🎙 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:

• Paul’s move from massage therapist to science writer — and the unresolved questions that pushed him there
• “Modality empires” and why techniques so easily become identities
• The challenge of separating your identity from your methodology — and why it matters
• Confirmation bias in clinical practice: how we see what we expect to see and miss contradictory evidence
• Placebo, context, and why they complicate claims about mechanisms in manual therapy
• Paul’s critique of “structuralism” — the exclusive focus on alignment, posture, and movement dysfunction
• How to think about biomechanical explanations without falling into reductionist storytelling
• Why connecting dots between distant body parts (like foot problems causing back pain) can slip from plausible hypothesis into speculation
• The role of neurophysiological effects in manual therapy outcomes
• How to engage with research critically without becoming paralyzed by uncertainty
• Why practitioners may need intellectual humility more than confidence in untested theories
• The tension between skepticism as a tool and skepticism as a communication style — and what can get lost when critique outpaces curiosity
• The future of manual therapy as it integrates pain science and biopsychosocial models — and where Paul remains unconvinced

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 👉 Paul’s website with articles and books: https://www.painscience.com

🌱 Sponsor Offers: - Books of Discovery – Save 15% with code thinking at https://booksofdiscovery.com/ - ABMP – Save $24 on new membership at https://abmp.com/thinking - Advanced-Trainings – Try one month free of the A-T Subscription at https://a-t.tv/subscriptions/ with code thinking - Academy of Clinical Massage – Grab Whitney’s free Assessment Cheat Sheet at https://academyofclinicalmassage.com/cheatsheet

✨ Watch the video / connect with us: • Til Luchau – https://advanced-trainings.com | Facebook: https://facebook.com/advancedtrainings | Instagram: https://instagram.com/til.luchau • Whitney Lowe – https://academyofclinicalmassage.com | Facebook: https://facebook.com/WhitneyLowe

📧 Email us: info@thethinkingpractitioner.com

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.

🎙 5 Years of The Thinking Practitioner: Our Favorites & Top 5 Most Popular Episodes

It's been 5 years since we launched The Thinking Practitioner — with over half a million downloads and 130,000 unique listeners along the way. In this special retrospective episode, Til and Whitney look back at personal favorites that shaped their own thinking, then count down the top 5 most-listened episodes of all time.

What stands out? A clear shift from tissue-focused to nervous-system-first thinking. Ideas about consent, context, and the client experience that once felt radical now feel like common sense. And the conversations that resonated most? They're about fascia, trauma, pain, and the practitioners brave enough to challenge what we think we know.

🎧 Episodes discussed (in order of appearance):

Personal favorites: - Ep 140: Embodied Attention & Contact Improvisation (Nita Little) - Ep 23: Do Expectations Shape Results? (Mark Bishop) - Ep 80: What We Might Learn From Sex (Betty Martin) - Ep 144: Movement Optimism (Greg Lehman) - Ep 130: The Body of Grief (Jun Park) - Ep 146: Inflammation, Touch & the Grieving Body (Mary-Francis O'Connor) - Ep 135: The Neuroscience of Bodywork (Mark Olson)

Top 5 most popular of all time: 5. Ep 108: Trauma & Bodywork (Peter Levine) 4. Ep 79: Hypermobile Ehlers-Danlos, Fascia, and Pain (Tina Wang) 3. Ep 45: Fascia in Sport & Movement (Robert Schleip) 2. Ep 69: Back Pain, Stiffness & Fascia (Stuart McGill) 1. Ep 126: Fascia: A Deep Dive (Dr. Antonio Stecco)

✨ Watch the video / connect with us: - Til Luchau: https://advanced-trainings.com | https://facebook.com/advancedtrainings | https://instagram.com/til.luchau - Whitney Lowe: https://academyofclinicalmassage.com | https://facebook.com/WhitneyLowe | https://twitter.com/whitneylowe

Sponsor Offers: - Books of Discovery – Save 15% with code thinking at https://booksofdiscovery.com/ - ABMP – Save $24 on new membership at https://abmp.com/thinking - Advanced-Trainings – Try one month free of the A-T Subscription at https://a-t.tv/subscriptions/ with code thinking - Academy of Clinical Massage – Grab Whitney's free Assessment Cheat Sheet at https://academyofclinicalmassage.com/cheatsheet

📧 Email us: info@thethinkingpractitioner.com

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.

🎙 Can You Really Palpate the Psoas? MRI Evidence, Clinical Debate & a Bonus Visit from the Researcher

Can manual therapists actually palpate the psoas, or is it anatomically out of reach? In this episode, Til Luchau and Whitney Lowe unpack a new real-time MRI pilot study presented at the 7th International Fascia Research Congress by UCSF physical therapist Christopher DaPrato and colleagues. The study offers rare imaging-based insight into what really happens when we try to touch this deep, controversial muscle. And at the end, Christopher drops in for a brief bonus segment to share safety insights and his hopes for future research.

The debate around psoas palpation has become a kind of proxy war in manual therapy — between pain-science and movement educators who question highly specific anatomical claims, and hands-on practitioners who have used psoas work for decades and find it clinically meaningful. This conversation explores how DaPrato’s imaging helps reframe that debate.

In this episode, they discuss: - Why psoas palpation has become a flashpoint debate and a stand-in for deeper philosophical disagreements in the field - How DaPrato’s team used dynamic MRI to observe what happens under the hands during attempted psoas palpation - What the images showed about depth, tissue layers, and muscle deformation when pressure is applied - The surprising finding that even a higher-BMI participant showed clear psoas shape change under palpation - How viscera behaved under pressure — including what the study suggests about visceral compression and safety - Clinical implications for angle, depth, and pressure when working in the anterior hip/abdominal region - The role of tools like the PSO-RITE compared with hand palpation, and what may (or may not) be interchangeable - How this research interacts with the idea of “palpatory pareidolia” (imagining specificity that isn’t there) - What this study does — and doesn’t — say about treatment effectiveness and future research priorities - And in a bonus segment, Christopher DaPrato joins Til to talk safety, visceral sliding, and practical precautions for working this sensitive region

Whether you regularly include psoas work in your sessions, or you’re skeptical of deep abdominal palpation claims, this episode offers a nuanced, evidence-informed look at what our hands may — and may not — be doing.

✨ Resources 👉 DaPrato et al. pilot study abstract (MRI of psoas palpation): https://www.cuptherapy.com/_files/ugd/12c814_c0500f355036456eb450562461ff267c.pdf 👉 Thinking Practitioner Ep 25: https://podcasts.apple.com/us/podcast/25-psoas-work-is-it-safe-is-it-necessary/id1492004207?i=1000496358416 👉 Video version of this episode: https://www.youtube.com/@AdvancedTrainings/podcasts 👉 Episode image courtesy Christopher DaPrato @cuptherapy

Sponsor Offers: - Books of Discovery – Save 15% with code thinking at https://booksofdiscovery.com/ - ABMP – Save $24 on new membership at https://abmp.com/thinking - Advanced-Trainings – Try one month free of the A-T Subscription at https://a-t.tv/subscriptions/ with code thinking - Academy of Clinical Massage – Grab Whitney's free Assessment Cheat Sheet at https://academyofclinicalmassage.com/cheatsheet

✨ Connect with us: Til Luchau – https://advanced-trainings.com | Facebook | Instagram Whitney Lowe – https://academyofclinicalmassage.com | Facebook | Twitter

📧 Email us: info@thethinkingpractitioner.com

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.