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    Health & Fitness

    Tough to Treat

    Welcome to Tough to Treat: A Physiotherapists’ Guide to Managing Those Complex Patients, with your hosts Erica Meloe and Susan Clinton, who discuss how they successfully treated patients that others could not. Via case history discussion, they share their physical therapy expertise from treating long standing pelvic pain to persistent neck pain. They present a holistic and integrative view on assessing and treating chronic pain. Unique movement strategies and specific patient exercise prescription are also presented so you can be ahead of the curve when it comes to treating these types of patients. Oftentimes, the source of the problem is not where you think it is!! For example, chronic low back pain emanating from the neck. Or hip pain coming from the foot. It pays to look up and down the kinetic chain!

    Podcast music: “Fearless First” Kevin MacLeod (incompetech.com)
    Licensed under Creative Commons: By Attribution 3.0 License
    http://creativecommons.org/licenses/by/3.0/

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    Latest Episodes:
    Treatment Progressions for the Tough To Treat- Clinical Pearls Jul 15, 2021
    Show notes

    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


    SI Joint Pain - An Updated Approach Jul 01, 2021
    Show notes

    Here is the clinical story of a client that is presenting with pain/sensitivity in the area of the (R) posterior pelvis. In this episode we discuss what has been unhelpful for her with regard to past interventions and why the biospsychosocial approach and creating the therapeutic alliance is so important to give her the ability to improve her movement system. Meaningful activities, violating expectations and movement system changes were key to her healing journey.

    Check us out: Toughtotreat.com


    What To Do When Your Patient Plateaus Jun 17, 2021
    Show notes

    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


    What To Do When Your Patient Plateaus Jun 17, 2021
    Show notes

    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


    Clinical Pearls for the Shoulder-Understanding the Connections in the Upper Quarter Jun 03, 2021
    Show notes

    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


    The Key To Functional Movement Assessments May 20, 2021
    Show notes

    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.


    "Why Does My Foot Hurt? What's Going On?" May 05, 2021
    Show notes

    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


    Musculoskeletal Driver of Hip Pain in a Young Dancer Apr 22, 2021
    Show notes

    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


    The Knee and its Relationship to the Whole Person Apr 08, 2021
    Show notes

    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


    Chest Pain In An Endurance Athlete Mar 26, 2021
    Show notes

    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


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