Episode Transcript

Summary:

• Introduction to the podcast (0:00)
• Background of Justin Solace (2:00)
• Pursuing a master’s degree in kinesiology (6:00)
• Integrating exercise into massage therapy (10:00)
• The influence of psychology and motor learning on massage therapy (14:00)
• The boundaries of massage therapy and exercise recommendations (18:00)
• The role of massage therapy in pain management (22:00)
• The importance of validation in pain management (26:00)
• Balancing work and self-care as a massage therapist (30:00)
• Creating a supportive work environment for massage therapists (34:00)
• The future of the massage therapy field (38:00)
• How to connect with Justin Solace (42:00)

 

Whitney Lowe:

Welcome to The Thinking Practitioner. And welcome to the Thinking Practitioner podcast, where Books of Discovery has been a part of the massage therapy and bodywork world for over 25 years. Nearly 3,000 schools around the globe teach with their textbooks, e-textbooks, and digital resources. Books of Discovery likes to say learning adventures start here and they find that same spirit here on The Thinking Practitioner podcast and are proud to support our work knowing that we share the mission to bring the massage and bodywork community, thought-provoking enlivening content that advances our profession.

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Welcome, everyone. Til is off this week, and I am joined by my friend and colleague, Justin Solace here. Justin holds a master’s degree in kinesiology, a BA in psychology, and is a board-certified massage therapist and corrective exercise specialist, orthopedic massage therapist, and currently working on his certified pain specialist certification, which we want to hear some more about. Justin, welcome to Thinking Practitioner. Great to have you here.

Justin Solace:

I’m happy to be here. This is fantastic.

Whitney Lowe:

Yeah, I read a little bit in there, but tell me a little bit about your background, how you got into doing what you’re doing. You’ve gone into some interesting little pathways there.

Justin Solace:

I was actually a music major back in college undergrad, and wish someone had told me somewhere along the ways that maybe music should just be a hobby and not a career. About two and a half years in, I realized music should be a hobby and not a career. My roommate-

Whitney Lowe:

We share that background.

Justin Solace:

I know right?

Whitney Lowe:

We talked about that before.

Justin Solace:

That’s fun. We got to jam sometime. Then, I fell into psychology. My roommate at the time was taking a, I went to the Evergreen State College, which is basically elementary school for adults, so it’s all interdisciplinary. It was one class. I was taught by a philosopher, a biologist, and a psychologist, and it was about just health and human development and that really kind of set me down the pathway of health sciences and working with kind of getting people well and did my studies in psychology, also something we have in common.

Whitney Lowe:

That’s right, yeah.

Justin Solace:

But then when I graduated, I wasn’t quite sure what to do with myself next. At the time, my wife was working as the front desk at a massage school while she was getting her grad degree. I just started hanging out there and ended up in massage program and kind of slowly worked my way through that. Graduated my massage education, started doing sports rehab primarily. That led me to doing strength training certifications, led to getting a master’s degree in kinesiology, led to dealing with people with pain, started studying pain. It’s kind of been just a very slow growth and evolution over 15 years now.

Whitney Lowe:

Yeah. Tell me a little bit about this, because a lot of people ask me all the time, should I go get an advanced degree? What should I do to further my education? You are one of the few people who have really done that at the graduate level in our field. Tell me a little bit about your thoughts in terms of what led you to pursue that master’s in kinesiology and how has that integrated with what you’re doing with massage?

Justin Solace:

Yeah, so I was an athlete my whole life, stopped taking it super seriously, and about high school when I went to a little artsy high school, that’s where I started playing music. Still played all through high school, played all through college, and then didn’t get back into competitive sports until I was in my late 20s. I was an ultimate Frisbee player. We went to nationals, so I took that really seriously. I’ve always been an avid athlete myself.

Then, my massage practice just happened to be in the beginning, primarily sports rehab mediated. Here in Boise, I’m in Boise, Idaho, Boise State’s got a pretty cool kinesiology department that ever since I moved here, I kind of wanted to get involved with somehow. That was again, about 15 years ago. When the time finally presented itself that it was actually an option, I jumped on it just because why not? I’m always learning anyway, right?

Whitney Lowe:

Yeah.

Justin Solace:

In Idaho, you only need six CE credits a year. I take about a hundred, so I’m learning anyway, so why would I not do this? For me, especially with the movement towards pain rehabilitation, it’s really important for me as a practitioner to integrate with the medical system. Sometimes it was hard to get a meeting to sit down with a doctor or physical therapist when they’re like, “Oh, you’re a massage therapist and a strength coach. I don’t really have time to meet with you.” Then, all of a sudden it was, “Oh, okay, you’ve got a master’s degree in kinesiology, you must know a little more. You must have put yourself out there. I might take this meeting a little bit more seriously.”

For me, it was a combination of not just the learning, which was incredible, but it was also to make me a little bit more marketable and integrated into the system here because especially in Idaho, massage therapy is a little bit behind the times compared to other states.

Whitney Lowe:

You have seen that actually make a difference then in terms of opening doors for you that you think might not have been as easily accessible?

Justin Solace:

Yeah, for sure, and it is only as much as you choose to push it. It’s not just going to happen magically. Unfortunately, in America, physical health is not a primary priority for a lot of people or the healthcare system. I had a lot of classmates that really weren’t sure what they were going to do with their grad degree in kinesiology. It didn’t open too many doors.

It was like cardiac rehab, physical therapy, education, go on to be a PhD in exercise science. Then, there was me who was already had my foot in the door and knew what I wanted to go with it, but yeah, no, it makes it much more credible. It makes me higher. Above the rest, I stand out. Then, the education itself was phenomenal, and that’s just an education that you can’t get really in any other way.

What I assumed would happen is I would take my grad degree in things like exercise, science, strength and conditioning, sports, nutrition would just immediately be the primary things that really influenced the way I work and it was actually quite the opposite. It was the philosophy of sport and exercise, I think is the class that most impacted the work that I do here, which totally took me by surprise.

Psychology, motor learning, those are the ones that really have found their way into my practice on a day-to-day basis. The work and strength and conditioning and exercise phys and nutrition is great and it helps with a lot of different ways, but it didn’t really change anything fundamentally for me. It just gave me a greater depth of knowledge.

Whitney Lowe:

Can you tell me a little bit about that? Tell me how, I’m interested in terms of the psychology of sport and the motor learning and things like that. How have that really influenced what you’re doing with your massage work?

Justin Solace:

For me, even with athletes, but especially with pain, it’s all about it’s an outcomes-based driven, and we can’t fix them or heal them. Only they can do that themselves. When you look at people who are struggling or have been on and off issues, the question is always like, why is this persisting or why is this returning over and over and over again?

It’s traditionally always going to be some sort of lifestyle behavior issues. Understanding from a psychological piece is there fear or anxiety or whatever blockages are happening there. From a philosophical standpoint, it’s like what motivates this person? Where’s the value system here? They’re not going to change things unless there’s a high degree of caring and concern and value.

Then, with motor learning, it’s how do we most effectively and efficiently reteach people to do things differently, whether it’s movement-based exercises or breathing or just changing behaviors in general, best practices on all those things, but to start off with any client, patient, whatever, if you don’t know what their barriers are and what their motivations are, it’s going to be really hard to A, connect and then B, begin to initiate change. That’s where that philosophy in psych really kind of changed the way I look at things.

Whitney Lowe:

Yeah, I get this question all the time, and I’m really interested to hear your perspective on this because you have a really strong background in this area, but massage therapists are asking all the time, what sort of is the parameter or the boundaries or limits in terms of what we can do with corrective exercise and exercise suggestions and things like that? What’s your take on that?

Justin Solace:

I mean, most states don’t have any licensing requirements for personal trainers, right?

Whitney Lowe:

Mm-hmm.

Justin Solace:

In that regard to act as a personal trainer, it’s almost always like voluntary certificates. Most facilities will want you to have your personal training certificate or at least an undergraduate degree in some sort of exercise science, but there’s no legal licensing, at least in most states for personal training.

In that regard, is exercise out of our scope? Well, it’s not within the scope of massage per se. We’re not trained in that, but there’s also in very few places, any legal barriers either. Now, we’re not prescribing exercise like a physical therapist would just say, “You’re going to do X, Y, and Z to treat and cure these issues.”

For me, pre-getting all these other certifications in education, I would talk about the value of exercise, how exercise affects the brain, that was my undergraduate study was psychology and brain development, I mean, the exercise and brain development. We talk about the value there, why it’s important, and then figure out if they’re doing things, why they’re doing them. If they’re not doing things, how can we get them to do things?

When it comes to really integrating exercise into a session, that’s a little different. Now, you kind of want to be well-trained, know what you’re doing, making sure you’re within scope within your state or your licensing precinct or whatever it is, but at the end of the day, evidence is very, very clear that movement is the most efficacious thing we can do for people.

Anything we can do to help motivate people to start moving or more often, more dynamically, whatever is going to be the way that they get healthy. Massage, we use as a tool, a preparatory activity to facilitate movement, but then they have to go home and do it. So if they don’t know what they’re doing or they’re not doing it safely, or if they’re scared, are they going to do it? Probably not.

Whitney Lowe:

Yeah. Yeah. I’ve often sort of looked at the movement process and how movement and massage integrate together is massage seems like, in many instances, what we’re doing is sort of cleaning the slate neurologically and sort of preparing the potential for the integration of healthier or new, or maybe restored movement patterns or something like that, but we can’t do that necessarily for people. It seems like that’s something that’s kind of like how the motor learning, how I see this sort of motor learning process fitting into all of it.

Justin Solace:

And the philosophical piece, because if you’re not tapping another value system, it’s hard to adhere, right?

Whitney Lowe:

Mm-hmm.

Justin Solace:

That’s one of the biggest barriers with any type of rehab facility is adherence, self adherence, not coming to the office and doing the work, but then going home and making the change or sustaining the self-care, whatever it might be, right?

Whitney Lowe:

Yeah.

Justin Solace:

That adherence is essential. When someone comes in and they’re scared to move because it hurts, that’s where having a good knowledge of pain and pain science is really helpful to kind of dispel some of those fears, but then most importantly, if you can work on them and they get up and they’re like say someone comes in with back pain, I’m not as worried about the back pain in that moment like in an acute phase, at least, because the body’s going to do what the body’s going to do, but if they can move a little better, if they’re a little less worried, if they’re taking a deeper breath, then they’re going to heal themselves faster.

They’re going to be less scared to do things, and then the more they do, the better they’re going to feel. Using massage really is that tool to either increase range of motion or decrease, like you said, working on that sensory down regulation, opening up movement pattern, whatever it might be.

Whitney Lowe:

Yeah. I want to talk a little about, you are currently doing this certified pain specialist certification, and I want to hear a little bit more about that process and how you, you’ve alluded to this a couple of times of looking at and speaking with people about pain, how has that sort of influenced your work?

Justin Solace:

Yeah, that’s primarily what I do now, and I approach it from the lens of a massage therapist. I’ve gotten the other certs too and stuff, but that’s the lens I kind of look at it through. I first started studying pain. I went to my first pain conference with you. What year was that, 2017, ’18?

Whitney Lowe:

I’m thinking like ’17. I think it was in ’16, ’17.

Justin Solace:

For the past six, seven, eight years, that’s kind of been my primary focus. I mean, it hasn’t been on hands-on techniques so much. It hasn’t been on exercise or stuff like that. It’s been on pain, pain science, pain research, pain rehab. That was the San Diego Pain Summit, which was a phenomenal resource and they’re kind of on hiatus right now, but they’ve still got access to all their video libraries if you’re interested in learning more. That kind just started to open the door for me.

Then, I started studying with all these great practitioners over the years. One of the benefits of COVID was a lot of those pain conferences internationally were now online, so I got to do a lot of studies with really intelligent people that I might not have gotten the opportunity to otherwise, so silver lining there. Now, I’m doing a therapeutic pain specialist program. It’s been intensive. It’s six months long and I’m on my capstone project now. I got to finish it. It’s due in two weeks. It’s got some work to do.

When you look at the study of pain, I mean, that’s a whole can of worms in its own. That’s a lifetime career that you can dedicate just to that, but massage is more and more and more often being sought out as a source of pain relief, especially in the wake of the opioid epidemic and I know there’s enough research out there that shows very strong evidence for short to moderate pain relief just from the massage therapy alone, and that’s not really even treating the pain as it would be. That’s just taking care of the person in the moment, more kind of quality of life stuff.

Massage has a greater role to play. If we were at the national conference last year in Phoenix, the closing keynote panel was talking about integrating massage therapy into all these major healthcare systems, primarily through the lens of pain management or pain controlling options. It’s definitely a growing field and it’s something that we’re going to see a lot more of as we continue moving forward.

Whitney Lowe:

Yeah. Tell me a little bit about how that might look from what you’re doing on a day-to-day basis with your clients. How has your study of pain processes and everything impacted or changed the way you work?

Justin Solace:

Yeah, so I’ll just bullet point nutshell because it’s too big to get into right now, but essentially, pain is a lived experience. It’s not in the tissues. We don’t have pain receptors. We’ve got no receptors. We’ve got sensory receptors. I mean, all that feedback comes into our brain and then it decides what to do with it. We’ve all had situations where we’ve had a pretty decent injury and didn’t realize it until that night, or you wake up the next morning, where’s this huge bruise or I can’t put weight on my foot, what did I do and we’ve all had situations where we barely stub our toe, but because we’re tired or cranky or mad at somebody, it’s excruciatingly painful, even though really the injury itself is not that big a deal.

Pain’s more about protection, not damaged. The sensory experience that’s happening in the moment. When you begin to help people understand that distinction, that pain is not necessarily damaged, now it can be, right? Pain is about threat, damage can be threatening, but it doesn’t have to be. For most people, unless there was a big impact, trauma, slip and fall, whatever it might be, that’s usually what the pain’s not about and these kind of chronic persistent pain conditions.

You help people to dispel that fear, give them a little breath, take them nice and slowly through that process so they can kind of down regulate from a central nervous system perspective. Then, you can use massage therapy techniques to kind of reinforce that notion. You had a client come in here just a couple days ago, 30 years of back pain, her back was the least sensitive area. It was not in her back, not in the tissues in her back. It was other things going on.

After 30 years of pain, you’ve got changes that happened in the brain, changes that happened in the spinal cord, changes that happened in your heart and your emotions, and then she had to super locked up hip flexors, glutes, things like that. You use the massage to kind of open up the pathway, let her take a deep breath, show a little glimmer of light, but then, we use the educational piece to help them understand what they have to do to move forward.

That’s, for me, the nice thing about it is it takes pressure off the hands. If I’m doing full client work weeks, which most weeks I’m doing, if I’m not traveling teaching, it’s nice to just have a little less stress on the body. We spend a lot more time doing the educational piece, say foundational movement piece, some massage therapy as well.

Whitney Lowe:

Yeah. Tell me a little bit about the whole educational strategy, because I’ve been interested to watch this whole trend with this sort of the bubble or fascination with pain science education in the clinical treatment room with so many people and it seemed like there was, I’m not going to say fad, but there was definitely a huge interest in for a short period of time, especially in the teens, probably the 20 teens when we saw this really evolve.

Then, I think there was a little bit of backing off that I sensed from some of that after a lot of people were recognizing there’s some real challenges in trying to teach people who don’t know anything about physiology, some of the complexities, because I think some of the practitioners kind of went overboard and trying to tell, overwhelm people with pain information sometimes.

Justin Solace:

That’s definitely drinking from the fire hose kind of conundrum, right?

Whitney Lowe:

Yeah, uh-huh.

Justin Solace:

That’s just experience, just like any other type of intake or education or outtake that you just get over time, the more you know, just like you’re an educator, you get this, the more condensed you can create a presentation and get the message across when you’re familiar with the material, but it’s not deeply set. You don’t have all the foundational stuff. It’s hard to really grab the little pieces that you know this person’s really going to latch onto.

I’ve definitely been that person who the session ends and I’m like, dude, I flooded them. They walked out of here just like deer in the headlights. Now, I do follow up every appointment with an email that has links to YouTube videos, me demoing things, stretches or self-care, whatever it might be. I let them know right in the beginning, you do not have to memorize all this.

Whitney Lowe:

Now, this is interesting. Yeah, tell me more about this. You’re doing this with your clients, sending them the resources after your time with them based on what you do.

Justin Solace:

Sometimes before, so sometimes before. If I know we’re dealing with a complicated pain, someone calls me and I talk to them on the phone, if I’m the one who interacts with them, and I’m like, okay, they’ve had 20, 30 years of pain. They’ve seen all these doctors. No one’s gotten them well. Anything I can do to pre-educate them like you would for a conference or a class, look at these foundational things, so that way when we’re in the class together, we don’t have to worry about going over the super basics. We can dive into the meat of the material.

I’ll send them one or two, maybe short, easy links of smart people saying smart things, so then when they come in, we’ve already kind of laid a light layer of foundation, which opens up a little more space to kind work around because everyone’s different. You don’t know what metaphor they’re going to respond to. You don’t know if their pain is centrally mediated or peripherally mediated or it’s just a pulled muscle.

You can’t really tell until you’re really in the session talking with them but anything you can do to kind of make them feel like they’ve got a little foundation before they come in, ideally, but then definitely following up, because if you’ve ever taken a class and it’s brand new material, it doesn’t matter what the content is, if it’s too much, it’s just…

Whitney Lowe:

Right.

Justin Solace:

… you flood them, right? I say to them, “Don’t worry about it. We’re going to take notes if you want to, ask questions as we go, I will send you an email when we’re done that highlights just a few key bullet points,” and I usually send two or three. “Let’s be a little less still. Let’s introduce some of these movements. Work on your hydration. Remember that pain is not damaged, you’re not broken, you’re just hurt. Take a deep breath.”

I’ll just leave them with a few little nuggets and then some video links of smart pain researchers saying things in fun, cute, funny ways, or me demoing little movements and wiggles and things like that, just so they’ve got that. They start to build a little library of care.

Whitney Lowe:

What do you do with the person who’s pretty convinced that there is a particular problem with them because let’s say they’ve seen a scan, they’ve been told by so-and-so different practitioners or people that this is what’s wrong with them?

Justin Solace:

They’ve been told all the things.

Whitney Lowe:

Yeah.

Justin Solace:

Yeah, I believe that and it’s really frustrating, half of what I do in the pain management world is usually dispel misinformation. Whether the misinformation came from Dr. Google or somewhere else on the internet, TikTok these days, good Lord, people come in here all the time, “I saw this TikTok video, this person said this thing, it’s what I’ve got.”

Whitney Lowe:

Oh, man, yeah.

Justin Solace:

I’m like, “Well, maybe, but let’s talk about reality here.” You’ll get well-meaning practitioners that say things that are extremely nocebo and it scares them and then they get locked in this cycle of pain equals damage, which means I shouldn’t do anything, so I stop moving, which creates more pain, and just that feed-forward cycle just spins and spins and spins.

Whitney Lowe:

Can you, for people who may not be familiar with that term, tell us what does that mean about something being nocebo? Like what does that mean?

Justin Solace:

So we’re familiar with the placebo effect, familiar in quotes. Most people think it’s not a thing, it’s just they feel better, but in the placebo response, changes are happening in our body. There’s neuroendocrine responses that are happening based on this treatment. It’s just not the treatment itself that’s doing the work. It’s the person that’s doing the work, right?

Whitney Lowe:

Yeah.

Justin Solace:

There’s lots of really great research. Some of my favorite research that gets distilled from Louis Gifford, he’s one of my favorite practitioners there, and he’s got a couple great books that really dive into some of the research of nocebo or placebo, and they’ve done some really fun funky things, but a lot of the stuff that we do in all healthcare is a placebo response. There’s not a lot of great evidence that really substantiates specific effects for lots of manual interventions, lots of different types of work that we do. That’s kind of common practice.

On the flip side of the coin, however, is the nocebo effect, which is actual negative changes happening within our bodies, neurophysiologically, in response to, again, something that should be benign. My words aren’t actually physically hurting you, but I could say something stupid and now you’re scared and in more pain or have increased anxiety and stress or whatever it might be.

I’ve got a whole class that just talks about let’s look at the ways we communicate with people verbally, visually, marketing your office, your uniforms, whatever, and say, what message are you sending this person? Is it actually going to be enhancing outcomes or is it potentially causing conflict and reduced outcomes?

In the beginning, it’s just listening to their story and where they’ve come from and what they’ve been told, and then you need to validate their reality because real, but then you also want to help them find a new path forward, and that’s a lot of client reports working together as a team. It’s not me talking down to them, but they need to get a little dose of reality to help them break whatever cycle they’re in.

Whitney Lowe:

What about those instances where there is something that is, let’s say tissue-based, the muscle strain, the ligament sprain or something like that. How do you make those distinctions and talk with people about those?

Justin Solace:

In the pain world, they’ll lump things into three main categories. They’ll call it nociceptive, which is what this would totally be, and this is what we see almost always in our massage practice, and this is the kind of stuff that bread and butter kind of work, back, cramping, hamstring pull, Achilles issue, whiplash, something like that.

In those situations, the pain usually matches the provocation. They exercise a little bit, it hurts a little more. They rest, it feels a little bit better. You poke on it, it hurts reasonable based on the amount of pressure. Then, that kind of work, it’s like, “Yeah, let’s get in there. Let’s do some massage. Let’s stretch them out, work on some range of motion,” whatever it might be. If there’s a light tear in there, that’s just going to take a little bit of time to heal and they’re going to be just fine. That’s 95% of what we see almost on a daily basis.

When you look at peripheral nerve issues, it usually follows dermatomes or myotomes. It’s usually a pain process referring down a very kind of predictable pathway and we can look at that whole pathway all the way from the nerve root down to the terminal ends and say, do we see any kind of obstructions, irritations, things like that.

When you’re looking at the longer term, 10, 20, everything hurts. It doesn’t follow any real patterns. It hurts way more than it should based on the light little bit of pressure I’m giving you. It hurts at night when you’re not doing anything. All those things start to really indicate that there’s more central nervous system or peripheral nervous system changes and that really completely changes the way we work with this person. Just going in there and loosening things up really isn’t going to do much big picture. It can feel good in the short term, super.

But at that point, we’re looking at a lot of brain spinal cord, slow lifestyle behavior changes, and that’s a little more complicated, and that’s the crux of the deep pain work. It’s just a very different presentation. When someone comes in, they’ve got very clear pains, “It hurts right here when I do X, y and Z,” we’re thinking more nociceptive tissue-based mechanical issue. It makes perfect sense.

Yesterday, it was Memorial Day, everyone did the Murph workout in the CrossFit world. We’re going to get people coming in this week that have shoulder issues because of all the pull-ups and push-ups. It makes sense. I did the thing, I pulled something or I tore something, help me heal faster.

Whitney Lowe:

Right. Then, there’s some degree of assessment and evaluation that’s a key part of making that distinction for people and then driving some of those different treatments

Justin Solace:

Yeah, definitely a good verbal intake always first. I use a lot of your work all the time, differentiating between active and passive tissues and nerve tissues, looking to see if it’s, you can do neurodynamic tests, is it test a specific nerve to see if it lights off that whole pathway. Then, again, you can kind of see when it’s more that central nervous system, nociplastic pain because there’s a lot of psycho-emotional baggage that kind of comes in with that also.

Whitney Lowe:

Yeah. What’s your take on this? This is another one. I get this question a lot and I think there’s a lot of people that just honestly, I think mess some things up by trying to be too much eager in this area where they’re not maybe quite a skill, but that whole psycho-emotional facet of this work in terms of how much do we tell people and talk to people about what’s going on that’s not necessarily biological tissue-based, but is more in the psychosocial realm because this is certainly an area that we’re not trained in as massage therapists as a general guideline.

Justin Solace:

The simple metaphor that you’ll see is the water cup metaphor, right? When the cup overflows, we have symptoms, and those symptoms could be pain, they could be anxiety, they could be depression, it could be whatever. That’s how your body protects itself. It causes you to withdraw and be safe and hopefully repair and recover, whatever it might be. There are a lot of different types of practitioners out there, a lot of different modalities, and some of them really pride themselves on eliciting emotional responses.

I think unless they’re a trained licensed counselor or trauma therapist, that’s not a good idea. It will happen and it’s okay to have that happen, but I’m not planting seeds with people. I’m not trying to tell them X, Y, and Z, psycho-emotionally. This is what we’re trying to do here, but I do talk about the value and the weight it can carry because a lot of times they don’t understand that piece, if they hate their job or their marriage is in distress or they just lost a family member.

One of the clients that I just had, I think it was that 30-year pain client, she just moved here a few years ago, doesn’t know a lot of people, and that’s really when the pain got worse. It didn’t get worse because she slipped and fell on the ice. It got worse because she went through all these huge life stress changes and it just elevated her sensitivity.

You have to understand if you’re going to do this kind of work, how much value and weight the psycho-emotional-social stuff can carry and then you have to temper yourself to make sure that you express it in a way that’s not opening up Pandora’s box because in no way are we trained to properly care for that.

Also, I have referrals in your network. When I get someone coming in and I got a client and they got a lot of pain, and I’m like, “Yeah, massage is maybe step three. Massage is not going to really push you too far right now because you need help here. Here’s some options for you.” It could be psychology, it could be meditation, it could be hypnotherapy, it could be faith-based care, whatever it might be, but they got to work on their head and their heart first before we’re going to see real robust changes happen in the physical and discerning the difference is not easy. If it was easy, we’d all do it and everyone would feel great, right?

Whitney Lowe:

Yeah, of course.

Justin Solace:

That’s the kind of stuff that’s the beautiful thing between science and art of what we do is you can have all the science in the world, but if you can’t be a sensitive human in the presence of another distressed human, it doesn’t matter how talented you are, it doesn’t matter how good your techniques or skills are, you’re not going to get the outcomes you’re looking for.

Whitney Lowe:

Yeah, this is one of the ones that I’ve really grappled with a lot over the years because people have frequently asked me like, “Well, how do you get trained in this stuff? How do you really learn how to do a lot of this stuff?” There’s certainly a lot of things that you can learn, but I also think it’s really important that you work on yourself to get to that place, to be able to understand how to be in that kind of therapeutic space with somebody. That’s a challenging one that doesn’t really get a lot of emphasis and there’s not a real clear path for people to learn all those skills.

Justin Solace:

I would definitely agree. You have to get outside of the massage profession. I mean, you can’t just always be taking classes in the massage profession. You will box yourself in a little bit. A lot of the studies I do these days are not massage CEs. I get enough CEs, it doesn’t matter.

Whitney Lowe:

You mean there’s not a magic technique that does this?

Justin Solace:

I know. Wouldn’t it be beautiful? It’d all be great. One person would be really rich, so rich. But no, that’s where things, like I said, the philosophy in psych and my grad program came through, my undergraduate psychology at the San Diego Pain Summit this year. The very first presentation was like a two and a half hour kind of roundtable on validation. How do we sit with this person and listen to them and best validate them?

Anyone who deals with pain will tell any clinician that the moment their life changed was when their practitioner validated them. You just came in again, 30 years of pain. What did the doctors say? They’re like, “Nothing.” I said, “I’m good.” I said, “I’m fine.” I’m like, “Well, we know you’re not fine because you can’t even go hiking in the hills or pick up your grandkid anymore, so you’re not fine. You might not be broken physically, but you’re not fine.’

When you get unvalidated like that, the pain actually gets worse. The more practitioners people see, the more diagnoses they get, the pain gets worse. How do we best learn to hold our own emotional space so we don’t take it home with us? That’s what’s going to lead to burnout, but then also be super present.

There’s great research out there on compassion, compassion science, which is kind of phenomenal. How do I be as efficient and kind and compassionate as I can be? Like I said, how do I properly validate this person in a way that’s super meaningful? Active communication skills, eye contact, patience, and listening are kind of the key things. Again, for massage therapists, we’re winners here because one of the biggest variables that medicine does not provide is time.

Whitney Lowe:

Mm-hmm. Yeah.

Justin Solace:

We have the time. We have the time to sit with somebody. We all know that sometimes it takes sitting with somebody or working on somebody for 20, 30, 50, 90 minutes before all of a sudden, they take that deep breath or they mention something that kind of unlocks the next phase of getting well and sometimes it just takes time. We’re very well situated to be working with these types of populations, just naturally based on how we do our work.

Whitney Lowe:

Tell me, I’m curious to hear, and maybe you can give some advice to our listeners and the people out there, you are extremely busy with the things that you’re doing. You run a clinic, you have, and I want to talk a little bit about your clinic here too in a moment, but you’re running a clinic, you’re doing a lot of this intensive self-study work that you’re doing, you’re teaching a lot, you got a lot of irons in the fire, how do you encourage people to, let’s say the average busy clinician who’s saying, “I’d like to learn more about this stuff, but I’m always busy with my clients,” how do you fit in? How do you fit in the research and the learning and all that kind of stuff?

Justin Solace:

Bags under your eyes. I don’t know. You go slowly. You just go slowly. You got to prioritize. You can’t do it all and you can’t do it all well. Last year, I kind of got caught exactly what you’re saying, too many irons in the fire, and it totally overwhelmed me a little bit. It was just a little bit too much and everything was getting done, but I’m not a perfectionist, but I really care and it’s got to get done well, and basically nothing was getting done well except for being a dad. That’s the one thing I was doing well, was focusing on my kid.

My home, taking care of the house was getting done, B plus. My clinic was running, it was going, it was hanging on there, but it wasn’t elevating, I wasn’t providing enough mentorship to the new therapists. I was doing my studies, but not as well as I would’ve liked to. Don’t bite off more than you can chew. Take on one thing at a time. Slowly increase and grow, figure out where your priorities are, create a priority list, pluses and negatives. If you do too much, you will burn out. Then, when you burn out, you’re not there for anybody, especially your clients. That’s not acceptable either.

For me, I have a nice mixture. I’m really fortunate. Anyway, I run the office part-time. Right now, I’m doing a full-time client load. Usually, I do about 15 to 18 clients a week. Right now, I’m doing more like 25, but that’s just going to be temporary. I’m not teaching too much in this moment. I’ll be teaching a lot this fall. When this fall comes around, I’ll have to reduce my client load so I don’t burn out. Doing your best to make sure that you’re keeping yourself, as you mentioned before, just with the self-care piece, you can’t be there for people if you’re not there for yourself.

Whitney Lowe:

Yeah. Tell me a little bit more about your clinic because I know there’s a lot of questions that practitioners ask. We see a lot of stuff on social media about people having a difficult time finding a good work environment that really fits them, but you’ve really done some things here to put a lot of emphasis on the development of the people who work for you. You’ve got a clinic with, how many therapists do you have currently in your clinic?

Justin Solace:

Technically right now, there’s 10 of us on the scheduler. One’s an intern. He just started with us and he’s doing great. Then, we’ve got a physical therapist that rents space from us. We got not full-time, not full-time therapists, so we got eight therapists working under the Hybrid Health name, one intern and then a physical therapist who leases space from us, which is great because she provides a visceral manipulation and craniosacral work, which we don’t really do here. It’s a nice kind of option to have.

Then, my wife is actually going through, she’s about to start, I’m not sure if you know this yet, she’s going to start doing her mental health counseling certification, so we can start offering mental health in office as well.

Whitney Lowe:

Oh, nice.

Justin Solace:

It’ll be huge for having a “one-stop shop.” There’s always referrals to be made, but being able to do the mind-body health in one office, I think it’s going to be really fantastic, but I worked for a franchise and it was not the best experience, and I worked for a chiropractor and he shoved me in a closet and it was not the best experience. I realized very quickly, I never thought I’d own my own clinic, but I realized when I was really young that if I was going to do the work I wanted to do and find joy in it, I was going to have to do it on my own, especially here in Idaho. There was nothing.

The mission at Hybrid Health is about our therapists. It’s about providing the highest quality working environment for our therapists. If we provide the highest quality working environment for our therapists, they, in turn, will provide the highest quality care to their clients. We all know what it’s like to get a massage from a therapist who does not want to be there.

My number one goal is to ensure they have all the tools they need, resources, products, hands-on tools, massage guns, self-care tools, whatever it would be. We’ve got a nice little break room with a couch and a lazy boy where they can relax when they’re not working. I don’t ask them to do things that aren’t in their contract that we write up together, and I pay them as much as I possibly can. They want to be here. I’m really fortunate that when a therapist comes, the only reason they leave is they’re eventually ready to do their own thing, which is fun to watch happen. Therapists go off and open up their own practices, and they’re doing really, really well.

I got one therapist right now who’s pretty close to phasing out. We’re going to miss him dearly, but he is totally ready to go crush his own thing, and I’m super excited for him, so finding a place, and one of the things that happened, at least here in Idaho, our population exploded right around the COVID time. We lost a lot of practitioners and got a lot of people, and that actually was a great thing for the working therapists because in order for businesses to keep them, they had to start taking better care of them.

Whitney Lowe:

Yeah.

Justin Solace:

I think that’s kind of happened a little bit everywhere, but it definitely happened here, but yeah, don’t sell yourself short, not just in the clinic you work in, but compared to other healthcare providers too. We offer a service that no one else offers, and our service is no less valuable than theirs are. I would argue for most people in this world, we offer one of the most valuable services.

More people struggle with stress, anxiety-related disorders, chronic inflammation, what have you, and one of the best things they could do for themselves and for those around them is to come in and get a monthly massage and just breathe and chill out and be cared for, and get their cup filled a little bit so then they can go back out into the world. We really are offering a quality level of care that no one else is.

Whitney Lowe:

I think when people can reconnect with that mission and with that message about what it is that we’re doing, because let’s say, I mean, of course, I’ve been there. It’s a Friday afternoon, the last massage of the day, I’m like, you’re really tired. I’m really kind of over doing this, but you got to remember that that person may have waited a month or two and they’ve been waiting for this time, and they’ve been just knowing that this is going to really, really help them and change them, and it’s you got to bring it.

Justin Solace:

There it is again so make sure you don’t burn yourself out.

Whitney Lowe:

Yeah.

Justin Solace:

If you are overloading yourself and you do catch yourself, I mean, I got a buddy, I got a couple buddies that do way more hours than I think they should, and physically, they’re doing just fine, but I’ve definitely wonder at that seventh massage of the day, are you really providing the highest quality care? At that 35th massage of the week, are you really providing that high quality care? If you can do it, bless your heart. We need you.

I can’t, that’s too much for me, but yeah, it’s important to keep yourself healthy, keep yourself cared for so you can be there and if you catch yourself burning out, for me, I go to the National Massage Conference almost every year. I go to my state conference almost every year.

I used to go to that San Diego Pain Summit almost every year, and I started going to the World Massage Festival. Super fun, but I need those events to get around peers and just light my fire because if I don’t, within six months or so, I start to feel myself trending downward with my motivation and excitement, but then once I get around my community, it really lights me up. Having a community locally is essential to kind of keep in that, because we’re still kind of isolated in here. It’s one of the issues with burnout and massage, right?

Whitney Lowe:

Yeah. Mm-hmm. A lot of people I think need to remember that that is something that it needs nurturing and care. I think that’s a really great point because we are kind of solo in the treatment room a lot of times, and it’s easy to get in your little zone and not connected with folks, but.

Justin Solace:

For sure.

Whitney Lowe:

Yeah. Well, tell me a little bit about what, you’ve got a very forward-thinking vision about the field of massage and your own strategy for doing that. What do you see on the horizon coming up for you personally, things that you’re interested in, where are things going for you, but also I’m curious to hear where do you see some things going trend wise for us as a field too?

Justin Solace:

I mean, I think everything’s trending in the positive direction as far as making the progress that we want to make. It’s just going at a turtle’s pace. Seeing that closing keynote at National last year, we had like NIH and the VA and all those people there talking about how important they feel massage is and should be integrated into the system, which I completely agree with. However, that does require us as practitioners taking the responsibility to do the work. I just haven’t really seen that part quite happen yet.

I think until we, as the practicing therapists elevate ourselves, endogenously from our own desire to be better, then progress is going to continue to go at a snail’s pace, but we know there’s enough research out there now that just there’s enough support for massage therapy as an intervention for a wide variety of health conditions, especially at the preventative level, which when it all comes down to the end of the day, it’s all about money.

If insurance companies or healthcare systems can save money once it’s agreed upon, we’re there on that front line to help be that preventative care, and then we do also have a role in post-care. There’s great research on massage for post-operative pain and recovery, post-cancer pain and recovery, lifestyle, but we have to be the ones to really get into trenches and do the work.

If you want to help support your local state chapters or legislative organizations, your state boards, anything that we can do to motivate and get ourselves in the room to have those conversations, that’s going to be huge, but again, why didn’t I do the grad degree? Part of the reason was just that piece right there to get myself in the room. It’s hard to get in the room when you’re just an LMT.

You can get there. You got there, right? You’ve done incredible things, right? I remember we had a conversation way back when when I thought about dropping my grad program, and you’re like…

Whitney Lowe:

Don’t do it.

Justin Solace:

… don’t do it. Finish it. I should have finished mine.

Whitney Lowe:

I’m glad you did that.

Justin Solace:

I’m glad you told me not to drop it.

Whitney Lowe:

Yeah. Having two halfway finished master’s degrees looks like nothing on paper, but I think that… Yeah.

Justin Solace:

Unfortunately, even though it’s just a thing on paper and it’s silly. Like I said, the studies were great, but at the end of the day, I could have done those studies technically on my own. What I have, I don’t know, but I could have, but what I wouldn’t have gotten is Master of Kinesiology, which is now all of a sudden maybe I get that invitation that I wouldn’t have gotten to before.

Whitney Lowe:

Exactly.

Justin Solace:

You have to do the work and then put yourself out there. It takes not being afraid to be told no. Don’t be afraid of being told no or having someone kind of talk down to you, and you just, the more you know, the more you can… After 15 years, I can sit down with pretty much anybody, and if they start trying to talk down to me, I can rebuttal anything they’re going to say. I just know enough at this point where I feel confident that I can be like, “Let’s have a conversation about that, because what you’re saying is not accurate,” but it took a lot of hard work to get to a place where I felt confident to do that.

Whitney Lowe:

Yeah, yeah. Well, I continually continue to find you very inspiring for new therapists and people who’ve been in the field for a long time, just seeing what are the possibilities for things that they can be accomplished. I just want to salute you for your hard work and dedication to all the things that you’ve been doing and the giving back. Also, you’re a very generous person giving back to the field, so I see great things in the horizon for you in the future.

Justin Solace:

Well, I wouldn’t be here without your care and support.

Whitney Lowe:

Right. Yeah.

Justin Solace:

Pat on the back to you as well, my man.

Whitney Lowe:

All right. Thank you so much, sir. Well, where can people find out more about you and your work and what you’re doing there? How might people, if they want to ask you questions or connect with you, how can people find you?

Justin Solace:

Yeah, you can send me an email. My website is hybridpainrelief.com. My business is Hybrid Health. If you just do a Google search Hybrid Health, boy, see that’ll pop up. You can just search my name. I’ll pop up. You can connect on social media. Hybrid Health Continuing Education is the Facebook page where I do my best to stay up-to-date on posting things. Sometimes I’m great, sometimes I’m not.

You can contact me to the website, but no question’s a bad question. I love to talk about this kind of work. I’m a super nerd. People are always like, “Oh, I don’t want to bother you.” I’m like, “Literally, you’re making my day. I want to talk about this all day long, as much as I can.” Yeah, reach out anytime. I’ve got some classes coming up, some state stuff in Ohio. I’ll be at the World Massage Festival. I’m looking to come out to Maine potentially this fall too. If anyone’s looking to partner with me sometime next year, 2025, that’s what I’m looking at right now.

My classes, I teach hands-on classes, but the stuff I love to teach is more the contextual work that happens around the massage table, not on the massage table. It’s the communication piece. It’s the psychosocial pain science piece. Those are the things that I think are really not getting the attention they deserve because they’re not quite as sexy.

Whitney Lowe:

Yeah.

Justin Solace:

You want to learn the cool technique, I get it, but if you don’t know how to critically think, this is why I love your program with, anyone of my new therapists, I immediately signed up for your program. I sent you an email for a new intern. I want you to set up for your spine class for him. If you can’t critically think, if you don’t really know what you’re working with, it doesn’t matter how good your technique or your skills are if you’re not applying them appropriately.

I think that’s a piece that people recognize as important, but then don’t give the emphasis I think it deserves, and at the end of the day, I think it deserves most of the emphasis because there’s really no evidence that supports one technique or modality being significantly better than another. It’s about how do I work with the person in front of me.

Whitney Lowe:

Yeah, people-centered care, man.

Whitney Lowe:

All right. Thank you Justin, so much for hanging out with us today. I really appreciate your coming here and joining us. The Thinking Practitioner podcast is supported by ABMP, Associated Bodywork and Massage Professionals, and ABMP membership gives professional practitioners like you a package including individual liability insurance, free continuing education, and quick reference apps, online scheduling and payments with PocketSuite and much more.

ABMP’s CE courses, podcasts, and Massage and Bodywork Magazine always feature expert voices and new perspectives in the profession, including from Til and myself. Thinking Practitioner listeners can save on joining ABMP at abmp.com/thinking.

I want to say again, thank you to all of the listeners for hanging out with us today. Hope you got some good insights from our discussions. You can stop by our sites for the video, show notes, transcripts and any extras. You can find that over on my site at academyofclinicalmassage.com and over on Til’s site at advanced-trainings.com.

If you have comments, questions, or things that you’d like to hear us talk about, just record a short voice memo or send us an email to [email protected] or look us up on social media. You can find Til under his name Til Luchau and me also under my name on social, Whitney Lowe, and we’d be happy to have a conversation with you there.

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