Rehab Science

Dr. Rachel Zoffness, pain scientist and psychologist who teaches and writes about chronic pain, explains the biopsychosocial view of pain. She talks about why medicine over-relies on pills and scans. She shares the “pain recipe” idea and how sleep, movement, thoughts, and attention shape pain. Practical strategies like pacing and graded exposure are highlighted.

Dive into the world of SLAP tears, where the shoulder's superior labrum meets the biceps tendon. Learn how these injuries can occur during overhead activities and the surprising presence of asymptomatic labral changes. Discover the overlap of symptoms with other shoulder conditions and why diagnosis is often tricky. Explore the shift from surgical solutions to a focus on rehabilitation techniques for restoring function and strength. Get insights into when surgery might be necessary as we unravel the complexities of shoulder injuries.

Shoulder blade pain may actually stem from neck issues, not tight muscles or poor posture. Dr. Tom Walters reveals how cervical spine irritation can refer pain to the interscapular area. Learn the misdiagnoses often made and how local treatments provide only temporary relief. He discusses neural anatomy's role in referral patterns and identifies specific cervical nerve roots linked to various pain sensations. Additionally, discover essential rehabilitation principles and exercises to effectively address the true source of pain.

Dive into the intricate world of rotator cuff tears! Discover how the four crucial muscles stabilize shoulder movement, and why the supraspinatus is often the weakest link. Learn the key distinctions between partial and full-thickness tears. Surprisingly, imaging doesn’t always align with symptoms—pain doesn’t always correlate with tears. Uncover effective rehab strategies that focus on pain reduction and progressive strengthening, with many achieving full recovery without surgery. Plus, find out when surgical options are truly necessary!

Dive into the complexities of thoracic outlet syndrome, where compression wreaks havoc on nerves and blood vessels. Discover the distinctions between neurogenic and vascular types, and learn the crucial symptoms that signal the need for immediate medical attention. Unravel the common confusion with cervical radiculopathy and explore effective physical therapy strategies for relief, including postural retraining and breathing techniques. Whether you're a clinician or a patient, there’s vital info that can help you navigate upper extremity pain.

In this episode of the Rehab Science podcast, Dr. Tom Walters, DPT, breaks down one of the most common sources of neck and shoulder discomfort—trapezius myalgia. Often experienced as persistent tightness or aching in the upper trapezius muscle, this condition affects individuals who spend long periods sitting, working at a computer, or holding static postures under stress. Dr. Walters discusses the underlying anatomy and biomechanics of the trapezius, highlighting how postural overload, fatigue, and nervous system sensitization contribute to chronic discomfort. He explains why passive strategies like stretching alone may be insufficient, and emphasizes the role of progressive resistance training in improving muscle function and reducing symptoms. The episode concludes with practical movement strategies, rehab principles, and key behavioral tips for lasting relief. Resources 📘 Rehab Science Book on Amazon 🎥 Rehab Science YouTube Channel References Andersen LL, Jørgensen MB, Blangsted AK, et al. Effect of physical training on pain sensitivity and trapezius muscle morphology in females with trapezius myalgia: randomized controlled trial. J Appl Physiol (1985). 2008;105(4):1128-1134. doi:10.1152/japplphysiol.90391.2008 Larsen CM, Hansen M, Hansen EA. Effectiveness of strength training versus stretching exercises for the treatment of trapezius myalgia: a randomized controlled trial. Scand J Work Environ Health. 2013;39(2):143-150. doi:10.5271/sjweh.3320 Blangsted AK, Søgaard K, Hansen EA, et al. The effect of physical coordination training on posture, muscle activation, and musculoskeletal symptoms in office workers. Scand J Work Environ Health. 2008;34(1):55-65. doi:10.5271/sjweh.1194

In this episode of the Rehab Science Podcast, Dr. Tom Walters discusses proximal hamstring tendinopathy (PHT), a common condition affecting athletes, particularly runners and lifters. He explains the anatomy, biomechanics, and causes of PHT, emphasizing the importance of understanding the condition as a sensitivity issue rather than inflammation or a tear. The episode covers diagnostic strategies, effective rehabilitation techniques, and treatment options, highlighting the significance of gradual loading and physical therapy in recovery. Takeaways Proximal hamstring tendinopathy (PHT) is common among active individuals. Chronic mechanical overload is a primary cause of PHT. Symptoms often worsen with activities involving hip flexion and knee extension. Diagnosis is typically clinical and does not require imaging. Physical therapy is the cornerstone of PHT treatment. Gradual resistance training is essential for tendon healing. Rest alone will not lead to healing of tendinopathies. Education and movement-based care are crucial for recovery. PHT can be frustrating but responds well to proper rehab strategies. Most individuals can return to full activity without surgery. YouTube Link Amazon Book Link Chapters 00:00 Introduction to Proximal Hamstring Tendinopathy 02:55 Understanding the Anatomy and Biomechanics 06:09 Signs, Symptoms, and Diagnosis 08:49 Rehabilitation and Treatment Strategies 15:08 Medical Interventions and Final Thoughts

In this episode of the Rehab Science Podcast, Dr. Tom Walters interviews Dr. John Rusin, a physical therapist and injury prevention specialist. They discuss the concept of pain-free performance, which is a movement system designed to help individuals transition from pain to optimal performance. Dr. Rusin shares his background in professional athletics and how it shaped his approach to training and rehabilitation. The conversation delves into the importance of individualized training, movement quality, and the six foundational movement patterns. They also explore the significance of movement screens and assessments, the six-phase warm-up sequence, and the structure of Dr. Rusin's new book on pain-free performance. In this conversation, John Rusin and Tom Walters delve into the intricacies of movement patterns and performance training. They discuss the importance of creating a comprehensive movement program that caters to individual needs, assessing movement patterns for optimal performance, and the significance of a non-dogmatic approach to training. The conversation emphasizes understanding movement quality, spinal neutrality, and the necessity of individualized training to liberate movement and enhance overall performance. Visit the links below to learn more about John's certification program and his new book: Pain Free Performance Specialist Certification Pain Free Performance Book

In this episode of Rehab Science, Dr. Tom Walters, DPT, breaks down cervical radiculopathy—a common condition involving compression or irritation of the nerve roots in the neck. He explores the relevant cervical spine anatomy, including how disc herniations or degenerative changes like bone spurs can narrow the neural foramina and impinge nerve roots, leading to symptoms that radiate from the neck into the arm and hand. Dr. Walters reviews hallmark symptoms such as radiating pain, numbness, tingling, and muscle weakness, and discusses how these typically follow a dermatomal distribution depending on the affected cervical level. Dr. Walters also explains the clinical examination process for diagnosing cervical radiculopathy, including provocative orthopedic tests and the role of imaging like MRI when necessary. He outlines both medical and physical therapy approaches to treatment—ranging from anti-inflammatory medications and injections to targeted rehab strategies like cervical traction, neural mobilization, postural correction, and strengthening exercises. The episode wraps up with practical advice for managing this condition through movement-based rehabilitation. YouTube Video with Exercises Nerve Mobilization Exercises Amazon Book Link

In today's episode, I speak with Dr. Mark Kargela, a seasoned clinician and educator, about chronic pain—its complexity, its impact, and how practitioners can better support patients struggling with it. The discussion focuses on shifting clinical approaches from tissue-centric models to ones that integrate contemporary neuroscience and lived experience. Key topics include: Understanding Chronic Pain: The conversation defines chronic pain not simply by duration (e.g., beyond three months), but as a biopsychosocial phenomenon that fundamentally changes the nervous system. Dr. Kargela emphasizes that chronic pain is often not a direct marker of tissue damage, but a protective output of the nervous system influenced by biology, psychology, and social factors. Pain Neuroscience Education (PNE): Both clinicians stress the importance of PNE in helping patients reframe their pain experience. Teaching people how pain works can reduce fear and catastrophizing, improve self-efficacy, and set the foundation for graded movement and recovery. Central Sensitization and Nervous System Dysregulation: The discussion highlights how sensitized neural pathways can perpetuate pain even in the absence of tissue pathology. Techniques that modulate the nervous system—such as breathing, sleep optimization, gentle movement, and mindfulness—are presented as key therapeutic tools. Limitations of Traditional Biomedical Models: Dr. Kargela critiques overly mechanical approaches that chase tissue "damage" or perfect biomechanics, advocating instead for approaches that validate patient experiences and support behavior change. Clinician Takeaways: The episode encourages health and fitness professionals to: Ask better questions that uncover contributors to a person's pain narrative. Shift from "fixing" people to coaching them toward resilience. Recognize that empathy, listening, and patient-led goals are central to helping people move forward. To learn more about Mark's work, visit his social media accounts and website below. Instagram: Modern Pain Care YouTube: Modern Pain Care Pain Courses for Clinicians