Progressive Podiatry Project

P3's Research Round-Up

In this episode we're doing a deep dive into the clinical application of a recent research publication, that aimed to assess & measure the adherence to exercise for patients with musculoskeletal pain.

Yes, we are talking about research, BUT we are focusing on how we can apply this clinically.

Why is this research important?

This tool explores 6 domains that are commonly associated, either positively or negatively, with rehabilitation adherence.

By gaining insights into how a patient is scoring relative to these domains, we can adjust our management strategy, improve their adherence, and ultimately, improve our rehab outcomes.

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https://www.progressivepodiatryproject.com/researchroundup

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https://www.progressivepodiatryproject.com/blueprint

Find out more about P3's monthly CPD subscription, GFM: Gait | Footwear | Movement

https://www.progressivepodiatryproject.com/gfm

Article: Bailey DL, Bishop A, McCray G, Foster NE, Holden MA. A new measure of exercise adherence: the ATEMPT (Adherence To Exercise for Musculoskeletal Pain Tool). Br J Sports Med. 2024 Jan 3;58(2):73-80. doi: 10.1136/bjsports-2022-106347. PMID: 37945324; PMCID: PMC10804013.

Are you considering "Should I take this job?"

In this episode we explore a number of self-reflective questions that will help you answer this question and more...

What elements of a job opportunity do I need to consider to understand if it is the right job for me?

What are some ways I can identify potential red flags of an organisation?

Getting somewhat philosophical, we look at some conceptual frameworks that have built our understanding of the various elements that contribute to job compatibility, fulfilment and satisfaction.

If you're a new graduate looking for work or something thinking about a bit of a career shift, this extended episode is for you.

There's a multitude of reasons when the typical sets & reps for exercise prescription may not be appropriate.

In this episode we explore the clinical utility of AMRAP (As Many Reps As Possible).

Including; what it is, when we may utilise this option, and how we may program it (for rehab).

Want a free rehab resource to help guide you through the exercise rehabilitation prescription process?

Download the Movement Prescription Blueprint from https://www.progressivepodiatryproject.com/blueprint

Self-reflections and practical strategies to build confidence when discussing treatment costs with our patients.

It's possible that in caring TOO MUCH we end up sabotaging our treatment outcomes.

In this episode we explore;

What happens when we make assumptions?

How can I know if I am making assumptions about my client's financial position? Self-reflection questions.

How can I improve my confidence & delivery when discussing treatment costs? Practical strategies.

What are some strategies I can implement to help navigate financial barriers? Clinical tips.

In this episode we explore The Windlass Test and how clinicians can get more 'bang for buck' with the information this test can provide.

Many clinicians may utilise objective tests to identify what pathology they may be dealing with.

However, many stumble when it comes to figuring out the selection and timing of the therapeutic interventions that may be beneficial to aid their client's recovery.

In this episode we explore how we can use the information gathered from performing the Windlass Test to select exercises that may better align with an individual's load-tolerating capacity.

ie: prescribing for a PERSON with a pathology, as opposed to simply prescribing for a pathology.

In this episode we talk about the importance of individualising our rehab programs. That is, treating the person NOT just the pathology. - What's the difference between standardised care & "cookie-cutter" care?

- How should we be using the published Best-Practice Clinical Guidelines?

- What can we standardise & what can we individualise?

Best Practice - Plantar Heel Pain - https://bjsm.bmj.com/content/55/19/1106

Best Practice - Achilles Tendinopathy - https://bjsm.bmj.com/content/55/20/1125

Need help ditching the cookie-cutter rehab approach? Download the Movement Prescription Blueprint here https://www.progressivepodiatryproject.com/blueprint #podiatry #physiotherapy #rehab #rehabilitation #exercise #exerciserehab #running #runninginjury #sportsmedicine

Foot orthoses - where do they fit into your clinical management?

Does everyone need orthoses? No

Do those who are prescribed orthoses need them for life? It depends...

What should we consider if we are to make appropriate recommendations & management plans for our patients?

In this episode Podiatrists Talysha & Jackson explore some elements of orthotic prescription that are often equally important (if not more) to the script itself.

For more information head to https://www.progressivepodiatryproject.com/p3me

#podiatry #running #runninginjury #runningrehab #orthotics #orthsoes #trailrunning #physiotherapy #physicaltherapy #sportsmedicine

In this extended episode Talysha & Jackson talk about their experiences of undertaking post-graduate university studies, and share some insights to consider when deciding if formal post-graduate education is for you. Some of the questions & considerations discussed are: - Get real about your ability to engage in self-directed learning. - Return on investment - will the time, money & effort yield the results that you're after? - CPD activities vs formal education, pros and cons of both - and what may be more suited to your goals. Keen to learn more about managing musculoskeletal injuries? www.progressivepodiatryproject.com/p3me #podiatry #physiotherapy #university #alliedhealth #career #goals #alliedhealth #careerdevelopment #healthcare #unistudent

Dr Doug Ritchie & Rebecca Rushton aka The Blister Pod from @Blister-Prevention joins P3 to deep-dive further into the science, mechanics & management of blisters. In this episode Doug & Rebecca break down: - Are blisters a modern problem? - Walking & running mechanics and blisters - can altering gait play a role? - Where do shoes fit into the equation? - The 'ideal' sock for preventing blisters. - Orthoses (+ top covers) and their role in blister management. - The unique skills podiatrists have that can improve the management of blisters. To find out more head to https://www.progressivepodiatryproject.com/partners #blisters #running #trailrunning #barefootrunning #runninginjury #footwear #runningshoes #podiatry #physiotherapy

In this episode Talysha & Jackson give clinicians an insight into utilising the VAS (Visual Analog Scale - of Pain) & RPE (Rate of Perceived Exertion), to help your clients dose their rehabilitation exercises. 

The inverse relationship is very important for progressively loading tissue, to increase the load-tolerating capacity & restore function.
That is, as pain/reactivity decreases, applied load & complexity can increase.
By utilising the VAS - RPE we can help decrease the likelihood of a client 'over dosing' their rehabilitation exercises, leading to an injury flare. 

For a free resource to help you formulate exercise rehabilitation programs for your clients - download the Movement Prescription Blueprint
https://www.progressivepodiatryproject.com/blueprint

Want this episode to count towards your CPD? Watch via P3 for FREE (https://www.progressivepodiatryproject.com/freecpd) 
New Balance Technical Manager - Matt Spicer and Podiatrist & Orthotist - Sam Turner (aka That Football Podiatrist) joins P3 to talk all things footy boots and clinical practice.   

In this episode we explore: 
- Where are clinicians going wrong with their understanding of football boots in clinical practice?
- What influences client's purchasing decisions for footy boots?
- How can clinicians improve their understanding & recommendations of footy boots for their patients?
- The New Balance range (Tekela, Furon, 442) - Clinical insights & take-aways.  

Register your interest for P3's new subscription - Athletic Footwear for Health Professionals  
https://www.progressivepodiatryproject.com/afhp 

What is Athletic Footwear for Health Professionals?  Each month you'll hear from industry experts on all things footwear - from pathology to performance, we've got you covered.

#newbalance #football #soccer #afl #rugby #podiatry #physiotherapy #sportsmedicine #turf #footy #sportspodcast

In this extended episode Talysha & Jackson unpack 9 different ways you can modify an exercise to tailor our movement prescriptions from pathology management to improving performance. 

With each variable the team explain what it is, where it fits into your programming and how these variables fit into a clinical setting when it comes to tissue adaptations.

To grab your free rehab resource - head to https://www.progressivepodiatryproject.com/blueprint

1. Load
2. Reps
3. Sets
4. Rest
5. Frequency
6. Tempo
7. Range of Movement
8. Joint Angles 
9. Complexity

Grab our free rehab guide The Movement Prescription Blueprint - www.progressivepodiatryproject.com/blueprint

Today Talysha & Jackson tackle another common P3 Community question - "How many rehab exercises should we give our clients?"

Whilst the answer is very nuanced and it will vary from person to person, there are some factors we can consider that will help guide our decision for each client.

Time Stamps
2:30 What impacts how we answer this.
4:00 Prescribing behaviour impacts adherence.
9:00 Approaches for clients who don’t want to do rehab exercises.
12:30 Bang for Buck rehab exercises.
18:00 Some bang for buck exercises for runners.
22:45 Client accountability with rehab.
26:00 Final thoughts & clinical tips.

In this episode Talysha & Jackson answer a P3 Community question - "Does every musculoskeletal injury need rehabilitation exercises?"

The simple answer, no.
But we obviously want to shed some light on the nuance of where exercise therapies fit into managing musculoskeletal pathologies.
Sharing some case examples, questions to ask (both your client and yourself) and tips to help develop your critical thinking skills, this episode will definitely help you avoid falling into the illusion of action and move towards prescribing exercises with purpose.

If you'd like a free resource to help guide you through the exercise prescription through process, download the Movement Prescription Blueprint from www.progressivepodiatryproject.com/blueprint

Time stamps
4:00 Where do exercises fit into managing a musculoskeletal pathology.
5:40 Situations where we may or may not prescribe exercises therapies.
7:40 Using prescribed exercises to fill the Capacity Gap (and how do we identify if there is one & how much of one there is).
10:00 Are you prescribing treatments simply because of the Illusion of Action?
12:45 Prescribing for rehab vs prescribing for performance.
18:10 Transitioning exercise programming from rehab to performance

In this extended episode Talysha answers a P3 Community question - "What's the ultimate new grad's work-life balance".

This episode isn't just for new graduates, it's for anyone who is looking for work or who may not be as happy in their workplace as they thought they would be.

Getting somewhat philosophical, Talysha gives an insightful rundown into the fundamental needs we have as employees that contribute to our feelings of work satisfaction and ultimately influence how engaged we are in the workplace. 

Then we explore how we can use this information to find out what our ideal work-life balance is and how you can screen your prospective employers to get a better understanding if you're compatible with that organisation (before you're committed to a job that may not be for you!)

If you're joining us on Spotify - leave your answers in the poll for what contributes most to your work satisfaction.

When we think of physical rehabilitation, we often think of a younger athlete wanting to get back to their sport.
However, it is often overlooked and arguably more important for clinicians to pay attention to the functional capacity of our older clients after periods of illness, injury &/or immobilisation. 

In this episode Talysha shares some insights regarding the impact ageing has on our skeletal muscle and how this can be further amplified due to periods of immobilisation &/or inactivity.

Timestamps

03:00 The Capacity Gap - why we can neglect to consider the functional restoration of our older clients.

04:55 Senescence - what is it and how does it impact our functional capacity as we age.

09:45 What happens to our skeletal muscle as we age?

11:30 What happens to skeletal muscle as a result of age AND immobilisation?

16:15 Older vs Younger individuals - does disuse & immobilisation affect these groups differently?

22:20 What positive changes can we observe in skeletal muscle as a result of exercise & movement?

24:45 What can we do in the clinic to help our older clients live & age well?

To register your interest for our upcoming short course Therapeutic Movement & Functional Assessments for Older Clients head to www.progressivepodiatryproject.com/p3me

Can minimalist shoes help or hinder the recovery from plantar fasciopathy?

In this episode Australian Podiatrists Talysha @p3podiatry, Kirsty @theliftingpod & Aaron @aaronwilsonrehab discuss footwear, injuries & how they are related. 

Timestamps 

04:00 A study exploring minimalist shoes & improving running economy.
13:20 Who is/isn't suited to changing footwear to potentially improve running economy?
15:00 Should I transition to a minimalist shoe to reduce my risk of injury?
17:10 Where do things stand in regards to running injuries & shoe types?
20:20 What types of shoes contribute to different types of injuries?
21:40 Minimalist shoes & plantar fasciopathy - good or bad?
27:00 A bit of physiology, clinical reasoning & some literature exploring why minimalist shoes may help plantar fasciopathy (or make it worse).
32:00 How may we use footwear as a therapeutic intervention?
37:00 Take-aways

In this episode Podiatrist - Talysha discusses why sometimes the BEST rehabilitation exercises is actually NONE AT ALL.  

If you want to improve your patients' rehabilitation outcomes P3's Online Exercise Therapies course will help you do just that! https://www.progressivepodiatryproject.com/extxpp 

Timestamps 

02:56 Tissue stiffness vs compliance – what is it & why it matters in Achilles Tendinopathy & Plantar Fasciopathy.  
05:45 How age &/or diabetes can impact our Plantar Fascia & Achilles Tendon.
07:00 Why some runners won't need rehab exercises part 1.
11:02 How can we figure out if someone needs or doesn't need rehabilitation exercises?
17:00 Why some runners won't need rehab exercises part 2. 18:35 Why inactive people usually need rehab exercises &/or therapeutic movement.
20:30 Important clinical takeaways to improve your patient outcomes.  

#plantarfasciitis #heelpain #running #runninginjury #runninginjuries #orthotics #orthoses #sportsperformance #healthcare #podiatrist #podiatry #physio #physiotherapy #physiotherapist #footpain #plantarfasciopathy #alliedhealth #exercise #rehab #rehabilitation

In this episode Talysha discusses how assuming a person's plantar fasciopathy is purely a result of their biomechanics can short-change your treatment outcomes.
If their pathology is not purely a cause of their biomechanics, then what else can be contributing to the development?

Timestamps

08:29 Plantar fasciopathy risk factors - more than biomechanics.

10:15 What loads contribute to the development of plantar fasciopathy?

12.20 Vital elements of our clinical history that can predict poor outcomes.

14:30 How our history influences our treatment narratives.

17:00 what can we do instead of a biomechanical assessment?

In this episode Talysha is joined by Hamish Vickerman - Physiotherapist, inventor of the @fasciitisfighter  

Talysha & Hamish discuss;

- What is the Fasciitis Fighter.
- What research inspired the Fasciitis Fighter.
- Clinical insights into plantar fasciopathy rehabilitation & management.

If you're a clinician wanting to advance your knowledge, skills & confidence formulating EFFECTIVE rehabilitation for your plantar fasciopathy clients, head to https://www.progressivepodiatryproject.com/pfmasterclass 

To find out more about the Fasciitis Fighter head to www.fasciitisfighter.com.au  

Time Stamps 

07:15 Some theory behind rehabilitation exercises for plantar fasciitis.
08:20 Dosing rehabilitation exercises.
10:15 Calm things down vs Build things up - when is it appropriate to load the plantar fascia in rehabilitation?
11:30 What are some ways we can 'calm down' an aggravated plantar fascia?
13:30 Progressing rehabilitation & the fasciitis fighter.
19:00 Dosing rehabilitation & rehab considerations.
21:00 Giving your injured self (or clients) permission to move.
22:30 In rehab, why less is sometimes more.  

If you're a clinician wanting to advance your knowledge, skills & confidence formulating EFFECTIVE rehabilitation for your plantar fasciopathy clients, head to https://www.progressivepodiatryproject.com/pfmasterclass 

To find out more about the Fasciitis Fighter head to www.fasciitisfighter.com.au  

In this episode Talysha discusses an all-too-often overlooked element of managing chronic musculoskeletal pathologies - that is, psychological load.  

Our load-tolerating capacity isn't just in relation to physical load, psychological load is equally (if not more) important for many of our clients.

So what does this look like in a clinical setting and why is it important?

In this episode New Balance Technical Representative - Matt Spicer, joins Talysha discussing the current New Balance range.

From the staple footwear that makes up a podiatrist's recommendation list, to the new performance range, this episode gives a great update to clinicians to help with your footwear referrals. 

Shoes covered: 1080, 880, 860, Fresh Foam More, Fresh Foam More Trail, Hierro, Fuel Cell Rebel, RC Elite, Supercomp Trainer.

Clinicians are often faced with the uncertainty of HOW to load an injured tissue as part of their therapeutic exercise prescriptions.

In this episode Talysha explores one approach that will begin to simplify the process and improve your confidence when it comes to identifying what exercise(s) will formulate your rehabilitation programs.
The key word here is FUNCTION.

When a client fails to engage or adhere to our management plans because we've failed to link OUR therapeutic goals to THEIR goals, that's on us.

In this episode Talysha explores;

• What are Therapeutic Goals
• How they differ from Client Goals
• Why we need to be able to link Therapeutic Goals to Client Goals
• The process clinicians can follow to link these goals & implement successful management plans.

In this episode Talysha explores how what we focus on during the initial consultation can either set us up for success, or fast-track to treatment failure.

When clinicians approach chronic & complex musculoskeletal pathologies through a purely biomedical lens, KEY elements can be missed, leading to ineffective management. 

Talysha will guide you through some essential questions to ask your clients during the initial assessment, and how to use their answers to formulate your management plan to achieve great clinical outcomes.

In this episode Talysha shares some insights regarding how we can manipulate foot positioning of the calf raise for more targeted rehabilitation responses.

When it comes to rehabilitation, we know that WHAT you are doing with your exercise prescription will yield specific tissue adaptations, but also HOW you perform your exercise can broaden the scope even more.   

By performing the calf raise in either ABducted or ADducted positions, we can improve our outcomes when managing calf strain injuries.
In addition to lateral ankle sprain and even posterior tibial tendon dysfunction rehabilitation.

Ben Cormack from Cor-Kinetic & The Better Clinician Project joins Talysha for an insightful discussion around the application of the Biopsychosocial Treatment Paradigm.

- Where are we going wrong with its application?

- Where are we going right?

- How can clinicians start to improve their patient care via a more person-centered approach?

In this episode, Talysha and Jackson discuss:

1. Jackson's top 3 social media pages that he follows that are podiatry industry related and more clinically focussed

2. Talysha's top 3 social media pages that she follows that are podiatry industry related but more research focussed

3. Career / motivation related pages

Join the conversation on social media using #P3podcast

In this episode, Talysha and Jackson discuss:

1. Strength and conditioning vs rehabilitation- are they the same thing?

2. The benefits of integrating the two disciplines

3. Some of the nuances of S+C vs Rehab, and how they are relevant to podiatry

Join the conversation on social media using #P3podcast

In this episode, Talysha and Jackson discuss:

1. Jackson's top 3 mistakes so far in podiatric practice with specific examples

2. Talysha's top 3 mistakes so far from a podiatry career point of view

3. Some of the lessons learned and take-aways from these mistakes

Join the conversation on social media using #P3podcast

In this solo episode Talysha explores how a clinician's decision to rest &/or immobilisation an injury can do more harm than good.

Topics covered:

- 'Overdosing' our rest/immobilisation can lead to prolonged recovery times, impaired functional restoration & potentially increase the risk of re-injury.

- Impact of overdosing rest/immobilisation on recovery from acute & chronic injuries.

- What is 'minimal effective dose' when it comes to managing musculoskeletal pathologies?

In this solo episode Talysha shares some insights into how we can help our client navigate their exercise rehabilitation (& dosage) in the presence of pain. 

When it comes to allied health practitioners 'dosing' exercises in both a rehabilitation and performance setting, there are various ways in which we can monitor the client's response to our dose.  

Topics discussed include;

- External loads for triggering adaptation with exercises. 

- Internal loads for monitoring load (inc heart rate & RPE)

- Building patients' self-efficacy via encouraging self-dosing exercise rehabilitation

We have tried to clean up the audio after some mic tech issues, apologies if the quality is a little lax.

In this episode, Talysha and Jackson discuss:

1. The benefits of social media for your career and business

2. The top 5 strategies for driving engagement on social media

3. How social media and clinical practice are very similar

Join the conversation on social media using #P3podcast

In this episode, Talysha and Jackson discuss:

1. The 5 ways to improve your confidence as a practitioner in prescribing exercises to your clients

2. The Exercise Therapies in Podiatric Practice online course

3. What "confidence" in prescribing exercises really means and allows you

Join the conversation on social media using #P3podcast

In this episode, Talysha and Jackson discuss:

1. Why do podiatrists struggle with exercise adherence?

2. The difference between adherence and compliance

3. The four ways to improve your clients' exercise adherence- collaboration, communication, keeping it simple and following up/building rapport

Join the conversation on social media using #P3podcast

In this episode, Talysha and Jackson discuss:

1. Quality vs quantity- two ways of approaching clinical practice, and the pro's and con's of each.

2. Is your clinic a production line, and how does this look to your clients?

3. How do you know which model will suit you best?

Join the conversation on social media using #P3podcast

In this episode, Talysha and Jackson discuss:

1. The benefits of having longer consultations- how more time with our clients gives us the best chance of success.

2. The importance of going slow to go fast, when it comes to career success.

3. Structuring your clinical day to get the most out of it, and prioritising what refuels and recharges you.

Join the conversation on social media using #P3podcast

Welcome to the very first episode of the Progressive Podiatry Project!

In this episode, Talysha and Jackson answer:

1. What is the Progressive Podiatry Project, exactly?

2. Who is the Progressive Podiatry Project for?

3. What can you expect from this podcast?

Join the conversation on social media using #P3podcast