Latest / The STA Clinician Podcast / Ep.254 'Evidence Informed Practice In Massage Therapy' with Anna Maria Mazzieri of The ST School

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Ep.254 'Evidence Informed Practice In Massage Therapy' with Anna Maria Mazzieri of The ST School · The STA Clinician Podcast

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You're listening to the Sports Therapy Association podcast, putting evidence
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back into soft tissue therapy.
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Music.
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And we're live. Hey people. Welcome to episode 254 of the Sports Therapy Association podcast.
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My name is Matt Phillips, CorelliverOneChatLive.com. And as always,
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this episode is being recorded live on the Sports Therapy Association YouTube
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channel and Facebook page on a Tuesday night at eight o'clock in the evening.
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Right then. So we're going to continue our countdown to the STA Southwest and
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Hands On Hub conference happening in Exmouth this September the 20th and 21st
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in collaboration with the ST School.
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If you can't make it then you're not going, then please don't switch off.
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This isn't just about the conference whatsoever. we're just using the conference
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as a conduit for some magnificent information and
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you'll still be able to gather loads from the last three episodes
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we've had with speakers and also just all the social media and
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stuff we're talking about so you know i don't want you all sitting there suffering
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from fomo because you can't make it but we have got the director of the st school
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in tonight so we're going to go into a little bit more detail about what the
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conference is and what some of the priorities and the goals are of it because
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it's only 10 days 10 days away now something no about 12 days away now.
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And so we're all getting very much ready for it.
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It's going to be an amazing weekend. It's a full day on Saturday,
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half day on a Sunday, full of presentations, workshops and networking.
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And like I said, in this episode, we're going to talk to the director of the
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ST school herself, Anna-Maria Matsieri,
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who's going to be discussing on this episode, what we mean by evidence-informed practice,
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which is something that was raised when we did an episode on a panel episode
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with less experienced therapists talking about some horrible experience they've
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had in Facebook groups suffering at the hands of people who probably well intentionally
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were trying to point out that what they said on their website or what they were
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saying in their post was not evidence-informed.
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And a couple of them, if not all of them, kind of said, but we weren't taught
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what evidence-informed is. So
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having that shouted from the rooftops at us doesn't really kind of help.
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What are we supposed to do? Where are we supposed to go if people are just going
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to shout that in our faces? So we're going to have a look at that tonight.
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And fortunately, it's good timing because Anne-Maria is going to be giving two
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presentations at the conference, which are very much about that.
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The first one is when pain echoes trauma and when massage echoes embodiment.
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And then the second one is massage and manual therapy for scars.
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So we're going to talk in more detail about that later on.
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But firstly, I must thank extremely my guests from last week.
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If you missed that, then it's a fantastic episode. I know I say that all the
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time. It was such a good episode.
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With Dr. Claire Minchell, founder of Get Back to Sport, and Serena Simmons,
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who I haven't had the pleasure of sitting down and talking with before.
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Founder of the Psychology School.
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In that episode, they discussed the importance and value of clinicians combining
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exercise education and psychological skills in practice, which is something
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so close to my heart and something that I'm going to be talking about at the
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conference as well with my presentation,
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Mindful Strides, How to Communicate with Runners.
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So it's something, obviously I'm biased. I love everything to do with communication,
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but it was such a great insight into how when we've got a human being in front
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of us, we need to consider everything.
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We've kind of learned about biopsychosocial a while ago now,
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but how to put that into effect is something we didn't have quite as much as we do have now.
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Wonderful episode. Dr. Clare Mitchell is going to be presenting at the conference
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on Saturday, September the 20th at 10.30am in the main theatre with strength
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and conditioning for preserving joint health.
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Then Serena Simmons is at 12.15 beyond the treatment couch, the hidden power
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of words, belief and behaviour.
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That's going to be absolutely amazing. I recommend that you make a beeline for that.
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And then at 1.40pm, I'm sorry, whoever's in the breakout room at that point,
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or it might even be me, I don't know. But yeah, I do recommend you consider that anyway.
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And then at 1.40pm, Claire and Serena are going to join forces
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together in the breakout room to deliver why rehab
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needs a joint approach apologies in advance if you look at the program at the
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st school decoder uk you're gonna there's gonna be clashes you can't learn and
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experience everything there we've got two rooms a main theater and a breakout
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room with the idea of the breakout room being a little bit more practical in
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nature although both they're going to involve a lot of the time kind of practice
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So there's going to be clashes, but you're just going to have to think,
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right, what can I do this time around and then save the rest for next time?
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But yeah, so looking forward to that.
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And then next week, just to finish off this countdown with great pleasure,
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my guest is going to be conference speaker, James Earles,
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writer, lecturer and body worker and founder of Born to Move,
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whose presentation at the conference is entitled The Knee, Why Do We Have It All Back to Front?
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Which again is a passion of mine of how anatomy we are taught in such a strange
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backward way sometimes when it comes to suddenly working with human beings and
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not with kind of 2D and anatomically perfect kind of posters.
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And James in his unique style manages to turn complex ideas into something simple
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and we can take away in practice and clinic.
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So I recommend you join me next Tuesday if you can at eight o'clock on the Sports
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Therapy Association YouTube channel or Facebook page.
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And that'll take us all the way up to the conference, like I say,
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on the 20th and 21st which i should include i mean
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you'll see advertised there is a social event
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on the saturday night before you get all excited i'm afraid that
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tickets have sold out for that those of you who have signed up
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the social event which has got buffet and live music and all sorts of stuff
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going on then you'll receive an email soon in the next few days with details
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of that but if you can't make that well you can now if you haven't booked for
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it then make sure that you you can still get tickets for the conference itself
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for the Saturday and the Sunday at thestschool.co.uk.
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So many other speakers, which I haven't mentioned already, but just a shout
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out to Michelle Lyons, Siobhan O'Donovan, Jinty Sheeran and Lou Hawkins-Thompson
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of Womankind Collective, Andy Hosgood, Dr.
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Nora Nelson, Tristan Attenborough, Gary Benson, me, and so many others.
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And apologies if I didn't put it in that list, but it just wouldn't have been
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good podcast listening.
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Right, that's it. Let's get back to tonight's show. I'm very excited to bring
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up the director of the ST Score.
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A lot of people will know Anna Maria Matsieri through Therapy Expo,
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through other conferences, and through a lot of the webinars and courses and everything.
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So it's a great pleasure to bring up Anna Maria.
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And he's a doctor then. We'll talk about that. It's not quite ready yet.
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But Anna Maria Matsieri. Let's bring her up.
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Music.
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You're listening to the Sports Therapy Association podcast, putting evidence
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back on a software tissue therapy.
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Anna-Marie Macziari nearly slipped up then. I imagine the day I could say,
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Dr. Anna-Marie Macziari.
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Tell us about that, first of all. How's that going?
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Starting off the 1st of October. I literally, when I got the confirmation,
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I spent the whole day in bed the day after because I kind of had a little bit of a meltdown.
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And my son said, but mom, you applied for it? Yes, but I never thought it would.
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Did he thought I get it? I get it.
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Oh dear. I'm so excited for you. You didn't imagine that was going to happen,
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did you? But I mean, it's a natural progression.
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No i never i people like me
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don't do phds we are not supposed to do phd we are not supposed to to be academic
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people like me been told but actually you realize that we once you use once
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you are in an environment that nurture you and you feel comfortable who you are.
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You you would be surprised what the skills
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that you you you achieve and where you find yourself
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and I think it's at the right time
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and I think it's the right thing to do for my you know
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for me from doing it for me personally more
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than you know for the professional anything I'm doing
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it for me and I think it's fantastic I'm really
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excited actually I'm sure a lot of people are going to benefit from them
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from it though because you've already been involved in papers haven't you
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and and and work with roger carey and co and so no
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it's brilliant we're all very happy to see you in it thank you
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right then so it's nice it's nice oh go on then yeah go on yeah just when you
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said before about the conference and you said oh you might have to choose people
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you know yeah to the main room of the breakout room but actually i must say that you and Andy,
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I created these four words tagline, pause, reflect,
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connect and grow, because actually part of it, the pause and reflect is,
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you know, you have to actually stop a moment,
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reflect on where your knowledge gap is, and then go and choose what.
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Topics you might want to listen to. And I do think that, you know,
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that posing and reflecting in itself,
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that is something that we are sometimes missing in our industry because we don't
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have the opportunity or maybe because we are not,
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you know, we don't have the right CPD that we value or it has been valued to do that.
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And this is, you know, a link very much to evidence-based practice because what
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is evidence-based practice is not being critical and being evaluating of one's own practice,
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one's own values, and so on. So to me, that links very well.
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To me, the fact that people have to choose between going and listen to Claire
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Mitchell or going to listen to Nora,
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for me, what they choose, that comes from a reflection and identifying a knowledge.
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And that is important. That is learning.
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That's such a good point. That's really good. And you've made me feel guilty
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now because I'm like, oh, you're just going to be running around.
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I mean, trying to find the next conference, trying to find the next speaker.
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But it's so interesting what you say.
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And it is that the tagline of the conference is to pause, which is a lovely first word to say.
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But as soon as you walk in, just take a breath and to soak it all in and don't
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make any decisions yet and reflect and connect and grow.
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It's great. and you might not decide who you're going to see until until
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you've actually witnessed one presentation or workshop and then
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you have a look and go actually this could lead on quite nicely from that so very
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cool i like that when i was writing the the latest email
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and about a little sentence for each of them
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i got quite excited because actually let's let's
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use those four words as our driver for
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those two days and for the futures after those
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two days you know it can be a mantra check that
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out my martin mantra you yeah you created a
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mantra and it's so cool as well the way you've you've
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raised the fact that pausing reflecting is
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evidence-informed learning i mean it's no surprise if you go into teaching and
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that's what students have to do in order to process information so why aren't
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we doing that at conferences why are we running around like headless chickens
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trying to go from one show to the other without chatting about it and reflecting
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so because we're not used to this is the problem even with evidence-based practice
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Sorry if I'm deviating from what you wanted.
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This is the problem also with evidence-based practice. Why it is difficult to
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introduce evidence-based practice in our profession?
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Because by default, we are being made to think that our profession is only practical.
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It's only doing hands-on. There is no digging deep.
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I always say to my potential students, I say, the course in itself is not difficult.
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What is difficult, are you going to dig deep?
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In your thinking process and that
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because every time a client comes in into our clinic we
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got to dig deep then so we need to learn
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that and i think sometimes that's why evidence-based
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practice don't come as easy for us because sometimes
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we're not used to think at that
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more reflective and
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evaluating level which i guess is
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what level five should be using your brain more
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as opposed to traditionally where level five is amazing new ways of
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using your hands and doing kind of tests it's more about yeah
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using your brain you use your hands in the same way but
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the the reasoning behind it the justification of why you do it it's a changing
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well it shouldn't be a changing mindset it should be a progression to a mindset
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that somebody already gave you a level three and four but that's that's what
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it is people expect to learn these advanced techniques as actually is the reasoning
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behind it that can make all the difference.
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That's so cool. I really hope that, I mean, the reason why, one of the reasons
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why we're doing this episode on what is evidence-informed practice for massage
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therapists is because we had that episode a while back, like I mentioned in the introduction,
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where kind of less experienced therapists were coming to Facebook groups looking
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for support, particularly people who work by themselves in clinic,
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thinking, oh yeah, I'll get some support for some people who've been in the game a bit longer.
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And there is unfortunately a trend now, and I think a lot of the time it is
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well-meaning, like we discussed, where people kind of say, no, you can't say that.
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You don't do that. Where did you learn? Did you pay money for that course?
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And a lot of the time, it's not kind of trolling. It's just people who don't
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realize what it's like, maybe have forgotten what it's like.
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But so yeah, it's wonderful to have you along. How does it make you feel when,
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could you, you've been involved in a few of those threads as well? On both sides.
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On both sides, haven't you? Sometimes I am on both sides, Mark,
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because sometimes despite me and people who knows me,
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they know how long it takes me to write a post because I can be so blunt and
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for people that don't know me, they think, oh my God, how patronised it is and
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the last thing I want to do because I want to be supportive.
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So I've been on both sides.
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I don't think that,
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In the moment in which we are on Facebook, I say that as a context,
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we need to be prepared to have to cope with some personalities and with the
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fact that words in text loses the nuance.
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It's also true that you cannot be writing an essay to create a nuance. said that.
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However, from the other side, you said it beautifully.
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People are joining the forums because they say I can be, because our profession
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is very, if you're a one-man band or even if it's not, it's quite isolating.
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So what a beautiful thing having forums, you know, people like you.
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So you go there and opening up your heart.
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I'm okay with being critical to receive,
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but then you have to offer also a
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counterbalance to say okay this is the way
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you're thinking it might be outdated because this
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is new way of thinking or this is
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what the most accepted way of
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thinking and I think sometimes that is missing I think sometimes he has become
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much more attractive on both sides to actually go and pick those forums to pick
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for people that they might write a message that is not quite up-to-date.
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But actually, I know from, you know, different forums, that sometimes people might ask it,
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you know, you might have the most up-to-date therapist, but sometimes the way
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they ask a question might have been a little bit different and we should not
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be there lurking to just, you know.
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And ultimately, why are we doing it? Do we want to support our colleagues or
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do we want to knock them down?
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You know, we can never change people's minds, but I'm hoping that when I write a message,
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if hopefully I use the right words, the person might not change their mind,
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but they might have something else to think and more ideas come out of it.
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You know, there is not the right or wrong.
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And I'm a little bit worried that we are losing that support.
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You know, why are we doing it?
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Do we want people to become better therapists or do we want just to knock people down?
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Yeah. Said that, said that, and I always have the answer.
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Be strong, learn how to debate because that's, you know, I might sound very
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confident on social media, but people do in such a long time.
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Just be able to justify, even if you're making a mistake and say,
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actually, sorry. I thought that was, thank you very much.
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Justify your position and learn to debate.
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Absolutely learn to debate. And that, I think, would benefit everybody,
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will increase everybody's confidence.
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Great, great point. And in all honesty, as well as having a bit more,
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well, I mean, it's so difficult, but yeah, courses from the very beginning should
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be talking about evidence-informed and that sort of stuff, shouldn't they?
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And they're not, which is for another conversation, traditional courses.
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But there should also be, I imagine, modules on how to survive on social media
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these days and how to debate and how to kind of, you know,
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logical fallacies and all these things you know it should be there from the
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beginning shouldn't it to me when we're talking
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about evidence-based practice there is this
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great confusion out there thinking they think that evidence-based practices
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practicing what the meta-analysis tells you it's more complex than that i i
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i will say to everybody to go and look some socket the original socket paper,
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about evidence-based practice.
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It is a beautiful interplay between, you need to take into consideration, yes, the evidence.
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But in order for you, with your therapist expertise, not even experience,
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you don't have to be experienced, you have to have expertise in order to cater for the client's needs.
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It's about having the client's there, listening to the clients,
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to the needs, to the values, to the social, you know, psychosocial well-being.
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And then for that particular case, what does the evidence tell in us?
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And then we need to, our expertise is to match the two so that we can provide
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a treatment or an approach that is evidence-based,
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but also, you know, don't go and look, oh, is massage, you know,
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Is there evidence for massage benefiting, I don't know, you know, in plantar fasciitis?
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No, let's look, what does plantar fasciopathy, how does plantar fasciopathy behave?
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How do people with plantar fasciopathies, what do we know about plantar fasciopathies,
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treatment and so on? Then let's have a look out of that.
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What are my skill set that I can provide? Because I argue with a hands-on.
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Because we know, even with things like tendinopathies, there have been quite
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good studies coming out that they find that the risk factors often are much
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more psychosocial than, you know, psychosocial than biomechanical.
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So being in a room with somebody that is in your team in terms of supporting
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you with a hands-on, that in itself is evidence-based.
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You know obviously then you know you have to provide
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the right exercise you have to if you
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do not do exercise you have to send post them to the right people
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and so on but i argue that there is you know there is evidence it doesn't have
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to you have to have to look for oh is that evidence for massaging or changing
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plant of a shop or things like that because that's not what we should be looking
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for we should be looking at how do we help the person with plant of a shop,
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That's very cool. I like that.
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How do we help the person? That goes for everything, doesn't it?
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How do we help the person with? How do we help the person with?
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It should be the person who comes first in the sentence.
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Very nice. Was this in your mind when you kind of decided to put this conference together?
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Is this to do things slightly differently and have the power and a way to address
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these things and help other people know about it?
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A couple of things. I mean, everybody knows that I've been toying with the idea
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of having a conference in Exmouth for a long time because at Southwest,
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we never get anything. And I'm just very proud of Exmouth.
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I had the experience of other conferences. I had the hands-on at Therapy Expo,
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which we've been very, very happy with. However.
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What we always found that was missing was the meaningfulness of making a conference
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meaningful not only for content,
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making it meaningful for the particular therapist, for their values.
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Because how many times we go to conferences and we literally just go from one
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to another to another, that we get bamboozled by good content and we go home, that is gone.
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And so the idea has been there for a while. And I know that,
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you know, we talked much and so on.
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But then it all came because, again, Gary Benson is always in the middle of
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everything, Mr. Benson.
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Absolutely in the middle of everything. You know, one day he called and he said,
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would you like to do the southwest part of our conference?
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Because he already planned to do different ones. And I said,
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you know what, that was a sign from Lincoln, was a sign that,
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you know, I already wanted to do that.
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So, and I collaborate very, very well with Gary and we get on very well in terms of ethers.
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And we align quite well because we both, you know, all our teams have the same drive.
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So that's what we wanted, but something really meaningful for the therapists.
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So everything that is delivered there is literally things that you can use in
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clinical practice because we find both within training or conferences,
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does it really help the people that they're catering to?
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Or is it just somebody wanting to showcase their own skill set at the conference?
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Or is it, you know, what do our audience, our massage therapist,
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our soft tissue therapist,
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those other manual therapists that use hands-on a little bit more,
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what might they benefit from?
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And how would they look like in the practice?
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Very cool. Yeah. And that's exactly what we've lined up at this conference. So very exciting.
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Yeah, we're putting the experience, aren't we, back into learning.
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We're putting the play back into it.
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All these things we talk about, it's so weird, isn't it? We talk about all these
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things, the importance of play, to learn, of experience, of reflection.
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And then, bam, comes a conference for learning. And we go along. We sit down there.
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And the stage then, we just listen and maybe write some notes down.
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We go to the next one. We go to the next one. And then we go home.
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And it's funny how it's... And this one is different.
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Because it's going to be... Sorry, Marta, stop you. I'm quite excited.
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You've been a big driver of that. So, you know, let's give you the credit.
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You've been a big driver of that.
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So even the environment, we're not going to have theater. How do you call it?
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Theater style? We're going to have tables.
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Yeah, yeah, yeah. Yeah, because then people have to network or people have to
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feel they're part of something and go together with something somewhere.
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We we know you know people sometimes says
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to me says oh now how do you get yourself onto those you
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know things i've got my hands because i network and i ask and i challenge and
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i ask questions then you see them again somewhere else and somewhere you build
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then a group of people so Or, you know,
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I was talking, I have to prepare something,
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you know, I can email plenty of people in the industry and say,
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well, how can I do that? Or how would you do that?
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People are there to support, you see, but you have to, you know, network.
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And I don't know what you think of it, Matt, because I know that you like online and I like it as well,
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But I have seen this just lack of easiness in being in person again.
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How many of us feels now overwhelmed to be in an environment like that?
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You know, it's, we need, and again, I said it into one of the latest emails
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I sent out, you know us, that we will never jeopardize or compromise on in-person courses.
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We still do the online. In fact, now we change, we do a lot of hybrid because it works.
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But in-person just gives you the something as a practitioner.
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There is a reason we became practitioners.
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Let's not make that you might need for human connection die down definitely strong words.
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It's actually it's probably that's a good segue it's probably worth mentioning
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that for those people have joined us and are listening and they want to learn
25:13
about what is evidence-based practice in massage therapy and what social media
25:16
doesn't tell you then guess what there's a course there's a webinar on the SD
25:22
school website, which is called, I quote,
25:25
evidence-based practice and massage therapy, what social media doesn't tell you.
25:28
And that's been around for a long time, isn't it? It must be frustrating when
25:31
you see so many, I know I get frustrated.
25:33
You see so many therapists struggling with what is evidence-based practice.
25:38
And then you've had a webinar for, I don't know how many years,
25:41
telling people what evidence-based practice is and evolving with it,
25:44
but it's just so difficult to reach people, isn't it? It's a problem we've got now.
25:48
Great information about how do you reach people but how how's
25:51
that course going what do you find some of the takeaways and
25:54
some of the surprises that people have when they join it i love
25:57
i love the course and all of our webinars we have quite a lot of enrollments
26:03
one of the things that i would love to see more it's in person i know in person
26:09
sorry joining live many people likes to listen to it which i appreciate it,
26:17
But it takes away sometimes the interaction that can happen.
26:21
So from that perspective, I prefer people coming more, you know, on screen.
26:26
That's why we don't just put them up and sell them. We could just put them up
26:29
and just sell them like that. I just don't want that. I want the interaction.
26:34
Because when they come in with questions, Matt, and this is the beautiful things,
26:39
and it happened with pain as well, I am seeing that difference.
26:43
I am seeing that now when I start asking people about evidence-based practice,
26:50
they might not have the right words, but they're starting understanding more
26:54
and more about the need for it and not pushing back as much.
27:00
What I find that consistently, absolutely consistently, people come out with
27:06
and they say, oh my God, I didn't realize that actually it is about these three dimensions.
27:14
And the way I teach, I teach it very much as,
27:18
because there are many different interpretations, there have been,
27:22
but I very much follow one particular, kind of call it the school of thoughts and so on,
27:31
that keeps on to the saket, original saket and gayat definitions where you have
27:38
this interplay between evidence,
27:41
client's need and therapist or patient's needs and values.
27:44
And therapist experience because Eric Mayra a few years ago,
27:48
he made a, I think it was his one actually, he made a funnel and he put the
27:53
funnel, everything needs to be funneled through the evidence.
27:56
And to me, I do not like that because he gives the evidence.
28:02
There is a hierarchy between evidence and client preferences or expertise,
28:10
especially, and this is going to assign such a nepotism so forgive me for that
28:15
but my son is going to deliver a session and i kid you know even if he wasn't
28:20
my son i would have had him to deliver this session okay because what,
28:25
anthropology you know looking at looking at evidence-based from an anthrop effective
28:32
efficacy sorry from an anthropological perspective all of a sudden we're starting realizing that,
28:39
There are different, there is what he calls a medical pluralism, there are different.
28:45
Approaches to a different perspective to it.
28:52
So we have to be very, very careful when we talk about evidence-based practice
28:56
and we define it and we understand it as it should be understood and not making it as reductionist as.
29:05
But it's important that when we practice it, we practice it well,
29:09
that we are not going to scour mice study to support an argument,
29:16
because that's not what evidence,
29:19
that's not what research is, that's not what science is.
29:22
So that, for me, is quite important.
29:27
Definitely. It is. Cecily has actually summed it up nicely.
29:31
Cecily Hirslopper says in the comments, thanks, Cecily, for the comment,
29:34
joining webinars live totally takes me out of my comfort zone,
29:38
but it's so much better than experience.
29:39
And I usually get to make a total crap out of myself. I can't believe that,
29:42
Cecily, by talking far too much.
29:44
But I think the key words in there are take you out of your comfort zone.
29:47
I mean, we learn a lot when we're taken out of our comfort zone.
29:51
You know, it's like either place you're spending time. You might know a little
29:53
village called Numana in Italy, a very beautiful place.
29:56
And I didn't go over there learning Italian, only a few words.
30:00
But when you're actually going into a bar or you've got kids running around
30:03
and you need to get something done and suddenly you're speaking it because you're
30:05
outside your comfort zone and the communication happens and you learn it and
30:09
your brain registers it and even that even on holiday made me think wow it's
30:12
so true we just sitting there and watching a stage and the words go flowing
30:16
into one ear and out the other you don't learn a thing you need to be tested
30:19
you need to be put on the spot a little bit,
30:22
caused to reflect maybe a little bit of pressure but not too much just enough
30:25
to actually question yourself and go to a place you wouldn't normally go to
30:28
in predictive processing matt that's how we explain learning.
30:33
In predictive processing, if you always match the prediction,
30:37
your body and your brain is nice.
30:40
Actually, when the prediction is not matched and there is a prediction error.
30:45
My dear, the prediction error that is where the new learning takes place.
30:51
So, again, talking about the, there is a lovely sentence on top of the CPD booklet
30:58
for the conference, Feynman, where he says that we can only learn,
31:06
when we see a gap in our knowledge.
31:10
A gap in our knowledge can only happen if we are questioning from a question,
31:16
you know, something like that.
31:17
And that's true, you know, until we are uncomfortable with something, we won't learn.
31:23
It's a great boy. So basically, if you come to conference, get ready to feel uncomfortable.
31:26
Very uncomfortable. We've got horrible chairs for you. Dig deep. Dig deep.
31:31
No, but that's part of a job of an educator, isn't it? A modern educator of
31:35
knowing how to, I mean, there's parallels there when you're talking to a client,
31:41
especially if your client or patient, you know, is going to have to make some
31:43
behavior or lifestyle changes.
31:45
In order for that to happen and to find their motivation, they might not want to do it straight away.
31:49
You've got to cleverly through active listening and
31:52
that challenge them a little bit you know give the right reflections to
31:55
make them dig a little bit deeper to peel off a layer so
31:58
we do it with our clients we should be doing with our clients so we should be
32:01
doing it to ourselves as well if we want to learn and get better it's a great
32:05
point cecily i bet you didn't realize you're going to generate so much interesting
32:09
talk from that it's great to be taken out of your comfort zone not all the time
32:13
but a lot of the time so thanks for that cecily right talking of look at the time already.
32:18
We could talk about this for ages, but no surprise when we get together and
32:21
talk, it could go on forever, which I love.
32:24
Let's look at in a bit of detail the presentations that you are going to give.
32:29
Because again, I think there are areas where there can be some debate of is
32:32
it evidence-informed and is it evidence-based and that sort of stuff.
32:35
So let's have a little look at them. I'm going to bring them up here now.
32:40
So the first one that you're delivering at the conference is going to be on the Saturday,
32:44
September the 20th in the main theatre at 3.10 if
32:47
people are writing these things down it's on the screen if this is the podcast
32:50
then we do obviously do it live it's on youtube and you've got like all sorts
32:54
of visuals if you're that sort of person so go along to youtube to have a look
32:57
but the first talk is yeah when it's called when pain echoes trauma and when
33:01
massage echoes embodiment how could you turn that into mickey mouse language
33:06
so that mere mortals like me could understand what it's going to be about,
33:10
Stison comes from the last
33:13
now three years has happened to be three years work with Laura Case et al from
33:19
Neuromatters in America that
33:22
we have created this massive piece of work a review of the evidence around.
33:31
It's part of a project of mechanistic research for massage and manual therapy
33:37
and we looked at the evidence for a more somatic or body-wise effects of trauma.
33:48
And so after this long time, like doing this paper, which should be hopefully
33:55
coming out soon, if there are no need to do any more revisions on it.
34:01
Is, you know, the things that I discovered were quite shocking and I didn't know.
34:07
So I didn't know, for example, that chronic pain. So when pain equals trauma,
34:12
actually people with trauma,
34:15
nearly three times more likely to suffer with chronic pain in the future.
34:24
Not only with chronic pain, but also with other diseases like metabolic diseases,
34:30
like type 2 diabetes, or even with obesity and so on.
34:36
So from that perspective, we're going to be looking at the link.
34:43
So what is evidence telling us about the link?
34:46
Is there evidence? And how good is the evidence? How can we rely on that?
34:53
Because actually, the evidence is a bit different what we have here, that in normal stress.
34:59
So there are some markers there that makes it a little bit different working
35:04
with people with historic trauma.
35:06
And then, and this is where, this is a proposition, and this is the future work
35:14
that I'm on, is we know that pain, the trauma.
35:21
Affects the coherent sense of self.
35:25
You probably hear it as embodiment. So the awareness that you belong within
35:32
your body, that your body is yours, that you feel connected within you.
35:39
And if so we know that trauma disrupts
35:43
that but we also know that somatosensory
35:47
integration helps bringing you back I gave an example actually this weekend
35:54
to my students if I touch you if you get touched by somebody else's how do you
36:02
know that you get touched that it confirms that you get in touch,
36:06
it confirms that you are you because you feel the touch, but you also feel that
36:13
the hand touching you is not yours.
36:16
So it is evidence because if you have a good sense of embodiment,
36:21
it is evidence that you are within your body and the person touching you is different.
36:29
How many times you had a client coming to you and they say, oh, feel my arms is not mine.
36:34
Obviously, you would have been a good clinician and checked any neurological
36:38
or neuropathic, but sometimes with chronic pain, they say, oh,
36:41
I just feel that, you know, the arm doesn't belong to me or the leg doesn't belong to me.
36:46
That happens in chronic pain, and that is the disruption between what they feel
36:53
from outside with what they feel from their interoceptive signaling.
36:58
That mismatch the inability to give the right meaning to those sensations create this sense of.
37:08
Disembow, il lacco cohere, what I would call il lacco cohere in self.
37:13
So we know that that can be improved through somatosensory integration.
37:21
So to bringing in so many more senses during our work, and that's in a nutshell,
37:30
you don't have to come and listen to me.
37:33
No, because I get it now. Now, I mean, so basically, and this will be like music
37:38
to the ears of a lot of people whose profession is making people feel good.
37:42
There's now more research to show what's actually happening with whether you're
37:46
using cupping or dry needling or massage or anything.
37:50
We're beginning to actually now potentially have mechanisms of action.
37:54
And, you know, it's the old cliche, but so true. If we know how something works,
37:59
we can make it work better.
38:00
So that's where this research is potentially taking us, which is so exciting.
38:05
Yeah. If we know how something works, not only we can make it work better,
38:08
we can change our approach.
38:12
And then because of that, our client would change their approach to their own
38:17
pain and injury and so on.
38:19
So one of the things that I'm going to be talking on that is that we need to
38:23
be very, very careful about what they call trauma-informed practice.
38:28
And, you know, I see a lot of courses out there, you know, trauma-informed massage.
38:32
Or trauma-infoil massage or you know courses that teaches you certain type of
38:36
techniques because you know some part of the body releases some trauma there
38:41
is a lot you know i will be discussing that because we need to be very very
38:47
very careful we're dealing with that sounds great,
38:50
yeah yeah no sounds sounds obviously especially useful
38:54
if if your clients do involve people who have been
38:57
through those sort of experiences but also if not because you're
39:00
just getting into the nitty-gritty of what's happening when you're
39:03
touching somebody and and the kind of you wouldn't
39:06
believe how many people i didn't realize that actually for
39:10
a child financial instability in the
39:13
household that is trauma a child
39:16
no you know certain things that we would not even think that might be trauma
39:22
then that actually can be traumatic and we don't even know So it's not to us
39:28
to diagnose or to even say that's trauma, certainly not,
39:35
but for us to be absolutely aware of it.
39:39
Wow. Okay. Right. We're going to do a whole episode of that.
39:41
My brain's just started now firing and I've got loads of things to ask you,
39:44
but no, not now because I mean, that's what the content of that's going to be.
39:48
And that's, I mean, that's a great example of how that's people going to walk
39:51
away with that and need time to reflect and kind of consider,
39:53
probably look inwards as well.
39:55
Cause I mean, there's going to be loads of people who have suffered things like
39:57
that themselves and it's, and that's always healthy, isn't it?
40:00
Not, you know, for therapists to look inwards and look at themselves and,
40:03
and then that helps you help someone else.
40:05
Cause if you don't understand yourself and you don't give time to yourself and
40:07
how are you going help others.
40:08
Anyway, I'm going to sweep that forward and move on to the next one,
40:12
which is still a look, a wonderful look at the evidence behind certain things we do.
40:16
And the next one with Anna Maria at the conference is going to be on the Sunday
40:20
in a breakout room. And that's nine o'clock.
40:22
Do you reckon I'm going to be there at nine o'clock? Well, I'm not going to
40:26
say the conversation we had, but yeah, that's what it is.
40:29
And that's called Massage and Manual Therapy for Scars, an evidence-based approach.
40:33
I'm really interested this because I was one of the people from probably 10
40:39
years ago who were very much including in all sorts of presentations about massage
40:47
and manual therapy doesn't break down scars.
40:51
A surgeon's use a scalpel for scar tissue. So this is often kind of used in
40:56
the old argument of you've got to be more evidence informed.
40:58
So I'm always very excited when I come across people who are talking about massage
41:02
and maniotherapy for scars, especially when they follow it with an evidence-based approach.
41:06
So give us a little look into what this is going to involve.
41:09
Yeah, you just actually said it.
41:11
First of all, working with scars does not mean that we break down scars or that
41:17
we want to break down scars.
41:19
What it means, we know that scars can have...
41:26
Effect, they become hyper, if they don't heal well, so if a wound doesn't heal
41:33
well, scars can become hypertrophic,
41:37
they become hypersensitized, and actually they become restrictive in movement,
41:42
especially where they are after certain type of surgeries.
41:47
So we can
41:50
intervene and help the person
41:54
with the scar so we know that
41:57
how the body we know about wound
42:00
healing or we think we know about wound healing there
42:03
are certain things we cannot interrupt it but we
42:06
can definitely make it worse the way we
42:09
we add load when we add load can
42:13
we affect it with our hands we cannot
42:16
but we can affect how something feels so
42:20
that then the movement that
42:23
somebody then gets because they feel better that will help
42:26
and also I'm going to be using cupping I'm going to be using
42:29
silicone sheathing talking about different strategies
42:33
to work with scars I'm
42:36
going to be focusing a little bit more for what we see much more often
42:39
which is joint replacement scars especially
42:43
knees hips and mastectomies and we're going to have bodies coming in so unfortunately
42:48
the people with the scars that are coming in they're going to be very the scars
42:54
are quite old but it does not make a difference because what you're doing it's
42:58
about changing the way the person,
43:00
we'll see it we'll see it, but it's about supporting the person where the scar is healing.
43:06
Certainly not breaking down scars one of the things I'm going to be talking
43:11
about as well, I'm going to be talking about what we know, some really nice
43:17
research around fascia,
43:19
because there are some really nice research coming out from the fascia world.
43:26
Does that mean that that research will, do I make my clinical reasoning out of that research?
43:34
No, because it's not clinically relevant but
43:38
is that knowing about that research is
43:42
important for me because what is now preliminary
43:45
it might form the basis in the future so it's important even if I know to know
43:51
about you know the research in mice for example because although I cannot make
43:56
a clinical a clinical reasoning out of that research because it's not valid
44:00
for clinical reasoning but it's still important for us to know what's happening.
44:05
Excellent. Very interesting. And we're going to, I mean, it seems to come to
44:09
us, but we're going to do a fascia special on the podcast sometime after the
44:13
conference to talk about how the research is changing.
44:17
Because again, my passion now is looking at how we are getting explanations
44:21
for things which have been traditionally poo-pooed.
44:25
We've been through that era of denying everything and saying that's rubbish, rubbish.
44:28
And now it's so interesting that things, I mean,
44:31
this presentation you're talking about is now giving a
44:34
different perspective for cupping you know so this
44:37
is so empowering for therapists because it's you can
44:40
do what you do and on saying you have to stop that's not evidence-informed practice
44:44
is it's just having a little think about what's happening and why you're doing
44:47
it and what's happening to the individual with you and that sort of stuff and
44:50
and this is going to be a good example of that very exciting really good and
44:54
as it's in the breakout room then that's obviously going to be more practical
44:58
in nature is the idea the breakout room that people watching will be able to
45:02
get involved with some of these,
45:04
so we're gonna have couches i mean some sessions are practical and they're gonna
45:09
be couches you can be hands-on or some of them there is some yoga breathing
45:15
yoga so much more you know i think,
45:19
using rehab equipment and the same for clan minchel core but that breakout room
45:25
is those sessions where they're going to be mainly practical aspects.
45:31
Where people actually get involved, interactive. That's the right word.
45:35
Wonderful. Very exciting.
45:38
Right. Where are we? 10 minutes. Oh, that looks like it is a word,
45:41
dogs. It does, doesn't it? It's a great photo. It's a great photo.
45:47
So I wanted to check. Oh, there's something. So the Saturday and the Sunday,
45:51
all day Saturday, half day Sunday, which I think is a great touch because it
45:54
means people can actually get home.
45:56
It's taking the stress out of things as well, which is nice, isn't it?
46:00
And also, I believe there's something happening on the Friday night,
46:03
especially for people who are local.
46:05
For everybody who wants to attend, if there is a space, especially for the local people.
46:10
And first of all, we managed to put the diaries together and we have several kind of jump sessions,
46:18
the free afternoon between 3 and 5.36, where people can join a massage for lower legs.
46:28
One session is massage for lower legs. Another session is getting up,
46:33
you know, how to help clients, how to teach clients how to get up from the couch.
46:38
It's all led by tutors or led by very, very experienced therapists.
46:44
And there are going to be some other massage sessions. We're going to release it this week.
46:48
But what I'm very, very pleased about that we managed to pull it together is
46:53
that because the times now fit, James Earls will be running,
47:02
he runs usually in London, what is called the Anatomy Cafe, that we're going
47:07
to be running the Aperitivo Cafe.
47:09
So it's going to be open to 20 people.
47:13
It's a little bit of a ticketed event, but it's quite, you know,
47:17
it's very economical because we're going to go to a local Italian store there.
47:21
They're going to give us a glass of wine with a lot of affettato,
47:26
like parma ham and all things, while James discusses something about anatomy.
47:33
We did it once. It was me, I don't know, Sarah is not here, but it was me,
47:37
Sarah, and James, and we were at the clinic, and James was talking about the
47:42
food. So he took the food model.
47:45
We went to the Italian store full of people, you know, and having a coffee.
47:51
And us three there talking about the food. And James is planning to ask the anatomy.
47:56
And it was really good. And so we thought, let's do it there.
47:59
So it's going to be between 6.30, like an hour.
48:03
And then we all go and sleep. Sounds amazing.
48:07
It's fantastic. Because the way James is just such an elegant,
48:13
elegant speaker, but he's very original in his thinking of anatomy.
48:18
Because he's a therapist, he thinks anatomy like we think it.
48:24
Definitely hashtag be more like james definitely and
48:27
and it is and by no coincidence uh
48:30
we will be speaking to james earls himself uh next week
48:33
on the show so we'll talk a little bit about that as well be more like
48:36
james great right we're
48:41
sadly we are running out of time so just
48:44
to remind people tickets are still available for this conference if
48:47
you want to go along but it is happening in 12
48:50
days time but if you are especially if
48:53
you are local because that's the idea we're going to be doing more of
48:56
these around the country this is the little baby which is kind of starting all
48:59
off and putting this new way of kind of experiencing and
49:02
pausing reflecting connecting and growing that kind
49:05
of educational conference we're trying to put that together but um if you are
49:08
around the experts region in devon or can get there then go to the sd school.co.uk
49:12
and you can check tickets on there and join us but if you can't then don't worry
49:18
there'll be more and we'll be coming to you soon on the Hansel Hub Roadshow on a lorry,
49:25
fantastic oh I love that.
49:28
Hansel Hub an SGA roadshow I love that we can do that just need to get Noah
49:33
Levens out of retirement Annabelle is in Exmouth,
49:37
Annabelle Soravit is in Exmouth Exmouth Devin oh
49:40
fantastic yeah yeah yeah is that a comment in there sorry I didn't see that
49:43
yeah yeah let's bring that down thank you everyone who's joined us live um apologies
49:47
if i didn't get to some of your comments brian huxley is here and saying hello
49:50
you're late brian just send the reason as normal on an email to matt the sda.co.uk
49:55
and just with a doctor's note whatever it is,
49:58
and then annabelle as well annabelle soravito good to see you here uh where
50:01
is the where is the conference um yes at exmouth devon yeah on the beautiful
50:06
jurassic coast just south of exeter,
50:09
Yes, lucky place. My hometown. That was from my hometown.
50:13
Anna Maria's hometown. Not where she was baptized, because I've seen the church
50:16
and touched the door and kissed the ground of where Anna Maria was baptized.
50:20
In Italy, the place near Numana. I took a picture there. Yeah,
50:24
but that's another story for another show.
50:27
Right. Thank you, everybody who's listened to the show.
50:30
I hope this hasn't been boring. If you know you can't make it.
50:33
I mean, there's so much we talked about today, which hopefully is relevant to
50:36
listeners. And so, yeah, if you can't make it, then hopefully we've still given
50:39
you some information to ponder on and reflect on.
50:42
If you do want to join a live recording and ask questions to the guests,
50:46
then as you can see on the banner below, all you've got to do is come to the
50:49
Sports Therapy YouTube channel or Facebook, if you prefer, on a Tuesday at 8 o'clock.
50:53
And like I say, we'll be here next Tuesday at 8 o'clock with James Earls of Born to Move.
50:57
And if you do enjoy the show, then do please subscribe to our YouTube channel.
51:03
And even if you don't like YouTube much, it just really helps with the algorithms
51:06
and for the good information from people like Anna Marie Matsieri to just appear
51:09
more and for people to find out about her evidence informed for massage therapists
51:14
rather than feeling alone and not knowing where to go for the information.
51:18
So yeah, subscribe to YouTube channel and leave a rating or review on the podcast
51:21
app, particularly Apple Podcasts. That would be wonderful.
51:24
But for now, I think that's all my housekeeping done. I just want to say thank
51:28
you once again to Anna Marie Matsieri. Thank you for joining us. Thank you.
51:32
So interesting. I mean, I knew what you were talking about. And now I'm just
51:34
so excited about those two presentations. I'm not lying either.
51:37
Well, it would be very interesting if people that are coming,
51:40
or even people that are not coming, but maybe they send emails on what question
51:45
they would like to ask about, so that somebody can actually ask those questions
51:49
to the speakers on the day.
51:51
Oh dear, here we are. I mean, because there might be people that might not be
51:53
able to come, but let's, you know, talk especially the STA members.
51:57
So, you know, ask some of the questions that you might have been always interested.
52:01
And we'll collate them and we'll get some of the team to collate them and then
52:05
we can ask those questions for you because that will all stand itself and then
52:10
you can write it down there is another CPD activity,
52:14
that we'll do that that's a great idea that was great yeah we've got time yeah
52:18
it's good to introduce new ideas 11 days before the conference starts great we'll do that,
52:24
I know just the personal sort of view right that's
52:27
it everyone thank you so much for joining us and if you are free next Tuesday
52:30
to join us live in person on screen then that'd be lovely as well if you can't
52:33
you're working then no pressure but if you can rearrange a few things that'd
52:37
be lovely to kind of join you and hear your experiences and thoughts and ask
52:40
questions to James in direct until then take care of yourselves and take care of each other.
52:47
Music.