Explore every episode of the podcast Tough to Treat
| Title | Pub. Date | Duration | |
|---|---|---|---|
| Treatment Timelines and Tackling HEP Non-Compliance: Real Patient Cases | 13 août 2025 | 00:27:26 | |
How long should you keep treating a patient? And what’s the best approach when they’re skipping their home exercise program? In this listener Q&A episode, Erica shares practical strategies—illustrated through two real patient cases, one a golfer and the other a cyclist—for answering the tough question of treatment length and for addressing non-compliance. She highlights how building a strong therapeutic relationship can improve follow-through and make these conversations more productive. Erica also highlights the most important phases of an exercise program to ensure efficiency and compliance. To close, Erica offers a brief update from her doctoral research on menopause, focusing on the role of muscle power in older women and why it may be a more critical predictor of function than strength alone.
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| Managing the Complex Patient – When the Body Chart Is Full | 03 juil. 2025 | 00:17:31 | |
In this episode, Erica talks about how to approach care when a patient has a long history of injuries and a body chart that seems to be "lit up" everywhere. It can feel overwhelming—for both the patient and the clinician. She focuses on the importance of prioritization: identifying what’s most clinically relevant right now. This involves connecting the dots to perhaps an old injury to what the current problem is. In this particular case, frequent bilateral ankle sprains, an ACL reconstruction plus a continued pattern of bilateral issues help you nail down your focus to what is important for you to assess and what is important for the patient to feel. These patterns not only shape your clinical focus—helping you decide what truly needs assessment—but also give the patient a clearer sense of what their body is trying to communicate. What is relevant to you may not be important to them. It's up to you to explain to them why. Key takeaways include: · Avoiding the trap of chasing every symptom. · Establishing a hierarchy of concerns using patient input and objective findings. · Acknowledging the complexity of the history without letting it dictate the entire plan.
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| Bone and Power: Training Smarter Through Menopause | 19 juin 2025 | 00:34:00 | |
This episode dives into some of the evidence on resistance vs. high-velocity power training in postmenopausal women and its impact on bone mineral density (BMD). Research is highlighted showing that high-speed training protocols may stimulate bone more effectively than traditional resistance training by increasing strain rates and promoting osteogenic adaptation. You’ll learn how moving with speed and control helps strengthen bones and prevents age-related decline better than slow, heavy lifting alone. Some of Erica’s research for her doctoral dissertation is discussed and she then presents a case study of a menopausal patient with insidious-onset shoulder pain and offers some clinical pearls as to why, especially in anyone who has played a racquet sport, the shoulder is not the only driver. She also highlights a few targeted interventions that allowed this woman to weight lift and strengthen her shoulder without feeding into her symptoms.
The content contained therein, including text, images, audio, or other formats, were created for informational purposes only. The content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition.
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| Physical Performance Decline in Menopausal Women: Strength vs Power | 03 juin 2025 | 00:35:00 | |
In this episode, Erica dives into the latest research exploring how menopause affects physical performance in women—highlighting changes in power and strength. These findings are reshaping how we approach exercise and rehab in midlife women. Next, she shares an update on her dissertation, which compares premenopausal and postmenopausal women on key physical performance metrics. Erica discusses early patterns emerging from the data, including potential implications for exercise training and rehab prescription. She wraps up with a clinical case involving a woman in menopause experiencing persistent neck and shoulder pain, along with difficulty breathing. She breaks down the history along with a few clinical pearls outlining how past injuries have and continue to contribute to this woman’s issues. Erica also breaks down her exercise program, discussing the do’s and don’ts of exercise progression. Hormonal changes can contribute to musculoskeletal tension and diaphragmatic dysfunction- we know this. But do we really educate our patients on this? Many do not. Whether you're a clinician, researcher, or someone navigating midlife changes, this episode offers insight, evidence, and strategies for supporting well-being during menopause.
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| Building Better PT Practices: Courses, Clinical Reasoning, and Mentoring Insights | 28 nov. 2024 | 00:28:17 | |
In this episode, we answer the most common questions we get from listeners. We dive into course recommendations, highlighting resources for continuing education, mentoring and evidence-based practices.
A key focus is on clinical reasoning strategies—how to approach complex cases and integrate patient-specific factors into your decision-making. We also discuss the value of spending the majority of your first session taking the patient’s story.
Your patients will make you a better physical therapist, if you listen to them. Be curious and let it lead you towards mastery.
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| Complex shoulder pain - how the narrative and red flags paint a different picture | 07 nov. 2024 | 00:47:31 | |
Clients self-refer for many reasons and we find ourselves on the front line of health care screening. Join Susan and Erica as they uncover key elements in a client's history and narrative around long-standing shoulder pain. Simplistic presentations usually mask true underlying considerations including the client's beliefs and red flags.
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| Shoulder Pain With Pull Ups or Push Ups? The Elbow Changes Everything | 24 oct. 2024 | 00:43:02 | |
In this episode, we explore the surprising journey of a boxer battling chronic shoulder pain that left him struggling to do even the most basic workout. Despite focusing on his shoulder, it turns out the root of his problem lay elsewhere—his elbow. Is that surprising? It was in his injury history. Do not discount the power of an old injury that could come back and haunt you. And think about the load on the elbow when you're doing a push or pull-up. Join us as we clinically reason through this interesting case from start to finish.
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| Chronic Knee Pain - Where to Begin! | 10 oct. 2024 | 00:38:35 | |
Susan and Erica are back together for the Fall season! Chronic knee pain can be much more than a regional event. Susan presents a client with an extensive timeline and clinical reasoning as to why it is important to consider the entire system in this integrated approach. The key here is also maintaining relevance and sustainability for the client.
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| Assessing Knee Health For Hip-Related Walking Pain | 26 sept. 2024 | 00:22:12 | |
In this episode, Erica explores the often-overlooked relationship between hip pain and knee function during walking when the patient does NOT have knee pain. Join in as she dives into the role of the knee in compensating for hip dysfunction, and how a thorough knee assessment can uncover hidden contributors to hip discomfort. Remember: old injuries have a way of sneaking up on us and becoming one of the drivers of our current problem. An old hamstring tear 5 years ago as a contributor to this patient's problem? Think again.
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| When shoulder pain is dominant, but not the driver! | 12 sept. 2024 | 00:33:12 | |
Shoulder pain, like any other joint can present as primary pain and can be the #1 reason a client may be seeking help! In many cases, treating the obvious joint dysfunction (because it checks all of the boxes) may not result in optimal outcomes. Join the conversation as Susan and Erica explore the various reasons and important timelines in the client's history that has led to her shoulder pain. Most importantly follow the clinical reasoning that led to the real driver of this issue. Bonus - we also offer a great discussion of a good exercise progression!
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| Beyond Tennis: Exploring Shoulder Compression Across Sports | 05 sept. 2024 | 00:21:03 | |
In this episode, Erica discusses the why behind shoulder problems, comparing the unique challenges faced by tennis players and non-tennis players alike. She explains why traditional shoulder treatment often fails these types of patients. A significant relationship between the shoulder and another region of the body is often missed. Erica also tells the story of one of her patients who does play tennis and the reason why he can do a full pushup but can't lift his arm over his head. For our physio listeners, oftentimes you can progress patients through a full range of CKC exercises but the OKC piece does not progress as quickly.
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| A Stiff 1st MTP Joint can Affect Everything! | 29 août 2024 | 00:36:14 | |
One of the most overlooked joints in the lower quarter is the first MTP joint unless that is the client's primary complaint. How does the stiffness of the MTP joint affect gait and lower quarter movement of all kinds? We spend some great time discussing differential diagnosis and practical interventions and sharing some new discoveries. Hint: the exam and intervention do not always center around the stiff 1st MTP - there is likely a primary driver elsewhere.
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| Fencer with Bilateral Calf Pain | 22 août 2024 | 00:52:27 | |
What is the cause of bilateral calf pain in this young fencer? From start to finish, it shows the power of a thorough evaluation, a specific exercise progression, and a return to the sport she loves. When it comes to exercise progression in persistent pain, think about context. How can you improve optimal movement patterning by changing the context? Think about this one. You can intervene via the visual system, eyes open, eyes closed. How about changing their base of support? Wide to narrow. And why not have them do their exercises to their favorite music? These are just some examples. Look at your patients through a different lens and then see positive change.
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| The Role of the Diaphragm in Chronic Low Back Pain and GI Dysfunction | 15 août 2024 | 00:41:34 | |
How similar are the neuromuscular responses to pain with Chronic low back pain and GI pain? Join Susan and Erica in a great discussion of the role of the diaphragm and how this changes with pain and inhibiition/over-recruitment in the system. In chronic low back pain and abdominal bloating/distention the diaphragm becomes a postural control muscle which greatly limits the respiratory ability and is an ineffectual model for spine stiffness and visceral organ pusher. This is an excellent discussion following the podcast episode 185. 1) Kolar P, Sulc J, Kyncl M, Sanda J, Cakrt O, Andel R, Kumagai K, Kobesova A. Postural function of the diaphragm in persons with and without chronic low back pain. J Orthop Sports Phys Ther. 2012 Apr;42(4):352-62. doi: 10.2519/jospt.2012.3830. Epub 2011 Dec 21. PMID: 22236541. 2) Villoria A, Azpiroz F, Burri E, Cisternas D, Soldevilla A, Malagelada JR. Abdomino-phrenic dyssynergia in patients with abdominal bloating and distension. Am J Gastroenterol. 2011 May;106(5):815-9. doi: 10.1038/ajg.2010.408. Erratum in: Am J Gastroenterol. 2011 Jul;106(7):1405. PMID: 21540894. 3) Sicilia-Gomez C, Fernández-Carnero S, Martin-Perez A, Cuenca-Zaldívar N, Naranjo-Cinto F, Pecos-Martín D, Cervera-Cano M, Nunez-Nagy S. Abdominal and Pelvic Floor Activity Related to Respiratory Diaphragmatic Activity in Subjects with and without Non-Specific Low Back Pain. Diagnostics (Basel). 2022 Oct 18;12(10):2530. doi: 10.3390/diagnostics12102530. PMID: 36292219; PMCID: PMC9600311.
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| Hypermobility and Low Back Pain | 08 août 2024 | 00:48:12 | |
How do you rehab someone who is VERY hypermobile and suffers from persistent low back pain? Carefully and specifically! This episode highlights the beauty of a specific exercise progression tailored to the patient's meaningful movement. Listen as we go through the clinical reasoning process to determine what types of movement patterns will work and what ones won't. Doing the right thing at the right time is clinical expertise.
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| Low Back Pain - Regional vs. Movement System Considerations | 01 août 2024 | 00:33:23 | |
If it walks like a duck and quacks like a duck - it must be a duck, right? Low back pain is a descriptive term at best, indicating where symptoms present. Join Susan and Erica as they explore this Tough to Treat client with low back pain and mild stress urinary incontinence. Discover the history and the movement system examination and interventions that led to the successful reduction of symptoms. *Hint: this really isn't a duck! Visit our website: toughtotreat.com
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| What To Do When You Are Their Last Resort | 25 juil. 2024 | 00:52:38 | |
Now, this is a CHALLENGING one! Ever have those patients who have been everywhere, had everything done to them (injections, surgeries, acupuncture) and nothing helped? Well, this is your lucky day because this episode really takes us down the chain from head to toe with someone who had low back pain. Pretty standard, right? But this was FAR from standard. Hint: her low back was not the source of her problem. Why do you think that is? Remember, we bring all of our compensations to our life events. And our movement and injury history sets us up and our dominant patterning keeps us there.
Visit our website: toughtotreat.com
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| Nociplastic Pain and a Visceral Driver | 18 juil. 2024 | 00:38:00 | |
What do you do when a client presents with a myriad of LQ symptoms without a clear regional driver? Look to the history and keep asking questions even further back than the recent onset or episodic flare. Join us as we discuss complex neurology of a visceral driver that has signs of dysfunction and a somatic pain presentation. Once again, the history is so important!
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| Junior Golfer With Persistent Unsolved Knee Pain | 11 juil. 2024 | 00:52:14 | |
Golf is a sport of weight shifts and a narrow base of support. What happens when your knee can't adapt to an altered base of support? This is what exactly happened here with this case. This young golfer, in standing (and standing is VERY relevant for the golf swing) had an 80/20 load, R/L in this position. And it stayed that way throughout the golf swing. This begs the question: Did you know that right knee pain can be caused by an imbalance in your center of mass? If you continuously load your painful side, that has some serious implications for loading. Erica and Susan discuss in this episode how treating the left hip as well as the left side of the low back, got rid of this young golfer’s knee pain. He needed options for movement to his left side. A functional and interactive evaluation really hones in on where the true source of his knee pain lies. Remember: for persistent, unsolved problems, correlate the patient's history with your objective assessment. Hint: this patient had a history of concussion. You think that would alter his BOS?
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| What's Stopping this Former Fighter from Doing Push-Ups and Pull-Ups? | 27 juin 2024 | 00:18:40 | |
In this episode, Erica dives into the intriguing story of a former fighter who faced unexpected challenges with basic exercises like push-ups and pull-ups. She sheds light on how years of specialized training led to muscle imbalances and problems outside the ring. The "push" and "pull" are different movement patterns. What region(s) of the body are challenged with these movements? Remember the "push" is a 4-point closed chain movement and the "pull" is not. What do fighters do on a routine basis to their wrists before a fight? Why is the "negative" on a pull-up more important than the push on a push-up? Listen in as Erica discusses how to make this type of assessment more efficient by really listening to the story, connecting the dots, and ultimately going back to basics to treat another region of the body that was a secondary driver to the "pull". If you want the visual, here is a link to our YouTube channel.
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| Chronic Constipation: Interventions Beyond Pelvic Floor Dyssynergia Part 2 | 13 juin 2024 | 00:25:12 | |
This episode is part 2 of episode 213. Utilizing evidence-based research and the latest clinical guidelines, the presentation will examine the multifactorial nature of chronic constipation, including non-pelvic interventions that can complement existing treatments. One key aspect will be the practical application of the balloon catheter, demonstrating its effective use for both assessment and therapeutic interventions.
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| Chronic Constipation: Interventions Beyond Pelvic Floor Dyssynergia Part 1 | 06 juin 2024 | 00:24:23 | |
Utilizing evidence-based research and the latest clinical guidelines, the presentation will examine the multifactorial nature of chronic constipation, including non-pelvic interventions that can complement existing treatments. One key aspect will be the practical application of the balloon catheter, demonstrating its effective use for both assessment and therapeutic interventions.
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| Postpartum Pelvic Pain and Urgency | 23 mai 2024 | 00:52:23 | |
There are many ways to approach pelvic pain and symptoms of urinary urge incontinence, but did you know that how the MSK system moves can affect these symptoms as well? On this podcast, we dive into the movement system, past/present autoimmune history, and post-partum process while changing this client's symptoms as well as her urinary incontinence. In turn, she regains control over her pelvic pain!
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| How To Assess The Knee Differently | 16 mai 2024 | 00:16:34 | |
In this episode, Erica explores new and novel ways to evaluate and treat the knee. She discusses different approaches aimed at providing a more accurate assessment of the knee. Join her as she emphasizes the importance of training your vision. What does "optimal" movement look like for that particular patient? Does what you see match what you feel? Are you assessing the knee in a movement that is relevant to the patient? If someone's right knee is sore when they are walking with that leg behind, then assessing the knee in dorsiflexion and knee flexion is not efficient or effective here. Train your vision to see what optimal movement looks like. And then put your hands on the femoral condyles and the joint lines to train your own brain to feel what is optimal. That's how you increase your clinical expertise. Erica also discusses a movement you can evaluate if the patient has a hard time squatting or lunging. Finally, do not discount the patient's prior history. An old untreated hamstring tear from years ago could absolutely be relevant to someone's increased knee pain. Makes sense, right? But we often forget that - do not ignore prior history and its importance to current symptoms. A glance at this episode:
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| Addressing the Gaps in a Patient's Exercise Program | 09 mai 2024 | 00:35:13 | |
This episode zeroes in on a scenario many physical therapists face: patients diligently following their exercise routines but not seeing the expected progress or recovery. We discuss thorax, foot, and knee drivers as examples and why there can be holes in someone's program even after they've been doing advanced exercises. Being able to identify the patient's impairments is a good start. We discuss common strength holes along with typical overactivity patterns in these patients. Susan and Erica also discuss a patient who is a high-level athlete with a fear-based movement that is a big hole in her program. A glance at this episode:
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| Food Allergies vs. Intolerance | 02 mai 2024 | 00:21:02 | |
What is the difference between food allergies and food sensitivities? Join Susan as she discusses the importance of following the science and taking the guess work out of the food allergy vs. sensitivity issue and why this is important for systemic inflammation.
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| Back Pain/Leg Pain - Making the Right Call For Our Clients | 25 avr. 2024 | 00:39:38 | |
This episode presents what should be a straightforward case of a significant nerve root irritation. Unfortunately for this client, her situation was not addressed adequately and has left her in a lot of pain for over 3 months. Join us as Susan presents this client case, what went wrong, and the assessment and intervention with a rich discussion of the path forward. Here is a Hint: center of mass and chronic loading play a strong part in this story!
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| Clinical Pearls For Effective Exercise Progression | 18 avr. 2024 | 00:25:23 | |
In this episode, Erica speaks about prescribing specific exercises based on the difficulty level relative to the region of the body driving the patient's symptoms. NOT the pain generator. NOT the area of symptoms.
If someone has knee pain, and their driver is their foot, then the exercise program is geared towards the foot, NOT the knee. SLR's and quad sets won't work here.
She also explores the significance of personalized exercise prescriptions in optimizing recovery outcomes. There are many clinical pearls in this episode, one of which is, "Why would a side-to-side deep squat be harder for the foot than the thorax?" Both are lateral movement patterns.
She also discusses the clinical reasoning behind a well-thought-out exercise plan. Remember: we are trying to give our patients options for movement and variability across many activities. Building volume of exercise at low levels is key to this outcome as is challenging the driver across many planes.
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| When The Driver Is Not The Pelvis | 11 avr. 2024 | 00:47:16 | |
In this episode, we discuss the case of a very active woman grappling with SI (sacroiliac) joint pain. These symptoms manifest while walking and with hip external rotation. Furthermore, the episode unravels the complexities surrounding assessments, especially when individuals seek consultation for a single visit. We also delve into why and when using a pelvic belt is helpful. Also, for the non-pelvic health therapists out there, we discuss how you can palpate relevant muscles externally to further confirm or negate your hypothesis as to whether the pelvis is a driver. This patient had an extensive medical and surgical history. We also discuss certain aspects of her history that are very relevant for treatment. When someone has had 3 C-sections, an abdominoplasty, breast reconstruction, and more, do you think that the pelvis is the main driver? Think again if you do. Remember, we are a product of our compensations and adaptations to prior injuries and surgeries.
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| Physical Therapy Examination and Intervention of GI Dysfunction | 04 avr. 2024 | 00:20:18 | |
In this short episode, Susan presents a good algorithm for the examination and interventions in clients with GI dysfunction. Follow along as she discusses different nuances and considerations in the presence of pelvic and abdominal aspects of GI dysfunction.
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| Overactive Bladder and Hip Dysfunction | 28 mars 2024 | 00:40:52 | |
This episode presents a client with a seemingly straightforward diagnosis in pelvic health of overactive bladder (OAB). The history and physical presentation tell a different story. Join Susan and Erica as they explore why often a regional approach will not help the client progress to their highest levels of function without symptoms. We discuss the various drivers viscerally and MSK regionally and why tendon function and the client's stage of life require the utmost consideration. Join us in the conversation and discover the multi-system approach in consideration of the examination and interventions for this client
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| Exploring Open Chain vs Closed Chain Exercise in Upper Extremity Dysfunction | 21 mars 2024 | 00:19:33 | |
In the episode, Erica explores the strategic use of open and closed-chain exercises for upper extremity dysfunction. She discusses the distinct benefits and applications of each type of movement, shedding light on how these exercises can be tailored to meet specific needs to enhance performance. She uses an example of a tennis player who suffered from right shoulder pain with radiculopathy. She also tackles the critical question of when to load open-chain versus closed-chain exercises, offering practical guidelines based on the stage of recovery and individual progress. OKC can be very difficult for someone who has a true shoulder driver. Based on her experience with these patients, most people who play an overhead sport, display a lot of compression in their upper rib cage and shoulder joint. This can masquerade as "thoracic outlet syndrome" or "rotator cuff strain" when it's a movement pattern created by their sport carried over to all life events. By understanding the principles of load management and exercise progression for open and closed-chain exercises, listeners will gain valuable insights into prioritizing certain movements during the rehab process.
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| The Push Up: 2 Individuals, 2 Different Drivers and 2 Distinct Treatments | 14 mars 2024 | 00:43:21 | |
In our latest episode, we explore the fascinating stories of two individuals navigating the challenges of mastering the push-up despite their unique injury history. Both individuals had different pain experiences with this movement. Remember-What set them up? What kept them there? We explore why the push-up experience varied greatly between these 2 people and why it was so unique in these 2 individuals. "Push" is a part of daily life whether we realize it or not from pushing open an umbrella to pushing a door open to a full push-up on the floor of a declined bench. The "What set them up?" is a significant factor in how they were assessed and treated. One individual was a former boxer and the other held a desk job but had an extensive exercise and injury history. Join us as we unravel the complex interplay of factors shaping each individual's journey toward mastering this seemingly simple yet profound exercise.
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| Outcome Measures and Pain in GI Dysfunction | 07 mars 2024 | 00:16:57 | |
This episode is a short compilation of an algorithm in looking at basic outcome measures and pain in GI Dysfunction. Susan explores the basics of the history which can give great insight into the addition of more sophisticated outcome measures and pain exploration. Start with the basics and then expand!
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| The Balance System As A Driver | 29 févr. 2024 | 00:48:54 | |
Join us in episode #200 where Susan and Erica explore the potentiality of the balance system as a primary or secondary driver. With a client's history of injury or illness, there is an event that sets up their system for adaptation. Oftentimes, in regional-specific rehab, the balance system is not considered as a driver. What keeps the client in this adapted pattern may be the primary driver; however, the balance system adapts to keep the entire body and physiology upright against gravity. This system can change, and the need for activity to accomplish this becomes a primary consideration in the assessment and the intervention. Listen in to the conversation and find easy clues to discover in your client assessment for effective interventions.
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| The Body's Story: Finding Out Why You Hurt Through Your Story and Movement Patterns | 22 févr. 2024 | 00:17:14 | |
In this episode, we explore the profound connections between personal narratives and the origins of someone's injury. Join Erica as she delves into the stories of individuals who've experienced persistent injuries, and learn how to find clues in their narrative to help you prioritize the movement assessment and eventually find their driver(s). You will learn how to make the connections between the story and their movement patterning. Through the lens of their injury and movement history, we can uncover the reason why someone can't move the way they want. This leads to precise diagnosis and effective treatment. You don't treat the symptomatic region unless it's the driver. There is a video companion piece with slides on our "Tough To Treat" YouTube channel for this episode.
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| Chronic Low Back Pain and an Underlying Pathophysiological Change: We Adapt Until We Can't | 08 févr. 2024 | 00:22:27 | |
How important are past events to present movement patterns and restrictions? What about past events of herniated lateral discs or hypermobility on the current presentation of the movement system? Clients can heal with faulty movement systems that can show up as new and different presentations in the future. This podcast is from a presentation that links the neuromuscular systems together and provides insight for evaluation and interventions.
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| Overcoming Fear-Based Movement Patterns | 01 févr. 2024 | 00:40:09 | |
In this empowering episode, we dive deep into the realm of fear-based movement and explore strategies to help patients conquer their anxieties, helping them move towards a more confident and pain-free existence. Anxiety and fear of movement are real things and can prevail even when we are termed "fit to play", "fit to move" or "pain-free". Just because someone is pain-free, it doesn't mean that they can move well or move without fear. We discuss the implications of movement anxiety and explore the roots of fear and how it manifests in the body. Our discussion involves 2 specific case studies where fear of a certain movement was stalling their recovery and includes specific techniques and exercises for a positive outcome. By the end of this episode, you'll be equipped with valuable tools and insights to help your patients move better, even when fear holds them back.
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| How To Find The Driver Through Patient-Centered Listening | 25 janv. 2024 | 00:35:36 | |
Discover the art of being an active listener who can pick up clues in your patient's narrative to help you find their driver quicker. This will save you lots of time in your movement assessment. Listen in as Erica discusses how to reframe your patient's story to help you maximize your time with them in the clinic. She discusses clues in their "subjective" that can aid you in prioritizing regions of the body to assess in your movement analysis. This is done with 3 case studies from her practice where she discusses each patient's story (injury and movement history) and what clues she honed in on to effectively make a clinical hypothesis about their driver(s).
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| Take Back your Mental Fitness - Part 2 | 18 janv. 2024 | 00:18:06 | |
Welcome to the New Year and one of the topics always discussed by Healthcare providers is burnout and imposter syndrome. Join Susan in this short podcast - Part 2 Taking back your mental fitness. Learn how to identify the voices of your inner Judge and Saboteurs, how to limit their voices, and find a pathway to your Sage Brain!
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| Take Back Your Mental Fitness - Part 1 | 12 janv. 2024 | 00:24:56 | |
Welcome to the New Year and one of the topics always discussed by healthcare providers is burnout and imposter syndrome. Join Susan in this short podcast episode - Part 1 Taking back your mental fitness. Learn how to identify the voices of your inner Judge and Saboteurs, how to limit their voices, and find a pathway to your Sage Brain!
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| A Case of Lateral Hip Pain | 04 janv. 2024 | 00:48:51 | |
Hip pain can be brutal. And more often than not-it's chronic. Not like an acute ankle sprain or even acute low back pain. People who suffer from hip pain, for whatever reason, sink into the chronic side of musculoskeletal pain. One size does not fit all - join us as we discuss the findings in this "not so unique" case and the discovery of the underlying movement patterns, impairments, and why lateral rotator strengthening is not always the answer.
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| Thoracic Mobility Beyond The Breath | 21 déc. 2023 | 00:57:12 | |
In this episode, Susan and Erica discuss the many ways the thorax can be the driver for a multitude of upper and lower extremity issues. This important region of the body tends to cause a lot of movement dysfunction we often see. As an example, the thorax is an important component in driving foot pain as well as issues in the pelvic girdle. Suppose you can get the thorax to move differently. In that case, this can help people down-train old movement patterns that do not serve them and ultimately restore global movement patterning across many tasks. Key point: The thorax can be a key driver, in how someone transfers load after an injury (no matter when that injury took place). It is a region of the body that compensates for pain and dysfunction elsewhere and then ends up being the driver years later. Don't miss it.
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| Stress, Exercise and Sleep as it Relates to the GI System | 14 déc. 2023 | 00:17:43 | |
Many times, clinicians find that people with correlative GI system dysfunction are very overwhelming. The complexity makes it difficult to know where to begin to intervene. Join us as Susan discusses some very simple mediations to help improve the GI system with stress, exercise, and sleep. Complex clinical pictures can often change when we address the foundations of health with simple interventions.
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| A Complex Client With Medical Red Flags | 07 déc. 2023 | 00:43:11 | |
Susan and Erica welcome Kelly McClain to the podcast to discuss a very complex client with pelvic health, orthopedic, and neurological issues. Follow along as the client case is presented and we pursue a rich discussion of tying together the systems involved as well as the red flags. Digging deeper into the client's story is key here to help with obvious referrals and also to recognize other systems and issues deeper into the client's history to gain insight.
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| How To Diagnose A Young Soccer Player's Groin Pain | 30 nov. 2023 | 00:18:53 | |
Why doesn't my groin pain go away? When someone is an athlete, you must understand what regions of the body are challenged with their sport. With soccer, you think of the thorax, foot, hip, and pelvis from the get-go. Listen in as Erica discusses the movement she and her patient chose to assess and what they discovered. Short-term treatment of someone's symptomatic region may help in the short term, but getting them back in the game is another matter entirely. When a person has an issue with a long lever movement like kicking a soccer ball, recognize and respect the length-tension relationships of the muscles involved in the movement, like how someone's lack of adductor power can stem from an overactive posterior tibialis muscle.
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| Why Does My Foot Hurt? What's Going On? | 23 nov. 2023 | 00:36:04 | |
Why would someone who is 3 months post-fibular fracture get worse after a basic theraband ankle exercise? Not everyone needs inversion and eversion theraband exercises. Right? This is an in-depth clinical discussion on understanding the "why" hidden in the patient narrative. And a specific process for assessing the whole foot, not just the ankle. We also discuss why this patient's center of mass is biased toward her involved side and what implications this has for treatment.
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| The GI System - Food intolerances vs. Allergies | 16 nov. 2023 | 00:21:05 | |
We continue with our GI dysfunction theme in this podcast about food intolerances/sensitivities vs. allergies. Join Susan as she takes you through the algorithm to understand how to recognize what is the underlying information behind why certain food bothers us and when we should eliminate food.
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| The Role of the Diaphragm in Chronic Low Back Pain and GI Dysfunction | 09 nov. 2023 | 00:41:49 | |
How similar are the neuromuscular responses to pain with chronic low back pain and GI pain? Join Susan and Erica in a great discussion of the role of the diaphragm and how this changes with pain and inhibition/over-recruitment in the system. In chronic low back pain and abdominal bloating/distention the diaphragm becomes a postural control muscle which greatly limits the respiratory ability along with an ineffectual model for spine stiffness and visceral organ pusher. This is an excellent discussion following the podcast episode 185. A glance at this episode:
Articles mentioned in the episode: Postural function of the diaphragm in persons with and without chronic low back pain. Abdomino-phrenic dyssynergia in patients with abdominal bloating and distension.
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| When Do You Treat The Viscera? | 02 nov. 2023 | 00:18:38 | |
When do you treat the viscera? And why? This episode discusses a bit about the abdominal viscera. It is certainly not all-encompassing by any means. We just want our audience to be aware of the possibilities. Erica relays some clues in the patient's history as to why you would screen for GI dysfunction. She uses 2 case examples of when the abdominal viscera was the secondary driver in one case and when it was a significant impairment in a patient with a dural driver in the other. Once again, it all comes down to listening to your patient and connecting the dots.
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