The Thinking Practitioner

🎙 Dizziness Roundtable (with Ruth Werner)

Ruth Werner returns to The Thinking Practitioner for a roundtable discussion with Til and Whitney on one of the most overlooked topics in manual therapy: balance challenges. Ruth is the author of A Massage Therapist’s Guide to Pathology (now in its 7th edition), a long-time educator, and host of the podcast I Have a Client Who. In this wide-ranging conversation with Til and Whitney, Ruth brings her characteristic clarity to a complex subject — helping us understand what’s really happening when clients feel dizzy, wobbly, or unsteady.

Balance difficulties show up constantly in clinical practice, yet most of us never learned how to think about them. Clients get dizzy turning over on the table. They feel lightheaded sitting up from prone. They mention casually that they’re “always a little unsteady” after sessions — and we realize we’ve never asked the right questions. This episode gives MTs a framework for understanding, responding to, and even helping with balance challenges — while knowing when to refer out.

✨ Topics discussed include: Ruth, Til, and Whitney unpack the sensory triad behind balance (vision, proprioception, and the vestibular system), explore common conditions like BPPV and POTS, and discuss what the research actually shows about massage and balance — including some encouraging findings about foot work and gait in older adults.

• What we really mean by “balance” — and why Ruth finds the word frustratingly vague
• The difference between vertigo (spinning) and dizziness (lightheadedness)
• Why position changes on the table can trigger symptoms — and what to do about it
• BPPV, the Epley maneuver, and “rocks in our head” (otoliths)
• POTS, blood pressure medications, and the challenge of sitting up
• Hypermobility, Ehlers-Danlos syndrome, and their links to balance issues
• Red flags: progressive changes, asymmetry, and when to refer
• Research on massage, foot work, and balance in older adults
• Why there’s no “dizziness muscle” — and what we can do instead
• Fall risk, deconditioning, and the cascade of consequences
• Vestibular physical therapy and other referral options

✨ Resources:
• Ruth Werner’s website: https://ruthwerner.com/
• Ruth’s podcast I Have a Client Who: https://www.abmp.com/podcasts?defined_term=353
• A Massage Therapist’s Guide to Pathology, 7th Edition: https://booksofdiscovery.com/
• Sefton et al. (2012) – Six weeks of massage therapy produces changes in balance: https://pmc.ncbi.nlm.nih.gov/articles/PMC3457720/
• Tarkhasi et al. (2025) – Corrective exercises with massage improve balance and gait: https://pubmed.ncbi.nlm.nih.gov/39550789/

🌱 Sponsor Offers:
• Jane – Practice management for health and wellness practitioners. Try one month free with code THINKING1MO at https://a-t.tv/jane
• 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:
• 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: info@thethinkingpractitioner.com

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.

🎙 A Master in Plain Sight (with Art Riggs)

Art Riggs is a Certified Advanced Rolfer™, massage therapist, and creator of some of the most influential instructional video courses in our field. His recordings were among the first truly comprehensive video trainings available to bodyworkers. Decades later, practitioners still return to them again and again, finding new insights each time. They age well because they’re packed with technique, yet grounded in principles that never go out of style.

Here’s the paradox of Art’s work: he shares a staggering wealth of techniques, yet what he emphasizes most isn’t technique at all. It’s listening, allowing, and refining your touch. “Deep tissue,” he explains, isn’t about pressing harder. It’s a conversation with the body, where pressure is just one word in the vocabulary.

At 80, and still seeing clients most days, Art brings warmth and infectious enthusiasm to everything he discusses. He’s humble about his contributions, generous with credit to his teachers, and genuinely delighted by the craft he’s practiced for decades. This conversation is a joy from start to finish.

✨Topics discussed include:
Whether you’re early in your career or decades in, this episode is a masterclass in how to think with your hands.
• Why Art chose “deep tissue massage” over a proprietary name — and why that made his work more accessible
• The difference between deep tissue and “pressing harder”
• Touch as communication: pressure, speed, angle, and reading the body’s response
• “Refine your touch” — the three words that changed everything
• Allowing vs. forcing: offering something for people to take
• Why his first video set covers techniques while his second shows integration into a fluid, full session
• The limits of online learning — and why hands-on classes and receiving work still matter
• The overlap (and differences) between massage therapy and Rolfing® — and what each can learn from the other
• Movement, getting clients off the table, and working in real-world positions (not just neutral on the table)
• The skill of knowing where to work — and when you’re done
• Acknowledging Helen James, who Rolfed until 95: choosing a profession where you can keep learning until you drop

✨ Resources:
• Art Riggs’ video courses (now also eligible for NCBTMB-approved CE): https://advanced-trainings.com/artriggs
• Art Riggs’ book: Deep Tissue Massage, Revised Edition: A Visual Guide to Techniques – https://www.northatlanticbooks.com/shop/deep-tissue-massage-revised-edition/

🌱 Sponsor Offers:
• Books of Discovery – Save 15% with code thinking at https://booksofdiscovery.com/
• ABMP – Save $24 on new membership at https://abmp.com/thinking
• Advanced-Trainings – Try one month free of the A-T Subscription (including lessons from Art Riggs' courses) at https://a-t.tv/subscriptions/ with code thinking
• Academy of Clinical Massage – Grab Whitney’s free Assessment Cheat Sheet at https://academyofclinicalmassage.com/cheatsheet

✨ Watch the video / connect with us:
• Til Luchau – https://advanced-trainings.com | https://www.youtube.com/@AdvancedTrainings/podcasts | https://facebook.com/advancedtrainings | https://instagram.com/til.luchau
• Whitney Lowe – https://academyofclinicalmassage.com | https://facebook.com/WhitneyLowe | https://twitter.com/whitneylowe

📧 Email us: info@thethinkingpractitioner.com

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®, Rolfer™, Rolf Movement®, Rolfing Ten-Series™, and the Little Boy Logo are service marks of The Rolf Institute of Structural Integration®, Boulder, CO.

🎙 AI in Massage: Thinking Partner, Threat, or Crutch?

Is artificial intelligence coming for your massage practice? Not the way you might think. In this episode, Til and Whitney dive into the rapidly evolving world of AI — exploring where it genuinely helps manual therapists, where it falls short, and why the human elements of touch, presence, and clinical reasoning remain irreplaceable.

From AI-generated anatomical images with mysterious octopus tentacles to "massage robots" that feel like being rubbed by a cow, they share their own experiences with these tools and separate the hype from the helpful. Whitney unveils his Clinical Massage Coach — a custom AI tool trained on curated clinical knowledge that engages practitioners in Socratic dialogue rather than just spitting out answers. The key insight: AI works best not when it replaces thinking, but when it prompts better thinking.

✨ Topics covered:
• How AI is already quietly influencing bodywork education and practice
• The "hallucination" problem — why AI sounds confident even when it's wrong
• Will massage robots take your job? (Spoiler: the client-therapist relationship isn't going anywhere)
• Personalized learning: the "holy grail" of education that AI might help unlock
• The de-skilling danger: when easy tools erode hard-won skills
• Using AI as a reasoning partner vs. a script generator
• Whitney's Clinical Massage Coach: SOAP notes, treatment planning, and Socratic questioning
• Ethical considerations: energy consumption, bias, and the "human in the loop"

✨ Resources
• Whitney's Clinical Massage Coach (CMC)
Ever wish you could have a clinical expert on call 24/7? The CMC is an AI-powered assistant trained on over three decades of Whitney Lowe's textbooks and articles as well as hundreds of peer-reviewed resources. As a core feature of our Orthopedic Medical Massage Specialist (OMMS) program, it's designed to help you navigate complex clinical questions with science-based precision. Explore the CMC here: www.academyofclinicalmassage.com

✨ Watch the video / connect with us:
• Til Luchau – https://advanced-trainings.com | https://www.youtube.com/@AdvancedTrainings/podcasts | https://facebook.com/advancedtrainings | https://instagram.com/til.luchau
• Whitney Lowe – https://academyofclinicalmassage.com | https://facebook.com/WhitneyLowe | https://twitter.com/whitneylowe

🌱 Sponsor Offers:
• Books of Discovery – Save 15% with code thinking at https://booksofdiscovery.com/
• ABMP – Save $24 on new membership at https://abmp.com/thinking
• Advanced-Trainings – Try one month free of the A-T Subscription at https://a-t.tv/subscriptions/ with code thinking
• Academy of Clinical Massage – Grab Whitney's free Assessment Cheat Sheet at https://academyofclinicalmassage.com/cheatsheet

📧 Email us: info@thethinkingpractitioner.com

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.

🎙 Science, Skepticism, & Keeping Heart (with Paul Ingraham)

What happens when a former massage therapist turns a skeptical eye on his own profession and starts asking uncomfortable questions about pain science and manual therapy? You get Paul Ingraham of PainScience.com — a writer whose work has challenged, irritated, and influenced practitioners in equal measure.

In this episode, Til Luchau and Whitney Lowe sit down with Paul to explore how clinicians can think clearly in a field crowded with confident claims, competing models, and stories that feel true even when the evidence is thin. The conversation doesn’t shy away from friction. Paul is known for his sharp critiques of manual therapy’s favorite explanations, and many practitioners bristle at his tone. Here, we examine both the substance of his skepticism and the costs that can come with it.

Together, they explore questions many therapists wrestle with, often quietly: How do we tell the difference between what helps clients and the stories we tell ourselves about why it helped? When does confidence in a method turn into intellectual blinders? And how can practitioners stay curious and effective without clinging to explanations that may not hold up?

In this episode, they discuss:

• Paul’s move from massage therapist to science writer — and the unresolved questions that pushed him there
• “Modality empires” and why techniques so easily become identities
• The challenge of separating your identity from your methodology — and why it matters
• Confirmation bias in clinical practice: how we see what we expect to see and miss contradictory evidence
• Placebo, context, and why they complicate claims about mechanisms in manual therapy
• Paul’s critique of “structuralism” — the exclusive focus on alignment, posture, and movement dysfunction
• How to think about biomechanical explanations without falling into reductionist storytelling
• Why connecting dots between distant body parts (like foot problems causing back pain) can slip from plausible hypothesis into speculation
• The role of neurophysiological effects in manual therapy outcomes
• How to engage with research critically without becoming paralyzed by uncertainty
• Why practitioners may need intellectual humility more than confidence in untested theories
• The tension between skepticism as a tool and skepticism as a communication style — and what can get lost when critique outpaces curiosity
• The future of manual therapy as it integrates pain science and biopsychosocial models — and where Paul remains unconvinced

This conversation won’t give you comfortable answers or a new technique to believe in. Instead, it invites you to sit with uncertainty, examine your assumptions, and reflect on how skepticism can sharpen thinking — and how, at times, it can narrow it. Whether you admire Paul’s work, struggle with it, or find yourself somewhere in between, this episode offers a chance to engage the questions underneath the disagreements.

✨ Resources
👉 Paul’s website with articles and books: https://www.painscience.com

🌱 Sponsor Offers:
- Books of Discovery – Save 15% with code thinking at https://booksofdiscovery.com/
- ABMP – Save $24 on new membership at https://abmp.com/thinking
- Advanced-Trainings – Try one month free of the A-T Subscription at https://a-t.tv/subscriptions/ with code thinking
- Academy of Clinical Massage – Grab Whitney’s free Assessment Cheat Sheet at https://academyofclinicalmassage.com/cheatsheet

✨ Watch the video / connect with us:
• Til Luchau – https://advanced-trainings.com | Facebook: https://facebook.com/advancedtrainings | Instagram: https://instagram.com/til.luchau
• Whitney Lowe – https://academyofclinicalmassage.com | Facebook: https://facebook.com/WhitneyLowe 

📧 Email us: info@thethinkingpractitioner.com

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.

🎙 5 Years of The Thinking Practitioner: Our Favorites & Top 5 Most Popular Episodes

It's been 5 years since we launched The Thinking Practitioner — with over half a million downloads and 130,000 unique listeners along the way. In this special retrospective episode, Til and Whitney look back at personal favorites that shaped their own thinking, then count down the top 5 most-listened episodes of all time.

What stands out? A clear shift from tissue-focused to nervous-system-first thinking. Ideas about consent, context, and the client experience that once felt radical now feel like common sense. And the conversations that resonated most? They're about fascia, trauma, pain, and the practitioners brave enough to challenge what we think we know.

🎧 Episodes discussed (in order of appearance):

Personal favorites:
- Ep 140: Embodied Attention & Contact Improvisation (Nita Little)
- Ep 23: Do Expectations Shape Results? (Mark Bishop)
- Ep 80: What We Might Learn From Sex (Betty Martin)
- Ep 144: Movement Optimism (Greg Lehman)
- Ep 130: The Body of Grief (Jun Park)
- Ep 146: Inflammation, Touch & the Grieving Body (Mary-Francis O'Connor)
- Ep 135: The Neuroscience of Bodywork (Mark Olson)

Top 5 most popular of all time:
5. Ep 108: Trauma & Bodywork (Peter Levine)
4. Ep 79: Hypermobile Ehlers-Danlos, Fascia, and Pain (Tina Wang)
3. Ep 45: Fascia in Sport & Movement (Robert Schleip)
2. Ep 69: Back Pain, Stiffness & Fascia (Stuart McGill)
1. Ep 126: Fascia: A Deep Dive (Dr. Antonio Stecco)

✨ Watch the video / connect with us:
- 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

Sponsor Offers:
- Books of Discovery – Save 15% with code thinking at https://booksofdiscovery.com/
- ABMP – Save $24 on new membership at https://abmp.com/thinking
- Advanced-Trainings – Try one month free of the A-T Subscription at https://a-t.tv/subscriptions/ with code thinking
- Academy of Clinical Massage – Grab Whitney's free Assessment Cheat Sheet at https://academyofclinicalmassage.com/cheatsheet

📧 Email us: info@thethinkingpractitioner.com

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.