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.)