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…
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Shoulder pain doesn't always start in the shoulder. In this episode, I break down a real client case where the true driver of persistent shoulder pain was actually coming from the lower extremity — not the shoulder itself. I walk through the theory behind this concept and explain how dysfunction in one part of the body can show up as pain somewhere else entirely. I tell you how I connected the…
Do you ever have patients or even yourself, that are chronically gripping their back? Using their back muscles for practically everything? It's fairly common, but can get in the way of a very strong and thoughtful rehab program. You've seen this before. Everything is braced, stiff and locked down — they are essentially planking through their entire day. In this episode, Erica breaks down this…
Her back hurt. But her back wasn't the problem. This is where the nuance comes in. In this episode, I dive into a fascinating clinical case involving a hypermobile pole dancer presenting with low back pain — where the lumbar spine was the pain generator but not the driver. The real culprits? Her knee and foot. Surprised? I walk through the clinical reasoning process that shifted the treatment…
If you have patients or are a person who "does all the exercises," gets stronger, and still doesn't feel better—this episode is for you. In this episode, Erica dives into how to advance exercise prescription for patients who are often labeled as "tough to treat." These are the individuals who don't respond well to traditional strengthening or mobility programs and may experience pain, guarding, or…
In this episode, Erica explores how clinical reasoning informs decision-making across diverse areas of physical therapy practice. This is a clinical pearls discussion that will save you lots of time in the clinic. From CKC to OKC brain mapping in an MMA fighter to exercise progression in ACL rehabilitation to thoracic dysfunction in a post partum runner experiencing hip pain and incontinence, she…
How long should you keep treating a patient? And what's the best approach when they're skipping their home exercise program? In this listener Q&A episode, Erica shares practical strategies—illustrated through two real patient cases, one a golfer and the other a cyclist—for answering the tough question of treatment length and for addressing non-compliance. She highlights how building a strong…
In this episode, Erica dives into a fascinating case of a patient experiencing neck pai n and how that seemingly isolated symptom actually traced back to an old foot injury . This case exemplifies the deep, interconnected nature of the human body. For those you have been listening for a while, this should not surprise you. She unpacks the biomechanical and neural links between the foot and…
In this episode, Erica talks about how to approach care when a patient has a long history of injuries and a body chart that seems to be "lit up" everywhere. It can feel overwhelming—for both the patient and the clinician. She focuses on the importance of prioritization : identifying what's most clinically relevant right now. This involves connecting the dots to perhaps an old injury to what the…
This episode dives into some of the evidence on resistance vs. high-velocity power training in postmenopausal women and its impact on bone mineral density (BMD). Research is highlighted showing that high-speed training protocols may stimulate bone more effectively than traditional resistance training by increasing strain rates and promoting osteogenic adaptation. You'll learn how moving with speed…
In this episode, Erica dives into the latest research exploring how menopause affects physical performance in women—highlighting changes in power and strength. These findings are reshaping how we approach exercise and rehab in midlife women. Next, she shares an update on her dissertation, which compares premenopausal and postmenopausal women on key physical performance metrics. Erica discusses…
