The Thinking Practitioner

🎙 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

✨ Resources:

• Dr. Wang’s 1-hour course: https://advanced-trainings.com/product/hypermobility-for-hands-on-therapists/

✨ 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

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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.

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.

Walt’s "Counter-Culture" Evolution: Moving from the myofascial release "rabbit hole" to a more generalized, neurocentric manual therapy model.

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.

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

YouTube: The Thinking Practitioner Playlist

Whitney Lowe: Academy of Clinical Massage | Facebook

Til Luchau: Advanced-Trainings.com | Instagram

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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.

🎙What if the key to resolving your client’s back pain isn’t loosening things up — but “adding” stiffness? Dr. Stuart McGill is one of the preeminent back pain researchers in the world, and in this conversation, he makes his case — passionately and controversially — for why biomechanical factors deserve far more attention than they typically get in back pain assessment and treatment. He argues that the label “nonspecific low back pain” masks what a skilled clinician could find with a thorough enough assessment, and that too many patients with real mechanical issues are being dismissed as psychosocial cases. Not everyone in the field agrees, but his perspective is fascinating, clinically detailed, and full of provocative ideas for manual therapists.

This episode originally aired as episode 97 and quickly became one of our most popular — a listener favorite we’re bringing back for those who missed it and those who are ready for a second listen.

✨ Topics covered in this episode include:

• Why Dr. McGill believes “nonspecific low back pain” doesn’t exist — and how he argues it undermines both research validity and clinical outcomes

✨ Resources mentioned in this episode:

• Dr. Stuart McGill’s website and clinician directory: https://www.backfitpro.com

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• YouTube: https://www.youtube.com/@AdvancedTrainings/podcasts

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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.

🎙Dr. Joi Edwards is a physical therapist with nearly 20 years of experience specializing in orthopedic injuries and a licensed massage therapist who bridges the gap between clinical assessment and intuitive soft-tissue work.

She joins Whitney on The Thinking Practitioner to dive deep into the world of cupping therapy—exploring the physiological mechanisms, the various types of tools, and why this ancient modality is about much more than just leaving red marks on the skin.

Joi’s fascination with cupping began in the clinic when she discovered the modality "pre-Michael Phelps" and noticed an immediate 15-degree increase in her own shoulder's range of motion after experimenting with the cups. Her journey was further shaped by international patients who shared how their families had used cupping for generations to treat everything from systemic colds to localized chronic pain.

This episode is an exploration of how decompression—rather than the compression typically associated with massage—can restore tissue mechanics and stimulate a nervous system response that even the most skilled manual techniques sometimes can't replicate.

✨ Topics discussed include: Whitney and Joi walk through the different categories of cupping, the science of tissue decompression, and how to safely integrate cups into a clinical practice.

✨ Resources:

🌱 Sponsor Offers:

• Jane – Practice management for health and wellness practitioners. Try it free for one month with code THINKING1MO at https://a-t.tv/jane

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• YouTube: https://www.youtube.com/@AdvancedTrainings/podcasts

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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.

🎙 Does Massage Research Actually Work? (with Bodhi Haraldsson)

Bodhi Haraldsson is a registered massage therapist, researcher, and self-described “pracademic” who has spent over 25 years bridging the gap between clinical practice and scientific inquiry. He joins Whitney on The Thinking Practitioner to talk about one of the most important — and most misunderstood — questions in our profession: what does the research actually tell us about massage therapy?

Bodhi’s journey into research began at McMaster University — the birthplace of evidence-based practice — where he joined the Cochrane Cervical Overview Group and helped author a landmark systematic review on massage for mechanical neck disorders. That review, first published in 2006 and later in Spine, analyzed thousands of studies down to just 14 qualifying trials — and found that most of the evidence was limited or unclear. Nearly 20 years later, a 2024 update reached essentially the same conclusions.

But this isn’t a discouraging story. It’s a call to understand what research can and can’t tell us — and why that matters for every practitioner. Bodhi and Whitney explore why absence of evidence is not evidence of absence, why no single study can capture the complexity of clinical practice, and how evidence-based practice isn’t about recipes or checklists — it’s about better understanding what we do and why.

✨ Topics discussed include: Whitney and Bodhi walk through the Cochrane review process, the state of massage research, and what individual practitioners can take away from the evidence conversation.

• What a “pracademic” is — and why massage needs more of them

✨ Resources:

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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 Interstate Massage Compact (with Deborah Persinger)

Deborah Persinger is the Executive Director of the Federation of State Massage Therapy Boards (FSMTB), and she joins Whitney on The Thinking Practitioner to break down one of the most significant regulatory developments in our profession’s history: the Interstate Massage Compact.

If you’ve ever moved to a new state and had to navigate a whole new set of licensing requirements — or if you live near a state border and can’t legally work on the other side — this episode is for you. The compact would create a multi-state license allowing eligible massage therapists to practice across state lines without meeting separate requirements in each state. It’s already been adopted by five states, with two more needed to stand up the commission and make the license a reality.

But there’s more at stake than portability. Deborah explains how the compact was carefully designed to address human trafficking in the massage profession — a daily reality for regulatory boards — and why the details of how the compact is written matter enormously for keeping bad actors out while making life easier for legitimate practitioners.

✨ Topics discussed include: Whitney and Deborah walk through the compact’s origins, the 625-hour education standard, the role of the Department of Defense, and the current obstacles to getting it across the finish line.

• What the Interstate Massage Compact is — and how multi-state licensing works

✨ Resources:

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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.

🎙 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

✨ Resources:

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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:

✨ Resources:

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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:

✨ Resources

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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:

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

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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.