health and wellness practitioners. Thinking Practitioner listeners get a free first month; enter code THINKING1MO at checkout: https://a-t.tv/jane • Deep Roots Massage & Bodywork — Carefully crafted, small hands-on CE workshops in Keene, NH. Save 10% with code THINKING: https://deeprootsmb.com • ABMP — Associated Bodywork & Massage Professionals. Thinking Practitioner listeners save at https://www.abmp.com/thinking • Books of Discovery — Explore their collection at https://www.booksofdiscovery.com and save 15% with code thinking • Advanced-Trainings — Try one month free of Til Luchau’s A-T Subscription with code thinking: https://a-t.tv/subscriptions/ • Academy of Clinical Massage — Grab Whitney’s free Assessment Cheat Sheet: https://academyofclinicalmassage.com/cheatsheet ✨ Watch the video / connect with us: • Whitney Lowe – https://academyofclinicalmassage.com | https://facebook.com/WhitneyLowe | https://twitter.com/whitneylowe | https://www.youtube.com/@whitlowe  • Til Luchau – https://advanced-trainings.com | https://facebook.com/advancedtrainings | https://instagram.com/til.luchau | https://www.youtube.com/@AdvancedTrainings/podcasts  📧 Email us: [email protected] The Thinking Practitioner Podcast is intended for professional practitioners of manual and movement therapies — bodywork, massage therapy, structural integration, physical therapy, osteopathy, and similar professions. It is not medical or treatment advice.

🎙 Hypermobile Ehlers-Danlos, Fascia, and Pain (with Tina Wang) Listener Favorite Why do people with extra-flexible tissues often hurt more, not less? What does fascia actually look like on ultrasound in someone with hypermobility — and why did the findings surprise even the researchers? Dr. Tina Wang — a board-certified physical medicine and rehabilitation physician whose research uses ultrasound to study fascial dysfunction in hypermobile patients — joins Til and Whitney for a wide-ranging conversation about Ehlers-Danlos syndrome, the paradox of mushy tissue that won’t glide, and why the deep fascia may be where most myofascial pain actually lives. This is one of our most listened-to episodes ever — a listener favorite we’re bringing back for those who missed it and those ready for a second listen. Dr. Wang also offers a 1-hour class on hypermobility in the A-T subscription library (get a free month with code thinking: https://a-t.tv/subscriptions/) ✨ Topics covered in this episode include: • The hypermobility paradox: why people with EDS have tissue that feels “mushy” and spongy yet lacks fascial glide • The diagnostic framework for hypermobile EDS — Beighton scores, systemic manifestations, body proportions, piezogenic papules, and why 30% of the population is hypermobile without pathology • Dr. Wang’s ultrasound research: sternocleidomastoid fascia that was profoundly thicker in EDS patients than expected, and the surprising elastography findings about stiffness • Why the deep fascia — not muscle alone — appears to be the primary source of myofascial pain in 75% of cases • Ultrasound-guided fascial injections and the role of different tissue layers in pain • The connection between EDS, neurodivergence, autism, and ADHD — and Dr. Wang’s case that hypermobile EDS may be neurodevelopmental • Why some patients respond to treatment with fevers, catatonia, and autonomic dysfunction — and what that tells us about their nervous system • Interoception, exteroception, and why people with EDS often have heightened sensory processing • The fibroblast–nerve–immune cell crosstalk happening at the tissue level • Why “go slow and form the connection” may be the most important clinical advice for working with this population • Dr. Wang’s personal experience as a clinician with EDS and co-occurring autism ✨ Resources: • Dr. Wang’s 1-hour course: https://advanced-trainings.com/product/hypermobility-for-hands-on-therapists/ • Dr. Wang’s clinical practice: https://tupelopointe.com/ • Dr. Wang’s neurofascial inflammation seminars: https://www.thebraincelledu.com/seminars ✨ Selected research: • Wang, Tina J., and Antonio Stecco. “Fascial Thickness and Stiffness in Hypermobile Ehlers‑Danlos Syndrome.” American Journal of Medical Genetics Part C: Seminars in Medical Genetics 187, no. 4 (December 2021): 446–52. https://doi.org/10.1002/ajmg.c.31948 • Wang, Tina, Roya Vahdatinia, Sarah Humbert, and Antonio Stecco. “Myofascial Injection Using Fascial Layer-Specific Hydromanipulation Technique (FLuSH) and the Delineation of Multifactorial Myofascial Pain.” Medicina (Kaunas, Lithuania) 56, no. 12 (December 20, 2020): 717. https://doi.org/10.3390/medicina56120717 🌱 Sponsor Offers: • Jane App — Practice management built for health and wellness practitioners. Thinking Practitioner listeners get a free first month; enter code THINKING1MO at checkout: https://a-t.tv/jane • ABMP — Associated Bodywork & Massage Professionals. Thinking Practitioner listeners save at https://www.abmp.com/thinking • Books of Discovery — Explore their collection at https://www.booksofdiscovery.com and save 15% with code thinking • Advanced-Trainings — Try one month free of Til Luchau’s A-T Subscription with code thinking: https://a-t.tv/subscriptions/ • Academy of Clinical Massage — Grab Whitney’s free Assessment Cheat Sheet: https://academyofclinicalmassage.com/cheatsheet ✨ Watch the video / connect with us: • YouTube: https://www.youtube.com/@AdvancedTrainings/podcasts • Til Luchau – https://advanced-trainings.com | https://facebook.com/advancedtrainings | https://instagram.com/til.luchau • Whitney Lowe – https://academyofclinicalmassage.com | https://facebook.com/WhitneyLowe | https://twitter.com/whitneylowe 📧 Email us: [email protected] The Thinking Practitioner Podcast is intended for professional practitioners of manual and movement therapies — bodywork, massage therapy, structural integration, physical therapy, osteopathy, and similar professions. It is not medical or treatment advice.

🎙 Exploring the Anterior Neck: (with Walt Fritz) Walt Fritz is a physical therapist who has been in practice since 1985 and has spent the last 30 years evolving from a traditional myofascial release (MFR) background into a collaborative, patient-led approach to manual therapy. He returns to The Thinking Practitioner to talk to Whitney about one of the most intimidating regions for manual therapists: the anterior neck. Walt shares his transition from the "clinician-as-expert" model to one rooted in shared decision-making, where the patient’s input on pressure, direction, and duration isn’t just welcomed—it’s the primary driver of the intervention. They discuss the "metatherapy" of the therapeutic relationship, the physiological realities of treating deep neck structures, and how to safely navigate the "danger triangle" of the throat to help patients with voice and swallowing disorders. ✨ Topics discussed include: Walt’s "Counter-Culture" Evolution: Moving from the myofascial release "rabbit hole" to a more generalized, neurocentric manual therapy model. The Clinician-as-Expert vs. Shared Decision-Making: Why we should stop pretending we know exactly what a patient is feeling. Metatherapy & Carl Rogers: How the relationship and context of the treatment can be as important (or more so) than the technique itself. Navigating the Anterior Neck: Understanding the anatomy of the "danger triangle," including the carotid sheath, jugular vein, and vagus nerve. Treatment for Voice and Swallowing: How manual therapy can assist with dysphagia (swallowing disorders) and globus pharyngeus (the sensation of a lump in the throat). The "Emergency Exit Strategy": Empowering patients with the ability to stop or modify treatment at any second to ensure safety and comfort. Platysma: The Forgotten Muscle: Why superficial structures deserve more love in our clinical assessments. The Problem with High-Force Interventions: A critique of aggressive MFR techniques and the importance of patient-led pressure. ✨ Resources: Walt Fritz’s Website: https://WaltFritz.com Leah Helou (University of Pittsburgh): Research on "Metatherapy" Carl Rogers (1957): Landmark paper on the necessary and sufficient conditions of therapeutic change Freedom to Learn: Book by Carl Rogers Harry von Piekartz: Research and texts on craniofacial pain Cochrane Review: Massage for Mechanical Neck Disorders Walt's Google Drive folder with key papers 🌱 Sponsor Offers: Deep Roots Massage & Bodywork: Save 10% on upcoming classes in Keene, NH, with code THINKING at https://deeprootsmb.com Jane App — Practice management built for health and wellness practitioners. Thinking Practitioner listeners get a free first month; enter code THINKING1MO at checkout: https://a-t.tv/jane ABMP — Associated Bodywork & Massage Professionals. Thinking Practitioner listeners save at https://www.abmp.com/thinking Books of Discovery — Explore their collection at https://www.booksofdiscovery.com and save 15% with code thinking Academy of Clinical Massage — Grab Whitney’s free Assessment Cheat Sheet at https://academyofclinicalmassage.com/cheatsheet Advanced-Trainings — Try one month free of Til Luchau’s A-T Subscription with code thinking: https://a-t.tv/subscriptions/ ✨ Watch the video / connect with us: YouTube: The Thinking Practitioner Playlist Whitney Lowe: Academy of Clinical Massage | Facebook Til Luchau: Advanced-Trainings.com | Instagram 📧 Email us: [email protected] The Thinking Practitioner Podcast is intended for professional practitioners of manual and movement therapies — bodywork, massage therapy, structural integration, physical therapy, osteopathy, and similar professions. It is not medical or treatment advice.