Nervous System-Informed Assessment & Bodywork for Active Clients

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Nervous System-Informed Assessment & Bodywork for Active Clients Webinar Transcription

Hey everyone, welcome in, thank you so much for being here today.
Would love to know where you're tuning in from by using the chat.
I'm going to go ahead and kick things off for us.
Hello everyone and welcome to the Massage Magazine Insurance Plus webinar series in session.
We might also recognize us as Massage Magazine or MIP for short.
I'm Shannon, excited to be your co-host today.
If you're new to MIP, we're an all-inclusive liability insurance provider for massage therapists,
bodywork professionals, Ricky practitioners, and more across the United States.
Our mission is to support you with quality coverage that gives you peace of mind and
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We also offer a wide range of exclusive member benefits, including discounts on industry products,
up to 50 free CE courses with Neil Asher, other amazing continuing education opportunities
in a wide range of valuable resources tailored with the massage and bodywork community in mind.
To learn more, I'll be dropping our website link in the chat for easy finding.
This is some quick housekeeping tips.
A reminder that today's webinar will run for one hour and it is being recorded.
The recording will be emailed to everyone this week.
Today's webinar is also eligible for CEU credit through our CE provider, Neil Asher.
Instructions for earning this EU will be shared in the chat toward the end of the session and
included in the post-webinar follow-up email along with the full recording.
We encourage you to ask questions, so feel free to use the chat or the Q&A feature and
we'll be monitoring both the route and we'll also be reserving the last 10 minutes for
a Q&A session.
With that said, let's dive in.
The topic for today's webinar is near nervous system informed assessment and bodywork for
active clients.
Please join me in welcoming our host, Josh Williams, a visionary and nervous system
informed bodywork and founder of the touch code method.
With a BS in exercise science, a doctoral candidacy in occupational therapy at Hawaii Pacific University
and over two decades as a licensed massage therapist in Oregon and Hawaii, Josh is also
a certified health and wellness coach.
His expertise spans exercise, physiology, cardiac rehab, luxury resort spas, and his
concierge bodywork studio in Bend, Oregon.
Josh's innovative touch code method blends biomechanics, manual therapy, and nervous system
science for humans and horses.
A lifelong student of movement and meditation, he combines evidence-based skill with creative
story-driven approaches to transformation.
We're excited to have and share his innovative approach with us today.
Welcome, Josh, and thank you so much for tuning in to MIPS in session webinar series.
Great.
Thank you so much, Anand.
Hi, everybody.
I'm so excited to be with you all.
Massage therapists are just the best and I mean that authentically I've been doing this for
24 years.
I've met some of the most incredible people.
Such a diverse range.
The work you do is so important.
The world we live in today, it's so divided, people are so disconnected, and I really believe
that we offer the antidote through the connection we provide people, the incredible services
you provide.
I know it's a hard job, thank you for the work you do.
And thanks for tuning in today, I mean I'm sure there's a lot of other things you could
be doing today, but you came here to work on your career, to work on your skills and
to share knowledge with me and with Shannon and everybody involved here.
So thanks for showing up and thanks for being here and I hope this is helpful for you.
I'm going to share my slides here.
All right, so welcome to my webinar on nervous system informed assessment and bodywork for
active clients.
So I'm sure you're all thinking, all right assessments, the glamorous and adrenaline-fueled
world of range of motion assessments and documentation.
I know we all became massage therapists for spreadsheets and data, right?
But this really is not about data for data's sake.
It's not about better assessments or fancier techniques.
What I'm hoping to share with you today is kind of a new perspective.
It's more about creativity and connection and meaning making for you and your clients.
And hopefully something that can shift your practice, help you get paid more, and most
importantly, help your clients get better results.
So if I could just share a little bit, many of us came into massage therapy as part of
a deeper calling.
I know for me, I was really young when I started and I just thought it was magical to be able
to work with people's bodies and to help them realize their potential, be a part of
the healing arts world.
It was just a way to combine my love of all those things.
And you know, passion, purpose, healing, human connection, and these are powerful things that
we get to interface with in a way that a lot of wellness and healthcare providers don't.
I mean, we spend 60, 90 minutes directly with our people.
You know, however, unfortunately, the reality is a lot of times we end up having to settle
in our careers.
You know, we might not work with the people we really want to work with.
We might not be making the money we hope for.
And many of us are flirting with exhaustion, injury, and burnout.
I can only say that because I've been there.
The thing is, when we try to be everything to everybody, sessions get routine.
The markets pushing us to compete on price and it can get harder to stand out.
You know, I just call that it's like a race to the bottom.
But the good news is we don't have to run that race.
And I want to share with you guys today this and some ideas about nervous system and foreign
body work and assessments to just help offer a new path, a new creative outlet for your
art and your work.
And if you don't mind, before I get into, you know, some of the nuts and bolts here, if
we could just go a little deeper for a second because, you know, this isn't really about
business or it's not really about assessments at a core, at the very core, this is one of
the most transformative forces we can offer as healers, and that's hope.
As Desmond Tutu says, Nobel Peace Prize recipient, hope is being able to see that there is light
despite all the darkness.
And look, hope isn't fluffy, it's actually evidence based.
Strong therapeutic alliance predicts outcomes as much as the techniques we use.
We're going to share a resource pack with you that's got links to different journal articles
and whatnot.
And several of them talk about this thing called therapeutic alliance.
And so I want to repeat that because I think it's kind of crazy, like strong therapeutic
alliance predicts outcomes as much as the techniques we use.
So we'll be talking a lot about that later, but what this really means is that our presence,
our regulation, our intention, it gives clients something that maybe they haven't
felt in years, I can look at it like a mirror and a map, it's a mirror to see themselves
with clarity and self-awareness and a map that helps them believe in where they're headed
and that's hope.
You know, early in my career and still the day, I suffer from imposter syndrome, even getting
ready for this webinar was like, what am I doing here, what do I have to share with all
these amazing people tuning in from all over the country.
When I first got out of massage school, I waited six months to go interview for a job because
I was so nervous to work on the lead massage therapist or the spa director.
And I definitely just figured assessments and things like that were out of my scope.
And sometimes when you do some research or reading, it'll straight up say that, you know, it's
like you should only use donia meters as things that measure joint angles by, you know, licensed
medical professionals and often they don't include massage therapists in there.
So we're going to talk a lot about scope and how you can actually use these tools in
creative and meaningful ways while staying in scope.
You know, and for me, what I thought was a good way to get out of imposter syndrome was just
to keep working on my education, my training, my technique, because I had just figured the
right knowledge and great technique was what was needed to, you know, be good at my job.
And I didn't realize that in all that work I was doing that I was missing the key that
kind of unlocked it all.
So you know, I recently went back to school and then grad school is a doctoral candidate
in occupational therapy.
And I got exposed to these evidence-based assessment models, you know, and for occupational therapists
it's totally in scope and it was a great window into that world.
And also the art and science and behavior change in health and wellness coaching.
That's when the light bulb started going off for massage therapy.
You know, I kind of, I learned the power of what occupational therapy calls the therapeutic
use of self and that assessments don't have to be just diagnostic tools.
All the scope conversations are like you can't diagnose, right, when in doubt, refer out.
So who says we have to use assessments to diagnose?
We can get creative.
We can use them as ways to build rapport and therapeutic alliance.
And that's exactly what builds client self-efficacy and it leads to holistic, sustainable, and
positive client outcomes.
So when I saw his limitation, my imposter syndrome, you know, our limited scope within the medical
model, staying in scope by not diagnosing is what gives us freedom because we're not tied
to giving our clients labels.
We can use assessments more creatively as tools for meaning making and connection.
Ultimately, it's about evoking belief and hope in our clients about themselves and their
ability to reach their goals.
This process of meaning making turns our clients problems, hopes, and goals into the elements
of a powerful story.
And through our therapeutic alliance, we can guide them to be the hero of that story.
So when this happens, they not only get amazing results, they'll become your biggest advocates
and it's a great way to build a wait list only practice without advertising.
So by the end of our time together today, you'll know how to run some simple intakes using
validated tools to build trust and give you numbers you can track without stepping outside
of scope.
We'll talk more about how you can turn those results into a story your clients can see themselves
in and how to apply the principles of nervous system informed touch to help clients feel
safe and get results at last.
And finally, how do you can adopt this method any niche you choose without reinventing the
wheel every time?
Runners, pickleball players, weekend warriors, whoever excites you most.
I wanted to focus on active clients today, because it's a title of the webinar.
And B, it's who I tend to work with in my practice and work with a lot of runners, lately
I've been collaborating with pickleball players, it's one of the most popular sports in America,
it's a great niche.
But this isn't just about adding more techniques, it's about transformation for your clients
and differentiation for you in the marketplace.
It's about moving out of that race to the bottom pricing game and stepping into your own
special niche where you get to define the value and write the story.
It's about keeping you inspired, creative, and free from burnout.
I don't want this to be another boring webinar you grind through to get your CEO and never
think of it again.
So I'm going to start off by sharing you with you five philosophy of success principles.
It's kind of like teaching you to fish rather than giving you a fish.
So I want you to make this work your own.
This is steel like an artist, if you've ever heard that title, it's a book I read once and
I thought it was genius.
There really aren't any totally original ideas in the world, we're all just borrowing
ideas and combining them in unique ways.
So take everything you get today and make it your own.
And this is probably a good time to start taking some notes if you haven't already.
So the first philosophy of success is about learning.
So if you've ever heard this stat before, you'll only remember 20% of what I say today by tomorrow.
And that's if you're really paying attention.
So how many of us are driving in a car or have a couple other windows open or just going
on our phone on the side?
So 20% is not a lot.
So here's some tricks to make it stick.
As Bruce Lee famously said, absorb what is useful, discard what is not, but most importantly,
add your own truth.
So these little tricks help you add your own truth.
All right, so the first thing you do, grab a piece of paper, draw a line right down the
middle.
So you got a top half and a bottom half.
On the bottom half is where you make notes and on the top half is where you take notes.
And what I mean by that is on the top half, take notes, you know, write down key words
that you think are interesting.
Maybe some ideas I share with you, you don't want to forget.
On the bottom half is where you make your own notes.
Maybe you have an idea, maybe you have a thought about a client of yours or somebody you want
to connect with or something unrelated that just like a creative idea that comes out.
You can draw pictures if that helps you learn.
So on the top half, you take notes and on the bottom half, you make notes and that idea
comes from learning and memory expert, Jim Quick.
So let's just start together right now.
Let's start making some notes together.
On the bottom half of the paper, you write down three questions.
The first one is what question mark?
So what is this about in your own words?
Not necessarily what I'm saying.
You had to, if I was hanging out with you having coffee tomorrow, I was like, what were
we talking about yesterday?
How would you describe it?
Two is so what question mark?
Like, why does this matter?
And more importantly, why does it matter to you specifically?
And three is now what?
How can you use this tomorrow?
Like literally tomorrow, maybe later this afternoon if you're seeing clients.
So now we're not just taking notes from making notes, which makes us training something
you can take and make your own and I can't wait to see what you do with it.
So another key principle, philosophy success number two, and my kids were laughing at me,
I had to get Gandalf and Yoda into my slides somehow, is to move from this idea from a
technician to a trusted guide.
One of the most important shifts in my career was realizing I was not the hero in the practice
room.
My client was.
For years, I just, I thought the secret was technique, you know, and that was me just kind
of covering up my insecurities and trying to get out of that imposter syndrome I was talking
about earlier.
More training, more modalities, more technical stuff.
And I would see other therapists who had less training took things, honestly, kind of
more casually, and they're having more success or getting more repeat bookings or didn't have
to advertise as much.
And I always wonder why, what's going on?
I believe they were framing their work differently.
They knew something I was missing.
And it's more about the relationship with the client than about the technique they're
applying.
Then regarding business, I was reading a book by Donald Miller called Story Brand.
And he put a simply, the businesses that thrive, make the customer, the hero, and themselves
the guide.
And that kind of flipped everything for me.
So think Obi-Wan, not Luke, Gandalf, not Frodo.
When I stepped back into the guide role, not only could I relax more, but my clients began
believing themselves more, and that's results got better, stickier, more fun.
Okay, now the third philosophy of success is the power of context.
So look, skill matters.
We wouldn't all be here today if we didn't care about skill, learning, and furthering
our career growing as massage therapists.
It matters.
But context is what really changes everything.
And I don't know if any of you have heard of this incredible experiment that The Washington
Post did with Joshua Bell long time ago.
Joshua Bell is one of the world's greatest classical violinists.
He's world renowned, plays at the like, fanciest concert auditoriums across the world.
He's exceptional.
And they thought, well, what would happen if Joshua Bell just went to a New York City
subway and played?
Now he took his three and a half million dollar Strata various.
That violin he's playing is priceless, really.
It could not be replaced.
And he showed up the subway, he positioned himself for the acoustics were amazing, and
he played compositions that were known for their death and complexity.
And hardly anybody stopped a thousand and ninety seven people passed by him.
Guess how many stopped?
I can't hear you, but I'm curious, like, what do you think?
I mean, I would have thought maybe at least a hundred.
The answer was seven, seven people out of a thousand and ninety seven actually stopped.
Twenty seven dropped off some money, and he made a grand total of thirty two dollars
and seventeen cents.
But that's skewed because that included a twenty dollar bill from somebody that recognized
him.
So anyway, the same music, the same extraordinary skill, I mean, this guy's at the mountaintop
of skill, completely ignored in the subway, in the concert hall in the same city, let's
take its average for over a hundred dollars a seat.
So the difference is just context.
So what I'm getting at here is that assessments and framing, give your work, that concert hall
effect, the elevate massage from just another session to a guided transformation, your clients
understand value, feel like they are an active participant in, and will invest real
money toward.
And here's the thing, context doesn't just change perception, this isn't just an idea,
it actually changes physiology.
And what I'm talking about here, and there are many studies linked in your toolkit, you'll
get in your email, some of them by Ellen Langer.
And she did a lot of research on the placebo and the no-cibo effect.
And one of these research studies showed how hotel mates actually lost weight, you
know, real pounds of weight lost and improved other health markers, just when they were
told their daily chores, counted as exercise.
Nothing else change, it's just the frame and the context.
So in this same way, when you frame assessments as a story of progress, clients don't just
see you differently, their body physiologically responds differently.
Context fuels belief, belief seeds hope, and hope fuels outcomes.
Okay, so the next philosophy of success is nitching down and pricing up.
When your work looks the same as everyone else's, the only thing left to compete on
is price.
In business terms, that's called the commoditization trap.
It hurts my soul when I see therapists advertising locally for like $50 or $60, you know, for
the first session, like, it's just, it's not good, it's a race to the bottom.
So instead, think about a blue ocean.
Now a red ocean, this is kind of dark, so I apologize, but a red ocean symbolizes a competitive
hungry market where sharks are all fighting over the same food.
It's stressful, it's exhausting, but in a blue ocean, you're not competing at all.
You've created your own category in your own blue ocean.
Now the most successful companies all do this.
And as massage therapists, we can do it with a lot of integrity.
You know, we actually have it easier than like an apple or a Nike.
Those companies, they have to trick us, you know, like basically thinking the shoes are
going to make us jump higher or that the type of computer we use is going to make us
more creative or successful.
However, that what we provide as massage therapists, we are really providing tangible transformation
for people.
We really deliver transformation in every session.
We just have to name it and claim it.
So assessments are a tool that make this practical.
You tailor your intake to your favorite niche.
Maybe it's runners, maybe it's pickleball players, maybe it's something else.
We'll do a little exercise in a little bit so you can find your niche.
And then suddenly, you'll be the go-to expert for that niche.
It gives you referral power, pricing power, and the ability to get above that $60 race
to the bottom.
Alright, final, last but definitely not least, principal of success today is a trauma-informed
perspective.
This is a really crucial point.
Good assessment is trauma-informed.
This means we invite curiosity instead of judgment.
Training differences as patterns, not flaws.
Look for what's strong, not what's wrong.
Remember Joshua Bell in the subway, context matters.
And one of my favorite quotes relating to this is from the great author and therapist,
Gabor Maté, who said, safety is not the absence of threat, it's the presence of connection.
And wow, what do we offer clients, but connection, right?
And actually, here we got one more philosophy of success.
Nervous system informed touch.
You know, I'm sure we all had that light bulb moment, studying massage and working in
the industry where it's just like, wow, everything is about the nervous system.
At the end of the day, our central nervous system, our brain, our emotions, our thoughts,
our feelings, our perceptions, the way we use our body, everything is between the central
nervous system and the peripheral nervous system.
You take that out and there's like really like we don't exist, right?
So where this really came home to me in a more practical tangible way was in my work with
horses.
I do a lot of equine-assisted body work and I love it.
It was really like a game changer for me in my career, it helped me get more creative
and see things differently.
And the thing is, horses don't talk, they don't use words, they do talk, but they don't use
words like we do.
And I had to refine my ability to listen and develop what I call listening hands.
And then I learned this fact that over 80% of our peripheral nerves is somatosensory, meaning
they travel from the body to the brain, body to brain, 80%.
So think about that for a second.
Your job is working with people's bodies, 80% of their nerves are traveling right back
to their brain.
So there's all these interesting sensory inputs that you can explore in our manual therapy and
you can look for assessments and this is stuff you can train yourself to do over time.
This doesn't happen overnight.
Things like proprioception, introception, motor control, awareness, and I think perhaps
most important, your own grounded presence.
I call this in my work with horses, neuroceptive presence.
It's like the technical nerdy name, but the fun simple name is present hands.
You start with present hands and then you move to listening hands and that's when you get
the foundation of real change and that's a lot of what I'm talking about when I talk about
a nervous system of form touch.
So hopefully it's kind of helps you see the way of thinking behind some of this, pulling
back the curtain a little bit.
Assessment is not about diagnosing.
It's about direction, rapport, and story.
Carl Rogers was the guy who kind of created this theoretical framework called humanistic theory,
the thought of like holistic treatment kind of come out came out of that.
It's a really cool model, amazing framework.
It's really popular in coaching too.
And he had this quote called, the good life is a process, not a state of being.
It's a direction, not a destination.
That makes me think of my other favorite saying that the joy is in the journey.
I don't know who you said that so I can't attribute it, but it's all about direction
rather than like getting there, right?
So with that frame, let's look at what direction you'd like to go in your practice before we
explore the actual assessments and some of the nervous system and form methods you can
implement.
So it was definitely a good time to get out your paper and let's talk about what direction
maybe would inspire you in terms of your niche.
And here's a little blueprint and we'll send you these slides if you don't have a good
spot to do this right now.
But if you are, follow along with us and let's do this together.
So this is a simple blueprint for creating your own blue ocean, a space where you're not
competing on price, but you're standing out for the transformation you want to be known
for.
And it's actually pretty simple.
You identify your niche, the population you're passionate about.
You get really clear on their problems, the challenges of their body that hold them
back.
And then you get really clear on what they want to see happen, what are the outcomes?
What's better look like to them?
And then you pair and find some scope appropriate assessments that help measure those outcomes
and then you take them on a healing journey where they're the hero and you're the guide.
All right.
So here's the exercise, you know, on the left of the slide, you see those three circles,
the Venn diagram.
On the top, I want you to think about what do you know well and what, I'm sorry, on the
top, what are you really excited about?
What are you passionate about?
Like what lights you up, in other words?
And you know, I might say live music lights me up, but let's keep this bodywork centric.
Keep this in your career as massage therapists.
Like what lights you up?
I really enjoy working with athletes, there's just something about people that are interested
in exploring their potential that I think is fascinating and I'm passionate about working
with those people.
I think they're very engaged, they're very active participants in their sessions where
I live in central Oregon.
We have a really robust ultra endurance running community, but fascinating people running
is like a spiritual experience for these folks and I love helping them on their journey.
So what are you passionate about?
What lights you up?
What's interesting to you?
What kind of people do you want to be hanging out with?
So now we're going to move down to the right.
What are you really good at?
You know, what do you know well?
Are you maybe you have a yoga background and you're really good at passive assisted stretching?
Maybe you have a background in structural integration and you really are good at technical
deep work to help create balance in the structure.
Maybe you really like more gentle treatments like cranial circle therapy and that's where
you shine.
You know, what are you passionate about?
Don't think about money, don't think about clients, don't think about marketing, just in
a perfect world, if you could do whatever you want, what would you do in your body
or career?
What are you passionate about?
Okay.
Now, the third Venn diagram is what are people want?
Like what are they, what will people pay for?
Where's demand?
You know, for me, all to runners, I mean, that's a hungry crowd.
Like they work very hard at their craft.
A lot of them have pretty serious day jobs and they invest a lot of their time and money
in going to races.
They travel around the world and do these things and their health of their body is paramount
to them.
So think about that.
Like where's demand?
You know, cyclists is another great one, pickleball players.
A lot of pickleball players, not all, but a lot tend to be a little older, like over 50.
What happens when you get over 50?
Injuries start to happen more.
They don't want to spend, you know, they work their whole life.
They've got themselves set up well.
They want to go have fun.
They don't want to be dealing with injuries.
So they're hungry for sessions.
So think about those three things and hopefully you've got a couple now that overlap.
We'll see a little space in the center.
Those are probably good spots that might be a sweet spot that might be your niche.
So chew on that.
Think about it.
You don't have to have a perfect today.
Even just sketching this out a little bit and it kind of plants a seed.
When you name your niche, you can see where your messaging gets clearer going back through
the five steps.
Once you get really clear on who it is, if we're talking about ultra runners, I'm going
to know that chronic injuries and injury prevention is going to be all their problems are going
to relate to that.
If I'm talking about pickleball players, we've got this interesting upper body and lower
body combination.
A lot of them are going to be dealing with shoulder problems, external rotation.
There could be a lot of ankle and knee issues.
So you really get to know that niche and then you get really good at defining their problems.
Similar with outcomes.
So you want you to find the population and get really clear on the problems and the solutions.
And then your service gets more referable.
Your work starts standing out in the marketplace.
So without any further ado, let's get into some of these practical scope appropriate assessments.
You know, in the exciting world of assessments, there's basically two camps we can borrow from.
There's forms the client fills out.
You can have them fill it out in advance or as part of an intake session.
And we call those self report tools.
And then the other are physical tests that you can perform in your clients where you measure
things.
So I'm going to give you a few examples here today and I'll be in the resource pack that
we email you to.
These are things you can Google and research on your own.
Google scholars, great for finding evidence based things.
Everything I'm giving you today is validated, meaning it's evidence based.
Let's pass that gold standard check and, you know, in the high levels of our science world.
And in the physical checks are the same.
And I think that's important to keep you rooted in credibility.
And just remember the big take home for saying in scope, this is not diagnostic.
We're not diagnosing things.
We're not telling them when they're better.
We're not telling.
We're not clearing them for activity.
You know, these kind of things were we're helping them create meaning and story around
their therapeutic journey.
It helps them with self awareness and it helps you with therapeutic rapport.
Okay.
So on that note, I just want to hammer this home and you're going to I know I'm repeating
this a bit, but it's just so dang important, I got to keep going back to it.
Okay.
What really makes assessments effective, it's not the form, the scale or the score.
I'm going to give you some good ones here that are good to start with, but there are
like dozens and dozens of these things out there that are validated.
The core, no matter what you use, no matter what you do is this thing called therapeutic
alliance.
Again, an occupational therapy, we call it the therapeutic use of self, it's the same
idea.
It's the idea that who you are in the room matters just as much about what you do with
your hands.
That concept was deeply influential by Carl Rogers humanistic psychology and he emphasizes
things like empathy, unconditional positive regard and authenticity.
I just want to double click on that word unconditional positive regard.
I mean, that is such a cool thing, you know, it's like it's basically a way of saying non
judgmental awareness, it's something that Buddhists say.
And when clients feel accepted without judgment, they don't feel like they just have problems
to fix their people with stories that are going somewhere.
You see the difference, one is like looking forward, the other is looking backward.
That's where we get to shine this massage therapist.
We don't have to diagnose and just talk about all the problems and we get to help them get
to where they want to go.
Empathy and reflection, it's about listening deeply, mirroring the words back.
This just helps people feel seen and understood.
We all need that.
That's extremely therapeutic.
We offer autonomy and choice.
This one of my favorite words is evoke.
We don't prescribe, it's out of our scope, right?
We can evoke clients own their goals, it's their goals and that ownership is what will
create their follow through.
The more we can evoke their ownership and their hope for the outcome they want, the more likely
they will to follow through and the better results they're going to get.
Last but not least is the strength based framing.
Don't just point out flaws.
I've certainly fallen into that before, oh wow, your hamstring over here is so tight.
It's so easy to do or so programmed to focus on flaws.
Think about patterns and possibilities.
That's where hope lives.
You look for what's strong, not what's wrong.
The last thing is assessments are not interrogations, they're invitations.
Data builds charts, but rapport builds change.
When you leave with alliance, every tool you use becomes more effective.
Here's just a few examples of some actual validated assessments that you can use.
This first one, and these are the simplest way to start.
These are the self-report tools.
These are real short.
One of them is a little longer.
They're not about diagnosing.
It's about listening, creating that buy-in, and it gives a wave to help them find your
clients, find their own words for what they're trying to get at.
This one, you literally ask your client to name two or three meaningful activities.
Might be run a mile without knee pain.
Might be to get my swing back and pickleball without shoulder pain and my right external
rotation, if they've been to PT and know that kind of language.
This is powerful because you're measuring their goals and their words.
This is how we get to that story-driven care, and then you can reflect it back to them.
Playing pickleball without shoulder pain is your mountain to summit.
Let's track that together.
You start the journey that way.
Another one here is called the NPRS, and again, all these PDFs will be in that packet
too.
This is a classic 0-10 pain skill.
Take seconds.
Everybody understands it.
This is really good for before and after sessions to anchor change.
Think of that context, Joshua Bell experiment, where we want them to focus on things so
that they believe and evoke in their own healing journey more.
Just remember, when you're talking about this, pain isn't the whole story.
It's just a signal.
Another one is called the Global Rating of Change or GROC.
This one, you can start people off with a simple one lighter.
Compared to before, how's your condition now?
This is one of those that has a negative 7 to positive 7 scale.
The magic of how these things work, I'll never fully understand, just know that a lot of
great minds have put a lot of work into these, and they look really simple, almost even like
a little too simple sometimes, but these really work.
They're very effective, and not every assessment has to be quite the simple either.
If you want to get a little deeper, if you're into mindfulness and self-awareness type
stuff, there's some really interesting assessments to go into that too.
This one is called the MAIA2, the Multidimensional Assessment of Introceptive Awareness.
What a mouthful.
This is a validated research back questionnaire that measures how people perceive signals
from their own body.
Things like noticing breath, sensing muscle tension, or trusting their gut feelings.
This is a longer form.
This is something you might want to give people before a session, unless you have just
integrated a long intake into your session, but I just wanted you to see where some of
these go.
Then you can do them before, after mid-session series, it's a great way for trying to develop
packages to help chart progress.
Now we're going to move on to some of the quick physical checks inside massage scope.
These are quick, non-diagnostic screens, and really you can add these in just a couple
of minutes.
First one is range of motion.
I love goni meters.
This is one of those things I thought was out of scope, and sometimes when you look stuff
up, it'll basically say it is out of scope, but it's always in the frame of if you're
using this to tell them that they have a condition or that they do not have a condition
based on the measurements.
Just be very upfront with clients.
I find they really appreciate it when just say, hey, I'm not a doctor.
I'm not a physical therapist.
I'm not here to give you a prescription or a diagnosis, but I do like to keep track of
some of these things because it helps shows progress, session to session.
It helps us focus on maybe something that we can work on to help you reach your goals,
something like that.
Goni meters are a lot of fun.
I learned some of this in grad school.
For a massage therapist, you pull out your anatomy and kinesiology books, grab a meter.
They're cheap and easy to find.
You can get a friend and start just testing it out a little bit.
You'll want to practice this one a bit in advance, and rather than try to test every muscle and
joint in the body you don't need to, find just a couple of key ones in the hip extension,
hip av deduction, glute max, glute medius.
Find external rotation is a great one for the shoulder.
Honestly, if you just start with those three, that's a great starting point.
I've included some links to pretty amazing trainings and YouTube that will get you started off
on this.
It's a lot of fun, it's interactive, and as Zig Ziegler says, you don't have to be great
to begin, but you have to begin to get great.
The one here is called manual muscle testing.
This is a very old school, very evidence-based, works great.
Again, preface with that saying, okay, I'm not a doctor, I'm not here to prescribe, or to
tell you what's wrong with you.
We're actually just trying to help you reach your goals here, and these are some ways that
we can find how your patterns are showing up.
Think of it as giving the muscle a general challenge and seeing how it responds.
Again, I gave you a link to some trainings on this.
It's, again, it's pretty easy.
Pick three motions to start with.
Don't get caught up in all the little micro muscles of the forearm.
Just start with the prime movers and go from there.
It's amazing.
What this really does, like with assessment and interceptive awareness, it helps people
just focus on their bodies.
We're a massage therapist, we're always thinking about bodies.
A lot of people out there in the world, they're never thinking about their bodies, so this
helps them focus on their body.
It's more about that than the actual measurement for our scope.
Another one is balance and proprioception.
I'll often just leave it at this, a single leg stance.
A lot you can tell from there, hip stabilizers, glute medias, glute maximus, all that stuff.
People are complaining about knee pain.
This is a really good one, watch other knee moves.
It's just like a glimpse and proprioception and we're not grading them.
Again, when diagnostic procedures, there's grades, proprioception, it's very precise.
Don't worry about that.
That's outside of our scope.
Remember, we have this freedom to be more creative and use our assessments for
meeting, making, storytelling.
Just look for their strategies they're using, are they gripping their toes, are they hiking
a hip, are they holding their breath, are they sway and catch themselves?
See how long they can do, you might measure in seconds and try again after each session.
The thing here is these self-report tools and just a couple of quick physical screens.
You got to compact intake and outtake set.
You can start using pretty quickly.
They're simple, they're scope appropriate and most importantly, they're client-centered.
And they hope you create this narrative, this story of hope, progress and possibility.
Assessments are not about gatekeeping or diagnosis, it's a story, buy-in, and direction like Carl
Rogers is saying, what direction are we going?
Looking forward.
Okay, and we're getting close here to wrapping up, but I want to share a little bit about
this concept of nervous system and foreign body work, okay?
Now, here's a fact that just kind of blows my mind.
We talked about this a little bit earlier, 80% of the fibers in your peripheral nerves
are sensory, not motor, somatosensory system.
In other words, your body is mostly listening, not talking.
So really mastery and body work is not about fancier techniques, it's about listening to
what the tissue under your hands is saying, moment to moment.
My work with horses, that's what we call listening hands.
And it really comes down to safety.
For the body to change, the nervous system has to feel safe.
Back to Gabormati, safety is not the absence of threat, it's the presence of connection.
Again, this isn't soft skills type stuff, it's not fluffy.
Research across PT and rehab shows a strong therapeutic alliance predicts better pain and
function outcome than actual treatment.
Clients don't just respond to what you do, they respond to whether they feel safe, seen,
and supported.
And a great, quick way to kind of check your clients is to think about it from a poly bagel
perspective.
This comes from the work of Dr. Steven Porges.
I got links to all this stuff in your resource guide.
So if any, if one of these subjects, something you want to nerd out on, you can go diet
deeper on that.
This is a big subject, I'm just going to divide it into three parts for now.
There's a ventral bagel, sympathetic, and dorsal.
Basically, are they calm and connected?
Are they on the muscle or they just go, go, go?
Are they kind of shut down, frozen and tired?
We're not diagnosing, we just want to recognize where they are so that we can signal appropriate
safety.
All right, and this is not about lecturing clients on neuroscience, it's just the way
to frame how you meet people, okay?
And then practically speaking, in terms of our techniques, there's a thing called
affective touch, got a bunch of journal articles for you on this.
Really interesting stuff.
General slow techniques, they activate nerve fibers that are wired for comfort and bonding.
Remember, you have to feel safe before you can get any real work done.
So the other one is breath and presence.
Breathing cues paired with steady contact is amazingly powerful.
A lot of, it's a great way to start sessions, I'm sure a lot of you are already doing this.
This is kind of some of the how and why beneath the techniques.
So a way you can do this, real practically speaking, is you can gently put your hands on
somebody's back, ask them to take some big breaths.
You have a gentle touch, you might even do a little rocking.
That combination stimulates the affective touch and the parasympathetic nervous system through
the breathing and presence and that helps people get really calm, quiet and connected.
And then you can get more work done in your session.
So as we wrap up here, it's about safety and technique, presence, breath and touch, simple
cues, and differentiating yourself with nervous system and form pressure, alright?
The final thing I want to touch on is how you adapt this to any sport or client population.
The main thing is anchoring in three universals.
What do your people want to do?
Remember the niche exercise?
What do they want to do?
What's in their way and how can you measure it?
Just keep it simple and build rapport.
That's how you get started.
Don't take forever.
Don't feel like you need to go get a bunch of certifications to start playing around with some
of this stuff.
You can use it and stay in scope.
The key with range of motion and muscle testing is to simply find the activities that are
important to their sport.
We touched on this earlier.
Excuse me, you don't need every test.
Just one or two motions or muscles tied to their goals makes you work memorable.
So a simple way to do this is just start with what they talk about, okay?
And here's some quick examples.
Range of motion for runners, hip extension, glute medius, pickleball and tennis.
Think about shoulder external rotation, manual muscle test, super spinatus or scapular stabilizers.
Just start with what they talk about, give some little tests.
This is the mistakes you want to avoid.
You got to be really reliable with your bony landmarks when you're working with gonia meters.
And don't get all in the weeds with your manual muscle testing.
Don't worry about the grating and all that stuff, that's for diagnostics.
You're just noticing are they able to hold or does their body start to drift when you're
doing the test?
And always refer out when you're not sure.
So in conclusion, we've covered some scope appropriate assessments.
We've looked beyond numbers and how it's really about rapport and therapeutic alliance.
We've talked about how nervous system informed touch helps changes get lasting.
And how this is a flexible framework, you don't have to reinvent the wheel every time.
You can actually use the same test but meeting people where they are at for their goals.
And just a reminder, they are going to email you.
All these resources, I included some motivational interviewing which is how to talk to people and
framing strength based lenses and that kind of stuff.
And if you'd like to reach out to me, my contact is here.
I'll include these slides in the pack too.
And I'm launching a sub stack in October and I'd love for you to come join me there.
Be fun to have a little party started over on sub stack.
It's a nice alternative from the other social media.
So I just want to say thank you for showing up today.
Congratulations on getting to your personal and professional growth.
Remember this is not about diagnostics, it's about direction, story and safety.
You don't need more techniques.
You just need deeper rapport and a way to spark your own client's clarity.
So I look forward to seeing how you make this your own.
Thank you again for showing up.
I hope this was helpful and I hope that it was able to give you some creative ideas.
Hi Josh.
Hey Shannon.
So much.
That was awesome.
I just wanted to kind of kick off our Q&A portion with this comment from Renee.
Watching from Denton, Texas, this is amazing spot on.
I am so excited to see this stuff being shared to the massage community by the massage community.
I love that and hi to you as well.
When I first started learning about this stuff, I was like, this is what we do.
This is our strength.
This is what we do.
It's just kind of putting more names to it and helping us get more clear so we can stand
out.
Awesome.
Then I did want to point out I added the instructions for attendees to earn your credit
for today's session.
So please follow those simple three steps.
Again, it will be included in the post webinar follow up email with the recording and like
Josh said, all of his links and email contacts will be included in that follow up email.
And from there, if we have any questions, we can kick off that portion of today's session.
I know that we had a question towards the top here.
Janice asked, what kind of meter?
I believe that was the- Oh, for the- Yes.
For the goni meter?
Yeah.
There's different sizes.
Like if you're measuring a big muscle body part like hips and shoulders, they kind of
have these bigger ones.
And if you're doing little stuff like fingers, they have these little tiny ones.
I'd recommend for our purposes, just get the big one and work on those big range emotions
at first.
You can always kind of refine and get more into that later.
But the big ones are the best and it takes a little practice.
It's not super intuitive, but there is a process to it that once you get that down and probably
take about 30 minutes of YouTube and a little practice with a friend, and you'll get it down.
You put the axis on the joint, there's a stationary arm, and then there's a moving arm.
And then you just got to track the reading on the meter.
And yeah, it's called goniometer with a G. It's like a two Greek gonia and something.
I forget the etymology, but it's a really fun one.
And just don't be afraid of, you know, when you look it up and they're like, only doctors
and physical therapists can use that.
When you stay in scope like we talked about today, there's no problem with using goniometers.
It helps with client awareness, and it's a great rapport builder, so you can have conversation
while you're working on it.
So it's a really fun tool that you're practiced.
Awesome.
A question from Crystal, any live classes by Josh or even more zooms, working with you
in person would be a blast.
No, thank you, Crystal.
That means a lot.
I love sharing this stuff.
It's just fantastic.
Come join me over on the sub stack.
There's nothing there right now, but you can subscribe.
I'm launching that in October.
I got some articles ready, and that's a way we can stay in touch and stuff.
I'm here in Bend, Oregon, if you're ever in Central Oregon, and you guys got my email
as well, or we'll send it to you as part of the pack.
I'd love to hear from you.
Any ideas you have, anything you're interested in, share with me as well.
I've done a lot of teaching and equine massage, working with horses, and working with Neil
Asher and the good folks over there.
Danny has kind of got me working more with my favorite people, human massage therapists.
So I'd love to hear anything you're interested about too, because I could help guide that.
And working with horses is a lot of fun for people.
It doesn't mean you need to create a career in horse massage, but it helps inform your
practice.
It helps you develop your sense of touch and feel that will, I think, really elevate and
change your human practice, at least it did for me.
Awesome follow-up comment from Crystal.
Perfect.
Thank you.
I'll be in my hometown of Olympia in December.
Equine is my next certification I'd like to work on.
Oh, cool.
Right on, Crystal.
Yeah.
Good luck with that.
Have fun with it.
And reach out.
That's kind of one of my favorite topics.
Awesome.
And then we have a comment from Renee.
I have really super appreciated how you defined staying in our scope.
Very helpful.
Oh, thanks Renee.
I'm glad that was helpful.
Yeah.
Again, I just have been all this imposter syndrome stuff.
It just feels like we can't do anything, you know, it's like, oh, the whole medical industry
is going to judge us.
And it's like, you know, it's not that scary, guys, like, and I think what we do is so important
and the research backs it up.
Like I said, there's articles, Therapeutic Alliance is better predictor of positive outcomes
than technique.
So just having good rapport, good dialogue with your client, sometimes, you know, that's
all it takes.
I mean, it's not to oversimplify it, but yeah, I think you guys are picking up what I'm putting
down.
Awesome, Josh.
Well, I don't see any more questions in the chat, but again, we will be providing
your email in the follow-up email to everyone that attended today.
So if any questions do pop up, feel free to email Josh directly or visit his sites and
the links that we will be including.
And I want to just say thank you so much to everyone that's attended.
We really appreciate it and we very much look forward to seeing you at our next session.
Thank you so much, Josh, for your time.
Thank you, Shannon.
Thanks for putting these on.
With your whole catalog, I was like, wow, there's some good stuff.
It's an incredible resource you provided, so thank you for the work you're doing.
Yes.
Thank you so, so much for that call out.
Awesome.
Everyone have a wonderful rest of your week.