Tough to Treat

Latest Episodes:

063: Hip arthritis! Update from #37 Jan 16, 2020

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What do you do when you run into a true hip joint limitation with persistent pain. altered patterns of movement and loss of the closed pack position? Join us as we explore the update of the female injured on her boat in Podcast #37 - what has improved, what has changed! Most importantly - how to help someone really work a new movement pattern and achieve ROM/Mobilization in some non-threatening ways!

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062: Persistent shin pain & a lateral shift-implications for gait Jan 02, 2020

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Is a lateral shift a reaction to an irritated nerve root? Or is it part of a functional scoliosis? Or neither? This patient experienced persistent right shin pain with prolonged walking. A year ago she noticed a significant shift in her pelvis to the right. This episode highlights the importance of identifying the non-optimal movement strategy and prescribing exercise to correct it. We discuss how to re-pattern her movements with a focus on the "why" she moves a certain way vs just training a muscle in an isolated non-meaningful exercise.

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061: Back pain, stiffness and the search for the cause! Dec 19, 2019

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What happens when you are an athlete and have endured many injuries in your life that have all healed, and now you have a back injury that is stubborn and is now a persistent pain issue. Compound this issue with a diagnosis of a torn lumbar ligament and the thoughts of instability/grinding joints/bone on bone and other thoughts take over the movement system. Join us as we explore some strategies and option for changing fear and moving in novel ways.

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060: Changing symptoms- a motor control problem or something else? Dec 05, 2019

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We have all been through this-as providers or patients. One day your low back hurts on the right, the next day it's the left, and 2 days later it's your right hip and the saga goes on and on and on. Why? Is it because there is a movement control problem and you are just running out of options? Or is there perhaps another systems impairment that is contributing to all of this? Join us as we clinically reason through a male patient of Erica's who is experiencing these symptoms. Hormones are not just the domain of the female.

More information at www.toughtotreat.com

059: Stress urinary incontinence - muscle weakness or load transfer? Nov 14, 2019

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What flashes through your mind with a diagnosis of SUI - muscle weakness? That is certainly one hypothesis! Listen in on this episode where we explore another client with a "systems" problem that is much more involved than just simple pelvic floor muscle exercises.

More information at www.toughtotreat.com

058: Foot pain of questionable origin Oct 31, 2019

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Failed epidurals, back surgery and you still have buttock pain along with foot pain. Why? We all know back surgery is not always the answer, but why would someone's symptoms persist after all these interventions? Why would walking barefoot in the sand make this person feel better? Is the strategy different or is the nerve root still aggravated after all these interventions or both?

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057: Elbow pain or cervical? Oct 17, 2019

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Join us on this podcast as we work through the differentials of this complex post-partum client with the onset of elbow joint pain. Issues that have become so problematic, it's interfering with her sleep. Is it the elbow or the cervical spine - or neural tension?

www.toughtotreat.com

056: Is this patient tough to treat? Oct 03, 2019

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How does someone who has had 4 sessions of PT somewhere else become complex? The answer: She got the wrong treatment. And what happened? It sensitized her nervous system to the point that she was afraid that she was never going to get better. Ever hear of less is more? If you intervene at the right time with the right treatment, less is DEFINITELY more.

More episodes at www.toughtotreat.com

055: Back pain or leg pain - why is it getting worse? Sep 19, 2019

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Explore the narrative of this client with persistent hip and leg pain for over 20 years. In this episode we explore the behaviors and mitigating factors that have increased the symptoms and are slowly turning this person with confronter behavior into an avoider. Sometimes the small changes can have a huge impact.

Find out more at www.toughtotreat.com

054: Leaking and Running - A solution Sep 05, 2019

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You have not run in over a year because of a foot and hip injury. Finally, it's all coming together-you have less hip pain and your foot pain has been gone for weeks. You are cleared for a return to run program and then after 2 minutes into it, you leak. Does this sound familiar to you or your patients? In this episode we bring in the patient who has these symptoms. This is a rare glimpse into "real time" clinical reasoning. We highlight some unique treatment ideas as well as provide the patient with a strategy she can tap into when she does leak.

Physical Therapy with Tough To Treat hosts Erica Meloe and Susan Clinton

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