Tough To Treat

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Tough To Treat

A podcast for the physiotherapist struggling to treat the clinically complex patient

Susan Clinton and Erica Meloe are clinical masterminds in the field of physical therapy. Join them bi-weekly as they discuss actual patient cases and dissect their thought process to uncover the root of the problem. If you're interested in taking your clinical skills to the next level visit the Tough to Treat website to learn more about their Clinical Mentoring Mastermind. In this program, you wil

l work closely with Susan and Erica through coaching calls to learn their process of looking at patients through a unique lens to help you turn your thought processes and clinical skills to master level.

14/02/2025

Build Your Personal Brand as a Clinician

Even if you work in a hospital system or under an organization, you can still create your own unique “brand” as a clinician. 🎯 Identifying your strengths is the first step to defining your niche and standing out in your role.

💡 Tools like StrengthFinder 2.0 or the free High 5 Test can help you uncover your top strengths and guide your personal branding journey.

Links to both are in our bio!

🌟 Have you taken the assessments? Drop your top strengths in the comments below—we’d love to hear from you!

11/02/2025

How Does Exercise Affect Your Patients’ GI Symptoms?

💡 Did you know your patients’ exercise routines can reveal key insights during GI assessments? Asking about how physical activity impacts their symptoms—whether it soothes or aggravates discomfort—can uncover patterns that guide treatment.

By incorporating exercise-related questions into your GI evaluations, you can create more personalized and effective treatment plans.

🎧 Tune into Episode 201: Outcome Measures and Pain in GI Dysfunction for a deeper dive into assessment strategies and tools.

📲 Listen now at buff.ly/2mT1Fcv!

10/02/2025

Did you know that sleep impacts more than just your energy levels? 🌙

Join Susan at CSM 2025 on February 15 at 8:00 AM for a session that dives into the powerful role of sleep in:
💤 Stress resiliency and recovery.
💤 GI dysfunction and digestive health.
💤 Chronic and acute pain syndromes.

This engaging presentation will cover:
📚 Sleep neurophysiology and its impact on health.
📚 Practical, evidence-based interventions for optimizing sleep.
📚 Tools to collect measurable sleep outcomes.

Whether you’re a pelvic health professional, a physical therapist, or someone passionate about improving client outcomes, this session is packed with knowledge you can apply immediately.

💻 Let’s discuss how better sleep transforms lives!

07/02/2025

Working with the right patients shouldn’t feel like a chore—it should fuel your passion. Specializing in a specific patient population allows you to leverage your strengths, refine your expertise, and find deeper satisfaction in your work.

💡 When you align your skills with the patients you’re most passionate about, both you and your patients benefit.

Have you specialized in a particular area? Drop a comment and share your experience! ⬇️

04/02/2025

Clinical Reasoning in Postpartum P***c Symphysis Pain

When a postpartum patient presents with p***c symphysis pain, how do you determine the true driver? Is it really the p***c symphysis? Could it be the anterior hip? Or is something else at play?

💡 10-20% of women with pelvic girdle pain during pregnancy continue to experience symptoms postpartum. For persistent pain cases, clinical reasoning is key—not just to identify the root cause, but to develop interventions that fit the demands of daily life with small children.

In Episode 113, we break down a real patient case, tracing the history that led to a meaningful assessment, targeted interventions, and an achievable treatment plan.

🎧 Listen now: Persistent P***c Symphysis Pain/Right Anterior Hip Pain
📲 Available at https://buff.ly/3MB4c5p

✅ Want more clinical insights? Sign up for our email list and get a free copy of our Clinical Pearls PDF & Sleep Tips Guide!

03/02/2025

Is Myofascial Pain Overlooked in GI Dysfunction?

Patients with chronic GI dysfunction often experience referred myofascial pain from visceral organs—yet these underlying drivers are frequently missed. A targeted assessment of the abdominal wall and thoracolumbar region can reveal hidden dysfunctions that contribute to persistent symptoms.

Incorporating trigger point release and myofascial techniques can be a game-changer in managing GI-related pain and restoring function.

💡 Do you integrate these strategies in your practice? Share your insights below!

🎧 Listen now at https://buff.ly/3MB4c5p

31/01/2025

Segmenting your clientele can help identify your ideal client avatar. And as we’ve covered previously, this can help get clients in the door and set you apart from other therapists.

28/01/2025

Is Balance the Missing Link in Your Patients’ Progress?
Your patients’ balance system could be the hidden driver behind chronic pain or repeated injuries. In Episode 200, we unpack how subtle shifts in balance can trap patients in dominant patterns, limiting movement variability and stalling long-term progress.

Whether it’s helping patients rediscover midline after years of compensation or unlocking better movement, we’ll show you how to treat more holistically by addressing balance.

🎧 Don’t miss this episode: The Balance System as a Driver.
📲 Listen now at homepage - Tough To Treat .

"Is Balance Keeping Your Patients Stuck?"

27/01/2025

Quality of Life Matters in GI Dysfunction
Bowel dysfunction can significantly impact patients’ daily lives and social interactions, limiting their overall quality of life. Using quality-of-life (QOL) questionnaires allows PTs to identify how GI issues affect patients and prioritize meaningful, functional goals for treatment. 💡

How are you integrating QOL measures into your GI cases? Share your experiences below!

🎧 Tune into Episode 201: GI Dysfunction Outcome Measures and Pain in GI Dysfunction for actionable insights.

📲 Listen now at homepage - Tough To Treat .

24/01/2025

When progressing patients to higher levels of exercise, it’s common to uncover non-optimal movement patterns. Observing your patient as they perform the exercise is crucial—not just to ensure they can complete it, but to identify areas that may need refinement for better outcomes.

Consider starting the session with the exercise you want to trial, or save 10 to 15 minutes at the end to let your patient attempt it.

🎧 Subscribe to Tough to Treat for weekly insights on managing complex cases.

📩 Don’t miss out—visit buff.ly/2mT1Fcv to sign up for our newsletter today!

21/01/2025

Athletes, dancers, and even your everyday patients tend to over-rely on dominant patterns due to past injuries. In Episode 200, we dig into how repeated ankle sprains, back pain, or sports habits can shift balance over time – sometimes permanently. Discover practical ways to assess and reset your patients’ balance systems, especially in functional movement.

💡 Want to help your patients build resilience and regain natural movement? Listen now!

The Balance System as a Driver https://buff.ly/3DirzkE

20/01/2025

As physical therapists, we lean on objective assessments to guide our decisions. Yet, there are moments when a gut feeling—whether it offers reassurance or raises concern—can provide insights that data alone cannot. Research underscores the importance of integrating intuition alongside evidence, especially when addressing complex, hard-to-diagnose cases.

Learn how to balance evidence-based practice with clinical intuition on Tough to Treat: https://buff.ly/3MB4c5p

Explore more here: https://buff.ly/40ohiuT

17/01/2025

Have you ever walked into a follow up session with a patient and not known what you were going to do with them that day?

Yeah, I think we've all been there.

Here is Erica's tip for making sure that doesn't happen to you!

14/01/2025

When it comes to treating chronic pain, building stability and control isn’t always enough. Our balance system needs to be nimble to keep up with life’s surprises! In our latest episode, we discuss reactionary balance training—why it matters, and how it makes a big difference for everyone from active patients to older adults.

Discover practical ways to reset the balance system and achieve better outcomes for patients of all ages. 👣

🎙️ Listen to Episode 200 here: The Balance System as a Driver

$What factors should we consider when a patient is still experiencing pain from an ankle fracture over a year later? It m...$

13/01/2025

What factors should we consider when a patient is still experiencing pain from an ankle fracture over a year later? It might seem straightforward, but chronic pain from old injuries often points to deeper issues.

💡 Which biopsychosocial factors would you prioritize?
💡 Would you approach this with a targeted regional intervention or explore a global, whole-body approach?
💡 And how could a past ankle fracture be impacting the spine or even driving pain elsewhere?

Let’s talk about these questions in the comments! Sharing insights and techniques helps us all grow as clinicians.

🎧 Listen to Tough to Treat bi-weekly for more strategies, and head to homepage - Tough To Treat to join our email list for the latest episodes and best practices to elevate your clinical practice.

✨ Bonus: When you join, you’ll get our free Clinical Pearls download and Sleep Tips Guide to help support your patients!

10/01/2025

Breath holding: Is it necessary or a learned behavior?

07/01/2025

For patients with GI dysfunction, abdominal pain often accompanies other symptoms—lumbar, pelvic, and even shoulder pain. Addressing the source of GI pain involves considering both visceral and musculoskeletal connections, with special attention to the thoracolumbar region. 🧘‍♀️

Integrating pain assessment and a holistic history helps uncover these links. Have you noticed back pain tied to GI dysfunction in your patients?

Comment below!

Listen to episode 201 for more information! Outcome Measures and Pain in GI Dysfunction - https://buff.ly/423DWev

06/01/2025

Incontinence isn’t just about the pelvic floor! In our 200th episode, we dive into how imbalances and hip rotation can contribute to stress and urge incontinence. Tune in to learn how standing assessments and balance training can help patients overcome leakage and improve overall pelvic health.

Help your patients move with confidence. Hear the full story in this episode!

https://buff.ly/3DirzkE

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Videos

Play to Your Strengths (1).mp4

Build Your Personal Brand as a Clinician Even if you work in a hospital system or under an organization, you can still create your own unique “brand” as a clinician. 🎯 Identifying your strengths is the first step to defining your niche and standing out in your role. 💡 Tools like StrengthFinder 2.0 or the free High 5 Test can help you uncover your top strengths and guide your personal branding journey. Links to both are in our bio! 🌟 Have you taken the assessments? Drop your top strengths in the comments below—we’d love to hear from you! #PersonalBranding #PhysicalTherapy #PTInsights #StrengthsBasedLeadership #ToughToTreat #ClinicianSuccess #High5Test #CliftonStrengths #HealthcareLeadership #PTCommunity

Should PT’s Specialize (1).mp4

Working with the right patients shouldn’t feel like a chore—it should fuel your passion. Specializing in a specific patient population allows you to leverage your strengths, refine your expertise, and find deeper satisfaction in your work. 💡 When you align your skills with the patients you’re most passionate about, both you and your patients benefit. Have you specialized in a particular area? Drop a comment and share your experience! ⬇️ #PhysicalTherapy #ClinicalSpecialization #FindYourNiche #ToughToTreat #PTInsights #PelvicHealth #ComplexCases #PatientCare #PTCommunity

segmenting your clients (1).mp4

Segmenting your clientele can help identify your ideal client avatar. And as we’ve covered previously, this can help get clients in the door and set you apart from other therapists. #toughtotreat #physicaltherapist #physicaltherapybusiness

The importance of trialing exercise with your patient. (1).mp4

When progressing patients to higher levels of exercise, it’s common to uncover non-optimal movement patterns. Observing your patient as they perform the exercise is crucial—not just to ensure they can complete it, but to identify areas that may need refinement for better outcomes. Consider starting the session with the exercise you want to trial, or save 10 to 15 minutes at the end to let your patient attempt it. 🎧 Subscribe to Tough to Treat for weekly insights on managing complex cases. 📩 Don’t miss out—visit buff.ly/2mT1Fcv to sign up for our newsletter today!

Write down what exercies you want to do in you note (1).mp4

Have you ever walked into a follow up session with a patient and not known what you were going to do with them that day? Yeah, I think we've all been there. Here is Erica's tip for making sure that doesn't happen to you! #Toughtotreat #physicaltherapy #planahead #beprepared #treatment #patients #clinicpractice

Copy of Breath Holding Is it necessary or a learned behavior.mp4

Breath holding: Is it necessary or a learned behavior?

Red Flags Shoulder Pain.mp4

Continuing with our Red Flags- Here are things to consider when seeing someone with shoulder pain. Download and subscribe to our weekly podcast for more great insights to treating the Tough To Treat patient! #toughtotreat #Redflags #clinician #healthcare #physicaltherapy

What makes you unique as a PT (1).mp4

It’s sometimes hard to think about the business end of things when you’re a therapist. After all, you really just want to help people right? But you have to get the right patients coming to see you. The patients that light you up inside and make you excited to go to work. One way to get them in your door is by identifying what makes you unique as a clinician. What sets you apart from other clinicians? Share in the comments! #toughtotreat #valueproposition #marketing #physicaltherapist #attractclients

Tough To Treat.mp4

In this short clip, Susan covers how to assess and influence the movement of the pelvis for pelvic girdle pain through innominate rotation. Listen to Tough to Treat for more insights on treating the tough to treat! buff.ly/2mT1Fcv

What Makes a Clinical Expert (1).mp4

What makes a clinical expert? … What do you think? share with us in the comments. Download and subscribe to our weekly podcast for more great insights to treating the Tough To Treat patient and increasing your clinical expertise!

TTT Red Flags - Made with Clipchamp_1732559519687.mp4

🚩Red Flags 🚩--Always be on the lookout for them! If you liked this, head over to our website, buff.ly/2mT1Fcv and sign up for our email list. When you do, we'll send you a free copy of our Clinical Pearls pdf, Sleep tips guide. Then head over to wherever you get your podcasts and subscribe to Tough to Treat so you never miss a new episode!

Accommodating for pregnant belly (3).mp4

Accommodating for a growing belly on a pregnant person can certainly pose challenges when trying to do typical assessments. With a little thought and creativity, we can modify these tests to accommodate and get a good assessment of mobility. #pregnancy #pregnantpatient #physicaltherapy #pelvicpain #toughtotreat

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