EP. 068: The Athletic Shoulder - Overcoming Instability for Peak Performance with Edel Fanning

Download the FREE Physiotutors App 📲: https://physiotutors.app Get 3 months free of WriteUpp's Practice Management Software. Visit: https://writeupp.com/physiotutors for more Summary In this episode, physiotherapist Paul Houghhoughi, known as the climbing physio, shares his extensive expertise on climbing injuries, rehabilitation, and injury prevention. We explore common injuries, assessment techniques, rehab strategies, and the evolving landscape of climbing physiotherapy.

Download the FREE Physiotutors App 📲: https://physiotutors.app Get 3 months free of WriteUpp's Practice Management Software. Visit: https://writeupp.com/physiotutors for more Summary In this episode, Dr. Bart Dingenen, a sports physiotherapist and ACL rehab specialist, discusses the complexities of rehabilitating multidirectional athletes. Topics include movement demands, deceleration, agility vs change of direction, and best practices for late-stage rehab.

Download the FREE Physiotutors App 📲: https://physiotutors.app Get 3 months free of WriteUpp's Practice Management software. visit https://writeupp.com/physiotutors for more info! Summary In this episode, physiotherapist Bahram Jam shares his 34 years of experience in understanding and treating chronic pain, emphasizing the importance of shifting from structural fixes to a focus on primary pain and the psychological aspects of pain management. Discover insights on how to better approach persistent pain, debunk common misconceptions, and explore innovative concepts like pain as a musical. 00:00:00 Introduction 00:01:28 How has your understanding of chronic pain changed over time? 00:04:14 When does pain stop being mainly tissue-driven? 00:06:27 If tissues have healed, why can pain still persist? 00:08:43 What do patients with persistent pain get told that makes things worse? 00:11:36 Sponsored segment: Physiotutors courses 00:13:20 How do you explain persistent pain in a way that helps patients move forward? 00:16:32 What is primary pain versus secondary pain? 00:22:43 What are you trying to figure out in a first consultation? 00:25:17 How do you handle resistance when patients are skeptical? 00:27:09 Sponsored segment: Physiotutors membership 00:29:05 Where do clinicians go wrong with persistent low back pain? 00:39:04 How do you approach patients who have tried everything? 00:41:49 How do you explain MRI findings that do not match symptoms? 00:45:44 What makes TMJ disorders tricky and what do clinicians miss? 00:49:29 Sponsored segment: WriteUpp 00:51:04 What exercise approach do you use for persistent low back pain? 00:57:08 How do you balance manual therapy, exercise, and education? 00:58:41 How important are lifestyle factors in persistent pain? 01:01:42 What is your one piece of advice for clinicians treating persistent pain? 01:06:18 Is there anything else you want to add? 01:08:08 Outro Bonus Material Download the referenced transcript including PubMed Links and a high-resolution infographic on this episode as part of your Physiotutors membership on the Physiotutors App. Download the Free App now

Download the FREE Physiotutors App 📲: https://physiotutors.app Get 3 months free of WriteUpp's Practice Management software. visit https://writeupp.com/physiotutors for more info! Summary This episode explores the critical role of breathing in health, recovery, and performance, featuring Steven Zwerink, a breathing physiologist. Discover how dysfunctional breathing impacts the body, the importance of CO2 over oxygen, and practical techniques for physiotherapists to incorporate breathing exercises into their practice. Guest Steven is a breathing physiologist and the founder of the Dutch Institute for Breathing Physiology. His work focuses on how breathing influences health, recovery, and performance. His interest in breathing started after a serious cycling accident, where he experienced a long and difficult recovery with symptoms like a concussion and whiplash. Traditional approaches only got him so far, but when he started working with breathing, things began to change. That experience became the foundation of his work today. With a background in elite sports and extensive training in different breathing methods, Steven now works with physiotherapists, healthcare professionals, and athletes. His goal is to make breathing practical, evidence-informed, and clinically applicable. Chapters: 00:00:00 Introduction to breathing in physiotherapy 00:01:17 Steven Zwerink's accident and recovery journey 00:07:57 Sponsor: Physiotutors membership and learning platform 00:09:04 Dysfunctional breathing, CO2, and nasal vs mouth breathing 00:16:38 Why nasal breathing can feel difficult 00:20:26 Early-life habits, jaw development, and airway problems 00:24:38 Sponsor: Physiotutors courses 00:25:39 Why breathing matters in everyday physio practice 00:31:45 How to assess when breathing is part of the problem 00:36:05 Three practical breathing techniques for therapists 00:42:26 Box breathing dosage and workplace applications 00:46:23 Advanced breath control and prolonged exhale training 00:50:55 Coherent breathing and nervous system regulation 00:50:54 Sponsor: WriteUp practice management software 00:52:30 When breathing is complementary vs primary treatment 00:56:46 Sleep-disordered breathing, recovery, and injury risk 00:59:14 Clinical case: post-COVID recovery with breathing work 01:01:34 Mistakes to avoid when adding breathwork to physio 01:04:20 Key myth, nervous system regulation, and therapist takeaways 01:06:13 Diaphragm, psoas, and overlooked physical links 01:08:11 Where to find Steven and final outro Bonus Material Download the referenced transcript including PubMed Links and a high-resolution infographic on this episode as part of your Physiotutors membership on the Physiotutors App. Download the Free App now

Download the FREE Physiotutors App 📲: https://physiotutors.app Get 3 months free of WriteUpp's Practice Management Software. Visit: https://writeupp.com/physiotutors for more Summary In this episode, Firat Kesgin, founder of the German Institute for Vestibular Rehabilitation, discusses the controversial topic of cervicogenic dizziness. He challenges the validity of this diagnosis, arguing that dizziness often associated with neck pain and limited cervical mobility should not be considered a distinct disorder. Kesgin references the Barani Society's stance, which suggests that the connection between cervical issues and dizziness lacks high-quality evidence. He explains that patients with vestibular disorders often restrict head movement, leading to neck problems over time, which can be mistaken for cervicogenic dizziness.Kesgin emphasizes the importance of accurate diagnosis and the risks of relying on exclusion-based diagnoses. He highlights the need for specialized knowledge in vestibular disorders to avoid misdiagnosis and unnecessary treatments. The discussion also touches on the psychological aspects of dizziness, comparing it to chronic pain conditions where the central nervous system plays a significant role. Kesgin advocates for a more comprehensive understanding of vestibular disorders and cautions against simplistic mechanical explanations for complex symptoms. Guest Firat is the founder of the German Institute for Vestibular Rehabilitation and has been teaching postgraduate courses throughout Europe. His work focuses on helping clinicians better understand and treat patients with dizziness and balance disorders. Alongside his clinical and teaching work, Firat is currently pursuing a PhD on the standardization of BPPV testing and the implementation of structured vestibular rehab programs in outpatient care. Chapters 00:00:00 Intro 00:01:22 Why "cervical dizziness" isn't a valid diagnosis 00:03:36 Neck pain/limited ROM as consequences of vestibular issues 00:04:26 Sponsor: WriteUpp 00:06:00 Temporal link to neck pain doesn't prove causation 00:08:15 Does treating the neck fix dizziness? Short-term vs long-term 00:10:51 Risks of diagnosis by exclusion 00:12:24 Diagnostic gaps in routine ENT practice 00:14:20 No specific test: is that enough to reject it? 00:16:59 Vestibular migraine vs "cervical dizziness" 00:20:51 Sponsor: Physiotutors Premium 00:21:27 Common mislabels: BPPV, hypofunction, and 3PD 00:25:45 Cervical proprioception: acute vs chronic relevance 00:32:32 Interpreting cervical torsion and SPNT tests 00:36:53 Sponsor: Physiotutors Courses 00:37:55 Parallels with chronic low back pain 00:38:41 Why the research persists and biomechanical bias 00:45:19 Clinical guidance for dizzy patients with neck pain 00:46:54 Myth-busting: negative ENT and psychology factors 00:49:23 Closing thoughts 00:50:33 Where to find Firat 00:51:19 Outro Bonus Material Download the referenced transcript including PubMed Links and a high-resolution infographic on this episode as part of your Physiotutors membership on the Physiotutors App. Download the Free App now