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Recent Episodes
Is Physical Therapy Worth the Cost for Plantar Heel Pain? A 3-Year Answer
In this episode of the Hands-On, Hands-Off Podcast, Dr. Trenton Rehman sits down with Dr. Shane McClinton to discuss plantar heel pain and the role of physical therapy in both clinical outcomes and healthcare costs.Dr. McClinton walks through a series of studies stemming from his doctoral research, including a randomized clinical trial, a detailed case series, and a three-year cost-effectiveness analysis. Together, they explore how adding physical therapy to usual podiatry care impacts pain, function, quality of life, and long-term costs.Key themes include manual therapy, impairment-based exercise, proximal contributions to heel pain, interdisciplinary collaboration, and why plantar heel pain may deserve the same clinical mindset as low back pain.Key Takeaways (Listener-Facing)Plantar heel pain is a multidimensional condition with local and proximal contributors.Adding physical therapy to usual podiatry care improved outcomes and reduced costs over three years.Manual therapy and exercise were delivered pragmatically and tailored to impairments.Strengthening may be underutilized in plantar heel pain management.Collaboration between physical therapists and podiatrists benefits patients and reduces downstream burden.⏱️ TIMESTAMPED CHAPTERS (YouTube + Podcast)00:00 – Introduction to the episode and guest00:01 – Dr. Shane McClinton’s background and research focus00:03 – Why plantar heel pain referrals to PT are low00:07 – Rationale for studying cost-effectiveness00:10 – Study design overview (RCT + pragmatic approach)00:15 – Description of podiatry-only vs podiatry + PT care00:17 – Inclusion and exclusion criteria00:22 – Case series: why eight different heel pain presentations00:26 – Manual therapy strategies used in the study00:30 – Clinical practice guidelines and decision-making00:32 – Pain mechanisms, education, and chronicity00:35 – Proximal vs local treatment decisions00:38 – Three-year cost-effectiveness results explained00:44 – Implications for referrals and collaboration00:48 – Final take-home message from Dr. McClinton
Low Back Pain Doesn’t Have to Be Confusing | Andreas Remis
Andreas Remis joins the podcast to unpack low back pain in a way that finally makes sense — bridging APTA CPG classifications, real-world clinical diagnosis, and the confusing world of radiographic findings.As faculty across multiple fellowships and residencies within the Duke Health System — and an educator shaped by his own poor rehab experience as a patient — Andreas brings a thoughtful, grounded approach to one of PT’s most complex conditions.In this episode:• LBP classification: CPG vs imaging vs clinical reasoning• How expert clinicians simplify diagnosis• Why radiographs often mislead clinicians and patients• The turning point when PTs begin to feel “value-confident”• Teaching LBP across OMPT pipelines• Lessons Andreas learned from being a failed patientIt’s a must-listen episode for clinicians, residents, and fellows treating low back pain.
Directional Preference When Time Matters | Josh Kidd
When the cost of delay is measured in millions of dollars and operational readiness, guesswork isn’t an option.In this episode, we sit down with Josh Kidd, physical therapist, researcher, residency director, and embedded clinician working with special operations personnel and fighter pilots. Josh shares how directional preference plays a central role in clinical decision-making when time, performance, and safety all matter.We explore what directional preference actually is (and what it isn’t), why it should be viewed as an assessment rather than an exercise, and how inconsistent definitions in the research have led many clinicians to misunderstand or abandon it altogether.Josh also walks through real-world data from a tactical setting, where his team has used directional preference to help service members return to duty 36% faster, while empowering patients to self-manage and reducing recurrence.This conversation connects research, clinical reasoning, and performance-based care—challenging clinicians to rethink not just what they do, but how they think.???? In This Episode, You’ll Learn:Why directional preference matters beyond the spineThe most common misconceptions clinicians have about directional preferenceHow inconsistent research definitions affect real-world practiceHow directional preference can guide prognosis and return-to-duty decisionsWhat clinicians can learn from high-stakes military performance environmentsOne mindset shift that can immediately improve clinical reasoning
Trauma-Informed & Psychologically Informed Care in PT with Faith Stokes
Faith Stokes joins the podcast to talk about treating the patients many clinicians feel least prepared for — those navigating trauma, addiction, suicidality, chronic pain, pelvic health conditions, and complex biopsychosocial presentations.Faith practices in rural North Georgia, where she blends manual therapy, psychologically informed care, and lifestyle medicine. As a residency coordinator and adjunct faculty across multiple programs, she’s passionate about helping clinicians develop clarity when treating patients whose stories involve trauma, fear, avoidance, social instability, or chronic stress.In this episode:• Simple vs. complex PTSD in clinical practice• Why trauma-informed care is essential in OMPT• Yellow flag screening and why it’s our responsibility• The PT’s role in addiction and suicidality• Integrating pelvic health with orthopedics and manual therapy• Using lifestyle medicine without shame or judgment• How experts reason through overwhelming complexityThis is a deep, human, and incredibly practical conversation for every PT.
OMPT vs MDT Is the Wrong Debate!
Dr. Moyo Tillery sits down with Dr. Ron Shank to explore the evolving relationship between Orthopaedic Manual Physical Therapy (OMPT) and Mechanical Diagnosis & Therapy (MDT). Drawing from decades of clinical practice, mentorship, and research, Ron reframes the debate — arguing that integration, not ideology, leads to better patient outcomes.Together, they unpack directional preference, centralization, test–retest frameworks, patient empowerment, and the leadership principles that shape great clinicians. This is a must-listen for anyone navigating modern manual therapy practice.Key Topics Covered:Directional preference vs centralizationEnd-range testing as common groundHands-on vs hands-off decision-makingPatient self-efficacy and dependencyMentorship, leadership, and legacy in OMPT
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