Do you measure your patient's ability to produce or manage forces? Why or why not? Ours is a profession of movement-oriented focus, and yet it often lacks investigation of basic concepts vital to movement, i.e. the forces involved. This is true regarding the ability to produce and control movement, and the decision-making processes regarding how much to prescribe and why. These issues are fundamentally relevant to rehabilitation activities, and daily life. So, why do we do the things that we do? And, why do we not do other things that make sense? Join me as I discuss these and other ideas that will help sharpen our focus on issues related to dosing, modifying, and monitoring our work to improve the care we provide to our patients and, over time, improve our outcomes.    REFERENCES Dominguez-Romero JG, Jiménez-Rejano JJ, Ridao-Fernández C, Chamorro-Moriana G. Exercise-Based Muscle Development Programmes and Their Effectiveness in the Functional Recovery of Rotator Cuff Tendinopathy: a Systematic Review. Diagnostics. 2021;11:529. Souza LA, Martins JC, Moura JB, Teixeira-Salmela LF, De Paula FV, Faria CD. Assessment of muscular strength with the modified sphygmomanometer test: what is the best method and source of outcome values?. Braz J Phys Ther. 2014;18(2):191-200.  Mueller MJ, Maluf KS. Tissue adaptation to physical stress: a proposed "Physical Stress Theory" to guide physical therapist practice, education, and research. Phys Ther. 2002;82(4):383-403. White JM. Mechanobiologically Oriented Rehabilitation of a Complex, Comminuted, Displaced Acetabular Fracture in a 70-Year-Old Medically Complicated Patient: a Case Report. JOSPT Cases. 2021;1(3):185-196. doi:10.2519/josptcases.2021.10266  

A man with over 2-decades of complaints related to an old traumatic ankle injury as a consequence of a motorcycle crash now faces a critical decision: surgery or no surgery to fix his problem? Except that it might not work. The uncertainty is backed by a history of a multitude of past incomplete or failed treatments and the reality of a worsening problem that includes increasing pain, loss of balance, and change of lifestyle. Join me in this podcast as I discuss how preconceived obstacles to recovery realized in a hypothetico-deductive reasoning model can be eliminated or reduced with a varied problem-solving tool set.    This is our sixth story in an ongoing series. It illustrates lessons learned from a transformative moment in a PT's career. Like all of our stories, it is drawn from real-world experience. 

Patients with chronic musculoskeletal conditions are often thought of as resistant to treatment. This is true for both conservative and non-conservative treatments, including pharmacological interventions. In settings where this is not the prevailing thought, then the amount of change expected as a result of conservative interventions is often small and seemingly insignificant, especially if improvements are not durable. In my practice, approximately two thirds of patients I work with have chronic musculoskeletal conditions. Join me as I discuss the why and how of a simple rule we use that helps signal significant improvement has occurred, the kind that often signals greater potential for recovery. 

Many patients with chronic neuromusculoskeletal problems, including pain and disability, have been through the healthcare system and reached the dreaded impasse where 6 discouraging words tell them all they need to know about the path they are on: "We've done all we can do...." By this time, they have utilized more healthcare dollars and visits than other patients. The amount of improvement they experience when they are helped is often small and short-lived despite the time and effort and dollars. Still, some small improvement is better than no improvement. And, very likely, it signals that more can be achieved. Despite these experiences, it is possible in many cases to create dramatic improvements. The kind that exceeds expectations. Join me in this podcast short as I discuss what is possible.     

Pressure pain tolerance algometry can help with phenotyping pain, identifying responder patients likely to improve with a given intervention, aid tracking and monitoring changes in patients, and much more. Join me in this podcast short as I discuss what is perhaps the most underutilized, yet useful, tool in the neuromusculoskeletal toolbox. 

Musculoskeletal residuals. What are they? Join me in this podcast as I provide an introductory discussion of what they are, and provide some important ways to think about them which helps frame our understanding of their role in a rehabilitation science and clinical context. This is especially critical with regard to unrealized recovery. Know the right questions to ask, and what do with the information you acquire. Knowing how to look for and interpret the presence of residuals can provide guidance for what to do next.  

Sometimes the origin of a problem can be unexpected, and sometimes treatments don't go according to plan. It's easy to get flustered, frustrated, and lost. But paying attention to important clues along the way, such as responses to special tests, and detailed symptom behavior, can help anchor our understanding of what is actually happening. Sometimes, it even offers us a glimpse of the bigger picture, one that ties the rehab process together in new or unexpected ways. When this happens, it can reveal deeper connections that lead to useful revelations. Part of the process to gain such insight is understanding what normal recovery should look like, even when we are confronted with novel circumstances. Join me in this podcast short as I discuss these issues in context to an unusual case.    This is our fifth story in an ongoing series. It illustrates lessons learned from a transformative moment in a PT's career. Like all of our stories, it is drawn from real-world experience. 

Treatment design is a complex problem facing every clinician. But how well do we understand this issue? What does the science have to say? How much can we rely on what is in the research literature? As it turns out, the answer is: it depends. Join me in this podcast short as I discuss some recent research findings regarding the completeness of treatment descriptions and what this means for treatment design. 

Biomarkers can provide much needed information that is critically important to our work with patients. One you need to know about, the Load Tolerance Test (LTT), may be among the most broadly useful tools at our disposal. It may also be among the least well-known. Join me in this podcast short as I discuss today's topic in more detail, and why you need to know more about this. 

What is mechanotoxicity? This term relates to mechanisms of injury. We recognize that mechanical insults to the musculoskeletal system occur in many different ways. Join me in this podcast short as I define, explain, and provide examples linked to the meaning behind some of the terminology we use within the framework of mechanobiologically oriented rehabilitation.