Finding a Clinical Roadmap- LTAP™ Level 1 Alumni Interview
In this bonus episode, I’m joined by my friend and colleague Dr. Katrina Kneeskern, a physical therapist based in Minnesota, who shares her journey from professional burnout to rediscovering her passion for patient care through the LTAP™ approach.
We dive into what initially led her to the LTAP™ Level 1 course, how she’s been using it in her practice since taking the online training last fall, and what shifted for her after experiencing the in-person course in Denver.
Katrina opens up about:
How she went from feeling stuck in a rigid orthopedic model to confidently treating the whole person
Why learning where to start (and not just what to treat) changed everything
Her experience as a neurodivergent learner and how the LTAP™ format supports different learning styles
The powerful shift that happens when you stop guessing and let the body guide you
Whether you’re feeling a little bored in your clinical work or just looking for a more effective way to treat complex patients, this episode is packed with real talk and practical insight.
Resources Mentioned In This Episode
Online LTAP™ Level 1 Spring 2025- Starts April 14th! enroll April 7th-10th! ENROLL NOW!
Learn the LTAP™ In-Person in one of my upcoming courses
Considering the viscera as a source of musculoskeletal pain and dysfunction is a great way to ensure a more true whole body approach to care, however it can be a bit overwhelming on where to start, which is exactly why I created the Visceral Referral Cheat Sheet. This FREE download will help you to learn the most common visceral referral patterns affecting the musculoskeletal system. Download it at www.unrealresultspod.com
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Hello. Hello, back with another episode of the Unreal Results Podcast, doing an additional bonus of Facebook Live I did with a couple ltap Level one alumni. This conversation is with my friend and colleague, Dr. Katrina Knesskern. She is a physical therapist in the Minnesota area. And, um, she joins us to discuss sort of like what led her to the ltap level one course and how she's been integrating in her work since participating in the online course last fall.
And then, um, sort of her insights from getting to experience an in-person course this past weekend in Denver. So super stoked to share this conversation with you. It was really great. She had some really wonderful points and uh, I hope you enjoy.
Anna Hartman: Hello. Hello. Welcome.
I appreciate you making it. We're, we are live in the Facebook group, so Oh.
Um, yeah, it's super informal. We're, but we're here, we're, we're, we're going. Um, yeah, I appreciate you helping me out. Um, of course, yeah. I've been kind of nonstop since the course, so. Yeah.
Katrina Kneeskern: I feel like you're always nonstop. It's like, it's kind of your mo
Anna Hartman: Yeah, you're right. You're not
Katrina Kneeskern: wrong. Yep. I was bragging about you though, to my, so my bestie that I was staying with in Colorado, she's an OB GYN that runs a practice and like her niece is a PTA and I was just like, she's like, I want all of her info 'cause she's doing a functional medicine stuff.
So I shared your podcast. And your website. And so she was super excited to learn from you too. Oh, I appreciate that. Love
Anna Hartman: that. Um, yeah. So I was gonna say, I, you know, like I said, I'm live in the Facebook group. This is the Facebook group for the, um, everybody that was a participant in the missing link this past week.
Katrina Kneeskern: That's where
Anna Hartman: I started. That's where you started. Yep. So, um, for those of you joining us, this is my friend and colleague Katrina. She is You're a pt. Yeah. You're a pt. Yep. Um, where. Minnesota. Minnesota. That's right. I always ask you that. I don't know why I can't get it in my brain maybe 'cause I've not been there.
So it's like, yeah, seems like this weird foreign place to me. It's, um, but yeah. So your PT in Minnesota, um, like you said, you're fairly, fairly new. I think it was the last round that you joined, like last fall that you joined the um, online in link. Yep. And then the online course. And then you've been devouring the podcast and then you joined me this past weekend in the Denver course, the in-person course.
So, um, you know, for these Facebook. Lives. And, and, and I also end up putting on the podcast because I found that people who even have already gone through the course, they like to hear from other, per other people, like how they're using it, how they fit, how it fits in their practice, like what changed, what brought you even in.
So, you know, this is not a super like, formal thing, um, interview. It's just more of a conversation. So, but I think it is really helpful for people to hear sort of what led you to me, like what un unwanted experience for you having that you were hoping that the ltap in learning from me could help you with.
So
Katrina Kneeskern: yeah,
Anna Hartman: you, and you can do a little intro about yourself too, like maybe the patient population that you work with, et cetera.
Katrina Kneeskern: Well, and I thought it, and you can always cut me off if it's tmmi, but just to give even like more background of. So I originally, like I was a dancer growing up, dancer figure, skater gymnastics.
Started seeing a PT when I was 12 for injuries. Right. Um, and my journal from eighth grade said I wanted to be a dance major, physical therapy minor. So I always knew I wanted to do that. And I was originally a dance major musical, theater minor in New York City. So I was a dancer first. And then, so I was always very in tune with my body and injury.
And, um, when I left the dance world, I went into the PT world. It just turned to be very orthopedic, you know, research black and white. And I just never felt like it made sense and I would always get kind of glared up by my classmates because I can't regurgitate information. I like the why I would ask a lot of questions and, um, I can't just.
Accept things as they are, like without knowing the why or the root cause of that. Mm-hmm. And then throughout my PT career, I've been a DPT 16 years. I just started to hate my, like, career and profession. It was very machismo, very um, cut and dry. Oh, sorry, my dog is You good. Might you might have a little puppy in here.
Yeah. You missed me. Um, so, um, then I did like fellowship. So I did spinal manipulation, cupping needling, trying to learn more. And it wasn't until I did a pelvic floor residency like three years ago, I also got certified in Kundalini yoga, which is like breath and meditation, learning the nervous system regulation.
I myself went through trauma, GI stuff. Um, I. Then going into the pelvic floor about three years ago, it was finally all the things that I'd learned before was like accepted about the nervous system regulation and how the, it's all connected and how the learning visceral stuff was brand new to me and stuff in my old brain that was like, oh, that's all woo woo.
But then in my own body, I had stomach surgery, GI stuff, nervous system dysregulation, hormonal imbalance, and all my tests came back normal and everything was fine and no one could figure out, or I did all the regular PT and nothing made sense until I started getting some visceral stuff and addressing more not true orthopedic or black and white.
Right? Right. So when I started experiencing that myself and started experiencing it on my patients, I just. I've always been passionately curious, so I just wanted more.
Anna Hartman: Mm-hmm.
Katrina Kneeskern: And I was learning all these techniques. I did visceral mobs, I did dry needling, I had all these tools, but how do you know like which organ to treat or which to do that?
And I just, I don't know how I fell upon You probably came up on my Instagram. Yeah. Probably not. Sorry. Or was like the missing link. Like it was the missing link and I was like, everything that you said was like, this is what I was looking for. Like
Anna Hartman: Yeah. Like you had a bunch of the tools. You knew Yes. You knew you wanted to treat the whole organism and you had tools to do it, but you just didn't know how to like blend them all together and
Katrina Kneeskern: Exactly.
Or where to go. Mm-hmm. And how, how you presented your information of like breaking it down. And that's how I felt fellowship was too. It's like we have all these puzzles, but how do you know where to go and how to get there faster? Yeah. Trial and error. You're wasting their time. You're wasting your time.
You're frustrated. They're frustrated.
Anna Hartman: Yeah.
Katrina Kneeskern: And it, what you say, it's all anatomy and it just makes sense. And it's a roadmap for that differential diagnosis of like, here's very clear cut things to do that tells you is it central nervous system visceral or is it orthopedic? And it's just a clear road map and a tool to like not, it's not an assessment tool, but it kind of like, you know what I mean?
Mm-hmm. It just helps you to figure out where to go first. Yes. So better, faster results and like. It's just amazing how much it works and yeah, I'm just grateful.
Anna Hartman: Yeah, so that's something I wanted to ask too 'cause we haven't really gotten to talk about it too much, but, you know, having gone through the online course, and I know that you, when we went through the online course, you were on, you know, part of it, you were on vacation, so you did a little bit kind of like self-paced catch catchup as well.
Correct. Um, before you came to this in-person course. So how did you feel like the online course, like, gave you the tools that you were able to practice and start seeing results already within your patients before you even came this weekend?
Katrina Kneeskern: For sure. Mm-hmm. So starting with the missing link and like the SI assessment, like that first part of the ltap, because of all the tools I had, it helped me to know am I going visceral, central nervous or peripheral first?
And like that in itself was helpful, but even your lectures. The breakdown of the anatomy and physiology just started having me question more root causes. So even if I didn't have all the skills or fully understand like the steps of the ltap, which is why I did the in-person, because Right. I had to do a lot of it on my own and I just didn't, and then holidays hit and it was my own thing.
Yeah. I didn't practice enough. It was on, it was on myself, and I just, yeah. I mean, life get, yeah, life, life happens. It's tough. I get it. And then I had a student and all the things. Um, so, um, but yeah, it just helped you just have such a in-depth explanation of the anatomy and physiology and it helps us to start questioning why, like what are the nerves that innervate that?
Yeah. Like, or that area. What are the referral pain patterns and stuff. So, but it's like with anything, layers of learning and repetition for sure. That's why I just wanna keep doing it and,
Anna Hartman: mm-hmm.
Katrina Kneeskern: Over and over, over because that's how we learn.
Anna Hartman: So the, uh, the results that you were getting, you know, since implementing the SI joint test especially, and then under, you know, having more of that insight on the anatomy and the physiology and the root causes, were you noticing that treatments were sticking more or you're getting people like better, faster?
Or what was the change you noticed? Especially sometimes I ask people like, you know, we all have patients that have seen us like continuously, no matter what's going on in their body. Right. And so like what about those patients who, you know, maybe we're tough cases or just repeat cases. Have you seen them and use this as a model?
And are you, are you noticing that it's, yeah. Less visits or less time or like you can progress, you know, what exactly are you noticing?
Katrina Kneeskern: I feel like it's, especially for my male pelvic pain patients, I am getting a lot more comfortable results 'cause. Me orthopedic like, and not to say that ego, but like we need to fix the muscles or do treat the muscles and go into colon.
That's not very comfortable for a lot of people. And so I really like that a lot of what we can do addresses the central nervous system, which addresses the parasympathetic nervous system, which addresses the pelvic pain. Yeah. That's internal. And then so I just feel like it's a way more approachable and more effective.
Anna Hartman: Mm-hmm.
Katrina Kneeskern: And longer lasting. Yeah. And then it gives them tools and things to work on at home and also just helps them feel like they're not broken and that they're like their understanding of it. It's such a relief and like hope for them, which again produces a bunch of chemicals that probably their healing as well.
Yeah,
Anna Hartman: absolutely. Yeah. Giving people hope and giving people their autonomy back through some of the exercises. And then also through like not feeling that they are have to do intense manual therapy or internal manual therapy forever in, in order to like feel whole is
Katrina Kneeskern: Yeah.
Anna Hartman: So powerful.
Katrina Kneeskern: Yeah. Or dry needling too.
'cause dry needling is super effective. Yeah. But a lot of people don't like needles. Yeah. So having just like the touch, and that's why I needed the in-person is I, I didn't know how to read like the visceral, so that was really helpful. 'cause I never took a baral. I took a IPA visceral course. Mm-hmm. Yeah.
Yeah. Definitely. So it just taught us how to treat, but it didn't teach us like how to read. Yeah. And so I really enjoyed that aspect of the in-person. Yeah.
Anna Hartman: That's great. Yeah. The um. Sometimes, you know, I'm, I'm assuming too, this is kind of, public pain can often be kind of like people with back pain. Like, I mean, any sort of long, more like chronic or longer term pain mm-hmm.
Or like pain that we all know is gonna like, be cyclical in na na in nature or come and go is like oftentimes patients are just looking to guidance on like how to understand their flareups and how to manage their flareups. And so, um, yeah. When you give them all these tools and understanding around what's going on, like from a nervous system's perspective, from a visceral perspective, and be like.
You don't have to get, you know, next time you get flared up, whatever it may be like, instead of like, you know, getting depressed and like taking pain meds or like waiting to get on your physical therapy schedule. Like there's all these things that you can do to take care of yourself. Well, you're waiting for that more specific manual therapy or drain needling or whatever it is.
So,
Katrina Kneeskern: and I used to always refer them to get that book Activate your vagus nerve. Mm-hmm. Which covers a lot of the things, but I feel like your tools, like even with the Cordes ball, that's just like even way more accessible or feasible for people sometimes. Mm-hmm.
Anna Hartman: So that's awesome. I love that. Yeah. What, what are your, um, well, and you've talked about this, I mean, you haven't talked about this at the beginning of your introduction in terms of like the type of learner you are in terms of, you know, asking more questions and.
I don't wanna say that you, uh, like go slowly through the work, but like, I know you want to like repeat it, right? Like, but you go slowly, but you wanna repeat.
Katrina Kneeskern: Yeah. I have like a d ADHD and school was a struggle for me. Mm-hmm. And so I, I go, I do go slow, but I tell people I'm like the turtle, like I'm a slow starter, but fast finisher and I repeat, repeat, repeat, repeat.
And once I got it, then I like flow. Then you got it. Yeah. But it just takes me longer to process and
Anna Hartman: Right. And so why I'm asking that and bringing it up is just, you know, I I, there's a lot of people that come through my programs that are just like you and, and like, you know, have some like neurodivergence, like the a DH, ADHD that makes learning hard period in any setting, whether it be in person, school or online.
Um, but I think I. A lot of them, especially with this online learning environment, get a little discouraged and maybe even, you know, the tough part with the missing link is it's that free week to let you all experience what it's like to learn with me and experience the ltap, but it's also like a little bit faster pace than the rest of the course.
Mm-hmm. By nature of like, it's six days and we're trying to get so much information in. Yeah. So can you speak to that aspect of the, on specifically the learning through the online course and like, you know, I don't know how it supported you or what you've liked or what you even still feel challenged with.
The online course
Katrina Kneeskern: was so good and I, I was in Greece for two of the weeks, so I did, it was just off and had to kind of play catch up. But even still how she gives you just little pieces at a time to practice one thing and the skill. It's just, and it was the same with fellowship. The manipulations just reps, reps, reps get the reps.
And you can think about the why after that, but also because of my A DHD, like I processed best while walking or running. So like I could play your module while I was running on the treadmill and I'd replay it at night while I was walking my dog. Like, so being able, like when you go to an in-person thing like that was part of it is gone.
Anna Hartman: Mm-hmm. And like
Katrina Kneeskern: all of your lectures, I would, and then I would be like, oh wait, and I could rewind.
Anna Hartman: Yeah.
Katrina Kneeskern: Then there's all the handouts and things that then I could go back and look at it and read it and re-listen again. So again, it provides you the ability. And then I would play it while I was cooking and cleaning.
Like again, just listening into your subconscious, just you can play it and get that repetition and I felt like that really helped. Yeah, it took in more and better. And having that foundation too just better helped me. Mm-hmm. Get so much more outta the in-person. Like, if I hadn't done the online before the in-person, uh, I would've been overwhelmed, I think.
Yeah,
Anna Hartman: yeah. Yeah. And that was good feedback to hear. And we talked in the in-person course, like I get people telling me both ways, like, oh, I, it was really good to do the in person or the online first. And then the in person. Then I get people being like, oh, I really like doing the in person. And then the online, everybody's different.
Key is repetition. The
Katrina Kneeskern: key is repetition. They like the repetition and the reinforcement. Exactly that.
Anna Hartman: Well, and that's too why it's like, you know, I offer the online course twice a year, but, and it's lifetime access. Yeah. But then you also get like. In the next cohort, you can join the live calls and follow along.
Yeah. Just like you're going through the course again. So it's like no matter when you do the in-person course, there's an always an opportunity to do online first or online after, or multiple rounds of online to support it. And so, um, and like you said, I think that is exactly what it is. It's the repetition that actually is the thing that matters the most.
And, um, you know, so whatever order you end up doing it in, like at the end of the day, the repeating is necessary. And that is even why too, like when I decided to roll out a certification program, why I was like very adamant of like, no, you gotta do both. Like you have to do the online and you have to do the in person because one, I wanna like see you talk to you, feel your hands, let you feel my hands.
But then also I know that it forces the repetition and um. I just, yeah, I mean, and actually it's funny that you said that that's how the Manual therapy Fellowship was for you. And that's where you like, that's what they highlighted. Because whenever I teach, I always end up sharing about, one of my first Con Ed courses when I was a professional was, um, some muscle energy technique courses.
There's three of 'em that I took from the same teacher. His name was, um, Pete Emerson. I, I always wanna say Pete Mitchell, but that's the from, uh, top Gun, that's like Tom Cruise's character from Top Gun. Um, so his, his, I'll take course. So it was Pete Emerson and he, his background was, he was a high vol, high velocity manipulative pt.
Yeah. And so. And that's what he hammered home with us was like repetition. Like forget the, like, don't even worry about the interpretation. Like your whole goal of the class is repetition to get the assessment in your hands, to get the treatment in your hands. And then when you go back to work on Monday, he's like, I don't care who your patient is.
Every single patient gets this technique. Yeah. He's like, and that's the way you're going to learn it best. And I've, I, well, one, because of the repetition, I used those skills every, like I, I taught some of the stuff that I learned in that class, this like a few weeks ago at the mastermind, the level two course.
And I was like, it just blows my mind to that. I still have such good skills from that original course, and that is why, because he emphasized the repetition too. And then too, he just was really good at teaching like a lot of soft skills. And I, I will say that because I had that such wonderful learning experience from him, I find myself, the more I teach, the more I style my entire course very much like that.
Not even intentionally, right? Mm-hmm. Like it's not like I was like, Ooh, let's make this course just like Pete's. It's like, no. Now that I, as I've taught more people, I see that that is what works. And so I have like done it organically, but then now I reflect, I'm like, it's literally exactly what his course was like.
And so I'm You teach is that
Katrina Kneeskern: you teach from your own experience. Yeah, for sure. And so you have something that works. It becomes a part of who you are. Yeah. Yeah.
Anna Hartman: Yeah. So it's just interesting that you said that that was kind of like the message from the manual therapy world. 'cause I'm like, yeah, that is exactly repetition even for people like me in my brain who I retain stuff really fast and I remember things like photographic memory.
But at the end of the day, I do, every time I take a class, what, what really makes the difference is I am diligent of committing to do it on every single person I see for the next couple weeks, regardless of if they need it or not. Yeah. So, yeah. It's so cool. I love that. I, I'm, I'm like forgetting the other questions.
I mean, I guess there's not other questions other than like, is there anything else that you would wanna share with somebody, like if they were on the fence and not just like, oh, do it. Anna's great and the course is great 'cause I love that, but also like, what do you think, like what else is there to share about like how it's affected your practice or your, even like your personal.
Personal things about your professional life, like stress levels or finances or wait lists or like view of you and your community, like, you know, all those kind of like Yeah. Harder to measure things.
Katrina Kneeskern: I think the thing is, is like we all go through stagnation in our careers, right? And, um, I've had to struggle through multiple moves.
Like, I've lived in Arizona, Minnesota, California, Colorado, like Covid. I was begging groceries and Whole Foods, like, just a lot of like in health extremes, like hospitalizations. So I just have a different perspective and I think you are never losing out when you invest in yourself. And the thing is, is like I paid 20 to $25,000 out of pocket for fellowship, for Healthcare, mastermind for that, and like.
When you think abundantly, whatever you put out there will come back to you. So like absolutely that amount that I invested, I ended up getting a different job that paid me exactly that much more. Okay. Or like, yeah, there was like different things where I did the mastermind and then there was like an affiliate thing and how much the like mastermind cost ended up giving me that like, so there's just little, or like I got that amount in a tax refund.
Like there's just different things. And also like your happiness is not gonna be in stuff and we're constantly being sold to and like that $20,000 or $2,000 new iPhone or a ring can like be put on hold and that. This will seem like nothing five years from now. Yeah, for sure. And it will bring you so much happiness and joy to feel confident and competent and help other people.
And that again, whatever you're investing, it will come, it will be paid back to you. Yeah. With interest. Yeah. Even like, it just like don't even money is just so subjective and I know it's important. Yeah. But like you can always make more money. Yeah. But like these experiences and when you're learning in your brain and making these connections, like they're gonna bring you such more lasting happiness that you're not going to need or want another dopamine fix from the next Lulu jacket or whatever.
Like, I don't know. Yeah. But basically too, if you're on the fence, just know that this is, this is the deeper level of learning and that stagnation. Stop. When you keep being curious and you keep learning new ways of thinking and opening up your mind, you get excited about what you're doing again, because otherwise it's just like Groundhogs Day.
Yeah. And you get resentful. You start to get resentful at your patients. But really it's because you are unhappy, you're, and you're unhappy that you're not getting different results or there's something in your life that you're not looking forward to. Mm-hmm. And when you learn new skills and new ways of helping people, it excites you.
Yes. And to get those results and to learn different ways to help people. So like literally, yeah, Anna's amazing and awesome and do it, but like invest in yourself. Invest in learning. Invest in learning different ways to look at the body and what you're doing and the people that you're working with because like that is ever fulfilling and everlasting and sustaining and will bring you eternal like.
Internal. Yeah. And eternal. Just like, yeah.
Anna Hartman: Helping eternal Jesus. I'm kidding
you. Say you're preaching. I love it. I love it. But also like you are, like you said it, like the, the, the, when you start feeling like you're resenting your patients or annoyed with your patients, or feeling like your patients are an energy sucker, like that's actually more to do about what's going on with you and how you're feeling than your patients.
And like, yeah, you're burnt out, you're like not feeling confident and you're like all the things. And I, I was there too, and I, you know, and I thought, I wa I, there was a point in my career that I was like, I'm so over treating patients. Like I'm so sick of everybody needing me. Mm-hmm. And I'm so sick of dealing with everybody's problems and I just don't have time for it and it doesn't bring me joy anymore.
And all the things. And I was very ready to like at my. At the place I was working, which was at EXOS at the time, I was ready to actually leave the patient care setting and go fully into like the course like content creation for the education side of things. And, um, they, in the, in the interim, I was, when I was switching from leadership role to that, they asked me to, um, go back to just treating clinically for like three months during our busy season.
And it was the first time in like seven or eight years. My only role in the company was to just see the athletes just treat the athletes. And in that three months, like I found myself again and I found joy again. And I was like, this is, and I, it was just this huge realization of like, oh my gosh, like. Why would I ever leave this?
Like this is what I love the most, is working with people and helping people. And how could I ever think that, like I didn't, but it's because I was just burnt out and like tired and doing too much and like all the things. And so that was just such a huge realization that like, no, like I'm in this, like this is what I love and this is what I'm good at.
Like, I I shouldn't leave it. So yeah, you're, you're right. I
Katrina Kneeskern: totally relate to that. I was a director of physical therapy at like two. I was just like totally burnt out. Yeah. And it, during Covid, when I came back after Pelvic Reine, I came back. I was like, I just wanna treat, I don't wanna be the boss. I don't wanna be in charge.
I just. I, I, I love helping people. Mm-hmm. Mm-hmm. I wanna be in charge of anybody else. Yeah. Same. So tough.
Anna Hartman: Um, right after I had that realization, I, um, I had that realization and then I, I quit. I mean, I quit my job 'cause I was like, okay, well yeah, I actually, I actually wanna keep doing patient care. But it was hard to go from a director level back to like an assistant level.
Um, both financially and just like when you're working with the same people, they're still gonna come to you for all the director stuff, even though you're not getting paid for it anymore. And so I took time off and then that was the first time too, that I, like, that was the beginning of my like, self care journey when I was like, oh, okay, so I guess I need to take care of myself.
And then the more I took care of myself, the more it like fueled me to be better for my patients and you know, so on and so forth. And so, yeah, it was just a huge tipping point. Is that realization. So I love that we covered that. So thank you. Um, welcome Bethany. Hello. Um, Katrina, I really appreciate you being here.
You're welcome to hang out if you want, but also you can go. Um, I am so grateful for you and the community and have met you and been able to meet you in person finally, and I just really appreciate all your insight
Alrighty, well have a good day. Thank you. You too. Get some rest. I'll. Okay, bye.