The Ask Mike Reinold Show

Squatting is one of the first activities that becomes painful in people with patellofemoral pain. It is also one of the first exercises many clinicians remove from the program.But is avoiding the squat helping the knee, or simply reducing the athlete’s capacity to tolerate it? Somewhere between ignoring pain and eliminating every painful movement is a more useful approach.In this episode, we discuss how much discomfort may be acceptable, which squat modifications can help, and how to progress loading without constantly provoking the knee. Check out this week’s podcast to hear how we manage painful squatting in active patients.To see full show notes and more, head to: https://mikereinold.com/should-you-squat-through-patellofemoral-pain/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

Seeing more patients can provide valuable clinical experience. It can also leave a young therapist rushing through examinations, repeating generic treatments, and completing documentation long after the clinic closes.That makes “How many patients do you see?” an incomplete question. Visit complexity, double-booking, support staff, documentation expectations, mentorship, and control over the schedule all influence whether a caseload is sustainable.In this episode, we discuss how new graduates should evaluate a job offer and how owners can balance productivity with patient care and staff development. Check out this week’s podcast for the warning signs both clinicians and employers should recognize.To see full show notes and more, head to: https://mikereinold.com/how-many-patients-per-day-is-too-many-and-setting-you-up-to-burn-out/ 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

Heavy lifting builds the strength behind every jump and sprint. But during a grinding competitive season, all that mechanical load piles onto athletes who are already worn down from games and practice, and at some point it stops helping and starts hurting. So what if you could keep training explosive power without the wear and tear?A new study out of the Journal of Sports Sciences put that question to the test with Division I basketball players in the middle of their season. One group squatted heavy the traditional way. The other squatted light, around 30% of their max, with blood flow restriction cuffs on their thighs. Eight weeks later, the results were not what most of us would predict.The light group didn't just keep up. On the two qualities that matter most for a basketball player, jumping and sprinting, they came out ahead, and they did it with a fraction of the physical load on their bodies. That last part is what makes this interesting for anyone managing in-season athletes.But before you throw out the barbell, there's a catch in how the study was built that changes how much we can actually conclude, and one detail in the numbers that's easy to oversell. I get into both on this week's episode, along with exactly when and how I'd use this with in-season athletes.Check out this week's podcast for the full breakdown.To see full show notes and more, head to: https://mikereinold.com/does-in-season-training-with-bfr-improve-strength-or-performance/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

We're taught to treat systematic reviews and meta-analyses as the gold standard. They sit at the top of the evidence pyramid, so when one lands in our inbox saying an intervention works, we tend to believe it and move on. But what if that instinct is exactly the problem?A new editorial from two of the most respected methodologists in sports medicine makes an uncomfortable argument: the explosion of meta-analyses in our field has outpaced the rigor behind them. Sport-related meta-analyses now make up a striking share of everything published, and when you look under the hood, a lot of them are built on shaky ground. In one recent example, only a single review out of nearly forty was at low risk of bias.On this week's episode, I break down the specific red flags that separate a meta-analysis you can trust from one you can't, including one common practice that leading evidence organizations have flatly called "unacceptable." I also get into an example that hits close to home for a lot of us: a widely prescribed injury-prevention exercise whose evidence looks very different once the analysis is done right.If you make clinical decisions based on the research you read, and we all do, this one will change how you read it. It won't take a statistics degree, just a handful of questions you can ask of any review before you let it change your practice.Check out this week's podcast for the full breakdown.To see full show notes and more, head to: https://mikereinold.com/drowning-in-evidence-how-to-read-a-meta-analysis-without-getting-fooled/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

If you've ever programmed rotator cuff work, you've probably hit the same wall this week's listener did. You start with the classic light band or dumbbell external rotations, everything progresses nicely for a few weeks, and then it just stops. Add a couple pounds and the movement falls apart. So you assume you've maxed out what these little muscles can do and go back to maintenance mode.Here's the question we got, and it's a good one: the infraspinatus and teres minor are small muscles, so at some point linear progression seems to stop working. Do they respond to heavier loading like three sets of eight, or is there a ceiling because of their size?It's a smart question, and the answer starts by challenging a premise almost everyone believes. The idea that the external rotators are "tiny" muscles that can only handle light work is one of the most persistent myths in shoulder training, and it quietly shapes how most people program the cuff for years. Once you see the actual anatomy and understand what these muscles are really built to do in a throwing athlete, the whole approach to loading them changes.So can you lift heavy for the rotator cuff? Should a performance athlete be doing sets of eight with real weight? And if linear progression has stalled, what's the variable you should reach for before you just pile on more load? We get into the exact framework on this week's episode, including why your progress probably stopped and the order we'd progress these muscles to break the plateau. Give it a listen.To see full show notes and more, head to: https://mikereinold.com/how-to-progressively-load-the-rotator-cuff/ 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

If you treat young athletes, you have seen this note a hundred times. A 14-year-old gets referred for low back pain, and somewhere in the orthopedic report is the phrase "hamstring tightness," presented as if it settles the question. Tight hamstrings, tilted pelvis, cranky back. Case closed. Go stretch.It's a tidy story. It's also the kind of story that survives because it sounds mechanical and nobody stops to check it. And when you actually look at what the research says, the picture gets a lot more complicated in a way that should change how you evaluate these kids.Start with the obvious problem. Almost every adolescent in the middle of a growth spurt has tight hamstrings. Bones outpace soft tissue, flexibility drops, and it happens to the kids with back pain and the kids without it. So if you're going to call it a cause, you have to explain why the vast majority of tight-hamstring teenagers walk around perfectly fine. Then there's the direction of the arrow. Does the tightness create the back pain, or does the back pain create the tightness?That second question is where this gets clinically important. Because there is one specific scenario in adolescent back pain where hamstring tightness matters enormously, and in that scenario it is not something you stretch. It's something you recognize, and it should send you looking somewhere else entirely. Miss it and you can spend six weeks on a mobility program while the actual problem gets worse.On this week's episode of the Ask Mike Reinold Show, we get into what hamstring tightness in a young athlete is actually telling you, how to tell the difference between short tissue, neural tension, and protective guarding, and the specific findings that should make you stop treating and start imaging. Give it a listen.To see full show notes and more, head to: https://mikereinold.com/is-hamstring-tightness-correlated-to-low-back-pain-in-young-athletes/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

Hamstring strains are incredibly frustrating. You get an athlete feeling great, they go for a sprint, and the muscle grabs again. We have all been there. It is the most common time-loss injury we see in running and field sports.For years, sports medicine professionals have debated whether biologics actually speed up recovery. Some studies show great results. Other studies suggest they are a waste of money. The conflicting data makes it hard to give our athletes a straight answer when they ask if an injection will get them back on the field faster.A recent randomized controlled trial finally standardizes the protocol to give us better clarity. The researchers looked specifically at grade 2 tears and used ultrasound-guided injections alongside a traditional rehabilitation program. The results completely change how we should view biological adjuncts in muscle rehab.Listen to this week's podcast episode to hear a full breakdown of the study. We discuss exactly how much time these injections can shave off a recovery timeline and how you can apply these findings to the athletes you treat.To see full show notes and more, head to: https://mikereinold.com/does-prp-actually-work-for-hamstring-strains/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

Pitchers are constantly looking for the best way to recover after a long outing. Walk into any training room, and you will hear the hum of massage guns and see guys strapped to ice machines. We're seeing newer things too, like ESTIM machines and even BFR after an outing. We know pitching causes microtrauma and neuromuscular fatigue. The debate over how to properly manage that fatigue never seems to stop.A recent study finally put percussive massage and traditional ice therapy head to head. Researchers had collegiate pitchers throw 75 pitches and then gave them either a targeted massage gun session or 15 minutes of isolated icing. They tracked exactly what happened to the shoulder over the next 48 hours.The results might force you to change how you handle your athletes post-game. One of these popular methods actually restored shoulder external rotation strength and proprioception. The other completely fell flat after two days. Check out this week's podcast episode to hear my breakdown of the data and find out exactly what you should be doing to keep your pitchers healthy and performing at their best.To see full show notes and more, head to: https://mikereinold.com/does-icing-your-shoulder-still-work-for-baseball-pitchers/ 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

Every sports physical therapist remembers the first time they handed a young, anxious athlete an MRI report filled with terms like "partial-thickness tear," "labral fraying," or "degenerative changes." It is a defining moment in a clinician's career. Instantly, the psychological landscape of the rehab process shifts. The athlete, who might only have mild, intermittent symptoms, suddenly views their joint as a ticking time bomb. As a clinician, it is incredibly easy to let that piece of paper dictate your entire treatment plan, leading to over-protection and a fear-avoidant rehab environment.The reality of dealing with overhead athletes—especially baseball pitchers—is that structural abnormalities on an image are often just the cost of doing business. If you scan enough high-level shoulders, you are going to find fraying and partial tears in completely asymptomatic arms. The real skill lies in balancing those structural findings with the actual human being sitting on your treatment table. How do you maintain clinical objectivity when the scan says one thing but your manual muscle testing and special tests say another?On this episode of the podcast, we answer a great question from a listener struggling to navigate this exact scenario with a collegiate pitcher. We discuss how to educate a freaked-out athlete, when to respect the structural pathology, and how to ensure you are treating the functional deficits rather than just chasing a clean image. Check out this week’s episode for our full breakdown and clinical pearls on mastering the physical exam.To see full show notes and more, head to: https://mikereinold.com/stop-treating-the-mri-and-start-treating-the-athlete/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

Building a sports physical therapy practice used to follow a predictable playbook. You opened your doors, printed some business cards, and spent your Friday afternoons dropping off food at local orthopedic clinics hoping to get on their referral list. For decades, doctor relationships were the lifeblood of private practice growth. But the modern healthcare consumer operates differently. Today, even when a physician hands a patient a specific script, that patient immediately pulls out their phone to check Google reviews, Instagram feeds, and website content before booking an appointment.This shift has created a massive fork in the road for early-career professionals and aspiring clinic owners. Is the classic physician marketing route dead, or is it still the most reliable way to build a sustainable caseload? On the flip side, does a massive social media footprint actually translate into paying clients, or is it just an expensive vanity metric that takes time away from clinical care? If you were launching a brand-new hybrid performance facility today with zero brand awareness, where should you actually spend your time and marketing dollars?In this week's episode of The Ask Mike Reinold Show, the crew dives headfirst into this exact dilemma. We break down the real-world math behind direct-to-consumer marketing versus physician networking, and share the exact strategy we would use if we had to start Champion from scratch today. Tune in to find out which avenue deserves your focus so you can build a thriving practice without wasting your time.To see full show notes and more, head to: https://mikereinold.com/physician-referrals-vs-online-presence-which-one-grows-your-sports-pt-clinic-faster/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