Tough to Treat

Latest Episodes:

Training the Tough To Treat Shoulder Oct 22, 2020

Show notes

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

Pelvic Pain - Things Are Not Always As They Seem! Oct 08, 2020

Show notes

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

Elite Soccer Player with Low Back Pain Sep 24, 2020

Show notes

Why can't this athlete get rid of his low back pain? "Running- I have no problem with" "Lateral-side to side-movements really aggravate me". " Why?" How do we make a differential diagnosis here? And with significant unilateral calf weakness to add into the mix. Four ankle sprains and a 4th metatarsal fracture later, plus a "stress reaction" at L5, why wouldn't his low back be the source of his problem? Join us as we clinically reason through multiple facets of his case. Check us out: Toughtotreat.com

Full Squat vs. Partial Squat? Sep 10, 2020

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A recent article on various depths of squats revealed information that a full squat is more beneficial than partial squats in improving function and pain over time. Have a listen as we explore interesting comments/bias/evidence on why we rely on the squat as a revealing part of our examination and interventions.

Follow link: https://www.tandfonline.com/doi/abs/10.1080/17461391.2019.1612952?journalCode=tejs20

Check us out: Toughtotreat.com

Medial Elbow Pain and Tingling/Numbness Aug 27, 2020

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Another case with elbow issues! This case involves neural tension, pins/needles, and catastrophization. What is the best way to begin to work with someone who has multiple issues around fear of neural symptoms without neuro changes? Join us as we discuss dosing, position changes, problem solving and fear reduction in this interesting case.

Check us out: Toughtotreat.com

Demystifying Tennis Elbow Aug 13, 2020

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Tennis elbow is one of those conditions that is extremely frustrating for both patient and practitioner alike. It turns into a persistent problem very fast. This was another one of our popular FB Lives we did recently. We unpacked the myths and theories around tennis elbow and what to do to treat it. Is it neurally driven? Cervical Spine driven? Does it emanate from poor shoulder mechanics? Or does it come from poor thoracic control? The key word here is "myths". Your pain generator may be the elbow, but the longer it persists, the driver(s) behind this frustrating problem migrate away from the elbow pretty quickly. Where do they go? Check us out: ToughtoTreat.com

Runners With Recurrent Knee Pain-Finding The Driver Jul 30, 2020

Show notes

We all have patients for whatever reason, who always come back for the same problem over and over again. Even if they haven't been back for over 5 years. Our bodies tend to take the path of least resistance and more often than not, when someone has fully recovered and they're back doing what they want, something happens and they return with the SAME problem in the SAME place. Why? Is that their achilles heel, so to speak? Or has their strategy changed because of something new in their life?

Check us out: Toughtotreat.com

Exercise progressions for the tough to treat foot Jul 16, 2020

Show notes

Your client has low back, hip, or pelvic girdle pain as examples, and you determine that the foot is the driver for these symptoms. What types of exercises would you prescribe to get them back to where they want to be? This is where you take the clinical reasoning to the next level! Whether it's loaded or unloaded, movement re-patterning requires you to really "connect the dots" in the body when it comes to moving someone through a sound exercise progression. This was initially recorded as one of our popular FB lives and we decided to share it as a podcast as well!!

Check us out: Toughtotreat.com

Are patients really good historians? Jul 02, 2020

Show notes

What happens when your patient/client forgets to tell you key pieces to their history? It happens alot - and sometimes can have great impact on our decision making within the evaluation or treatment sessions. It is not their fault, it is just the way the central nervous system prioritizes events. Helping our clients remember and string these events together can not only help them solve their problem, but might be just the piece they need to integrate for healing.

Check us out: Toughtotreat.com

Does scapula stabilization always work? Jun 18, 2020

Show notes

This episode is about a weightlifter who suffered a T1 avulsion fracture, had surgery to remove the fragment and still had symptoms. Why? Because the avulsion was not the cause for this patient's lingering symptoms. Neuromuscular holding strategies as well as poor motor patterning were still there post-operatively. Think about what a weightlifter does before he performs a heavy lift and it will give you a clue as to what we needed to change.

Check us out: Toughtotreat.com

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