Untold Physio Stories

In this episode of Untold Physio Stories, Dr. E and Dr. Sean Wells break down a case that is all too common in youth sports: a talented 14-year-old baseball player caught between a painful hamstring strain and a coach who won't take "rest" for an answer.Dr. Wells shares the story of an athlete who was forced to "circumduct" his leg just to run, all while his coaching staff remained silent about his obvious limp. We discuss the critical role of the physical therapist as the ultimate advocate for a minor's long-term health when sports culture prioritizes the "star player" over the person.Key Discussion Points:The Coach vs. Clinician Conflict: How to handle high-pressure environments where coaches push for immediate return-to-play despite significant strength deficits (nearly 50% loss in this case).Breaking the "Stretch It Out" Myth: Why passive care and aggressive stretching can actually hinder a muscle strain, and how to educate parents who are being told otherwi

In this episode of the Untold Physio Stories podcast, Dr. E and Dr. Sean Wells talk about how a simple technique can have a huge impact on shoulder mobility. Dr. E shares a story about his daughter, who had limited shoulder range of motion and trunk rotation after a diving accident. After trying several techniques with little success, Dr. E tried a simple PNF variation of sustained cervical retraction and extension. After just a few minutes, his daughter’s shoulder mobility was back to normal!Dr. E and Dr. Sean discuss the science behind this technique and how it can be used to improve mobility and reduce pain in patients with a variety of conditions. They also share some tips on how to perform the technique safely and effectively.In this episode, you’ll learn:How a simple PNF variation can improve shoulder mobility and trunk rotationThe science behind the effectiveness of this techniqueHow to perform the technique safely and effectivelyTips for using this technique with your patientsUntold Physio Stories is

How do you determine when a leg length discrepancy requires structural intervention? In this episode of Untold Physio Stories, Dr. Wells presents a case study of an 80-year-old patient managing the long-term effects of a complex total hip replacement. Following a revision surgery two decades ago, the patient was left with a 2cm leg length discrepancy on her right side.While she remained active with yoga and Pilates for years, a recent decrease in activity led to noticeable changes in her gait and discomfort in her lower extremities.Structural Findings: A functional and anatomical measurement confirmed the right lower extremity was 2cm longer than the left.Gait Observations: Assessment revealed a compensatory trunk lean to the right to facilitate clearing the left leg during the swing phase.Joint Mechanics: The patient exhibited significant pronation in the right ankle and a varus thrust in the left knee during ambulation.Strength Deficits: Evaluation showed weakness in the left gluteal and quadriceps muscle g

Ever had a patient ask for a full refund after a rock-solid evaluation?

Ever feel like the PT world is just one big "small world"?

Ever meet a clinician who is so married to their "system" that they stop listening to the person in front of them?

"Don't Assess Yourself."Gray Cook told me that years ago during an SFMA course, but apparently, I needed a painful reminder.I’ve been dealing with this nagging, chronic left-sided low back pain for a while now. Being the "Modern Manual Therapy" guy, I threw the absolute kitchen sink at it:Dry Needling

Stop me if you’ve heard this one before: "The patient’s PSIS is 2 degrees higher on the right, so their pelvis is rotated and that’s why their back hurts."In this episode of Untold Physio Stories, we’re diving into the weeds of the Sacroiliac Joint. We’ve all been taught the intricate palpation models, but when we look at the actual kinematics, we’re often talking about movements so small they’re nearly impossible to reliably detect with human hands.In this episode, we discuss:The "Two-Degree" Threshold: Is a 2-degree shift a clinical "aha!" moment or just measurement error (or normal human asymmetry)?Reliability vs. Reality: Why our obsession with "alignment" might be distracting us from what actually gets the patient moving.The Untold Story: A real-world case where focusing on the "degrees" led a clinician down a rabbit hole, and how shifting to a multi-modal, loading-based approach changed the outcome.The bottom line: If your treatment plan changes based on

We've been seeing lots of videos and promotion on MSKUS training for PTs.We all love new toys. And let’s be honest, showing a patient their supraspinatus in real-time looks cool. It builds buy-in. It feels high-tech.But does it change what you do Monday morning?Does seeing the calcification actually change your loading protocol? Does the image change the fact that you need to treat the person in front of you, not just the tissue?In this week's episode of Untold Physio Stories, we’re breaking down the ROI of Musculoskeletal Ultrasound.We discuss:The steep learning curve (it’s harder than it looks).Diagnostic accuracy vs. Clinical utility.When it’s a "Game Changer" and when it’s just a "Nice to Have."If you've thought about or gone through the training leave a comment or reach out! We'd love to hear from you!Untold Physio Stories is sponsored by⁠Comprehend PT⁠- Leave Comprehend PT running in the background or record audio when you have time. The AI based SOAP note generator d

Let's get real. Every one of us has been there: the patient who churns, the bad review that stings, the demand for a refund. You think it's because your manual therapy technique wasn't perfect or your exercise prescription was lacking. Wrong.In this must-listen episode, Dr. E sits down with cohost Dr. Sean Wells to dissect the uncomfortable truth about business, clinical practice, and patient satisfaction.We pull back the curtain on two recent, personal cases where even we—the experts—had our expectations utterly torpedoed, resulting in a frustrating experience (and almost a negative review!). We dig into the core principle that governs all service-based businesses:Negative Experiences = Unmet Expectations. Have you had similar hard learned lessons?Untold Physio Stories is sponsored by⁠Comprehend PT⁠- Leave Comprehend PT running in the background or record audio when you have time. The AI based SOAP note generator does the rest! No need for accuracy or exact wording! It's a game changer and wi

Why is "conservative care" treated like the alternative, while surgery is the default setting?

When an acute ankle sprain hobbles into your clinic, do you treat them all the same?

Dr. E here with another asynchronous episode of Untold Physio Stories, featuring the great Dr. Wells!We're diving deep into the trenches of chronic elbow tendinopathies, specifically lateral epicondylalgia, and the surprising speed of response in a couple of recent patient cases.What We Cover in This Episode:The Power of Length and Load: We revisit the concept of using isometric contractions in a lengthened position (70-80% MVC) for superior tendon loading, inspired by Dr Michaud's excellent tendinopathy article.Dr. E shares a recent article on LinkedIn by Dr. Malliaras showing that this position creates significantly higher tensile force in the tendon compared to concentric/eccentric exercises, making it ideal for remodeling and managing inflammation.Case 1: The WFH Warrior (Lateral Epicondylalgia): A work-from-home patient with bilateral elbow pain from excessive arm raises found complete symptom resolution in just two weeks using the lengthened isometric contraction technique (wrist flexion, pronat

You know I preach the Eclectic Approach and empowering patients with Self-Treatment Strategies... but this one was straight out of the McKenzie Method textbook, almost too good to be true.I recently saw a PT with a five-year history of chronic LBP. He initially felt better with extension (press-ups), but that eventually faded and his flexion became painful and limited.Then, he started noticing something crazy that you parents will understand: every time he'd bend over to put his 5-month-old in or out of the crib (a repeated flexion activity!), his back pain got better. Even more so when he had to lower the crib level!

Is your e-stim unit just gathering dust?

Why do some patients struggle with their home exercise programs, no matter how simple? It's a question every physical therapist faces. In this episode, we're joined by Dr. Sean Wells to unravel the complex issue of patient non-compliance.We explore the "5 Whys," a powerful yet simple technique borrowed from industrial problem-solving, and adapt it for the clinic. Learn how to peel back the layers of a patient's excuses to uncover the true, deep-seated barriers to their recovery. This isn't just about adherence; it's about fostering genuine, lasting motivation.In this episode, you'll learn:What the 5 Whys framework is and how it helps you look beyond surface-level answers.Practical tips and phrasing for asking "why" without making patients feel defensive.How to use the root cause you uncover to create a truly collaborative and effective plan of care.Real-world case study of how this technique transformed patient outcomes.Stop the cycle of frustration and start buildi

Dr Wells and Dr E talk about feet, toes, cases, exercises and more. Specifically we coverzero drop shoes, should everyone be in them?toe spacersThe Toe Pro Exercise deviceand more! Let us know what you think and if you have any questions/comments.

Dr Wells reviews a recent case of acute post op ACL repair. May be old hat for many, but neither he nor Dr. E sees post op in their practices. What was surprising to Sean was that the surgeon called for 1 week of complete NWB. Sean did research and was surprised at the amount of variability in many ACLR protocols. They also discuss lifestyle medicine and other rehab topics.What do you do when a post op protocol seems outdated?

In this episode, Dr. E is joined by Dr. Chance Unger. Chance discovered his passion for running in college and found as a DPT, he had a unique ability to help those that needed to keep their passion going. You can find Chance's amazing resource on running here or go to his websiteUntold Physio Stories is sponsored by⁠Comprehend PT⁠- Leave Comprehend PT running in the background or record audio when you have time. The AI based SOAP note generator does the rest! No need for accuracy or exact wording! It's a game changer and will give you more time with your patients! Use code MMT50 to save 50% off your first month. Free trial available at sign up!⁠⁠The Eclectic Approach Network⁠⁠ - Check out Dr. E's all new private, non tracking and ad free network for rehab pros! It's free to join, has chat, feed, and all the features of other social networks without the creeping tracking.Check out ⁠⁠EDGE Mobility System⁠⁠'s Best Sellers - Something for every PT, OT, DC, MT, ATC or Fitness Minded Individual https://edgemobilit

Dr. E is joined by Dr. Joe Simon. Joe talks about watching the PT profession change and grow over 20 years and how many of us are struggling. He wanted to use our unique contact points and relationship with patients to give PTs an opportunity to be paid for referring for second opinions. Sign up for early access to his platform which is going live soon here.Untold Physio Stories is sponsored by⁠Comprehend PT⁠- Leave Comprehend PT running in the background or record audio when you have time. The AI based SOAP note generator does the rest! No need for accuracy or exact wording! It's a game changer and will give you more time with your patients! Use code MMT50 to save 50% off your first month. Free trial available at sign up!⁠⁠The Eclectic Approach Network⁠⁠ - Check out Dr. E's all new private, non tracking and ad free network for rehab pros! It's free to join, has chat, feed, and all the features of other social networks without the creeping tracking.Check out ⁠⁠EDGE Mobility System⁠⁠'s Best Sellers - Something