08/02/2026
Does the order of your treatment matter?
Most of us were taught what to treat.
Fewer of us were taught what to treat first.
In musculoskeletal practice we often have some latitude. Address the thorax and then the hip, or the hip and then the thorax — the outcome is frequently similar. The system tolerates our sequence.
When fluid and dural systems enter the picture, that latitude narrows.
Drainage is directional.
Pressure is directional.
And a region with nowhere to drain into will not respond to being asked to drain more.
It is a little like opening a door into a corridor that is still closed. The door was the right door. It simply was not the first thing that needed to happen.
Before asking a region to move fluid, we have found ourselves asking three questions:
Where is this region draining into?
Is that route open?
Have we created capacity before asking for flow?
It also offers an explanation for something most of us have experienced.
A technically sound treatment. A reasonable clinical rationale. A clear change on reassessment.
And then very little carry-over.
Sometimes the technique was not wrong.
Sometimes the order was.
Day 2 of the 2026 ISM Update is built around this idea — identifying and treating the musculoskeletal barriers to pressure regulation and drainage before we turn our attention to the cranium.
Not a new protocol.
A reasoning principle — and one that, once you see it, is difficult to unsee.
Date: October 23, 2026 1pm – 7pm | October 24 & 25, 2026 8:30am – 4:30pm
Location: Akasha Studio at Diane Lee & Associates in South Surrey, BC, Canada
For more information please check out the course website: https://learnwithdianelee.com/product/2026-ism-series-update-bc-2026-10/
We hope you'll join us!
Diane & Judit
