198 episodes

Welcome to Tough to Treat: A Physiotherapists’ Guide to Managing Those Complex Patients, with your hosts Erica Meloe and Susan Clinton, who discuss how they successfully treated patients that others could not. Via case history discussion, they share their physical therapy expertise from treating long standing pelvic pain to persistent neck pain. They present a holistic and integrative view on assessing and treating chronic pain. Unique movement strategies and specific patient exercise prescription are also presented so you can be ahead of the curve when it comes to treating these types of patients. Oftentimes, the source of the problem is not where you think it is!! For example, chronic low back pain emanating from the neck. Or hip pain coming from the foot. It pays to look up and down the kinetic chain!

Podcast music: "Fearless First" Kevin MacLeod (incompetech.com)
Licensed under Creative Commons: By Attribution 3.0 License
http://creativecommons.org/licenses/by/3.0/

Tough to Treat Susan Clinton and Erica Meloe

    • Health & Fitness
    • 5.0 • 116 Ratings

Welcome to Tough to Treat: A Physiotherapists’ Guide to Managing Those Complex Patients, with your hosts Erica Meloe and Susan Clinton, who discuss how they successfully treated patients that others could not. Via case history discussion, they share their physical therapy expertise from treating long standing pelvic pain to persistent neck pain. They present a holistic and integrative view on assessing and treating chronic pain. Unique movement strategies and specific patient exercise prescription are also presented so you can be ahead of the curve when it comes to treating these types of patients. Oftentimes, the source of the problem is not where you think it is!! For example, chronic low back pain emanating from the neck. Or hip pain coming from the foot. It pays to look up and down the kinetic chain!

Podcast music: "Fearless First" Kevin MacLeod (incompetech.com)
Licensed under Creative Commons: By Attribution 3.0 License
http://creativecommons.org/licenses/by/3.0/

    Chronic Constipation: Interventions Beyond Pelvic Floor Dyssynergia Part 2

    Chronic Constipation: Interventions Beyond Pelvic Floor Dyssynergia Part 2

    This episode is part 2 of episode 213. Utilizing evidence-based research and the latest clinical guidelines, the presentation will examine the multifactorial nature of chronic constipation, including non-pelvic interventions that can complement existing treatments. One key aspect will be the practical application of the balloon catheter, demonstrating its effective use for both assessment and therapeutic interventions.
     
    A glance at this episode:
    [0:01] Chronic constipation interventions and assessment, including muscle tightness and behavioral factors
    [3:27] Using balloon catheter for rectal biofeedback to treat constipation
    [8:37] Constipation, abdominal distension, and neural tension, with exercises to improve GI function and reduce discomfort
    [14:54] Stress, sleep, and nervous system regulation for chronic problems
    [20:16] GI health, manometry for constipation in infants, and mindfulness techniques
     
    Related links:
    Tough To Treat Website
    Erica’s Course: Decoding the Complex Patient
    Susan’s Pelvic Health Education Subscription
    Access the Transcript
     

    • 25 min
    Chronic Constipation: Interventions Beyond Pelvic Floor Dyssynergia Part 1

    Chronic Constipation: Interventions Beyond Pelvic Floor Dyssynergia Part 1

    Utilizing evidence-based research and the latest clinical guidelines, the presentation will examine the multifactorial nature of chronic constipation, including non-pelvic interventions that can complement existing treatments. 
    One key aspect will be the practical application of the balloon catheter, demonstrating its effective use for both assessment and therapeutic interventions.
     
    A glance at this episode:
    [0:01] Chronic constipation and its impact on pelvic floor health
    [4:24] Constipation and irritable bowel syndrome (IBS) causes, symptoms, and diagnosis
    [12:18] Bloating and distension in chronic constipation, including causes and treatments
    [17:07] Diaphragm function in chronic low back pain
     
    Related links:
    Tough To Treat Website
    Erica’s Course: Decoding the Complex Patient
    Susan’s Pelvic Health Education Subscription
    Access the Transcript
     

    • 24 min
    Postpartum Pelvic Pain and Urgency

    Postpartum Pelvic Pain and Urgency

    There are many ways to approach pelvic pain and symptoms of urinary urge incontinence, but did you know that how the MSK system moves can affect these symptoms as well?  
    On this podcast, we dive into the movement system, past/present autoimmune history, and post-partum process while changing this client's symptoms as well as her urinary incontinence. In turn, she regains control over her pelvic pain!
     
    A glance at this episode:
    [0:01] Postpartum pelvic pain and urinary incontinence in a 34-year-old woman
    [2:07] Pregnancy, autoimmune disorders, and migraines
    [5:36] Postpartum health, nutrition, and urinary incontinence
    [11:18] Postpartum care and pain management
    [14:40] Back pain and mobility issues
    [17:56] Postpartum pelvic floor dysfunction and urgency issues
    [24:09] Managing urinary incontinence through diet and exercise changes
    [27:42] Urgency and pain during sex, pelvic exam, and internal rotation
    [30:22] Pelvic pain and cranial flexion
    [36:17] Evaluating and treating a patient's urgent symptoms through neural tension and movement
    [38:54] Breathing techniques for managing urinary urgency and stress
    Related links:
    Tough To Treat Website
    Erica’s Course: Decoding the Complex Patient
    Susan’s Pelvic Health Education Subscription
    Access the Transcript
     

    • 52 min
    How To Assess The Knee Differently

    How To Assess The Knee Differently

    In this episode, Erica explores new and novel ways to evaluate and treat the knee.
    She discusses different approaches aimed at providing a more accurate assessment of the knee.
    Join her as she emphasizes the importance of training your vision.
    What does "optimal" movement look like for that particular patient?
    Does what you see match what you feel?
    Are you assessing the knee in a movement that is relevant to the patient?
    If someone's right knee is sore when they are walking with that leg behind, then assessing the knee in dorsiflexion and knee flexion is not efficient or effective here.
    Train your vision to see what optimal movement looks like. And then put your hands on the femoral condyles and the joint lines to train your own brain to feel what is optimal. That's how you increase your clinical expertise.
    Erica also discusses a movement you can evaluate if the patient has a hard time squatting or lunging. Finally, do not discount the patient's prior history. An old untreated hamstring tear from years ago could absolutely be relevant to someone's increased knee pain. Makes sense, right? But we often forget that - do not ignore prior history and its importance to current symptoms. 
    A glance at this episode:
    [4:03] Knee pain and its compensatory patterning
    [8:14] Using vision and palpation to assess knee joint movement and patterning for optimal assessment and treatment
    [12:09] Assessing the knee through a body twist
    Related links:
    Tough To Treat Website
    Erica’s Course: Decoding the Complex Patient
    Susan’s Pelvic Health Education Subscription
    Access the Transcript
     

    • 16 min
    Addressing the Gaps in a Patient's Exercise Program

    Addressing the Gaps in a Patient's Exercise Program

    This episode zeroes in on a scenario many physical therapists face: patients diligently following their exercise routines but not seeing the expected progress or recovery. 
    We discuss thorax, foot, and knee drivers as examples and why there can be holes in someone's program even after they've been doing advanced exercises. Being able to identify the patient's impairments is a good start. 
    We discuss common strength holes along with typical overactivity patterns in these patients. Susan and Erica also discuss a patient who is a high-level athlete with a fear-based movement that is a big hole in her program.
    A glance at this episode:
    [4:00] Exercise program for patients with knee and foot issues, focusing on strengthening key muscles
    [7:30] Lunges and split squats for a runner with a thoracic driver
    [13:56] Proper lunge technique and addressing knee pain through strengthening exercises
    [20:24] Improving lunges with a stick and target practice
    [23:43] Lunges and squats for runners with a focus on proper form and progression
    [29:30] Exercise safety and program development for patients with knee pain
    Related links:
    Tough To Treat Website
    Erica’s Course: Decoding the Complex Patient
    Susan’s Pelvic Health Education Subscription
    Access the Transcript

    • 35 min
    Food Allergies vs. Intolerance

    Food Allergies vs. Intolerance

    What is the difference between food allergies and food sensitivities? 
    Join Susan as she discusses the importance of following the science and taking the guess work out of the food allergy vs. sensitivity issue and why this is important for systemic inflammation.
     
    A glance at this episode:
    [3:19] Dietary elimination for gut health and food intolerances
    [9:18] Gluten sensitivity and its impact on IBS symptoms
    [13:14] Gut microbiome's role in digestion, immunity, and weight gain
     
    Related links:
    Tough To Treat Website
    Erica’s Course: Decoding the Complex Patient
    Susan’s Pelvic Health Education Subscription
    Access the Transcript

    • 21 min

Customer Reviews

5.0 out of 5
116 Ratings

116 Ratings

JaneyLSC ,

Always insightful, helpful information

I have found this podcast to be very helpful in learning more in-depth clinical reasoning.

BridgetKane ,

Thought provoking

The conversations between Erica and Susan are fabulous. They have some fabulous takeaways.

SJamesClinton ,

Fantastic Conversations!

Loving the podcast! Came across a great note on sitting postue that allowed me to make a small tweak that helped tremendously, can't wait to listen to more!

Top Podcasts In Health & Fitness

Huberman Lab
Scicomm Media
The Dr. John Delony Show
Ramsey Network
The School of Greatness
Lewis Howes
Perform with Dr. Andy Galpin
Dr. Andy Galpin
Health Hacks with Mark Hyman, M.D.
OpenMind
Skinquiries
iHeartPodcasts

You Might Also Like

Pelvic PT Rising
Nicole Cozean, PT, DPT, WCS & Jesse Cozean
Celebrate Muliebrity with Michelle Lyons
Michelle Lyons
JOSPT Insights
JOSPT
Birth Healing Summit Podcast
Lynn Schulte, PT
Dr. Streicher’s Inside Information: THE Menopause Podcast
Lauren Streicher, MD
The Ask Mike Reinold Show
Mike Reinold