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What happens when the science we rely on and the patients we treat seem to be telling us different things? In this thought-provoking conversation with osteopathic practitioner Sam Jarman, we dive deep into the sometimes confusing relationship between evidence-based medicine and patient-centered care in manual therapy.

Sam challenges us to reconsider how we apply evidence in our hands-on practice, noting that "the map is not the territory" – research papers represent averages and populations, while our clients are unique individuals whose responses may not match what studies predict. This leads us to one of the most fascinating paradoxes in our field: techniques like myofascial release that work clinically despite research suggesting they shouldn't be effective based on their proposed mechanisms. Rather than abandoning these approaches, Sam suggests we might be "talking about the wrong mechanism but doing the right behavior."

Perhaps most valuable for practicing therapists is Sam's framework for balancing technical skill and bedside manner. When there's an identifiable problem that will respond to technical intervention, your expertise should lead. When there's no clear target or when conditions aren't responsive to manual techniques, your interpersonal skills become your most powerful tool. This elegant framework provides clear guidance for the moment-to-moment decisions we make in treatment.

We also explore why experienced therapists from different disciplines often converge toward similar techniques despite different theoretical backgrounds, suggesting there are fundamental principles underlying effective manual therapy that transcend our professional divisions. Sam proposes focusing on these bedrock principles rather than getting lost in terminology that may not fully apply to our work.

Whether you're a massage therapist, physical therapist, chiropractor, or osteopath, this conversation will give you practical insights to enhance your clinical reasoning and treatment outcomes. Subscribe to the podcast for more conversations that bridge the gap between science and practice in manual therapy.

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The integrity of scientific research is under unprecedented pressure. In this eye-opening conversation, Senior Lecturer Sharmella Roopchand Martin reveals the alarming rise in research paper retractions—10,000 in the past year alone—and the shadowy industry that's emerged to exploit academic publishing demands.

Discover the shocking world of "paper mills," businesses that guarantee publication for a price, offering everything from ghostwritten papers to fake peer reviews. These operations thrive in an environment where career advancement depends on publication counts rather than research quality. Martin explains how the detection of scientific misconduct has evolved alongside increasingly sophisticated methods to commit it, including the emergence of bizarre "tortured phrases" like "counterfeit consciousness" (artificial intelligence) and "bosom peril" (breast cancer) that signal AI-assisted plagiarism attempts.

The conversation explores how retracted papers continue influencing public health decisions long after being debunked, the challenges facing researchers from developing nations, and the ethical dilemmas created by publication pressures. Most concerning is the gap between identifying problematic research and its formal retraction, creating windows where misinformation spreads unchecked through academic and public channels. For healthcare professionals and anyone who relies on scientific evidence, understanding these dynamics is crucial.

Ready to protect yourself from dubious research? Martin recommends resources like Retraction Watch and verification strategies including checking funding databases. If you're involved in research yourself, consider taking a short course in research ethics—many graduate programs don't include this crucial training. In a world flooded with information, the ability to distinguish sound science from misconduct has never been more important.

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Ever felt underprepared in your professional role and wondered how to bridge that knowledge gap? Join us as esteemed expert Ruth Warner shares her transformative journey from feeling unprepared as a massage therapist in the early 80s to becoming a beacon of knowledge on massage therapy's intersection with pathology. Ruth passionately advocates for therapists to solidify their knowledge base, moving beyond the superficial safety net of doctor's notes. Her insights into the importance of education and her celebrated textbook, "A Massage Therapist's Guide to Pathology," are sure to inspire anyone keen on advancing their professional capabilities and confidence.

We tackle the myths surrounding the infallibility of doctor's notes, clarifying the true legal responsibilities of massage therapists. Rather than relying solely on external validation, Ruth encourages therapists to cultivate a richer understanding of their craft and their clients' needs. By fostering better communication with healthcare providers, therapists can align treatment goals and prioritize client safety, ensuring they remain within their professional boundaries while collaborating effectively across the healthcare spectrum.

The conversation then widens to the broader theme of interdisciplinary collaboration and critical thinking in therapeutic practices. Ruth underscores the importance of overcoming healthcare silos and integrating evidence-based approaches with patient-centered care. We discuss the strategies for building a robust referral network and the ongoing necessity of critical thinking in healthcare. Highlighting her podcast "I Have a Client Who: Pathology Conversations with Ruth Werner," and her interactive webinars, Ruth invites listeners to engage with her in this enriching journey of professional development and continuous learning.

https://ruthwerner.com/

https://booksofdiscovery.com/product-category/a-massage-therapists-guide-to-pathology/

https://www.criticalthinking.org/pages/index-of-articles/1021/

Ruth Werners table for critical thinking:

 1 - Recognize and analyze the question at hand = What is this client asking for, and can I provide it?
 2 - Identify relevant variables that must inform your decisions = What factors affect this client's ability to safely receive massage therapy?
 3 - Challenge your pre-existing assumptions = What more do I need to learn about this client's situation? Do I have a clear grasp of what he wants and needs?
 4 - Consider possible solutions to challenges and explore alternatives to those solutions = What skills do I need to bring to this client's session? Do I need to refer this client to another provider? How might other strategies compare with my first choice? What have others done in similar situations? What have I missed?
 5 - Plan and execute a course of action that incorporates relevant variables = Based on all this, what is my session plan?
6 - Reflect on how things went after you made a decision = What worked well, and didn't work well, in that session? What will I do differently next time?

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What happens when the clinical application doesn't match the research results? Musculoskeletal specialist Ben Cormack joins us to explore this critical question and offers his invaluable insights into the world of therapeutic presence in clinical practice. We promise you'll uncover the gap between statistical effectiveness in studies and the real-world outcomes in practice. Dive into the exploration of randomized control trials, the magic of natural recovery, and the often-overlooked contextual effects that shape patient outcomes. Plus, we discuss the fascinating phenomena of placebo effects—sometimes dismissed as mere ‘happy accidents’—and consider how to harness their potential to elevate patient care.

Our conversation takes a closer look at the powerful mechanisms activated through treatments such as exercise and manual therapy, and how these can mimic each other by engaging similar pathways in the brain. We rethink the traditional views on inhibition and examine how placebo effects, driven by context and belief, can be as active as any other treatment component. Insights from expert Luana Coloca highlight the surprising potential of placebos when properly understood and applied. We also emphasize the importance of transcending traditional patient interviews, advocating for meaningful clinical conversations that truly consider the lifestyle and goals of each client, all while employing the biopsychosocial model for holistic care.

Communication stands at the heart of effective therapy, and this episode sheds light on enhancing these skills to foster genuine connections and maintain essential boundaries. Through personal anecdotes and expert perspectives, we stress the significance of professional growth and self-preservation for balanced therapeutic practice. We explore the benefits and challenges of interdisciplinary approaches in medicine, weighing the roles of generalists versus specialists. Whether you're seeking to improve your clinical practice or just interested in thought-provoking discussions about enhancing therapeutic alliances, this episode offers valuable insights and actionable advice.

https://cor-kinetic.com/

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What happens when a therapist loses their way? Dr. Jesse Reynolds, a respected practitioner in acupuncture and traditional Chinese medicine, faced this very dilemma. After adopting the persona of "Dr. Jess" to meet external expectations, he found himself burnt out and questioning his path. Together, we navigate his inspiring journey back to authenticity and how redefining therapeutic presence can prevent the emotional toll of burnout.

Our conversation unfolds with a focus on the softer skills that truly define successful therapeutic practice. While many practitioners relentlessly pursue technical expertise, we share compelling insights from a survey of over 3000 professionals that highlight the underestimated power of empathy, self-awareness, and effective communication. We explore practical strategies for maintaining professional boundaries and personal well-being, offering actionable advice for therapists who are eager to cultivate a more meaningful connection with their clients.

Finally, we shine a light on the importance of embracing one's unique approach to therapy. By sharing personal stories and experiences, we underscore how authenticity and individuation not only prevent exhaustion but also attract clients who resonate with your genuine presence. Join us as we unravel the complexities and rewards of being true to oneself in the therapy room, and discover how a heartfelt approach can transform both the practitioner's and the client's experience.

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Can touch actually alleviate pain? Discover the groundbreaking insights from Pavel Goldstein, head of the Integrative Pain Laboratory at the University of Haifa's School of Public Health, as he unpacks the profound power of touch in pain management. Inspired by his personal experience during his wife's labor, Goldstein's research reveals how empathetic touch from partners can provide significant pain relief. Join us as we explore his compelling study with romantic couples, where simply holding hands demonstrated remarkable analgesic effects.

Touch is more than just a physical sensation; it's a powerful tool for communication. In this episode, we delve into a fascinating study on empathetic touch and its neurophysiological impacts. Learn why the initial research focused on female subjects in pain and their male partners, and how empathetic touch enhances brain synchronization and physiological harmony. We also touch on the broader implications for therapeutic practices, shining a light on how intentional touch can bridge emotional and physical gaps.

Finally, we navigate the complexities of chronic pain and its distinction from acute pain. Chronic pain, often misunderstood, requires innovative approaches like Pain Reprocessing Therapy (PRT) and rethinking the role of placebos in pain management. Hear compelling case studies that illustrate pain as an alarm system that sometimes misfires, and the evolutionary perspectives that frame pain as vital for survival. Pavel Goldstein's insights offer a fresh and hopeful perspective on understanding and managing pain, encouraging listeners to be attentive to their bodies and the messages pain conveys.

For more information on Pavel Goldstein and his work visit: iPainLab and to share your stories please go to PainStory.Science

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Unlock the potential of placebo effects in clinical care with insights from our special guest, Guillaume Leonard, a leading physiotherapist and researcher. This episode promises a deep dive into how integrating placebos, especially within manual therapy and pain management, can enhance treatment outcomes when combined with active components. Guillaume discusses the ethical conundrums and the balancing act of setting realistic expectations without fostering false hopes, all while navigating the intricate landscape of pain diagnosis and treatment.

Explore the critical distinction between diagnosis and prognosis through compelling real-world cases. Guillaume and I dissect the psychological ramifications of diagnoses like fibromyalgia, emphasizing careful communication to prevent nocebo effects. We also highlight the transformative power of effective patient education and the nuanced role of language in shaping patient perceptions and recovery trajectories.

Discover the comparative benefits of massage therapy and transcutaneous electrical nerve stimulation (TENS) for chronic low back pain, backed by evidence from a guideline study by the Ottawa panel. We tackle the challenges of translating research into practical clinical applications and underscore the importance of maintaining hope and positive conditioning. This episode is a must-listen for anyone interested in merging evidence-based medicine with patient-centered care to optimize pain relief and improve quality of life.

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Can a simple therapeutic interaction release powerful chemicals in your brain like endorphins and oxytocin? Discover how the relationship between a therapist and client can turn an ordinary manual therapy session into a powerful healing experience. Join us as we sit down with Luana Colloca, professor at the University of Maryland and director of the Placebo Beyond Opinion Center, to unravel the profound effects of placebos in manual therapy. Luana takes us through the myriad ways trust, warmth, and competence in the therapist-client relationship can significantly enhance therapeutic outcomes.

Ever wondered how your expectations can shape your recovery? We dive deep into the impact of patient expectations and expectancy on therapeutic success. Learn how managing expectations through honest dialogue and realistic goal-setting can prevent disappointment and bolster treatment efficacy. Luana shares compelling insights into the subconscious mechanisms of expectancy and how therapists can utilize cognitive-behavioral techniques to harness these for better patient outcomes. We also uncover fascinating studies on post-operative pain management, illustrating how patient awareness of treatment can dramatically influence its effectiveness.

In our exploration of subtle cues and future directions, we touch on everything from the influence of environmental factors in therapy to the revolutionary concept of open-label placebos. Luana recounts her journey from skepticism to belief in the placebo effect, inspired by groundbreaking research. Look ahead to the future of placebo therapy as we discuss reversing impaired inner pharmacy mechanisms and personalizing treatment plans. Whether you're a therapist or simply curious about the mind-body connection, this episode promises to expand your understanding of the powerful interplay between psychology and treatment outcomes.

Please download her free manual on Placebo Effects Through the Lens of Translational Research: https://academic.oup.com/book/54240

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Unlock the mysterious efficacy of placebos and their role in pain management as we host neuroscience professor and esteemed author Serge Marchand. Together, we unravel the power of patient-practitioner interactions, where empathy and positive reinforcement can significantly alter a patient's pain experience. Listen to how even the most seasoned professionals must navigate the fine line between science and empathy, and how this dance can redefine healing approaches across healthcare.

This episode isn't just about the sugar pill effect; it's an expedition into the heart of expectation and its profound impact on treatment success. Serge Marchand gifts us with insights from his latest research, sharing personal stories that illustrate the interplay between the psychological and physical realms of pain. We tackle the controversial pendulum swing in pain neuroeducation, revealing the importance of balancing biomechanics with psychological factors in pain perception. We also probe into the ethical conundrums that arise when deploying placebos, emphasizing the delicate balance required to maintain patient trust while maximizing treatment efficacy.

Wrap up your understanding of the placebo's role in therapy with a discussion on the brain-body nexus and its implications for manual therapy. We consider how even non-efficacious treatments can sometimes yield surprising benefits, and ponder the potential of emerging research techniques like hypnosis and transcranial stimulation. The episode culminates with a forward-looking anticipation of future discussions, promising to shed even more light on the enigmatic workings of the nervous system. Join us for a journey that is as much about the science of healing as it is about the healing power of belief.

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Join us for a riveting journey through the landscape of trauma and healing, where Bethany Ranes Ph.D. and I navigate the mind's labyrinth following traumatic experiences. As a cognitive neuroscience research scientist with notable tenures at United Health Group and the US Army, Ranes lends her profound insights into the ways trauma shapes our physiological and psychological wellbeing. From the subtleties of microaggressions to the roar of chronic pain, our dialogue offers a fresh perspective on how small-scale stressors accumulated over time can manifest into significant psychological hurdles.

This episode paints a vivid tableau of the body's response to trauma, elucidating how evolutionary mechanisms and sensory cues influence our reactions to stress. The discussion spotlights the transformative potential of therapeutic touch, dissecting the dance between trauma responses during massage therapy and the human immune system. Delving into the art of creating a safe space for clients, we discuss the critical importance of empowerment and control in fostering a healing environment. Dr. Ranes's expertise demystifies the complex interplay of the body's alarm systems, offering practical strategies for managing trauma responses with mindfulness and kinesthetic awareness.

Concluding with a teaser of her "Firing and Wiring" blog series, we explore the interface of neuroscience and daily life, promising insights into how to navigate the brain's intricate circuits to enhance our daily experiences. Whether it's the psychological barriers to pain management or the soothing cadence of ASMR principles in massage therapy, our conversation encapsulates a treasure trove of wisdom that promises to empower listeners in their own journeys toward understanding and overcoming trauma.

Find out more about Dr. Bethany Ranes here: https://interoceptlabs.com/

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