Tough to Treat

In this short episode, Susan discusses the upper cervical region and its effects on the rest of the body: core, pelvic floor dysfunction, muscle recruitment, balance, dizziness, etc. Join Susan as she takes a journey into the remarkable system from one of her lectures. Erl Pettman's work has long influenced Susan on her clinical reasoning and the importance of convergence of symptoms throughout th...

In this episode, Susan and Erica discuss a series of patients that all presented lumbosacral pain. Clinical pattern recognition is an important part of the assessment process.  The pattern does not dictate the intervention process, but the inability or ability of the pattern to change in the assessment and intervention process is key. This practical presentation of a typical female with lumbosacra...

In this short episode, Erica discusses her perspective on what to do when your patient plateaus.  We've all been there. The proverbial plateau. Your patient is doing well and then all of a sudden they get stuck. Why?  More often than not, there is a secondary region of the body that has cropped up. Go back to your patient's movement and injury history. There will most likely be a clue there.  Also...

In this episode, Erica and Susan discuss how to begin and progress treatment with a knee OA without exacerbating their symptoms. Knee pain can be quite provoking as we age, especially for those older adults who have always been active and want to stay that way.  Osteoarthritis is fairly common, however, exercise designed for this patient population tends to fall short and can often exacerbate the...

Join Susan as she shares a segment from a course she teaches on GI Dysfunction.  This clip is dedicated to the Gut-Brain Axis and why the complex interactions can have such a direct effect on the behavior of the movement, endocrine, nervous and visceral systems.  It is all about balance and the direct need to make sense of input and the actions necessary. A glance at this episode: [0:40] Susan sha...

In this episode, Susan and Erica discuss how very old drivers can present in a novel situation, as well as why new drivers will appear if compensatory patterns are allowed to become dominant. Susan's patient in this episode came to her with shoulder pain which quickly led to full-on arm pain. Susan discusses how she used clinical reasoning and the patient's history to find the driver. The driver h...

In this short episode, Erica highlights the importance of center of mass by assessing a semi-competitive golfer with hip pain. He suffered an avulsion fracture of his iliopsoas tendon with resulting surgery. Two years later, he became symptomatic in his hip after golfing for consecutive days.  Hip pain is quite common in golf because of the rotary nature of the sport, but you have to wonder why th...

In this episode, Susan and Erica discuss a young squash player with long-standing low back pain.   They highlight the importance of injury and movement history.   What do we know of squash players? What regions of the body are stressed in this sport? Look at different movement patterns to tease out the driver. How can you apply your clinical reasoning using a timeline of his injury history coupled...

In this short episode, Erica gives her perspective on when and why you should tape. This is one of the most commonly asked questions in her practice and this episode reveals Erica's perspective on taping all throughout the body. She also shares the types of taping techniques that she uses whether it's for supportive purposes or facilitatory purposes, or just nervous system input.  Taping can be a...

Low back pain is a descriptive term at best, indicating where symptoms present. Discover the history and the movement system examination and interventions that led to the successful reduction of symptoms.

The shoulder can be tough to treat at times, right?  It consists of many regions of the body and in order to design an exercise progression that gets results, you must: *Down train the old dominant strategy first *Be innovative with release positions to tease out certain muscles that are overactive *Train volume of easy exercise at a low level  *Use hands and knees as a treatment and exercise prog...

How do you rehab someone who is VERY hypermobile and suffers from persistent low back pain? And their driver is NOT the lumbar spine. This episode highlights the beauty of a specific exercise progression tailored to the patient's meaningful movement as well as their driver. A very important principle of successful and long lasting improvement is training new movement strategies and giving the body...

This episode highlights exercise progression for a patient with neck pain and concurrent headaches. This elusive driver can often be lost when it comes to exercise progression. Hint: the neck is one of the foundations for the movement system. And just because the neck is the driver, this doesn't mean that you exclude all other regions of the body. Why? Because EVERYTHING IS CONNECTED. We discuss h...

Working with a ballet dancer with hip pain, even with a very subtle driver, means continuing to look at the full movement system in its entirety! Regional exercises targeted at the hip may not solve the issue and stretching may contribute further to the problems. Listen to the story, ask questions, and find out where the real issues are! Some pain issues may not show up in the regular human moveme...

Can you find clues in your patient's narrative that will help you find the driver quicker? Make your assessment more efficient and save you time? Think about someone's movement and injury history and how that can be relevant to their current symptoms. Their initial injuries will SET THEM UP for compensatory movement patterning down the road. There are 2 case examples in this episode that highlight...

Success=picking the best functional movement to assess with your patient.   Can you imagine shaving minutes off of your initial evaluation time? And at the same time, connecting with your patient in a way that not only increases the therapeutic alliance but will help you find the driver quicker.   A glance at this episode: [1:21] How to assess functional movement patterns that have meaning for you...

Erica and Susan discuss in this podcast how treating the left hip as well as the left side of the low back, got rid of this young golfer's knee pain. A functional and interactive evaluation really hones in on where the true source of his knee pain lies. Assessing center of mass (COM) here is crucial. Think about golf, you don't need a wide stance. Most of your patients will look different dependin...

There is usually a ten-year lag from published research to accepted practice in clinical arenas. Pelvic girdle pain in Pregnancy is no exception. Join us as we discuss the most important systemic and movement system presentations that can greatly impact this population. In this episode, we cover unhelpful language, true risk factors, and functional problem-solving for these clients. We also discus...

What constitutes an effective and efficient exercise progression? How do you smartly move someone through a movement program targetting their driver? Do not get hung up on someone's symptomatic region if that's not what is driving their symptoms. In this episode 2 cases are presented where their drivers were distal to their symptomatic areas. Categories of movement, neutral to non neutral, as well...

Clients report urgency/frequency and are most often treated with medication and pelvic floor PT. When only a regional approach to the pelvic floor over-recruitment is considered, many of the underlying drivers can be missed. Consider the client on this podcast and join us as we explore how multiple drivers can influence the hypersensitivity of the bladder. Taking into consideration the possibility...

What happens when you take away a compensation? Movement patterns change for starters. But what if these new strategies are not optimal for whatever activity you are trying to do? New sport you want to master? That's where the reality unfolds. Healthy systems need choices and when you take away a compensation or a movement pattern that no longer works (i.e. painful), your brain is forced to develo...

The movement system is adaptable until there is maladaptation! Why is tendonopathy so difficult to treat? What if straight eccentric loading doesn't work? Join us as we discuss this female client and the unique consideration of the system changes that have led to the development and persistence of her persistent heel pain. Yes, this includes pelvic health and the cervical spine! check us out at to...

Can there be 2 drivers to someone's shin pain? Of course! What is the relationship between them? Are they directly connected? Is there some underlying neurally driven mechanism? Or both? This episode digs deep into why certain positions like sitting in a specific environment versus other sitting positions make him worse. Why would biking be ok for someone and sitting in an office chair not be? Thi...

Differentials of common segment's neurology - Join us as we discuss the shared neurology of the T12/L1 region and how this can be a driver to anterior hip and groin pain. We are looking at multitudes of clients that show up with various aspects of what Erl Pettman discusses in his work of the psoas triangle.