Tough to Treat  By  cover art

Tough to Treat

By: Susan Clinton and Erica Meloe
  • Summary

  • 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/
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Episodes
  • Food Allergies vs. Intolerance
    May 2 2024

    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

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    21 mins
  • Back Pain/Leg Pain - Making the Right Call For Our Clients
    Apr 25 2024

    This episode presents what should be a straightforward case of a significant nerve root irritation. Unfortunately for this client, her situation was not addressed adequately and has left her in a lot of pain for over 3 months.

    Join us as Susan presents this client case, what went wrong, and the assessment and intervention with a rich discussion of the path forward.

    Here is a Hint: center of mass and chronic loading play a strong part in this story!

    A glance at this episode:

    • [2:21] Back and glute pain, stretches, and fatigue

    • [7:37] Back pain and re-curring mobility issues

    • [12:16] Chronic pain and it's relationship to mobility

    • [17:02] Proper standing and walking techniques for comfort and mobility

    • [22:00] Standing balance and stretching exercises for improved mobility

    • [26:51] Chronic back pain and neuroinflammation

    • [31:26] Back pain treatment options and the importance of proper imaging

    • [36:01] Proper treatment approaches for a patient with persistent 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

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    40 mins
  • Clinical Pearls For Effective Exercise Progression
    Apr 18 2024

    In this episode, Erica speaks about prescribing specific exercises based on the difficulty level relative to the region of the body driving the patient's symptoms.

    NOT the pain generator.

    NOT the area of symptoms.

    If someone has knee pain, and their driver is their foot, then the exercise program is geared towards the foot, NOT the knee. SLR's and quad sets won't work here.

    She also explores the significance of personalized exercise prescriptions in optimizing recovery outcomes. There are many clinical pearls in this episode, one of which is, "Why would a side-to-side deep squat be harder for the foot than the thorax?" Both are lateral movement patterns.

    She also discusses the clinical reasoning behind a well-thought-out exercise plan. Remember: we are trying to give our patients options for movement and variability across many activities. Building volume of exercise at low levels is key to this outcome as is challenging the driver across many planes.

    A glance at this episode:

    • [3:38] Prescribing specific exercises based on the patient's main driver, not the symptom

    • [8:02] Identifying the level of difficulty for a specific exercise using regional analysis

    • [14:02] How to dose exercise based on what is meaningful for the patient

    • [17:58] Exercises for improving lower body control and center of mass

    Related links:

    • Tough To Treat Website

    • Erica’s Course: Decoding the Complex Patient

    • Susan’s Pelvic Health Education Subscription

    • Access the Transcript

    Show more Show less
    25 mins

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