Tough to Treat

Latest Episodes:

Post-partum back and abdominal pain - what is the priority? Jun 10, 2020

Show notes

Let's continue with the 3 powerful questions in determing the direction and priority of intervention. Immediate post-partum females can present with a myriad of complaints that often go "unheard" or "untold". The fears surrounding these symptoms can greatly change the person's ability to move forward with confidence in their body and their ability to achieve their life vision. Join us as we explore simple, but powerful ways to help this individual change her beliefs and tackle her fears while gaining confidence in her movements.

Herniated disc? Or Fear of sitting? May 21, 2020

Show notes

What do you do when your patient tells you she has not sat for 9 months? And furthermore, a healthcare practitioner told her this! How do you "debunk" this myth of not sitting while at the same time give her body the ability to toelrate sitting postures? Imagination, contextual change as well as letting the patient take control of the session. What? The patient takes control? Listen as Susan and Erica talk about giving the patient new and novel ways of movement while at the same time changing the patient's unhealthy belief that sitting is bad for you.

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Pelvic girdle pain and the BPS approach May 07, 2020

Show notes

What are your three powerful questions that you use with your clients? Join Erica and I as we talk about working with clients from a full biopsychosocial approach. Does this mean all you do is pain education? How do clinicians best use the total approach to help clients regain self efficacy and manage their symptoms. There are also some great pearls around pelvic girdle pain in pregnancy as well.

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I Hurt Everywhere Apr 23, 2020

Show notes

Who hasn't heard this? This patient was seen in the clinic once just prior to the COVID-19 crisis and then progressed virtually from there. When someone says, " I hurt everywhere" and their symptoms appear randomly, how do you find a meaningful movement to assess? In particular, one that encompasses the whole body/whole person. Not an easy task, for sure, especially for someone who has significant amounts of anxiety related to movement and exercise. And with a past medical history of concussion, trauma and failed treatments. Listen as Susan and Erica take a deep dive into what is really going on here.

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Chronic Achilles Insertional Tendonosis Apr 09, 2020

Show notes

What do we really know about the achilles tendon and the various forms of tendonosis? What do you do when the eccentric exercise programs outlined in the literature do not bring about a significant change of symptoms? Join us to explore some of the facets of tendonosis and a clinical discussion on changing interventions.

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Higher Load Exercise Progressions and Secondary Drivers Mar 26, 2020

Show notes

Success-your patient's original symptoms are gone and you are moving along with their program. They are progressing to higher loads, higher impact as well as incorporating tri-planar movement into their exercise. Then another region of the body starts to hurt. Why? Secondary and even tertiary drivers can appear at higher loads; even when they do not appear at the beginning. Be aware of this as your patient progresses. Susan and Erica discuss this fun case as they paint the clinical picture and offer many options for treatment.

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Foot numbness - differentials and interventions Mar 12, 2020

Show notes

Have you ever had a patient where the story and the problems they were having were easy to solve, but your thoughts were - "It can't be this simple?" Follow along with us as we discuss the differentials and treatment of a gentleman with numbness on the balls of his feet. It may not be what you are thinking - and then again, maybe it is!

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5 years Post-Partum with Persistent Low Back Pain Feb 27, 2020

Show notes

This patient has had low back pain since she was a child. She has coped well until the birth of her own children. The innate response to threat here is the inabillity to arch her back. Her system cannot lengthen and she cannot do a back bend or sit and perform an anterior pelvic tilt. But she can get into prone on elbows and extend no problem. Post-partum is ALWAYS post-partum and her standing strategy is reflective of this.

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Heel pain - is it always a MSK issue? Feb 13, 2020

Show notes

What goes through your mind in pattern recognition when you hear the word heel pain? What do you begin to think - and then their story actually does not reflect the functional limitations expected. Join the co-hosts as they discuss the impact of multimodal issues that could be affecting this clinical presentation.

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Butt pain-where's it coming from? The low back? Hip? Pelvis? Jan 30, 2020

Show notes

One main symptom but 3 potential drivers. Is this person's glute pain coming from his hip? Low back? Pelvis? In this episode Erica and Susan discuss the differential diagnosis of a patient's butt pain which gets worse with sitting and driving. They discuss how multiple exam findings can lead you to one diagnosis but when all the pieces of this clinical puzzle are put together, a different story appears.

Check us out at: Toughtotreat.com

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