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Ruth Werner returns to The Thinking Practitioner for a roundtable discussion with Til and Whitney on one of the most overlooked topics in manual therapy: balance challenges. Ruth is the author of A Massage Therapist’s Guide to Pathology (now in its 7th edition), a long-time educator, and host of the podcast I Have a Client Who. In this wide-ranging conversation with Til and Whitney, Ruth brings her characteristic clarity to a complex subject — helping us understand what’s really happening when clients feel dizzy, wobbly, or unsteady. Balance difficulties show up constantly in clinical practice, yet most of us never learned how to think about them. Clients get dizzy turning over on the table. They feel lightheaded sitting up from prone. They mention casually that they’re “always a little unsteady” after sessions — and we realize we’ve never asked the right questions. This episode gives MTs a framework for understanding, responding to, and even helping with balance challenges — while knowing when to refer out.