The Thinking Practitioner

Whitney interviews tendon expert Dr. Jill Cook, who discusses the current understanding of tendinopathy as a degenerative condition, emphasizing the importance of proper loading in rehabilitation. She explains why she advises against traditional treatments like friction massage and stretching, why anti-inflammatory medications are ineffective, and highlights the risks of certain drugs on tendon health. Throughout the conversation, Dr. Cook provides evidence-based insights for all manual therapists on treating tendinopathies effectively.

Key Topics:

1. Shift from thinking of tendinopathies as inflammatory conditions to degenerative conditions (03:01 - 04:24)
2. Factors that contribute to pain in tendinopathies (04:40 - 05:41)
3. Clinical signs and symptoms of tendinopathy (06:06 - 08:34)
4. The role of loading and compression in tendon pathology (08:54 - 16:45)
5. Treatment strategies for tendinopathies, including friction massage and anti-inflammatory medications (19:06 - 31:48)
6. Medically-induced tendinopathies, such as those caused by fluoroquinolone antibiotics (32:05 - 35:04)
7. The role of active movement and soft tissue treatments in tendinopathy rehabilitation (35:30 - 38:29)

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:

• Jill Cook: J.Cook@latrobe.edu.au
• Fairclough J, Hayashi K, Toumi H, et al. The functional anatomy of the iliotibial band during flexion and extension of the knee: implications for understanding iliotibial band syndrome. J Anat. 2006;208(3):309-316. doi:JOA531 [pii] 10.1111/j.1469-7580.2006.00531.x

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: info@thethinkingpractitioner.com

(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, 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: info@thethinkingpractitioner.com

(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: info@thethinkingpractitioner.com

(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: info@thethinkingpractitioner.com

(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: info@thethinkingpractitioner.com
(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.)