This episode presents a client with a seemingly straightforward diagnosis in pelvic health of overactive bladder (OAB). The history and physical presentation tell a different story. Join Susan and Erica as they explore why often a regional approach will not help the client progress to their highest levels of function without symptoms. We discuss the various drivers viscerally and MSK regionally and why tendon function and the client's stage of life require the utmost consideration. Join us in th...
Mar 28, 2024•41 min•Ep. 204
In the episode, Erica explores the strategic use of open and closed-chain exercises for upper extremity dysfunction. She discusses the distinct benefits and applications of each type of movement, shedding light on how these exercises can be tailored to meet specific needs to enhance performance. She uses an example of a tennis player who suffered from right shoulder pain with radiculopathy. She also tackles the critical question of when to load open-chain versus closed-chain exercises, offering ...
Mar 21, 2024•20 min•Ep. 203
In our latest episode, we explore the fascinating stories of two individuals navigating the challenges of mastering the push-up despite their unique injury history. Both individuals had different pain experiences with this movement. Remember-What set them up? What kept them there? We explore why the push-up experience varied greatly between these 2 people and why it was so unique in these 2 individuals. "Push" is a part of daily life whether we realize it or not from pushing open an umbrella to ...
Mar 14, 2024•43 min•Ep. 202
This episode is a short compilation of an algorithm in looking at basic outcome measures and pain in GI Dysfunction. Susan explores the basics of the history which can give great insight into the addition of more sophisticated outcome measures and pain exploration. Start with the basics and then expand! A glance at this episode: [0:01] Evaluating and managing pain in people with GI dysfunction [1:18] Abdominal pain and its relationship to GI dysfunction [4:47] Visceral pain and myofascial pain s...
Mar 07, 2024•17 min•Ep. 201
Join us in episode #200 where Susan and Erica explore the potentiality of the balance system as a primary or secondary driver. With a client's history of injury or illness, there is an event that sets up their system for adaptation. Oftentimes, in regional-specific rehab, the balance system is not considered as a driver. What keeps the client in this adapted pattern may be the primary driver; however, the balance system adapts to keep the entire body and physiology upright against gravity. This ...
Feb 29, 2024•49 min•Ep. 200
In this episode, we explore the profound connections between personal narratives and the origins of someone's injury. Join Erica as she delves into the stories of individuals who've experienced persistent injuries, and learn how to find clues in their narrative to help you prioritize the movement assessment and eventually find their driver(s). You will learn how to make the connections between the story and their movement patterning. Through the lens of their injury and movement history, we can ...
Feb 22, 2024•17 min•Ep. 199
How important are past events to present movement patterns and restrictions? What about past events of herniated lateral discs or hypermobility on the current presentation of the movement system? Clients can heal with faulty movement systems that can show up as new and different presentations in the future. This podcast is from a presentation that links the neuromuscular systems together and provides insight for evaluation and interventions. A glance at this episode: [0:01] Lumbopelvic pain caus...
Feb 08, 2024•22 min•Ep. 198
In this empowering episode, we dive deep into the realm of fear-based movement and explore strategies to help patients conquer their anxieties, helping them move towards a more confident and pain-free existence. Anxiety and fear of movement are real things and can prevail even when we are termed "fit to play", "fit to move" or "pain-free". Just because someone is pain-free, it doesn't mean that they can move well or move without fear. We discuss the implications of movement anxiety and explore t...
Feb 01, 2024•40 min•Ep. 197
Discover the art of being an active listener who can pick up clues in your patient's narrative to help you find their driver quicker. This will save you lots of time in your movement assessment. Listen in as Erica discusses how to reframe your patient's story to help you maximize your time with them in the clinic. She discusses clues in their "subjective" that can aid you in prioritizing regions of the body to assess in your movement analysis. This is done with 3 case studies from her practice w...
Jan 25, 2024•36 min•Ep. 196
Welcome to the New Year and one of the topics always discussed by Healthcare providers is burnout and imposter syndrome. Join Susan in this short podcast - Part 2 Taking back your mental fitness. Learn how to identify the voices of your inner Judge and Saboteurs, how to limit their voices, and find a pathway to your Sage Brain! A glance at this episode: [3:21] Mindfulness techniques for neural plasticity [6:48] Mindfulness and neural pathways for busy people [10:33] Cultivating self-empathy and ...
Jan 18, 2024•18 min•Ep. 195
Welcome to the New Year and one of the topics always discussed by healthcare providers is burnout and imposter syndrome. Join Susan in this short podcast episode - Part 1 Taking back your mental fitness. Learn how to identify the voices of your inner Judge and Saboteurs, how to limit their voices, and find a pathway to your Sage Brain! A glance at this episode: [4:38] Saboteurs in the brain and their impact on decision-making [9:11] Personality types and their impact on work performance [13:30] ...
Jan 12, 2024•25 min•Ep. 194
Hip pain can be brutal. And more often than not-it's chronic. Not like an acute ankle sprain or even acute low back pain. People who suffer from hip pain, for whatever reason, sink into the chronic side of musculoskeletal pain. Let's face it-consideration of lateral hip pain requires a thoughtful clinical reasoning process to discover the physiology/movement patterns as well as neural contributions required to make a diagnosis and successfully build an intervention that lasts. One size does not ...
Jan 04, 2024•49 min•Ep. 193
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 cause 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. Suppose you can get the thorax to move differently. In that case, this can help people down-train old movement patterns that do not serve them and ultimately...
Dec 21, 2023•57 min•Ep. 192
Many times, clinicians find that people with correlative GI system dysfunction are very overwhelming. The complexity makes it difficult to know where to begin to intervene. Join us as Susan discusses some very simple mediations to help improve the GI system with stress, exercise, and sleep. Complex clinical pictures can often change when we address the foundations of health with simple interventions. A glance at this episode: [1:38] Stress, its effects on the body, and exercise as a remedy [6:38...
Dec 14, 2023•18 min•Ep. 191
Susan and Erica welcome Kelly McClain to the podcast to discuss a very complex client with pelvic health, orthopedic, and neurological issues. Follow along as the client case is presented and we pursue a rich discussion of tying together the systems involved as well as the red flags. Digging deeper into the client's story is key here to help with obvious referrals and also to recognize other systems and issues deeper into the client's history to gain insight. A glance at this episode: [3:05] Pel...
Dec 07, 2023•43 min•Ep. 190
Why doesn't my groin pain go away? When someone is an athlete, you must understand what regions of the body are challenged with their sport. With soccer, you think of the thorax, foot, hip, and pelvis from the get-go. Listen in as Erica discusses the movement she and her patient chose to assess and what they discovered. Short-term treatment of someone's symptomatic region may help in the short term, but getting them back in the game is another matter entirely. When a person has an issue with a l...
Nov 30, 2023•19 min•Ep. 189
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 for assessing the whole foot, not just the ankle. We also discuss why this patient's center of mass is biased toward her involved side and what implications this has for treatment. A glance at this epi...
Nov 23, 2023•36 min•Ep. 188
We continue with our GI dysfunction theme in this podcast about food intolerances/sensitivities vs. allergies. Join Susan as she takes you through the algorithm to understand how to recognize what is the underlying information behind why certain food bothers us and when we should eliminate food. A glance at this episode: [3:49] Elimination diets for digestive health [7:42] Gluten sensitivity and its effects on the body [11:56] Gut microbiome's role in IBS symptoms and behavioral changes [15:20] ...
Nov 16, 2023•21 min•Ep. 187
How similar are the neuromuscular responses to pain with chronic low back pain and GI pain? Join Susan and Erica in a great discussion of the role of the diaphragm and how this changes with pain and inhibition/over-recruitment in the system. In chronic low back pain and abdominal bloating/distention the diaphragm becomes a postural control muscle which greatly limits the respiratory ability along with an ineffectual model for spine stiffness and visceral organ pusher. This is an excellent discus...
Nov 09, 2023•42 min•Ep. 186
When do you treat the viscera? And why? This episode discusses a bit about the abdominal viscera. It is certainly not all-encompassing by any means. We just want our audience to be aware of the possibilities. Erica relays some clues in the patient's history as to why you would screen for GI dysfunction. She uses 2 case examples of when the abdominal viscera was the secondary driver in one case and when it was a significant impairment in a patient with a dural driver in the other. Once again, it ...
Nov 02, 2023•19 min•Ep. 185
In this episode, Susan and Erica welcome Darcie Pervier to the mic! Darcie is a pelvic health and orthopedic PT who practices a fully integrative approach to complex client care. Susan, Erica, and Darcie really delve into "brainstorming" various aspects of examination and intervention in connecting some dots on this complex canvas. Dural issues, fracture healing, bone health red flags, thoracic stiffness, neural tension, and GI visceral systems are tied together to help guide more meaningful int...
Oct 26, 2023•48 min•Ep. 184
This episode captures a critical aspect of integrating sensory and motor aspects of colorectal rehab from constipation and IBS to fecal incontinence. The information is categorized under the hyposensitive vs. the hypersensitive quality of symptoms and the motor control from decreased muscle capacity, tissue quality, and motoric coordination. A glance at this episode: [3:27] Rectal balloon therapy for bowel dysfunction [7:58] Rectal muscle exercises for constipation management [12:46] Rectal sens...
Oct 19, 2023•24 min•Ep. 183
In this episode, Erica and Susan welcome Julia Rosenthal to the mic. Julia is a physical therapist in NYC. She brings a complex case of a postpartum patient of hers who has symptoms of urinary incontinence as well as other bowel and bladder issues that were made worse after giving birth. The patient is a personal trainer and used to high-load exercise, so the need to get back to this is strong. She also has complaints of abdominal bloating along with occasional musculoskeletal pain with CKC lowe...
Oct 12, 2023•1 hr 3 min•Ep. 182
How do you increase patient compliance with their exercise program? This can be very frustrating for both the therapist and the patient. In this shortie episode, Erica discusses how she helps keep her patients on track with their movement program. She often says, "If it's not trialed, then the chances of your patient doing the exercise are reduced at least 10-fold." What is the goal of exercise? Ultimately, it's about training the brain and optimizing movement. You need to get the patient to "bu...
Oct 05, 2023•14 min•Ep. 181
In this episode Susan and Erica welcome a Tough To Treat listener, Megan Barclay. Megan brings a case of a patient who continues to suffer neuralgia after a bout of shingles, along with persistent neck pain. Listen to the client's history, significant findings, and differentials as we navigate this client's journey and discuss relevant findings. There is also a rich discussion on possible interventions targeting many points of the trigeminal system and cranial region. A glance at this episode: [...
Sep 28, 2023•49 min•Ep. 180
Look beyond the traditional regional approach of the pelvic and pelvic floor and understand how discovering and addressing dysfunctions of the trigeminal and respiratory system including the voice and heart rate variability can have an impact on pelvic health. HRV is a well-researched indicator of the balance between the Sympathetic and the Parasympathetic nervous systems. The balance has a large impact on the performance of the GI system and can influence pain, motility, and inflammation. Worki...
Sep 21, 2023•23 min•Ep. 179
Look beyond the traditional regional approach of the pelvis and pelvic floor and understand how discovering and addressing dysfunctions of the trigeminal and respiratory system including the voice and heart rate variability can have an impact on pelvic health. HRV is a well-researched indicator of the balance between the Sympathetic and the Parasympathetic nervous systems. The balance has a large impact on the performance of the GI system and can influence pain, motility, and inflammation. Worki...
Sep 14, 2023•19 min•Ep. 178
In this episode, we dive into the often overlooked and misunderstood world of male health, exploring the complexities of groin pain, the challenges of taking deep breaths, and the impact on his pelvic girdle pain. The history will give you the answer. This is a complex case with many parts but listening to his story helps you to prioritize which regions of the body you need to rule out. Visceral connections are key to this presentation. Join Susan and Erica as they unravel the potential causes, ...
Sep 07, 2023•48 min•Ep. 177
When does motor control come into play when someone has persistent shoulder pain? Is it soft tissue related, a joint problem, or a neuromuscular repatterning issue? Or something else? How does our nervous system adjust? In this episode, we talk about the multiple sources of this person’s shoulder pain and how retraining his arm lift was the key to his recovery. And we mean retraining, the right way. A glance at this episode: [7:27] Assessing symptoms associated with cycling [8:47] The brachial p...
Aug 31, 2023•35 min•Ep. 176
Here is the clinical story of a client that is presenting with pain/sensitivity in the area of the (R) posterior pelvis. A common area of symptoms for many patients. But there are many potential drivers and the need to differentially diagnose is crucial. Why? Because you won't want to miss the hidden connections that are so often present in patients, that when missed, can make the difference between a successful outcome and a patient who walks away unhappy. In this episode, we discuss what has b...
Aug 24, 2023•45 min•Ep. 175
