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We often fall into the Manual Therapy OR Exercise Camp - that's why this is an interesting studyThis randomized controll...
04/27/2026

We often fall into the Manual Therapy OR Exercise Camp - that's why this is an interesting study

This randomized controlled trial (Villanueva-Ruiz et al., 2025) provides some critical nuances for our clinical reasoning.

The study compared Manual Therapy (cervical/thoracic mobilization/manipulation) to Neck-Specific Exercise (loading/CCF) for non-specific neck pain.

Key Findings:

1️⃣ MT showed significantly better overall outcomes (superior in ITT analysis).
2️⃣ Exercise only achieved equivalence when patient adherence was ≥95%.

The MMT Catalyst Perspective:

In the real world, patients don't perfect-load themselves. Adherence is hard. This study demonstrates that MT is a "robust catalyst."

Stop choosing sides. Use MT to build buy-in and movement tolerance, so you can transition the patient to the high-load, resilient model they need.

Full details and infographic attached.

What are your strategies for bridging the adherence gap for loading?

04/17/2026

💆‍♂️ Unlock the Power of Subcranial Shear Distraction! 💆‍♂️
Are you looking for effective ways to help your patients with headaches, neck pain, and TMJ issues? 🩺 Our latest video demonstrates the subcranial shear distraction technique—a game-changer in manual therapy!

Why Use Subcranial Shear Distraction?

This technique is designed to improve:
🔵 Headaches: Targeted relief for cervicogenic headaches.
🔵Neck Pain: Enhanced mobilization for subcranial stiffness.
🔵TMJ Issues: Effective management for jaw discomfort and dysfunction.

How It Works:

Cervical retraction naturally protracts the mandible, which is often the directional preference for both neck and jaw issues. By incorporating this into your treatment plan, you can offer your patients significant relief.

Post-Treatment Care:

Encourage your patients to perform high-dose cervical retraction with overpressure. For those with TMJ concerns, adding isometric mandible protraction can further alleviate headaches, facial pain, and neck pain.

🚀 Take Your Practice to the Next Level!

Become a TMJ specialist today! 🎓 Enroll in our fully online course, Modern Manual Therapy: Temporal Mandibular Management, and master the skills needed to provide exceptional care for your patients.
👉 Learn More and Register Here - link in the comments!
ProfessionalDevelopment ModernManualTherapy

04/17/2026

💆‍♂️ Unlock the Power of Subcranial Shear Distraction! 💆‍♂️

Are you looking for effective ways to help your patients with headaches, neck pain, and TMJ issues? 🩺 Our latest video demonstrates the subcranial shear distraction technique—a game-changer in manual therapy!

Why Use Subcranial Shear Distraction?

This technique is designed to improve:

🔵 Headaches: Targeted relief for cervicogenic headaches.
🔵Neck Pain: Enhanced mobilization for subcranial stiffness.
🔵TMJ Issues: Effective management for jaw discomfort and dysfunction.

How It Works:

Cervical retraction naturally protracts the mandible, which is often the directional preference for both neck and jaw issues. By incorporating this into your treatment plan, you can offer your patients significant relief.

Post-Treatment Care:

Encourage your patients to perform high-dose cervical retraction with overpressure. For those with TMJ concerns, adding isometric mandible protraction can further alleviate headaches, facial pain, and neck pain.

🚀 Take Your Practice to the Next Level!

Become a TMJ specialist today! 🎓 Enroll in our fully online course, Modern Manual Therapy: Temporal Mandibular Management, and master the skills needed to provide exceptional care for your patients.

👉 Learn More and Register Here - https://modmt.com/tmm

👀 Are we overestimating the power of an explanation?I’ve been a big proponent of Pain Neuroscience Education (EPE) for a...
04/16/2026

👀 Are we overestimating the power of an explanation?

I’ve been a big proponent of Pain Neuroscience Education (EPE) for a long time. I took David Butler’s first Explain Pain course way back in 2002 and have integrated it into my seminars ever since.

But here is a reality check: I have never once seen PNE, in the best-case scenario, actually reduce a patient's pain. Recent research supports this.

Adding therapeutic neuroscience education to a multimodal program—even with manual therapy and exercise—doesn’t seem to offer significant long-term improvements in pain reports. If you are measuring success solely by a 0-10 scale, you might conclude that PNE is a waste of time.

I view it differently.

The Real "Win" of Pain Science

While pain levels might stay the same, the research—and my own clinical experience—shows something much more valuable:

🔵 Decreased Kinesiophobia: Patients move with less fear.
🔵 Increased Confidence: They realize that hurt does not equal harm.
🔵 Faster Loading: They get back to lifting, moving, and sport much sooner.

We’ve fallen into the trap of thinking we can talk someone out of their symptoms. We can’t. Pain typically remains unchanged by a mere explanation, even when combined with great manual therapy.

🏈 Shift the Goalposts

Focusing strictly on the pain scale misses the point. Our priority should be function.

If a patient still has a 4/10 ache but is no longer terrified to pick up their child or hit a deadlift PR, that is a massive win in my book. We aren't just treating a sensation; we are restoring a person's agency.

What do you guys think? Are you still using PNE to "lower pain," or have you shifted your focus to kinesiophobia and confidence?

Let’s discuss in the comments. 👇

The "Magic" of Disney (and Vitamin M) 🏰Scan: "Bone on bone" knee OA.Doctor’s verdict: "Nothing we can do. Just live with...
04/15/2026

The "Magic" of Disney (and Vitamin M) 🏰
Scan: "Bone on bone" knee OA.

Doctor’s verdict: "Nothing we can do. Just live with it."
The result: Fear-avoidance and a sedentary desk job.
But then, January happened. He went to Disney World.

Now, normally, a sedentary patient with "confirmed" arthritis + 20,000 steps a day + Florida heat = a recipe for a flare-up, right? Wrong.

He told me he walked more that week than he did in the entire previous year. The result? His knee actually felt better. Much better. In fact, he hasn't even kept up that level of activity, yet he’s still reaping the benefits 3.5 months later.

Why did this happen?

Movement is medicine (Vitamin M). We know this. But for a patient who has been told their joint is "wearing out," they stop moving to "save" it.
Disney forced him into a massive dose of loading, synovial fluid circulation, and—let's be honest—the neurochemical distraction of a family vacation.

The Game Plan:
Since he’s back at his desk, we had to make it sustainable.

• The Missing Link: He was missing terminal knee extension. We started with Repeated Knee Extensions (Reset).
• The 20/20 Rule: Every 20 minutes of sitting, get up for a 20-second "movement snack" (Reinforce).
• The Habit: Two outdoor walks a day to keep that "Disney Effect" alive (Reload).

Stop letting scans dictate function. The knee didn't change in January, but the loading did.
Have you ever had a patient realize that "activity" was the very thing they were missing, despite what their imaging said? Drop a comment below!

04/10/2026

🦵 Think Sciatic Nerve Testing is One-Size-Fits-All? Think Again.

We all know the standard Straight Leg Raise (SLR). It’s a staple in our neurodynamic toolkit. But what happens when your patient’s symptoms don't perfectly fit the "textbook" sciatic distribution?

If you aren't biasing the nerve, you might be missing the full clinical picture.

In this clip from one of our lab sessions, I’m breaking down how subtle changes in ankle position can shift the tension to specific nerve branches. This is the key to differentiating between neural tension and local tissue issues like plantar fasciopathy or chronic ankle sprains.

🔬 The Quick Breakdown:

Sural Nerve Bias: Dorsiflexion + Inversion (Great for lateral ankle pain).
Tibial Nerve Bias: Dorsiflexion + Eversion (Essential for medial ankle or plantar symptoms).
Common Peroneal Bias: Plantarflexion + Inversion (Crucial for those stubborn "recurrent" ankle sprains).

🚀 Level Up Your Manual Therapy Skills

Neurodynamics is just one piece of the puzzle. If you want to master the full spectrum of Modern Manual Therapy—from easy to learn assessments, patient education and full Recovery Plans—my online curriculum is designed for you.

Earn CEUs while you learn: Get unlimited access to over 13 hours of content, including neurodynamic variations, IASTM, and the full Eclectic Approach.

👉 Join the community at: https://MODMT.COM/LEVELUP

Stop chasing protocols and treat Achilles with evidence. This infographic simplifies the 2024 CPG revision into an actio...
04/10/2026

Stop chasing protocols and treat Achilles with evidence. This infographic simplifies the 2024 CPG revision into an actionable clinical cheat sheet for physical therapists and healthcare providers.

Learn which interventions have Strong Evidence (A), what's a Weak Recommendation (D), and what is off the list.

Key Highlights:
✅ Grade A Strong Evidence: Progressive overload is the gold standard. Consistency over complexity. Heavy Slow Resistance (HSR) and Eccentrics are equally effective.
✅ Education is Grade A: Teach patients to monitor pain (0-4/10 is okay). Address the 'Mindset' factor. 🧠
✅ What's Grade D? Manual therapy for joint restrictions to improve ankle dorsiflexion.

Check out the full infographic for a complete evidence breakdown! 👇



level up with my flagship online seminar and get unlimited CEUs https://edgemobilitysystem.com/pages/mmtuq

While I think most Modern PTs don't easily dismiss patient's pain levels based off of "negative" scans, I do think we ne...
04/07/2026

While I think most Modern PTs don't easily dismiss patient's pain levels based off of "negative" scans, I do think we need to do a better job at validating what they're feeling when using a PNE approach. What do you think?

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