Forward Physio How Adam Meakins Actually Helps Patients - Clinical Reasoning in 3 Case Studies
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Jan 5, 2026 
In this discussion with Adam Meakins, a skilled physiotherapist and educator, he addresses his approach to clinical reasoning through three intriguing case studies. Adam tackles controversial online critiques and shares practical insights into managing low back pain and diabetes-related frozen shoulder. He emphasizes the importance of graded exposure, realistic recovery timelines, and the role of corticosteroid injections. Additionally, he highlights how to gently shift patient beliefs and the significance of addressing underlying metabolic issues.
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Graded Exposure Beats Rigid Bracing
- Exclude serious pathology first, then use graded exposure to rebuild tolerance gently.
- Use experiential tests (relaxed sitting, gentle flexion) to violate fear-based beliefs and show movement is safe.
Use Experiential Education To Reduce Guarding
- Start gentle, compassionate education and show movement is modifiable rather than arguing.
- Use breathing and relaxation to reduce guarding before progressing movement exposure.
Recognize True Red Flags In Low Back Pain
- Watch for red flags: bilateral leg symptoms, severe motor loss, saddle numbness, or bowel/bladder change.
- Urgent evaluation is needed if those neurological signs appear, even if pain severity alone is high.