PODCAST · health
Perfecting PT
by Dr. Nathan Norr, Doctor of Physical Therapy
Long-form conversations with rehabilitation and fitness experts to provide additional insights and perspectives required to improve your practice.
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27. Total Knee Replacement Quick Tips with NATHAN NORR
Hello Friends! Happy to have YOU here!I have recently had the opportunity to evaluate and treat many total knees, and I wanted to take the chance to share my approach to the early rehabilitation process. I specifically focus on the first two sessions and overview the goals and timelines I set in therapy. I don't think that rehabbing a total knee needs to be difficult, although it can be frustrating at times with how slow the progress comes. Thanks for listening!**********Additional Resources**********- Wells Criteria - Total Knee Clinical Practice Guidelines (CPG)**********Disclaimer**********This podcast is not intended to replace professional medical advice and expertise. This podcast is not intended as instruction for performance of acts or skills intended to be performed only by licensed professionals in appropriate settings. If you or someone you know is experiencing anything that may be discussed in this podcast, please seek medical direction from qualified healthcare providers near you.
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26. Low Back Pain Assessment with NICK RAINEY
Welcome! Happy to have YOU here!Support the podcast by subscribing!Nick Rainey is the owner and founder of Rainey Pain and Performance in Sierra Vista, AZ. He is fellowship trained in orthopedic manual therapy and has additional training for the cervical spine and TMJ. He teaches courses for Evidence In Motion and also works with the Movement Brainery as a mentor to clinicians looking to improve their practice. We discuss our understanding and approaches to assessing low back pain - similarities and differences. Hope you find it helpful and insightful. Thanks! ********** ADDITIONAL RESOURCES **********Rainey Pain and PerformanceThe Movement Brainery - Nick RaineyEvidence In Motion - Nick Rainey
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25. Plantar Fasciitis CPG with NATHAN NORR
Welcome! Happy to have YOU here!Support the podcast by subscribing!The 2nd episode in the clinical practice guidelines series. I discuss what plantar fasciitis is, other diagnoses that can present similar to plantar fasciitis, and the physical therapy evidence available to guide treatment from a skilled healthcare/fitness professionals. I also provide my personal insights into the condition and how I have found best to intervene. Thanks for listening!********** Additional Resources **********Clinical Practice Guideline PDFs- Plantar Fasciitis 2008- Plantar Fasciitis 2014- Plantar Fasciitis 2023- Chronic Foot Pain Imaging Guidelines********** DISCLAIMER **********This podcast is not intended to replace medical advice and expertise. This podcast is not intended as instruction for performance of acts or skills intended to be performed only by licensed professionals in appropriate settings. If you or someone you know is experiencing anything that may be discussed in this podcast, please seek medical direction from qualified healthcare providers near you.
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24. Achilles Tendinopathy CPG with NATHAN NORR
Welcome! Happy to have you here!Support the podcast by subscribingThe first episode of many exploring clinical practice guidelines for Physical Therapists. Clinical practice guidelines (CPGs) are compilations of data that are condensed into guidelines and given ratings of strength for application. It's important to know the levels of evidence available, but sometimes the guidelines are super vague and unhelpful. I want to fix that. I go over the evidence, why the rating was given and how to apply it. This is my first go at this, but I found it very insightful and the future ones will only get better. Thanks for listening!********** Additional Resources **********Clinical Practice Guideline PDFsAchilles Tendonitis CPG - 2010Achilles Tendonitis CPG - 2018 revisionAchilles Tendonitis CPG - 2024 revisionOutcome Measures (PDFs available by clicking "instrument details" on website)- Victorian Institute of Sports Assessment - Achilles (VISA-A)- Foot and Ankle Ability Measure (FAAM)- Lower Extremity Functional Score (LEFS)********** DISCLAIMER **********This podcast is not intended to replace medical advice and expertise. This podcast is not intended as instruction for performance of acts or skills intended to be performed only by licensed professionals in appropriate settings. If you or someone you know is experiencing anything that may be discussed in this podcast, please seek medical direction from qualified healthcare providers near you.
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23. Fixing Lower Body Pain, Part 4: Exercise Selection with NATHAN NORR
Welcome! Happy to have you here!Support the podcast by subscribingIn this final part of the fixing lower body pain series, I go over exercise selection for the lower body as well as practical insights on how to progress those exercises. I also address modalities for the lower body and how I use them, including parameters. It's difficult to create a podcast addressing all questions, but I do my best. I hope you find it insightful and thought provoking. Reach out to join the podcast!**********Additional Resources**********People mentioned- Bill Hartman- James Cyriax- Vladimir Janda- Nikolai Bogduk- Freddy Kaltenborn- Olaf Evjenth- Shirley Sahrmann- Dr. Stuart McGill- Ludwig Ombregt- Diane Lee- Joel Seedman- GOATA - Functional Patterns
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22. Fixing Lower Body Pain, Part 3: Choosing Manual Therapy Interventions with NATHAN NORR
Welcome! Happy to have you here! Make sure to subscribeIn this part, I go over the manual interventions that I provide for all of the joints of the lower body. I go over each joint, what I look for when I assess it and how I determine which joint mobilization to perform. I apologize ahead of time; I realized I misspoke about the anatomy of the foot after I finished recording. The cuneiforms are distal to the navicular, not cuboid. I will clarify and correct that in the next episode - thanks for your patience. I was hoping to get to exercise interventions as well, but it would have been too long. Exercise interventions will be the next part. Stay Tuned! Thanks for listening. **********Additional Resources**********Instagram: @perfectingptHip Bump Video (UFIR manipulation by Gail Malloy)DISCLAIMER: This podcast is not intended to replace medical advice and expertise. This podcast is not intended as instruction for performance of acts or skills intended to be performed only by licensed professionals in appropriate settings. If you or someone you know is experiencing anything that may be discussed in this podcast, please seek medical direction from qualified healthcare providers near you.
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21. Fixing Lower Body Pain, Part 2: Assessing the Lower Body with NATHAN NORR
Welcome! Happy to have you here! Make sure to subscribeIn this part of the fixing lower body pain series, I discuss my assessment of the lower body - everything from the low back and down. I go over each step of my evaluation process and some of the things I'm looking for and what I interpret them to mean. I will also tie in patterns of compensation and biomechanics discussed from part 1. Although not the focus of this episode, I also go into manual interventions and treatment goals based on exam findings. I hope you find it both interesting and insightful. Thanks again for listening!**********Additional Resources**********Instagram: @perfectingptGail Malloy Hip Manipulation Article
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20. Fixing Lower Body Pain, Part 1: Biomechanics and Patterns of Compensation with NATHAN NORR
Welcome! Happy to have you here!My name is Nathan Norr. I am a Doctor of Physical Therapy and practice in Colorado. Today, I go over lower body (everything from the low back down) biomechanics and patterns of compensation that I see and address constantly in the clinic to help people get out of both acute and chronic pain and return to normal activities. Further show notes will be here soon. Thanks for watching!
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19. Cervicogenic Headaches with ANTHONY FALCO
Welcome! Happy to have you here!Anthony Falco is a Doctor of Physical Therapy who is additionally credentialed as an Orthopedic Certified Specialist, Fellow in Orthopedic Manual Therapy from Bellin College, and currently serves as the VP for the APTA chapter in New Jersey. He specializes in the treatment of cervicogenic headaches and works closely with a pediatric neurologist. Other headache types including migraines are also discussed.We dive into identifying headache types, whether or not physical therapy can address them and how, and answering the question of how many headaches is "normal". ********** Resources **********Anthony's InformationProvider Profile at Summit HealthInstagram: @afalco_dptPeople Mentioned- Geoffrey Maitland (Anthony recommends checking out his textbooks)Research Articles- Canadian C-Spine Rules- IFOMPT Cervical Vascular Pathology Screening
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18. PT for Golfers with MICHAEL POMYKALA
Welcome! Happy to have you here!Michael Pomykala is a Doctor of Physical Therapy who specializes in the treatment of golfers of all ages and skill levels at Sports Solutions Physical Therapy in New Jersey. He is additionally credentialed as a board-certified sports and orthopedic specialist, Titleist Performance Institute certified levels 1-3 (and more through TPI), and a Certified Strength and Conditioning Specialist. We discuss various factors that contribute to someone being able to play golf efficiently and also discuss compensatory patterns and Michael's views of the body and why it breaks down in golfers. This won't be the last time Michael is on the podcast and we are planning an upcoming episode where we go through a full PT golf evaluation. Stay tuned!********** RESOURCES **********Michael's InfoInstagram: @sportssolutionsMichael's WebsitePeople ReferencedGreg and Vicky JohnsonProducts and Course ReferencedTitleist Performance Institute (TPI)Selective Functional Movement Assessment (SFMA)Institute of Physical Art (IPA)Postural Restoration Institute (PRI)
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17. All Thing ACLs with BRIAN KOKULAK, Part 1
Welcome! Happy to have you here!Brian Kokulak is a Doctor of Physical Therapy at Edge Physical Therapy and Sports Medicine. He Specializes in treating patient's undergoing ACL surgery (repair or reconstruction) and has worked with many professional and competitive athletes of all ages. We discuss the types of ACL surgeries performed as well as their benefits, indications, and limitations of each. We also discuss timelines for rehab that allow you to know your patient is progressing well. Part two will be more focused on exercise selection, progression, and return to sport testing, so STAY TUNED!********** Resources **********- Brian's Instagram: dr_brian_dpt- Brian's ClinicResearch Articles- Knee ligament sprain clinical practice guidelines- ACL clinical practice guidelines- Exercise-based ACL injury prevention guidelines
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16. Practical Approach to Treating Low Back Pain with NICK RAINEY
Welcome! Happy to have you! Nick Rainey is the owner of Rainey Pain and Performance in Sierra Vista, Arizona. Nick is a fellow in Orthopedic manual therapy (FAAOMPT), orthopedic certified specialist (OCS), certified strength and conditioning specialist (CSCS), certified cervical and temporomandibular therapist (CCTT), as well as pelvic health certified. In this episode, we discuss many things related to low back pain. Much of this information is condensed from a presentation he gave at an APTA conference. We discuss whether or not the research on low back pain and exercise really says what we are often told it does; we discuss theory related to it's biomechanical origin, whether form matters, the value of the biopsychosocial model, the general buckets of diagnosis, and how to begin treatment, as well as one of his key focuses when introducing exercise to patients with low back pain, and more. Hope you enjoy!Resources:Nick Rainey- Instagram: RaineyPainPerformance- Rainey Pain and Performance- Courses Taught by Nick Research Articles- Hawthorne Effect: People change their behavior when they are being observed.- MRI Findings of Disc Degeneration are More Prevalent in Adults with Low Back Pain than in Asymptomatic Controls: A Systematic Review and Meta-Analysis- Association Between Directional Preference and Centralization in Patients With Low Back Pain- Trunk Muscle Stabilization Training Plus General Exercise Versus General Exercise Only: Randomized Controlled Trial of Patients With Recurrent Low Back Pain
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15. Shared Decision Making and Leveraging Patient Preference with WALT FRITZ
Follow us on Instagram:- Walt Fritz: @waltfritzpt- PerfectingPT: @perfectingPTOverview: Walt Fritz is a physical therapist that specializes in speech and swallowing disorders, but more than that, he specializes in including the patient in the plan of care and leveraging their insights and beliefs to provide the most efficient treatment. Although this episode starts with us discussing some of the reasons for PT to treat speech and swallowing, we quickly transition to patient care and shared decision making. Hope you enjoy. Happy to have you here! RESOURCESWalt's Info- Walt Fritz Website- Instagram: waltfritzptPeople mentioned- Jeffrey MaitlandResearch mentioned- The Demonization of Manual Therapy, Chad Cook- Manual therapy: Exploiting the role of human touch, Tommaso Geri- Rocabado's Approach
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14. Cervical Instability and CRPS with MICHAEL FANNING
Follow us on Instagram!Nathan Norr @perfectingptMichael Fanning @mfanning_dacbspMichael Fanning is a chiropractor with the LAPD and USA fencing and cycling team, faculty in the Tactical Sports Medicine department at SCUHS, and Air Force veteran. He has had extensive mentoring with specialists in Chronic Regional Pain Syndrome (CRPS) and neuropathic pain and their treatment with sympathetic blocks/nerve hydrodissections. He also has looked extensively at cervical spine instability prevalence and treatment related to trauma, especially in law enforcement. We discuss how to identify the types of CRPS and neuropathic pain as well as cervical instability, and available treatment options.*******Resources*******PEOPLEEdward Carden, MDThomas B. Clark, DC, RVT, RMSKYao-Wen Eliot Hu, MDCoach John HofmanStuart McGillStanley LamJoseph HorriganPRODUCTSMedX Cervical Extension
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13. Distance Runners, Building a Business, and Adding Value with MIKE THE PT
Mike Russell, DPT is one of the most well-known physical therapists for runners and business owners in the Las Vegas area. We discuss his treatment of runners as well as his views on building a business in an ever-changing environment, and adding value through a variety of treatment options. He himself is an avid runner, regularly running both street and trail. Mike Russell is my original mentor and gave me my first job working in physical therapy as his tech. He owns Elevation Physical Therapy, which is his second clinic after building Optimal Physical Therapy to multiple successful clinics and selling it a handful of years back. His drive for business and excellence has lead to his reputation as someone who adds value and always seeks out and maximizes opportunities to improve patient care and outcomes. ResourcesMike's Info- Insta: mike_the_ptPeople- Bob Donatelli- Chris JohnsonResearch- Changes in muscle activation patterns when running step rate is increased (Chumanov et al 2012)
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12. Upper Extremity in Baseball Players with ZACH LEAL
Zach Leal, PT, DPT, CSCS owns Forged Physical Therapy and Performance inside baseball training facilities. He has two locations near Los Angeles and specializes in treating baseball players of all ages and skill levels along with other motivated athletes. Zach was a student with Mike Reinold and does 1-on-1, hour long, cash appointments. We discuss the most common goals and injuries associated with each age group, research for baseball players and overhead athletes, the biggest "buckets" he makes sure to hit to generate the greatest outcomes, and his very clearly delineated system for evaluation and intervention. See resources below for people, products, and research mentioned.ResourcesPeople-Kevin Wilk, PT, DPT, FAPTA-Mike Reinold-Dan Pope - Fitness Pain Free-Shirley Sahrmann, PT, PhD, FAPTA-Eric Cressey-Keith Meister, MDProducts-Vald Dynamometers-Lafayette DynamometerResearch-The strength characteristics of internal and external rotator muscles in professional baseball pitchers
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11. Diagnostic Ultrasound and EMG Utility in Conservative Care w/ BART MCDONALD
Bart McDonald is the owner of Superior Physical Therapy in Idaho. His clinics specialize in diagnostic ultrasound as a means to provide greater insight into diagnosis, treatment plan, and progress. In this episode, we discuss the utility of diagnostic ultrasound and EMG and how you can use that information to determine prognosis and provide more efficacious treatment. Below are some helpful resources!Resources:Bart's Personal Email: [email protected]: Superior.physical.therapyWebsite:Superior Physical TherapyMohini Rawat Ultrasound Textbook
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10. Low Back Pain and Measuring Spinal Stiffness with SEAN M. HARRIS
What if there was a way to measure how much stiffness you are generating around the spine and correlating that number with how much weight you lift to determine your risk of pain? That's exactly what Sean is researching and the topic of our conversation. Sean is a DPT, PhD, OCS, FAAOMPT and we cover how he measures spinal stiffness using a Tindeq scale and a modified lifting belt. We discuss his current research, some of his views on low back pain, his approach to assess it, and more. Below are resources to get access to more of Sean's content. Please check it out! Resources Instagram: @dr.sean.m.harris Sean's Website (Various service provided) Tindeq Scale
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9. Transitioning Between Rehab and Performance with EMILY FERREE
Emily Ferree is a Doctor of Phsyical Therapy affiliated with multiple MLB organizations to assist in pitching analysis as well helping multiple players with the Chargers organization. She is also a biomechanist who trained with Christ Powers at USC. Topics of this conversation include thoughts on both upper and lower quarter biomechanical assessment. Posture, and exercise progression tips to help you understand how to get your athlete back to full performance effectively. Resources: - Instagram: ferree.pt.lab
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8. Starting a Cash-Based Practice with RAY GORMAN
Ray Gorman is the founder of Engage Movement. He specializes in helping providers who want to work with active populations to create cash-based practices that include both in person and online clientele. We discuss Ray's process step by step to make it as easy as possible to understand as well as addressing my most requested questions. Something to know: investing in the future you want will require a lot of frontloaded work and sacrifice, but with effort and guidance, it is achievable. If you are interested in contacting Ray's group or seeing if they could be right for you, follow the links below. Links: Instagram: @raygormandpt Website: Engage Movement Free Training Courses: Here Free Business Starter Checklist: Here
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7. Chiropractic Systems of Intervention with Strat Poulson
What and why do chiropractors do what they do and how is it different than other methods of intervention you may receive? Strat and I cover that question and more in this conversation, including the original theory behind chiropractic care, his personal views, and what some of the current evidence suggests about chiropractic care. Dr. Stratton Poulson is the owner of Apex Chiropractic in Dallas, Texas, and the founder of Apex Chiropractic Education, an international seminar company that provides in-person and online courses to improve the hands-on skills of students and seasoned clinicians. Resources: - Apex Chiropractic - Instagram: @stratpoulson - YouTube: Dr. Stratton Poulson - TikTok: @dr.strattonpoulson
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6. The Pelvic Floor in Orthopedic Rehab with Jennifer Stone
Dr. Jennifer Stone , PT, DPT, OCS, PHS is a current instructor for Evidence in Motion (EIM). The pelvic floor may be the missing link your patient or client needs to finally clear out that persistent low back, SI, or hip pain. The best part is that you don't need to take a bunch of courses or learn how to do internal exams to begin addressing those limitations. Dr. Jennifer Stone demystifies how the pelvic floor can be screened, assessed, and begin to be addressed in orthopedic settings. Obviously, if pelvic floor therapy interests you, you should of course seek out continuing education to gain the highest learning available to help your patients, but there may be strategies you can begin to introduce now that could make a world of difference. Happy to have you! Resources - Dr. Stone Bio - Pelvic Health 1 course $629
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5. Why You're Still in Pain with Jared Countess (Professor Corrective)
With over 15 years of experience, Jared Countess, known as Professor Corrective, is a trainer who specializes in seeing the body as a unified system - not separate and distinct, but an organized and highly connected system. It could be that you or your patients are continuing to have pain because there are dysfunctions found outside the location of pain that are not being addressed. It could be that the area of pain was never the problem to begin with, but rather where the system broke down because of dysfunction elsewhere that overloaded the area that experiences pain. We dig into this and similar ideas in this insightful episode. Professor Corrective Info: - Instagram: @prof_corrective - Founder of Upcoming Wellness @upcoming_wellness - Website and classes can be found in his instagram bio. - Jared's course: R.A.S. (Release, Activate, Stretch) found on Instagram Jared's Favorite Resources: - Fascial Training: A Whole-System Training Approach by Bill Parisi -"From Muscle to the Myofascial Unit: Current Evidence and Future Perspectives", Stecco et. al. People Discussed: - Bill Hartman - Vladimir Janda - Assessment and Treatment of Muscle Imbalance: The Janda Approach
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4. Physical Therapy Fellowships: An Overview with Mark Shepherd
It can be hard to know the best way to move forward and continue to have real purpose after PT school . In this episode, Mark and I condense what you need to know about fellowships to help you better understand if it may be a good path for you, as well as the types of fellowships available and the importance of pursuing continued education. Mark Shepherd is a well-known name in physical therapy continuing education. He is a fellowship trained physical therapist and currently serves as the Orthopedic Manual Physical Therapy (OMPT) fellowship program director for Bellin College as well as faculty for their DPT program. He is also a top contributor and group expert on the "Mindful Clinicians" therapy group on Facebook (which I think has some excellent content). Mark's info: X: @shepdpt Instagram: @mark_h_shepher Email: [email protected]
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3. Police Officers with Brian Schmitz
Police and first responders are a special group of patients when it comes to physical therapy. They deal with high stress and schedules that may affect their ability to participate in physical therapy in your standard treatment models. This episode will highlight different aspects of law enforcement that will help you better understand what they are going through as you work to provide the highest quality of care. Brian Schmitz is a fellowship trained physical therapist who owned his own practice until decided to pursue a career in law enforcement. He is still licensed and is currently working on research to better understand how to prevent and treat common injuries experienced by law enforcement. He is happy to collaborate with other people interested or pursuing the same goals. **** This podcast is not medical advice. Please seek competent medical attention to address any health-related issues. Any and all actions taken by you are your sole responsibility as well as the consequences.
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2. TMJ with Ryan Lynch
Ryan Lynch is a Certified Cervical and Temporomandibular Therapist (CCTT) and primarily treats orofacial pain. He owns Lynch Physical Therapy in Severna Park, Maryland. TMJ treatment is much more than jaw pain, and this episode is aimed at better understanding causes of orofacial pain and how to move forward with confident treatment. Ryan's contact information [email protected] *****The content of this podcast is no substitute for competent, in-person medical advice. Please talk to your physician or physical therapist if dealing with orofacial pain.
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1. The Square1 System with Shawn Sherman
What if you could quickly clear out compensations and dysfunctions of the nervous system on a subconscious level that are leading to pain and movement dysfunction to reveal remaining limitations that may require further treatment? With the Square1 System, that may be a possibility. Join me and Square1 inventor, Shawn Sherman, as we discuss his problem solving framework and its unique applicability in todays health and fitness space.
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Intro: Welcome to Perfecting PT
Welcome to the channel! My name is Nate, a physical therapist with big questions and bigger plans to go on a journey to answer them for myself and you. All episodes are aimed at providing concise, clinically relevant and applicable information related to a given topic that will help healthcare and fitness providers improve their work as well as help potential patients and enthusiasts learn the essentials to advocate for the best care. Thanks for reading. I'm happy to have you here!
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