In this episode, Erica explores how clinical reasoning informs decision-making across diverse areas of physical therapy practice. This is a clinical pearls discussion that will save you lots of time in the clinic.

From CKC to OKC brain mapping in an MMA fighter to exercise progression in ACL rehabilitation to thoracic dysfunction in a post partum runner experiencing hip pain and incontinence, she highlights key clinical reasoning strategies that guide effective treatment and exercise progression.

For example, if your patient has a bracing strategy in their lumbar spine where they always "grip" their back when they sit, stand and even go supine, how would you prescribe exercise to "take out" that strategy to give them more options for movement?

Many people do this in our "sit up straight" culture. This will make a huge difference in your practice!

Related links:

• Tough To Treat Website

• Erica's Website

• Susan's Website

How long should you keep treating a patient? And what's the best approach when they're skipping their home exercise program? In this listener Q&A episode, Erica shares practical strategies—illustrated through two real patient cases, one a golfer and the other a cyclist—for answering the tough question of treatment length and for addressing non-compliance.

She highlights how building a strong therapeutic relationship can improve follow-through and make these conversations more productive. Erica also highlights the most important phases of an exercise program to ensure efficiency and compliance.

To close, Erica offers a brief update from her doctoral research on menopause, focusing on the role of muscle power in older women and why it may be a more critical predictor of function than strength alone.

Related links:

• Tough To Treat Website

• Erica's Website

• Susan's Website

In this episode, Erica dives into a fascinating case of a patient experiencing neck pain and how that seemingly isolated symptom actually traced back to an old foot injury. This case exemplifies the deep, interconnected nature of the human body. For those you have been listening for a while, this should not surprise you.

She unpacks the biomechanical and neural links between the foot and cervical spine, exploring how altered load distribution and compensatory patterns can persist long after the original injury appears to have healed.

A key focus of the discussion is the role of the center of mass—how shifts in its control can influence motor strategy and postural control, ultimately impacting regions far from the original site of injury.

Erica also covers exercise options, including progressions that integrate both the foot and cervical spine. How to adapt your treatment when load transfer is compromised is a key factor in this patient's outcome.

This episode is a reminder that in rehab, it's rarely just about the joint that hurts—it's about the whole system that moves around it.

Related links:

• Tough To Treat Website

• Erica's Website

• Susan's Website