In this conversation, Dr. Beau and Mike Stella discuss the role of manual therapy in rehabilitation and performance enhancement. Mike shares his origin story as an athletic trainer and how his injuries led him to explore different approaches to recovery. They discuss the importance of manual therapy in pain modulation and creating movement opportunities. They also address the criticism of manual therapy and the need for transparency and education. The conversation highlights the value of manual therapy in the context of individualized care and the unique needs of elite athletes. In this part of the conversation, Dr. Beau and Mike Stella discuss the challenges of providing individualized care in a healthcare system that often prioritizes volume and efficiency. They explore the complexity of movement and how it can vary from person to person, making it difficult to define optimal movement strategies. They also touch on the relationship between movement dysfunction, pain, and injury, highlighting the need for a personalized approach. Mike shares his experience in building a sustainable private practice that offers high-quality care and discusses the importance of patient education and communication. They also discuss the role of social media in marketing and building a brand. In this final part of the conversation, Mike Stella discusses how he gained a following on social media and the importance of providing valuable content. He emphasizes the need for competence in one's field and the ability to display that competence in a consumable way. Mike also shares his journey of building his business and the lessons he learned. He highlights the importance of authenticity and the power of the relationship between clinician and patient. Mike concludes by discussing the qualities he looks for in his staff and the importance of overcoming adversity.

Dr. E was heavily involved in the early days of blogging and podcasting in the physical therapy field. He developed an ISTM course and brought his own tools to market. He initially resisted the evidence-based movement but eventually embraced it and changed his approach. Dr. E's parents are both physicians, which influenced his decision to pursue a career in healthcare. He leaned heavily on manual therapy techniques early in his career but has since shifted towards a more eclectic approach. He emphasizes the importance of being open-minded and not being 100% certain about anything in healthcare. Dr. E has gone through different phases of practice and has learned to critically evaluate different treatment approaches. Dr. E emphasizes the importance of McKenzie principles in his practice, as they modulate pain and improve function. He appreciates that McKenzie's techniques work, even if the theories behind them have been disproven. Dr. E believes in empowering patients with loading strategies and modulating pain before introducing strengthening exercises. He emphasizes the importance of dosage and patient compliance in achieving successful outcomes. Dr. E also discusses the need to refer patients when necessary and the challenges of integrating different treatment approaches. Dr. E discusses the importance of balancing work and family life, and not being solely defined by one's career. He shares his own experience of achieving his goals and finding a balance between work and personal life. Dr. Beau agrees and emphasizes the importance of finding a balance and being passionate about what you do. They also discuss the impact of being a role model for their children and the importance of enjoying what you do.

Severs' disease, also known as calcaneal apophysitis, is a condition that affects children between the ages of 8 and 14 who are going through a growth spurt. It is characterized by pain and inflammation in the heel, particularly in the back of the calcaneus. The condition is caused by the growth of bones outpacing the growth of soft tissues, such as tendons and ligaments. Factors that contribute to the development of Sievers' disease include playing sports during the growth spurt, wearing restrictive footwear, and lack of attention to growth spurts in sports physicals. Treatment options include rest, immobilization, isometric exercises, motor control training, and dry needling. It is important to accurately diagnose the condition and tailor the treatment to the individual.

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In this episode, Dr. Beau and his team discuss the importance of triage in musculoskeletal care and the decision-making process when determining whether a patient needs to see a specialist or undergo surgery. They share several case examples, including a high-level runner with a foot injury and a patient with a chronic shoulder dislocation. The team emphasizes the need for individualized care and the importance of considering the long-term implications for young athletes. They also highlight the role of primary care providers in ordering imaging and making treatment decisions. In this conversation, Dr. Beau discusses two patient cases. The first case is a 36-year-old male with chronic low back pain and disc bulges. Dr. Beau focuses on addressing the patient's pain and improving his movement patterns. The second case is a 47-year-old male who experienced increased headache and neck pain after receiving a Y-strap adjustment. Dr. Beau emphasizes the importance of a thorough examination and appropriate treatment.

The conversation discusses a case of a 34-year-old female with hip pain and a history of low back pain. The patient is active in CrossFit and has been experiencing right anterior hip pain associated with squatting, running, and jumping. The pain started several months ago and has worsened recently. The chiropractors suspect an internal hip issue and work on stabilizing her back while calming down the hip. However, further examination reveals that the patient has a history of ovarian cysts and potential endometriosis. The chiropractors recommend that she see an OB/GYN and consider functional medicine to address the hormonal dysregulation.

In this conversation, Dr. Beau and Dr. Phillip discuss the neurocentric approach and the importance of diagnostic specificity and determining the appropriate intervention points and treatment modalities. They also touch on topics such as staying up to date with research, using AI in healthcare, and balancing creativity in practice. The neurocentric approach focuses on the role of neurology in physical medicine and integrates various treatment modalities to address neurologic dysfunction. It emphasizes the importance of assessing neural contributions to musculoskeletal issues and tailoring interventions accordingly. Dr. Phillip Snell and Dr. Beau Beard discuss the importance of having an organizational heuristic to guide clinical practice. They emphasize the need to identify the tissue that is causing pain, develop a narrative about why it is irritated, educate the patient, and provide a symptom modification procedure. They also highlight the significance of addressing systemic factors such as stress, poor sleep, lifestyle choices, and diet, which can contribute to increased systemic inflammation. Dr. Snell shares his method of staying up-to-date with research by using spiders on PubMed and reading abstracts that catch his attention. He also discusses the potential of AI and Web 3.0 in healthcare. In this final part of the conversation, Phillip discusses how he utilizes GPT-4 in his creative process. He takes GPT-4 with him on runs and asks for feedback on his ideas. He envisions a future social app where people can seek medical advice from multiple sources. Dr. Beau shares his struggle with integrating his creative self into his profession. They discuss the importance of balance and collaboration in pursuing creative projects.

In this conversation, Dr. Beau, Dr. Alex, and Dr. Seth discuss the differentiation between trigger points, radiculopathy, and peripheral nerve entrapment. The docs present three cases of heel pain in runners and ask the audience to determine which condition each case represents. Dr. Beau emphasizes the importance of history taking and examination in making a diagnosis, and highlights the need to rule out other potential causes of pain. He also mentions the use of different treatment interventions and adjunctive care for each condition.

Chapters

00:00 Differentiation between Trigger Point, Radiculopathy, and Nerve Entrapment

05:05 Exam Flow Chart and Case Presentations

09:25 Differentiating Trigger Points

19:50 Differentiating Peripheral Nerve Entrapment

23:40 Treatment and Homework for Each Condition

27:00 Case Analysis and Diagnosis

35:57 Announcement of the Last Live Session

Dr. Beau and Dr. Alex sit down to discuss a case of an elite gymnast dealing with ankle issues 5 months post-op, as well as an acute onset of hip pain that is proving a bit tricky.

In this conversation, Dr. Beau interviews Shawn Sherman, the creator of Square 1 Systems, a problem-solving framework for movement professionals. They discuss the development of Square 1 and its focus on restoring organization within the nervous system to improve upright posture and locomotion. Shawn explains how he moved away from traditional training methods and began using muscle testing and isometric contractions to address disorganization in the nervous system. He also emphasizes the importance of understanding neuromechanics and the temporary nature of interventions. The conversation concludes with discussing the significance of locomotion and gate recognition. In this part of the conversation, Dr. Beau and Shawn Sherman discuss the integration of changes in gait and how it reflects the effectiveness of treatment. They also explore the assessment of neurologic pathology and rule out true neurologic damage. The conversation delves into the impact of stroke on neurological function and the challenges of treating stroke patients. They discuss the value of understanding the brain's impact on movement and the limitations of current knowledge. The conversation also touches on joint restrictions and trigger points, as well as the integration of psycho-emotional inputs in treatment. They conclude by discussing the customization of the Square One system and managing expectations for pain relief in different cases, including athletes and non-pain cases. In this conversation, Dr. Beau and Shawn Sherman discuss the importance of supporting other therapies and the individual neurological response to different inputs. They explore the potential negative effects of certain inputs and the need to replicate and integrate them into the nervous system. They emphasize the role of supporting other professionals and the initial temporary negative response that may occur. They also discuss the relationship between stimulus and response and the importance of exposure and integration. They touch on the impact of inputs on visual acuity, mobility, grip strength, and exit velocity. They highlight the need for a lab and education center to explore new ideas and geek out on numbers. They conclude with the idea of keeping an open mind and the analogy of Bigfoot to emphasize the importance of being open to possibilities.

In this conversation, Dr. Beau and Steven Capobianco discuss the complex topic of trigger points and their role in manual therapy. They explore various theories and mechanisms behind trigger points, including the soft tissue milieu, neurogenic inflammation, and peripheral and central sensitization. They emphasize the importance of considering the broader context of the patient and adopting a synergistic approach to treatment. The conversation also touches on the interrater reliability of palpation and the role of experience in improving accuracy. In this part of the conversation, the subjectivity and objectivity of palpation are discussed, highlighting the challenges of accurately locating trigger points. Advancements in technology, such as MSK ultrasound, elastography, and T1Q mapping, are explored as potential tools for identifying trigger points and dysfunctional tissue. The role of hyaluronan in the extracellular matrix and its impact on tissue mobility and sensitization is examined. The concept of peripheral sensitization and neurogenic inflammation is introduced, emphasizing the importance of addressing cutaneous nerve entrapments in treatment approaches. In this conversation, Steven Capobianco and Dr. Beau discuss the role of touch and movement in addressing pain and dysfunction. They explore the influence of peripheral and central structures, such as trigger points and the limbic system, on the experience of pain. They also delve into the importance of the therapeutic alliance and the need for open-minded discussions in the field of musculoskeletal therapy. Overall, the conversation highlights the complexity of pain and the need for individualized approaches that consider both physical and psychological factors.