This is an excerpt from Erica's DCP course call in February of 2023. 

In this episode, she delves into the crucial aspect of meeting patient expectations and facilitating their progress. 

She explores the dynamic relationship between healthcare providers and patients, discussing effective strategies for understanding, managing, and aligning expectations throughout the treatment journey. 

Join her as she navigates the complexities of patient satisfaction, communication, and empowerment, offering insights and practical tips to foster positive patient-provider relationships and drive meaningful progress.

A glance at this episode:

• [2:02] How to develop a script for complex patients

• [3:44] How to ask patients how committed they are to recovery

• [7:49] The pelvic girdle and hip drivers

• [9:01] Treatment time expectations

• [10:10] How long it will take the patient to get back to their activities

• [11:37] Setting expectations during visits

Related links:

• Tough To Treat Website

• Erica’s Course: Decoding the Complex Patient

• Susan’s Pelvic Health Education Subscription

• Access the Transcript

Shoulder pain, like any other joint can present as primary pain and be the #1 reason a client may seek help! 

In many cases, treating the apparent joint dysfunction (because it checks all of the boxes) may not result in optimal outcomes. 

Join the conversation as Susan and Erica explore the reasons and important timelines in the client's history that led to her shoulder pain. 

Most importantly follow the clinical reasoning that led to the real driver of this issue. 

Bonus - we also offer a great discussion of a good exercise progression!

A glance at this episode:

• [1:39] Shoulder pain and internal rotation

• [7:52] Which side of the table should you work from

• [12:40] Learning to tape the wrist

• [20:00] Opening the hands

• [22:46] Using the yoga blocks

• [27:58] Grip strength as a sign of health

Related links:

• Tough To Treat Website

• Erica’s Course: Decoding the Complex Patient

• Susan’s Pelvic Health Education Subscription

• Access the Transcript

Join Susan in a two-part interview about Pelvic Girdle Pain in the Antepartum Population. 

Clinical practice guidelines provide the practitioner with the most up-to-date research on a certain diagnosis or condition. 

In part 1 there is a rich discussion of what Clinical Practice Guidelines are, risk factors for developing pelvic girdle pain, and most importantly, the language change around the pelvic joints' stability and instability.

A glance at this episode:

• [2:16] What is pelvic girdle pain

• [3:36] Pelvic pain prevalence and risk factors

• [5:56] What drives the pain experience

• [8:19] Pelvic girdle and osteoporosis

• [10:35] How the brain creates patterns in response to pain

Related links:

• Tough To Treat Website

• Erica’s Course: Decoding the Complex Patient

• Susan’s Pelvic Health Education Subscription

• Access the Transcript

Does stretching work when a muscle is over-recruited? 

Not if you don't change the movement pattern. 

This is an excellent follow-up to episode #162, showing how you clinically reason through another weightlifting injury. 

Join Susan and Erica as they discuss a patient who sustained a shoulder/neck injury during a "basic" tricep extension exercise. 

The main takeaways are twofold: You must assess the connections between the 2 drivers and treating one region alone will not improve this patient's symptoms. 

Why? 

Because if you look at his mechanism of injury plus his old movement history as a rower, you will understand that these connections exist and why one region was more dominant, depending if it was OKC or CKC. 

Enjoy!

A glance at this episode:

• [3:01] Physical therapy for a hip injury

• [6:29] Looking at the head and neck area

• [12:58] Lumbar spine rotation and compression fracture

• [15:58] Understanding the movement pattern

• [19:50] Treating both areas of the body

• [26:20] Sensory input to the joints

• [32:23] The best way to recruit deep muscles

Related links:

• Tough To Treat Website

• Erica’s Course: Decoding the Complex Patient

• Susan’s Pelvic Health Education Subscription

• Access the Transcript

The purpose of release is to train. Remember that. 

Long gone are the passive release positions for patients. 

Think about the connections in the regions of the body to each other and then design a position that engages those long vectors connecting one region of the body to each other. 

An example, is the use of head rotation and the GHJ, to engage the barriers BETWEEN those regions of the body to each other. 

Join Erica as she discusses a unique way to achieve end-range shoulder flexion for a neck driver.

A glance at this episode:

• [2:00] The connection between the head and neck

• [4:02] How to engage barriers between different regions of the body

• [7:18] What are the main drivers for shoulder dysfunction?

• [9:18] What drives symptoms at end of range shoulder flexion?

Related links:

• Tough To Treat Website

• Erica’s Course: Decoding the Complex Patient

• Susan’s Pelvic Health Education Subscription

• Access the Transcript

Where do you start with a client with complex regional pain that has full-body implications?

Listen to their story, look for the change talk, and gain active participation by allowing them to lead the way in a judgment-free zone.

Sometimes, clients know what they need to do, they just don't know how to implement the changes and find simple action steps. 

Join us as we talk about this interesting case of a surgeon hijacked by his work environment, which has accumulated several body system symptoms from GI dysfunction, neural tension, pain, and pressure system dysfunction. 

This starts with simple action steps and progresses to a complete lifestyle change.

A glance at this episode:

• [1:58] What does microsurgery look like

• [4:52] How to deal with the pain of surgery

• [10:14] Looking at the problem in this case

• [13:01] Breathing to relieve neural tension

• [15:37] Rolling a towel method

• [22:16] Solving the problem of constipation

• [22:25] Tai Chi pros and cons

• [31:00] Tennis balls and headstands

Related links:

• Tough To Treat Website

• Erica’s Course: Decoding the Complex Patient

• Susan’s Pelvic Health Education Subscription

• Access the Transcript

What is the referral pattern for the Trigeminal System?  

What does that mean for our clients?  

The cervical nucleus of the trigeminal system can have profound effects on multi-body symptoms 

Join Susan as she describes this unique and vital phenomenon.

A glance at this episode:

• [1:45] Trigeminal system as a sensory experience

• [3:06] The interconnecting cranial nerves

• [3:51] How the trigeminal system affects the voice

• [5:17] Trigeminal ganglion and the spinal nucleus

• [7:54] How to bring your heart rate down

• [8:31] Trigeminal system and tooth pain

• [10:32] Lateral spinal thalamic track and ventral trigeminal limb

• [12:28] Convergence of the trigeminal nerve

• [14:02] How chewing gum impacts the sympathetic nervous system

Related links:

• Tough To Treat Website

• Erica’s Course: Decoding the Complex Patient

• Susan’s Pelvic Health Education Subscription

• Access the Transcript

This episode is all about low back pain with a pelvis component in a 33-year-old male weightlifter. 

Erica and Susan discuss how his history of chronic low back pain along with some bowel issues played a significant role in how he recruits muscles under load. 

Some highlights include why pelvic taping helped in this case, how to perform the same movement pattern in different positions, why assessing the pelvis was necessary, and the clinical reasoning as to how to differentiate whether it was an overactive anterior-posterior chain.

A glance at this episode:

• [5:42] What triggered this patient’s symptoms

• [8:33] The primary driver for his low back pain, it's not what you think

• [12:49] What's the lower extremity component of his problem

• [19:50] Diarrhea, constipation, and how it relates to his symptoms

• [25:38] Letting go of the coccygeal muscles

• [32:25] Mass movement patterns and internal rotation

Related links:

• Tough To Treat Website

• Erica’s Course: Decoding the Complex Patient

• Susan’s Pelvic Health Education Subscription

• Access the Transcript

In this "shortie" episode Erica discusses different ways she assesses the knee. 

There are 3 parts to the knee joint and assessing a movement pattern that takes into account all these regions is key. 

It's not all about patellar tracking, right? 

More often than not, one part of the knee is being compressed because of some overactivity in the muscles surrounding it. 

The main takeaway is that evaluating these regions takes precision and it's worth it to spend a few extra minutes doing so. Your patients will appreciate the specificity.

A glance at this episode:

•[1:45] Why the knee is the victim 

•[2:57] Knee assessment

•[5:08] Clinical pearl on knee mechanics

•[7:03] How to assess the knee in 3D

•[8:48] Assessing the knee with 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

Erica and Susan have presented several podcasts discussing the exercise progression of the foot as the primary and secondary driver. 

Today they discuss the idea of taking the movement pattern down a couple of steps in preparation for the foot to handle loads, change the body posture, and progress to appropriate AP sway. 

The clinical reasoning process is key for understanding how the foot should be working before strengthening and challenging movement patterns can be improved.

A glance at this episode:

• [7:36] How to get the foot to turn on to work

• [11:05] Creating a tripod position for the foot

• [15:32] How to mobilize your feet

• [20:17] Neural tension work and increasing mobility

• [24:45] The split squat position

• [28:18] How do you learn to squat down

• [33:23] The importance of building volume at low levels

The other episode mentioned in this podcast on exercise progressions for the tough to treat foot.  Episode # 76.

Related links:

• Tough To Treat Website

• Erica’s Course: Decoding the Complex Patient

• Susan’s Pelvic Health Education Subscription

• Access the Transcript