From Probe to Practice

Advanced Musculoskeletal Ultrasound Center
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From Probe to Practice is a weekly podcast on musculoskeletal ultrasound — diagnostic scanning, ultrasound-guided injections, and how MSK ultrasound changes the way clinicians practice regenerative and musculoskeletal medicine. Hosted by Colin Rigney and Ryan Martin, founders of the Advanced MSK Ultrasound Center, who have trained clinicians for years and bring the reps to prove it. This is not a 45-minute monologue on probe physics. It's a high-energy dialogue about what actually happens inside a practice: the diagnostic gaps nobody mentions, the injections that miss and why, the referrals you didn't need to make, the business of integrating ultrasound, and the case studies that only come from tens of thousands of scans. Plus, in Ryan's words, "a lot of dirt on each other." Every episode is built around one promise: take something you learned from a podcast on Friday and implement it on Monday. For physicians, regenerative medicine clinicians, sports medicine providers, anyone preparing for the RMSK exam — and anyone who works alongside them. Because you can't diagnose what you can't see. New episodes weekly. An Advanced MSK Ultrasound Center podcast.

Episodes

  1. 3d ago

    MSK Ultrasound Anisotropy: The Artifact That Makes Normal Tissue Look Torn

    "It's the only imaging modality that you can create your own pathology with the flick of a wrist." Tip the probe a few degrees off perpendicular and less sound comes back to it. Less sound back means a darker picture. A darker tendon reads as hypoechoic, and hypoechoic reads as torn. The image still looks fine. The finding is invented. Colin Rigney and Ryan Martin spend this episode on the two things that decide whether you can trust what is on your screen: anisotropy, the artifact that fools everyone early and that experienced scanners turn into a tool, and the vocabulary underneath it — hyperechoic, hypoechoic, anechoic, homogeneous, heterogeneous — which most clinicians use loosely and the RMSK exam does not. Also in this episode: how to toggle the probe to make peroneus longus and brevis wink at you one at a time, how far off 90 degrees you can be before it costs you (about five degrees, and it is obvious by fifteen), why the Achilles is the tendon most people position wrong, Dr. Joel Sellers' wall test for telling homogeneous from heterogeneous, what a denervated muscle looks like as it loses water and takes on fat, and why the contralateral side is the cheapest control you have. The Monday-morning takeaway: put the tissue on tension before you judge it. A slack Achilles bows, a bowed tendon changes your angle, and a changed angle changes the diagnosis. In this episode: 0:00 — Anisotropy, the artifact that fools you0:54 — Welcome to From Probe to Practice2:33 — The only modality where you can create your own pathology3:32 — Why this shows up on the RMSK exam3:56 — It clicks after the first 50 to 100 intentional scans5:21 — What anisotropy actually is6:41 — Using it on purpose: making the tendons wink7:36 — Where it bites: supraspinatus, patellar, Achilles7:56 — How far off 90 degrees can you be?9:47 — Hyperechoic, hypoechoic, anechoic12:32 — 256 shades of gray, and why it is all relative13:40 — Patient positioning, starting with the Achilles16:12 — Put the tissue on a stretch19:01 — Homogeneous vs heterogeneous: the wall test19:52 — Acute hematoma vs chronic ossification20:59 — What a denervated muscle looks like22:53 — Always check the other side24:13 — RUSI, a topic for another day26:32 — The machine will lie to you all day long Mentioned in this episode: Introduction to Musculoskeletal Ultrasound, the physics and machine-optimization course Ryan built: https://www.amsku.com/courses/introduction-to-musculoskeletal-ultrasound/ New episodes every Tuesday. From Probe to Practice is brought to you by the Advanced MSK Ultrasound Center — courses, residency and live workshops: https://amsku.com

  2. Aug 18

    If You Can't Diagnose It, You Can't Inject It | Greg Zakas, DO

    "That's actually the easy part, is the injection. If you can't diagnose it, you can't inject it." Dr. Greg Zakas trained in physical medicine and rehabilitation, did an interventional pain fellowship, and spent years in clinics where the model was opioids first and procedures second. He came out the other side as a full-time regenerative orthopedics physician. This is the whole route, told honestly — including the $400,000 of debt that shaped which specialty he picked, the forty-to-fifty-patient days that made real conversations impossible, and the VA research that settled the opioid question for him. Colin Rigney and Ryan Martin take him through the part most clinicians get wrong: the assumption that ultrasound-guided injection is the hard skill. Zakas argues the needle work is the easy half. What separates practitioners is whether they can see the thing they are treating in the first place — and he makes the case that in trained hands, diagnostic ultrasound matches MRI for finding rotator cuff tears. Also: why showing a patient their own tear on the screen builds more trust than any explanation, how the ability to talk about ultrasound and the ability to do it feed each other, why he refused to post about anything he had not seen dozens of times, and what he would tell a physician who is ten years behind him and wondering whether it is too late. The Monday-morning takeaway: the diagnostic skill is the bottleneck, not the needle. If you are getting your orthobiologic into the joint but not to the lesion, more injection practice is not the fix. In this episode: 0:00 — If you're not embracing it, you're going to be left behind0:54 — How the three of us met1:55 — PM&R, pain fellowship, and $400,000 of debt2:22 — When prolotherapy was still considered voodoo5:59 — Mission trips: Lima and Guadalajara7:35 — Meet your hosts11:42 — Why traditional pain medicine broke for him12:52 — The VA study that changed his mind on opioids15:30 — Insurance volume vs. time with a patient16:17 — The slow pivot into orthobiologics18:14 — Which courses were actually worth it21:16 — The injection is the easy part21:54 — Ultrasound vs MRI, and the naysayers23:47 — What ultrasound does to patient trust26:35 — Ultrasound as a communication tool32:12 — Imposter syndrome and earning the right to teach35:08 — What he's working on next41:29 — Advice to a doctor ten years behind him49:50 — Where to follow the work New episodes every Tuesday. From Probe to Practice is brought to you by the Advanced MSK Ultrasound Center — courses, residency and live workshops: https://amsku.com

  3. Aug 11

    MSK Ultrasound Probe Selection: Linear vs Curvilinear

    Linear or curvilinear? Which frequency? And what should you actually be doing before the probe touches the patient? Colin Rigney and Ryan Martin open From Probe to Practice with the decisions that quietly set the ceiling on every MSK ultrasound exam you run — probe selection, frequency, gain, and the positioning nobody talks about until an injection goes sideways. Ryan's rule, from his mentor Wayne Smith: "Scan everything with a linear probe until you cannot." Colin's version of the same idea: "Ultrasound is an extension of your clinical brain." Both come back to intent — why are you scanning, and will it change what happens to this patient? Also in this episode: a case from that same morning where a patient's anterior hip sat almost 12 cm deep and the linear probe simply could not reach it, why the curvilinear's crossing arrays can make a straight bone look curved, what to do when your clinic owns exactly one probe, and the scouting habit that prevents the most common avoidable injection problem. The Monday-morning takeaway: always scout in the position you're going to inject in. A shoulder scouted seated and injected supine is a different shoulder. In this episode: 0:00 — Ultrasound is an extension of your clinical brain0:53 — Welcome to From Probe to Practice1:51 — Before you touch the probe: why are you doing this?3:02 — Scope of practice and clinical reasoning4:24 — Optimisation starts before the patient5:37 — Linear, curvilinear, hockey stick6:32 — Use a linear probe whenever you can7:03 — Trading depth for resolution9:35 — The case that forced a curvilinear10:51 — When you only have one probe11:53 — The physics caveat nobody mentions14:01 — Patient position, practitioner position15:17 — Scout in the position you'll inject16:02 — Start with why17:18 — If you're not optimising the gain New episodes every Tuesday. From Probe to Practice is brought to you by the Advanced MSK Ultrasound Center — courses, residency and live workshops: https://amsku.com

  4. Aug 3

    MSK Ultrasound Is the Gateway to Regenerative Medicine

    "Whether you know it or not, you have a gap in your practice." Colin Rigney and Ryan Martin — the founders of the Advanced MSK Ultrasound Center — introduce From Probe to Practice: what it is, who it's for, and why they built a show about musculoskeletal ultrasound that deliberately isn't a lecture. This is not a 45-minute monologue on probe physics. It's two people who've trained clinicians for years talking about how MSK ultrasound actually works inside a practice — the diagnostic gaps nobody mentions, the injections that miss and why, the referrals you didn't need to make, the business of integrating it, and the case studies that only come from tens of thousands of reps. Plus, in Ryan's words, "a lot of dirt on each other." Guests this season include Greg Zakas and Don Buford, among others from across regenerative and musculoskeletal medicine. Stay to the end for a look at what's coming. In this episode: 0:00 — The gap in your practice0:12 — From Probe to Practice0:30 — Who's talking0:57 — What the show is2:01 — Why it exists2:23 — Who we made it for3:07 — The moment you reach for it3:45 — Why ultrasound, why now4:37 — What this show is not5:47 — What you can expect7:37 — What one episode gets you8:56 — Who else this is for10:17 — The invitation11:07 — This season on From Probe to Practice New episodes every Tuesday. From Probe to Practice is brought to you by the Advanced MSK Ultrasound Center — courses, residency and live workshops: https://amsku.com

  • 4 Episodes

About

From Probe to Practice is a weekly podcast on musculoskeletal ultrasound — diagnostic scanning, ultrasound-guided injections, and how MSK ultrasound changes the way clinicians practice regenerative and musculoskeletal medicine. Hosted by Colin Rigney and Ryan Martin, founders of the Advanced MSK Ultrasound Center, who have trained clinicians for years and bring the reps to prove it. This is not a 45-minute monologue on probe physics. It's a high-energy dialogue about what actually happens inside a practice: the diagnostic gaps nobody mentions, the injections that miss and why, the referrals you didn't need to make, the business of integrating ultrasound, and the case studies that only come from tens of thousands of scans. Plus, in Ryan's words, "a lot of dirt on each other." Every episode is built around one promise: take something you learned from a podcast on Friday and implement it on Monday. For physicians, regenerative medicine clinicians, sports medicine providers, anyone preparing for the RMSK exam — and anyone who works alongside them. Because you can't diagnose what you can't see. New episodes weekly. An Advanced MSK Ultrasound Center podcast.

Information

  • Creator
    Advanced Musculoskeletal Ultrasound Center
  • Years Active
    2026
  • Episodes
    4
  • Rating
    Clean
  • Copyright
    © 2026 Advanced Musculoskeletal Ultrasound Center
  • Show Website
    From Probe to Practice