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Wednesday 10am - 2pm Friday 10am - 7pm Saturday 10am - 5pm

Ryan Hayes RMT, 799 Bloor Strest West, Toronto, ON (2026)

04/28/2026

The Race for the Root Cause: how terminology in manual therapy becomes cliche.

When reading manual therapy biographies, many of them state that the practitioner treats the root cause of a problem. While I fully endorse manual therapies and their benefits, I don't believe we should advertise this as something that we do. Why? Primarily, because we can't prove this claim. Often, before people show up in our clinic, they have seen doctors, they have tried medication, and they have negative imaging. Do we know something they don't? Maybe.

Grant it this isn't the route that every patient takes. We may be one of the first ports of call if a patient has an issue. However, if the long and winding road approach has shown no cause, what percentage of the time are we correctly quantifying a root cause and is this important? Yes. We are naming a root cause, but it is our root cause. We are making the most educated guess we can with the information that we have gathered. However, this information isn't validated.

Using our palpation, our knowledge of anatomy and physiology, and our clinical expertise, we ascertain either contributing factors or a single factor as the likely source of the problem and treat accordingly. Would a physiotherapist, chiropractor, and massage therapist all find the same factors in the same patient? What about comparing the findings of a new grad to a fifteen-year veteran? Is the root cause confirmable by everybody? Probably not.

Be clear of a desire for a result. Be clear of dogma. Be Clear. Be. - Hugh Milne

We can only ascertain a root cause to the best of our ability. There are many variables that go into the symptomatic resolution such as years of practice, type of practitioner, complexity of problem, diagnosis (if available) of problem, and longevity of a problem to name a few. There are so many variables contributing to the presentation of a symptom. We have eleven systems to consider. How do we navigate this conversation?

It is more practical to observe and treat the anatomy that we find in dysfunction and try to match it to the symptoms present. In this way, we are supporting systemic health rather than looking for a silver bullet. We can speak with confidence to what we find. We are neither guessing nor speculating. Otherwise, to use another trending word, we are falsely offering a patient certainty about something that has the most uncertainty: the root cause.

04/23/2026

So often people have disc issues in their neck or low back. Can we do more?

04/23/2026

The Intervertebral Disc: a new target in manual therapy?

The intervertebral disc (IVD) is clinically important for various reasons. In both the cervical and the lumbar spine, the load placed through the disc via can become dysfunctional. This can lead to degeneration of the disc and, in some cases, various degrees of disc herniation. The discs are often implicated in neuropathy of the extremities, which presents as numbness and tingling in the arms and legs.

Disc problems are common in a population that works in a seated position. Postural challenges place excess structural load through the neck and the low back. While herniations in the thoracic spine are uncommon, anatomically the ribs attach through radiate ligaments to the IVD and vertebral body. This means the disc receives compressive forces from all sides.

Anatomy of a Disc

The disc is composed of two parts: the external annulus fibrosus and the interior annulus pulposus. The striated annulus fibrosis is a group of concentric rings numbering 15-25 layers thick. This ring is made of fibrocartilage. The fibres run obliquely and in alternating directions, which increases tensile strength. The depth of the annulus fibrosis varies from 1.5mm to 3mm and is thicker anteriorly.

The annulus fibrosus encircles the nucleus pulposus. The nucleus pulposus, which is 70-80% water, is the gelatinous centre of the IVD. Aggrecan is the major structural proteoglycan produced within the IVD; these glycoproteins are responsible for maintaining hydration. As we age, the water component of the disc decreases and the discs lessen in height.

Like fascia, the two components of the IVDs are made of collagen. Also, the annulus pulposus has a similar water percentage to fascia. This structural similarity makes the IVD an excellent treatment target! The IVDs can be influenced by placing a load through either the ribs or the vertebrae with the aim to restore hydraulics within the disc. This allows for load bearing to be more evenly distributed and the degeneration rate to be slowed.

Degeneration to Herniation in 4 Easy Steps

A disc herniation is an umbrella term that is used to describe one of four pathological conditions of the IVD:

Bulging - the disc weakens and pushes beyond its normal shape, but the outer layer remains intact

Protrusion - the nucleus pulposus pushes against the annulus fibrosus creating an observable bulge

Extrusion - the nuclear layer breaks through the annulus fibrosus but remains associated with the disc

Sequestration - the nuclear layer breaks through the annulus fibrosus with pieces that fragment into the spinal canal

From a manual therapy standpoint, we are unlikely to see a patient in the acute stages of either extrusion or sequestration. However, patients suffering from bulging and protrusion diagnoses can be treated quite effectively.

Embryological Relevance

The nucleus pulposus is the portion of the IVD that embryologically develops from the notochord. The notochord develops in week 3. A primary function of the notochord is to signal the development of the nervous system and the vertebral column. The notochord also defines the longitudinal axis. This makes the IVDs significant as a functionally important remnant of the progenitor of structural organization.

Consideration should also be given to the articulation of the disc with the vertebrae via hyaline cartilage and Sharpey's fibers. This attachment forms a fibrocartilaginous joint known as an amphiarthrosis. Other examples of an amphiarthrois occur at the p***c symphysis and costochondral joints. These joints only have slight movement, but this movement can be modified in manual therapy.

What does this all mean?

It means we can use pressure in a direction that passes through the IVD to redistribute fluid dynamics. This will optimize reception of compressive forces. Our direction of pressure relies upon feedback from the collagenous IVD. Therefore, we must visualize the anatomy and adjust pressure accordingly. For example, the annulus fibrosus has a dense ring structure making it easy to sense in palpation. We are always aiming to disperse tension and restore health.

Master mechanical perception - Hugh Milne

Aside from removing pressure from the disc, the increased buoyancy opens up more space for the nerve roots to exit. There must be consideration to the anterior and posterior longitudinal ligaments as they also attach to the IVD. While it takes practice to effectively dialogue with a disc, a good knowledge of associated anatomy helps. If we are effective fascial workers, in time we can be effective disc mechanics.

04/16/2026

Manual Therapy: clarity or confusion?

As I have been reading manual therapy posts on social media recently, I have noticed that many of them sound eerily similar: they discuss the value of one specific manual therapy profession over another; they explain why everything should focus on neuroregulation; they describe how the biomechanical model is overused; they outline how mobility is the key to unlocking health. The posts are often presented in the same tone, explain things in the same way, and ask the same questions before giving answers to those questions.

Manual therapy and healthcare are not in competition. A person is not one isolated system. We should be supporting each other rather than trying to promote our own brand. It feels like the quest for clarity is creating a lot of confusion. People want professional identity yet seek individuality. If it isn't supported by research, it doesn't have value. There is so much marketing and browbeating in manual therapy that it seems we have lost sight of our fundamental aim.

Back to Basics

In simplest, and most overused, terms we are attempting to treat the root cause of a problem. In reality, there are so many variables that go into this (complexity of problem, longevity of problem, diagnosis of problem, skill of practitioner, type of practitioner, etc) that we are likely not going to know the exact genesis of an issue. We use our knowledge, our assessment, and our clinical experience to hedge our bets on how best to treat the patient. Nothing more.

One person's root cause is another person's compensation. Does it really matter? No. We treat what we find and try to optimize health. Whoever we are. With the knowledge and skills that we have. We should know our own strengths and weaknesses. We should know when our treatment has stalled. We should know when to refer out. Some problems will require a team approach. These are all basic things, but important things.

The Strength of Manual Therapy

The primary tool of the manual therapy practitioner is palpation. We pride ourselves on it. However, many practitioners never learn to effectively combine the skills of palpation and tissue engagement to optimize the application of our techniques. This triad is essential to effective treatment outcomes. We are taught these skills in isolation and left to our own devices to integrate them.

Superlative technique has its genesis in moment-to-moment perception of the client's channel of consciousness and their needs - Hugh Milne

As we evolve in practice and master the fundamentals, there are several things we should consider implementing to amplify the effect of our treatment:

Visualization - seeing the anatomy will focus our palpation

Broadening our field of perception - touch is systemic, we need to palpate on a wider lens to see how local tension contributes to distant tension

Listening to tissue feedback - being present to what the body is seeking rather than what we are proposing will make our techniques more efficient

There is no doubt that our interests and philosophy in treatment are diverse. What we all have in common is a desire for the individual to feel better. Far too often we decide what the body needs. We must listen to what the body requires. If we are unable to apply the foundational skills with effect, we have little hope of improving health in either the short term or the long term.

04/09/2026

How to be Tissue Trauma-Informed.

With mental health being promoted in all aspects of life, manual therapy needs to be considerate of what this means for us as healthcare providers; in the least we should consider taking a course in Trauma-Informed Care. There are numerous free courses online providing an overview of topics to establish a baseline of knowledge. We should also be considerate of what this means for us on the cellular and tissue level; tension is tied to emotion.

What does being trauma-informed mean?

Firstly, there is an acknowledgement and recognition that trauma is multidimensional: trauma impacts biology, neurology, and psychology. By extension, trauma may also impact behaviour and sociological aspects of life. Supporting survivors of trauma minimizes re-traumatization while providing safety and empowerment. The symptomatic picture of trauma is variable and systemic with treatment often requiring a team approach.

Generally, a trauma-informed approach will recognize the four R's as established by the Substance Abuse and Mental Health Services Administration (SAMHSA):

Realizing - the widespread impact of trauma

Recognizing - the signs

Responding - by integrating knowledge into practices

Resisting - retraumatization

Further, there is also consideration given to safety and trustworthiness, empowerment and choice, cultural competence, and application of universal precautions that protect people who seek help but may not share (for various reasons) known experiences of trauma; physical, emotional, and psychological safety must be exemplified. We must consider our systemic biases.

As manual therapists, we can aid in supporting choice, building confidence, and giving back aspects of control that allow for small daily victories. For example, these victories could come in the form of performing daily stretches. Choosing to actively perform these exercises with consistency and efficacy is a form of success. This can build confidence.

What does being "tissue trauma-informed" mean?

We are manual therapists. We know that releasing tension can occasionally lead to an emotional reaction. The relationship between emotions and tension is bigger than the discussion of this article. However, many of us have experienced it on our tables more than once. From a massage therapy and osteopathic perspective, we must be observant of the vulnerability of tissue. This is different to tissue fragility.

"Part of the beauty of touching is that the body, especially at the level of the fine motility patterns, will tell you the truth" - Hugh Milne

We must approach the body with humility and patience. We must provide an ear to listen. We must be compassionate in our touch and transparent in our message. Trust is paramount. Vulnerability has a palpable presence. It often feels like either an absence of "energy" in the body or a hesitance of the tissue to touch. This level of palpation skill requires experience, practice, and awareness. However, gaining trust of the tissue will yield greater results.

Tension will not be forced into submission. We may feel tension beneath our hands, but the body may be either unwilling or unready to let it go. We have to be present to this. If the body is willing to accept treatment we may have to be in contact with the anatomy until it has become physiologically "ready" to participate in the work required to facilitate change. This waiting period will vary depending on the longevity of relationship to the patient, astuteness in discerning readiness, and quiet observation.

How does emotion present in tension?

In general, feeling somatic tension in tissue is enough in most cases. However, we also need to be open to the mood of tension. Some restrictions are overly eager when they realize help is at hand. Other tension may cower at touch and need to be gently coaxed out of its hiding place. Sometimes tension needs a moment to gather its resources to support the upcoming changes. Whatever the tissue presentation, we must be observant of the receptivity of the body to our techniques.

How do we quantify this sensory perception? It is a skill that is learned through time, presence, and openness. Like feeling temperature change in tissue with inflammation, vulnerability has a frequency that resonates. There is a tangible quality to it. Tension in anatomical form is not the only sensorial sign of dysfunction. We need to see the individual in their entirety. Body and mind.

Massage therapy is framed around the hard sciences. However, there is a philosophical and spiritual aspect to massage therapy that is more difficult to quantify. It goes beyond structure. It will not have meaning to everybody, but it can be taught. It is these skills that will help to discover when tissue may need extra compassion. This is being tissue trauma-informed.

03/31/2026

Is Deep Tissue Massage a Commodity?

Deep tissue massage is harming patients and therapists alike. Patients often request deep tissue massage with the understanding that they will receive some sort of hard pressure that targets deeper muscles. Therapists try to fulfill these requests for pressure, which puts too much force into shoulders, wrists, fingers, and thumbs. Patients endure pain and leave their treatments feeling sore. Practitioners put deleterious pressure through their joints.

What is deep tissue massage?

Deep tissue massage is typically performed with either a hard or firm pressure. The general intention is to address deeper anatomical structures. Typically, these deeper anatomical structures will be muscles. Therapists often "warm up" superficial structures with lighter strokes before switching to harder and more focused techniques that address deeper tensions in the body. How deep do we need to go?

If we consider layers of muscles the answer is not far. The deepest muscles in the back are only covered by either the lats or the traps. The hamstrings and quads aren't covered by other muscles. The lateral hip rotators are covered by glute max, which can pose a problem. Tibialis posterior and the long flexors of the foot are covered by the triceps surae. The point is, we don't need to pull out the sledgehammer that many therapists use.

Oliver Twist or Goldilocks?

Just because we are asked for more should we acquiesce? It can be challenging to understand when and where to apply pressure; if we don't use enough pressure, we haven't engaged the tissue adequately. If we use too much pressure, we are overtreating the tissue. Like Goldilocks, there is a bandwidth of "just right." When we are in the right place, pushing with appropriate force, in the right direction, and for the right length of time, the tissue will release.

"You have to learn a thousand techniques in order to understand a single one. Then you only need one." - Hugh Milne

Massage therapy is one of the few health professions where the patient has a substantial say in how the treatment is applied. If a patient asks for more pressure, we comply. If a patient wants to spend an hour on the back, we comply. Chiropractors often don't adjust the cervical spine at the request of patients, but there can be valid risks with that specific application. Massage therapy wants inclusion and credibility, but we also allow subservience.

Unfortunately, it takes years to gain the skill necessary to effectively dialogue with different tissue types. Many practitioners will leave the profession before this happens. Tissue engagement isn't taught comprehensively in schools. Students are shown techniques, but not how to effectively apply them. Palpation is supposed to be our bread and butter, but we continuously fall short. We choose power over precision. This is a losing battle for the therapist.

How do we create longevity?

We need to work efficiently. We need good ergonomics. We must observe how tissue responds to pressure. We need to find alternatives to fingertips and thumbs. We must stop trying to force the body into submission. We should approach the body with curiosity and humility. We need to understand that treating individually is a thing we say rather than a thing we do: each technique is unique within the context of each individual treatment.

"Patience is the least used tool in the massage therapy arsenal."

Massage therapy is its own worst enemy. We are always looking for a silver bullet. I heard Bodhi Haraldsson say in an interview recently that the techniques we learn in school will carry us a long way in our careers. I agree. There are too many techniques that don't live up to the hype. We pride ourselves on palpation, but we really need to focus on tissue engagement. Massage therapy is a game of perception, not a game of strength.

03/24/2026

Joint Mobilization: a lost art.

Joint mobilization typically involves an evaluation of the mechanics of a joint through its planes of movement, followed by some sort of mobilization that varies in speed and breadth depending on the professional performing it.

In massage therapy, there are three degrees of mobilization that create excursion of the joint capsule. The amplitude of this mobilization can be either small or large and applied with either an oscillation or a sustained hold. As a student, these assessments and techniques are difficult to learn.

Massage therapy schools teach courses that are entirely dedicated to joint mobilizations. Unfortunately, students often struggle with these techniques as evaluation can be hard to quantify with inexperienced hands. The amount of movement that occurs through some joints is easier to ascertain than others: consider a ball and socket joint as opposed to a costovertebral joint. Consequently, when students graduate and become massage therapists these techniques often fall onto the refuse pile through lack of confidence.

It takes several years to become proficient in joint mobilizations and decades to master them. Joints that don't move through a full range of motion don't allow muscles to move through a full range of motion; this creates tension. If a practitioner only treats the muscles and tendons with no consideration to the joint, the tension will diminish for a short period of time before returning a few days later. This can be a reason as to why some tension persists: the cause of the tension resides in the limitation of the joint.

Tension can also be perpetuated by a misaligned joint. A joint that is not resting in its position of normalcy will force muscles into a stabilizing role, which manifests as tension. Depending on the joint and the longevity of the problem, this tension can become pain. Further, the joints adjacent to the problem may compensate, which can create problems up or down the skeletal chain. For example, a misaligned knee may cause knee pain locally as well as issues with either the ankle or the hip or both.

There are numerous joints that are seldom addressed but are instrumental contributors to systemic issues: the subtalar joint; the talocrural joint; the tibiofemoral joint; the sacroiliac joints; the p***c symphysis; and the costovertebral and costotransverse joints. In truth, all joints may have a percentage of importance to the presentation of the patient. Joint dysfunction can lead to, but is not limited to, pain, inflammation, tendinopathies, degenerative changes, and neuropathy.

It takes years to effectively evaluate and treat joints. However, joint mobilizations can be a major contributor to the resolution of a problem. A hyperkyphotic posture cannot be corrected without effective mobility of the thoracic spine. Far too often, massage therapists rely on treating the pectoral muscles, strengthening the interscapular muscles, and suggesting postural changes. This treatment will only offer short term relief. A structural presentation requires structural improvement. Joint mobilizations must be included in all treatment.

A treatment that utilizes only joint mobilizations will remove more tension than a treatment that utilizes only Swedish massage.

03/16/2026

Manual Therapy: a global conversation

Who doesn't love a good double entendre??

Firstly, why "global?"

Manual therapy is a global occupation that uses various different approaches: Japan has shiatsu; China has tuina; Thailand has Thai massage; India has ayurvedic massage; Turkey has hammam; Russia has venik massage; east Africa has rungu massage; Mexico has hakali massage; and the most well known and most ubiquitous style in North America and beyond is Swedish massage. This list isn't exhaustive, but as manual therapy has been around for thousands of years it makes sense that various forms and derivatives can be found all around the world.

The philosophy and application of these modalities will vary in application: some may use broad strokes; some use a hands-on approach only while others make use of both hands and feet; some modalities use techniques more akin to acupressure points; both eastern and western methodologies may incorporate various aspects of energy work. The point being, there is much diversity in philosophy and style depending on where and with whom you find yourself in the world.

Secondly, why a "conversation?"

Consider that different countries speak different languages; think of these languages as different modalities. As languages have regional dialects within them, thus different modalities have various techniques under their umbrella. Take Swedish massage for example, petrissage, effleurage, tapotement, rocking, and vibrations all fall under the heading of Swedish massage. When navigating a particular problem we may defer to a specific modality of choice. Further, we may opt for a specific technique of choice within that umbrella that has demonstrated efficacy in the past.

Why is this important? The more languages we know, the more countries we can visit where communication and acceptance are facilitated. Let's consider going to Mexico and donning our Spanish hat. It is likely that we can communicate in most any part of Mexico under the wide-brimmed sombrero of Spanish. However, if we can converse in either Norteno, Costeno, or Yucateco to name a few regional dialects, then our acceptance increases; this acceptance builds trust. Research in manual therapy shows that trust improves patient outcomes.

Conversing with the body:

Like languages and dialects, certain physiological states and mechanical issues can be addressed with numerous modalities and techniques. However, there will be options that will have either a more comprehensive effect, a longer lasting effect, a faster effect, or facilitate better resolution. Further, if we can recognize the language of the problem, we can select the technique that is most appropriate. If we don't speak the dialect it doesn't mean we can't have a conversation, but some of the message may get lost in translation.

This is why it is important to continue our education by learning new techniques and new modalities: it allows us to travel around the body and speak the language of the given region. English will get you a long way, but what if you find yourself in rural Japan? If we need the Tsugaru dialect of northern Honshu and we don't even speak basic Japanese, then we can't communicate at all. We are left to either gesticulate, guess, act out, or find alternate means to get our message across. This is laborious, time consuming, and often ineffective.

How do we learn to communicate effectively?

With learning any language, in the beginning we only know single words. As we grow and progress we can string words into sentences, turn sentences into paragraphs, and paragraphs into stories. Communication is as precise as the breadth of our vocabulary. The physiological narrative of the body is an unknown history of languages and dialects that require translation. In some ways, we must become corporeal philologists: becoming fluent in various techniques will allow us to interact with differing anatomical problems. The key to fluency is practice.

For those who have had the opportunity to travel, you may have found that knowing a few words in the local language can go a long way in establishing a connection. The body is no different: it will respond more enthusiastically to something helpful and familiar. Conversely, being bombarded with a foreign language, however we choose to express it, is not likely to yield any sort of understanding. It is better to know a few sentences in many languages than to be verbose in only one.

To summarize:

Languages are akin to modalities. Techniques are akin to regional vernacular. The more we travel does not mean the better we can communicate. There must be active participation on the part of the traveler. Similarly, just because we have practiced manual therapy for years it does not mean we can communicate fluently with anatomy. We must continue to learn and apply ourselves with awareness and presence. We cannot be reliant on one modality and expect all anatomical problems to understand it.

We must explore. We must be curious. We must practice the applicability of what we learn. We must strive to increase our vocabulary and seek out new methods of communication. As widely spoken as some languages are, occasionally we may encounter either Swahili or Tagalog, Amharic or Gujarati, Italian or Urdu. The more we can communicate globally, the more understanding we will have. The objective of a technique in manual therapy can be paralleled to the objective of a Japanese haiku:

Haiku: to capture a specific, fleeting moment of insight or emotion, often in nature, through concise and vivid imagery

Manual therapy: to release a specific, accumulated aspect of tension and emotion, through precise application of technique

03/10/2026

Quantum Consideration in Manual Therapy: quackery or credible?

Over the last quarter of a century, I have been observing how the body responds to touch. I have considered the science of touch, the sensory perceptions affiliated with touch, the psychology of touch, the philosophy of touch, and the building blocks of nature. I am presenting an overview of my thoughts and my experience as it relates to my personal treatment approach.

Background:

I have been a manual therapist for twenty-five years. During this period, I have invested much time, energy, observation, presence, and awareness into seeing how the body responds to touch. What I have found is not that the body should respond to my touch, but rather I must respond to the guidance of the body. The body will neither be forced nor coerced. However, the body is willing to lead if we are willing to follow.

Every technique is a study for the next. As one thing is mastered, something new becomes its replacement. Not everything is a success; this is why it is called practice. The more we practice the more we strive to communicate effectively with the complex organism we call the human body. I am currently employing a working hypothesis in treatment: the implementation of quantum theory.

I have been interested in quantum mechanics and the potential application in manual therapy for a long time. The genesis of this idea began when I read about the Heisenberg Uncertainty Principle.

"It is fundamentally impossible to simultaneously know the precise position and momentum (or velocity) of a particle with absolute accuracy."

It is worth noting that the "uncertainty" stipulated in the equation first introduced by Werner Heisenberg in 1927, is not a measurement uncertainty. Further, the uncertainty principle is independent of either the observer or experimenter effect. The uncertainty principle stipulated here is intrinsic to nature.

How this relates to manual therapy:

Tension in the body directly relates to atoms. Structurally speaking, tension results from forces acting between atoms and molecules, which pulls them apart while restoring forces attempt to maintain structure. These facts overlap with the objectives of the manual therapist: we aim to release tension while restoring homeodynamics: maintenance of stability through a constant dynamic flux rather than a specific set point (homeostasis). We are an external restoring force.

The position of an electron is more relevant to us than the velocity of an electron. The research that was successfully completed in the Electron Observation Experiments also contributes to my treatment formula. These experiments found that electrons act like waves when unobserved, but act like particles when observed. This behaviour is fortunate for the manual therapist as we sit in observation. Therefore, this knowledge aids in determining position.

Finally, we look at the key properties of electrons: position (P); momentum (M); spin (S); and energy (E). There's position cropping up again! Let's add a few more facts before we move into the hypothetical realm:

1. Electrons are part of atoms

2. Atoms make up cells

3. Cells make up tissues

4. issues make up organs

5. Organs contribute to systems

6. Systems contribute to the organism

The question is how do we translate this science into a working experiment? This is where knowledge and creativity merge: we use the tools we apply in practice, in combination with the sensorial information received from the body, to overlap with scientific fact (at this point in time) to find position. To quote Einstein:

"Imagination is more important than knowledge. For knowledge is limited, whereas imagination embraces the entire world, stimulating progress, giving birth to evolution."

Why is position so important?

We want to know position so that we can release tension at the source. Is this the "root cause" everybody is always talking about? Using the Uncertainty Principle, we know that lack of positional certainty necessitates alternating our attention between momentum and position in order to increase positional certainty. Shifting our perception towards waves allows us to localize our positional certainty to a specific region. That region needs to be larger in the beginning to facilitate "observation."

In quantum theory, position isn't restricted to one point. Therefore, we must search for position within the ever-shrinking wave region of our observation; this is the fine-tuning part of our technique. Observing wave regions and intermittently taking snapshots of position will allow us to close the walls in on the point of release; this boosts our opportunity to find position based on the likelihood that the point will appear within this region. We continue to tighten the noose until we "land" on the position of dysfunction allowing the tissue to release.

To summarize: we want to find the root cause of tension by having a wide-angle lens to observe its location. Then, we gradually tighten our focus through the pressure and mechanics that are communicated in our techniques until the point releases. There is a palpable physiological release that awareness and presence will highlight when this point is reached. These discoveries led to the formulation of the following equation:

P = +/-M +/- S +/-E

where:

P = position

M = directional movement of the anatomical/structural volume (inertia)

S = rotational spin

E = energetic compression or expansion (relates to emotional components of tension)

(+) and (-) relates to the direction of force applied

The closer we get to P, the closer we bring M, S, and E to 0. The exact hand position, amount of pressure, direction of pressure, and length of pressure, will balance out and release the positional anchor. If we arrest momentum, then we discover position.

More research required:

I have been applying this general concept with more and more acuity over the last 18-22 years of practice. However, it has only been recently that I have put more pieces of the puzzle together. There is much overlap between manual therapy, manifestation of tension, emotion, and quantum mechanics. At present, this is a working hypothesis in a longitudinal study: practice. It is founded upon science, reflection, presence, and personal experience. The synergy of mind and body are the human experience.

Ryan Hayes RMT

04/28/2026

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