Milo Strength Rehab

Milo Strength Rehab Dr. Jon Kilian, PT, DPT, CSCS
🟢 Doctor of Physical Therapy
🟢 Strength Coach

04/21/2026

Sometimes we gotta have a bit more patience 🤷‍♂️

One reason could be 👇Trigger point referral patterns refer to hyper-irritable spots of muscle tissue that may manifest a...
04/14/2026

One reason could be 👇

Trigger point referral patterns refer to hyper-irritable spots of muscle tissue that may manifest as pain elsewhere (referred).

The scalenes have an interesting referral pattern potentially to the interscapular (mid back) region.

Palpation of regional structures could answer the confusing question of why your patient isn’t getting better 🤷‍♂️

Another successful VA state clinic! Had some challenging questions and great talks with other talented coaches and clin...
04/11/2026

Another successful VA state clinic!

Had some challenging questions and great talks with other talented coaches and clinicians!

Just remember, if squats and creatine doesn’t fix it you’re probably doomed.

Athlete needs analysis should occur with every single athlete that walks through the door. Rehabbing for football is dif...
04/10/2026

Athlete needs analysis should occur with every single athlete that walks through the door.

Rehabbing for football is different than rehabbing for recreational activity/return to daily life.

Rehab should gradually reintroduce the forces associated with the end game activity.

Return to sport doesn’t just mean they play the sport again. It means you get them back the same, if not stronger than before they were injured.

04/09/2026

Insert plug about how important good mentorship is.

04/05/2026

“He is not here; he has risen, just as he said. Come and see the place where he lay.”
‭‭Matthew‬ ‭28‬:‭6‬ ‭NIV‬‬

Happy Easter!

04/04/2026

Not a knock on surgeons. But DEFINITELY a knock on outdated and time driven protocols.

Protocols can be a great guide… but good long term rehab will probably deviate at some point.

04/01/2026

Also I drink too much coffee ☕️

03/30/2026

🤷‍♂️

Imaging can be useful but here’s some more data supporting the limitations of its use! Many asymptomatic people display ...
03/25/2026

Imaging can be useful but here’s some more data supporting the limitations of its use!

Many asymptomatic people display an anatomical rotator cuff abnormalities WITHOUT accompanying symptoms.

Importantly:
👉 abnormalities increased with age beginning with tendinopathy as a common finding in 45-54 and increasing damage after that
👉 worse damage was associated with more likelihood of symptoms
👉 no substantial differences between genders
👉 most abnormalities were found in asymptomatic individuals underlaying the poor causality between symptoms and imaging

“Consequently, a positive MRI result does not confirm causality unless features such as a clear traumatic event, acute strength loss, or persistent functional deficit increase the pretest probability.”

So that tear you see on the MRI? Do we really know that it wasn’t already there when you started developing pain recently? NO. Yet we are so quick to push people towards surgeries 👉 maybe this is why we see a lot of sham surgeries having similar outcomes 🤷‍♂️

Unless there is
👉 clear mechanism of injury
👉 acute strength loss
👉 lack of improvement with skilled care

… we CANNOT say that the abnormality found on imaging alone is the cause for the dysfunction.

The shoulder is a complicated beast, sometimes the issue doesn’t lay within the first hypothesis we think we identify 🧐

Further reading 📖:

Ibounig, T., Järvinen, T. L. N., Raatikainen, S., Härkänen, T., Sillanpää, N., Bensch, F., Haapamäki, V., Toivonen, P., Björkenheim, R., Ryösä, A., Kanto, K., Lepola, V., Joukainen, A., Paavola, M., Koskinen, S., Rämö, L., Buchbinder, R., & Taimela, S. (2026). Incidental Rotator Cuff Abnormalities on Magnetic Resonance Imaging. JAMA internal medicine, e257903. Advance online publication. https://doi.org/10.1001/jamainternmed.2025.7903

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