Hands On Hands Off: Manual Therapy & Orthopedic Physical Therapy (AAOMPT)

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The Hands On Hands Off Podcast from the American Academy of Orthopaedic Manual Physical Therapists explores the debate at the heart of modern rehab: How much treatment should be hands-on… and how much should empower patients to move independently? Through conversations with leaders in manual therapy, orthopedic physical therapy, pain science, and rehabilitation, we break down: • clinical reasoning • manual therapy techniques • patient education • exercise-based care • evidence vs tradition in PT If you’re a physical therapist, manual therapist, DPT student, or rehabilitation professional, this show will challenge assumptions and sharpen your practice.

  1. When Headache Starts in the Neck: Gwen Jull & Zhiqi Liang on Migraine, Cervicogenic Headache, and Clinical Reasoning

    vor 3 Tagen

    When Headache Starts in the Neck: Gwen Jull & Zhiqi Liang on Migraine, Cervicogenic Headache, and Clinical Reasoning

    Neck pain and headache often travel together. But as Gwen Jull and Zhiqi Liang explain in this episode, that does not automatically mean the cervical spine is driving the headache. In this AAOMPT and IFOMPT collaborative episode, hosts Amy McDevitt and Michael Boney explore the evolving science around cervicogenic headache, migraine-associated neck pain, sensitization, and clinical examination. Gwen Jull discusses the development and validation of physical criteria for cervicogenic headache, emphasizing the need for a cluster of comparable musculoskeletal signs involving joint, movement, and muscle impairments. Zhiqi Liang expands the conversation into migraine, reminding clinicians that neck pain can be part of a migraine presentation rather than proof of a cervical source. She challenges clinicians to rethink the meaning of symptom reproduction during upper cervical examination and to consider sensitivity, irritability, and migraine cycles when examining and treating these patients. Together, the guests make a compelling case for more careful clinical reasoning: listen to the patient’s story, examine without over-provoking symptoms, look for comparable signs, and match treatment to the impairments that are actually present. Big takeaway: The neck may matter — but clinicians need to prove it through the whole clinical picture. Timestamped Chapters00:00 — Welcome to Hands On, Hands Off 00:31 — Introducing the AAOMPT and IFOMPT collaboration 01:19 — Meet Gwen Jull and Zhiqi Liang 03:19 — Why headache and neck pain matter to manual physical therapists 03:40 — Major shifts in clinical thinking around cervicogenic headache 04:09 — Validated physical criteria for cervicogenic headache 05:37 — Joint, movement, and muscle signs 07:33 — The physiotherapist’s role in differential diagnosis 08:02 — How headache can refer pain into the neck 08:51 — Are cervicogenic headache and migraine distinct or a spectrum? 09:26 — Migraine as a primary neurological condition 11:33 — Sorting out mixed headache presentations 12:05 — Patient history clues: migraine vs cervicogenic headache 13:27 — Comparable signs and why intensity matters 14:51 — How much does pain location matter? 16:20 — Why no single feature is enough 17:17 — Neck pain in migraine may not be a neck problem 17:53 — Rethinking symptom reproduction during examination 19:22 — How to decide whether the neck is a driver 20:01 — Avoiding confirmation bias 21:27 — Why non-provocative examination matters 23:08 — Scapular dysfunction and other regional contributors 24:37 — Broadening beyond the diagnostic cluster 26:05 — Sensory-motor control, dizziness, and balance 28:41 — Local cervical findings and global systems 29:31 — Listening for migraine evolution over time 30:46 — Central sensitization and comparable physical findings 31:28 — PIVM vs PAVM assessment considerations 32:08 — Avoiding symptom provocation in migraine 33:04 — Migraine cycles and changing sensitivity 34:36 — Trial treatment and rigorous re-evaluation 35:41 — Individualized care beyond guidelines 36:19 — Who may benefit from a cervical-focused approach? 37:07 — Education, exercise, sleep, stress, and lifestyle strategies 39:02 — Let the physical exam guide treatment 39:46 — PTs as rehabilitation experts, not just pain reducers 41:38 — One assumption clinicians should rethink tomorrow 42:12 — Don’t forget the jaw 42:27 — Neck pain may reflect sensitivity, not source 43:16 — Final reflections and closing

    44 Min.
  2. Why Kyle Feldman Never “Works a Day”

    7. Apr.

    Why Kyle Feldman Never “Works a Day”

    In this episode, we sit down with Kyle Feldman, National Director of Physical Therapy for ReEnvision PT and owner of WE ARE Physiotherapy. Kyle shares how clinical reasoning, therapeutic alliance, and intentional growth have shaped his work as a clinician, educator, and leader. We discuss: Why clinical reasoning is often misunderstoodHow strong therapeutic alliance amplifies patient outcomesSafety, intent, and application of spinal manipulation in elderly patientsUsing fellowship training to step into leadership or ownershipKyle’s career path and the mindset that keeps him energizedThis is a must-listen episode for clinicians looking to level up their reasoning, build meaningful patient relationships, and explore new opportunities in the profession. Key Takeaways: Clinical reasoning is more than pattern recognition — it’s dynamic decision-making.Therapeutic alliance isn’t “being nice”; it’s a critical clinical skill.Older adults are often under-treated due to clinician fear, not evidence.Fellowships can be springboards for business ownership and leadership innovation.Growth in PT requires curiosity, reflection, and courage. Guest Info: ???? Kyle Feldman – kylefeldmandpt@gmail.com ???? ReEnvision PT ???? WE ARE Physiotherapy

    16 Min.

  3. 24. März

    How to Teach Clinical Reasoning in OMPT

    What happens when you mix decades of movement science, deep mentorship, and a passion for solving complex MSK problems? You get Lee Marinko — one of the most beloved educators and mentors in OMPT. Lee has been teaching in the Boston University DPT program for more than 20 years, serves as Chair of the AAOMPT Program Director SIG, and launched the BU OMPT Fellowship in 2014 with one goal: “We can do better than that.” In this conversation, Lee shares her philosophy on mentorship, the joy of Ah ha moments, how to keep clinical problem-solving fun, and what young professionals really need from their teachers and clinical leaders. In this episode, we explore: ???? Why movement science is the foundation for great OMPT ???? Lee’s favorite teaching moments — and what they reveal ???? How to guide learners through complex cases ???? Mentorship tips for faculty, fellows, and CI’s ???? The origin story of the BU Fellowship ???? Why curiosity beats certainty in clinical reasoning ???? The mindset that makes clinicians grow faster ???? How to “do better” for people with MSK pain If you teach, mentor, or simply want to think better as a clinician — do not miss this one.

    13 Min.
  4. Why Hip Dysplasia Goes Undiagnosed for 7 Years

    19. März

    Why Hip Dysplasia Goes Undiagnosed for 7 Years

    Why do patients with hip dysplasia go years without a diagnosis? In this episode, physical therapist and researcher Dr. Libby Bergman explains why hip dysplasia in young adults is frequently overlooked—and what clinicians can do to catch it earlier. Her research explores whether simple clinical tests physical therapists already use—range of motion, strength testing, and hypermobility measures—might help identify hidden hip instability. The findings could help clinicians recognize hip dysplasia sooner and potentially prevent years of unexplained pain and delayed treatment. In this conversation we discuss: • Why hip dysplasia is commonly missed • Early clinical signs physical therapists should watch for • Why athletes like dancers and swimmers may be at higher risk • New research linking range of motion and adductor strength to dysplasia • Why patients often wait 5–7 years for the correct diagnosis

    15 Min.
  5. When a PTA Crosses Scope of Practice: An Ethics Case Every PT Should Hear

    18. März

    When a PTA Crosses Scope of Practice: An Ethics Case Every PT Should Hear

    What should a clinician do when they discover an ethical breach in the clinic? In this episode, members of the AAOMPT Ethics Committee walk through a realistic clinical scenario involving a physical therapy fellow who discovers a physical therapist assistant performing manipulation techniques outside their scope of practice. When the fellow raises the concern with the clinical director, the issue is dismissed—creating tension, professional risk, and uncertainty for a student observing the situation. This conversation explores the ethical principles that guide clinical decision-making and the leadership responsibilities that often come with fellowship training. The panel discusses how clinicians can navigate difficult ethical situations while protecting patients, maintaining professional integrity, and supporting colleagues. In This Episode • Ethical responsibilities of physical therapy fellows • Scope of practice considerations for PTAs • Patient expectations vs professional standards • The role of accountability and integrity in clinical practice • Leadership development through fellowship training • How students and clinicians can report ethical concerns • Why ethical issues in healthcare are often underreported

    26 Min.

  6. 16. März

    Screening Social Determinants of Health in Outpatient PT

    What does it look like when an early-career clinician steps up to solve real barriers patients face — not just their pain? Wisconsin-based PT and Fellow-in-Training Rachel Beilfuss joins us to talk about her mission to integrate social determinants of health (SDoH) into everyday outpatient PT practice. As a Northwestern OMPT fellow with a clinical site at Marquette University, she's building systems to help clinicians screen, identify, and address the life factors that shape recovery and access. Rachel is also this year’s FOMPT scholarship recipient, representing the next generation of OMPT clinicians who are redefining what comprehensive care looks like. In this episode, we dig into: ???? Why SDoH screening belongs in musculoskeletal care ???? How Rachel is building clinic workflows + resource guides ???? Her experience as a Fellow-in-Training at Northwestern/Marquette ???? The importance of advocating for patients’ basic needs ???? What early-career leadership looks like in AAOMPT ???? How lifestyle, access, and equity affect rehab outcomes ???? Why clinicians need support beyond biomechanics to serve patients fully This one is full of passion, practicality, and vision from one of the profession’s rising voices.

    15 Min.

  7. 10. März

    The Future of Musculoskeletal Care with Clare Ardern

    What does the future of musculoskeletal care look like — and how can physical therapists lead it? Dr. Clare Ardern, Assistant Professor at the University of British Columbia and leader of the DigiMSK research team, joins us to break down digital health innovations, access bottlenecks, advanced practice roles, and the tools clinicians need to navigate a rapidly changing MSK landscape. We explore how technology, triage systems, and research literacy can reshape global MSK care — and why PTs are uniquely positioned to lead. Clare also shares practical insights from her work designing and testing new health care technologies and services in partnership with patients, clinicians, and health systems. In this episode, we cover: ???? Why MSK health care is ripe for redesign ???? Digital health tools: what works, what doesn’t, and what’s coming ???? Virtual triage & advanced practice physiotherapy models ???? How PTs can improve access to MSK care globally ???? Leadership skills every clinician needs today ???? Tips for reading and interpreting research (without getting overwhelmed) ???? How to get your research published ???? The mission and work of DigiMSK A deep dive for clinicians, researchers, and leaders who want to be part of the solution in MSK care.

    19 Min.

  8. 3. März

    Life After Fellowship: Why Post-Professional Growth Matters

    In this AAOMPT interview, we sit down with Liam Globensky, Center Manager at Brooks Rehabilitation and a brand-new fellow from the Brooks Institute of Higher Learning. Liam shares his passion for post-professional development, advocacy, and the responsibility fellows have to give back to the profession. We dive into: What life after fellowship should look like How new fellows can become leaders, mentors, and advocates Why post-professional opportunities are essential for the growth of PT The role of clinicians in “raising the tide” for the entire profession A preview of Liam’s AAOMPT platform presentations How orthopedic clinicians can screen for pelvic floor dysfunction Whether you're a student, a fellow, or a seasoned clinician, this episode offers an inspiring look at how PTs can serve, teach, and elevate the profession long after formal training ends. Chapters: 00:00 – Opening 00:48 – Meet Liam Globensky 03:10 – The Fellow → Clinician transition 06:20 – Why post-professional opportunities matter 10:55 – “Raising the tide” through advocacy 15:40 – How new fellows can give back 20:10 – Orthopedic screening of pelvic floor dysfunction 26:30 – Working alongside his wife: the joint lecture 30:20 – What the future of fellowship-trained PTs looks like 35:00 – Advice to new grads & future fellows 38:50 – Closing If you’re passionate about fellowship training, clinical growth, and elevating our profession, be sure to like, subscribe, and share this interview with a colleague.

    17 Min.
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The Hands On Hands Off Podcast from the American Academy of Orthopaedic Manual Physical Therapists explores the debate at the heart of modern rehab: How much treatment should be hands-on… and how much should empower patients to move independently? Through conversations with leaders in manual therapy, orthopedic physical therapy, pain science, and rehabilitation, we break down: • clinical reasoning • manual therapy techniques • patient education • exercise-based care • evidence vs tradition in PT If you’re a physical therapist, manual therapist, DPT student, or rehabilitation professional, this show will challenge assumptions and sharpen your practice.

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