Episode 19: Q&A Series #3

In this episode, we answer questions from the ClinicalAthlete Community!

Topics Covered: 

- 6:09: Handling disagreement with colleagues

- 15:51: Affective-reflective theory of physical inactivity

- 21:25: Peripheral vs. central sensitization

- 42:07: Future research that we would like to see

Follow Michael on Instagram @michaelvamato  

To learn more about the ClinicalAthlete Community:

Episode 18: Q&A Series #2 with Steph Allen

In this episode, we answer questions from the ClinicalAthlete Community with special guest Steph Allen, DPT!

- 7:00: Compliance & fear avoidance with ACL rehab
- 16:06: Using the objective measures learned in school
- 27:22: Applying acute:chronic workload ratios to barbell sports
- 40:09: Residencies - are they worth it?
- 47:14: Advice to new grads making a 5-year plan

Follow Steph on Instagram @stephallen.dpt

To learn more about the ClinicalAthlete Community:

Episode 14: Gender Differences in Resistance Training with Greg Nuckols

In this episode, we welcome strength coach and science aficionado Greg Nuckols onto the show. Greg discusses the similarities & differences between men and women regarding their responses to resistance training, based on fundamental physiology and a comprehensive overview of the scientific literature.

Greg's blog:

Greg's monthly research review:

To learn more about the ClinicalAthlete Community:

Episode 13: Thawing The Narrative of 'Frozen Shoulder' with Jarod Hall

What is Frozen Shoulder and how do we manage it? 

In this episode, we welcome Jarod Hall, DPT onto the podcast to answer these questions and to discuss:
- the importance of the subjective exam
- the impact of placebo & nocebo on these patients
- pain neuroscience education as a whole
- therapeutic exercise treatment for the frozen shoulder

Follow Jarod on IG: @drjarodhalldpt

To learn more about the ClinicalAthlete Community:

Episode 12: Urinary Incontinence in Athletes: The common, but not commonly talked about dilemma

In this episode, we are joined by Meryl Alappattu, DPT, PhD to discuss current evidence and management of urinary incontinence.

- How common is it, and why isn't it talked about more?
- Evidence-based treatment
- Considerations for athletes
- Resources and referral systems

Connect with Dr. Meryl Alappattu:
Twitter: @pundispice
Meryl's Univ of FL contact page:
APTA section on Women's Health:
Girls Gone Strong:


To learn more about the ClinicalAthlete Community:

Episode 11: (In)effectiveness of Knee Scopes: When Sounding Good Isn't Good Enough

Arthroscopic knee surgery is common, but is it warranted? Today we are joined by Sydney-based Orthopedic surgeon and researcher, Dr. Ian Harris.

Dr. Harris discusses the evidence-practice gap regarding the use of arthroscopic knee surgery and provides insight into how we can improve the system. We discuss one of Dr. Harris' research papers - in which there was a strong recommendation AGAINST the use of arthroscopy in nearly all patients with degenerative knee disease. 

Link to Paper:

To learn more about the ClinicalAthlete Community:

Episode 9: Practical Periodization with Scot Morrison

How do we define and track "load" with progressive rehab? How do we organize the rehab plan while managing other athlete stressors?

In this episode of the ClinicalAthlete Podcast, we welcome Scot Morrison onto the show to discuss these topics, as well as:

-When is it better to strive for “good enough” rather than “optimal”
-Examples of feedback loops and metrics to track in order to keep the rehab plan on track
-Frequency of loading
-Loading tests for patients to gauge daily progress with tendinopathy
-Issues with exercise dosage in current rehab practices
-Issues with "predictive" models

If you'd like to learn more about this topic, check out Scot's ClinicalAthlete Webinar at:

Scot's Instagram: @physio_praxis
Scot's Website: www.physiopraxis.co

Episode 8: If You Listen To This Show, Let's Set Some Expectations First

In this episode of the ClinicalAthlete Podcast, we discuss how patient beliefs and expectations of care can have a significant effect on patient outcomes. We also discuss how we can manage, potentially reframe, and measure patient expectations clinically. We finish the show discussing a case study of an injured athlete, and how to incorporate patient education as it relates to appropriately framing patient expectations of care.

Peer-Reviewed References:

Bialosky JE et al. Individual Expectation: An Overlooked, but Pertinent Factor in the Treatment of Individuals Experiencing Musculoskeletal Pain. 2010

Geurts JW et al. Patient expectations for management of chronic non-cancer pain: A systematic review. 201

Episode 7: To Foam Roll or Not To Foam Roll

That is the question we attempt to answer in this episode. What does "self-myofascial release" do and how does it do it? Is it worth spending time on? Does it effect recovery, performance, or injury? What does the research say? Here's our take..

Peer-Reviewed References:

Beardsley. Effects of self-myofascial release: A systematic review. 2015
Cheatham. The effects of self-myofascial release using a foam roll or roller massager on joint range of motion, muscle recovery, and performance. 2015
Schroeder. Is self myofascial release an effective pre-exercise and recovery strategy? A literature review. 2015

Episode 6: Debate Series 1: Bio vs. Psychosocial

Support the Podcast

In the first edition of the ClinicalAthlete debate series, we are joined by Dr. William Brady, DC of: integrativediagnosis.com.

During this professional debate, we discuss the biopsychosocial model of pain and injury. What effect does a clinician have on the "bio"? When and how should the "psychosocial" element be addressed? Should we take a "structuralist" or "pain science" approach when diagnosing and managing injury? Is it a dichotomy?

We also discuss, at length, the existence and management of fascial adhesions. What are adhesions? Can we identify them with palpation? Can we make structural changes with manual interventions?

We would like to thank Dr. Brady for coming on this show. Professional discussion and debate is what helps to push our fields forward. To suggest future debate topics or possible guests, please use the contact email below.

References mentioned by Dr. Brady:

Flexor tendon adhesion in rats: https://goo.gl/qQf1p2
Tensile properties of collagen matrices: https://goo.gl/F42YB9
Endoscopic treatment of sciatic nerve entrapment: https://goo.gl/DdQ8SG

Referenced mentioned by Derek Miles:

Assembly and mechanical properties of extracellular matrix: https://goo.gl/Ysz5zu
Looking back on back pain: https://goo.gl/JCe931

Referenced by Michael Ray:

STarT Back and low back pain: https://goo.gl/5kir6j
Effect of denervation on pain intensity: https://goo.gl/69ix8C
Relieving pain with expectation interventions: https://goo.gl/1iLfgM
The logic of Rehab blog on pain science: https://goo.gl/VEZeGj

For resources and education in sports medicine, athletic rehabilitation, & performance: www.clinicalathlete.com

For questions and comments: info@clinicalathlete.com

Episode 5: LTAD: Developing a Specialized Athlete Resilient to Acronyms

Are children specializing too soon? How early is too early to pick one sport? What can we do to foster long-term development? In this episode, we discuss youth athletic development and whether early sport specialization is a risk factor for our young athletes.

Peer-Reviewed References:
Feeley BT. et al. When is it too early for single sport specialization? AJSM. 2015
Myer GD. et al. Sport specialization, Part I: Does early sports specialization increase negative outcomes and reduce the opportunity for success in young athletes? Sports-Health. 2015
Myer GD et al. Sports specialization, Part II: Alternative solutions to early sport specialization in youth athletes. Sports-Health. 2015

For resources and education in the fields of sports medicine, athletic rehabilitation, and performance:

Episode 4: Pain Science: This Sh*t is Complicated

What is "pain"? Does pain mean tissue damage? Can we, or should we, treat pain directly? Does the approach change in acute versus chronic cases? In this episode, we attempt to talk through the complex topic of pain science, as it relates to clinical application.

Logic of Rehab pain science blog:

Peer-Reviewed References:
Williams AC. Craig KD. Updating the definition of pain. Pain. 2016.
Hauck M et al. Top-down and bottom-up modulation of pain-induced oscillations. Frontiers in Human Neuroscience. 2015
Smith BE. et al. Should exercises be painful in the management of chronic musculoskeletal pain? A systematic review and meta-analysis. BJSM. 2017
Sullivan MJL. et al. The influence of communication goals and physical demands on different dimensions of pain behavior. Pain. 2006

For resources and education in the fields of sports medicine, athletic rehabilitation, and performance:

Episode 3: Came for the Tendinopathy but stayed for the donuts.

In this episode of the ClinicalAthlete podcast, we are joined by Jason Eure, DPT, to discuss the physiology and current best practice for the management of Tendinopathy.

Follow Jason on Twitter

Read Jason's awesome blogs on Tendinopathy:
Squatting with Patellar Tendinopathy
Training with Biceps Tendinopathy

Find your nearest ClinicalAthlete Provider or ClinicalAthlete Event at

Peer-Reviewed references used in the show:
1. Revisiting the continuum model of tendon pathology: what is its merit in clinical practice and research? Cook JL. 2016
2. Human tendon adaptation in response to mechanical loading: a systematic review and meta-analysis of exercise intervention studies on healthy adults. Bohm S. 2015
3. Heavy-Load eccentric calf muscle training for the treatment of chronic achilles tendinosis. Alfredson H. 1998
4. Heavy slow resistance versus eccentric training as treatment for achilles tendinopathy: A randomized controlled trial. Beyer R. 2015

Episode 1: Do You Even Epistemology Bro?

Epistemology - the theory of knowledge. How do we know what we know?

In the very first episode of the ClinicalAthlete Podcast, Quinn Henoch, DPT, Michael Ray, DC, and Derek Miles, DPT discuss the past, present, and future of evidence-based practice.  


  1. Evidence Based Medicine: What It Is And What It Isn't: It's About Integrating IndividualClinical Expertise And The Best External Evidence. Sackett, 1996

  2. Evidence-based medicine has been hijacked: a report to David Sackett. Ioannidis, 2016

  3. Progress in evidence-based medicine: a quarter century on. Djulbegovic, 2017

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