Institute of Clinical Excellence

Institute of Clinical Excellence We help rehab pro's achieve clinical excellence through transformational educational experiences.
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Providing high quality continuing education for outpatient orthopedic physical therapists.

04/10/2026

Nutrition is already in your scope!
The question is, are you addressing it intentionally?

We sat down with Madison Johnston to unpack what nutrition actually looks like through a clinical + performance lens 👇

➡️ When is nutrition within our scope as PTs?
➡️ When is it time to refer out?
➡️ How do we navigate the gray area without overstepping or underserving?

From working with clients chasing aesthetics ➡️ to athletes chasing elite performance, Madison brings a perspective that helps clinicians think beyond “just exercise.”

Because the reality is
You can’t out-train poor fueling.
And you can’t optimize performance without addressing it.

This conversation will challenge how you think about your role as a clinician and give you a clearer framework for integrating (or collaborating around) nutrition in your practice.

🎧 If you’ve ever felt unsure where you stand—this is for you
🎧 If you’re confident—this will sharpen your approach

Heavy barbell. No hiding.💥 INTENDED STIMULUSModerate-to-heavy barbell sprint with repeatable efforts under fatigue.Goal:...
04/09/2026

Heavy barbell. No hiding.

💥 INTENDED STIMULUS

Moderate-to-heavy barbell sprint with repeatable efforts under fatigue.
Goal: Unbroken or fast singles, ~8–12 min finish.

⸝

⚙️ MOVEMENT STANDARDS

🏋️‍♀️ Bench Press
• Bar starts at full lockout (arms extended)
• Bar must touch the chest every rep
• Finish with elbows locked out at the top
• Feet stay in contact with the ground (no dancing around)
• Butt + shoulders remain in contact with the bench


👉 Rep = chest touch → full lockout

⸝

🏋️‍♂️ Power Clean
• Bar starts on the ground every rep
• Must be received in a power position (above parallel squat)
• No squat cleans
• Elbows must come through and in front of the bar
• Finish standing tall with hips + knees fully extended
• No hang reps — each rep starts from the floor

👉 Rep = ground → catch above parallel → stand to full extension

⸝

🔥 STRATEGY

Bench Press
• Unbroken if possible
• If needed: quick 2–1, avoid failure

Power Cleans
• Touch-and-go early → fast singles later
• Stay tight, bar close, no wasted time

⸝

⏱ PACING
• Rounds 1–3: Controlled
• Rounds 4–7: Settle in
• Rounds 8–10: Grip + lungs → commit to movement

⸝

🛠 MODIFICATIONS
• Scale weight so:
• Bench = repeatable sets of 3
• Cleans = consistent singles or touch-and-go early

Options:
• 155/105 → 135/95 → 95/65

04/09/2026

Why don’t we open a door at the hinge?

One of the most consistent cues we give in our courses is about the relative balance of force between the manipulator’s left and right hand—regardless of the technique.

Tips for cleaning up a lower cervical thrust manipulation:
• Use secondary levers of rotation and translation to take up slack.
• Increase the contribution of the top-side hand during thrust.
• Focus on balancing force between both hands, specifically reducing PA force over the painful segment.

Think of it like a door:
• The segmental PA contact = the hinge
• The patient’s head = the door handle

You need far less force to open a door from the handle than from the hinge.

Use physics! Check out Total Spine Thrust Manipulation Live course to clean up techniques with one on one coaching.

People with Type II DM lose muscle mass 2-4x faster than those without. When treated this population of older adults we ...
04/07/2026

People with Type II DM lose muscle mass 2-4x faster than those without. When treated this population of older adults we know we are already fighting sarcopenia and maintaining muscle mass is critical for positive long term health outcomes.

This triple blinded RCT demonstrated improved strength & insulin resistance with the combination of resistance training and supplementing 20g of whey protein!

Resistance training + protein supplementation even in relative small dose goes a long way with this population! It’s important to note this may not be the ideal dosage & these were previously untrained individuals.

*If you want more helpful content to better serve older adults, sign up for our MMOA Digest = Free Bi-Weekly Email packed with helpful links, posts, & research relevant to your work. Link In Bio or PTonICE.com

**Looking for CEU’s & courses that will change your practice? Check out our Older Adult Course Offerings (Online & Live) Link In Bio or PTonICE.com

Spring’s heating up and so is that schedule ☀️🔥Longer days. Better weather.No excuses to sit on the sidelines.Whether yo...
04/06/2026

Spring’s heating up and so is that schedule ☀️🔥

Longer days. Better weather.
No excuses to sit on the sidelines.

Whether you’re leveling up your skills or finally taking that course you’ve been eyeing, this is your season to move.

Lock in your next course before summer fills up 👇
Drop “upcomingcourses” and we’ll send you the full lineup.

Did you know that the shoulder is the most commonly injured region in functional fitness athletes? In particular, the co...
04/06/2026

Did you know that the shoulder is the most commonly injured region in functional fitness athletes? In particular, the combination of loaded internal rotation & extension found in common movements like bench press, burpees, push-ups, and ring work seems to be particularly bothersome

Rehab providers & coaches must be comfortable modifying horizontal pressing to keep people training in the gym around pain while they recover

When individuals experience pain during horizontal pressing, we can implement many strategies to maintain shoulder loading. These include modifying position and equipment, as well as adjusting tempo & tension

Check out these modifications for high, moderate, and low irritability presentations

Have some others? Drop a comment below to share with the community!

——

On the road or online, we’re looking forward to serving you in 2026!

Join us for our 2-day Fitness Athlete Live Seminar around the country & learn the fundamentals of functional fitness: weightlifting, gymnastics, and conditioning

In our 8-week, online, guided, synchronous course, Fitness Athlete L1, starting April 13th, we’ll take you through all the research supporting the need for resistance training, including squatting/deadlifting/pressing. We’ll also tackle what happens in the other 23 hours outside of the gym: how the body adapts to load, sleep, nutrition, supplements, and recovery modalities

Already completed L1? Don’t forget to jump into the next Fitness Athlete L2 cohort starting August 4th with to tackle programming (strength/hypertrophy/CrossFit/mobility/gymnastics), advanced weightlifting & gymnastics movements, and business planning

Stop waiting.Start building.Provide better care and get paid what you’re worth, starting Monday morning and it all start...
04/05/2026

Stop waiting.
Start building.

Provide better care and get paid what you’re worth, starting Monday morning and it all starts with Brick by Brick 🧱

04/04/2026

We need to treat falling like a fundamental human SKILL. Not a one-off drill we only use with certain higher-level patients.

If we know how to fall WELL, 1. we can lower risk of an injurious fall AND 2. will likely be less afraid of the ground.

Teaching fall mechanics is infinitely scalable and can be applied across the spectrum of function.

If we want our patients to be truly resilient, we have to stop avoiding the ground and start normalizing the skills required to navigate it.

The new guidelines just confirm what we already see in the clinic:👉 there is no perfect program👉 there are a lot of ways...
04/03/2026

The new guidelines just confirm what we already see in the clinic:
👉 there is no perfect program
👉 there are a lot of ways to drive adaptation

Heavy. Fast. High volume.
Basic. Gym-based. Home Based. Doesn’t matter.

If it progresses, it works.

As clinicians, we’ve gotta stop hiding behind perfect variables or creativity and start doing the actual job:

• dose the stimulus
• meet the human in front of you💚
• progress it over time

Because adaptation isn’t built on perfect programming—
it’s built on consistent, progressive loading

Everything gets better when you applyenough stress—consistently—over time.That’s it. It’s that simple. The new guideline...
04/03/2026

Everything gets better when you apply
enough stress—consistently—over time.

That’s it. It’s that simple.

The new guidelines just confirm what we already see in the clinic:
👉 there is no perfect program
👉 there are a lot of ways to drive adaptation

Heavy. Fast. High volume.
Basic. Creative. Doesn’t matter.

If it progresses, it works.

As clinicians, we’ve gotta stop hiding behind perfect variables
and start doing the actual job:

• dose the stimulus
• meet the human in front of you💚
• progress it over time

Because adaptation isn’t built on perfect programming—
it’s built on consistent, progressive loading

04/03/2026

As our world becomes more digital and flexible, the clinicians who win are the ones who build systems that support their teams.

Something as simple as scheduling messages for when your staff is actually available?
Game changer.

🎧 Last week’s podcast breaks down how to use technology to lead better, communicate better, and operate at a higher level.

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Charlotte, NC
28201-28237, 28240-28247, 28250, 28253-28256, 28258, 28260-28262, 28265-28266, 2

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