184. Achilles Tendinopathy: Distinguishing Midportion and Insertional

Send us Fan MailIn this episode, we discuss how to differentiate Achilles mid-portion tendinopathy from insertional tendinopathy and why the distinction changes rehab. Depending on the patient, some tendon-loading exercises can actually have a negative impact on insertional tendinopathy cases, so being able to differentiate these can help to improve your success with your patients.00:00 Welcome to PT Snacks00:19 Episode Focus and Disclaimer01:08 Achilles Basics and Tendinopathy Terms03:09 Blood Supply and Watershed Zone05:30 Insertional vs Midportion Pathology07:27 Why Each Type Happens09:47 Treatment Principles and Load Management11:02 Insertional Rehab and Evidence14:22 Wrap Up and ResourcesNeed CEUs?Unlock unlimited online courses, live webinars, and certification-prep programs with MedBridge. You’ll get thousands of accredited, evidence-based courses. Use code PTSNACKSPODCAST at checkout to save over $100. Student? Use code PTSNACKSPODCASTSTUDENTSupport the showStudying for the NPTE? Check out PT Final Exam — they’ve helped thousands of students pass with confidence. Use code PTSnacks at checkout for a discount.Stay Connected!Follow so you never miss an episode. Send your questions via email to [email protected] the email list HERESupport the Show:Share the episode with someone who'd benefit.Contributing directly to the "support" link.Thanks for tuning in—your support makes this all possible!

Send us Fan MailIn today's episode, we discuss what VO2 max is, why it matters for physical therapists, and how it predicts cardiovascular risk and all-cause mortality. Join us as we discuss different protocols utilized in research, considerations for different  populations, and how we can help our clients successfully hit their target goals.00:00 VO2 Max Explained01:28 Why It Matters02:50 Physiology Behind Gains03:58 Training Intensity Basics05:08 Protocols That Work07:09 Choosing The Right Plan07:31 Population Specific Tips08:46 Key Variables And Caveats10:40 Measuring Without A Lab11:35 Main Takeaways12:10 Wrap Up And ContactNeed CEUs?Unlock unlimited online courses, live webinars, and certification-prep programs with MedBridge. You’ll get thousands of accredited, evidence-based courses. Use code PTSNACKSPODCAST at checkout to save over $100. Student? Use code PTSNACKSPODCASTSTUDENTSupport the showStudying for the NPTE? Check out PT Final Exam — they’ve helped thousands of students pass with confidence. Use code PTSnacks at checkout for a discount.Stay Connected!Follow so you never miss an episode. Send your questions via email to [email protected] the email list HERESupport the Show:Share the episode with someone who'd benefit.Contributing directly to the "support" link.Thanks for tuning in—your support makes this all possible!

Send us Fan MailOA is described as the most prevalent chronic joint disease worldwide, involving progressive degeneration of articular cartilage and sometimes subchondral bone, leading to pain, stiffness, and functional limitations. Rather than simple “wear and tear,” OA is a multifactorial whole-joint condition influenced by inflammatory, mechanical, and metabolic factors, with risk increased by age, obesity, mechanical stress, and joint trauma. The episode reviews how this happens, what physical therapists can do to help patients with this, and how to individualize our plan of care to our patients' tolerance and goals.00:00 Osteoarthritis Overview00:56 Defining OA Basics01:48 Beyond Wear and Tear03:32 Inflammation and Pain04:51 Exercise First Line06:21 Load Management08:40 Treatment Takeaways09:39 Wrap Up and ResourcesNeed CEUs?Unlock unlimited online courses, live webinars, and certification-prep programs with MedBridge. You’ll get thousands of accredited, evidence-based courses. Use code PTSNACKSPODCAST at checkout to save over $100. Student? Use code PTSNACKSPODCASTSTUDENTSupport the showStudying for the NPTE? Check out PT Final Exam — they’ve helped thousands of students pass with confidence. Use code PTSnacks at checkout for a discount.Stay Connected!Follow so you never miss an episode. Send your questions via email to [email protected] the email list HERESupport the Show:Share the episode with someone who'd benefit.Contributing directly to the "support" link.Thanks for tuning in—your support makes this all possible!

Send us Fan MailToday, we are answering a listener question about the difference between paratenonitis and tenosynovitis. We'll cover the roles of each of these in the body, how they get agggravated, and what we do to treat them.00:00 Welcome to PT Snacks00:42 Fan Mail Questions02:03 Episode Roadmap02:36 Paratenon Basics03:32 Synovial Sheath Function04:46 Evaluation Differences05:19 Paratenon Causes06:47 Paratenon Treatment07:55 Tenosynovitis Causes08:19 Tenosynovitis Treatment09:04 Key Takeaways10:00 Resources and Wrap UpNeed CEUs?Unlock unlimited online courses, live webinars, and certification-prep programs with MedBridge. You’ll get thousands of accredited, evidence-based courses. Use code PTSNACKSPODCAST at checkout to save over $100. Student? Use code PTSNACKSPODCASTSTUDENTSupport the showStudying for the NPTE? Check out PT Final Exam — they’ve helped thousands of students pass with confidence. Use code PTSnacks at checkout for a discount.Stay Connected!Follow so you never miss an episode. Send your questions via email to [email protected] the email list HERESupport the Show:Share the episode with someone who'd benefit.Contributing directly to the "support" link.Thanks for tuning in—your support makes this all possible!

Send us Fan Mail🎉 MedBridge Days Sale is Here! MedBridge's Bridge Days sale runs June 15–30! Use code PTSNACKS15 for:$126 off an Individual Subscription → Get your discount15% off Group Subscriptions → Group pricingMedBridge is also celebrating their 15-year anniversary, with tons of CEU courses for PTs, OTs, and SLPs — plus built-in exam prep for OCS, SCS, and other specialty certifications. Don't wait — this offer is only live for two weeks!In this episode, Kasey breaks down the high-level reasons why certain tendons are more predisposed to injury than others. Rather than memorizing isolated facts, this episode is designed to help you build a framework for understanding tendon behavior under load.00:00 Welcome to PT Snacks01:27 Why Tendons Get Injured02:15 Load Mismatch Basics03:27 Mechanical Risk Factors04:45 Tissue Quality and Healing05:26 Junctions and Tendon Size07:21 Composition and Demographics08:52 Intrasynovial vs Extrasynovial10:07 Framework and Wrap Up11:01 Resources and FarewellNeed CEUs?Unlock unlimited online courses, live webinars, and certification-prep programs with MedBridge. You’ll get thousands of accredited, evidence-based courses. Use code PTSNACKSPODCAST at checkout to save over $100. Student? Use code PTSNACKSPODCASTSTUDENTSupport the showStudying for the NPTE? Check out PT Final Exam — they’ve helped thousands of students pass with confidence. Use code PTSnacks at checkout for a discount.Stay Connected!Follow so you never miss an episode. Send your questions via email to [email protected] the email list HERESupport the Show:Share the episode with someone who'd benefit.Contributing directly to the "support" link.Thanks for tuning in—your support makes this all possible!

Send us Fan MailNot all rotator cuff tears are the same, and understanding why can completely change how you set expectations and build a plan with your patients. In this episode, we break down tendon anatomy and physiology, the different ways rotator cuff tears develop (degenerative vs. traumatic), the difference between partial- and full-thickness tears, and the factors that influence healing and prognosis for both conservative and surgical patients.In this episode you'll learn:What a tendon actually is and why its structure (and blood supply) matters for healingThe difference between degenerative and traumatic rotator cuff tearsRisk factors that make someone more likely to develop a tearArticular-side vs. bursal-side partial thickness tears — and why bursal tears tend to hurt moreWhat "massive" and "irreparable" tears mean, and how outcomes differPredictors of good outcomes with conservative care (hint: baseline ROM and strength matter)A quick look at steroid injections vs. PRP for rotator cuff tearsTest yourself:What is a tendon's main job, and what structures help it do that job?What are the main categories of rotator cuff tears?What are the two types of partial thickness tears, and how do they differ?What factors affect healing after a rotator cuff tear — for both conservative and surgical patients?🎉 MedBridge Days Sale is Here! MedBridge's Bridge Days sale runs June 15–30! Use code PTSNACKS15 for:$126 off an Individual Subscription → Get your discount15% off Group Subscriptions → Group pricingMedBridge is also celebrating their 15-year anniversary, with tons of CEU courses for PTs, OTs, and SLPs — plus built-in exam prep for OCS, SCS, and other specialty certifications. Don't wait — this offer is only live for two weeks!Resources:📋 Free rotator cuff study guide📱 Follow along on TikTok @ptsnackspodcast for visual study tools✉️ Questions or topic requests? Email [email protected] or join the email list for episode highlightsIf this episode helped you, please take a moment to leave a review — it helps the show grow more than you know! 🙏Need CEUs?Unlock unlimited online courses, live webinars, and certification-prep programs with MedBridge. You’ll get thousands of accredited, evidence-based courses. Use code PTSNACKSPODCAST at checkout to save over $100. Student? Use code PTSNACKSPODCASTSTUDENTSupport the showStudying for the NPTE? Check out PT Final Exam — they’ve helped thousands of students pass with confidence. Use code PTSnacks at checkout for a discount.Stay Connected!Follow so you never miss an episode. Send your questions via email to [email protected] the email list HERESupport the Show:Share the episode with someone who'd benefit.Contributing directly to the "support" link.Thanks for tuning in—your support makes this all possible!

Send us Fan MailWelcome to this brief episode on dry needling and what current research suggests may explain its pain-relieving effects. The episode clarifies why it’s called “dry” needling (no medication injected) and emphasizes the importance of being able to explain why it may help patients. Dry needling is presented as working locally and systemically through four main mechanisms: local muscle and tissue effects, biomechanical and inflammatory biomarker changes, peripheral and spinal pain modulation, and supraspinal/autonomic pathways. We also discuss who this is appropriate for, and how to combine it with other techniques to help our patients get to their goals successfully.00:00 Welcome to PTs Snacks00:48 Why Dry Needling Matters01:15 What It Is and Isn't02:39 Four Mechanisms Overview03:24 Local Tissue Effects04:19 Inflammation Biomarkers05:14 Spinal Pain Modulation06:35 Autonomic Brain Pathways07:16 Who Should Avoid It07:58 Patient Education and Training08:52 Wrap Up and Next StepsNeed CEUs?Unlock unlimited online courses, live webinars, and certification-prep programs with MedBridge. You’ll get thousands of accredited, evidence-based courses. Use code PTSNACKSPODCAST at checkout to save over $100. Student? Use code PTSNACKSPODCASTSTUDENTSupport the showStudying for the NPTE? Check out PT Final Exam — they’ve helped thousands of students pass with confidence. Use code PTSnacks at checkout for a discount.Stay Connected!Follow so you never miss an episode. Send your questions via email to [email protected] the email list HERESupport the Show:Share the episode with someone who'd benefit.Contributing directly to the "support" link.Thanks for tuning in—your support makes this all possible!

Send us Fan MailIn this PT Snacks episode, host Kasey introduces Baxter’s nerve (the first branch of the lateral plantar nerve, also called the inferior/anterior calcaneal nerve) as an under-recognized source of medial plantar heel pain that can mimic plantar fasciitis and may account for up to 20% of chronic heel pain. We review the nerve’s motor and sensory roles, common entrapment zones near the distal tarsal tunnel and medial calcaneal tuberosity, and typical presentation including burning neuropathic pain, possible paresthesia, focal tenderness, and potential abductor digiti minimi weakness or atrophy. This episode outlines key differentials, relevant imaging and testing findings (ultrasound, MRI, EMG/NCS), and a treatment progressions.00:00 Welcome to PT Snacks00:14 Baxters Nerve Overview02:14 Why It Matters03:03 Anatomy and Entrapment04:45 Symptoms and Differentials06:11 Imaging and Testing07:22 Clinical Exam Clues09:04 Treatment Options11:12 Key Takeaways12:58 Wrap Up and ContactNeed CEUs?Unlock unlimited online courses, live webinars, and certification-prep programs with MedBridge. You’ll get thousands of accredited, evidence-based courses. Use code PTSNACKSPODCAST at checkout to save over $100. Student? Use code PTSNACKSPODCASTSTUDENTSupport the showStudying for the NPTE? Check out PT Final Exam — they’ve helped thousands of students pass with confidence. Use code PTSnacks at checkout for a discount.Stay Connected!Follow so you never miss an episode. Send your questions via email to [email protected] the email list HERESupport the Show:Share the episode with someone who'd benefit.Contributing directly to the "support" link.Thanks for tuning in—your support makes this all possible!

Send us Fan MailIn this PT Snacks episode, Kasey breaks down the posterior cruciate ligament (PCL) for PTs and students, covering what it is, how it’s injured, and how we assess and manage it clinically. We review the PCL’s role, common mechanisms of injuries, plus what combined injuries may indicate. We also hit key exam findings and tests, imaging options, grading, and broad rehab principles focused on protecting against posterior shear, progressing quad strength, and using protocols thoughtfully while testing readiness stage to stage.00:00 Welcome to PT Snacks00:31 Support the Podcast01:13 What the PCL Does01:35 Anatomy and Bundles02:49 Injury Mechanisms04:08 Symptoms and History05:09 Clinical Tests and Imaging06:04 Grading and Treatment Paths07:18 Rehab Principles and Progression09:14 Protocol Reasoning and Homework11:34 Wrap Up and ContactNeed CEUs?Unlock unlimited online courses, live webinars, and certification-prep programs with MedBridge. You’ll get thousands of accredited, evidence-based courses. Use code PTSNACKSPODCAST at checkout to save over $100. Student? Use code PTSNACKSPODCASTSTUDENTSupport the showStudying for the NPTE? Check out PT Final Exam — they’ve helped thousands of students pass with confidence. Use code PTSnacks at checkout for a discount.Stay Connected!Follow so you never miss an episode. Send your questions via email to [email protected] the email list HERESupport the Show:Share the episode with someone who'd benefit.Contributing directly to the "support" link.Thanks for tuning in—your support makes this all possible!

Send us Fan MailThis episode explains how exercise can act as pain relief, addressing common patient concerns about exercise hurting and offering an alternative or complement to medications and passive treatments. We outline four key pain-modulating mechanisms: central modulation at the brain and spinal cord, immune and inflammatory changes, peripheral tissue and nerve effects, and psychological/behavioral pathways. 00:00 Welcome to PT Snacks00:57 Does Exercise Hurt?03:08 Four Pain Relief Pathways03:44 Brain and Spinal Cord05:28 Immune Inflammation Shift06:10 Peripheral Tissue Effects06:50 Psychology and Behavior07:24 Choosing the Right Dose09:44 Educate Without Jargon10:48 Wrap Up and ConnectNeed CEUs?Unlock unlimited online courses, live webinars, and certification-prep programs with MedBridge. You’ll get thousands of accredited, evidence-based courses. Use code PTSNACKSPODCAST at checkout to save over $100. Student? Use code PTSNACKSPODCASTSTUDENTSupport the showStudying for the NPTE? Check out PT Final Exam — they’ve helped thousands of students pass with confidence. Use code PTSnacks at checkout for a discount.Stay Connected!Follow so you never miss an episode. Send your questions via email to [email protected] the email list HERESupport the Show:Share the episode with someone who'd benefit.Contributing directly to the "support" link.Thanks for tuning in—your support makes this all possible!