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Genicular artery embolization (GAE) continues to gain traction worldwide, but is the evidence catching up to the hype? In this episode of BackTable Bone and Sports Podcast, host Dr. Kavi Krishnasamy welcomes Dr. Peter Minko, an interventional radiologist from Düsseldorf, Germany, to discuss GAE's evolving evidence, techniques, and international practice patterns. Dr. Minko highlights forthcoming clinical trials and emphasizes the need for high-quality research to guide patient care. --- Get the BackTable apphttps://www.backtable.com/app --- Timestamps00:00 - Introduction03:13 - The Embolization Landscape in Germany07:25 - The Basics of GAE Patient Workup 13:49 - The Unideal Patient Candidate for GAE16:55 - Measuring Outcomes Beyond Clinical Scores23:14 - Procedure Specifics: Minko's Choice36:28 - Discussing the Future of Temporary vs. Permanent Embolics43:47 - Collateral Flow Strategy and Procedure Wrap-Up49:05 - Post-Procedure Rehab Guidelines52:00 - Repeat GAE Treatment Algorithm 58:00 - Safety and Outcomes in Post-TKA Patients01:04:11 - GAE and Associations with the Hospital Anxiety and Depression Scale (HADS)01:09:40 - Call for Better Trials and Evidence in GAE01:14:11 - Case Presentation: GAE Transpedal Access Case01:21:05 - Case Presentation: “Three Stop Shop” Anastomosis 01:27:08 - Case Presentation: AV Fistula… Due to Arthroscopy?01:32:03 - Case Presentation: Popliteal Agenesis 01:38:14 - Dr. Minko's Perspective on the Future of MSK Embolization01:40:55 - Wrap Up --- More about this episodeThe doctors break down procedural specifics, including embolic materials, access site and catheter choices, and strategies for patient selection and contraindications. They discuss post-procedure rehabilitation, approaches to repeat GAE, and unique considerations for patients with prior total knee arthroplasty. The discussion also features interesting case presentations, explores the future of temporary versus permanent embolics, and examines the importance of robust study design in advancing MSK embolization. Dr. Minko shares his perspective on the direction of the field and the collaborative effort needed to move GAE evidence and practice forward. --- ResourcesDr. Peter Minkohttps://www.researchgate.net/profile/Peter-Minko --- BackTable Vascular & Interventional (VI) is the go-to podcast for interventional radiologists, vascular surgeons, and interventional cardiologists. Download the free BackTable app to get early access to new episodes, cases, and courses curated by physicians in your specialty.► https://www.backtable.com/app
"Employers have the right to expect much more from their benefit consultants than ever before. This isn't just about managing the fully insured renewal anymore."In this week's special bonus episode, I'm joined by Dr. Dena Bravata, physician, healthcare entrepreneur, and Clinical Advisor for ParetoHealth, to break down the findings from Pareto's inaugural 2026 State of Healthcare Spend Report.Based on responses from nearly 1,600 CEOs, finance, and HR leaders, Dena and I unpacked why employers have finally reached their "damn it" moment. We discussed the massive unpredictability of fully insured renewals, why 80% of employers are actively considering alternative funding mechanisms, and the real reason half of the market is ready to fire their current broker.We also dove into the clinical side of the data. We looked at top cost drivers like cancer, MSK, and GLP-1s, and explored why treating mental health and substance use as a core component of your medical plan is non-negotiable for cost containment.If you advise SMB employers or manage a health plan yourself, the era of the broker "apology tour" and basic renewal management is over. This episode is a reality check on exactly what clients are expecting right now. Tune in!Visit 2026 State of Healthcare Spencer Self Funding Podcast to review the report. Thank you to ParetoHealth for sponsoring this episode!ParetoHealth: ParetoHealth empowers midsize employers with a long-term solution to reduce volatility and lower overall health benefits costs. Visit https://www.paretohealth.com/events/ to learn more.Episode Chapters(00:00:00) Intro: Dr. Dena Bravata & The 2026 Healthcare Spend Report (00:01:05) Why Small & Midsize Employers Are Ignored in Healthcare Data (00:02:37) The "Damn It" Moment: Approaching $20,000 Per Employee (00:04:09) Survey Demographics: 1,600 Leaders Across 14 Industries (00:05:44) 80% of Employers Saw Double-Digit Healthcare Increases (00:07:28) Why Half of the Market is Ready to Fire Their Broker (00:10:59) Top Medical Cost Drivers: Cancer, MSK, and GLP-1s (00:15:01) The Amplifier Effect of Mental Health & Substance Use (00:18:38) Pharmacy Spend & Why Primary Care Can't Manage Obesity (00:21:14) Price Variance and the Need for Care Navigation (00:22:18) The Era of the "Apology Tour" and Renewal Management is Over (00:24:37) Closing Thoughts: Demand More From Your ConsultantKey Links for Social:@SelfFunded on YouTube for video versions of the podcast and much more - https://www.youtube.com/@SelfFundedListen/watch on Spotify - https://open.spotify.com/show/1TjmrMrkIj0qSmlwAIevKA?si=068a389925474f02Listen on Apple Podcasts - https://podcasts.apple.com/us/podcast/self-funded-with-spencer/id1566182286Follow Spencer on LinkedIn - https://www.linkedin.com/in/spencer-smith-self-funded/Follow Spencer on Instagram - https://www.instagram.com/selffundedwithspencer/
"Employers have the right to expect much more from their benefit consultants than ever before. This isn't just about managing the fully insured renewal anymore."In this week's special bonus episode, I'm joined by Dr. Dena Bravata, physician, healthcare entrepreneur, and Clinical Advisor for ParetoHealth, to break down the findings from Pareto's inaugural 2026 State of Healthcare Spend Report.Based on responses from nearly 1,600 CEOs, finance, and HR leaders, Dena and I unpacked why employers have finally reached their "damn it" moment. We discussed the massive unpredictability of fully insured renewals, why 80% of employers are actively considering alternative funding mechanisms, and the real reason half of the market is ready to fire their current broker.We also dove into the clinical side of the data. We looked at top cost drivers like cancer, MSK, and GLP-1s, and explored why treating mental health and substance use as a core component of your medical plan is non-negotiable for cost containment.If you advise SMB employers or manage a health plan yourself, the era of the broker "apology tour" and basic renewal management is over. This episode is a reality check on exactly what clients are expecting right now. Tune in!Visit 2026 State of Healthcare Spencer Self Funding Podcast to review the report. Thank you to ParetoHealth for sponsoring this episode!ParetoHealth: ParetoHealth empowers midsize employers with a long-term solution to reduce volatility and lower overall health benefits costs. Visit https://www.paretohealth.com/events/ to learn more.Episode Chapters(00:00:00) Intro: Dr. Dena Bravata & The 2026 Healthcare Spend Report (00:01:05) Why Small & Midsize Employers Are Ignored in Healthcare Data (00:02:37) The "Damn It" Moment: Approaching $20,000 Per Employee (00:04:09) Survey Demographics: 1,600 Leaders Across 14 Industries (00:05:44) 80% of Employers Saw Double-Digit Healthcare Increases (00:07:28) Why Half of the Market is Ready to Fire Their Broker (00:10:59) Top Medical Cost Drivers: Cancer, MSK, and GLP-1s (00:15:01) The Amplifier Effect of Mental Health & Substance Use (00:18:38) Pharmacy Spend & Why Primary Care Can't Manage Obesity (00:21:14) Price Variance and the Need for Care Navigation (00:22:18) The Era of the "Apology Tour" and Renewal Management is Over (00:24:37) Closing Thoughts: Demand More From Your ConsultantKey Links for Social:@SelfFunded on YouTube for video versions of the podcast and much more - https://www.youtube.com/@SelfFundedListen/watch on Spotify - https://open.spotify.com/show/1TjmrMrkIj0qSmlwAIevKA?si=068a389925474f02Listen on Apple Podcasts - https://podcasts.apple.com/us/podcast/self-funded-with-spencer/id1566182286Follow Spencer on LinkedIn - https://www.linkedin.com/in/spencer-smith-self-funded/Follow Spencer on Instagram - https://www.instagram.com/selffundedwithspencer/
In this episode, we review the high-yield topic of Osteopetrosis from the MSK section.Follow Medbullets on social media:Facebook: www.facebook.com/medbulletsInstagram: www.instagram.com/medbulletsofficialTwitter: www.twitter.com/medbullets
In this episode, we review the high-yield topic of Humeral Shaft Fracture from the MSK section.Follow Medbullets on social media:Facebook: www.facebook.com/medbulletsInstagram: www.instagram.com/medbulletsofficialTwitter: www.twitter.com/medbullets
In this episode, we review the high-yield topic of Carpal Tunnel Syndrome from the MSK section.Follow Medbullets on social media:Facebook: www.facebook.com/medbulletsInstagram: www.instagram.com/medbulletsofficialTwitter: www.twitter.com/medbullets
In this week's 5 Yrs Ago Flashback episode of the Wade Keller Pro Wrestling Post-show (7-6-2021), Nate Lindberg and Tom Stoup dive into the mailbag and take your calls on this year's Great American Bash, including Cole vs. KOR II, Thatcher & Ciampa vs. MSK, Shirai & Stark vs. The Way, Kross & Gargano meet in ring, Grimes vs. Knight, Nox's Return, and more.Become a supporter of this podcast: https://www.spreaker.com/podcast/wade-keller-pro-wrestling-post-shows--3275545/support.
In this episode, we review the high-yield topic of Femoral Neck Fracture from the MSK section.Follow Medbullets on social media:Facebook: www.facebook.com/medbulletsInstagram: www.instagram.com/medbulletsofficialTwitter: www.twitter.com/medbullets
In this episode, we review the high-yield topic of Reactive Arthritis from the MSK section.Follow Medbullets on social media:Facebook: www.facebook.com/medbulletsInstagram: www.instagram.com/medbulletsofficialTwitter: www.twitter.com/medbullets
In this episode, we review the high-yield topic of Raynaud Phenomenon from the MSK section.Follow Medbullets on social media:Facebook: www.facebook.com/medbulletsInstagram: www.instagram.com/medbulletsofficialTwitter: www.twitter.com/medbullets
In this episode, we review the high-yield topic of Volkmann Ischemic Contracture from the MSK section.Follow Medbullets on social media:Facebook: www.facebook.com/medbulletsInstagram: www.instagram.com/medbulletsofficialTwitter: www.twitter.com/medbullets
Is pelvic lymph node dissection still necessary in the era of PSMA PET imaging? In this episode of BackTable Urology, Dr. Ruchi Talwar interviews Dr. Kirsten Greene about how advanced imaging is influencing decisions for radical prostatectomy. They examine the strengths and limits of PSMA PET, the risks and benefits of PLND, and why careful, evidence-based decision-making remains essential. --- Get the BackTable apphttps://www.backtable.com/app --- Timestamps 00:00 - Introduction03:12 - Risk Calculators and Consent04:39 - Nomograms vs. Complications09:57 - Endpoints That Matter11:38 - PSMA PET Strengths and Limits13:51 - Negative PET Decision-Making15:08 - Positive PET and Multimodal Care18:02 - Fluorescence Guided Surgery19:10 - Counseling on Complications22:27 - Preventing Lymphocele24:56 - How Lahey Wrap Works26:45 - Future Mapping and Therapy28:47 - Research Gaps and Dogma31:07 - Key Pearls and Wrap Up --- More about this episode Dr. Greene explains her approach using MSK and Briganti nomograms alongside PSMA PET, noting that PET scans may miss small nodal disease and quality varies between centers. She emphasizes PLND as a staging tool rather than a curative procedure, outlining potential complications like lymphocele, lymphedema, vascular and ureteral injury, and neuropraxia. The episode highlights her shared decision-making process, surgical techniques for limiting risk, and the importance of multimodal planning, especially for PET-positive nodal disease. Dr. Greene also shares practical tips for lymphocele prevention, including the use of metal clips and the Lahey wrap. --- Resources Different lymph node dissection ranges during radical prostatectomy for patients with prostate cancer: a systematic review and network meta-analysishttps://pubmed.ncbi.nlm.nih.gov/36872312/ Limited versus Extended Pelvic Lymph Node Dissection for Prostate Cancer: A Randomized Clinical Trial https://pubmed.ncbi.nlm.nih.gov/33865797/ --- BackTable Urology is the go-to podcast for urologists, urologic oncologists, and urogynecologists. Download the free BackTable app to get early access to new episodes, cases, and courses curated by physicians in your specialty. ► https://www.backtable.com/app
Dr. Deb Muth 00:03What if bloating, back pain, and low energy aren’t separate problems, but clues from the same root cause? What if your posture and the way your fascia moves are changing how your digestion works and how you feel every day? Today, we’re unpacking why symptoms like bloating, fatigue, and persistent pain often come from deeper, whole body issues, and how a multimodal, root cause approach speeds real recovery. You guys can, put our advertisement in here for Venari before we do the intro.Welcome back to Let’s Talk Wellness Now, the show where we uncover the root causes of chronic illness, explore cutting-edge regenerative and integrative care, and empower you with practical tools to heal.I’m Dr. Deb, your medical detective, and today we’re talking about whole body recovery, how movement, fascia, gut health, and personalized medicine come together to restore function, energy, and confidence in your body. If you or someone you love struggles with bloating, pain that won’t quit. Slow recovery after surgery or postpartum, or chronic low energy, this episode is for you.So get comfortable, grab a warm drink, And let’s get into it.So today, I’m joined by Dr. Shalini Bhat, founder of the Movement Boutique in Toronto. She is a chiropractor and double-certified functional medicine practitioner who builds care around root causes, lady after my own heart. And rather than just treating the symptoms, as we all know, and you guys have heard me talk about before, that is how we get to the other side of things. So, what I love about your work is you blend the clinical expertise and that lived experience, and just before we started recording, we were talking about the difference of fascia.and chiropractic, and even when you’re looking at bringing in acupuncture and Pilates and functional medicine, having all those modalities together is so amazing. So, before we dive into all of this stuff. Tell us a little bit about your own story. Shalinibhat 02:49Yeah, well, my own story is that I grew up very steeped in Western medicine. My father’s a surgeon, and I had, you know, access to all the allopathic care that was out there, but I kind of had all that, what I call, gray area symptoms. That doesn’t make it into, you know, an allopathic answer, so to speak. And so, having access to all of… you know, the best… this specialist and that specialist didn’t really give my IBS you know, some type of help, and it didn’t really give my chronic back pain some type of help. And I kept, like, tearing my meniscus. I was a dancer, and I just kept, like, thinking, I’m doing all the same things as all these other girls in my class. Why am I the one who keeps tearing my meniscus? Like, what is up with… they… like, we all have the exact same tissues. Why is my tissue resilience so low? that this keeps happening to me. And I seem to be the only one in, you know. from dancing from 3 till I was… when I was 3 till when I was 18, and experiencing this, and I’m looking at everybody, like, what’s the deal? And I sort of felt different, but I couldn’t really pinpoint what was going on, and probably similar to your story. all the things that were coming at me were just labels and diagnoses, and like, you know, same with my meniscus, they were like, the first time, they were like, alright, we do surgery. I was like, okay, sounds good, like, went and did the surgery. The second time it, tore, I was like, that obviously didn’t, do it, because they took out 30% the first time, and then, you know, some of the 70%, you know, tore. And I said, there has to be… there has to be some reason why my My tissue resilience is low, and why that shear force is going through on my left knee every single time, like that same mechanical strain is happening, and fast forward to today, I realized that fascia is this fabric that runs all over the body in huge swaths, and in very large, sort of movement patterns, which we’ll get into, but basically, the way that I was, like, standing, the way that I was… my tissue resilience was less, that’s what was setting the stage for me to re-tear that meniscus, but nobody was asking those questions. My IBS, like the stealth infections I had, the leaky gut I had, all of those things creating excessive inflammation just in my body in general was decreasing my tissue resilience and making me re-injure that same area. So instead of, oh, I’ll just keep getting it, you know, shaved down or taken out, like, why was that same mechanistic injury and strain happening? on that knee, and I started asking different questions, which led me to, instead of going to medical school, say, oh, wait, chiropractors can actually, like, you know.Actually move the body, understand what’s going on, spend the time with patients to properly diagnose, and then actually use our hands, because I’ve always been a very tactile person. Being a dancer, you know you’re always using your body, I understand my body, so when I started my kinesiology degree. I… kinesiology was a no-brainer. I’m like, I have a body, I want to use it, I want to learn… you know, when I’m learning about the muscles and the hands and the… like, I have that, so it’s… I’ve always been a touch kind of person, and that makes sense to me, learning about the body. And, that’s why I ended up studying in such, let’s say, asking alternative questions, so to speak, and that’s why even when I finished my kinesiology degree, and even when I finished my chiropractic training, I still went to school to learn acupuncture training, because I still had more questions, and thenI… and concurrently, I was teaching Pilates as well, and Pilates always resonated with me because I thought, yeah, if you have this really strong powerhouse and this really strong core, that always helped my back. And it always helped my knee. And so, translating kind of all four of these modalities, the chiropractic, the fascial release, the acupuncture, and the Pilates, became sort of my… my own little method that I created on how to help people. I probably… a lot of people listening to this, think of chiropractic as, like, you go somewhere and you get crack, crack, crack top to bottom. That actually is not how I’ve ever practiced, either, because even when I was chronically inflamed with all these issues, even an adjustment would send me into more inflammation, and I would be, in… having aches and pains, so that was not even… I needed it so much gentler, and that’s why I started working with fascia and thinking, like, what else is here? And, like, if someone’s so inflamed, maybe an adjustment is too aggressive for, somebody in the moment. And there’s a time and a place for everything, don’t get me wrong, but that wasn’t my personal, you know, go-to, so to speak, and so that’s why I started working more gently around fascia, and that’s why I used acupuncture needles, and pilates training, and rehabilitation, and looking at people’s movement patterns, and seeing, okay, where are things going off here, and what’s the actual… I hate the word root cause, but that’s where we all come from, it’s just gotten so crazy. But really, truly, if you have back pain, why are we just looking at the back.Like, if your entire pelvis is off, if your entire, like, body is leaning to one side, and you’re putting way more weight on one foot than another, like, why are we… why are we just treating the back? Why are we just adjusting the back? Why are we just, you know, putting ice on the back, or put… or putting painkillers, or rubbing things on the back? We gotta look at the entire body as one whole system when it comes to injury, and that’s my very long backstory to tell you how I… sort of amassed these different things that I do, And in my training. Sorry, I forgot one piece in there, and that’s… with my gut thing and my IBS, I went back to school and did functional medicine training to figure out what that was about, because, and even when my uncle mentioned it, I think, oh gosh, early 2000s, he said, leaky gut, and I thought, well, people probably think these days, like, wait, there’s holes in my stomach? You know, like, what isAnd at that time, you know, way back in the day, the first test was, like, that, flakulose mannitol, like, that really. Dr. Deb Mut 08:53Boom. Shalinibhat 08:53You can get tests. Yeah. Now, obviously, we’ve come a long way. So yeah, that’s how I ended up with all these five random modalities that are sort of enmeshed into one, and that’s what we do in my practice. My clinical practice is literally all of those modalities, and we really meet people where they are. So we invite anyone to come to us with, whether they have an MSK issue, and that’s the primary thing they want to work on, we can do it by starting Pilates. We can do it by starting fascial training. We can do it by starting acupuncture. We can do it by running labs and seeing where you are functionally if you want to lower that inflammation, or those stealth infections, or whatever it is that you have going on. So we invite anyone to come in and sort of pick their service menu, because I feel we… we should help everyone, but not everyone feels… like, not everyone’s like, wow, I want to run a school test with you first. They may have the capacity to be like, okay, I’ll try a workout, or I’ll try a Pilates class, you know? And then once they’re in our space, they’re like, oh wait, what else do you offer here? This is really different than where I’ve been. So that’s sort of what my practice is all about. Dr. Deb Muth 09:58I love that. I love that blending of all of the different things, and I think, you know, some of the best practitioners are those who’ve been through things, and it doesn’t have to be that way, but we kind of explore all the different things that could be causing our issues, which allows us to have a little bit bigger reach, across modalities, because there’s never the one thing that fixes everything. It’s kind of like in the conventional medicine world, we’re looking for the one pill that fixes everything, and there just isn’t that. And so, when you’re looking at blending all of these things, eventually you will find the right thing for each person, because it could be very different. You know, what works for me might not work for you, or it might be a different combination, and I think looking at each person as an individual is really important these days. Shalinibhat 10:44Totally, yeah, and I can’t… like, I just have to emphasize what you said again, because everyone is looking for it to be… you have patients like this, I have patients like this who come and they’re like, I’m just looking for that one guru, that one person who’s gonna finally tell me what it is that I have. Finally, I’m looking for that one answer, I’m looking for that one supplement, and like, if I can just reiterate exactly what you said, like. there will be 10 different kind of things that could be bothering you, and 10 different kind of solutions that will be the best for any given person, and if we just change our mindset around that, like, just say, oh, there won’t be one exact thing, and one exact solution, and I should be bucketing myself into 10 different things, and like, just… even just the sheer change of mindset and expectation, I think would help like, everybody, including practitioners, right? Because people will come to us and say, what is the one thing? What is the one, like, what is the one supplement, right? Dr. Deb Muth 11:38Yeah. Shalinibhat 11:39it’s too much pressure, right? Dr. Deb Muth 11:41It is, yeah. Shalinibhat 11:42Yeah. Dr. Deb Muth 11:44Yeah. Yeah, when they come and say, you’re my last hope, and you’re like, oh boy. I hope not, but that’s how we get sometimes. We’re looking for that person with that final answer, and and there is… there’s not just one answer, and I think that’s the important takeaway. So, let’s dive into, fascia. It’s a word that a lot of people might have heard, but don’t really understand what that is. Tell us about fascia and how it fits into the influence of movement and pain, and how can we change that for people? Shalinibhat 12:19Yeah, I love this question, because even one of my own patients who I manually treated for, you know, 14, 13 years, she said to me, Charlie, you know what’s becoming so hot? There’s the word fascia. I’m hearing it all of a sudden. I was like, what? So, yes, even people receiving fascial care, sometimes don’t even put two and two together. Fascia is basically when you cut open a chain chicken breast. When you cut open a steak, there’s that sort of film that’s on, you know, the chicken, or there’s that kind of film around a steak, and those white kind of areas, that we sort of cut off. That is fascia, and if you picture it in a chicken breast, it’s really that… it’s really that thin layer that comes off of that chicken. And what’s really cool about fascia is it’s highly resilient when it’s stretched, so if you actually were to picture stretching that chicken, you know, piece, if you actually, like, you know, hit it with your finger, it would be pretty tensile.But if you kind of let it go and be, relaxed, it’s very flexible. So you could actually take your finger and almost put your finger through that piece of that film, and it would almost make it all the way. So fascia is very flexible, but it’s also extremely resilient. And that is… those two qualities of that fabric are what will give us more tissue resilience.The other thing that we need… sorry, I should also back up. Fascia, by the way, is just a fabric that encases everything in your body. So, it’s a support structure, it holds our organs up in the places where they’re meant to be, otherwise gravity would pull them all down into our pelvis. It surrounds every, you know, blood vessel and nerve and, lymph, area, and then let alone all your muscles and your bones. So, even when we’re talking about something like bone health and bone strength, you know, often people are talking just about this calcium conversation when we’re talking about bone, for example, and fascia is encasing that bone, right? So I just talked about the resilience of that type of, what’s on a chicken breast. I’ll actually change analogies here just to… for people to understand a little more. If you take women’s nylons, of those thin nylons, same thing, right? If you pull them really tight, and you were just holding them in your hand, and someone were to flick it, it’s very strong, right? But again, if you held it single layer and kind of put your finger through, it’s very flexible. So, in… as we age.If that tissue’s getting really tight and dehydrated and, you know, it’s not flexible as bone moves, right? That fabric is what’s holding that bone and creating that sort of shock absorption if we’re doing anything. It’s that women’s nylon that’s kind of shock absorbing that bone when it’s coming down you know, jumping, landing, whatever, running, whatever it is that we’re doing. So that’s why one of the big things of, you know, strength training or keeping your body moving as you age is because it continues to make that fabric that’s actually around the bone. So yes, we talk about things in such isolation. Oh, we need bone health, we need bone strength. Okay, that’s great, but what’s actually intertwined right around that bone, creatingthat integrity is fascia. And one of the ways to keep it, again, flexible and tensile and strong, which are the two qualities we wanted it, is to keep it very hydrated. And there’s, you know, another kind of way to think about hydrated and not hydrated fascia. If you think of beef jerky, but you think of steak, you can… a raw steak, sorry guys, if anyone’s vegan. The beef jerky spirit, you can tear it super easily. Right? But you can’t take a piece of raw steak and tear it with your bare hands, right? You can’t. It’s so strong. So the same thing goes for that type of hydration. You want to keep that tissue really hydrated, and that’s why in a lot of scenarios with chronic aches or pains.The tissue is really dehydrated, and so that’s why, when someone goes for a massage, or they go for fascial release, or they have direct stimulation to that tissue, that’s actually breaking those adhesions and kind of, almost like a sponge, it’s compressing and releasing, which is actually bringing more moisture into that gel-like matrix that is fascia which allows those fibers to move again, so again, we’re bringing that flexibility and that tensile strength back, which gives you more of that raw steak texture versus that beef jerky, right? That beef jerky’s so vulnerable. You go to do a workout on beef jerky, you’re ripping your muscle. I’m so sore, I can’t get up and, you know, people who are so unusually sore the next day, for example, versus those people who have nice, hydrated fascia that they… that they’re great, they’re working on a raw steak texture, they’re not going to rip something or have that feeling of being so vulnerable. So that’s basically, yeah, to answer your question about where fascia fits into, everything. And again, just to reiterate fascia it actually… when you look at… I don’t know if you know any of the work of Tom Myers, that’s who I studied way back in the day, like.In the early 2000s he, you know, wrote this book called Anatomy Trains, and what it, illustrates is how long the connections of fascia are. So, the exact same sheath might start from our forehead and our scalp and go all the way down the back of the skull, all the way down the spine, through the pelvis, down the back, down the hamstrings, down the calves, right into the plantar fascia. So, I… I say plantar fascia because that’s the one area I think people have heard the word fascia before. So, although they’ve heard plantar fasciitis probably more. Dr. Deb Muth 18:06But no. Shalinibhat 18:07you know, it’s from the plantar fascia. And the plantar fascia is a continuous sheath of fascia all the way up to our head. So, you know, at any point along that entire chain, there might be a dysfunction. So you might be having… you might be experiencing plantar fasciitis, but you’re… that… you could address that person’s fascia anywhere along that entire line. To be able to truly again, within quotation marks, root cause, address that plantar fasciitis, because someone might have plantar fasciitis, it hurts when they step out of bed in the morning, they have that exact classical pain, they’ve been to the GP, GP says, yep, you got plantar fasciitis, they go, okay, and now they’re, you know. no better off, they might give them, like, a few things to do, but really, if they actually address that entire channel of fascia, they would give themselves more space, and consequently decrease a lot of that inflammation in that one area that’s, again, getting… just like my knee injury at the beginning, why is that one area taking so much brunt? there’s an issue along the chain. And I’m giving you one train, but there are many different trains that work in long sheets throughout the whole body. And another way I, like, sort of. I like analogies because I’m a visual person. Again, back to that dance mindset. I think another way people can really get on board with, like, fascia being in long sheaths is picturing a woman in a one-piece bathing suit. If you pull up the shoulder straps of that one-piece bathing suit, can you give her a wedgie? Like, she can pick that wedgie all day long. Dr. Deb Muth 19:42Right. Shalinibhat 19:43actually the shoulder straps that you need to release to get rid of it completely. So that’s kind of, like, the easiest example I can give to someone to relate, like, because they might have that wedgie-type experience or symptom, and they go to their doctor, I’m having a wedgie, I’m having a wedgie, and they’re like. Dr. Deb Muth 19:58No. Shalinibhat 19:59let’s pick it, let’s glue the bathing suit down, let’s do this, let’s do that. Really, someone’s up here franking those shoulder straps way up. You’re never going to get rid of that wedgie unless you actually see where it’s getting, pulled. And really. rings true for the gut as well, which is what I’ve learned. And… like I mentioned, fascia’s encasing our entire organ and organ systems as well, so if people are, you know, messed up and torqued in their spiral line, for example, and if they also are having tightness in different areas of their, you know, whatever, stomach, small intestine, large, like, anywhere along the actual gut, that that does make a big difference for bowel habits, gas, you know, trapped gas, IPS, all that kind of stuff as well. So the musculoskeletal component. And this fascial tangling, for example, also does make a big difference with IBS and stomach aches and all that kind of stuff as well. Dr. Deb Muth 21:02Yeah, and I think, too, one of the biggest things that we disregard, or maybe just don’t think of when it comes to GI issues, is the psoas muscle. Like, when people are constipated, and you start pushing around on that psoas muscle, they’re not gonna like you very much. But even for, like, that low back, that pelvic pain, if we start adjusting that and start doing movements, or yoga, or just massage of that psoas muscle and do a release on the psoas muscle. it can make a huge difference in somebody’s lower back pain. Do you want to speak a little bit to that? Shalinibhat 21:39Yeah, I mean, so there’s… yes, and, I mean, the psoas also right there, fascially, is, on the same train as the diaphragm. So, right under there, how that rib cage is sitting. And how the diaphragm tightness related to exactly what you’re saying, let’s say the top of the psoas fascia, for example, that’s going to change our breathing mechanics, which is also going to change the pressure, you know, kind of pressing down through the gut and everything which we need. It’s also going to change how we’re breathing. So, you know, you and I know taking lower, slower belly breaths and full breaths Better than shallow, breathing up through the neck, which people can relate to by, you know, people always are like, oh, are you sure breathwork’s gonna help? I’m like, if I gave you a paper bag right now and told you to hyperventilate for a scene of a movie like you were an actor, would you actually induce a panic attack on yourself? Potentially. even go the other way, that yes, maybe, you know, sitting down and proper breathing could actually, yes, bring you into this relaxed state, which we, of course, know that, but sometimes people are like, breathing, whatever, that can’t make a difference, right? And you’re like, oh, let’s do the hyperventilation one, let’s give you the bag and start just going, right? See how you feel. Dr. Deb Muth 22:54Yeah, exactly. Shalinibhat 22:56that breathwork and changing someone’s breathing mechanics, and I mean this in a gross, sense of actually, because I’ve done a ton of hands-on work for the last 16 years, when you actually release… a lot of people have tight diaphragms, they don’t even realize, and when you actually get in there and can release that fascia. Not only are a lot of those peoplethose tight, psoaszy people that you just mentioned. But it can dramatically, change how the gut is moving and how they’re feeling in that area as well, right? Again, that pressure change, moving gas, all of that. And then. Going down, how the psoas goes from right under the rib cage to the front of the hip, and I know this is a podcast, so I’m trying to speak it out for people who don’t… who can’t, visualize it, but it comes off the front wall of the lower spine, and then goes all the way down to the hips. And when this muscle can feel tight, to your point, this could feel like appendicitis on one side, you know? At some point, this can be very uncomfortable. I had a patient, actually, very similar story recently. had, like, almost a psoas spasm with a torque through her spine, and diaphragm tight, that’s exactly what I was telling you about. Went to the hospital, thought she had appendicitis, had every, like, ran every single test, was in agony, came to see me, we did all this fascial release of all that exact area. She was like, my pain’s gone. And, like, that’s not something they would ever evaluate there. Dr. Deb Muth 24:21No, they don’t even think about it. Shalinibhat 24:24No, it wouldn’t even cross their mind. So, Yes, there are definitely postural consequences. to not only people who are having tummy aches, gut issues, stomach pain, but it will affect breathing mechanics, and to your point, releasing… I find releasing anywhere in that mid-area, so diaphragm, top of the psoas, like, getting in the obliques, like, anywhere that people can start to relieve in that area is fantastic, and if people need, like, a kind of at-home way to do that, you can take… you can, like, roll up a washcloth and even just put it under where your ribs kind of connect at the front, and just lie on it and let your rib cage kind of fall over it. If you have, we have a little cork ball here, that’s a thing you can sort of put in that area, like, kind of just, under the rib cage. And on either side of the midline is sort of where you would start. If anything felt completely uncomfortable, anyone listening, absolutely adjust it, and start with something less. But that can be such a big, tool, just opening up the front wall of that deeper fascia, for sure. Dr. Deb Muth 25:36That’s awesome. How do you use Pilates? Pilates is well known for so many things, right? But when you’re using Pilates, how do you use it to retrain the movement patterns to reduce pain long-term? Shalinibhat 25:50Okay, so that’s such a good question. So I did training in Pilates 20 years ago. so I would say it’s Pilates-informed, but it’s certainly not directly Joseph Pilates work that I, use by any means, if people are picturing his sequence or anything like that. But that basically informed my… understanding of the core, and I was teaching for 20 years, you know, like, just watching movement patterns, movement patterns, and what I noticed, which is so fascinating, the number of, men, actually, who have diastasis, who, you know, they maybe reach midlife and just Like, suddenly got that belly fat or something, and, like, they’re… they have a diastasis, and, like, they maybe play hockey, or they’re playing, you know, they’re weekend warrioring, kind of, their workouts, and suddenly get really bad back pain, and they have the tightest hips because they’re not really doing any type of cross-training, but they’re… They’re working… they’re doing so much hockey. And they have this back pain, and they’re like, I have no idea what’s going on. And again, they go to the… practitioner that myopically is like, it’s back pain, let’s do an image, oh, it’s a disc bulge here, and like, okay, you know, let’s do these XYZ. And I’m like, dude, these people… this is a diastasis, like, you have literally separated your. Dr. Deb Muth 27:06Nope. Shalinibhat 27:06You are not using your deep core at all. It’s completely, un, what’s the word? It’s unconnected. Like, they actually training as if they had a baby. So it’s really… it’s a population that I think is, like, not, because sometimes when we’re in school, you and me both, we learn these very textbook things that we know when a woman’s had a baby to evaluate her abdomen, you know, to look for diastasis. Dr. Deb Muth 27:33Right. Shalinibhat 27:33Or retraining, that’s a time in a woman’s life during school that we were very much, you know, that’s a… that’s where diastasis, that’s where you hear that word, right? Listening, sorry, diastasis is when your abdominal wall separates in the front from a quick or fast, abdominal expansion, which is why we think of it with, Prenatal, postpartum-type, situations. But we’re… we’re completely omitting this, this… you know, just evaluating people in general. I just saw, a young lady yesterday in her 20s, and she does Pilates every single day. Every single day she does Pilates, and she’s like, I can’t feel my obliques. And I was like, come in here, come in here, let me check this out. And her superficial, her, rectus abdominis, which is her most superficial abdominal layer, it was compensating For her obliques. And that shouldn’t be the case when you’re 20, and I had to undo a whole bunch of different kind of fascial torques that were happening, because When somebody… like, if you picture… if you picture blocks standing on each other and they’re not, sort of, perfectly aligned. then they’re gonna topple, right? And I’m just saying that for the people listening, like, that’s when I say fascial torque, it means that the structure isn’t, isn’t optimal in how it’s going to fire, and how the muscles are going to signal to contract. And so what I had to do, I had to say, wow, it’s actually so cool how your superficial rectus abdominis has compensated for your obliques in this way, and it was, like, really fascinating to watch it, actually, and how she would get around doing it. But we had to completely undo those torques, and then she was able to use her obliques afterwards. So I think there’s a huge miss in abdominal evaluation when it comes to chronic low back pain, or back pain, or, yeah, when you’re talking about, like, where does Pilates fit in, I think Pilates is great when you have somebody who’s really good at teaching it, and I use, principles from it to evaluate people’s core. I mean, so hard to say, because I’ve been doing it for so long now, where I’ve pulled the tools from, but yes, it’s definitely Pilates-informed of how I get their core firing back again, and I would be… you would be absolutely shocked, at the number of people who do work out tons, or do Pilates tons, or… and I own a Pilates studio, okay? I’m very openly admitting that, a ton of people are doing these things that are quote-unquote good for their course. Sit-ups, going to the gym, doing this.Thing, and they actually aren’t three-dimensionally training that area due to, again, these huge, long fascial chains that are just… they’re just not trained how they should be, and what I mean by that is we are so sedentary as a population, this, like, in 2026, like, we’ve never, ever, ever been more sedentary in our whole. like, lives, and we… these fascial chains, we are meant to be up and out, and, like, walking tons, and hanging off trees, and picking things up, and, like, we’re meant to be doing huge movements, and we don’t. We sit in chairs, and then we stand up, and we’re like, I’m gonna go to the gym, and we get on a bike, and we do this much range of motion, and then we do some bicep curls, and do this tiny bit of range of motion. We don’t do huge ranges of notion. things that we should be doing with… to keep that, again, those long swaths of fascia really healthy. And so that’s what ends up happening, because when we do those huge ranges of motions in all those different ranges of motion, like, we have many that we can access.And when we miss a lot of those, those huge swaths don’t get trained, and that’s why the core ends up so weak. And to your point about the psoas earlier, the psoas gets, you know, tight in the wrong ways, and we get weak as a result. But yeah, if I could just say back to… Pilates is not synonymous with a good core, and I think every single person listening should have a good, proper core evaluation, and that’s actually one of the things I’m working on, is for people to be able to self-evaluate properly their core, and their breathing mechanics on how to undo this for themselves, because I’ve done it now with so many people, and it’s been so changing, and it seems so easy to me, it’s almost like it’s like my side gig, because I do, like, oh, I’ll run your labs, and your gut health, and this, but this… it makes… You know, it makes such a huge difference that people… we should all be, you know, educated in looking at this. Dr. Deb Muth 32:14Yeah, so since we’re talking about core, let’s kind of talk about gut health. That seems to be something that you’ve dealt with before. So when we’re talking about people who have bloating and brain fog and low energy, which is half the population, if not more these days, right? What are you seeing as the most common underlying patterns from a physical standpoint, if not a, you know, an infectious standpoint as well? Shalinibhat 32:42I mean, from physicality alone, I would say, again, this… prescriptive, chronic, like, diagnosis of sedentation. Like, I… I can’t… I cannot say enough, like, if you go to work from 9 to 5, and then you go on your spin bike for half an hour in the day, and then sit and watch Netflix, I know… like, and I mean this from the nicest place, I know the person’s intention is correct, like, I know that they really are, like, yep, tick mark, did my workout today. I love that for you. Also, like, that is not an active person. Like, that’s not. Like, you know, 10,000 steps or, like, aiming to be mobile, like, moving as much as humanly possible in a day, like, really, that’s the goal. How much can you possibly move in a day? Because that is where a huge piece… bloating, brain fog, and low energy, let’s just cut to the chase. Hydration and lack of circulation, that’s just, like.Basically, here we go. So that’s… that’s one and two, right? So let’s just talk about move as much as humanly possible, because A, you’re going to move that gas, so trapped gas is going to move, you’re going to actually help digestion and peristalsis, you’re going to help your blood sugar. Then, when we’re talking about brain fog, you need, you know, circular… and again, you and I know there could be many issues, but let’s… let’s stay very high level, because you asked physicality. Moving tons is going to help that, too. Oxygenating those tissues, right? Again, breathing, right? So those breathing mechanics we talked about, our breathing mechanics are going to be better when we’re standing up than if we’re just sitting… like, collapsed, right? So, again, moving more is the ultimate prescription that I would give for every single thing that you just mentioned, energy included, because almost like, you know when you nap in the afternoon and you wake up, you feel less energy? That’s sort of where I think of, like, you know, non-moving, right? And you gotta… yes, there’s gonna be a point to everyone listening who’s like, I can’t even move that much, my weather sucks, or like, whatever.Just walk around your office, like, you know, make a… you’ve got to put the timer. Unfortunately, in the world we live in, we have to use timers, right? Because we’re just going to be, you know, not able to do that. The second thing I would say is even just in that sense of physicality is meet, which I’m sure you know about non-exercise activity time, right? Which is just standing more. So, even just setting your your phone timer for every 20 minutes, because every 20 minutes is when you know, your body’s going to… or every 15-20 minutes, A, it’s when your fascia just goes, oh, okay, you’re kind of not moving, so I’m just gonna, like, I’m just gonna sort of relax here, and that’s where it loses resilience. So that’s something called tissue creep. So that’s why, if you sat all day long, you were kind of semi-stretching it and, like, in a seated position, and that’s why when you then are at home showering, you go to reach for your razor, and you’re like. My god, I just, like, put my back out. It wasn’t that you went to go pick up a razor, it was that all day. Dr. Deb Muth 35:41long. Shalinibhat 35:41That tissue was semi-stretched in this one, you know, sedentary range of motion, for example, and that’s something called tissue creep. And when we have tissue creep, we are so prone to injury in that. So when you stand up every 15-20 minutes, you bring that recoil back to that fascia. So, like I said, we have that flexibility to it, and we have that tensile strength to it, and actually just standing up and sitting back down. will bring both of those qualities back to it, because it will hydrate it. So that’s another thing that, I think people could incorporate more in their day, is that non-exercise activity time called MEAT. That would be my answer for your physicality questions. Dr. Deb Muth 36:19I love that. I remember when I learned about the atomic habits, and I was reading that book, and one of the things that he had talked about was moving more, right? And how do we create these habits? And one of the things that he did was, every time he went to the bathroom, he would do 3 wall push-ups, 3 squats. And so, as you got up every day, you know, multiple times you get up to go, by the end of the day, you had a complete workout in, and you didn’t really even have to overexert yourself, you were just moving your body more, and I think we think of workout as, I have to go to the gym, I have to spend a half hour, 45 minutes there, I have to sweat, it has to be all at one time, and it really doesn’t have to be that way. It can be these small movements throughout the whole day, and by the end of the day, you’ve had your whole workout in. And for those people who are listening to us going, I don’t have time for a workout. I just gave you the time for the workout. Shalinibhat 37:15Yeah, exactly. And just one thing to add to that, only because you said squats and push-ups, I love that, but squats and push-ups are in the exact same range of motion as, cycling and running. So I think that… I think we actually spend too much time in that plane of motion, so if everyone thinks of sitting, standing, cycling, running, squatting, push-ups, they’re all in the same range of motion. We actually all need way more Twisting, like, huge twisting ranges of motion. Dr. Deb Muth 37:43And… Shalinibhat 37:44Need side bending. So if we can include, you know, jumping jacks, that’d be the side bending kind of thing, or side stretching, kind of think on that plane of motion, and big, huge twisting motions, those are two categories of planes of motion that we’re missing, so I would, like, just if someone thinks of, like, what do I do all day? Oh yeah, I do bicep curls, and I do push-ups, and I do squats, and I do lunges, and I… cycling, you are literally working on a range of motion, and, you know, again, back to that, how do we create fashion resilience? Dr. Deb Muth 38:18One Shalinibhat 38:19I’m twisting and side bending as well, those types of movements in our day, big time. Dr. Deb Muth 38:24I love that. That is… that is so great. I love that. So, when we put all of this together, you’re… you’re doing some acupuncture, you’re doing some chiropractic, some Pilates, some fascial release, and… and obviously functional medicine together, too. What does a coordinated, week-to-week look like for somebody who’s taking on all of these modalities to fix their chronic pain, or just to make their body move better? Shalinibhat 38:52Kind of what I said at the top of the call, meet yourself where you’re at, and look for results in what moves the needle for you. So let’s say you did go to a Pilates class, and you’re like, wait, I’m, like, actually feeling so much more energized in my, you know, from the twisting I did in this class, my digestion’s feeling a little bit better. Awesome, double down, go again.If you went for a treatment, and you were like, you know what? That fascial release made my back finally feel open, and I’m feeling great, and that’s made my mood lighter, and my sleep got better, amazing, go again. If you went to acupuncture and, you know, you felt that the needles, like, gave you this sense of calm and a nervous system reset, and that helped your digestion and your sleep, awesome, go back to it. Whatever, like, you can get those huge bucket you know, wins in any type of modality you’re going to… to start, you just gotta start it and notice whether there was a shift for you. If you went to a practitioner and you were like, then that’s not the person for you, and that’s not… and I should say the person, maybe, because maybe that modality is for you, but it was just the person. But do more stuff that makes you feel good. So, and I say that because I’ve had patients that are like, oh, I went to this person for 10 years, yeah, I felt okay, it was fine, they told me to come back. I don’t know, they told me to do this. Like, seek results, because, like, I’m a results-oriented person. When you come to see me.like, if I haven’t changed… if I haven’t made a huge difference in one session with you, like, please don’t come back. Like, you know, be like, that didn’t work for me, right? Dr. Deb Muth 40:26Number 7. Shalinibhat 40:26Reason it was complicated, and I explained to you why… like, if someone’s in major acute pain, and you can explain, this isn’t going to be the one-shot thing right now. Right. You know, and there are, like, listen to your practitioner like that, but you want to find a personal fit, first of all. It’s really important when we’re talking about these types of modalities, whether it’s acupuncture or hands-on care, fascial release, Pilates, you need to find someone who’s the right fit for you, because it has to be motivating and exciting, and you want to be able to want to go back. So, if you’re like, I don’t know, my friend kind of, like, goes, and like, they said I should go back next week. If that’s your energy going into it, you’re not going to get the best, most out of it, right? So just do whatever it is that, you know, I’m somebody… if I hear of someone through the grapevine with… through three people, that’s my thing. If three people say, so-and-so’s awesome, I’ll go try them. And then how I built my practice, I kept trying all these people that people would refer, and I would take the best bits of what they did through treatment and stuff, and I’d be like, okay, and I slowly started incorporating that into what I do as a clinician. And I would say the same for… not that you guys would be amassing it to do it as a clinician, but same thing when you go to seek any type of care, number one, make sure you have some type of a positive feeling when you’re coming out. Number two, don’t be… like, go back again. All of these things are meant to be compounded, so, you know, whether you decide to yourself, I’m going to do acupuncture once a month, then I’m gonna do fascial release twice a month, then I’m gonna do Pilates twice a month, and then I’m gonna make sure I get my walks in every single day, and I’m, you know, doing my breathwork and my relaxation techniques, and I’m just gonna prioritize my nutrition, drink my water, and go to sleep on time. Like, hello, you’ve already. Dr. Deb Muth 42:05I’m gonna leave our… Shalinibhat 42:07you’ve already done, you know, you’re gonna be better for it. So, put into your schedule whatever fits, and don’t make it overwhelming, because if something’s overwhelming, you’re also not going to do it, and then it’s not going to work either. Dr. Deb Muth 42:18Absolutely. This is a great conversation, I love this. I have one last question for you, and I ask this question of all of my guests. If you could change one thing in healthcare today, what would it be? Shalinibhat 42:31Oh my god. That’s such a good question. I… does it have to be realistic? Dr. Deb Muth 42:41It does not. Shalinibhat 42:43I would put someone with expertise like myself, and I’m not saying this, like, oh, I’m so good, like, just somebody with outer knowledge of the body and inner knowledge of the body from a gray area functional perspective in acute care. And what I mean by that is for example, that patient I gave earlier that went to the hospital with acute abdominal… within quotation marks, acute abdominal pain, seeking, like, is this appendicitis? If that person sought somebody who… or… That person sat and waited in the, you know. at ER for so long because they’re not bleeding from the head, you know what I mean? Right. And then you put a functional person in there, not only are they going to say, hey, you want to know what this is? That makes that patient feel great, because they feel heard, they feel seen, they now have an answer for what’s going on, and… they didn’t have to clog up the system. I think there’s a lot of functional, from an MSK perspective, people in the ER, and I think there’s a lot of functional you know, things that you and I would see in our practice in the ER. And I wish people were more equipped with the type of tools you and I might have that we take Granted, because if you or I have a symptom… I remember one day, actually, I had this… such an acute neck pain all of a sudden, and I knew exactly what it was, and I knew exactly what to do to, like, how… like, how to move, and how to lie, and what at that moment, and I said to myself, I said to my husband, I said, if I was a layperson right now, I would think death was on my door, I would make you run me to the ER right now in an ambulance, like, I would call an ambulance because of how I felt, but because I actually knew what it was, A, you have that locus of control. You’re like, oh, okay, I’ve seen this before, I’ve treated this before, I know how to deal with it. Okay, it’s gonna be 48 hours, here’s how it’s gonna start, like, here’s the position I need need to be in, blah blah blah.But if you don’t know that, that’s highly alarming. And so, the second… You didn’t ask me for two things, but I’m giving you two things anyways. That’s okay. The thing would be making sure that in schools, all of the children, all of the teenagers are extremely equipped with their own understanding of the body and understanding of tools available to them Should non-emergent things be happening to them that they could empoweringly address themselves. Dr. Deb Muth 45:12I love that, that’s great. I think you’re right, like, we’ve taken so much of how the body functions away from the general population of knowledge and made it so complicated that people can’t help themselves, and they’re so fearful of Any little thing that happens in the body. And I guess rightfully so, you know, there’s a lot of terrible things that can happen, and everybody’s afraid of the worst thing possibly happening, but I think if we could give power back to people so they understood their bodies. That would make all the difference in the world between them being a nervous wreck about something and waiting to see the doctor versus, I can treat this myself, and it’ll be better, and it’s okay. Because I think we’re… we’ve lost a lot of that magic of, folk medicine, so to speak, or the things we pass down from family generations, but we were able to treat a lot of things back then and make people not afraid of it, and we need to go back to learning that. Shalinibhat 46:10We do, and I think the other, like, one thing that I noticed with my son, even, like, all, like, immediate… like, if he even shows a sign of anything, I’m like, oh, immediately putting him on, like, homeopathic this or whatever, and that’s when to use those things, right? Is, like, at that. Dr. Deb Muth 46:26Right. Shalinibhat 46:26So, like, if we could teach people that, like, you know, the signs of when you’re feeling off, like, and really tune into that, so, like, how do I feel today? Like, what’s norm… what’s my normal, and what’s not, so that they can always catch things really. Dr. Deb Muth 46:41early. Shalinibhat 46:42When you catch things really early, all the amazing things that we have, you know, access to can make such a big difference. It’s when it goes on and on and on and on and on so long that you’re suddenly like, oh my gosh, now what’s wrong with me? And that’s the other thing, is like.That if, again, we could shift the mindset of when something happens to someone, they’re like, the hospital will fix me, the doctor will fix me, something’s wrong with me, you know? Dr. Deb Muth 47:03And then… Shalinibhat 47:04Like, oh, my neck is feeling like this because I XYZ, and now… and you know what? It just needs this. Instead of that, I’m going to take this body that’s kind of not mine and take it to the ER, you know, to fix it. Dr. Deb Muth 47:16written. Shalinibhat 47:17You know, and so that’s, like, yeah, that’s a piece that’s missing, too, that I wish we had. Dr. Deb Muth 47:22Awesome. This has been such a great conversation. Thanks for joining me. Is there any last comments or things you want to share with our audience today? Shalinibhat 47:31Yeah, I mean, you guys can come find me. I actually, write a newsletter myself, not through AI, and so if you liked learning these little nuggets from me, here on this podcast, I just talk like this, and this is what my newsletter sounds like, is like you’re chatting with me. So you can head over to my Instagram or my website and join, my newsletter list, and yeah, otherwise you can join me on my social channels, which I’m sure you’re gonna link here. And, yeah, it was really nice to meet you, and thank you for all the work that you do, because I know it’s hard doing the work that we do, and, you know, trying to hold the line for the people that really do need us, so I always, you know, just want to say thank you for that, too, and thank you for having me today. Dr. Deb Muth 48:16Oh, thank you, it’s been a great pleasure. Shalinibhat 48:18Yeah! Dr. Deb Muth 48:21Oh, goose this. Thank you for joining me today on Let’s Talk Wellness Now. If this episode gave you clarity about why your symptoms might be connected, or how, and how they’re integrated in root care cause. and you feel like this could help, share it with someone who needs to hear this. To learn more about Dr. Bhat and the Movement Boutique, you can look them up online or on social, and check out their links below. Until next time, I’m Dr. Deb. Remember that your recovery is a process, not a race. Be well, and I’ll see you next time.The post Episode 271 – The Tissue Saving Your Body (Or Making You Stiff): The Fascia Explanation first appeared on Let's Talk Wellness Now.
In this week's 5 Yrs Ago Flashback episode of the Wade Keller Pro Wrestling Post-show (6-29-2021), Nate Lindberg and Tom Stoup take your calls and dive into the mailbag to talk the Women Tag Team Triple Threat for the Number One Contendership, Kross and Gargano's building rivalry, Swerve vs. Reed, MSK head to head with Thatcher and Ciampa, Atlas & Martinez vs. Tien Sha, Grimes vs. Sterling, Hale vs. Strong, the new Breakout Tournament, and more.Become a supporter of this podcast: https://www.spreaker.com/podcast/wade-keller-pro-wrestling-post-shows--3275545/support.
In this episode of Talking Rheumatology, Ernest Choy interviews members of the Lupus guideline working group to discuss key updates in the 2026 life course lupus guideline, including new therapies, holistic care approaches, and recommendations spanning paediatric to adult services. Hear how these evidence-based changes aim to improve outcomes for people with lupus and support clinicians in delivering high-quality lupus care.Find the video version of this episode on the BSR YouTube channel. Read the full guideline and download the handy infographic and audit tool here. Thanks for listening to Talking Rheumatology! Join the conversation on X using #TalkingRheum or tweet us @RheumatologyUK.BSR is the UK's leading specialist medical society for rheumatology and MSK health professionals. To discover how we can support you in delivering the best care for your patients, visit our website.
Could we be in the middle of the biggest breakthrough in MSK medicine?James and Jeff check out the 2026 paper - Neuroimmune interactions in musculoskeletal conditions: An introduction for clinicianshttps://doi.org/10.1016/j.msksp.2025.103469
If you've spent any time on social media or in many gyms lately, you've probably heard the buzz about BPC-157. Often called the "healing peptide," it's being touted as a miracle cure for everything from chronic tendinopathy to acute muscle tears. Patients are showing up in our clinics asking where they can get it, and some "wellness clinics" are already handing out injections like candy.But as sports physical therapists, we have to look past the "bio-hacker" headlines and look at the hard data. Is there actually any human evidence that this works? And more importantly, is it even legal for your athletes to use?A brand-new systematic review just hit the journals, and it's the most comprehensive look we've seen yet at the mechanism, the MSK outcomes, and the massive safety "gray areas" surrounding this compound. The results are fascinating, but they come with some major red flags that every clinician needs to hear before their next patient interaction.In this week's episode, I'm diving deep into the science of BPC-157. We're breaking down the pathways it uses to (potentially) speed up tissue repair, the truth about the current human research, and the legal warnings you must give your athletes to protect their careers.To see full show notes and more, head to: https://mikereinold.com/the-truth-about-bpc-157-peptide-in-sports-medicine-what-you-need-to-know/Learn our proven system for sports PTs who want to master ACL rehab, confidently progress patients, and guide athletes safely back to high-level sport.Click here to learn more Click Here to View My Online CoursesWant to learn more from me? I have a variety of online courses on my website!Disclaimer: This post contains affiliate links. If you make a purchase, I may receive a commission at no extra cost to you.Support the show_____Want to learn more? Check out my blog, podcasts, and online coursesFollow me: Instagram | Twitter | Facebook | Youtube
In this week's 5 Yrs Ago Flashback episode of the Wade Keller Pro Wrestling Post-show (6-13-2021), Nate Lindberg and Tom Stoup took calls and dove into the mailbag to discuss NXT Takeover In Your House including the Fatal Five Way for the NXT Championship, MSK & Bronson Reed vs. Legado del Fantasma, Mercedes Martinez vs. Xia Li, Raquel Gonzalez vs. Ember Moon, Cameron Grimes vs. LA Knight, William Regal calling for a change in NXT, more.Become a supporter of this podcast: https://www.spreaker.com/podcast/wade-keller-pro-wrestling-post-shows--3275545/support.
In this insightful episode of the Friends of NPACE Podcast, we delve into essential strategies for preventing chronic musculoskeletal (MSK) pain. Host Teri speaks with Dr. Heather Jackson, a renowned pain clinician, about the critical early interventions healthcare professionals can employ to address acute pain effectively. They explore the importance of a thorough patient history, focused examinations, and comprehensive education as foundational steps to manage pain. Dr. Jackson emphasizes individualized care, highlighting how understanding a patient's unique experience can guide treatment decisions. With continuing education credits available, this episode is a must-listen for advanced practice providers looking to enhance their pain management skills. Join us for practical insights that can make a significant difference in patient care.
In this week's 5 Yrs Ago Flashback episode of the Wade Keller Pro Wrestling Post-show (6-1-2021), Nate Lindberg, Cam Hawkins, and Tom Stoup dive into the mailbag and take your calls to discuss Gargano vs. KOR vs. Dunne, LA Knight vs. Jake Atlas, Adam Cole's Run in, Kushida vs. Carmelo Hayes, Zoey Stark & Ramier vs. Candice LaRae & Indi Hartwell, MSK vs. Legado del Fantasmo, the upcoming Takeover In Your House card, and more.Become a supporter of this podcast: https://www.spreaker.com/podcast/wade-keller-pro-wrestling-post-shows--3275545/support.
It's comeback season! What's bringing lateral extra-articular tenodesis (LET) back to the landscape of ACL surgery? In this episode of BackTable Bone & Sports, Dr. Larry Balle joins sports orthopedic surgeon and knee specialist Dr. Kyle Borque to discuss the resurgence of lateral extra-articular tenodesis (LET) as an adjunct to ACL repair and reconstruction. They explore LET's origins as a solution for rotation instability in the era of open ACL surgery, and examine how modern arthroscopic techniques, patient selection, and surgical evidence have driven LET's renewed relevance in today's practice. --- Get the BackTable apphttps://www.backtable.com/app --- Timestamps 00:00 - Introduction 02:36 - LET Origin Story14:16 - Modern LET Technique Updates23:13 - A Run-Down of the Procedure in the OR26:54 - Patient Selection for LET34:18 - Supporting LET with Published Evidence38:43 - Rehab After LET44:33 - Dismissing OA Concerns50:10 - Case Example: ACL Revision53:02 - Wrap Up --- More about this episode The Drs. highlight the anatomy considerations, technical modifications, and the evidence that supports LET's role in reducing graft failure, without changing rehab or increasing lateral OA risk. They compare LET with anterolateral ligament (ALL) reconstruction, emphasizing anatomy and technical approach. Dr. Borque details his modified technique using an iliotibial (IT) band strip fixed proximal and posterior to the lateral epicondyle of the femur. Furthermore, the doctors discuss selection factors for high-risk and revision patients, tactics to avoid overconstraint, and tips for patient counseling. They review the latest evidence, outline perioperative protocols, and address persistent myths about LET's impact on recovery and osteoarthritis. The doctors highlight a real-world case example and the actionable insights for orthopedic surgeons to optimize ACL outcomes. --- Resources Dr. Larry Ballehttps://www.linkedin.com/in/larry-balle-ii/ Dr. Kyle Borquehttps://www.drborque.com/ Lateral Extra-articular Tenodesis Reduces Failure of Hamstring Tendon Autograft Anterior Cruciate Ligament Reconstruction: 2-Year Outcomes From the STABILITY Study Randomized Clinical Trial https://pubmed.ncbi.nlm.nih.gov/31940222/ --- BackTable Bone & Sports is the go-to podcast for orthopedic surgeons, sports medicine docs, pain specialists, and MSK radiologists. Download the free BackTable app to get early access to new episodes, cases, and courses curated by physicians in your specialty. ► https://www.backtable.com/app
Thanks for listening, and please follow us on Insta @NHPTalent and www.youtube.com/thePOZcast For all episodes, please check out www.thePOZcast.com This special episode is brought to you by our dear friends at Blood Cancer United. An organization very near and dear to me. I'm here to remind you to give to causes that make a difference. You want to help but you don't know where to start? Blood Cancer United is at the top of my list. They are the global leader in helping patients and families with blood cancer, and your dollars fund research, patient support, and advocacy. Please give today here: Thank you for supporting this important mission. Learn more and donate here: https://pages.lls.org/voy/nyc/nyclls26/aposner CHAPTERS: 00:00 – 500 Episodes: Introducing Geoffrey Rogow Adam opens the milestone episode, introduces Geoffrey Rogow — journalist, survivor, founder, author — and sets the tone for the most personal conversation in the show's seven-year history. 03:00 – Who Were You Before? The Person Before Treatment Geoffrey's life before diagnosis: 30 years old, living in New York and Sydney, feeling infallible, driven by professional ambition. And Adam's contrast — a father of two at 45, diagnosed only because he went to a cardiologist after his brother-in-law died. 07:00 – The Diagnosis: Two Very Different Moments Geoffrey's blood clot in the night that saved his life. Adam's cardiologist scan that caught a mass nobody expected. The two very different ways a diagnosis lands — one like a movie, one like a text message. 13:00 – Four Days vs. Six Weeks: The Window Before Treatment Geoffrey had four days between diagnosis and chemotherapy. Adam had six weeks. What that difference does to your mind, your fear, your processing — and why no two cancer stories are the same. 17:00 – The Thing Nobody Tells Young Adults: Fertility The Vanderbilt study that found 50% of young adults diagnosed with cancer are never told about their fertility options before treatment. Geoffrey's sperm banking story. Adam's moment of levity. The organizations that exist to help — and why you should use them. 23:00 – Chemotherapy: The Reality Nobody Films Steroids that make you feel like Batman. Fatigue that puts you to bed at 1 PM. The taste of treatment — Geoffrey's: a burning Nike Air Max. Adam's: Sour Patch Kids and Shrek's condom. The rhythm of treatment cycles and the crash that follows. 30:00 – Hair Loss: The Moment It Hits You Not just the hair on your head — all of it. Geoffrey's Jewish mohawk and the cat photos. Adam's man bun, the shower, the wall of clumps, the hairdresser call. Why the eyebrows and eyelashes are the part nobody prepares you for. 37:00 – Going Out in Public Without Eyebrows Geoffrey at his best friend's wedding, feeling like a freak. Adam at a bar mitzvah two weeks post-treatment, cancer beanie and all. Why "you look great" hits differently when you don't recognize yourself in the photos. 42:00 – Tribes, Villages & Crisis Language Geoffrey's lesson: his tribe was too small — just his wife and the cat. The mistake he'd change. Adam's: an oversharer married to a shield, learning to lean on his guy friends so his wife didn't have to carry everything. What "crisis language as a couple" actually means. 49:00 – Tolerance for Bullshit: The Larry David Effect What cancer does to your patience for other people's bravado. Geoffrey's bar story, running out into Times Square and crashing full speed into Elmo. The anger that's real, and the work it takes not to carry it forever. 55:00 – The Biannual Check-In: A Framework for Purposeful Change A scheduled, structured personal evaluation every six months — professional path, relationships, health, direction. The check-in that led Geoffrey to leave the Wall Street Journal after 21 years. Why you can't make the changes when the warning lights are flashing; you have to make them later, in clarity. 61:00 – Scanxiety: The Incurable Side Effect of Survivorship Geoffrey's scan is next Wednesday. He started thinking about it two weeks ago. The reality that scanxiety doesn't diminish with time — it sometimes gets worse. What helps, what stops helping, and why there's no permanent answer. 66:00 – After Treatment: The Part Nobody Celebrates The financial reality: bill negotiations, illegal anesthesiologist charges, state-specific protections, hospital programs for lower-income patients. Life insurance rejection at 35. Career decisions constrained by healthcare costs. The bills that arrive 18 months later asking "didn't I already pay this?" 73:00 – Ambition After Cancer: Don't Change the Level, Change the Lane The advice from career coach Michelle Woodward: keep the same level of ambition even if you have to find a different lane. Geoffrey's Hong Kong trip — the first time after treatment he felt like himself professionally again. Adam's silver lining of leaning into tech during treatment. 79:00 – Writing It Down: The Value of Documentation Adam's Super Whisper app diary — before and after every treatment session. Geoffrey's 14 years of running away from his cancer story, and what writing the book finally unlocked. Why every survivor should find their version of processing. 85:00 – I'm Alive: Now What? — The Book Geoffrey's nine-chapter guide for survivors — money, career, physical health, mental health, family planning, caregiving, purpose, the business of advice — built around real people's stories paired with expert guidance. Pre-order at after-treatment.com/the-book. 91:00 – Are You Getting the Support You Need? Geoffrey's question for Adam — and for every survivor. The cancer imposter syndrome that comes with a high-survival-rate diagnosis. Why you can't let anyone take away what you went through, and why the work doesn't end at remission. 97:00 – North Stars: What Keeps You Focused Geoffrey's: a willingness to change his North Star — short-term, practical, written down, evaluated regularly. Adam's: being the best example for his kids and leaving the world better than he found it. How cancer changes your definition of success. 104:00 – 500 Episodes: Thank You Adam closes the milestone episode with gratitude — for the guests, the listeners, seven years of consistency, and what comes next. TAKEAWAYS: 1. The Diagnosis Is Never Like the Movies — Except When It Is Geoffrey's came in an ER at 30. Adam's in a text from his cardiologist. No two stories are the same — but both changed everything. 2. 50% of Young Adult Cancer Patients Are Never Told About Fertility Options A Vanderbilt study found half of young adults aren't counseled on fertility preservation before treatment starts. The window is measured in days. Make sure this conversation happens first. 3. The Biannual Check-In Is the Most Powerful Tool for Purposeful Change Twice a year, scheduled, with a workbook: evaluate your path, relationships, and direction — in calm, not crisis. The check-in that led Geoffrey to leave 21 years at the Wall Street Journal. 4. Don't Change the Level of Your Ambition — Change the Lane If cancer takes away what you were world-class at, find another lane at the same level. Don't shrink. Redirect. That's not a lesser life — it's a different one. 5. Your Relationship With Time and Bullshit Changes — But Differently for Everyone Every survivor agrees on two things: time feels different, and their tolerance for bullshit has shifted. Geoffrey went full Larry David. Adam found unexpected clarity. The work is figuring out which version of you emerged. 6. Cancer Exposes Your Crisis Language as a Couple The couples who survive this well learn how to communicate what they need, what not to say, and what to let breathe. It's practiced, not instinctive. 7. Scanxiety Is Real, Incurable, and Changes Over Time What helped before may stop helping. Survivors need to plan for this, not be surprised by it. 8. The Financial Reckoning Comes Long After Treatment Ends Medical bills stay higher forever. Many are negotiable. Some are illegal. Own the advocacy, ask the questions, build the spreadsheet. 9. Write It Down — In Whatever Form Works for You Adam used Super Whisper before and after every treatment. Geoffrey wrote a book 14 years later. The form doesn't matter. Externalizing the experience gives you a time capsule you can go back to. 10. Are You Getting the Support You Need? Just the honest, periodic question. What you went through is not nothing — and the work doesn't end at remission. 11. You Are Different Now — Not Better or Worse. Different. Not better, not worse. Fundamentally changed in ways that can't be fully accounted for. That difference isn't a loss. The work is learning to live in the new timeline.
In this week's 5 Yrs Ago Flashback episode of the Wade Keller Pro Wrestling Post-show (5-12-2021), Nate Lindberg and Tom Stoup take your calls and hit the mailbag to discuss Theory vs. Kross, Breezango vs. MSK, Dunne vs. Ruff, Gonzalez vs. Martinez for the NXT Women's title, Kushida vs. Escobar for the NXT Cruiserweight title, Swerve's new “hit” faction, lack of babyfaces in NXT, and more.Become a supporter of this podcast: https://www.spreaker.com/podcast/wade-keller-pro-wrestling-post-shows--3275545/support.
In this episode of Chewing It Over, Jack speaks with Nick Ilic about shockwave therapy, clinical uncertainty, and the problem with taking overly confident positions in MSK practice.Nick argues that shockwave is only really “shocking” when clinicians either oversell it as a powerful long-term solution or dismiss it entirely without proper consideration. Much of the conversation sits deliberately in the middle ground: shockwave may have a role, but the evidence does not support grand claims across broad MSK conditions.The discussion explores the tension between proposed mechanisms and clinical outcomes. Shockwave is often described as creating a pro-inflammatory or mechanotransductive stimulus, potentially “restarting” a repair process in chronic tissue. However, Nick is cautious about mechanistic certainty, noting that many MSK interventions have attractive theoretical explanations that become far less convincing when tested rigorously.They also discuss how shockwave may simply act as another form of neuromodulation, particularly when outcomes appear similar between focused and radial approaches, or when benefits are mainly short term. Nick is especially critical of “condition creep,” where a modality gradually becomes marketed for more and more problems despite limited supporting evidence.Importantly, he does not dismiss shockwave altogether. He acknowledges stronger evidence for indications such as calcific tendinopathy and non-union fractures, where the mechanism and evidence appear more plausible. But for common tendinopathies and broader pain presentations, he remains sceptical of inflated claims, especially when patients are paying privately.Overall, this is a funny, sharp, and thoughtful conversation about evidence, uncertainty, informed consent, and why clinicians should be wary of both hype and lazy scepticism.5 clinical/professional takeawaysAvoid overconfidence in either direction. Shockwave should not be sold as a miracle treatment, but dismissing it completely may also be too simplistic.Mechanistic plausibility is not enough. Claims about pro-inflammatory effects, mechanotransduction, or tissue “restart” need to be matched by meaningful clinical outcomes.Context matters. Shockwave may be more defensible in areas like calcific tendinopathy or non-union fractures than in broad tendinopathy or general pain presentations.Short-term pain relief is not the same as recovery. Clinicians should be careful not to confuse temporary neuromodulation with long-term tissue change.Consent and expectation-setting are crucial. If patients are paying privately, they deserve a clear explanation of likely benefits, uncertainty, cost, and alternative options.
What if one of the biggest drivers of healthcare costs, missed work, and unnecessary surgeries isn't what you think? In this episode of Healthcare Americana, Christopher Habig sits down with Tim Spooner, CEO of Solveglobal, to break down why musculoskeletal (MSK) care continues to frustrate patients and employers alike. From delayed access and overuse of imaging to a system that rewards escalation instead of resolution, Tim explains how most people enter care at the wrong point and end up stuck in a costly, ineffective cycle.The conversation explores a better path forward by starting with early, hands-on evaluation and treating the root cause before issues spiral into major claims. Tim shares how a proactive MSK strategy can reduce costs, improve outcomes, and even shift workplace culture by helping employees feel better and stay productive. For employers looking to take control of healthcare spending and for patients tired of the runaround, this episode offers a clear look at what happens when care is built around solving problems instead of prolonging them.More on Freedom Healthworks & FreedomDoc HealthSubscribe at https://healthcareamericana.com/More on Tim Spooner & SolveglobalFollow Healthcare Americana: Instagram & LinkedIN
Menopause is not just “hot flashes”—it is a systemic hormonal shift that affects almost every organ system. For the emergency clinician, recognizing the symptoms of perimenopause and menopause is crucial for expanding the differential diagnosis once life-threatening conditions are ruled out. Dr. Pam Dyne joins us for a crash course on evaluating menopausal and perimenopausal patients in the ED. The “Why”: Why Menopause Matters in the ED The Mimic: Menopausal symptoms can mimic emergencies, including cardiac events, neurologic issues, and acute musculoskeletal injuries. The “Nothing Bad” Trap: After a negative workup (e.g., for chest pain or abdominal pain), telling a patient “everything is normal” often leaves them without answers. Identifying menopause as a potential etiology provides patient-centered closure and a path to treatment. Empowerment: Many medical providers are insufficiently trained when it come to menopause – ED clinicians can help patients advocate for themselves. Physiology Refresher: When the Ovaries Retire The Signal: Prior to menopause, the brain sends FSH/LH to the ovaries, and the ovaries answer with estrogen. The Shift: In menopause, the ovaries “retire.” The brain keeps shouting (higher FSH levels), but the ovaries don't respond. Perimenopause: Hormones fluctuate wildly, cycles become irregular, and symptoms are often at their peak due to inconsistency. Hormone Therapy (MHT): Debunking the Myths A major barrier to treatment is the “mass hysteria” caused by the 2002 Women's Health Initiative (WHI) study. The Correction: Modern re-analysis shows that for healthy females under 60 and within 10 years of menopause, hormone therapy is extremely safe. (There are some exceptions, including females at high risk for certain cancers) The Benefits: It has been shown to reduce all-cause mortality by 30% and has many potential health benefits, including lower the risk of Alzheimer’s, Parkinson’s, and osteoporotic fractures. The Difficult Pelvic Exam: ED “Hacks” Examining older female patients can be challenging for myriad reasons, including physical limitations and lack of proper ED pelvic exam gurneys. The Upside-Down Speculum: If you can’t use stirrups, keep the patient flat on the bed. Turn the speculum upside down (handle facing up) so it doesn’t hit the gurney. Tip: Push down on the handle; don’t pull up like a laryngoscope. Lateral Decubitus: Perform the exam with the patient on their side (top leg held up) if they cannot flex their hips. Comfort: Use liberal lubrication and consider topical lidocaine gel. The “Hidden” Problem: Always check for old/forgotten pessaries or fecal impaction in cases of pelvic pain or recurrent UTIs. Clinical Pearls: Specific Presentations 1. Post-Menopausal Bleeding Rule: Cancer until proven otherwise. Workup: Speculum exam (confirm source) + Ultrasound (measure endometrial thickness) + Endometrial biopsy (usually outpatient). 2. Genitourinary Syndrome of Menopause (GSM) Symptoms: Vaginal dryness, thinning tissue, pH changes, and recurrent UTIs (≥3 culture-proven UTIs in 12 months or ≥2 in 6 months). ED Treatment: ED docs can and should prescribe vaginal estrogen cream. It is not absorbed systemically and is highly effective at preventing future UTIs. 3. Pelvic Organ Prolapse Types: Cystocele (bladder), Rectocele (rectum), or Uterine prolapse. Exam Tip: Symptoms are often gravity-dependent. If you don’t see the bulge while the patient is supine, ask them to bear down. 4. Musculoskeletal (MSK) Syndrome of Menopause Presentation: atraumatic joint pain, tendinopathies. Cause: Estrogen receptors are located throughout the MSK system; loss of estrogen leads to inflammation and ligamentous changes. Key Takeaways for the ED Clinician Keep menopause on your differential: Don't dismiss vague aches, mood changes, or urinary issues in women aged 45–60 as “just stress.” Look at the Problem: If a patient has pelvic pain or bleeding, do the exam. You might find a simple fix, like a forgotten pessary or local atrophy. Connect to Care: If you suspect menopause is the culprit, point them toward menopause.org to find a certified practitioner. Hosts: Dr. Julia Magaña, Professor of Pediatric Emergency Medicine at UC Davis Dr. Sarah Medeiros, Professor of Emergency Medicine at UC Davis Guest: Dr. Pamela Dyne, Professor of Clinical Emergency Medicine and Chief Physician Wellness Officer at Olive View UCLA Medical Center Resources: North Americal Menopause Society (NAMS) – Menopause.org UTIs and Estrogen: the Overlooked Link, By Ashley Winter, MD; Rachel Rubin, MD; and Howie Mell, MD, MPH. ACEP Now, February 16, 2022 American College of Obstetricians and Gynecologists (ACOG): Menopause *** Thank you to the UC Davis Department of Emergency Medicine for supporting this podcast and to Orlando Magaña at OM Productions for audio production services.
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Discover how Detectify's hacker-DNA culture, multi-account AWS architecture, and Claude Code on Bedrock helped a lean security team deliver zero-day protection to customers before they even knew they needed it.Topics Include:Haris Kabiljagić leads cloud operations, data, and scanning at Detectify.Detectify started in 2013 as a group of ethical hackers in Stockholm.The platform continuously scans customers' attack surfaces for exploitable vulnerabilities.A global community of elite ethical hackers feeds real-world payloads into the engine.Early on, a centralized cloud team caused over 40 service disruptions monthly.A multi-account AWS strategy via Control Tower eliminated disruptions entirely.The hardest part of decentralizing wasn't technology — it was the culture shift.Cloud ops had to evolve from gatekeepers into enablers of secure, fast deployment.Detectify's architecture runs on three pillars: scalability, event-driven services, and security.MSK and Amazon MQ replaced self-hosted RabbitMQ, enabling true event-driven microservices.AWS Security Hub provides a single pane of glass for security posture visibility.When the CAPS zero-day hit, Detectify delivered a live test to customers same day.Customers logged in braced for panic — and found the threat was already handled.AI-assisted development via Claude Code on Bedrock accelerated code migration 30x.The team moved from five modules per week to 150, without sacrificing review quality.Success is now measured by speed of remediation, not volume of vulnerabilities found.A new internal scanner lets customers protect applications before they ever reach production.Detectify's roadmap: make security effortlessly native inside the pipelines teams already use.Participants:Haris Kabiljagić - Head of Developer Services, DetectifyJohan Broman – EMEA ISV, Head of Solutions Architecture, Amazon Web ServicesSee how Amazon Web Services gives you the freedom to migrate, innovate, and scale your software company at https://aws.amazon.com/isv/
In this week's 5 Yrs Ago Flashback episode of the Wade Keller Pro Wrestling Post-show (4-27-2021), Nate Lindberg, Kevin Cattani, and Bruce Hazelwood discuss Dakota Kai vs. Raquel Martinez, Toni Storm vs. Ramier, Bronson Reed vs. Austin Theory, Imperium vs. Killian Dain & Drake Maverick, Legado vs. MSK & Kushida, The Indi Hartwell/Dexter Lumis love story, promo abilities of L.A. Knight and Swerve, a Million Dollar cameo, more.Become a supporter of this podcast: https://www.spreaker.com/podcast/wade-keller-pro-wrestling-post-shows--3275545/support.
In this episode of Chewing It Over, Jack speaks with Wesley Clark Sullivan about Medimo, a marketplace designed to make private MSK care easier to find and book. The central idea is simple: in most sectors, people are used to consumer-friendly platforms like Booking.com, Uber, or Deliveroo, yet private healthcare still often relies on clunky directories, fragmented websites, and high-friction booking journeys.Wesley explains that the idea emerged from his background in marketing and e-commerce, combined with insight from private insurance pathways where even approved patients often fail to complete the final step of actually booking care. That gap led him to spot a wider opportunity: a marketplace that helps patients search by postcode, compare options, view live availability, and make an appointment quickly.A major theme of the conversation is fairness and visibility for clinics. Smaller independent practices often do not have the time, budget, or expertise to compete with bigger players in SEO, paid advertising, or constant social media output. Medimo aims to level that playing field by acting as a neutral marketplace where clinics can be found more easily, without needing large marketing budgets.Jack explores both the promise and the risks of this model, including concerns around patient data, platform dependency, and whether the service might simply intercept patients clinics would have acquired anyway. Wesley responds by outlining Medimo's approach to data security, its free-to-list structure, and its revenue model based only on the first appointment.Overall, the episode is about improving patient access while helping clinics reach the right people more efficiently, without compromising trust or standards.https://medimo.co.uk/
What if following the clinical guideline is sometimes the wrong call? Not occasionally. In the kinds of MSK situations that come up regularly. That's the argument physiotherapy researcher Matt Low makes in Part 2 of this conversation, and it's worth sitting with.About Matt: Matt Low is a physiotherapy clinician and researcher based in the UK whose work sits at the intersection of philosophy, epistemics, and clinical practice. He asks uncomfortable questions about what physical therapy actually is and where it's going.In this episode:Why rigid guideline adherence can be an ethical problem, not a clinical safety net (SIJ fusion as a concrete case)How value-based care's four pillars create friction rather than harmony in practiceWhat AI is already doing to MSK services right now (Cambridge UK is procuring AI for MSK management today)Why ambient documentation tools change more than just note-takingThe contextual architect: what the PT role looks like when AI handles algorithmic pathwaysWhat decentering the human in PT curriculum would actually mean in practiceResources mentioned:Chad Cook's paper on value-based care in MSK practiceDave Nicholls' work on the future of physiotherapyDeleuze and Guattari (rhizome concept applied to clinical thinking)Part 1 of this conversationWant to keep developing this kind of reasoning? Modern Pain Pro is the community where clinicians work through exactly this.--> Trial for 15 daysIf this episode was useful, leaving a review helps more clinicians find it.*********************************************************************
eosactive.co.ukIn this episode of Chewing It Over, Jack speaks with Jim Carr from EOS Active about a part of MSK practice that often gets overlooked or handled poorly: the relationship between products, pathways, branding, and patient communication.Although EOS Active technically sells products into the MSK space, Jim is clear that he does not want to be seen as simply “selling injections.” Instead, he argues that products only make sense when they are nested within a wider, well-reasoned patient pathway. An injection, brace, cryotherapy device, or sleeve is not the story in itself; it is only one possible component of a longer management process shaped by rehabilitation, education, timing, and patient context.A major theme of the conversation is that clinics often inherit their marketing language from manufacturers without fully realising it. Glossy flyers, miracle-style testimonials, and product-led messaging can slowly become part of a clinic's identity, even if they do not reflect how that clinic actually wants to practise. Jim's answer is to help clinics present information in a more neutral, patient-centred way that supports trust rather than hype.The discussion also explores why Jim feels unusually aligned with private clinics. He sees parallels between building a distribution business and building a clinical service: both require strategy, long-term thinking, and careful management of brand and reputation. Rather than pushing the newest thing, he prefers established, sensible options that fit real-world practice.Overall, this episode is about thinking beyond transactions. It asks clinics to be more intentional about what they communicate, how they communicate it, and how commercial choices shape the care experience patients receive.Cingal® as a multi-joint injection is now EU MDR certified.The certification includes expanded indications for multiple synovial joints, including the knee, hip, shoulder and ankle, supporting broader clinical application.As part of the MDR transition, the manufacturer is completing the final administrative steps to ensure update IFUs and supporting documentation are available in line with regulatory requirements. Further information will be shared in due course. Eos active as te UK partner are preparing updated marterials allowing you to communicate appropriatley with patients in clinic and can answer questions and quiries about this recent update.
In this episode, we review the high-yield topic of Pseudogout from the MSK section.Follow Medbullets on social media:Facebook: www.facebook.com/medbulletsInstagram: www.instagram.com/medbulletsofficialTwitter: www.twitter.com/medbullets
In this episode, we review the high-yield topic of Supracondylar Humerus Fracture from the MSK section.Follow Medbullets on social media:Facebook: www.facebook.com/medbulletsInstagram: www.instagram.com/medbulletsofficialTwitter: www.twitter.com/medbullets
In this episode, we review the high-yield topic of Polymyalgia Rheumatica from the MSK section.Follow Medbullets on social media:Facebook: www.facebook.com/medbulletsInstagram: www.instagram.com/medbulletsofficialTwitter: www.twitter.com/medbullets
In this episode, we review the high-yield topic of Muscle Conduction to Contraction from the MSK section.Follow Medbullets on social media:Facebook: www.facebook.com/medbulletsInstagram: www.instagram.com/medbulletsofficialTwitter: www.twitter.com/medbullets
In this episode, we review the high-yield topic of Duchenne and Becker Muscular Dystrophy from the MSK section.Follow Medbullets on social media:Facebook: www.facebook.com/medbulletsInstagram: www.instagram.com/medbulletsofficialTwitter: www.twitter.com/medbullets
In this episode, we review the high-yield topic of Radial Nerve from the MSK section.Follow Medbullets on social media:Facebook: www.facebook.com/medbulletsInstagram: www.instagram.com/medbulletsofficialTwitter: www.twitter.com/medbullets
In this episode, we review the high-yield topic of Compartment Syndrome from the MSK section.Follow Medbullets on social media:Facebook: www.facebook.com/medbulletsInstagram: www.instagram.com/medbulletsofficialTwitter: www.twitter.com/medbullets
This month: Multiple FDA regulatory decisions germane to dermatology, psoriasis and lupus; and Eosinophilic Fasciitis (EF) reminder and should you worry about fibromyalgia? Show Notes: 1. FDA Approves Icotrokinra for Plaque Psoriasis The FDA approved an oral IL-23 inhibitor, icotrokinra (Icotyde), for use in moderate-to-severe plaque psoriasis in adults and children 12 years of age and older who are candidates for systemic therapy or phototherapy, according to a https://t.co/q5b3TceFHx 2. FDA has approved secukinumab (Cosentyx) for use pediatric patients (aged 12yrs) with moderate to severe hidradenitis suppurativa https://t.co/oX4LGU16QP 3. FDA has accepted the supplemental biologics license application for use of interleukin-23 inhibitor tildrakizumab (Ilumya; Sun Pharma) in active psoriatic arthritis (PsA) in adults. https://t.co/cwqz9DoWsL https://t.co/ut0A4MwqW7 4. TYK2 Inhibitor Deucravacitinib FDA Approved for Psoriatic Arthritis On Friday, March 6th, the FDA approved deucravacitinib (Sotyktu) for the treatment of adults with active PsA based on the results of the pivotal Phase 3 POETYK PsA-1 and POETYK PsA-2 clinical trials. https://t.co/a6rmortnoS 5.vUCB announced topline results of the BE-BOLD head-to-head study where bimekizumab (IL-17i) was superior to risankizumab (IL-23i) study; 553 active PsA in achieving an ACR50 response at 16 weeks. Enrolled PsA pts were either bilogic naïve or who had previous exposure to 1 TNFi 6. Retrospective TriNetX Network cohort study of adult PsA (N 123,031) pts, propensity- matched to non-PsA controls. PsA had signif higher CV morbidity: MACE (HR 1.74); mortality (HR 1.95); CHF (HR 1.96), MI (HR 1.71), & CVA (HR 1.49). bDMARDs reduced MACE (HR 0.95) & mortality (HR 0.92) vs csDMARDs https://t.co/bHrq9KpwBM 7. Prevalence of fibromyalgia in PsA = 18%. FM-PsA pts have higher scores Dz activity scores from FM, rather than inflammation. Fibromyalgia is assoc w/ worse disease outcomes, including failure to achieve low disease activity state and poorer response to therapy. https://t.co/utQRXPmpDs 8. JAMA Patient Education Page on JAMA Eosinophilic Fasciitis (EF). EF is rare, but begins with swelling and redness of the arms and/or legs. Later the skin thickens and develops the peau d' orange appearance. EF does not involve fingers or toes, & doesnt have Raynauds https://t.co/WEFFITtmQC 9. REVEAL, a 5-yr real-world study of 236 SLE pts initiating anifrolumab (basekbube SLEDAI-2K 7 for mucocutaneous (67%) & MSK (49%) dz. At 6 months, 26% achieved remission, 66% reached LLDAS, and 57% achieved LLDAS5. Authors claim rapid onset of action https://t.co/16OQatOcPj https://t.co/mU9aciCNcH 10. Update on FDA complete response letter to AZ regarding BLA hold for anifrolumab (Saphnelo) for SC use in SLE. CRL originally issued 10/10/25, but announced 2/3/26. FDA CRL cites critical data quality w/ key analyses in SC-TULIP study. A BLA decision expected in 1st half of 2026 https://t.co/zuwtsdL6I9 11. NEJM: Obinutuzumab in Active Systemic Lupus Erythematosus https://rheumnow.com/news/nejm-obinutuzumab-active-systemic-lupus-erythematosus
In this episode, Rick Peng, Digital Ventures Lead in Memorial Sloan Kettering Cancer Center (MSK) Office of Entrepreneurship & Commercialization & Natalia Summerville, PhD, Director of Decision Intelligence at Memorial Sloan Kettering Cancer Center, discuss how MSK is advancing AI across clinical care and research while building a robust governance model. They share insights on balancing innovation with safety, ensuring accountability, and driving real impact through thoughtful AI deployment and monitoring.
In this episode, Dan is joined by Carlos Jimenez to discuss MSK Ultrasound in physical therapy practice, including assessment, intervention selection, and more. Carlos Jimenez, DPT, RMSK, CPSS, is a physical therapist, educator, and founder of Pura Health, an educational platform focused on advancing MSK ultrasound training for clinicians. With over a decade of experience in sports medicine and rehabilitation, Carlos specializes in integrating diagnostic imaging into real-world clinical decision making. He provides hands-on workshops, mentorship, and online education for PTs, athletic trainers, and sports medicine professionals. Carlos is also a PhD candidate at Amsterdam University and has been recognized by Inteleos for his contributions to ultrasound education.Instagram: @c_jimenez31 | @pura.health_ultrasoundSeason 7 of the Braun Performance & Rehab Podcast is proudly supported by Pura Health, bringing ultrasound into every clinician's hands. Learn more at purahealth.net and @pura.health_ultrasound.Additional support provided by Firefly Recovery, the official recovery partner of Braun Performance & Rehab (recoveryfirefly.com), and Dr. Ray Gorman of Engage Movement. Learn how to grow your income beyond sessions—follow @raygormandpt on Instagram and DM “Dan” for a free breakdown of the blended practice model.Episode Affiliates: Airbands BFR (Coupon Code: DANIELBRAUN for 10% off), MoboBoard (BRAWNBODY10), AliRx (DBraunRx), MedBridge (BRAWN)If you enjoyed this episode, share it with someone who would benefit and leave a 5-star review.Explore more from Dan at linktr.ee/braun_pr.
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 Rickets from our Basic Science at Orthobullets.com.Follow Orthobullets on Social Media:FacebookInstagram TwitterLinkedInYouTube
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 Articular Cartilage from our Basic Science at Orthobullets.com.Follow Orthobullets on Social Media:FacebookInstagram TwitterLinkedInYouTube
March 13, 2026: Your daily rundown of health and wellness news, in under 5 minutes. Today's top stories: Sword Health expands beyond MSK into GLP-1 support, mental health, and women's midlife care using AI and acquisitions to build broader specialty platform Withings launches Sleep Care Solution linking users to sleep specialists through app, addressing 30M U.S. adults with sleep apnea and 80% undiagnosed Maven Clinic returns to direct-to-consumer telehealth with hormone and GLP-1 support across 30+ specialties after reaching 28M patients through employer benefits Today's episode is brought to you by AIIR — a modern communications and experiential agency for health, wellness, fitness, and performance brands. From earned media to events and creator-led campaigns, AIIR helps companies sharpen their story, earn attention, and build trust that compounds. Visit https://aiir.agency to learn more. More from Fitt: Fitt Insider breaks down the convergence of fitness, wellness, and healthcare — and what it means for business, culture, and capital. Subscribe to our newsletter → insider.fitt.co/subscribe Work with our recruiting firm → https://talent.fitt.co/ Follow us on Instagram → https://www.instagram.com/fittinsider/ Follow us on LinkedIn → linkedin.com/company/fittinsider Reach out → insider@fitt.co
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 Unicameral Bone Cyst from our Pathology at Orthobullets.com.Follow Orthobullets on Social Media:FacebookInstagram TwitterLinkedInYouTube
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 Synovial Sarcoma from our Pathology at Orthobullets.com.Follow Orthobullets on Social Media:FacebookInstagram TwitterLinkedInYouTube
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 Osteoid Osteoma from our Pathology at Orthobullets.com.Follow Orthobullets on Social Media:FacebookInstagram TwitterLinkedInYouTube