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.

14/03/2025

🎧 Finding Hidden Connections in Functional Movement

Ever feel like you're missing something in your patient assessments? The key to unlocking persistent pain often lies in hidden movement connections.

In Episode 174, Erica dives deep into how subtle movement dysfunctions can contribute to ongoing pain—and more importantly, how to uncover them. She shares real patient cases and practical assessment strategies to help you pinpoint overlooked drivers and improve clinical outcomes.

💡 If you’ve ever wondered how to connect movement patterns with pain presentation, this is an episode you don’t want to miss!

🎧 Revisit Episode 174: Finding Hidden Connections in Functional Movement
👉 homepage - Tough To Treat

👇 What’s the most surprising movement connection you’ve found in a patient? Share your insights below!

🔥 Helping Patients Break Free from Stuck PatternsFinding the true driver of dysfunction isn’t just about assessment—it’s...
11/03/2025

🔥 Helping Patients Break Free from Stuck Patterns

Finding the true driver of dysfunction isn’t just about assessment—it’s about guiding patients toward movement patterns that restore function and reduce pain.

Once you uncover the why behind their limitations, the next step is designing an exercise progression that moves them out of their habitual patterns and into better, more efficient movement. 💡

🚀 How do you approach exercise progressions for patients stuck in inefficient movement patterns? Drop your insights below! ⬇️

🎧 Get more clinical insights on Tough to Treat! New podcast episodes drop weekly!

📩 Sign up at homepage - buff.ly/TfnvX0k

and grab:
✅ Clinical Pearls PDF – Erica’s expert insights for complex cases
✅ Sleep Tips Guide – Susan’s strategies to optimize recovery

🚨 Why wouldn’t the pelvis be the driver of pelvic girdle pain?When a patient presents with pelvic girdle pain, it’s easy...
10/03/2025

🚨 Why wouldn’t the pelvis be the driver of pelvic girdle pain?

When a patient presents with pelvic girdle pain, it’s easy to focus solely on the pelvis itself—but what if the true driver is somewhere else? 👀

Pain doesn’t always originate where it hurts. The body is a complex system of compensations, adaptations, and hidden contributors. If we don’t zoom out and assess beyond the obvious, we might miss the key to long-term relief.

💡 What do you think? Have you found unexpected drivers in your clinical practice? Drop your insights below! ⬇️

🎧 Dive deeper into complex case reasoning with Tough to Treat!

📩 Join our email list at homepage buff.ly/TfnvX0k for exclusive insights—and grab our FREE Clinical Pearls Guide & Sleep Tips Download to help you elevate your practice!

“I was told never to bend over again!” 😳Sound familiar? Many patients receive advice that unintentionally creates lastin...
25/02/2025

“I was told never to bend over again!” 😳

Sound familiar? Many patients receive advice that unintentionally creates lasting fear of movement. But as clinicians, our job isn’t just treating pain—it’s guiding patients toward movement confidence.

💡 So how do you safely and confidently reintroduce movement someone fears?

The answer lies in the biopsychosocial approach and a strong therapeutic alliance. These strategies help you empower patients to reclaim movements they've avoided, transforming fear into freedom.

🎧 Listen to Episode 101, where we explore a real-life case of a patient who was told never to bend due to (R) SI joint pain—and how thoughtful clinical reasoning restored their confidence.

📲 Listen now at buff.ly/2mT1Fcv

Are You Missing the Foot-Pelvis Connection?As clinicians, we know the body is deeply interconnected—but are you consiste...
24/02/2025

Are You Missing the Foot-Pelvis Connection?

As clinicians, we know the body is deeply interconnected—but are you consistently looking beyond the local area of pain? 🔎

The relationship between the foot and pelvis is often overlooked, yet it can significantly impact pelvic girdle pain. Poor foot control or altered foot mechanics can create lasting compensations, driving dysfunction all the way up the kinetic chain.

💡 Have you noticed this foot-pelvis connection in your patients?

💡 Could addressing foot mechanics unlock lasting relief in pelvic girdle pain?

👇 Share your experiences and insights below! When we share, we elevate patient care together.

🎧 Tune into Tough to Treat for more actionable insights on complex patient cases.

📩 Visit buff.ly/2mT1Fcv and join our email list for exclusive updates and resources—plus, receive our FREE Clinical Pearls Guide & Sleep Tips download!

21/02/2025

Shift the Focus: It’s About Them, Not You

When working with patients, your words matter. 💡 The way you frame progress can shape their mindset and motivation.

Instead of saying:
❌ “I can do this for you…”
❌ “I use this technique…”

Try:
✅ “You will feel more confident in your movement.”
✅ “You will be able to return to what you love.”

Empower your patients by focusing on their future, their progress, and their results.

💬 Do you agree? How do you frame success in your practice? Drop your thoughts in the comments!

Clinical Reasoning Challenge: What Would You Assess First?You spend 15 minutes on the phone with a new patient before th...
18/02/2025

Clinical Reasoning Challenge: What Would You Assess First?

You spend 15 minutes on the phone with a new patient before their first visit. They describe a complex history:
✔️ Multiple symptoms, including anxiety and depression
✔️ A history of concussions
✔️ Multiple failed treatments with doctors and PTs
✔️ Sympathetic blocks were the only thing that provided relief

💡 What regions would you prioritize in your assessment?
💡 What do you suspect as key drivers of their symptoms?

Drop your insights in the comments—when we share, we all learn together! ⬇️

🎧 Listen to Tough to Treat for deep dives into clinical reasoning and complex patient cases.
📲 Join our email list at buff.ly/2mT1Fcv for exclusive insights, plus a free Clinical Pearls guide and Sleep Tips download to help elevate your practice!

Mentorship Shapes the Best CliniciansNo matter where you are in your career—fresh out of school or years into practice—m...
17/02/2025

Mentorship Shapes the Best Clinicians

No matter where you are in your career—fresh out of school or years into practice—mentorship is invaluable. Having someone to bounce ideas off of, challenge your thinking, and offer a fresh perspective can transform your clinical reasoning and patient outcomes.

💡 Fun fact: That’s exactly how this podcast began!

Who has been the most influential mentor in your career? Drop their name below and give them the shoutout they deserve! 👇

🎧 Want more clinical insight? Listen to Tough to Treat for expert discussions on treating complex cases.

📲 Stream now at https://buff.ly/3MB4c5p

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!

How Does Exercise Affect Your Patients’ GI Symptoms?💡 Did you know your patients’ exercise routines can reveal key insig...
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!

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...
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! ⬇️

Clinical Reasoning in Postpartum P***c Symphysis PainWhen a postpartum patient presents with p***c symphysis pain, how d...
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!

Is Myofascial Pain Overlooked in GI Dysfunction?Patients with chronic GI dysfunction often experience referred myofascia...
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.

Is Balance the Missing Link in Your Patients’ Progress?Your patients’ balance system could be the hidden driver behind c...
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?"

Quality of Life Matters in GI DysfunctionBowel dysfunction can significantly impact patients’ daily lives and social int...
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!

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