Sensory Approach to Manual Therapy
Sensory Approach to Manual Therapy
Inside The Anatomy Assassin: Critical Thinking For Clinicians
Pain shouldn’t feel like guesswork. We sat down with therapist, educator, and former pro athlete Julie Pitois to pull back the curtain on a smarter, more human way to solve stubborn pain. Julie co-created the Anatomy Assassin approach, a true‑crime style framework where the “victim” is the loud symptom and the “criminals” are the hidden contributors—movement habits, stress loads, nerve sensitivity, and underperforming tissues—that quietly drive the case. That simple metaphor helps clients drop fear and lean into the process without jargon.
We talk about why time and curiosity matter more than any single technique. Short, protocol-driven care often misses the person in front of us; longer intakes, plain-language education, and frequent assess–treat–reassess loops turn sessions into a feedback-rich lab. Julie walks through practical tools: testing in and out of weight bearing, pairing manual inputs with immediate movement, and using clear metaphors—like nerves as subway lines—to explain entrapment, sensitivity, and why symptoms shift. The goal is not to “fix” someone, but to partner with them so they regain confidence to move while exercise builds lasting capacity.
You’ll hear how a blended model outperforms silos: early phases may lean on local tissue care, while long-standing pain requires more attention to the nervous system and life context. We cover the pitfalls of no-pain-no-gain thinking, how to avoid chasing symptoms, and how multidisciplinary teams work without hierarchy. If you’re a clinician, coach, or an everyday mover, you’ll leave with a clear roadmap: ask better questions, use targeted tests, explain what’s happening in simple terms, and let results guide the next step. Subscribe, share with a colleague who cares about critical thinking, and leave a review to tell us which metaphor clicked for you most.
For more information you can check out: https://www.anatomyassassinbooks.com
Hello, everybody, and welcome to another sensory approach to manual therapy podcast. Today, my guest is Julie Pietois, who is one of the co-authors of Anatomy Assassin Academy. And I had the chance to meet her at the American Massage Conference in May of 2025. And I was really impressed and interested in her approach to critical thinking inside a clinic, which is why I brought her on today because I want to start doing a small series on critical thinking and problem solving in the clinic, which is something you sorely missed. So welcome, Julie.
SPEAKER_00:Welcome. Thank you so much for having me. I am really excited to be here.
SPEAKER_01:Of course. So let's just start with a little bit of history about you. You're a licensed massage therapist, you've been a professional volleyball player in Spain, you've worked with athletes of all different levels. Just tell me a little bit about what it is that brought you into massage therapy as a profession from being an athlete historically.
SPEAKER_00:Yeah, well, actually, it was being an athlete that got me into this because uh having a lot of injuries, I was injured. I've been injured a few times in my career. I've played a lot of different sports growing up. Volleyball was the sport that got me into school and the sport that I ended up with. My first injury was at 14 with a bulging disc, where I had a coach who decided to also be my strength and conditioning coach and put me through a little too much. And it was because he didn't understand how the body actually worked that I ended up with my first injury. And going into college, I ended up with, you know, a cyst in my right knee, which instead of draining it, they took it out and ended up taking out more of the patella than they needed to. And that started this whole system of dysfunction in my body, being very tall because I'm six foot four. At least I was a while ago. I don't know what I am now, but I'm still I'm still identifying as six foot four. And uh in doing that, it kind of throws all of the compensatory patterns off. So that when I was over in Spain, I ended up hurting my knee. They want to do surgery there, brought me back. And it wasn't necessarily anything that I had done to injure myself. But the doctors, instead of saying, hey, let's take a conservative approach, they just cut out part of me and they just came in and did surgery and they said we couldn't find anything, but we just decided to take out your lateral retinaculum. So yeah, and I found that one out on the other side of the surgery. So, you know, I it wasn't so much having injury that brought me, it was having bad therapy or poor choices for, you know, giving better.
SPEAKER_01:And when I got to that sounds like some pretty brutal medical intervention. We didn't find anything, so we just took something out.
SPEAKER_00:Yeah, and and I think it was the 90s and a lateral release was a really big, it was a big thing back then, right? It was like a buzz, the new, the new hot thing to do. And so I think the doctor said, I think I'm gonna help you. But instead of thinking like, how can we do this in a different way? That's what they did. And then they sent me over to physical therapy, where the physical therapist said, I don't care that you are an athlete, do it the way that I tell you to do and don't ask any questions.
SPEAKER_01:So lots of compassion.
SPEAKER_00:Right. And it was always like, Well, why is this hurting? Why? Why? And so my thought was if it's happening to me, it's got to be happening to other people. And this doesn't work for me. And so it was really the door that shut on my professional athlete career opened the door for this.
SPEAKER_01:So I was like, So, what brought you to massage instead of deciding to do, let's say, for example, PT or chiropractic or you know, AT since you were doing so much with sports and things like that.
SPEAKER_00:I I wanted to get in and to be able to touch people for more than 20 minutes. And at that time, there's so much red tape in the physical therapy world that I felt like I'd be doing school forever to go and work in an in an insurance world. And I wanted to see. I wanted to see if there was some other way around it. And massage therapy at that time was starting to, this was like 27 years ago, right? So it was kind of still in the in the birth of not being so woo-woo. There was a lot of the woo-woo stuff, but it was starting to actually come into its own in the field of medical massage, quantum physics, quantum theory, a lot of medical, like osteopathic work was going on where people were starting to really jump into that. And I really loved the manual side of things, but I knew that in order to really affect change with somebody, you needed more than 15 minutes of exercise. Here you go, get passed off, and that's it. And so I decided to go for the wash out.
SPEAKER_01:It's it's one of the really hard things in our current you know medical system, both you know, both in the US and in Canada. Now I live in Canada and it's a little easier. We do have a lot of insurance building, but there's still private practice. Like I'm private practice primarily. And it protocol becomes when you're dealing with insurance, protocols become really valuable because they help the average, but they don't necessarily help the individual. And so it becomes a really tough thing. And and it's amazing the amount of massage therapists who that's their common story. I wanted more time with my clients. Um and it and it's funny too, because I mean I've speak I've I've done podcasts with PTs and sports specialists and you know, PhDs and all this stuff like this. And most of the time, they all say the same thing: time equals recovery. The more time you can spend with your client, the more likely or your patient, the more likely they are to recover. And it's such an amazing common concept.
SPEAKER_00:Yeah, absolutely. Absolutely. And and really, that's kind of that is the idea, right? It's like you can't you can't sit there and get into somebody within 15 minutes. You can't even get their nervous system to calm down in order to actually make any kind of gains anywhere, which we're finding out now, as we've spoken before, that the nervous system is kind of the key to everything. So if you don't have time to do it, how are you actually gonna do anything besides start a process, push them into exercise, and then say, we'll come back? You know, and I'm really in the ban of educating, right? Like you are. It's about if you don't have a buy-in from the person you're working with where they're not involved in their own recovery, then how is that gonna work? And I wanted something where it wasn't we were just not working on them, I was working with them. And massage, massage seemed like the best for me, the best avenue to push into it.
SPEAKER_01:So let's talk about that as well. Because you go, you know, like most people who go into massage school, um, they they may find it, they may have an goal of medical or orthopedic or therapeutic, whatever title we want to give it. Um because most of those titles are important to us within the profession, but outside of the profession, people don't care. They just say, I want a massage. And they have an image in their mind of what they think it will be, and then you give them your session, your version of treatment. And it's either completely different from what they thought it was, or it's exactly what they thought it was. Um, and it still just falls under the term massage. You know, whether you do loamy loamy or lymphatic or cupping or taping or I stem or Swedish or you know, Traeger or whatever other name you can modality you can possibly think of. Um, it still just falls into the realm of massage therapy. So massage therapy is this massive spectrum of over 350 different types of therapy, and yet you kind of knew in advance medical, orthopedic, um, that was or therapeutic, that was really your intention.
SPEAKER_00:Yeah, it was always my intention that way. I was never, I was never into the the relaxation stuff. I always wanted to make changes happen because I came from being coming from a sports background and coming from a, you know, I did when I was going to school, I was also doing personal training. I did, you know, exercise science. I was I was into all of that kind of let's see how the body moves. I'm fascinated with movement and I'm fascinated with how strong we can actually get if we understand how we're moving. And I wanted to see what we could do on the outside by working with the person and and seeing what they can do. And if I feel like the more knowledge that everyone has, the more empowered they are. When you educate them, you're empowering them, you're taking the fear away, and you're actually getting better gains that way than you are just working on someone. And that was always my I hate to say it, but when I first started, I was like, I had such a stigma about massage myself. I was like, this is just not my thing. And I fought it for the longest time until I was actually my um the place that I was working at, I was working at a tennis beach at a tennis and swim club, and I was the assistant fitness director. And the fitness director was like, you should really look into going into massage therapy. Because I was actually looking at physical therapy, going to physical therapy school, and I was like, I just there's something about it that it just doesn't ring right with me. And he says, look at me to massage. And he's like, I said, I just don't want to, I just don't want to do that. And he says, There's so much under this umbrella. You have to look. And once I got into it, it was like, oh, I could make huge changes because ultimately who go who do you go first? The first people on everybody's list is massage therapist. Everybody who gets hurt is like, oh, I pulled a muscle. You're going to get the majority of people. You are like the people to come to because that's what everyone thinks they have in the beginning, no matter what it is. You're gonna get people to come to you. So why can't you have an opportunity to make changes faster or more efficiently than a lot of other people because you aren't bound by a lot of the red tape that some of the other you know disciplines are?
SPEAKER_01:So it's one of the big pros and big cons in the massage profession, unless red tape means I can kind of do what I want, which is yeah, absolutely scary and horrible and absolutely wonderful and amazing all at the same time.
SPEAKER_00:Yes.
SPEAKER_01:Um and and so you know, earlier on you talked about how, and we'll get into this a little bit later here when we talk about your book a little bit and some of the some of the stuff, but you talked about the nervous system is really the key. Uh, and you know, you were at the AMC and you saw how the people, you know, like a lot of the educators at at the CNC and the AMC, we all speak about a similar concept about how moving away from the biomedical model of the hip bones connected to this and more to the holistic approach of the entire system and downregulating and things like that. Um, and you know, I I teach an entire class on allistotic load and things like that. And so I guess the question is, is now that you talk about the nervous system more, is your mentality because I used to be very much therapeutic, therapeutic, therapeutic, and over the past few years, I've noticed the past 10 years that I'm still very therapeutic. I'm still critically thinking, I'm still assessing, I'm still treating, reassessing. But I've also noticed that my brain space has allowed and opened up the idea of relaxing therapy as just as beneficial, especially when we're looking at like traumatic care, PTSD, things like this. And so, have you found a similar component that as you're aging in the profession, you're going, oh, the more I'm understanding, the more these things I didn't necessarily feel an affinity to in the beginning, like relaxation style massage, actually has not only a medical therapeutic benefit of the nervous system, but also if it's all the client can take today, that's all the client can take today, kind of thing like that. And I are you finding an attraction to it now?
SPEAKER_00:Oh, yeah. And I I never was not, I think it was just a difference in it, you know, because but you know, the biggest thing for me was when we were starting to talk about pain theory, right? And and all of the new pain theories came out. And it wasn't necessarily the the um the gate pain theory of like let's beat, let's beat the pain to the nervous system, but it was the neuromatrix theory of pain when that started to come out that it was really more of an emotional tie-in to the body, and that the body pain is really just a receptor, but what you're experiencing is the trauma associated with the last time you did it. And it was the emotion that's tied to it was a huge, like it just kind of blew my brain up, you know, because we I came up in that whole no pain, no gain world where it was like, how many bruises can you put on somebody? Oh, that's great. You know, I beat the tar out of you. This is awesome. You're gonna get so much better. And when you start realizing that the more that you're inflicting that, they're not gonna let you do anything to them. When I started to walk away and walk back from that more that, let's see if I can work with you, educate you, empower you, bring you into your own session and see, get your nervous system down to a point where if you're calm, the body feels safe, changes happen. And that's kind of my how I started changing my approach to it, where it was like this stuff shouldn't hurt. It should actually work with it. There's changes in levels of intensity, but the absolute pain of it all shouldn't be there.
SPEAKER_01:And so let me let me ask you about that. So let me ask you about that for a second, because when I was reading your book, um some of the approach and some of the chapters, the way it's written out, really have a older thought process, uh, like for example, the posture section, you know, things like that. And now the way you're talking about the neuromatrice of pain, which is a big concept that Ben Cormac, who was a previous guest on one of my podcasts, talks about a lot, um we we tend to move away from those theories. We tend to be moving away from the biomedical uh direct force coupling, even though it's still relevant. We see in the chronic phase, those things tend to have less importance, um, less of a role in pain management and pain manifestation. Um, so how much of your changes are making you re-evaluate what you've already put down in print, let alone you actively changing in your clinic, which changing the clinic is easy. One day you do one thing, another day you do another. You just have to convince your patients and clients that that's what they want. But, you know, getting something in print, getting it reviewed, getting it published, that that is a time-consuming process. Um, it is not an easy process. And then to have your mentality shift and change over time, and then to see, okay, this is what I did say. Do you find that there's now a conflict in what you're doing, or is it just a progression forward?
SPEAKER_00:I think it's a progression. I use both. I actually combine both when I'm doing it because I feel that you've got to give the emotional intelligence side to the client. Like there's there's there's a whole idea of where did this trauma come from and where are we working with? But you still have to understand that there's body parts involved in this. And the the body does adjust, like the body adapts to the tension that's being placed on it. And if you have the same patterns that you're doing over and over and over again because it's subconscious and this is a new way of doing things, it's only until discovery of what you're doing that things will change. So I kind of like to combine like the you don't know what you don't know, let's change that, and then that changes the body. But you still have to have an understanding of what's changing what in the body muscle, joint, bone, ligament, nerve, it's all connected. So if we understand the emotional side and put it with the physical side, then I think we have an actual way of changing the body rapidly in and in a long term, in my opinion.
SPEAKER_01:I I love that because for a long time, oh for a long time, for a while, uh Mark Chiyhoi and I speak about this quite often from two uh two RMTs in a microphone who runs the helps run the AMC and the CMC. Um, and him and I have spoken about this in detail and and quite passionately about it because a lot of pain model educators and researchers seem to throw the baby out with a bathwater. And I am absolutely guilty of this. When I first started getting into pain science, I completely had a crisis of faith and completely throw out the oh my god, this doesn't matter. It's all in the brain, it's all in the nervous system and all these kinds of things. Um and we still see that to be quite a common thing amongst pain science is that it throws the manual therapy component out, it throws the exercise therapy, it throws the physiological structures out with the, you know, throwing the baby out with the bottom water, bath water. And Mark and I talk about this all the time as in no, no, there is place for both. Um I I tend to think that there's a progression in that the acute and subacute phase, we look at the physiological, and as we move into chronic, it's less dominant and it's more the other thing. And I think a lot of people are moving into that with the neuromatrix of pain, that it's the biopsychosocial model, that it's all these other component um, you know, impacting factors. But a lot of time people get stuck in one field or the other. They feel like they can't live in both camps. It's you're either a complete biomedical person or a biopsychosocial person, not realizing that most people get better when you mix the two together component.
SPEAKER_00:Yes. I've always believed that. I believe that on everything, right? I believe that there's not one way of treatment. I believe that there's not one discipline that's better than the other. I'm a big fan of comprehensive work. That's why I have a sports rehab clinic that is multidisciplinary. And I've been that way my entire life. I've worked with, you know, osteopaths, medical doctors, physical therapy, athletic trainers. I'm in massage therapists, uh, personal training. I have every type of person in here that I've worked with, worked alongside and learned from, and they've learned from me because I don't think that one, there's no hierarchy in my world. It's like everyone brings their specialty to the table. And if we do it all the way it's supposed to be done, then the person that benefits is the person we're working with. And that's really my goal. And I think the more aware that we can get the person, I think the big thing thing for me, the big thing for my success and my growth is that the client, the one of the best things I've ever heard was when I first started, I was working on somebody and I just come back from a course. And I can't even remember what it was, but I was trying to find this technique because it was took for me, it was all about the next technique is gonna be the thing that unlocks the door for me, right? And so I was working on this person and she looked at me and she says, Hey, I'm in here. And it was mind-blowing for me. It was a very much of a shift for me because I was like, I didn't think about the person actually being human in there because I was so focused on I'm going to work with you and I'm gonna work on this body and I'm gonna change the body. But the body's attached to a human. And you, if you understand that there's a human being in there, they're going along the ride with you. You have to do it's therapy, it's combined. It's not me working on you, it's us working together. That's why I call clients clients and not patients, because patients can't do it without you, they can do it without you, they just need you to be the catalyst to help them. So it's to me, it's yeah, it's very strong, right? I like to empower people that you have this, you just didn't know you had it, and I'm just here to expose it. And if I can do that, then I can keep you because manual therapy helps to get you out. The exercise keeps you out, and that's what we if it's full circle, it's never one thing. And that's why, like when in the stuff in my book is never about technique, because whose technique am I going to teach? I could teach tens, tens of thousands of people's technique, right? But it's what about the strategy behind that? Because if somebody's coming to you in pain over and over and over again, you're missing it. Something else is going on.
SPEAKER_01:Let's let's explore that a little bit because that's really why I wanted to have you come on today. Because one of the things I liked about your book and and your approach is that again, it's not about the modality. It's about the idea of critical thinking. It's about the idea of looking at what is, you know, and going through a thought process of problem solving to come to a solution. Um, and in your book, you really talked about a multitude of those things. Um, and so one of the things I like was I I like how you break it down. I find that unique and makes it makes it for a fun story. Um I think for me, one of the my favorite things about it is when you talk about the screaming and the crying. Uh, for me, who's screaming and who's crying? So, do you do you want to talk a little bit about your book, introduce it so people, if they haven't read it, um, they know what I'm talking about when I say that?
SPEAKER_00:Sure, absolutely. Thank you. So I wrote a book called The Anatomy Assassin Academy, and it came from a class that I was teaching. Uh, I've been an instructor and a teacher for years, and I was teaching an orthopedic assessment class at a massage school. And the students weren't understanding really what it was that we were doing. They just wanted to get to, hey, what technique do I use for this? Hey, what technique do I use for this? And I kept saying, well, if you don't understand the why, throwing a technique at something isn't going to get you anywhere. You the goal is to be efficient. And I'm always a big fan of teaching to people's listening. And one thing that everybody understands in my world is food and/or shows or movies. So I wanted to make something relatable. And in in this, it's like, what's more relatable than true crime? Because if the bot person comes in and their body is hurting, let's say that they have back pain and somebody comes into you and they've got chronic back pain over and over again, it didn't, it is a mystery. And you are the detective, and your goal is to work backwards. So that back pain becomes my victim. So I created a book around victims and criminals being the anatomy detective with a skill set of an anatomy assassin who's really good and sharp at what they do, that we can take an injury and walk it backwards to find the root cause. So it's symptom versus root cause. And I've addressed it like victims and criminals. So your injury is your victim. It's a screaming thing because it's grabbing all of your attention. Is it the thing that did it? No. Is the victim always the one that takes themselves out? No, there's always a criminal somewhere else there. And it's your job to work backwards to find it. So it's fun for me because every victim, the the every detective has to now look at the body like a crime scene. So what we did is instead of having a crime scene with everything, we just took the tape and put it all the way around because the body's holistic and you don't know where it's coming from. It could be coming from the chest, it could be coming from the pelvis, the knees, the ankles, the feet, the neck. We don't know. So we need to look at all of it. And if we back up and take it in a bigger space, now we're able to see more about what's going on. Your suspects are your body parts. There's your shoulder, your elbow, your hips, your knees, they're big parts of you. And then your clues are your visual signs, how they walk, how they move, how they how they stand, what are you seeing as a therapist? And then the evidence is your physical. How do you palpate? What are you feeling when you're palpating? What's moving? What's not moving? And so when any detective looks at a crime scene, you look at who's standing there. And to me, who's who's at a crime scene is who's screaming, that's your victim. Who's crying? Those are your people who are the body parts that are under stress. What's compensating? Because we have to look at not just what is going and chasing the pain, but what could be creating something else from it? It's a it's it's a collateral damage, if you would. So it's if if is there is there pain? Is there intensity? How bad is this crime scene? If there's what is actually painful, is it truly painful? Is there something else? If there's who's silent, who's not doing their job? Is there are there body parts that are just not doing anything at all? Like is there inhibited muscles that should be working that aren't? Like if you have a back pain, are your glutes working? Are your hip flexors overworking? Are it what where is everything? So, what I did is I I kind of labeled them as people that you would see in a crime scene. And to me, it makes sense.
SPEAKER_01:Yeah. So uh in pain neuroeducation, you know, pain neuroeducation is a lot about metaphors and creating analogies that um, you know, the patients and clients associate with and create a connection with that helps them understand the idea of how pain behaves in the body so they can modulate and pay attention to the alarms and things like that. So when you talk about uh this to your clients, do you find that they latch on to these um examples more easily with this descriptive text, true crime theory and things like that?
SPEAKER_00:Yeah. Yeah. In fact, the one thing I always say is if your body, if your body is a crime scene, your victim screams, but your criminals stay silent. And every single person that I say that to says, Oh my God, that makes so much sense. Because people don't understand anatomy. They that's not their job. They don't understand the the breakdown of what it is. And if I'm talking above them, I'm not gonna get what I need from them. So I need to know like, what does this feel like? What's the intensity level? What is this? But if I put it in the world of a crime scene everybody's watched or listened to a true crime podcast, watched a movie, watched a TV show, and they all understand what it feels like. So now they're in it with me. So we're walking through the crime scene together.
SPEAKER_01:One one of the things that you talked about that um in the book that I liked, and here you you touched on it. You'd said that, you know, um, is it your hip, is it your back, you know, things like that, is it how you move? Um, and though those are all physiological manifestations of pain, yeah. Like, you know, that that's that's a structural approach, I would say. Um, but in the book, one of the things I liked that you talked about was I think it was in the clues section where it's observation and emotions and the intake process being longer and making sure that they sit there and and you listen to them for longer. And I think as my, you know, I'm 20 years in and as my practice has progressed, I think the structural approach uh after 20 years has almost become I don't want to say easy because it's not the exact, it's not the right word. Uh, but it's definitely not as difficult as um where does your pain coming from? It's becoming from the fact that you're mentally overwhelmed or emotionally overwhelmed or spiritually overwhelmed, as opposed to force overwhelmed. You know, like somebody lifts up an object and it's too heavy and it hurts. It's not that that's an easy thing, but it is a more clear thing. I see the injury, I see the catalyst, I see the trauma taking place, as opposed to I have pain is 20 years old. Sometimes it's there when I do these behaviors, it's variable, sometimes it's not, talking about neurogenic pains type stuff. Um, but it's it's there when I'm stressed, sometimes not. And and that component of what is the victim in that case, what is the screaming, what is the, you know, what is the crying victim, when you look at, oh well, maybe it's not physiological, it's manifesting as a physiological sign, but perhaps it's some other component. And I like that in the book that you you brought that up, and I wanted to highlight that because here you had mentioned the structural components, but I think it it's such a for me, it's probably the only part of the book that I think I I I love seeing more written on it because it's such a it's such a component that is being looked at more and more and still undervalued, I find.
SPEAKER_00:Yeah, I I just you know, I've done a lot of um, I've gone through a lot of leadership programs throughout my life. And one of the big things that really talk we talk about was the emotional intelligence department, right? It's like what happened to you a long time ago is still in there. And until you address it, it's not going anywhere. So even injuries that you had when you were younger, it's like your pain tolerance, right? How do you work with pain emotionally? How were you brought up to deal with pain and work around it? And that's really important. I'm a big fan of you have to speak to people's listening, you have to speak to how they understand things, you have to get them to understand it for things to change. And so when I'm working with somebody, this book is meant to be kind of the the start of the hypothesis of whatever your treatment's gonna be. And it really is like this is not I found this and this, so this is what it is. It's like I found this, what does this mean to you? So And I've actually gone through that with people where I'm like, hey, your body is telling me this doesn't work and this doesn't work. And you have internal rotation of this hip. What did you do? What have you done to have this? What? And it might not be anything that they remember in the moment, but all of a sudden now we're going through it and they're just like, oh my God, I I I ran track and field for I was a sprinter for years. Could that be it? And I was like, it could be. It's not for me to say yes or no, but let's start this. And I let them do almost like the self-discovery and exploration. And it really makes huge changes. So to me, it's like ending it a little bit.
SPEAKER_01:I I love what you just said. And for me, I want to highlight it to a lot of people who I do a lot of mentoring for massage therapists, both with AMTA and privately. And one of the most common, one of the more common questions, there are a few common questions, some around transference and counter-transference, but one of the really common questions I get is um how do you know what's wrong with them? How do you know what, you know, how do you know where the injury is coming from? Let's say if it's chronic and you weren't there to witness it. And you just said, you know, it's not us to know. It's not for us to say if that if it's that. It's very much up to the patient to evaluate, wonder, and perhaps have a light bulb moment. And they could be right, they could be wrong. That doesn't really matter. The key thing is that a lot of therapists, you know, we're not allowed diagnosing as massage therapists, and a lot of massage therapists love diagnosing. They love saying this is where it comes from and this is why it exists. And like you say in the book, and like you've said here, the body is so complex that, like, if you do have some there are millions of humans with internal hip rotation who have no pain.
SPEAKER_00:Yes.
SPEAKER_01:And then there are millions with internal hip rotation who have pain. And so it's like, far be it for me to say, oh, because you have hip pain or internal rotation, you're gonna have hip pain. And I think that's a big crux that a lot of I don't know if it's newer or I think maybe therapists who are less willing to look at the holistic approach, they find themselves hanging on to that component of I see it, therefore it is, as opposed to I see it, therefore it may be. And it's a subtle shift in nuance, but it seems to play a pretty important role. And most therapists who have been in the profession for a long time kind of fall into that category of we think, but we don't know. And it's a big change. And I like that because you talk about that in the book too. One of the other things you mentioned in the book that I think for me is so far has been my favorite part of the book, has been the nerve analogy.
SPEAKER_00:Oh, yeah.
SPEAKER_01:Do you want to talk about that? Because to me, I I thought, like when I read that, I was like, oh my god, that is so the protective tunnel. I was like, this is a really good example for people to understand myelin sheath, for them to understand the firing patterns, the backlog of information. I really enjoyed that.
SPEAKER_00:Thank you very much. Yeah, I always try to break down things to make it easy for people, and that's it's where my brain always goes. So the way that I describe the nerves in there is that if you think of your nerves like a subway station, right? And so the central nervous station is like grand central station, and people are coming in and out. It's a it's a train station, and all the people on the train, the subway, whatever you want to call it, are your nerve receptors and they have every type of people in there. And so the train comes through and it goes through a tunnel, and your tunnel is the nerve sheath. And so the goal for us is to get people on and off. And when it travels from the central nervous system down into the um your appendages or wherever they're going, hopefully it's gonna be a nice and smooth ride and that you're gonna get the passengers on and off. It's gonna be like afferent information, efferent information going back and forth. But sometimes what will happen is you'll get changes that happen into the tunnels. Like you're gonna go through a tunnel and there's going to be a little bit of buildup on the tracks. And then the train won't go as far as it wants to go, and it'll kind of get stuck. And that's where you're going to have a little bit more of your nerve, um, nerve compression or your nerve entrapment, where you're you're feeling like a tug on the nerve, and you'll have different changes into the nerve receptors going back and forth. You can go through a tunnel and have sometimes you'll have what'll happen is the rocks will come down and it'll cause a complete buildup into the tracks where you can't move at all. And that's where you have complete nerve entrapment and nothing is happening. So I the body is just changing left and right. And I just wanted to make it easy for people to understand kind of how things move back and forth when we're talking about the different stages of nerve entrapment and nerve dysfunction in the body.
SPEAKER_01:One of the other, yeah, one of the other things I like too was that when you talk about the muscles and the ligaments and the strains and the degrees, there are a lot of therapists like in school, we learn about those in our anatomy, physiology classes, but it's so quick and it's so fast, and it's not highlighted nor is it concentrated. It's just said in passing. Someone else will tell you what grade it is, move on, kind of thing like that. Um, I really liked how you broke those down because for me, it's something that not enough therapists pay attention to learning how to properly find out. Okay, how how intensely how intense is this injury? How significant is this injury? And so one of the things I one of the reasons I wanted you on the podcast, and one of the things I like about what you're doing with a book, but even just in your approach, is that you have a problem solving pathway. Now, your problem solving pathway is different from mine, but I'm imagining you're getting results with clients.
SPEAKER_00:Yes.
SPEAKER_01:Yeah. And I'm gonna have a few of the guests in the next series of critical thinking, and they're gonna have a different approach, and they're getting results with their clients. And I think that's the thing that I'm trying to express to most of the listeners is have a have an approach that is something you can follow to get to an understanding. But one of the key things that you talk about is not just understanding anatomy, that is part of it, but it's doing an assessment, treating, and then checking again. And you talked about checking in weight bearing and not weight-bearing stances and things like this. And for me, that's so valuable. So the critical thinking process, can you can you break into that and think about it a little talk about it a little bit in how we get from a client coming in to walking out feeling better and eventually to discharge? Because you talked about exercise, and one of the things I talk about in my class, I say, you know, manual therapy gives you confidence to move, exercise therapy keeps you moving, but manual therapy is not the solution, and exercise is not the solution, they work together very well. And so the critical thinking process is you come in, you have uh infinite possibilities in front of you about what's going on, and then you have to narrow it down. Um, so the narrowing it down process, yes, you've written a book on it, you use the um, you know, the anatomy assassin academy thought process of a true crime theory. But what is it that makes you want to do the critical thinking? What where's that come from for you? Is it a specific educator? Is it more because when you were an athlete, you had that happen from the medical care, the interventions you were receiving? Um, what brought that thought process in of I want to go through, as opposed to just, oh, you have IT band syndrome, this is the protocol for IT band syndrome, and out the door you go, which is still very prevalent in not only in manual therapy, but in in all medical interventions, the protocol approach.
SPEAKER_00:Yeah. So yeah, it and actually it's just happened now. So I've recently gone through and had some health issues, and I went through doctor to doctor to specialist to specialist, and they all said, Oh no, you just have tendinitis. And I said, I they can't, I can't have tendinitis in eight parts of my body all at the same time. There's something bigger. And to me, there's always a why, and I'm a big why person. And I I used to be that person who was like, aha, I'm gonna fix you. And I'm not a big fan of fix. I think fix is very egocentric. And if I think I can fix you, there's a problem. I think I always say, I can't fix you, you fix you. I'm just gonna open the door up for you to get you. So the way I take people and the way I've evolved my clinic, my clinic is is very much manual therapy, rehab movement into real-time movement into then moving for whatever the lifestyle that you patterns you have. It always has to be that way. I can't, I don't think there's one, there's not one space that's the only space to go. That's always just been my thing. So when people come in, I like to see them as a blank slate. So even if they have imaging, even if they have prior anything, my thought is I get a lot of people who have been to 10, 15, 12 people that that nobody has been able to figure out what's going on. And they're they're frustrated and they're they're upset because everyone's kind of cast them aside and said, you're fine, you're good, nothing's wrong. And yet they're still in pain. So my thought is is if they these guys are all probably pretty smart and they've all probably done the exact same thing. So what are they missing? And that's where I go after what what's missing in this? Because the body is going to give you what the body's gonna give you, right? Structurally, you know what's in there. But if you only go after one aspect, like you're only doing muscles and you're only working soft tissue. Well, you're missing bones, you're missing a structural alignment with the bones, you're missing the joints, you're missing the ligaments, and you're missing the nervous system. Because all of them are in there. No matter what body part we're working on, you've got all five things that have to be working efficiently. And if they're not, if one thing's not, it's going to be dysfunctional for all of it. So what else is missing in there? And I talk to them, I find out what their backstory is, I ask them questions throughout the entire, the entire time I'm with them because I see it as I'm just here to unlock different parts of your body and to see what is working and what isn't working efficiently. And that opens the story for it. And then you and I are working on the story together to go backwards to figure out what is happening. And and I love that part of it, right? That's that's my favorite thing in the world, is we do this together. And then from there, it's like, oh, let's do this.
SPEAKER_01:I love it because I can't I asked you that question with a very specific answer in mind and unplanned, because for those not knowing, we did not plan this conversation. Um, you gave the exact answer which I was looking for, which was I ask more questions and I listen to the story. And I think I think it's something that, you know, in most there there are pros and cons to turnover massage studios. There are pros and cons to it. There, it's it's good for um awareness of what massage therapy can do. It's good for certain versions of stress reduction, it's even good for certain stages of medical conditions. Um, but the quick five-minute intake, get on the table, lay down, exit interview super quick, out you go. Um it it's it's a very popular model of healthcare. I never I I've always actually tried to find where the 60-minute massage session came from. Yeah. And I actually haven't been able to find it. I need to ask Furby about this. He he runs uh uh archives for massage therapy. I need to ask him about if he's ever come across that because it's something that I've always wondered why did why was 60 minutes the appropriate time to say that's how long it takes for you to get better? Like, what if it only takes you five minutes to get better? What if it takes you two hours, right? But the key thing is, is during that time, it's not about five minutes laying a five-minute interview, laying on the table for 55 and out the door. It's about how many questions do I have to ask before I understand what's going on? And how many questions do I have to ask before the client understands what's going on? And how long is that story evolving and how and how frequently does it evolve session after session? And for me, that that creates the environment for critical thinking because it's not only about me as a therapist hearing the client, it's the more they go into their story and the more detailed they are in their uh vocabulary and their painful granularity, their emotional granularity, the more clear they have an understanding of, oh, these are my limits currently, but as my limits progress, I can adapt. These are my capabilities. This is what I've been avoiding out of fear, but not out of necessity because it actually doesn't cause pain. I just don't want to do it because I'm afraid it will cause pain. Yes. Um, but all that is in that critical thinking story process and those questionnaire processes.
SPEAKER_00:Yeah, absolutely. And I, when I'm teaching, because I we we're a teaching clinic over here. So we have, you know, we have San Diego State, their athletic training program. We have students in here all the time. And it's always like, work it through. It doesn't have to be right. This is not about being right. This is about understanding how the body works at every phase. So we'll do something and I'll say, okay, get up. Let's see how this works. Take it for a test spin. Get it back down. What'd you feel? Let's go here now. Take it up, take it for a test spin. What are we feeling? So every little step they're going. I'm going with them and they're going with me. And that is it's fun for me. And it's they're getting it because they're like, oh my God, this is exactly what it's supposed to feel like. And it changes, and you can feel their personality. My favorite thing in the world is seeing pain face and the beginning go to low pain face and the and the changes. I wish I could take pictures of people before and after with just the changes in their face because it's so amazing when they can feel their body changing and they're just like, I did this. And I was like, I you did it, I didn't do it.
SPEAKER_01:I don't think that would actually be a really cool art project. If you got permission, that'd be a really cool art project.
SPEAKER_00:Yeah, it would, you know, they do it with the dogs. You know, they have those dogs on social media where they're like before they're adopted, after they're adopted.
SPEAKER_01:They have they have one at the airport in Montreal where it says um one glass of wine, two glasses of wine, three glasses of wine, four glasses, and you see it. So it'd be interesting to do it with pain too. It would be amazing. But one of the things you said too was interesting is you know, you're talking about they get up and off the table quite frequently and they get into movement, which for someone who comes from a sports background, I've, you know, I've worked in sports most of my profession as well. Um, that makes sense. But I think for a lot of people who don't work in sports or in the that realm, that component becomes tricky. And so I've have found that even if they're not in the sports world, having them stay in clothing, shorts, and a comfortable top that they're willing to, even if they're under the sheets for treatment, it still gives them the space to reassess. Because then you really get to find out, oh, is that one thing I worked? Did that actually make a difference? Because when you treat 12 tissues, and then they get up and they go, I feel better, you're like, well, which one was I mean, they may it helped as a whole, and that's great. But was there one that was more efficient? Was there one that did nothing? Um, but that again that involves that reassessment component.
SPEAKER_00:Uh yeah, I love, I do it all the time. I we it that's with something that I teach in here that we all we all work with. It's like yours multiply, it's assessed and reassessed, assess, reassess all the whole entire time because you're you have to be involved with it, in my opinion. Um, the people that I work with, I want you, I want you with me. You're with me on this journey, and I'm just as excited for you on it. And it's it's interesting because I when I was teaching a long time ago, I I heard this, I read this great an analogy, I guess it was. I I don't know what it is. Anyway, it talks about there's um island A and island B. And island A is the island where everybody's in pain and they're they're upset and they're frustrated, and there's so many people on it, and everyone's unhappy because they're just they're just feeling terrible. Island B is where everyone's fit, they're happy, they're pain-free, they're moving. Island B is where everybody from island A wants to be. You are the person that takes them from island A to island B. You are not the boat that takes them to island A to island B. You are not the boat. So for you to sit there and go, look at my boat. My boat is amazing, my boat has the biggest engine, my boat has the shiniest uh window, my boat is so nice, da-da-da. They don't care about your boat. They care, can you take them from island A to island B? And if you're sitting there telling everybody about how great you are in whatever background, whatever this you have, speaking to them in languages that they don't understand, all they care about is can you take it from island A to island B? I don't care if we paddle in a little, you know, um, blow up raft. It doesn't matter to me. I want to be over there. And that's that's always stuck with me. It's like, I want to make sure that I'm taking them over here. And it really doesn't matter to me. They don't care about what I know or what I don't know. They care about what they know. So I make it about fully about them for the hour. And I think there's sometimes we tend to, in my experience with people, they've they've made it about themselves and how much they know when at the end of the day, it's what's going on with me. Uh that's all I care about. And can I feel better? And if I can get them there, they're there.
SPEAKER_01:I think that's I think that's a really great analogy. I the only part I want to fixate on that for a second is the fact that I don't think I've everybody ever ever heard anybody talk about how shiny their windows are in a boat. Um that's that's that's a unique one for me. How many of the other ones? Like how big my motor is, but how shiny my windows are then. That's a funny one. I mean welcome to California. Um well, so with that in mind, I mean that that's pretty much the I'll just give you a chance to talk a little bit about your book and about your clinic and about any of your classes coming up. Um, I'm really glad that I had you on board uh on the podcast. The critical thinking for me is so valuable and it's such such an important component of care. And I kind of had this thought process when I did a podcast with Ruth Warner last fall, and we talked about, you know, in massage therapy education, critical thinking is not taught. It's not part of our baseline education. Uh, we just don't have enough time, be it in a six-month program or a year-long program, that you know, the the schools that's not that's not what massage therapy schools are about. Different conversation, whether they should or should not be about that. That's a whole other concept. Um, but it is not part of the education. And it seems to be where most therapists who focus on pain management of some kind find success is in critical thinking. So I'm really glad you could talk to that component because that's really where I want to get people thinking about the assessment, treatment, reassessment component. So, um, do you want to tell us a little bit about any of your stuff you have going on so that if listeners are interested, they can find you on social media and stuff. And I'll be sure to put all your things in the podcast as well.
SPEAKER_00:Yeah, thank you so much. First of all, it's been fantastic. So I really appreciate you having me on because it's always nice to be able to talk about everything that I want. And I have so much that I want to talk about. Sometimes my brain just goes into like a whole nother world. Um, but yeah, I'm so I'm in San Diego here, California, and I own a clinic called a sports rehab clinic called Protocol Sports Systems. We've been around for nine years. I've been here for about 30, 27 years doing this. But um, that's what we do is we do all the critical thinking in here and we kind of move everything through. Uh, the book is the Anatomy Assassin Academy. You can find it on Amazon. And uh it really is a step-by-step connect the dot process to figuring out what's going on with people. It doesn't, it doesn't matter the technique, but it's really about the treatment strategies and understanding treatment strategies under it. If you can connect the dots, everything else becomes easy. You can use any technique that you understand. And that was really what I felt to be was the missing in everything. Um, I am on every social media platform. I am on Anatomy Assassin Academy and protocol sports systems on Instagram and Facebook and uh YouTube and you name it, I'm on it. Um TikTok, although I'm not that big on TikTok those these days. But I do small little videos where I kind of break down my goal is to take out the take the mystery out of injury. I want to make things relatable for people. And that was always my goal, is I feel like anatomy is so hard to understand for most people and it's very intimidating. And when people think find things to be too intimidating, they gloss over it. When actually it's the beauty of how we move. Like if you can understand how we move, then you're a part of your own body again. And it's a connection that you really need to be. Uh, so the Anatomy Assassin Academy is for every type of discipline. I wrote it not just for massage therapists, but for every type, for personal trainers, physical therapists, athletic trainers, medical doctors, because I think there's a missing in every discipline on how to really think objectively and truly connect the dots so that you can be efficient in your treatment and not spend so much time hoping that this technique that you're doing is the thing. And then your clients will come back to you over and over and over again because they're working with you and they see the changes that are being made. Uh I have uh AMTA in Dallas, if we're in Dallas coming up in August. I will have a booth there for Anatomy Assassin Academy and I will be there answering questions with all of my fun friends. And then uh we are gonna have an online course that's dropping in August. It's gonna be a learn as you go six-hour online course. And then in September, we're gonna be starting our um in-house courses. Right now I'm trying to get it into a bunch of different massage schools and different schools to do a masterclass for each place so that we can kind of start to introduce it into schools again. Like this is really important for us to understand. I I used it as a five, it's great. Yeah, I did a five-week course at the school I used to teach at. And they gave me stuff the cohort had no, they barely had any anatomy background. And in within five weeks, they were thinking completely differently. And it was so life-altering for them that it was really fun to see people think in a really powerful way. So yeah, that that's the goal is to try and get the Anatomy Assassin Academy in as a critical thinking type of force. And with this, we start with the back, but each book we're we're planning on having a book for each body part, and each body part becomes its own, its own case file. And so we'll do a whole mystery around it. Yeah, so it's not just one thing, it's everything that you can kind of find. Yeah. That's awesome. That's the goal.
SPEAKER_01:Oh, great. Thanks so much.
SPEAKER_00:Thank you so much. I really appreciate you having me on.