Breakout Presenter: Trends in Anatomy Education at the AFMTE 2021 Educational Congress

It was truly my pleasure and delight to get some one-on-one time with Ruth Werner to talk about the upcoming educational conference. I look forward to sharing information with fellow educators. The information applies to entry-level faculty as well as continuing education providers.

Learn how to motivate students to make them want to learn anatomy.

Get ideas for active and interesting learning experiences to use in the classroom.

Find out how anatomy and physiology are taught globally in different settings.

Saturday, July 17th

Summer 2022 Services

Zeth Pugh, MEd, MS, BS, CMBE, LMT

Freelance Instructional Design & Leadership Consultant 

My area of expertise is massage therapy and bodywork business and education. 

941-321-5311 please text /

Zeth holds a Master’s in Instructional Design, a second Master’s in Leadership, and a Bachelor’s in Healthcare Management. She is currently a doctoral student at USF in Educational Program Design: Innovation and Creativity. 

Services I offer updated for Summer 2022:

Massage and Bodywork School Consulting

Assistance with curriculum, instructional design, teacher training, in-service, change management, communication, and leadership. 

  • Learn how to communicate changes to your team more effectively.
  • Learn how to create relationships with staff and students.
  • Improve your formative and summative assessments. 
  • Clarify your instructional goals and methods. 
  • Integrate lessons learned from staffing and training challenges. 
  • Improve your interviewing, hiring, counseling, and firing skills. 
  • Create a culture that feels more inclusive and innovative. 
  • Identify weaknesses in your school’s strategy or its implementation.
  • Learn how to use improvisation and role-play to enforce clinical and professional skills. 

Spa/Salon Consulting

Assistance with management and leadership practices, organizational strategy, customer retention, training programs, and communication.

  • Provide better onboarding experiences for your employees.
  • Streamline your printed forms, job aids, and checklists. 
  • Learn to guide your team through role-playing difficult scenarios. 
  • Improve your policies and procedures. 
  • Help your lead therapists to grow into leadership roles as trainers and coaches. 
  • Help your front staff communicate more clearly with your back office team.
  • Identify weaknesses between your policies and implementation.
  • Learn how to evaluate the effectiveness of marketing campaigns, training programs, and more. 
  • Improve manager’s skills in interviewing, counseling, training, and firing. 
  • Improve owner’s skills in delegating tasks, hiring consultants, and achieving better work-life balance.
  • Create formal documents such as SWOT analysis, business plans, organizational mission statements, and more.

CEs for Hands-on Touch Professionals Consulting

Turn your expertise into a formal educational program. 

Solo-preneur Consulting

Individualized help with strategy, marketing, customer relationship, and more. Coaches can get help with program design, retreat planning, and more.

Facilitation of Instruction

Need help covering a virtual course? I have experience teaching entry-level massage topics business courses for massage therapists, study skills and student success, anatomy & physiology, pathology, ethics, prevention of medical errors, and trauma-informed touch. I can also offer one-on-one and small-group study sessions. 

Need a custom presentation? I can help you supplement your faculty and instructional staff. 

Custom Digital Portraits

Celebrate an achievement or milestone by having a custom portrait created.

COMING SOON! Interactive E-Learning Samples

You want an instructional designer who can use professional tools, right?

Well, sometime very soon, I’m going to have several experiences for you to interact with. I am currently getting my files uploaded to AWS and quality testing.

One e-learning unit is built with Storyline Rise. This is focused on higher education anatomy classrooms. Students rarely are given tasks they need to fully integrate the knowledge. E-learning tools such as Rise allow for rapid development of learning experiences. This unit is meant to help learners recognize terms and categorize them appropriately.

The second Rise unit is on Growth Mindset.

Another unit was built with Adobe Captivate. This short exercise teaches learners about bony landmarks of the body. Two types of bony landmarks are discussed. Multiple-choice, drag-and-drop, and other interactions were used.

Finally, I created a Moodle class. Hands-on service providers face unique customer service challenges. This lesson focuses on managing customer expectations, identifying treatment goals, and creating a sense of collaboration and shared responsibility. This training is designed to help estheticians, massage therapists, and other providers in the hospitality, wellness, and beauty industries.

RPG Concept Art: Swamp Mummy

I am thrilled to be providing concept art for Falcon Games. Gabriel Falcon is a Puertorican game master and dice-based RPG scenario creator from Orlando, Florida.

This is a sneak peek of one of the concept art pieces I recently sent in. Think swamp mummy/monster.

Procreate and MotionLeap

New Art Experiments

My duties as Director of Marketing & Communication for the Alliance have kept me busy lately. To balance that work, and the stress that job hunting brings, I’ve also been making a lot of artwork.

The Jellyfish & Pop Culture Series

As an adult I prefer the art on my walls be more mature, even if my heart aches to celebrate my favorite fandoms. This mashup experiment was a nod to the search for wall art that could do both.

Below is the Wicked Jelly of the West that I made in procreate and then animated on my iPhone with a fun app (paid) called MotionLeap.

Prints of Darth Jelly, Dr. Jelly, The Wicked Jelly of the West, and others await you at

The Jellyfish & Other Stuff Series

Prior to finding a strong subject matter, I experimented with the concepts of hurricanes, fireworks, and robots.

VQGAN+CLIP, ML, AI, and Neural Network Art

(This is the notebook I’m obsessed with:

I have been exploring graphic and design programs since Print Shop on the Commodore 64. Lately, though, a breakthrough has been made in technology that has blown my mind like no other.

There are many Google Colabs out there that use artificial intelligence, advanced mathematics, and other generative methods of using technology, programming, and neural networks to make artwork.

An AI generated video by Zeth Pugh, M.Ed.

Factors of Intensity: Ways to add to or subtract from perceived intensity during a massage therapy session.

One of the areas I love to talk about is health communication.

Massage therapists can benefit from expanding their vocabulary of touch and improving their communication with prospects and clients.

“Deep Tissue” has no well-defined or agreed-upon meaning in the industry. Clients ask for deeper pressure when it is impossible or inappropriate to provide. What should a therapist do? And how can a therapist modify a treatment to meet the needs of more sensitive clients?

When I think of a client asking for deep tissue, I picture someone who likes intense massages or has a problem they want help with. My practice is to set a specific goal with the client.

What do they hope to achieve? How will they know if their time and money were well spent with me? This will identify the clients who want intensity from those who want a solution to pain.

Next, I manage the expectations of the client and together we co-create a plan of action. This is important for clients who believe massage therapists are magicians who can fix them or stretch one hour into six.

“I hear that you want is ___________. What we have time today is either ________ or __________. Which do you prefer me to address during today’s session?”

Assuming that the client is concerned about the intensity of the massage (they want to be run over by a steamroller, walked on by a horse) or their sensitivity (they cannot handle a lot, have inflammatory reactions, are scared it will hurt) here are ways that I can increase or decrease the intensity.

It’s critical to be adaptable. Some of these factors may not be under the therapist’s control. Others will be. Each of these can be mixed and matched. Every client’s body and nervous system are different. (Keep that in mind as this chart will not be accurate for every person.)

I teach many other factors of intensity in my classroom. Here are the main ones:

Least IntenseSuperficialStaticMuscleBroad (forearm)Relaxed
SlowTendonNarrow (fist)Shortened
Most IntenseDeepFastLigamentSpecific (Finger tip)Neutral

The tissue depth that is being addressed is what most people think of when they think “deep tissue.” Tissue that is superficial is often less intense to have massaged than tissue that is deep.

Speed refers to two things:

How fast is your massage stroke? A massage stroke that is slower will be more relaxing and less intense than a fast massage stroke.

How quickly are you sinking in to the tissues? Are you allowing tissues to adapt and soften? Or are you digging into a taut area right away?

What type of tissue is being addressed? Muscle belly is often going to feel less intense than work on a tendon. A ligament is often going to be more intense still. Nerves can be most intense. (And should only be worked on by those who have been properly trained to do so.)

What are you using the manipulate the tissue? A forearm is a broad surface and can be used for light pressure as well as deep pressure. The area that it contacts is broad. The tip of a thumb or finger, however, is smaller. A smaller point of contact spreads the force over fewer nerves and therefore may feel more intense.

Finally, what position is the tissue in? Relaxed tissue will feel less intense than active tissue. Say the client has a temporal headache and needs work on the upper trapezius. A shortened upper trapezius (arm off the front of the table) will feel less intense than a lengthened upper trapezius (arm down by the side).

The hip will often be more intense when the client is sidelying as opposed to prone. How the nerves and tissues are exposed impacts the perception.

Briefly, some of the other factors I talk to students about:

  • Setting
  • Context
  • Pillows and bolsters
  • Environmental cues
  • Treatment length
  • Treatment frequency
  • Warmup/pre-treatment
  • Post-treatment

LinkedIn Articles

You can connect with me on LinkedIn here:

One of the articles I posted on the social media networking site involved the pay rate for massage therapists at chiropractic offices and why they weren’t likely to get raises anytime soon.

I have also written about why massage therapists need to step up and volunteer in professional organizations, job hunt tips for LMTs, and previously, when I was a practice owner, I wrote about my treatment philosophies.

Several Ways Massage Educators Can Utilize Available Images

As a massage educator, I am always looking for experiences to help my learners grasp complicated anatomical concepts. An understanding of the anatomy and physiology of the body is essential to applying safe and effective hands-on clinical skills.

Many massage teachers may feel overwhelmed when they cannot find an image that fits what is in their minds. Or, they spend half their time in content creation finding the “perfect” images.

I liken this to going to the grocery store with a meal plan, regardless of how much items cost or how fresh they are, then getting frustrated when your grocery bill is prohibitive.

Instead, work with what’s available. Check the food store’s online advertisement and make a list of meals based on what’s on sale and what you can afford.

To do this within the classroom, I’m going to use a free image that I downloaded and suggest a wide array of learning experiences to go with it. My goal is to give you ideas that you can use with almost any free image of a human.

One site that has free images is “Unsplash grants you an irrevocable, nonexclusive, worldwide copyright license to download, copy, modify, distribute, perform, and use photos from Unsplash for free, including for commercial purposes, without permission from or attributing the photographer or Unsplash. This license does not include the right to compile photos from Unsplash to replicate a similar or competing service.”

I looked for images of a person where the body was clearly available.

Here is the one I chose for this article:

A free image of a shirtless man facing away from Unsplash by James Barr

Activity 1: Get comfortable recognizing muscles

If your school has a projector, you can choose an image of almost any human and project it. In my school our projector goes onto a dry erase whiteboard.

  1. Simply point to a muscle on the image and ask students to name the muscle.
  2. Ask a student to use a marker to “color in” or “outline” a muscle that you name. “Please outline the right deltoid.” “Please color in the widest back muscle.” This helps students visually connect muscles from the textbook with a human.
  3. The instructor fills in the muscle and then assists the students in drawing the basic shape as an art-based note-taking activity.
  4. The instructor can ask students to mark where they think bony landmarks are located on the image.

Activity 2: Get comfortable with names of anatomical positions and movements

  1. “What is the position of the right g/h joint?”
  2. “Is the right hip flexed or extended?”
  3. “Is the right scapula upwardly rotated or downwardly rotated?”
  4. Multiple-choice options work for games like Kahoot: “What is the position of the right arm?” a) shoulder extended, elbow extended b) shoulder flexed, elbow extended, c) shoulder extended, elbow flexed, d) shoulder flexed, elbow flexed.

Activity 3: Get comfortable with actions of muscles

  1. “What neck muscle is contracted on the right?”
  2. “What muscles would he need to use to step up onto his right leg?”
  3. “What muscles are working in the right shoulder and what are they doing?

Activity 4: Play a game

Groups of two players compete. One partner is shown an image which they then must describe to their teammate by way of giving instructions that reinforce what the teacher feels the students need. “Flex your right knee. Flex your right arm.” It might be, “contract your right SCM, now contract your right hip flexors.” The team who gets their partner in the correct position first wins a point.

By Katie Bush, via Unsplash

There are many free images that are more dynamic such as this yoga photo by Katie Bush.

“Action shots” are great because they provide an opportunity to discuss positions, actions, synergists, antagonists, common complaints, and clinical skills.

You can ask a large number of questions about each image.

“What are some concerns that a person who loves yoga might show up with?”

“What are some common pain complaints that would prevent this particular posture?”

“Which muscles are flexed? Which are extended?”

“Describe the position of the scapula and name the muscles involved.”

Volunteering: Parkinson Cafe

Using knowledge to help empower others is what feeds me. This particular opportunity involved a group of people with Parkinson’s disease and their care takers.

I presented information about massage therapy to the group. I demonstrated some basic massage techniques that were easy for caregivers to reproduce. Later we shot some videos especially for the caregivers that were distributed digitally.

Volunteering: Women with CLASS

Back in the early 2010s I was a member of a fantastic group of women called SWAT. It stood for Successful Women Aligning Together.

A local realtor started to meet SWAT ladies for coffee on Friday afternoons. Soon a small group would show up. That’s when I came along. After a few months, we had a chat. She didn’t have time to run it anymore and I volunteered. SWAT recognized us as separate from them.

I hadn’t settled on a business name at the time of this award. It became Lakewood Ranch Medical Massage.

The group outgrew several spaces and our Friday morning coffees were the highlight of our week. Here is a shot of our second-to-last meeting space:

I facilitated the meetings for several years. We became “Women with CLASS” which stood for Concern, Love, Appreciation, Service, and Sass.

The design on the right ended up being chosen in 2013. I wouldn’t do the red text if I was designing options today.

Each week one of the women was scheduled to speak. The goal? It had to be educational. I wrote over 75,000 words in our weekly newsletters over the years, summarizing each speaker for those who couldn’t make the meetings.

We highlighted 12 charities a year and held ongoing fundraisers and drives. Each charity was nominated by one of our attendees. The charity was asked if they wanted to participate. They could come to one of our weekly meetings and give a 10-20 minute long talk about their charity. Most of them took advantage of this and I was blessed to meet many local non-profit leaders.

Our biggest event was the holiday party. Each member would bring a large plate of cookies. Each of us would take a few. That way each of our households could experience a wide range of baked treats over the holidays.

We had two vendor events, spearheaded and coordinated by me, both of which bombed badly. The vendors showed up and did a fantastic job. The turnouts were just very poor. I hadn’t asked for enough money from the vendors to market the event properly. Nor had I pushed vendors to promote it enough. I thought that the online posts, donated door prizes (valued at over $500), road-side signs, and mentioning it at all the other networking events I attended would be enough.

Lessons learned: No amount of enthusiasm and hard work can make up for a lack of resources and underestimation of people’s willingness to show up to shop. Sigh.

Sadly, WWC stopped being a part of my life. I had less and less time as my personal massage practice grew. Other women wanted to take the work I was doing and split it between them to enhance their own volunteer experience and personal growth. The direction of the group was shifting. I gracefully bowed out. As I had told them at the beginning, “I will lead the group as long as you all want me to.”

The relationships that I built with some of these women have become long-lasting friendships. Facilitating a group of women over the years, stepping on toes, getting my toes stepped on, and navigating the

Work History: My Favorite Team

You know when you have a team that clicks, works well together, and feels like a dream team?

Maya and Sara were that for me at the chiropractic office. We had a ton of fun. The patients loved coming in to find out what random days we would celebrate. It broke up the routine for us and helped distract our older patient population from their aches and pains.

My favorite was Talk Like a Pirate Day.

Educator Credentials: AFMTE Certified Massage and Bodywork Educator

The Alliance for Massage Therapy Education is one of the most important organizations in my profession. I truly believe that the best way to uplift the massage community is to better prepare massage educators to effectively influence the upcoming generations of students.

I joined as a teacher member.

Then I voluntarily began the portfolio and application process to prove I was a competent educator and had mastered ten competencies. I was the first faculty member at my school to gain this credential.

For more information on the certification process:

It was my honor to be worthy of certification. Since attaining certification I have gone on to volunteer within the organization.

Volunteering: AFMTE Committee

I am excited to be assisting in the planning of the educational conference in 2021. Read more about the call for speakers, conference details, and sponsorship opportunities here.

There isn’t a lot I can share (yet!) but I’m enjoying working with this group of people.

Contributions I can share:

  • Assisted in the creation of educational seminar topic suggestions for the annual survey. (The committee favorites that I suggested were: “Art-Based Approaches to Teaching Anatomy,” “What Educators Wish Admin Knew/What Admin Wish Faculty Knew.” Two of my suggestions that I’m personally rooting for: “Current Topics in Gender and Sexuality,” and “FERPA and HIPAA for Massage Educators.”)
  • Discussed and voted to approve tiered conference pricing
  • Provided ideas for fundraising
  • Provided ideas for value-added virtual conference experiences
  • Provided ideas for “celebrity” interactions

Volunteering: AFMTE Taskforce

At the time of this writing I have had the pleasure of serving the Alliance for Massage Therapy Education in two capacities. This post will focus on the EDI taskforce. (Check out my conference-planning commission contributions here.)

The AFMTE asked for a group of massage therapy educators to meet and advise the board on equity, diversity, and inclusion.

Over the course of several months I was able to participate in the following ways:

  • Group wordsmith
  • Assisted in creation of the charter for the taskforce, subject to board approval
  • Assisted in the final list of recommendations for the BOD
  • Assisted in the creation of qualitative research questions regarding equity, diversity, and inclusion to be added to the member survey, subject to board approval

Currently this project is in the wrap-up phases and awaits the results of the future survey.

Update 12/16/2020:

Once things are finalized and approved I intend to write more about my experiences with the task force.

Volunteering: COMTA Commissioner

How my resume reads: Served as Employment Commissioner with the mission of establishing and maintaining the quality and integrity of the massage therapy profession. Worked mostly remotely with bi-yearly meetings in Washington, DC. Evaluated applications for initial specialized accreditation, as well as renewals, for entry-level curriculum, programmatic compliance, and institutional stability. Assessed submitted budgets for evidence of improvement in schools that were placed on financial probation. Provided expertise in the employer experience related to practitioner preparation. COMTA is a US Department of Education specialized accrediting agency.

What actually happened: This brief stint serving COMTA was exactly what I needed to reinvigorate my career and life. Working with dynamic individuals on a national level made me realize that, while I have LOVED being a licensed massage therapist, it was time to get a higher degree of education and serve on a broader scale.

The motivation gained through my time with COMTA helped me earn a BS in Healthcare Management. That propelled me even further into MEd in Instructional Design. (Estimated early 2021)

It also lead me to understand how important it is for leaders to step up from within the industry and do the work needed to elevate this struggling occupation. I have volunteered time in other ways since.

Tattoo Design: Wolf Print

To be clear, I am NOT the tattoo artist that did the tattoo nor later touched it up. I designed the tattoo and the artist applied it.

There are several layers of hidden meaning within this tattoo. For example, the father and daughter share the sign of Capricorn. Each paw tip is an upside-down heart. The runes spell a name. The blue matches the coloring in the mother’s tattoo. The wolf print is an important symbol for the family.

Other Photography Projects

Over the years I have used photography as a way to make extra money, provide a fuller range of services to clients, and, mostly, as a form of pleasure.

I am beyond pleased that the phone I carry in my pocket can take photos as good as (and probably better than) the DSLR I used to take any of these.

For the record, I have shot two weddings. I’m not including photos here because I have no intention of doing that again.