The Fitness Pain Free Show

📌 FREE Guide -  Athletic Pubalgia & Sports Hernia Evidence Based "Cheat Sheet": https://fitnesspainfree.com/programs/athletic-pubalgia-cheat-sheet-lead-magnet/

🎓 Insiders Academy - https://fitnesspainfree.com/programs/fpf-insiders/ 

👉 Transform your career with the FREE FPF Mini Course & gets some FREE CEUs for PTs, PTAs & ATCs. https://fitnesspainfree.com/programs/fpf-certification-presale-page/ 

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Sports hernia, athletic pubalgia, core muscle injury, Gilmore's groin… whatever you call it, diagnosing groin pain in athletes can be incredibly challenging.

In this video, we break down the latest evidence on **sports hernia / athletic pubalgia diagnosis**, including clinical presentation, subjective examination, special tests, differential diagnosis, imaging findings, and the relationship between femoroacetabular impingement (FAI) and chronic groin pain.

You'll learn how to differentiate between adductor-related, inguinal-related, iliopsoas-related, and pubic-related groin pain — and how to recognize when multiple diagnoses may be contributing to your athlete's symptoms.

We also briefly discuss conservative versus surgical management, return-to-sport outcomes, and when referral may be appropriate.

**Our goal? Help you become more confident evaluating athletes with persistent groin pain and making better clinical decisions.**

Want to go deeper with evidence-based rehab education?

👉 Try Fitness Pain Free Insiders Academy for $1: https://fitnesspainfree.com/programs/fpf-insiders/ 

Insiders Academy includes evidence-based master courses, clinical cheat sheets, exercise progressions, treatment protocols, case studies, mentorship, and continuing education for rehab professionals.

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TIMELINE
00:00 Sports Hernia: What Physical Therapists Need to Know
01:43 The Doha Agreement & Why the Diagnosis Is So Confusing
02:32 Adductor-Related Groin Pain
04:49 Iliopsoas-Related Groin Pain
05:49 Inguinal-Related Groin Pain
09:00 Pubic-Related Groin Pain
16:18 How Common Is Sports Hernia & Groin Pain?
18:37 Which Athletes Are Most at Risk?
21:52 Anatomy Every Clinician Should Understand
23:46 The Problem With MRI Findings
27:16 Risk Factors for Athletic Pubalgia
35:29 Why Multiple Groin Diagnoses Often Coexist
36:32 The HUGE Connection Between FAI & Sports Hernia
40:02 How Sports Hernias Develop
46:04 Subjective Exam & Clinical Presentation
52:05 Physical Exam & Special Tests
54:37 Imaging & Diagnostic Injections
61:20 Differential Diagnosis of Groin Pain
64:01 Conservative Treatment & Physical Therapy
66:26 Shockwave, Cortisone, PRP & Other Treatments
73:07 When Should Surgery Be Considered?
77:26 Return-to-Sport Rates After Surgery
81:51 Surgical Takeaways for Rehab Professionals

If you regularly work with athletes experiencing groin pain, understanding the overlap between adductor-related groin pain, athletic pubalgia, core muscle injury, FAI, osteitis pubis, and true inguinal hernia can make your examination and clinical decision-making much more precise.

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#DanPope #AthleticPubalgia #SportsHerniaDiagnosis #GroinPain #SportsHernia #PhysicalTherapy #PhysicalTherapist #SportsPT #ExercisePrescription #PTSchool #DPT #OrthopedicPT #RehabExercises #CoreStability #AthleticPubalgia #SportsRehab

📌 FREE Guide - Adductor Strain Evidence-Based "Cheat Sheet" https://fitnesspainfree.com/programs/adductor-strain-cheat-sheet-lead-magnet/
Thanks for watching!

🎓 Insiders Academy - https://fitnesspainfree.com/programs/fpf-insiders/ 

👉 Transform your career with the FREE FPF Mini Course & gets some FREE CEUs for PTs, PTAs & ATCs. https://fitnesspainfree.com/programs/fpf-certification-presale-page/ 

******

Adductor strains and adductor-related groin pain can be frustrating injuries—especially when you're trying to safely progress an athlete from early rehab all the way back to sprinting, cutting, and sport.

In this video, we break down an evidence-based approach to adductor strain rehabilitation for physical therapists, athletic trainers, strength coaches, and other rehab professionals.

We'll cover how I think through the entire rehab process, including:

- Early-stage loading and pain monitoring
- How to progress from isometrics to heavier adductor strengthening
- Exercise selection for the different hip adductors
- Copenhagen adduction progressions
- Squats, deadlifts, lunges, and kinetic-chain strengthening
- When and how to reintroduce running
- Sprinting, cutting, change-of-direction, and sport-specific progressions
- Return-to-sport testing and criteria
- Strategies that may help reduce future groin injuries

The research supports an active rehabilitation approach emphasizing hip/groin and trunk strengthening, and the program in this video progresses from lower-intensity early loading toward heavy strength work, running, and eventually full-speed sport-specific activities.     

We also discuss some of the newer research on which exercises create the greatest forces through the different adductor muscles, including Copenhagen variations, deadlifts, squats, lateral lunges, and more.     

Later in rehab, the goal is to prepare the athlete for the actual demands of sport—including high-speed running, cutting, change of direction, kicking, and other mechanisms relevant to their injury.     

Want to earn CEUs while learning this material?

This type of content is also available inside Fitness Pain Free Insiders Academy, where you can take evidence-based continuing education courses designed specifically for rehab and fitness professionals—and earn CEUs while you learn.

👉 Join FPF Insiders Academy + Earn CEUs: https://fitnesspainfree.com/programs/fpf-insiders/  

**TIMESTAMPS**

0:00 Adductor Strain Rehab Overview
0:33 Evidence-Based Rehab Principles
2:37 Best Exercises for Adductor Strength
7:34 Phase 1: Early Adductor Strain Rehab
11:41 Phase 2: Progressive Strengthening
13:27 Return to Running After Adductor Strain
16:35 FPF Insiders Academy + Earn CEUs
19:06 Managing Adductor Strains In-Season
22:46 Phase 3: Heavy Strength & Sport-Specific Rehab
25:55 Sprinting, Cutting & Return-to-Sport Preparation
27:14 Can Adductor Strains Be Prevented?
31:58 Copenhagen Adductor Exercise Progressions
34:40 Return-to-Sport Criteria After Adductor Strain
38:40 Key Clinical Takeaways

#DanPope #PhysicalTherapy #PhysicalTherapist

🎓 Insiders Academy - https://fitnesspainfree.com/programs/fpf-insiders/ 

🧠 ACL Rehab Master Course [Mike Reinold & Kevin Coughlin] https://mikereinold.com/acl-rehab-masterclass/ 

📌 FREE Guide - ACL-Reconstruction Evidence Based Exercise "Cheat Sheet" https://fitnesspainfree.com/acl-reconstruction-exercise-prescription-cheat-sheet-lead-magnet/ Thanks for watching!

Are knee extensions bad after ACL reconstruction?

For years, clinicians have been told to be careful with open kinetic chain knee extensions after ACL-R because of concerns about anterior tibial translation, ACL graft strain, and potentially increasing graft laxity.

But does the research actually support avoiding knee extensions?

In this video, I break down the evidence on **open kinetic chain knee extension after ACL reconstruction** and, more importantly, how I think physical therapists should actually apply this information in the clinic.

We’ll cover:

• Why knee extensions place strain on the ACL graft — and why that isn’t necessarily a bad thing
• Open vs. closed kinetic chain ACL loading
• Why restoring quadriceps strength is so important after ACL-R
• Research comparing closed-chain rehab with combined open + closed-chain strengthening
• Whether early knee extensions actually increase ACL graft laxity
• How range of motion changes ACL strain during knee extension
• Why walking may actually strain the ACL more than lightly loaded knee extensions
• How graft ligamentization should influence our thinking
• Criteria for introducing open kinetic chain strengthening
• How I progress quad loading during the first 4+ weeks after ACL reconstruction
• Where BFR, isometrics, squats, and supine knee extensions fit into the progression

The big takeaway?

**Knee extensions aren't inherently “bad” after ACL reconstruction.**

The more useful question is:

**When should we introduce them, through what range of motion, with how much load, and does the knee currently tolerate that stress?**

We need to respect graft biology, joint effusion, range of motion, the graft harvest site, and the patient's overall irritability — while also recognizing that being too conservative with quadriceps strengthening can create its own problems.

If your athlete is several months into ACL rehab and still has a massive quadriceps deficit, simply avoiding knee extensions probably isn't helping them.

This is where criteria-based progression matters.

📚 **FPF INSIDERS ACADEMY**

Want more practical, evidence-based rehab education like this?

Fitness Pain Free Insiders Academy is my online membership for physical therapists and rehab professionals. You’ll get access to a growing library of courses, clinical resources, case studies, CEUs, rehab protocols, and the ability to submit questions that I may turn into deep-dive videos just like this one.

👉 Join FPF Insiders Academy for just $1: https://fitnesspainfree.com/programs/fpf-insiders/ 

🏋️ **ACL REHAB RESOURCES**

Want the exact exercise progressions, sets, reps, testing, and criteria we use throughout ACL rehabilitation?

👉 ACL Rehab Course / Resources: https://mikereinold.com/acl-rehab-masterclass/ 

⏱️ **TIMESTAMPS**

00:00 – Are Knee Extensions Bad After ACL Reconstruction?
01:28 – Open vs. Closed Kinetic Chain Exercises
03:22 – Why Clinicians Worry About Early Knee Extensions
04:40 – Why We NEED Open Kinetic Chain Strengthening
05:10 – Quad Strength & Knee Re-Injury Risk
07:01 – What the ACL Rehab Consensus Recommends
08:09 – Early Knee Extension Research After ACL-R
10:32 – Starting Knee Extensions at 4 Weeks
13:00 – A Major Limitation of the Research
16:03 – Quad Strength Results: Open vs. Closed Chain
17:09 – Hamstring Strength Results
18:13 – Did Knee Extensions Increase ACL Graft Laxity?
18:43 – Criteria for Starting Open Kinetic Chain Exercise
20:30 – How Early Can We Start Knee Extensions?
22:18 – Walking vs. Knee Extension ACL Strain
24:13 – Using ROM to Reduce ACL Graft Strain
25:34 – When Is the ACL Graft Actually Weakest?
29:38 – Quad-Biased Squats After ACL Reconstruction
31:41 – Closed Chain Doesn't Automatically Mean “Safe”
32:50 – Supine Knee Extensions for ACL Rehab
33:45 – BFR + Low-Load Quad Strengthening
36:09 – Weeks 0–2: Practical Quad Progressions
38:21 – Weeks 2–4: Progressing Knee Extensions
39:00 – Week 4+: Loading the Quadriceps Harder
40:08 – Final Clinical Takeaways

If you’re a physical therapist, athletic trainer, strength coach, or other rehab professional working with ACL reconstruction patients, let me know in the comments:

**When are you currently introducing knee extensions after ACL-R?**

And if you have another rehab question you want me to break down, drop that below too.

#ACLRehab #ACLReconstruction #PhysicalTherapy #KneeRehab #QuadricepsStrength #SportsPhysicalTherapy

📌 FREE Guide - ACL-Reconstruction Evidence Based Exercise "Cheat Sheet" https://fitnesspainfree.com/acl-reconstruction-exercise-prescription-cheat-sheet-lead-magnet/ Thanks for watching!

🎓 Insiders Academy - https://fitnesspainfree.com/programs/fpf-insiders/ 

👉 Transform your career with the FREE FPF Mini Course & gets some FREE CEUs for PTs, PTAs & ATCs. https://fitnesspainfree.com/programs/fpf-certification-presale-page/ 

Show Notes:
- https://fitnesspainfree.com/2026/08/the-complete-guide-to-acl-injuries-rehabilitation/

In today's episode we go over The Complete Guide to ACL Injuries & Rehabilitation - FPF Show Episode 198


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Want to master physical therapy for patients in the strength and fitness world?  


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Welcome to the Fitness Pain Free Show!  This is where we help physical therapists like YOU get your patients out of pain back to training


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📌 FREE Guide - Adductor Strain Evidence-Based "Cheat Sheet" https://fitnesspainfree.com/programs/adductor-strain-cheat-sheet-lead-magnet/
Thanks for watching!

🎓 Insiders Academy - https://fitnesspainfree.com/programs/fpf-insiders/ 

👉 Transform your career with the FREE FPF Mini Course & gets some FREE CEUs for PTs, PTAs & ATCs. https://fitnesspainfree.com/programs/fpf-certification-presale-page/ 

******

Groin pain in athletes can be incredibly sneaky and tricky to manage. As a sports physical therapist or strength coach, you know that 1 in 5 athletes will suffer from a new adductor strain over a single season — especially in high-demand sports like soccer, hockey, and football.

But while basic adductor pain seems straightforward, missing a critical red flag can completely derail an athlete's recovery and push back their return-to-sport timeline. How do you confidently differentiate a standard adductor longus strain from FAI (Femoroacetabular Impingement), a true hernia, or athletic pubalgia (core muscle injury)?

In this video, we'll break down the exact subjective clues, objective special tests, and clinical pearls you need to accurately diagnose adductor strains in under 10 minutes—ensuring you never miss a complete avulsion or a hidden hip joint pathology.

What We Cover In-Depth:
✅ The 91% Rule: Why the adductor longus is almost always the culprit, and how to isolate it during palpation.  
✅ Objective Special Tests: Step-by-step demonstrations of the Squeeze Test, Resisted Outer Range Adduction, and Passive Adductor Stretch.  
✅ Clearing the Hip Joint: How to use the FADIR and FABER tests to rule out Femoroacetabular Impingement (FAI), hip osteoarthritis, or dysplasia.  
✅ Spotting Red Flags: How to differentiate an acute strain from a true hernia or gradual-onset athletic pubalgia (core muscle injury) so you know exactly when to refer back to a physician.

******

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Blog Articles: https://fitnesspainfree.com/articles/

******
TIMELINE
00:00 – Why Sports Physical Therapists Struggle with Groin Injuries
01:04 – Most Common Athlete Populations & Mechanisms of Injury
01:44 – Subjective Assessment: Kicking, Cutting & Tearing Sensations
02:32 – How to Palpate the Adductor Longus (90%+ of Groin Strains)
03:26 – Red Flags: Bruising, Palpable Defects, and Complete Avulsions
04:04 – The Squeeze Test & Resisted Outer Range Adduction Test
04:50 – Passive Adductor Stretch Test Explained
05:01 – Differential Diagnosis: Ruling Out FAI (FADIR & FABER Tests)
05:48 – How to Screen for True Hernias vs. Groin Strains
06:13 – Athletic Pubalgia & Core Muscle Injury Assessment



#DanPope #PhysicalTherapy #PhysicalTherapist #LateralCore #CoreExercises #LowBackPain #SportsPT #ExercisePrescription #PTSchool #DPT #OrthopedicPT #RehabExercises #CoreStability #SidePlank #AthleticPubalgia #SportsRehab #ContinuingEducation

The FPF Specialist is On Sale Now and Open for Enrollment: https://fitnesspainfree.com/programs/fpf-certification-discount-sales-page/

📌 FREE Guide - Hip Osteoarthritis Evidence Based "Cheat Sheet" https://fitnesspainfree.com/programs/hip-osteoarthritis-cheat-sheet-lead-magnet/ Thanks for watching!

🎓 Insiders Academy - https://fitnesspainfree.com/programs/fpf-insiders/ 

🏋️‍♀️ Transform your career with the FREE FPF Mini Course & gets some FREE CEUs for PTs, PTAs & ATCs. - https://fitnesspainfree.com/programs/fpf-certification-presale-page/

Total hip replacement outcomes are generally good—but many patients are left with persistent weakness, gait deviations, and no clear plan for returning to higher-level activities like strength training, running, and sport.

In this video, I provide physical therapists with an evidence-informed, step-by-step framework for total hip replacement rehabilitation. We’ll discuss what the research says about supervised physical therapy after total hip arthroplasty, which patients may need more than a basic home program, and how to progress rehabilitation beyond simply restoring independence.

You’ll learn how to progress patients through:

• Early mobility, gait training, and postoperative precautions
• Hip mobility, strength, balance, and single-leg control
• Squat, hinge, step-up, lunge, and deadlift progressions
• Return to heavier strength training and recreational activity
• Plyometrics, running, agility, and return-to-sport testing

The goal isn’t just to help patients walk again—it’s to restore the strength, capacity, and confidence required to return to the activities they care about.

Always consider surgeon-specific precautions, surgical approach, healing status, medical history, and individual patient goals.

#PhysicalTherapy #TotalHipReplacement #HipRehab

Want More Evidence-Based Rehab Education?  Join Fitness Pain Free Insiders Academy for:

✅ Monthly CEU courses
✅ Case studies
✅ Exercise progressions
✅ Return-to-sport frameworks
✅ Clinical mentorship

👉  Insiders Academy - https://fitnesspainfree.com/programs/fpf-insiders/ 

Show Notes, Credit & References:
- https://fitnesspainfree.com/2026/07/how-to-actually-rehab-a-total-hip-replacement-step-by-step-guide-for-physical-therapists/

⏱️ TIMESTAMPS

00:00 Intro
00:30 Why Physical Therapists Matter After Total Hip Replacement
02:05 Does Every Total Hip Replacement Patient Need Physical Therapy?
08:05 Why Athletes Need More Than Standard THA Rehab
12:00 The Best Rehab Framework After Total Hip Replacement
13:47 Phase 1 (0–3 Days): Early Post-Op Rehabilitation
15:37 Early Exercises After Total Hip Replacement
16:34 Criteria to Progress Beyond Phase 1
22:15 Phase 2 (1–6 Weeks): Restore Mobility & Strength
23:22 Hip Mobility Exercises
24:53 Squat, Hinge & Single-Leg Progressions
27:05 Phase 2 Progression Criteria
29:03 Strength Testing After Total Hip Replacement
31:00 Phase 3 (6–12 Weeks): Advanced Strength Training
32:38 Progressing Single-Leg Strength & Core Training
33:30 Criteria to Begin Running & Sport
39:03 Phase 4 (3–6+ Months): Return to Sport
41:25 Return-to-Running Progression
43:42 Plyometric & Agility Progressions
45:17 Return-to-Sport Testing After THA
48:21 Final Takeaways

*****

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🧠 WANT TO LEARN MORE? Head over to fitnesspainfree.com and sign up for the newsletter.  I'll keep you learning and growing on a weekly basis!

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Blog Articles: https://fitnesspainfree.com/articles/

The FPF Specialist is On Sale Now and Open for Enrollment: https://fitnesspainfree.com/programs/fpf-certification-discount-sales-page/

📌 FREE Guide - Hip Osteoarthritis Evidence Based "Cheat Sheet" https://fitnesspainfree.com/programs/hip-osteoarthritis-cheat-sheet-lead-magnet/ Thanks for watching!

🎓 Insiders Academy - https://fitnesspainfree.com/programs/fpf-insiders/ 

🏋️‍♀️ Transform your career with the FREE FPF Mini Course & gets some FREE CEUs for PTs, PTAs & ATCs. - https://fitnesspainfree.com/programs/fpf-certification-presale-page/

The direct anterior and posterior approaches are the two most common surgical techniques used for total hip replacement (THA), but does one actually produce better outcomes?

In this video, we'll review the latest evidence comparing:
✅ Pain and functional outcomes
✅ Dislocation risk
✅ Recovery timelines
✅ Muscle preservation
✅ Rehabilitation considerations
✅ Return to sport and activity
✅ Long-term outcomes and revision rates

You'll learn the advantages and disadvantages of the anterior, posterior, and direct lateral approaches, and how surgical approach may influence your rehabilitation plan as a physical therapist.

Whether you're a PT, PTA, ATC, strength coach, student, or healthcare professional, this evidence-based review will help you better understand total hip arthroplasty and improve patient outcomes.

Topics Covered
- Direct Anterior Approach (DAA)
- Posterior Approach (PA)
- Direct Lateral Approach (DLA)
- Hip replacement rehabilitation
- Hip precautions
- Return to sport after THA
- Implant survivorship
- Dislocation risk
- Clinical decision making

⏱️ Chapters

00:00 Introduction
00:30 Why PTs Should Care About Surgical Approach
02:05 Direct Anterior Approach (DAA) Explained
03:45 Advantages of the Anterior Approach
05:30 Disadvantages of the Anterior Approach
08:05 Dislocation Risk: Anterior vs Posterior
10:00 Posterior Approach (PA) Explained
11:10 Advantages of the Posterior Approach
12:20 Disadvantages of the Posterior Approach
13:45 Direct Lateral Approach (DLA) Explained
15:10 Advantages of the Direct Lateral Approach
17:10 Disadvantages of the Direct Lateral Approach
20:15 Clinical Discussion: Which Approach Recovers Best?
22:15 How Surgeons Choose a Surgical Approach
25:45 Obesity, Anatomy & Revision Considerations
28:30 Hip Precautions: Do They Actually Matter?
31:00 Early Rehab Considerations by Surgical Approach
34:20 Muscle Recovery & Strength Deficits
37:45 Long-Term Outcomes & Revision Rates
40:00 Return to Sport After Hip Replacement
43:15 Which Sports Are Safe After THA?
45:45 Can Patients Run After Hip Replacement?
48:20 Modern Implants & Longevity
51:10 Clinical Takeaways for PTs
54:10 Final Summary
55:45 Insiders Academy & Continuing Education

Want More Evidence-Based Rehab Education?  Join Fitness Pain Free Insiders Academy for:

✅ Monthly CEU courses
✅ Case studies
✅ Exercise progressions
✅ Return-to-sport frameworks
✅ Clinical mentorship

👉  Insiders Academy - https://fitnesspainfree.com/programs/fpf-insiders/ 

Show Notes, Credit & References:
- https://fitnesspainfree.com/2026/06/anterior-vs-posterior-vs-lateral-hip-replacements-which-leads-to-better-outcomes/


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🤔Have a question/comment? Drop one below in the comment section - I love questions and they help the channel grow!

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🧠 WANT TO LEARN MORE? Head over to fitnesspainfree.com and sign up for the newsletter.  I'll keep you learning and growing on a weekly basis!

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📌 FREE Guide - Meniscus Pathology Evidence Based "Cheat Sheet" https://fitnesspainfree.com/clone-of-meniscus-pathology-cheat-sheet-lead-magnet/ Thanks for watching!

🎓 Insiders Academy - https://fitnesspainfree.com/programs/fpf-insiders/ 

🏋️‍♀️ Transform your career with the FREE FPF Mini Course & gets some FREE CEUs for PTs, PTAs & ATCs.
- https://fitnesspainfree.com/programs/fpf-certification-presale-page/

Timestamps:
01:02 Meniscus Anatomy Explained
04:09 Hoop Stress & Meniscus Mechanics
06:27 Meniscus Blood Supply & Healing Zones
08:00 Meniscus Function & Shock Absorption
09:54 Meniscus Tear Prevalence & Risk Factors
14:20 Mechanism of Meniscus Injury
19:42 Types of Meniscus Tears Overview
20:31 Peripheral Meniscus Tears
21:14 Vertical & Bucket Handle Tears
22:07 Radial & Parrot Beak Tears
24:32 Horizontal Cleavage Tears
25:47 Complex Meniscus Tears
28:14 Degenerative Meniscus Tears
31:25 Subjective Examination for Meniscus Tears
37:58 Acute vs Degenerative Meniscus Presentation
41:04 Objective Examination & Clinical Testing
43:28 Swelling, ROM & Strength Testing
46:30 Special Tests for Meniscus Tears
48:36 McMurray Test Explained
51:48 Joint Line Tenderness Test
56:00 Thessaly Test Explained
58:47 Meniscus Clinical Prediction Cluster
1:01:49 MRI Findings & Imaging Accuracy
1:03:21 Surgery vs Physical Therapy Overview
1:03:42 Meniscectomy vs Meniscus Repair vs Transplant
1:04:47 Clinical Practice Guidelines for Degenerative Tears
1:08:00 Mechanical Symptoms — Do They Matter?
1:12:00 When NOT to Operate on Meniscus Tears
1:18:00 Physical Therapy vs Surgery Research
1:24:00 Long-Term Outcomes After Meniscus Surgery
1:31:00 Meniscus Repair vs Meniscectomy Outcomes
1:38:00 Which Meniscus Tears Need Surgery?
1:45:00 Indications for Meniscus Repair
1:52:00 Meniscus Repair Healing Considerations
1:58:00 Root Tears Explained
2:05:00 Bucket Handle Tears & Locked Knees
2:12:00 Degenerative Meniscus Tear Management
2:20:00 Conservative Rehab Principles
2:28:00 Activity Modification Strategies
2:35:00 Managing Pain & Irrability
2:42:00 Restoring Knee Extension & Flexion
2:49:00 Quad Strengthening Principles
2:56:00 Hamstring Strengthening Considerations
3:03:00 Exercise Selection Based on Tear Type
3:10:00 Open vs Closed Chain Exercise Considerations
3:18:00 Squatting & Compression Forces Explained
3:26:00 Programming Rehab Progressions
3:34:00 Balance & Neuromuscular Training
3:41:00 Return to Running Progressions
3:48:00 Plyometric Progressions
3:55:00 Return to Sport Considerations
4:02:00 Criteria-Based Rehabilitation Principles
4:10:00 Post-Operative Rehab Overview
4:17:00 Meniscectomy Rehab Guidelines
4:24:00 Meniscus Repair Rehab Guidelines
4:32:00 Weightbearing Restrictions Explained
4:40:00 ROM Restrictions After Repair
4:48:00 Protecting the Healing Meniscus
4:55:00 Strength Training After Surgery
5:02:00 Return to Running After Surgery
5:09:00 Return to Sport After Meniscus Surgery
5:16:00 Common Rehab Mistakes Clinicians Make
5:24:00 Biggest Errors in Meniscus Rehab
5:31:00 Final Clinical Pearls & Takeaways

⚡ If you want to go deeper:

Inside of Fitness Pain Free Insiders Academy, we teach you exactly how to:
- Build step-by-step rehab progressions for real patients
- Use criteria-based decision making (not guessing)
- Stay current with the latest research in under 10 minutes
- Get your clinical questions answered

*****
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Blog Articles: https://fitnesspainfree.com/articles/

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📌 FREE Guide - Hip Osteoarthritis Evidence Based "Cheat Sheet" https://fitnesspainfree.com/programs/hip-osteoarthritis-cheat-sheet-lead-magnet/ Thanks for watching!

🎓 Insiders Academy - https://fitnesspainfree.com/programs/fpf-insiders/ 

When should you actually refer a patient for a total hip replacement vs continue rehab?

If you’re a PT, this is one of the most important—and most misunderstood—decisions in managing hip osteoarthritis.

In this video, I break down the pros and cons of physical therapy vs total hip replacement for hip OA—so you can make better clinical decisions, set realistic expectations, and avoid common mistakes that lead to poor outcomes.

You’ll learn:
- When conservative care is enough (and when it’s not)
- Key factors that should drive a referral for surgery
- What the research actually says about PT vs hip replacement outcomes
- How to manage patients who are on the fence about surgery
- Common mistakes clinicians make with hip OA rehab

🧠 Who this is for:
- Physical therapists & PTAs
- Athletic Trainers
- PT students / new grads
- Strength coaches working with hip pain
- Clinicians who want to improve decision-making with hip OA

⚡ If you want to go deeper:

Inside of Fitness Pain Free Insiders Academy, we teach you exactly how to:
- Build step-by-step rehab progressions for real patients
- Use criteria-based decision making (not guessing)
- Stay current with the latest research in under 10 minutes
- Get your clinical questions answered

🎓 Get started for $1 - https://fitnesspainfree.com/programs/fpf-insiders/ 

Show Notes, Credit & References:
- https://fitnesspainfree.com/2026/04/pt-vs-hip-replacement-for-oa-what-the-outcomes-actually-show/

⏱️ TIMESTAMPS

00:00 PT vs Hip Replacement: What Actually Works?
00:16 Why This Decision Matters (Real Patient Scenarios)
01:02 Is Physical Therapy Effective for Hip OA?
02:11 Can PT Delay Hip Replacement? (Long-Term Data)
02:55 How Effective is Hip Replacement Really?
03:58 Is Hip Replacement Safe? (What Patients Fear)
05:25 Who is Actually at Risk for Complications?
06:41 Age, Comorbidities & Surgical Risk
08:10 Why Hip Replacements Often Do Well Clinically
09:12 True Surgical Risk in Healthy vs Complex Patients
10:15 PT vs Surgery: Direct Comparison (NEJM Trial)
11:39 Resistance Training Protocol (What They Actually Did)
15:51 How Much Does PT Actually Improve Pain?
16:42 Surgery vs PT Outcomes (Pain + Function)
18:13 Quality of Life & Return to Activity Differences
19:44 Objective Performance: Surprisingly Similar?
20:29 What Changes Actually Matter to Patients?
21:28 Who Can Avoid Surgery?
22:05 Safety Comparison: PT vs Surgery
23:12 Clinical Takeaways (What You Should Actually Do)
23:57 When You SHOULD Recommend Surgery
26:14 The Biggest Mistake PTs Make With These Patients

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Want to master physical therapy for patients in the strength and fitness world?  

Click on the link and start to transform your career with the FREE FPF Mini Course & gets some FREE CEUs for PTs, PTAs & ATCs.
- https://fitnesspainfree.com/programs/fpf-certification-presale-page/

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📌 FREE Guide - Hip Osteoarthritis Evidence Based "Cheat Sheet" https://fitnesspainfree.com/programs/hip-osteoarthritis-cheat-sheet-lead-magnet/ Thanks for watching!

🎓 Insiders Academy - https://fitnesspainfree.com/programs/fpf-insiders/ 

👉 Transform your career with the FREE FPF Mini Course & gets some FREE CEUs for PTs, PTAs & ATCs. https://fitnesspainfree.com/programs/fpf-certification-presale-page/ 

Show Notes, Credit & References:
- https://fitnesspainfree.com/2026/04/best-evidence-based-treatments-for-hip-osteoarthritis-what-actually-works/

In today's episode we go over Best Evidence Based Treatments for Hip Osteoarthritis (What Actually Works)  - FPF Show Episode 192

If you treat hip osteoarthritis, this video breaks down the latest 2025 clinical practice guidelines so you know exactly what works—and what doesn’t.

We cover:

Exercise, manual therapy, and education
Injections (PRP, corticosteroids, hyaluronic acid)
Weight loss, modalities, and more

What actually improves pain, function, and outcomes

⏱️ TIMESTAMPS

0:00 – What Actually Works (Overview)
0:48 – Where This Evidence Comes From (2025 Guidelines)
2:02 – Exercise Has the STRONGEST Evidence (Grade A)
2:24 – Why Supervised Exercise Works Better Than Home Programs
2:49 – Exact Exercise Dosage (Frequency, Duration, Timeline)
3:33 – Education vs Exercise (What Matters More?)
4:49 – Aquatic Exercise (Best Option for Painful Patients)
6:59 – Best Strength Exercises for Hip OA (What to Prescribe)
7:44 – Functional Training, Gait, and Balance
12:02 – Manual Therapy Has Strong Evidence (Yes, Really)
14:10 – Dry Needling: New Evidence + When It Works
19:20 – The Truth About Outcomes (Why Results Aren’t Dramatic)
20:03 – The Most Effective Treatment Strategy (Big Picture)
23:00 – Patient Education (What Actually Helps)
26:06 – Pain ≠ Damage (Stop Scaring Your Patients)
36:18 – Weight Loss: How Much Actually Matters
37:06 – Ultrasound & Modalities (Worth It or Not?)
45:34 – Corticosteroid Injections (Benefits + Risks)
47:06 – Hyaluronic Acid (Why It Doesn’t Work)
48:08 – PRP Injections (Hype vs Reality)

🎯 KEY TAKEAWAYS

Exercise is the most effective treatment (especially supervised)
Manual therapy and dry needling can help (despite social media trends)
Education matters—but not on its own
Most passive treatments and injections have limited or short-term effects
Focus on what actually improves function and long-term outcomes

*****


Want to master physical therapy for patients in the strength and fitness world?  


Click on the link and start to transform your career with the FREE FPF Mini Course & gets some FREE CEUs for PTs, PTAs & ATCs.
- https://fitnesspainfree.com/programs/fpf-certification-presale-page/


*****


Welcome to the Fitness Pain Free Show!  This is where we help physical therapists like YOU get your patients out of pain back to training


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Want to support me?  Sign up for the FPF "Insiders Academy" where you can ask questions I'll answer for future episodes! https://fitnesspainfree.com/programs/fpf-insiders/


👊🏻Was this helpful? Subscribe to my Youtube channel for more!


🤔Have a question/comment? Drop one below in the comment section - I love questions and they help the channel grow!


*****
🧠 WANT TO LEARN MORE? Head over to fitnesspainfree.com and sign up for the newsletter.  I'll keep you learning and growing on a weekly basis!


*****
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Instagram: https://www.instagram.com/fitnesspainfree/
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Blog Articles: https://fitnesspainfree.com/articles/

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