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Tough to Treat
40 minutes | Jul 15, 2021
Treatment Progressions for the Tough To Treat- Clinical Pearls
Clinical pearl alert! This episode tells the story of 3 patients and their treatment progressions. Typical symptoms but atypical drivers. What types of exercises do you prescribe for your patient when their symptom is in their feet and their driver lies in their thorax? What is their impairment? This is a discussion of how you would SPECIFICALLY treat and develop a well thought out exercise progression. Using your clincal reasoning doesn't stop with assessment. Check us out: Toughtotreat.com
36 minutes | Jun 17, 2021
What To Do When Your Patient Plateaus
What do you do when a patient plateaus? Doesn't improve? Join us for our first Q and A broadcast on how to clnically reason through a patient's treatment program when their progress starts to slow down. We discuss a specific patient example and what constitutes a solid progressive exercise program. This also includes reset exercises to restore optimal motor patterning so she can identify what movements are hindering her progress and what she can do to get herself out of a flare up. Check us out: Toughtotreat.com
58 minutes | Jun 3, 2021
Clinical Pearls for the Shoulder-Understanding the Connections in the Upper Quarter
Join us for a special episode on the shoulder. This is a re-release of one of our most popular episodes to date. As a bonus, we present 3 case studies of patients with typical shoulder pain who have different drivers and certainly different exercise programs. Sometimes the key to helping a patient's persistent shoulder pain is looking at all of the underlying inputs into their system. What are the connections in the upper quarter? How do they relate to the patient's meaningful movement? Check us out: Toughtotreat.com
40 minutes | May 20, 2021
The Key To Functional Movement Assessments
Join us for Part 2 of our discussion on functional movement patterns. How can you make your assessment more efficient and reliable? We discuss what to look for when evaluating someone's ability to move in and out of certain movements. How do you determine if a dysfunctional foot is driving your client's hip pain when squatting? Or if poor thoracic control is responsible for low back pain when assessing someone take a step forward? We discuss some basic movement patterns and how to break them down so you as a clinician can hone in on the driver quicker.
36 minutes | May 5, 2021
"Why Does My Foot Hurt? What's Going On?"
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 on how to assess the whole foot and not just the ankle. We also discuss why this patient's center of mass is biased TOWARDS her INVOLVED side and what implications this has for treatment. Check us out @ Toughtotreat.com
41 minutes | Apr 22, 2021
Musculoskeletal Driver of Hip Pain in a Young Dancer
When working with young athletes it is easy to have early success in treating the acute or subacute injuries. What happens when the latest injury reveals a very chronic situation elsewhere in the body? Don't be fooled by generalized and chronic complaints underlying the present situation in these teenagers. They may improve quickly in one respect, but looking deeper can help them improve adaptation strategies that will help further down the road and even alleviate a chronic situation. Join us as we discuss the chronic MSK driver to hip pain irritability in this young athlete. Check us out: ToughtoTreat.com
44 minutes | Apr 8, 2021
The Knee and its Relationship to the Whole Person
How does the knee affect so many parts of the body? Join us for this discussion on this important intermediate joint of the lower kinetic chain and how dysfunction here can alter the movement system for the whole person. Check us out: Toughtotreat.com
45 minutes | Mar 26, 2021
Chest Pain In An Endurance Athlete
Does chest pain raise your eyebrows? Red flag? Or wild goose chase? This case is an insight into a classic endurance athlete and how his past injuries reveal a true deficit which can be the potential driver for his current symptoms. These symptoms that only occur 3-4 hours after a bike ride. We discuss viscero-somatic cross talk, the cardiac sinus and its biomechanics as well as a how to start treatment in someone who has many moving parts!! Check us out: Toughtotreat.com
38 minutes | Mar 11, 2021
Shoulder Pain and Distal Drivers
This episode features a case of shoulder pain with unusual drivers due to their distal proximity. Join us as we discuss this interesting clinical case on a very active man with chronic shoulder pain, fear avoidance, anxiety and some unique clinical reasoning to help him recover! Check us out: Toughtotreat.com
29 minutes | Feb 25, 2021
Not Your Ordinary Knee Patient
What do you automatically think when someone tells you they have knee pain? It's worse with walking SW and walking FW. And the patient cannot sleep sidelying because his knee hurts when he sleeps on either side. He can squat no problem. Are you thinking what we're thinking? Susan and Erica unpack this patient's story and dive into specific hints or cues that the patient gives to indicate that it's more than just the knee. Treatment? Well, that depends on the driver, doesn't it? The most important piece and message in this episode is the clinical reasoning behind why this may not be your ordinary knee patient. Check us out @ Toughtotreat.com
114 minutes | Feb 22, 2021
Thoracic Mobility Beyond The Breath
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 be the cause for 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. If you can get the thorax moving differently, this can help people out of old movement patterns that do not serve them and restore global movement patterning across many tasks. Check us out: Toughtotreat.com
47 minutes | Jan 28, 2021
Ankle fracture rehab - what is missing?
As health care providers and rehab professionals, there is the story that ankle fracture rehab is simple. Makes sense right? A regional intervention over an obvious acute traumatic event. But what is missing and why do so many individuals recovering from this injury (post-surgical) are having difficulty months and years down the road? Join us as we explore the Biopsychosocial approach to this individual who felt her rehab care was dismissive to her real fears and complaints. How to navigate the waters when peripheral symptoms migrate to central sensitization. Of special interest here is where the secondary driver actually becomes the primary driver! Check us out: Toughtotreat.com
53 minutes | Jan 14, 2021
Does Hip Pain Always Come From The Hip?
When someone complains of persistent hip pain, what do you think? Is the source the hip? It may be the pain generator but at this point, is the primary reason why they have hip pain because of some dysfunction intrinsic to the hip? Most likely not. Simple example- right persistent hip pain with going up stairs and standing on one leg. In standing, all their weight is on the right leg, why? Probably because of an old injury to their left side or an ingrained movement pattern they have adopted over the years. At any rate, they have lost options for movement and their left side cannot adapt, so they over use and over recruit their right hip, as a possible scenario. Listen for more! Check us out: Toughtotreat.com
50 minutes | Dec 31, 2020
The Shoulder Is Connected To Everything
Join us for a fun discussion on the relationship of the shoulder to the rest of the body. Learn about all the connections between the shoulder, the cranium, the neck, the upper thorax and much more! Did you know that an old clavicle fracture on your left can be responsible for right shoulder pain? Check us out: Toughtotreat.com
41 minutes | Dec 17, 2020
Double Vision Post Partum, Cause or Effect?
Tune in for an interesting discussion on a woman presenting with complaints of double vision 8 months after the birth of her third child. A coincidence? Maybe, maybe not. Either way, it needs to get addressed. Is this dural? Trigeminal wind-up? Listen in for the clinical reasoning process as well as some novel treatment techniques that worked. Check us out: Toughtotreat.com
42 minutes | Dec 3, 2020
Neural Tension and Beyond
Can neural tension be responsible for a tight hip? Absolutely! Would you believe that neural tension in the right hip can be responsible for left hip pain? Listen as Susan and Erica discuss the many possibilities of unsolved persistent pain. They also discuss several cases where neural tension plays a role in many typical musculoskeletal issues. Check us out: Toughtotreat.com
44 minutes | Nov 18, 2020
Neck Pain/Back Pain - Where Do You Start?
Finding clients with subjective pain in the low back and cervical region is not an uncommon presentation. The bias is to treat the most acute region and hope the other region gets better as a result. What happens when you look closely at the story, listen to the client and find a very unlikely driver of maladaption in this clinical case? Join us as Susan and Erica unravel this clinical presentation and align the intervention with the client's goals. Check us out at Toughtotreat.com
41 minutes | Nov 4, 2020
How To Master Functional Movement Assessment
Functional movement re-patterning is the key to changing someone's movement strategy. But how do you choose the right one, so you are more organized and efficient in your assessments? And how can you clinically reason so you can hone in on one area to get better results? Understanding the inter-regional relationships in the body as someone moves may be the game changer for you and your client. How does the foot relate to the shoulder as you squat and reach over head? How does neural tension affect your ability to perform a narrow based lunge or squat? Listen in as Susan and Erica discuss this and much more! Check us out: Toughtotreat.com
36 minutes | Oct 22, 2020
Training the Tough To Treat Shoulder
How many neck problems are really disguised as shoulder issues? A lot actually! It is extremely common to overwork some of those small muscles of the neck at the expense of a true shoulder weakness. And why is traditional cuff strengthening not always the way to start with these patients? Listen as Susan and Erica do a deep dive into this patient's underlying issue and discuss various ways to bridge the gap between early phases of exercise to higher loads. What positions do you start with? How can you provide neural input into the system without aggravating symptoms? Check us out: Toughtotreat.com
43 minutes | Oct 7, 2020
Pelvic Pain - Things Are Not Always As They Seem!
Don't let the diagnosis be your guide, listen to the whole story, and be curious outside of pattern recognition. Is the original thought about the case straight forward. Or is it as Sherlock Holmes says: "When you have eliminated the impossible, whatever remains, however improbable, must be the truth?". Have you indeed eliminated all of the impossible? In this episode, we discuss the reasoning behind this client who has a complex presentation of symptom progression following a traumatic accident. Join us as we explore the nuances of "test-retest" in this case study. Check us out: Toughtotreat.com
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