Tough to Treat

Latest Episodes:

Shoulder Pain and Distal Drivers Mar 11, 2021

Show notes

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!

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Not Your Ordinary Knee Patient Feb 25, 2021

Show notes

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

Thoracic Mobility Beyond The Breath Feb 22, 2021

Show notes

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

Ankle fracture rehab - what is missing? Jan 28, 2021

Show notes

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

Does Hip Pain Always Come From The Hip? Jan 14, 2021

Show notes

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

The Shoulder Is Connected To Everything Dec 31, 2020

Show notes

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

Double Vision Post Partum, Cause or Effect? Dec 17, 2020

Show notes

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

Neural Tension and Beyond Dec 03, 2020

Show notes

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

Neck Pain/Back Pain - Where Do You Start? Nov 19, 2020

Show notes

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

How To Master Functional Movement Assessment Nov 05, 2020

Show notes

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

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