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In this episode, I'm breaking down how extremity becomes identity. When you live at the very edge of your craft, you stand apart from the dabblers who only do it halfway. I share how, back in my basketball days, players admired Kobe Bryant's extreme work ethic even though most couldn't match it. To make something part of your identity, you don't have to be the only one doing it, you just have to take it further than anyone else. I'll explain how to push to that level so your extreme becomes who you are. Show Notes: [03:07]#1 Things you do at the extreme are how people come to define you. [10:47]#2 Repetition at the edges forces recognition. [17:54]#3 Extremity creates separation. [25:28]Recap Next Steps: ---
Metal on Merseyside are thrilled to announce our next major event, which is taking place in conjunction with BLACK LABEL Production and complements the KL Metal Mayhem festival UK edition. Crossing Borders: Metal Music Scenes and Extremity is a one-day event at Liverpool John Moores University that will take place on Friday 3rd October between 9.30am and 5pm. It will feature presentations and panel discussions from metal music academics and industry practitioners. Tickets for this daytime event are free and lunch and refreshments will be provided. But, it is important that you sign up for your ticket so that we can gauge numbers. https://www.tickettailor.com/events/blacklabelproduction/1818929
Doug's Sermon for today.
Welcome to Season 2 of the Orthobullets Podcast.In this episode, we review the high-yield topic of Lower Extremity Os from the Foot & Ankle section.Follow Orthobullets on Social Media:FacebookInstagramTwitterLinkedInYouTube
Find out more: https://functionalextremitieschiropractor.com drkyle@iceclinics.com Summary In this episode of The ChiroCandy podcast, host Billy Sticker sits down with Dr. Kyle Bryant as he shares his journey into chiropractic, focusing on extremity adjusting. He discusses the impact of his early experiences, the development of a specialized system for treating extremity injuries, and the importance of building referral networks. Dr. Bryant also introduces his Functional Extremities Chiropractor (FEC) program, aimed at educating other chiropractors and enhancing patient care. The conversation highlights the potential of chiropractic to address a wide range of health issues and the importance of community feedback in refining practice methods. Takeaways Dr. Bryant became a Certified Chiropractic Extremities Practitioner (CCEP) early in his career. Dr. Kyle emphasizes the importance of connecting extremity issues to spinal health. The FEC program aims to educate chiropractors on extremity adjusting techniques. He encourages chiropractors to join the community and provide feedback on the FEC program. Case Study #1: https://go.chirocandy.com/case-study Case Study #2: https://www.youtube.com/watch?v=po2nWAaKcho
On this episode of physical media reviews, Nadine Whitney & Andrew F Peirce delve into some of the major releases from Umbrella Entertainment. They kick off the discussion looking at Jamie Blanks Ozploitation throw back gorno flick Storm Warning, before taking a darker dive into the mammoth New Extremity Collection which features High Tension, Anatomy of Hell, Frontier(s), and Martyrs. Finally, they dive into one of the must have physical releases of the year, Tarsem's The Fall.Physical media copies were provided by Umbrella Entertainment for honest reviews.Follow us on Instagram, Facebook, and Bluesky @thecurbau. We are a completely independent and ad free website that lives on the support of listeners and readers just like you. Visit Patreon.com/thecurbau, where you can support our work from as little as $1 a month. If you are unable to financially support us, then please consider sharing this interview with your podcast loving friends.We'd also love it if you could rate and review us on the podcast player of your choice. Every review helps amplify the interviews and stories to a wider audience. Hosted on Acast. See acast.com/privacy for more information.
On this episode of physical media reviews, Nadine Whitney & Andrew F Peirce delve into some of the major releases from Umbrella Entertainment. They kick off the discussion looking at Jamie Blanks Ozploitation throw back gorno flick Storm Warning, before taking a darker dive into the mammoth New Extremity Collection which features High Tension, Anatomy of Hell, Frontier(s), and Martyrs. Finally, they dive into one of the must have physical releases of the year, Tarsem's The Fall.Physical media copies were provided by Umbrella Entertainment for honest reviews.Follow us on Instagram, Facebook, and Bluesky @thecurbau. We are a completely independent and ad free website that lives on the support of listeners and readers just like you. Visit Patreon.com/thecurbau, where you can support our work from as little as $1 a month. If you are unable to financially support us, then please consider sharing this interview with your podcast loving friends.We'd also love it if you could rate and review us on the podcast player of your choice. Every review helps amplify the interviews and stories to a wider audience. Hosted on Acast. See acast.com/privacy for more information.
SAMPLER & SANS REPROCHES (Radio broadcast)Playlist N° 1362 - Lundi 19 Mai 2025 - Horaire : 20h00-22h00EBM - DARKTECHNO - INDUSTRIEL & RELATED MUSICGALAXIE RADIO 95.3FM --- www.galaxieradio.fr [ S&SR Selection de la semaine... MY LOVE KILLS "Mors Nobis" (Progress Productions)] MY LOVE KILLS "Disgrâce" DIG Album : Mors Nobis (Progress Productions) AUTODAFEH « Never Say Never» DIG Album : Greed (Scanner) BATTERY 73 "Morality" DIG Album : LXXIII (Autoproduction) LUCIFER'S AID "Deep Inside 2" DIG Album : Enter And Exit (Progress Productions) KLANGSTABIL "Math & Emotion (The Square Root Of One)" DIG Album: Chronik (Ant-Zen) MEMORIA Feat MAJESTOLUXE « Closer » DIG Single : Closer (Autoproduction) HOLON "A Chance At A Fresh Start" DIG Album : Distributed Consciousness (Autoproduction) SHIPS IN THE NIGHT « Inside » DIG Album : Protection Spells (Metropolis Records) OXYD « Retrospective (Triode edit) » DIG Compilation : Hydra (Aliens Productions) TRIODE "Erase Mind (Meets HEADREAMER)" DIG Album : Demolition (Aliens Productions) LA MACHINE « Voyageurs Electriques » CD : Contrôle Total (BOREDOMproduct) HARDWARE PULSE "Future Frequency" DIG Album : Teknotix (Werkstatt Recordings) KHMAR "Mangler (Dima Donskoi Remix)" DIG Album : Doom (ScentAir Records) AH-CAMA SOTZ "The Cycle Trusn, The Night Is Done" DIG Album: Blood Moon (Bats & Cats) TRAUMA PHASE "Extremity" DIG EP: V (1984Audio) MY LOVE KILLS "Absolution" DIG Album : Mors Nobis (Progress Productions) TWIN TRIBES "Monolith (TOBIAS BERNSTRUP Remix)" DIG EP: Monolith Remixes V (Autoproduction) MINUIT MACHINE "I Don't Give Damn" DIG Album: Queendom (Synth Religion) PUBLIC IMAGE LTD."Animal" BOX CD : Album (Virgin) PUBLIC IMAGE LTD."The Order Of Death" LP: This Is What You Want... This Is What You Get (Virgin) DIVIDER "Reciprocate (R010R Remix)" DIG Single: Reciprocate (Re:Mission Entertainment) TORUL "Wish Upon A Star" DIG Album Superposition (Infacted Recordings) THX TO : PROGRESS PRODUCTIONS (Torny), SCANNER / DARK DIMENSIONS (Frank), ANT-ZEN (Stefan ALt), MAJESTOLUXE (Conny), HOLON (Mark Rydyger), METROPOLIS RECORDS (Gary Levermore), ALIENS PRODUCTIONS (Peter Ryby), WERKSTATT RECORDINGS (Toxic Razor), SCENTAIR RECORDS (Vladimir), AH-CAMA SOTZ (Herman), PERSONA GRATA (Xavier & Alison), THE BLACK LAB (Mic)PODCAST:YOUTUBE https://www.youtube.com/@SamplerEtSansReprochesYOUTUBE CHANNEL – NON STOP MUSIC -MIX ONLY + LIVE & INTERVIEWS REPORTS ITUNES :https://podcasts.apple.com/fr/podcast/sampler-sans-reproches/id1511413205 MIXCLOUD : https://www.mixcloud.com/SetSRradio/PODCLOUD :https://podcloud.fr/studio/podcasts/sampler-et-sans-reproches DEEZER :https://www.deezer.com/fr/show/1181282 GALAXIE RADIO http://galaxieradio.fr/ go to replay Sampler & Sans ReprochesAMAZON MUSIC https://music.amazon.fr/podcasts/9718c2fe-d841-4339-a3e5-82c31d018ed7/SAMPLER-SANS-REPROCHESHEARTHIS https://hearthis.at/sampler-sans-reproches/ ARCHIVE.ORG
Wow. This is the kind of week that can yield powerful results. Extremity and aggression is likely. Confrontation, moving with discomfort and blatant displays of taking the cake will be in the air. Use it for yourself to make goals happen and be cautious of the unhinged cuz we will see that out in the world. Be safe out there and be well my friends.SPIRITUAL WARRIOR TRAINING VOL 7 - BECOMING THE VESSEL - 4 WEEK TRAINING STARTS APRIL 27 NEXT SUNDAYLEARN MORE ABOUT OAK & OAK ASTROLOGY SCHOOL Private readings, teachings, classeshttps://bio.site/oak.kalawakan
This week on Comics and Chronic we're joined by some very special guests, hosts of fellow comic book pod The Oblivion Bar Podcast, Chris Hacker and Aaron Knowles! We're discussing Wonder Woman Dead Earth with story & art by Daniel Warren Johnson. “From DC's critically acclaimed Black Label line, Daniel Warren Johnson, the celebrated creator of Murder Falcon and Extremity, mixes sci-fi and fantasy into a harrowing post-apocalyptic vision of Wonder Woman. When Diana awakens from a centuries-long sleep, she discovers Earth has been reduced to a nuclear wasteland. Now she's marooned in a dark and dangerous future, protecting the last human city from titanic monsters and struggling to uncover the secret of this dead Earth...and how she may be responsible for it."We start the episode off by thanking Chris & Aaron for their service
Welcome to Season 2 of the Orthobullets Podcast.Today's show is Foundations, where we review foundational knowledge for frontline MSK providers such as junior orthopaedic residents, ER physicians, and primary care providers.This episode will cover the topic of Metastatic Disease of Extremity, from our Pathology section at Orthobullets.com.Follow Orthobullets on Social Media:FacebookInstagram TwitterLinkedInYouTube
On today's episode, I talk to comics creator Daniel Warren Johnson. Originally from Massachusetts, Daniel started in the world of cartooning with his web-comic Space Mullet, which ran from 2012 to 2017. This led to work at Dark Horse, and eventually Image published his comic Extremity, which netted him an Eisner Award nomination (he would go on to win four for other things). Since then, he's created a number of other series for Image including Murder Falcon, Do a Powerbomb and his latest The Moon is Following Us. In addition, Daniel is writing (and doing some of the art for) the new Transformers series for Skybound, and it's a delight! This is the website for Beginnings, subscribe on Apple Podcasts, follow me on Twitter. Check out my free philosophy Substack where I write essays every couple months here and my old casiopop band's lost album here! And the comedy podcast I do with my wife Naomi Couples Therapy can be found here! Theme song by the fantastic Savoir Adore! Second theme by the brilliant Mike Pace! Closing theme by the delightful Gregory Brothers! Podcast art by the inimitable Beano Gee!
Watch this as a full video episode on YouTube!Nicholas Binge is a bestselling author of speculative thrillers, literary science fiction, and horror. His novels include Extremity (2025), Dissolution (2025), Ascension (2023) and Professor Everywhere (2020). Binge is based in Edinburgh, UK, where he also lectures in creative writing.Regular listeners will know Nick as he has been on the pod not once but twice (does this make him our first three-peat guest?) We had a great chat with Nick, hearing about the influences on his new speculative thriller, Dissolution, out now!Links:Buy Dissolution nowFollow Nick on BlueskyVisit Nick's websiteSupport us on Patreon and get great benefits!: https://www.patreon.com/ukpageonePage One - Extra and Page One - The Writer's Podcast is brought to you by Write Gear, creators of Page One - the Writer's Notebook. Learn more and order yours now: https://www.writegear.co.uk/page-oneFollow us on FacebookFollow us on InstagramFollow us on BlueskyFollow us on Threads Hosted on Acast. See acast.com/privacy for more information.
Some betrayals do more than take money. They shatter trust in ways that can never fully be repaired. I sat down with Charlie Webster, the host, producer and writer of the top international podcast, Scamanda, to break down the shocking deception behind the story and the emotional damage it left behind. Amanda Riley didn't just lie about having cancer. She built an entire identity around it. She shaved her head, posted hospital photos, and wrote heartfelt blog updates, all while collecting over $100,000 in donations. But what makes someone go to such extremes? And how does that kind of deception affect the people who believed in her? Charlie shared what it was like to uncover Amanda's story, exposing how someone so seemingly normal managed to fool so many for so long. We explored the psychology behind these kinds of lies—why people are drawn to them, how victims struggle to process the betrayal, and what Amanda's case reveals about manipulation, trust, and the stories we tell ourselves. We also talked about Amanda's husband, Corey. Did he know? Should he have? And what does this entire saga say about the way we judge people based on the image they present? If you've ever felt deceived, questioned your instincts, or wondered how far someone would go for validation, this episode will make you think twice about what we choose to believe and why. Episode Breakdown: 00:00 Introduction 05:01 The Complexity of Human Behavior in Scamanda 07:11 The Intrigue of Amanda Riley's Story 10:47 The Emotional Impact on Victims 15:01 The Relatability and Extremity of Amanda's Actions 18:01 The Nuances of Amanda's Deception 23:32 Amanda Riley's Identity and Motivation 30:43 The Function of Dysfunctional Behaviors 36:03 The Reality of Amanda's Actions and Empathy 38:31 The Importance of Public Awareness 41:07 Why Amanda Agreed to Speak with Charlie Links Watch Scamanda Hulu https://www.hulu.com/series/f4ec2a4c-e234-4658-8728-1d17d1725b89 Watch Scamanda on ABC https://abc.com/show/1056ec91-9c44-4671-ae98-3c9feb3f35b3 Listen to Scamanda podcast wherever you get your podcasts https://podcasts.apple.com/us/podcast/scamanda/id1685691481 Connect with Charlie Webster: Instagram @charliewebster Website www.charliewebster.com Why It's OK to Talk About Trauma book https://amzn.to/41F5OUy Connect with Dr. Z: https://www.drjaimezuckerman.com/ https://www.zgrouptherapy.com/ https://www.instagram.com/dr.z_psychologist/ https://www.tiktok.com/@dr.z_psychologist https://www.youtube.com/@DrJaimeZuckerman Get my FREE breathing exercise here: http://www.drjaimezuckerman.com/newsletter Register for my on demand virtual courses here: http://www.drjaimezuckerman.com/workshops Order my workbooks! *Find Your Calm / Find Good Habits* http://www.drjaimezuckerman.com/books Shop my new Mindfully Messy hoodie here: http://www.drjaimezuckerman.com/apparel Podcast production and show notes provided by HiveCast.fm
In this episode, we review the high-yield topic of Lower Extremity Innervation from the MSK section.Follow Medbullets on social media:Facebook: www.facebook.com/medbulletsInstagram: www.instagram.com/medbulletsofficialTwitter: www.twitter.com/medbullets
Welcome to Season 2 of the Orthobullets Podcast. Today's show is Core, where we review Core Knowledge for Orthopaedic Surgeons. This episode will cover the topic of Metastatic Disease of Extremity, from our Pathology section at Orthobullets.com. Follow Orthobullets on Social Media:FacebookInstagram TwitterLinkedInYouTube
“The Extremity of Love: On Homer's Achilles” By Dr. Stephen Shivone Tutor at Thomas Aquinas College, New England January 18, 2025
Two episodes in a week? We're back again with an all homework episode. After catching up, we talk about Dear Santa, Transformers One, Red One, That Christmas, Christmas Vacation, Vacation, Jackpot, Monkey Man, The Beekeeper, My Old Ass, Wolfs, Beetlejuice Beetlejuice, Snack Shack, Juror #2, Super/Man: The Christopher Reeve Story, Will and Harper, Creature Commandos, Skeleton Crew, Shrinking, Starman, Klaus, Nailbiter, Do A Powerbomb!, Extremity, The Worst Ship In The Fleet, In, Superman: Jonathan Kent, and Skyward. This week's featured song is "Upper Riffspiratory Infection" by Oh The Humanity! You can find them at: Instagram | Facebook | Bandcamp | Spotify | Twitter/X Check us out at our website and on social media. Don't forget to rate and review the podcast on iTunes.
In the US, there are over 150,000 lower extremity amputations each year, adding up to 300-500 amputations per day. Over half of amputations are due to vascular causes, and those who experience this type of amputation are at higher risk for various complications, including higher mortality rates. Given these statistics, it is of optimal importance for us as rehabilitation professionals to take on a multifaceted approach from the beginning, and focus on giving our patients the tools to continue on with healthy habits and continued mobility when they leave our care. Physical and Occupational therapy professionals play an integral role in improving the lives and outcomes of those who have experienced lower extremity amputation, and through this podcast you will learn some valuable information for your toolkit to improve functional success when working with this population. To view accreditation information and access completion requirements to receive a certificate for completing this course, please click here. The content of this Summit podcast is provided only for educational and training purposes for licensed physical therapists and occupational therapists. This content should not be used as medical advice to treat any medical condition in either yourself or others.
About the Guest(s): Dr. Kyle Bryant is a respected chiropractor and expert in functional extremity adjusting, currently operating in Kennewick, Washington. He is a Certified Chiropractic Extremities Practitioner (CCEP) with extensive experience in integrating low-level laser therapy into chiropractic treatments. After beginning his chiropractic journey in Ireland, where he served as a team chiropractor for a traveling sports team, Dr. Bryant further honed his skills in Spokane, Washington. He has recently launched Functional Extremities Chiropractor (FEC), a robust training program for professionals aiming to specialize in extremity and joint care. Episode Summary: Join Dr. Chad Woolner and Dr. Andrew Wells in this enlightening episode of the Laser Light Show as they explore the intersection of chiropractic care and low-level laser therapy with special guest Dr. Kyle Bryant. Known for his expertise in functional extremity adjusting, Dr. Bryant shares insights about his newly launched program and the unique integration of laser therapy in his practice, ICE (Integrative Chiropractic and Extremities). Dr. Bryant discusses how his foundational experiences with sports injuries led to a passion for chiropractic care, particularly extremity adjustments. Through his Functional Extremities Chiropractor program, he aims to educate practitioners on handling extremity and joint issues effectively. The discussion highlights the complementarity of low-level laser therapy with chiropractic treatments, showcasing how these modalities can expedite patient recovery and enhance treatment outcomes. By stacking therapies like chiropractic adjustments and laser treatments, practitioners can offer comprehensive care that improves patient satisfaction and increases clinical efficacy. Key Takeaways: Dr. Bryant has launched the Functional Extremities Chiropractor program, designed to educate practitioners on effective extremity adjustments. Integration of low-level laser therapy with chiropractic adjustments can significantly expedite recovery and enhance treatment outcomes. The FEC system helps identify proprioceptive deficiencies in patients, allowing tailored treatments to improve joint function and alleviate pain. Laser therapy provides a non-invasive method to restore function and mitigate symptoms, benefiting a wide range of patient conditions. The combination of techniques and the systematic approach in Dr. Bryant's practice maximizes the physiological benefits for patients. Notable Quotes: "The FEC system helps chiropractors gain confidence by understanding how the biomechanical side of extremities influences the spine and vice versa." "Lasering the brain in conjunction with an extremity issue can help restore function as opposed to merely alleviating pain." "One of the biggest takeaways from chiropractic care combined with laser therapy is that there's only an upside potential." "With lasers, you can expand your ability to help a wider range of conditions walking through your door." "The goal is to find the source of issues, not only to relieve pain but to restore functionality." Resources: Functional Extremities Chiropractor Program: functionalextremitieschiropractor.com Clinic: Integrative Chiropractic and Extremities (ICE) Mentioned Practitioners: Dr. Trevor Berry, Dr. Brandon Brock, Dr. Kurt Gehr, Dr. Kristin Heischetter, Dr. Rob Silverman, Dr. Dan Murphy. Functional Health Mastery Delve into this episode to uncover a wealth of approaches on how low-level laser therapy can revolutionize extremity care in chiropractic practice and stay tuned for more enlightening content from the Laser Light Show.
We celebrated the Acme Comics Downtown One Year Anniversary on October 28th! To celebrate the conclusion of an incredible day we sat down with our guest for the weekend, Daniel Warren Johnson to record the first ever AcmeCast with a LIVE STUDIO AUDIENCE! Thank you everyone who made the weekend one to remember!
Dean's Chat hosts, Drs. Jeffrey Jensen and Johanna Richey welcome Dr. Lance Wissman to Dean's Chat. Dr. Wissman is faculty at the Arizona College of Podiatric Medicine (AZCPM). Dr. Wissman teaches the Lower Extrematy Anatomy and Dissection course, arguably the most important course taught at AZCPM! Dr. Wissman received his Bachelor degree at Michigan State University. He completed his Doctorate in Podiatric Medicine at the Scholl College of Podiatric Medicine at Rosalind Franklin University. He paracticed in both Michigan and Arizona before becoming faculty at AZCPM! Outside of podiatry, Lance enjoys music! He has electic tastes that are highlighted in this episode! Dr. Wissman also discusses the diverse experiences and opportunities within podiatric medicine, giving back to the profession by writing board exam questions, and assisting other Colleges of Podiatric Medicine with their curriculum! Enjoy this engaging conversation with a world leader in lower extremity anatomy! https://www.apmsa.org/ https://bakodx.com/ https://bmef.org/ www.explorepodmed.org https://podiatrist2be.com/ https://higherlearninghub.com/
As another exciting NFL season kicks off, Sports Medicine community members and fans alike continue to ponder whether the risk of lower extremity injury is higher on artificial turf versus grass. We welcome UCSF's Chief of Sports Medicine & Shoulder Surgery and host of the podcast 6-8 Weeks: Perspectives on Sports Medicine, Dr. Brian Feeley, MD to discuss his team's recent publication in OJSM examining this very question.
New? Not so much. French? Absolue! Extremity? Not for long. Join us as we explore the surprising twists and turns of this horror masterpiece directed by a real piece of work. That's right, it's Pascal Laugier's 2008 masterpiece: Martyrs. Are we all victims, monsters, or dancers? You be the judge, then witness your own guilt... or something. Bourgeoisie!
Chuck Dowell, PA-C discusses the increase in pickleball injuries seen with the increasing popularity of the sport. Achilles tendon ruptures and gastroc injuries or Achilles tendinopathy injuries are common. In this case study, a novice pickleball player was pushing off on his right leg, felt a pop within the right calf/Achilles tendon area, and was unable to continue to play. When do we need to do an ultrasound? When can Physical Therapy begin? How do we counsel the patient on recovery time?
In this week's episode, Bob, Joey, Aaron, and Steve walk the Witch's Road with Agatha All Along, waddle alongside The Penguin, witness the Twilight of the Gods, settle the Crocs controversy, and is the Moon Following Us?Books: Planetary #1-12, The Moon Is FOllowing Us #1, Extremity #1-6, The Power Fantasy #2, Avengers Assembly (OGN), Dazzler #1, X-Men #130, Fantastic Four #94Other Stuff: Agatha All Along Episodes 1 & 2 (No spoilers), The Penguin Episode 1 (No spoilers), Twilight of the Gods (TV series), Blink Twice (movie), Cuckoo (movie), Terminator Zero (TV series), How to Die Alone (Hulu TV series)The Comic Book Podcast is brought to you by Talking Comics (www.talkingcomicbooks.com). The podcast is hosted by Steve Seigh, Bob Reyer, Joey Braccino, Aaron Amos, Chris Ceary, and John Burkle who weekly dissect everything comics-related, from breaking news to new releases. Our Instagram handle is @TalkingComicsPodcast and you can email us at podcast@talkingcomicbooks.com.
The Florida Years: The Untold Story of drummer, Aesop DekkerDrummer Aesop Dekker shares his story for the first time, reflecting on his formative years in Florida. He recounts growing up in Hollywood, FL, and his early music experiences, including his time in the band SLA and White Riot, which later evolved into Fuckboyz, also known as the F Boyz. Aesop relocated to California in the late 1980s, further establishing himself in the music scene by playing in notable bands such as: Hickey, Agalloch, Extremity, Khôrada, Vhol, Worm Ouroboros, Nostalgist, Ludicra, and more! [Recorded on 09/02/2024]☞ Follow Florida Sound Archive on Instagram! @floridasoundarchive☞ Please SUBSCRIBE to the channel and give the video a thumbs up if you enjoy the contentConnect with Aesop Dekker:Instagram @aesop_dekker...Related Episodes:The untold story of 1980s Florida band THE ROIDZ (Palm Beach) with Jeano Roid - https://youtu.be/BRm2bAhRqtkThe Story of Russell Mofsky (Quit): https://youtu.be/TM5q2aKo4_MThe Story of Richard Shelter (Concert Promoter): https://youtu.be/UV8Ap-NGG3kExtended Cut! The untold story of Morbid Opera (Ft. Lauderdale) with Libby Bentley & Carmen Monoxide: https://youtu.be/-2wfpLLd9Xo
HABIT-ILE Australia: Randomised trial of Hand-Arm Bimanual Intensive Training Including Lower Extremity for Children with bilateral cerebral palsy
Dr. Valentin Fuster discusses a study on the effects of low-dose rivaroxaban combined with aspirin in fragile patients after lower extremity revascularization, focusing on the balance between efficacy and safety. It highlights that while frailty increases the risk of adverse outcomes, rivaroxaban reduces ischemic events but also raises bleeding risks, regardless of frailty status. The editorial emphasizes that frailty should not preclude the use of combined antithrombotic therapy, advocating for personalized treatment approaches.
This week we turn back the clocks to re-review a recent research letter from the team at the Harvard Congenital Heart Program about venous insufficiency in the Fontan patient. Why do patients with Fontan circulation develop chronic venous insufficiency and what are the implications of this problem in the Fontan patient? What sort of evaluation should be performed on the Fontan patient presenting with lower extremity venous changes? How worried should the cardiologist be when presented with a Fontan patient with these changes? These are amongst the questions reviewed on this topic with this week's guest, Associate Professor at Baylor University, Dr. Tony Pastor.JACC Adv 2022 Mar, 1 (1) 100002
Zach is joined by writer Damien Becton to discuss his brand new comic Kickstarting now: fantasy, action-adventure, The Few of Far Between! Links in the show notes below!But wait...that's not all!Zach and Damien also discuss a book from one of their favorite creators, Daniel Warren Johnson...MURDER FALCON!Jake is a down-on-his-luck guitarist who finds a new lease on life through a falcon-man with a robotic arm telling him his ability to shred is going to save the world! Can Jake and Murder Falcon use Heavy Metal to stop the evil Magnum Khaos before he harnesses the Earth's bad vibes to bring forth his evil army of monsters?---------------------------------------------------Check out more from Damien here!Go and back The Few of Far Between on Kickstarter!---------------------------------------------------GoFundMe to help my wife's family in VietnamAny help is appreciated. We also understand if you can't. A share would also be nice!---------------------------------------------------Check out Dreampass and all their killer tracks on Spotify!---------------------------------------------------Join the Patreon to help us keep the lights on, and internet connected! https://www.patreon.com/tctwl---------------------------------------------------Listen to my other podcast!TFD: NerdcastAnd I am also part of the team over at...I Read Comic Books!---------------------------------------------------Want to try out all the sweet gigs over on Fiverr.com? Click on the link below and sign up!https://go.fiverr.com/visit/?bta=323533&brand=fiverrcpa---------------------------------------------------Follow on Instagram!The Comics That We LoveFollow on Tiktok!The Comics that We LoveFollow on Twitter!@Z_Irish_Red
Your swell guide to the swollen leg We're taking a short summer break, but we'll be back at the end of August with brand new episodes. We have seen our esteemed guests, and they are us! Paul Williams (@PaulNWilliamz) leads the discussion with Matt Watto (@DoctorWatto) and Beth “Garbs” Garbitelli (@bethgarbitelli) on the evaluation and management of common causes of edema. Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME! Show Segments Intro, disclaimer Picks of the Week* The case of Lynn Fedema Pathophysiology of edema Differential diagnosis of chronic edema Chronic edema work-up Management of chronic edema Calvin Fedema and acute edema Evaluation of acute edema Outro Credits Written and produced by: Paul Williams, MD, FACP Infographic and Cover Art: Matthew Watto, MD, FACP Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP; Beth Garbitelli Reviewer: Emi Okamoto, MD Executive Producer: Beth Garbitelli Showrunner: Matthew Watto, MD, FACP Editor: Clair Morgan of nodderly.com Sponsor: Freed You can try Freed for free right now by going to freed.ai. And listeners of Curbsiders can use code CURB50 for $50 off their first month. Sponsor: Rocket Money Cancel your unwanted subscriptions by going to RocketMoney.com/CURB. Sponsor: Grammarly Get AI writing support that works where you work. Sign up and download for FREE at grammarly.com/PODCAST
I read from extremity to extroversion. The word of the episode is "extremophile". https://en.wikipedia.org/wiki/Extremophile Theme music from Jonah Kraut https://jonahkraut.bandcamp.com/ Merchandising! https://www.teepublic.com/user/spejampar "The Dictionary - Letter A" on YouTube "The Dictionary - Letter B" on YouTube "The Dictionary - Letter C" on YouTube "The Dictionary - Letter D" on YouTube "The Dictionary - Letter E" on YouTube Featured in a Top 10 Dictionary Podcasts list! https://blog.feedspot.com/dictionary_podcasts/ Backwards Talking on YouTube: https://www.youtube.com/playlist?list=PLmIujMwEDbgZUexyR90jaTEEVmAYcCzuq https://linktr.ee/spejampar dictionarypod@gmail.com https://www.facebook.com/thedictionarypod/ https://www.threads.net/@dictionarypod https://twitter.com/dictionarypod https://www.instagram.com/dictionarypod/ https://www.patreon.com/spejampar https://www.tiktok.com/@spejampar 917-727-5757
Matt, a 17-year-old athlete, experiences chronic muscle weakness, foot deformities (high arches and hammer toes), and sensory deficits in his legs and feet. These symptoms have been progressively worsening over the past few years, without any associated swelling or inflammation. Which condition is MOST likely present? A) Osteomyelitis B) Juvenile rheumatoid arthritis C) Sever's disease D) Hereditary Motor & Sensory Neuropathy (HMSN) LINKS MENTIONED: NPTE Tips & Tricks: www.nptegroup.com Truelearn: USE CODE: PTH020 Free Cheatsheets: www.nptecheatsheets.com --- Support this podcast: https://podcasters.spotify.com/pod/show/thepthustle/support
Commentary by Dr. Valentin Fuster
The boys review Extremity Vol 2: Warrior by Daniel Warren Johnson and Mike Spicer, as well as discuss what they've been reading and watching! - 0:00 - Intro 1:34 - Extremity Vol 2: Warrior Review 7:45 - Bionicle Ramble (Collin) 15:49 - Pirates of the Caribbean: Dead Man's Chest (Jacob) 21:14 - Wolverine Anime (Spencer) 28:33 - Pitch the next DWJ comic (Collin) 33:40 - Pirates of the Caribbean: At World's End (Jacob) 41:59 - X-Men Anime (Spencer) 45:05 - Outro
Margot, a 53-year-old woman, presents to physical therapy with bilateral, symmetrical enlargement of her legs extending from her hips to her ankles, sparing the feet. She reports the condition is painful and has worsened over several years. Skin texture is normal, and there is no pitting edema. Which condition is MOST consistent with these findings? A) Chronic venous insufficiency B) Obesity-related lymphedema C) Primary lymphedema D) Lipedema LINKS MENTIONED: PT Hustle Phone Number: (727) 732-4573 Get Your Episode Cheatsheet HERE NPTE Tips & Tricks: www.nptegroup.com Truelearn: USE CODE: PTH020 --- Support this podcast: https://podcasters.spotify.com/pod/show/thepthustle/support
Welcome to the Paint The Medical Picture Podcast, created and hosted by Sonal Patel, CPMA, CPC, CMC, ICD-10-CM. Thanks to all of you for making this a Top 15 Podcast for 3 Years: https://blog.feedspot.com/medical_billing_and_coding_podcasts/ I'd love your continued support of this content-rich, value-add podcast to help you succeed in the business of medicine: https://podcasters.spotify.com/pod/show/sonal-patel5/support Sonal's 12th Season starts up and Episode 2 features a Newsworthy update on the OIG Work Plan for April 2024. Sonal's Trusty Tip and compliance recommendations focus on supplemental documentation necessary for lower extremity endovascular procedures. Spark inspires us all to reflect on collaboration based on the inspirational words of Helen Keller. Thanks to Advanced Coding Services: Website: https://advancedcodingservices.com/ Paint The Medical Picture Podcast now on: Spotify for Podcasters: https://podcasters.spotify.com/pod/show/sonal-patel5 Spotify: https://open.spotify.com/show/6hcJAHHrqNLo9UmKtqRP3X Apple Podcasts: https://podcasts.apple.com/us/podcast/paint-the-medical-picture-podcast/id1530442177 Google Podcasts: https://podcasts.google.com/feed/aHR0cHM6Ly9hbmNob3IuZm0vcy8zMGYyMmZiYy9wb2RjYXN0L3Jzcw== Amazon Music: https://music.amazon.com/podcasts/bc6146d7-3d30-4b73-ae7f-d77d6046fe6a/paint-the-medical-picture-podcast Breaker: https://www.breaker.audio/paint-the-medical-picture-podcast Pocket Casts: https://pca.st/tcwfkshx Radio Public: https://radiopublic.com/paint-the-medical-picture-podcast-WRZvAw Find Paint The Medical Picture Podcast on YouTube: https://www.youtube.com/channel/UCzNUxmYdIU_U8I5hP91Kk7A Find Sonal on LinkedIn: https://www.linkedin.com/in/sonapate/ And checkout the website: https://paintthemedicalpicturepodcast.com/ If you'd like to be a sponsor of the Paint The Medical Picture Podcast series, please contact Sonal directly for pricing: PaintTheMedicalPicturePodcast@gmail.com --- Send in a voice message: https://podcasters.spotify.com/pod/show/sonal-patel5/message Support this podcast: https://podcasters.spotify.com/pod/show/sonal-patel5/support
For this week's podcast, we're digging out a treasure from the CBCC Patreon Feed: our deep-dive conversation with Daniel Warren Johnson about The Nam # 9. This thorough discussion launched our "Married to Singles" Patreon exclusive series, where we examine the favorite single issues of various comic book creators and critics. It's one thing to dissect an artist's work alongside or in front of them, as we often do, but it's an entirely different thing to scrutinize an artist's work with another artist. Daniel Warren Johnson is a can't-miss cartoonist. If he's on a book, you want that book in your pullbox. Extremity, Murder Falcon, Do a Powerbomb!, and Transformers are essential reads for those obsessed with the comic form. If you want to understand what DWJ does so well, our conversation with him about his passion for Michael Golden gives you another angle. As Johnson remarks in our chat, Michael Golden in The 'Nam # 9 does things he would never do, and those choices mystify and compel him. Johnson came to the Marvel series late in his comic reading history, picking up the first two issues and enjoying them but only coming across the rest of those Golden books years later at C2E2. He profoundly appreciates all those early 'Nam issues, but the ninth one just hits differently. Why? We get into it. After you enjoy our conversation with Daniel Warren Johnson, consider digging into the rest of our "Married to Singles" episodes. We have thorough inspections with Jason Ayers on Uncanny X-Men # 183, Christian Ward on Arkham Asylum, and more. The CBCC Patreon costs as little as $1 a month or $12 a year. You can also purchase these episodes individually, without joining the Patreon, for $3 an episode via our Online Shop. The 'Nam # 9 was originally published by Marvel Comics on May 19, 1987. It was written by Doug Murray, penciled by Michael Golden, inked by John Beatty, and lettered and colored by Phil Felix. G.I. Joe mastermind Larry Hama served as editor, while Jim Shooterwas Editor-in-Chief. You can continue this conversation by following Daniel Warren Johnson on Twitter, Instagram, and his Website. Other Relevant Links: Robert Kirkman, Joshua Williamson, and Daniel Warren Johnson at SDCC Appreciating Daniel Warren Johnson's Transformers, an essay Joshua Williamson and Tom Reilly on Duke The Ultimate Do a Powerbomb! Daniel Warren Johnson Interview The Ultimate Beta Ray Bill Daniel Warren Jonson Interview Subscribe to the Free CBCC Newsletter Final Round of Plugs (PHEW): Support the Podcast by Joining OUR PATREON COMMUNITY Join us at the Alamo Drafthouse in Winchester, Virginia, on 5/19 at 4:00 PM for our Batman (1989) screening, co-sponsored by Four Color Fantasies. Watch the latest episode of The B&B Show, where Brad and Bryan Review the Hottest Cinematic Releases. And, of course, follow Comic Book Couples Counseling on Facebook, on Instagram, and on Twitter @CBCCPodcast, and you can follow hosts Brad Gullickson @MouthDork & Lisa Gullickson @sidewalksiren. Send us your Words of Affirmation by leaving us a 5-star Review on Apple Podcasts.
When people dare to complain about modern Transformers stories, they often single out the human characters and how they drag the spotlight away from the glorious Cybertron titans they paid their money to see. Optimus Prime is enough. Bumblebee is enough. We don't need Spike or Sparky to stretch the narrative. Just give us the 'bots. And yet, Daniel Warren Johnson, the virtuosic cartoonist behind Extremity, Murder Falcon, and Do a Powerbomb!, could not imagine telling his Transformers story without Spike and Sparky. Why? The humans are at the forefront of this week's podcast as we reflect on Daniel Warren Johnson and colorist Mike Spicer's first six issues and their catastrophic climax. Johnson sees Optimus Prime as the ultimate dad, and he wants to tell his ultimate dad saga while simultaneously reintroducing the Autobots and the Decepticons to Image Comics readers. His Transformers create a significant branch in Skybound's ever-expanding Energon Universe, which includes other titles like Void Rivals, Duke, and Cobra Commander. Telling an emotional and singular story while supporting the most exciting event in comics is a herculean task, and thankfully, for all his readers, Johnson is absolutely up for it. After we pour ourselves over Transformers issues one through six, we invite Daniel Warren Johnson onto the show for a hearty debrief. We discuss the humanity at the core of his story, why Sparky was always Optimus Prime's parallel figure, and what we can expect after the heroic and tragic events of the sixth issue. Transformers 7 is currently on comic stands, while the trade paperback collecting the first story arc will arrive on May 21st. Catch a preview of Transformers 8 on Skybound's website. You can continue this conversation by following Daniel Warren Johnson on Twitter, Instagram, and his Website. As always, Omnibus, the Digital Comic Store and Reader, sponsors our Referrals segment. This week, we selected two comic book titles on the site that satisfy this episode's themes. We won't spoil what they are here, but if you click the links below, you'll be immediately escorted to those books. Brad's Referral Lisa's Referral Other Relevant Links: Robert Kirkman, Joshua Williamson, and Daniel Warren Johnson at SDCC Appreciating Daniel Warren Johnson's Transformers, an essay Joshua Williamson and Tom Reilly on Duke The Ultimate Do a Powerbomb! Daniel Warren Johnson Interview The Ultimate Beta Ray Bill Daniel Warren Jonson Interview Subscribe to the Free CBCC Newsletter Final Round of Plugs (PHEW): Support the Podcast by Joining OUR PATREON COMMUNITY Join us at the Alamo Drafthouse in Winchester, Virginia, on 4/21 at 4:00 PM for our Teenage Mutant Ninja Turtles II screening, co-sponsored by Four Color Fantasies. Watch the latest episode of The B&B Show, where Brad and Bryan Review the Hottest Cinematic Releases. And, of course, follow Comic Book Couples Counseling on Facebook, on Instagram, and on Twitter @CBCCPodcast, and you can follow hosts Brad Gullickson @MouthDork & Lisa Gullickson @sidewalksiren. Send us your Words of Affirmation by leaving us a 5-star Review on Apple Podcasts. Continue your conversation with CBCC by hopping over to our website, where we have reviews, essays, and numerous interviews with comic book creators. Podcast logo by Aaron Prescott @acoolhandfluke, podcast banner art by @Karen_XmenFan.
Here's a short preview of a bonus episode that was recorded earlier this month, with Badr, Chris, and Ed. The guys discuss the accusations against DC for the use of AI, and the growing and complicated presence of artificial intelligence in comics. We also discussed Daniel Warren Johnson's recent Extremity campaign, and the value of the Artist Edition, in the full episode. Check it out here Enjoy early-access to weekly episodes before anyone else, and tons of bonus episodes, and exclusive content over on our Patreon channel!SUPPORT THE SHOW: MERCH SALE! Get 20% off your next purchase from our merch store by using the discount code: “YOO“Take your comic shopping experience to the limit, by shopping online at Gotham City Limit!Join our Patreon Community and get VIP treatment, bonus episodes, and other perks and rewards! Try out a free 7-day trial, here. No pressureProudly sponsored by Gotham City Limit!Disclaimer: This post contains affiliate links. If you make a purchase, I may receive a commission at no extra cost to you.Support the showGET IN TOUCH WITH US!
In this episode, we review the high-yield topic of Lower Extremity Spine & Neuro Exam from the Spine section. Follow Orthobullets on Social Media: Facebook Instagram Twitter LinkedIn YouTube --- Send in a voice message: https://podcasters.spotify.com/pod/show/orthobullets/message
This week's podcast was recorded live at Collective Con 2024! Comic pros: Mike Spicer (Wonder Woman: Dead Earth, Extremity, Transformers), Karl Moline (Buffy The Vampire Slayer, Route 666), and John Tyler Christopher (Avengers, Star Wars, Spider-Man) joined Badr for an honest conversation about what it's like working in the comic book industry as artists, the sacrifices, and rewards, and share their best advice for aspiring comic creators.Photo courtesy of KTorjussen PhotographyWatch the video version of this episode on YouTubeListen to this a special bonus episode over on Patreon (here)SUPPORT THE SHOW: Get 20% off your next purchase from our merch store by using the discount code: “YOO“Join our Patreon Community and get VIP treatment, bonus episodes, and other perks and rewards! Try out a free 7-day trial, here. No pressureTake your comic shopping experience to the limit, by shopping online at Gotham City Limit! Proudly sponsored by Collective Con! Disclaimer: This post contains affiliate links. If you make a purchase, I may receive a commission at no extra cost to you.Support the showGET IN TOUCH WITH US!
Dr. Cody Gingerich // #ClinicalTuesday // www.ptonice.com In today's episode of the PT on ICE Daily Show, Extremity lead faculty Cody Gingerich explores the concept of "entertaining" patients by constantly introducing new & exciting exercises. Cody challenges listeners that just because they are bored, their patient may not be bored with PT, especially if they're seeing demonstrable progress with their rehab. Take a listen to the episode or check out the full show notes on our blog at www.ptonice.com/blog. If you're looking to learn more about our Extremity Management course or our online physical therapy courses, check our entire list of continuing education courses for physical therapy including our physical therapy certifications by checking out our website. Don't forget about all of our FREE eBooks, prebuilt workshops, free CEUs, and other physical therapy continuing education on our Resources tab. EPISODE TRANSCRIPTION CODY GINGERICHAll right, good morning everybody. My name is Cody Gingrich and I am one of the lead faculty in our extremity division. The big thing I want to come on and talk about today, it's going to be the title of today is called Are You Not Entertained? And really what today's conversation is going to be around is a bit of a blend between a couple of the lectures that we have in both of our extremity management division and then some of our spine division in our build a bike conversation. So if you've ever taken a course through the spine division we always talk about building the bike and then in extremity division the conversation is around dosage. Okay so the title of today called are you not entertained is really I want to focus in on are we as physical therapists, is our job to entertain our patients or is it to get them better, right? HELPING PATIENTS RECOVER VS. ENTERTAINING PATIENTS And so what we want to talk about is really our job is to get people better. We want people to improve health-wise, we want to improve their pain and all of those things, right? But where we see that tend to get a little bit lost in translation is when with our exercise dosage. Okay. We have so many, so many exercises at our disposal in physical therapy. We see things on Instagram, we see things all over the place. Right. And that leads to so many things swirling in our brain about like, Oh, let's do this exercise. Plus this exercise, plus this exercise, plus this exercise. Okay. And so what that does is that also clouds our judgment on what is actually bumping our patients forward. Okay. And when we talk about exercise dosage prescription, what that needs to be is a very methodical approach and then progressions over time. Of the same exercise, assuming that first exercise that you chose is showing benefit to your patient, right? And I think we veer from that too quickly, oftentimes. So let's take a shoulder pain, for instance, right? And we just give them a side, we've determined that it's coming from the posterior cuff and we really need to work on getting infraspinatus stronger, some of the teres group stronger, and that posterior shoulder really needs to build up some strength. So we start giving them side lying external rotation, okay? Now, is that the most fun exercise in the world? Potentially not, but we know that from EMG activity, that sideline external rotation is the best exercise that we could possibly give that person in front of us to build the capacity of their rotator cuff. And let's say up front, they can tolerate a two pound dumbbell for eight to seven to 10 reps somewhere in that neighborhood, which in extremity division, we would call that more in our rehab dosage. It falls in line with our rehab dosage and that's probably going to fall somewhere in there 70 to 80 percent of their one rep max shoulder external rotation. Now how does build the bike fall into that conversation? The building the bite comes the next visit when they show up and you have your subjective and objective asterisk signs. You have given them that one exercise and say, Hey, this is the best exercise for you. You need to do it seven to 10 reps, three sets, and you need to do that one time a day. You have a very specific rehab dosage laid out in front of them. and they come back in and your objective asterisk signs and subjectively, hey, they are sleeping better. They only woke up one time in the evening as opposed to three times. They were able to get through their workout, and they didn't have to stop or modify, or their pain was at a two out of 10 as opposed to a six out of 10. They were able to pick up their kid. Then, in your objective, they were able to raise their arm overhead, and they only had a very small window of a painful arc that was only a one or a two out of 10 as opposed to a five out of 10 the previous time. Now, your job at that point is saying, great, that exercise right there is working, We're going to go from a two pound dumbbell tip from that prescription to a three pound dumbbell. STAY FOCUSED ON WHAT IS WORKING That is not the time to decide, great, let me pull all of those other exercises that I have in the back of my brain that I've seen on Instagram and start giving them six to 10 different things or just like time to shift away. No, you have proven to that patient in front of you that that one thing that you gave them at the prescription and the dosage that you gave them was the right thing. Okay? So, Exercise and strength and conditioning principles tell us we need progressive overload. If you decide you wanted to get your back squat stronger, what is your back squat cycle look like? You are back squatting at least once, maybe twice a week, every week, and you add five pounds to that back squat and you do the exact same thing week over week. People don't get bored of that because they see progression. They see that they're getting stronger in that. IS YOUR PATIENT BORED OR ARE YOU? And I think we as physical therapists, I think sometimes it's us getting bored, not our patients. And we think that we, our job is to just be entertained or entertain them because we think the patients are getting bored of what they're doing. And so we need to give them the new fangled thing. Well, the reality becomes our patients are entertained by getting better and doing all of the things that they've told you that they haven't been able to do and now they can. Right. But, They will get bored and they will get frustrated if we don't also prove to them that they are getting better. It's not our patient's job to say, yes, I'm getting better. No, I'm not. Most of the time patients will feel they either have pain or they don't and you might get them that first time. Maybe they only could raise their arm to here and then the next time they're here and they're like, yeah, but it's still kind of bothering me. Your job then is to say, well, right, but last time you were able to get, you only were to hear, and now we're here. That's at least a 60 or 70% improvement. Now all of a sudden we're like, oh yeah, that is actually true. And I was able, I only woke up the one time last night. man, I am getting better. I need to keep doing that exercise. And you say, yeah, I wholeheartedly agree. But the thing is that seven to 10 reps for three sets now is getting too easy for you. So we need to bump that to the three pounder or the four pounder or whatever it is. Exactly the same thing, right? And that's where the patient gets entertained by seeing that they're getting stronger. improving all of their objective metrics that you're coming in to see, plus their subjective day-to-day life stuff. That's where the entertainment comes in. So don't get lost in the weeds of thinking, I need to give them the coolest brand new thing that I saw this week, right? Or I need to give them three, four, five different things. It is way, way, way more valuable for your patient, for you to know exactly right prescription, you've tested their one rep max, or you've tested a five rep max, or you have a very good understanding of their percentages of whatever movement that you're doing, that's going to challenge them appropriately, and that easily lets you determine whether or not that was the right prescription for them when they walked in, or that prescription needs to be adjusted. If they come in and they're a little bit worse, but it's the same symptoms, Great, that's not the wrong exercise still. That might be that you overdosed it up front and you can just pull that back. Maybe you handed them a five pound dumbbell and you said, okay, this is your exercise for the week. Maybe that needed to be a three pound dumbbell, not potentially a brand new exercise, right? And that's where the magic in rehab lives. Right? And that's where the entertainment factor comes in. Like you need to be entertained yourself because like I said, I think a lot of us as PTs, we're the ones that get bored before the actual patients do. Your entertainment needs to come from really figuring out the detailed prescription of what is going to be best for that patient, right? Use that as a puzzle each time they walk in and say, okay, well where, how can I dial this prescription in perfectly? And when they come in week over week, then you have to build that bike in front of them and say, okay, I'm proving to myself and to you that what I gave you previously worked and we can bump you forward with this same thing, but changing just the dosage. Don't go from, If you're trying to like, again, going back to that back squat, if you're trying to improve the back squat, how many different exercises can you do for your legs? You can do plenty. You can do back squat, you can do Bulgarian split squats, you can do hack squats, you can do leg press, you can do leg extensions, right? All of those things may get you stronger for sure. But if you want to improve your back squat, you are going to have to back squat and you're going to need to methodically and strategically bump that weight up time and time again. Once you feel like you have exhausted that thing and they come in and say, I have been getting better with this. You know, I followed exactly what you're doing. And this time, you know, we haven't seen as good of a bump. Maybe now we need to challenge that tissue in a different way, right? And that's when all of a sudden you can decide to switch exercises, okay? Find a new exercise, challenge the tissue in a different way, right? If that means that we need to go from really here and stop from this position here, maybe we raise it to a 90-90 here, or we do that wall slide that we talk about, that exercise is in the extremity management course, right? One of those two things, now we're challenging that through a little bit of a different range of motion. If we're doing a wall slide with a band, you start a light band, then you move to a medium band, then you move to a heavier band, right? And you dose that prescription the exact same way and we methodically take that approach to just adding resistance. REHAB EXERCISES DO NOT NEED TO ALWAYS BE DIFFERENT It does not need to be constantly shifting, constantly changing, constantly adjusting every single thing. that we're doing time and time again, right? So that's the big thing that I want to get on here and talk about that we see oftentimes throughout going around weekends is just that everyone wants all of the new things. And really they, it seems like the goal is trying to entertain our patients. We need to get our patients like they need to be able to like what they're doing. Absolutely. but they like when they get better. It's the same thing when people, this might be my own bias, but like if you're playing sports and everyone says like, Oh, I just, I want to be, I want to have fun. Well, you know what's really fun is when you're win, right? So like I have a lot more fun playing sports if I can also win at that sport. Right. And so that's the same thing. It's like, I might do some of the boring things because that's going to get me to win. which then therefore is fun. Same conversation here is like some of these boring activities or boring exercises, if you can prove to the patient that they're winning, now all of a sudden those boring exercises feel like fun because they can see the progress and they can see what's happening time and time again, week over week over week. And now they don't care about some monotony and some potential boring exercises if you have to prove that it is going in the right direction week over week over week. The second that you can't prove that to them, that's when all of a sudden compliance starts to dip. And once compliance starts to dip, now all of a sudden you're chasing yourself trying to figure out, well, what can I just do to get my patient to like do their exercises? Well, that's it. Prove to them that are getting better. Prove to yourself, right? Make sure every time they walk in, you're checking their subjective, you're checking their objective asterisk signs. So I want to challenge you this week, when your patients come in, give them the same exercises that if, assuming that things are getting better, don't abandon ship on that exercise. Add one pound, add the next band up, add three reps instead of it being a 10 rep, make it 13 or make it 12, same exact thing. at a set, right? These are the small details that we know bump people forward and actually progressively strength train. Okay, that's the podcast today. What I wanna talk about, are you not entertained, right? Entertain yourself by really dialing in that prescription dosage, right? Make sure that you have a good understanding and that's the fun part for you. It's like, well, last week we did 10, so this week we're gonna do 12, or it was two pounds or three pounds. That is the fun in rehab. Entertain your patients by proving to them that they're getting better, right? Using the dosage that you talk about and you're methodical over. Prove to them that they are getting better week over week over week. And now all of a sudden they're having a good time, right? Because they can do the things that they want to do. Catch us out on the road, extremity management. Myself, Mark, Lindsey, we're all over the country moving into the next couple weeks, so we appreciate you being on with me on this clinical Tuesday. Hope you all have a great day. OUTRO Hey, thanks for tuning in to the PT on ICE daily show. If you enjoyed this content, head on over to iTunes and leave us a review, and be sure to check us out on Facebook and Instagram at the Institute of Clinical Excellence. If you're interested in getting plugged into more ice content on a weekly basis while earning CEUs from home, check out our virtual ice online mentorship program at ptonice.com. While you're there, sign up for our Hump Day Hustling newsletter for a free email every Wednesday morning with our top five research articles and social media posts that we think are worth reading. Head over to ptonice.com and scroll to the bottom of the page to sign up.
In this episode, we review the high-yield topic of Metastatic Disease of Extremity from the Pathology section. Follow Orthobullets on Social Media: Facebook Instagram Twitter LinkedIn YouTube --- Send in a voice message: https://podcasters.spotify.com/pod/show/orthobullets/message
Dr. Cody Gingerich // #ClinicalTuesday // www.ptonice.com In today's episode of the PT on ICE Daily Show, Extremity lead faculty Cody Gingerich discusses the importance of thorough palpation to rule in or out differential diagnosis during an objective exam. Take a listen to the episode or check out the full show notes on our blog at www.ptonice.com/blog. If you're looking to learn more about our Extremity Management course or our online physical therapy courses, check our entire list of continuing education courses for physical therapy including our physical therapy certifications by checking out our website. Don't forget about all of our FREE eBooks, prebuilt workshops, free CEUs, and other physical therapy continuing education on our Resources tab. EPISODE TRANSCRIPTION CODY GINGERICH All right, good morning everybody and welcome to the PT on Ice daily show. My name is Cody Gingrich. I'm one of the lead faculty in the extremity division coming to you on a clinical Tuesday. So getting into it, what I want to talk about today is talking about palpation and using a good palpation exam in your objective exam for doing some differential diagnosis. We're going to talk about the upper extremity and the lower extremity and why doing a really solid palpation job in those areas, specifically when you're dealing with extremity management. is going to be super, super important when you're trying to differentiate, is this something that might be more of an extremity issue or is this potentially something that's coming more from the spine, okay? We're going to talk about different things that you might see from a subjective standpoint that might lead you to figuring out, not having a super clear picture on which of those two things it might be. UPPER EXTREMITY PALPATION So we're going to start in the upper extremity, okay? So things that you might see or hear, I guess, from your patient when you're doing your subjective exam. right? Numbness and tingling that comes down the arm that comes down lower than the, um, than the clavicle elbow, potentially even all the way into the hand. Okay. Anything noticing tingling. A lot of times when we hear numbness, tingling, we're immediately clued into, Oh, that might be a nervous system problem. That can be a cervical radiculopathy, all of those types of things. but then some of their other aggravating factors are going to be, right? Potentially sitting at a desk, if it's a more of a fitness athlete, pressing overhead, all of those type of things might bring out their symptoms. So if they're sitting, if they're driving, where they could be stressing the actual cervical spine, but they could also be very much stressing that posterior shoulder, okay? Another thing that I see all the time is anterior shoulder pain. Okay, anterior shoulder pain with a lot of pressing type of movements and a lot of times if you know someone's sleeping on that shoulder or whatever else, we need to figure out is that coming from that anterior shoulder, but also we get a lot of referral from the posterior shoulder that pings right to that anterior shoulder. Okay, so I want to talk about how then your palpation job is going to be most efficient in bringing out some of those symptoms. The number one thing is you have to have a system. You have to have a system to know when you're going, where you're going to be and how you get back to that spot every time and how you touch each and every muscle area on what you're trying to palpate. In the extremities, specifically posterior shoulder and posterior hip when we get to it, posterior lateral hip, you can actually hit all of those structures and feel good about where you are palpating is touching what you want to touch. In the spine and areas like that, there are so many layers of tissue, you can't really always say, like, I know what I'm on, but specifically in the back of the shoulder, you can say, I'm on infraspinatus, I'm on supraspinatus, I'm touching teres. All of those things can be very confident that you're hitting that. So where do you want to start? Inferior angle of the scapula. Then you work laterally. You know then when you work laterally and you come back to that inferior angle, you go thumb, thumb, and then you start here and then you work away again. Come back, thumb, thumb, thumb. Now you're three thumb widths up. Each time you're touching your thumb, like working and doing your palpation every time. Now the key with this is if you find a spot and your patient says, Ooh yeah, that's tender. You can't just say, oh great, and move on. You need to spend some time in that area and hold and sustain that pressure. If in this objective they said, well it takes sometimes half of the day in order to bring out my symptoms where I start to get that tingling, then four seconds of you palpating that area on the back of their shoulder is not going to be enough to bring out those symptoms. Maybe 30 seconds, maybe 40 seconds of you really sustaining pressure there is going to be necessary before maybe they start saying, Oh, you know what? It's not just tender there anymore. It's actually starting to creep a little bit here. That's when you can say, Oh, well, maybe that extremity management or that extremities focus is going to be where we need to be. And it's not as much in the cervical spine, right? So that's where you want to really pay attention to what you're doing. You don't always have to get symptoms all the way down the arm, because that may take a very long time for them to get those symptoms all the way down. But if it starts to creep, down the arm like this, you can be pretty confident. There's definitely something coming from that shoulder, that posterior shoulder, where it is relevant as opposed to the cervical spine. Same exact conversation. We're talking about anterior shoulder pain. We are really thinking a lot of times when someone says, Hey, yeah, it hurts right here. First clue might be like, Oh, that might be some biceps, uh, tendonitis, tendinopathy, something like that. But If you, and most people are going to be tender when you palpate right on that anterior shoulder. Note that, but also make sure you do that really solid palpation job on the backside of the shoulder and sustain some pressure. If they find some, if you find something that's tender, sustain that pressure very often. They're going to say, Oh, you know what? I actually do feel that in the front of the shoulder. Okay. Now we need to be hitting the back of the shoulder to treat the front of the shoulder. Okay. And that's where our differential diagnosis, that hypothesis list that we generate from the subjective exam pressing, right? You're like, Oh, okay. That's an anterior shoulder. Definitely a lot of heavy work for the anterior shoulder. But if we're pressing, if we're really working our elbows into that front rack or something like that, that post to your shoulder and that rotator cuff in the back is also getting a lot of work to get that hand on top of your elbow. Okay, so both things are relevant there. Those are going to be the two main things in the upper extremity that you're wanting to change that hypothesis list. Cervical spine, we're getting a lot of just numbness, tingling symptoms down the arm. Okay. If the cervical spine is not blipping a bunch of that stuff, check posterior cuff. Same thing with anterior shoulder. If they're saying anterior shoulder, I get that when I'm benching, when I'm pressing, when I'm whatever, palpate the back of the shoulder, make sure you're doing a good job sustaining pressure. This position right here is occluding blood flow to the back of the shoulder where we sit almost all day, just like this. We are now no longer giving the back of our shoulder a really good environment to allow blood flow and healing. Okay? And so if they're just tugging on those structures all day long, now all of a sudden sitting at a desk can bring out some of those symptoms. LOWER EXTREMITY PALPATION Shifting gears to the posterior lateral hip, very similar conversation. In extremity management, palpation can matter. You can be confident in what you are palpating to know that you're on the structures that you are trying to hit. Again, you want to have a system. There are two ways that you can really create your system. If you want to start at the greater trochanter and work your way superiorly, you can do that. And then each time, you know, I went immediately superior from this greater trochanter, we're hitting glute med, and then we are working and fanning away from the iliac crest. and we can work away that way to the posterior hip. So that way we can know we've hit glute med, we've hit glute min, we've hit glute max. You can also start from the PSIS and work your way more anteriorly and then down to the greater trochanter. Very similar in that you will probably need to sustain pressure. There are people that are going to be mostly tender there. If you find tender spots, sustain some pressure. if you have not sustained pressure for upwards of 30 to 45 seconds to at least see if symptoms have changed at all. And the question is, are you still feeling that right under my thumbs or has that started to creep anywhere? you'll get symptoms all the way down the leg. If we're trying to differentiate between lumbar radiculopathy, symptoms down the leg, into the calf, all the way into the foot, can be symptom generators coming from glute med, glute med. They can also be symptom generators of the spine. Okay, you have to get on those structures and see, is there anything creeping? Do you feel changes in your foot in your calf when I'm sustaining pressure on the muscle tissue? If you are on the muscle tissue, you can be pretty confident that that is not a back thing anymore, at least not fully. And you need to then have a good understanding of where am I? Can I then treat that out? We need to pump some blood to it. If we need to do dry needling, if we need to do some soft tissue and then work some strength, some blood perfusion type of exercises there. Okay. Also, hamstring type of things where people are not sure did I tweak a do I have like a high hamstring injury? Do I have more of a low back injury? That's another differential. When you're here and subjectively right sitting prolonged sitting is going to bring on these symptoms. Well, prolonged SIM sitting is stressing the lumbar spine, you are sitting in some lumbar flexion when you're sitting. The other thing that you're doing is you are occluding blood flow to that posterolateral hip at the same time. Okay, so both things can happen and then that can create irritation to the tissue. Very similar to this posture, any prolonged sitting can bring on that posterolateral occluding blood to that aorta and bring on tissue dysfunction. And that can create symptoms down the leg, again, hamstring, calf, foot, ankle, anything like that. COMBINING SUBJECTIVE & OBJECTIVE EXAMS Okay. So the big takeaways here are subjectively, these things are going to feel, you're going to have your hypothesis list, but you may not be like, they might be pretty equal when we're talking about the hypothesis list before you touch the objective exam. Then, same thing, when you're going through your objective exam, if you just do range of motion, if you do lumbar flexion range of motion, and that comes out, potentially you have stress lumbar flexion, yes, you are also tugging on your posterior lateral hip when you bend forward into flexion. Okay, so don't forget to make sure that you are ruling out that palpation and that lat posterior lateral hip in the hip, or that posterior shoulder when you're in the upper extremity, because those things might still be relevant. And you need to do a good job in palpating to make sure that you are clearing those areas and creating a really solid differential. because subjectively your hypothesis list is going to be very equal going into objective exam and not always with functional movements or range of motion. Are you going to really be able to bump one of those things up or down? But if you get into that palpation and say, you know, I've hit these areas and it wasn't maybe it was tender, but I sustained that pressure and I made sure I hit every single section because I was efficient and I was clean with where I was going each time and nothing really came out. then you can be pretty confident. Maybe it's not those tissues in the posterior shoulder or the posterolateral hip. Maybe we are looking more at the spine, okay? So that's really what I wanted to come on here and talk about today. In the extremity management division, we touch on that briefly when we're going through our objective exam, but I wanted to give a little bit more clarity today on what exactly you're looking for subjectively, and then how can you make a really clean objective palpation exam when you're trying to differentially diagnose. So that's what I wanted to come on here and touch on today. If you want to catch Extremity Management on the road here in the next couple weeks, we've got Lindsey on the road out in Carson City this weekend, so if you want to catch Mark or myself, both of us are on the road March 16th and 17th. I will be in Aiken, South Carolina. Mark will be in Spring, Texas. So we pretty much have West Coast to East Coast covered here over the next month or so. So jump into one of those courses. We'd love to see you out. And hopefully we will catch you all tomorrow on the iShow. OUTRO Hey, thanks for tuning in to the PT on ICE daily show. If you enjoyed this content, head on over to iTunes and leave us a review, and be sure to check us out on Facebook and Instagram at the Institute of Clinical Excellence. If you're interested in getting plugged into more ice content on a weekly basis while earning CEUs from home, check out our virtual ice online mentorship program at ptonice.com. 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A review of mononeuropathies involving the lower extremity, with Drs. Victor Bushlyar, William Signorile and Kevin Yan.Note: This podcast is intended solely as an educational tool for learners, especially neurology residents. The contents should not be interpreted as medical advice.
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In this 271st episode I welcome Dr. Gillian Isaac back to the show for another ABA keyword episode. We discuss lower extremity nerve blocks.Our Sponsors:* Check out Factor 75 and use my code accrac50 for a great deal: https://www.factor75.com* Check out Magic Mind and use my code ACC20 for a great deal: https://www.magicmind.com/Advertising Inquiries: https://redcircle.com/brandsPrivacy & Opt-Out: https://redcircle.com/privacy
June presents with complaints of pain during the midstance to terminal stance phase of gait. Upon examination, there's excessive pronation of the subtalar joint and pes planus deformity. What muscle is MOST likely weakened? A) Flexor digitorum brevis B) Tibialis posterior C) Abductor hallucis D) Extensor digitorum longus LINKS MENTIONED: Did you get this question wrong?! If you were stuck between two answers and selected the wrong one, then you need to visit www.NPTEPASS.com, to learn about the #1 solution to STOP getting stuck. Are you looking for a bundle of Coach K's Top MSK Cheatsheets? Look no further: www.nptecheatsheets.com --- Support this podcast: https://podcasters.spotify.com/pod/show/thepthustle/support
Your swell guide to the swollen leg We're taking a short summer break, but we'll be back in September with brand-new episodes. Can't wait? Join our Kashlak family at patreon.com/curbsiders for access to twice-monthly bonus episodes… there are already 9 of them available to feed your brain hole! Yummy! We have seen our esteemed guests, and they are us! Paul Williams (@PaulNWilliamz) leads the discussion with Matt Watto (@DoctorWatto) and Beth “Garbs” Garbitelli (@bethgarbitelli) on the evaluation and management of common causes of edema. Credits Written and produced by: Paul Williams, MD, FACP Infographic and Cover Art: Matthew Watto, MD, FACP Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP; Beth Garbitelli Reviewer: Emi Okamoto, MD Executive Producer: Beth Garbitelli Showrunner: Matthew Watto, MD, FACP Editor: Clair Morgan of nodderly.com Show Segments Intro, disclaimer Picks of the Week* The case of Lynn Fedema Pathophysiology of edema Differential diagnosis of chronic edema Chronic edema work-up Management of chronic edema Calvin Fedema and acute edema Evaluation of acute edema Outro Sponsor: Pathway Pathway is an innovative tool to improve your clinical decision-making process and enhance patient care. Download the app at pathway.md
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