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Perfecting PT
Dr. Nathan Norr, Doctor of Physical Therapy
27 episodes
6 days ago
Long-form conversations with rehabilitation and fitness experts to provide additional insights and perspectives required to improve your practice.
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Health & Fitness
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All content for Perfecting PT is the property of Dr. Nathan Norr, Doctor of Physical Therapy and is served directly from their servers with no modification, redirects, or rehosting. The podcast is not affiliated with or endorsed by Podjoint in any way.
Long-form conversations with rehabilitation and fitness experts to provide additional insights and perspectives required to improve your practice.
Show more...
Health & Fitness
Episodes (20/27)
Perfecting PT
26. Low Back Pain Assessment with NICK RAINEY

Welcome! Happy to have YOU here!


Support the podcast by subscribing!


Nick Rainey is the owner and founder of Rainey Pain and Performance in Sierra Vista, AZ. He is fellowship trained in orthopedic manual therapy and has additional training for the cervical spine and TMJ. He teaches courses for Evidence In Motion and also works with the Movement Brainery as a mentor to clinicians looking to improve their practice. We discuss our understanding and approaches to assessing low back pain - similarities and differences. Hope you find it helpful and insightful. Thanks!


********** ADDITIONAL RESOURCES **********

Rainey Pain and Performance

The Movement Brainery - Nick Rainey

Evidence In Motion - Nick Rainey

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2 weeks ago
1 hour 9 minutes 22 seconds

Perfecting PT
25. Plantar Fasciitis CPG with NATHAN NORR

Welcome! Happy to have YOU here!


Support the podcast by subscribing!


The 2nd episode in the clinical practice guidelines series. I discuss what plantar fasciitis is, other diagnoses that can present similar to plantar fasciitis, and the physical therapy evidence available to guide treatment from a skilled healthcare/fitness professionals. I also provide my personal insights into the condition and how I have found best to intervene.


Thanks for listening!


********** Additional Resources **********

Clinical Practice Guideline PDFs

- Plantar Fasciitis 2008- Plantar Fasciitis 2014- Plantar Fasciitis 2023- Chronic Foot Pain Imaging Guidelines********** DISCLAIMER **********

This podcast is not intended to replace medical advice and expertise. This podcast is not intended as instruction for performance of acts or skills intended to be performed only by licensed professionals in appropriate settings. If you or someone you know is experiencing anything that may be discussed in this podcast, please seek medical direction from qualified healthcare providers near you.

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4 weeks ago
58 minutes 15 seconds

Perfecting PT
24. Achilles Tendinopathy CPG with NATHAN NORR

Welcome! Happy to have you here!


Support the podcast by subscribing


The first episode of many exploring clinical practice guidelines for Physical Therapists. Clinical practice guidelines (CPGs) are compilations of data that are condensed into guidelines and given ratings of strength for application. It's important to know the levels of evidence available, but sometimes the guidelines are super vague and unhelpful. I want to fix that. I go over the evidence, why the rating was given and how to apply it. This is my first go at this, but I found it very insightful and the future ones will only get better.


Thanks for listening!


********** Additional Resources **********

Clinical Practice Guideline PDFs

Achilles Tendonitis CPG - 2010

Achilles Tendonitis CPG - 2018 revision

Achilles Tendonitis CPG - 2024 revision

Outcome Measures (PDFs available by clicking "instrument details" on website)

- Victorian Institute of Sports Assessment - Achilles (VISA-A)

- Foot and Ankle Ability Measure (FAAM)

- Lower Extremity Functional Score (LEFS)


********** DISCLAIMER **********

This podcast is not intended to replace medical advice and expertise. This podcast is not intended as instruction for performance of acts or skills intended to be performed only by licensed professionals in appropriate settings. If you or someone you know is experiencing anything that may be discussed in this podcast, please seek medical direction from qualified healthcare providers near you.

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1 month ago
1 hour 24 minutes 59 seconds

Perfecting PT
23. Fixing Lower Body Pain, Part 4: Exercise Selection with NATHAN NORR

Welcome! Happy to have you here!


Support the podcast by subscribing


In this final part of the fixing lower body pain series, I go over exercise selection for the lower body as well as practical insights on how to progress those exercises. I also address modalities for the lower body and how I use them, including parameters. It's difficult to create a podcast addressing all questions, but I do my best. I hope you find it insightful and thought provoking.


Reach out to join the podcast!


**********Additional Resources**********

People mentioned

- Bill Hartman

- James Cyriax

- Vladimir Janda

- Nikolai Bogduk

- Freddy Kaltenborn

- Olaf Evjenth

- Shirley Sahrmann

- Dr. Stuart McGill

- Ludwig Ombregt

- Diane Lee

- Joel Seedman

- GOATA

- Functional Patterns

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2 months ago
1 hour 11 minutes 38 seconds

Perfecting PT
22. Fixing Lower Body Pain, Part 3: Choosing Manual Therapy Interventions with NATHAN NORR

Welcome! Happy to have you here!


Make sure to subscribe


In this part, I go over the manual interventions that I provide for all of the joints of the lower body. I go over each joint, what I look for when I assess it and how I determine which joint mobilization to perform. I apologize ahead of time; I realized I misspoke about the anatomy of the foot after I finished recording. The cuneiforms are distal to the navicular, not cuboid. I will clarify and correct that in the next episode - thanks for your patience. I was hoping to get to exercise interventions as well, but it would have been too long. Exercise interventions will be the next part. Stay Tuned! Thanks for listening.


**********Additional Resources**********

Instagram: @perfectingpt

Hip Bump Video (UFIR manipulation by Gail Malloy)


DISCLAIMER: This podcast is not intended to replace medical advice and expertise. This podcast is not intended as instruction for performance of acts or skills intended to be performed only by licensed professionals in appropriate settings. If you or someone you know is experiencing anything that may be discussed in this podcast, please seek medical direction from qualified healthcare providers near you.



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3 months ago
1 hour 2 minutes 56 seconds

Perfecting PT
21. Fixing Lower Body Pain, Part 2: Assessing the Lower Body with NATHAN NORR

Welcome! Happy to have you here!

Make sure to subscribe


In this part of the fixing lower body pain series, I discuss my assessment of the lower body - everything from the low back and down. I go over each step of my evaluation process and some of the things I'm looking for and what I interpret them to mean. I will also tie in patterns of compensation and biomechanics discussed from part 1. Although not the focus of this episode, I also go into manual interventions and treatment goals based on exam findings. I hope you find it both interesting and insightful. Thanks again for listening!


**********Additional Resources**********

Instagram: @perfectingpt

Gail Malloy Hip Manipulation Article


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3 months ago
1 hour 26 seconds

Perfecting PT
20. Fixing Lower Body Pain, Part 1: Biomechanics and Patterns of Compensation with NATHAN NORR

Welcome! Happy to have you here!


My name is Nathan Norr. I am a Doctor of Physical Therapy and practice in Colorado. Today, I go over lower body (everything from the low back down) biomechanics and patterns of compensation that I see and address constantly in the clinic to help people get out of both acute and chronic pain and return to normal activities. Further show notes will be here soon. Thanks for watching!


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3 months ago
57 minutes 49 seconds

Perfecting PT
19. Cervicogenic Headaches with ANTHONY FALCO

Welcome! Happy to have you here!


Anthony Falco is a Doctor of Physical Therapy who is additionally credentialed as an Orthopedic Certified Specialist, Fellow in Orthopedic Manual Therapy from Bellin College, and currently serves as the VP for the APTA chapter in New Jersey. He specializes in the treatment of cervicogenic headaches and works closely with a pediatric neurologist. Other headache types including migraines are also discussed.


We dive into identifying headache types, whether or not physical therapy can address them and how, and answering the question of how many headaches is "normal".


********** Resources **********

Anthony's Information

Provider Profile at Summit Health

Instagram: @afalco_dpt


People Mentioned

- Geoffrey Maitland (Anthony recommends checking out his textbooks)


Research Articles

- Canadian C-Spine Rules

- IFOMPT Cervical Vascular Pathology Screening



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4 months ago
1 hour 12 minutes 53 seconds

Perfecting PT
18. PT for Golfers with MICHAEL POMYKALA

Welcome! Happy to have you here!


Michael Pomykala is a Doctor of Physical Therapy who specializes in the treatment of golfers of all ages and skill levels at Sports Solutions Physical Therapy in New Jersey. He is additionally credentialed as a board-certified sports and orthopedic specialist, Titleist Performance Institute certified levels 1-3 (and more through TPI), and a Certified Strength and Conditioning Specialist.


We discuss various factors that contribute to someone being able to play golf efficiently and also discuss compensatory patterns and Michael's views of the body and why it breaks down in golfers. This won't be the last time Michael is on the podcast and we are planning an upcoming episode where we go through a full PT golf evaluation. Stay tuned!


********** RESOURCES **********

Michael's Info

Instagram: @sportssolutions

Michael's Website


People Referenced

Greg and Vicky Johnson


Products and Course Referenced

Titleist Performance Institute (TPI)

Selective Functional Movement Assessment (SFMA)

Institute of Physical Art (IPA)

Postural Restoration Institute (PRI)

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5 months ago
51 minutes 41 seconds

Perfecting PT
17. All Thing ACLs with BRIAN KOKULAK, Part 1

Welcome! Happy to have you here!


Brian Kokulak is a Doctor of Physical Therapy at Edge Physical Therapy and Sports Medicine. He Specializes in treating patient's undergoing ACL surgery (repair or reconstruction) and has worked with many professional and competitive athletes of all ages. We discuss the types of ACL surgeries performed as well as their benefits, indications, and limitations of each. We also discuss timelines for rehab that allow you to know your patient is progressing well. Part two will be more focused on exercise selection, progression, and return to sport testing, so STAY TUNED!


********** Resources **********

- Brian's Instagram: dr_brian_kokulak

- Brian's Clinic


Research Articles

- Knee ligament sprain clinical practice guidelines

- ACL clinical practice guidelines

- Exercise-based ACL injury prevention guidelines

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5 months ago
43 minutes

Perfecting PT
16. Practical Approach to Treating Low Back Pain with NICK RAINEY

Welcome! Happy to have you!

Nick Rainey is the owner of Rainey Pain and Performance in Sierra Vista, Arizona. Nick is a fellow in Orthopedic manual therapy (FAAOMPT), orthopedic certified specialist (OCS), certified strength and conditioning specialist (CSCS), certified cervical and temporomandibular therapist (CCTT), as well as pelvic health certified.


In this episode, we discuss many things related to low back pain. Much of this information is condensed from a presentation he gave at an APTA conference. We discuss whether or not the research on low back pain and exercise really says what we are often told it does; we discuss theory related to it's biomechanical origin, whether form matters, the value of the biopsychosocial model, the general buckets of diagnosis, and how to begin treatment, as well as one of his key focuses when introducing exercise to patients with low back pain, and more. Hope you enjoy!


**********Stay posted for updated show notes including the articles referenced and updated links related to Dr. Rainey*********

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6 months ago
1 hour 6 minutes 49 seconds

Perfecting PT
15. Shared Decision Making and Leveraging Patient Preference with WALT FRITZ

Follow us on Instagram:

- Walt Fritz: @waltfritzpt

- PerfectingPT: @perfectingPT

Overview: Walt Fritz is a physical therapist that specializes in speech and swallowing disorders, but more than that, he specializes in including the patient in the plan of care and leveraging their insights and beliefs to provide the most efficient treatment. Although this episode starts with us discussing some of the reasons for PT to treat speech and swallowing, we quickly transition to patient care and shared decision making. Hope you enjoy. Happy to have you here!


RESOURCES

Walt's Info

- Walt Fritz Website

- Instagram: waltfritzpt

People mentioned

- Jeffrey Maitland

Research mentioned

- The Demonization of Manual Therapy, Chad Cook

- Manual therapy: Exploiting the role of human touch, Tommaso Geri

- Rocabado's Approach

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6 months ago
1 hour 23 minutes 14 seconds

Perfecting PT
14. Cervical Instability and CRPS with MICHAEL FANNING

Follow us on Instagram!

Nathan Norr @perfectingpt

Michael Fanning @mfanning_dacbsp


Michael Fanning is a chiropractor with the LAPD and USA fencing and cycling team, faculty in the Tactical Sports Medicine department at SCUHS, and Air Force veteran. He has had extensive mentoring with specialists in Chronic Regional Pain Syndrome (CRPS) and neuropathic pain and their treatment with sympathetic blocks/nerve hydrodissections. He also has looked extensively at cervical spine instability prevalence and treatment related to trauma, especially in law enforcement. We discuss how to identify the types of CRPS and neuropathic pain as well as cervical instability, and available treatment options.


*******Resources*******

PEOPLE

Edward Carden, MD

Thomas B. Clark, DC, RVT, RMSK

Yao-Wen Eliot Hu, MD

Coach John Hofman

Stuart McGill

Stanley Lam

Joseph Horrigan


PRODUCTS

MedX Cervical Extension


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7 months ago
1 hour 34 minutes 25 seconds

Perfecting PT
13. Distance Runners, Building a Business, and Adding Value with MIKE THE PT

Mike Russell, DPT is one of the most well-known physical therapists for runners and business owners in the Las Vegas area. We discuss his treatment of runners as well as his views on building a business in an ever-changing environment, and adding value through a variety of treatment options. He himself is an avid runner, regularly running both street and trail. Mike Russell is my original mentor and gave me my first job working in physical therapy as his tech. He owns Elevation Physical Therapy, which is his second clinic after building Optimal Physical Therapy to multiple successful clinics and selling it a handful of years back.


His drive for business and excellence has lead to his reputation as someone who adds value and always seeks out and maximizes opportunities to improve patient care and outcomes.


Resources

Mike's Info

- Insta: mike_the_pt

People

- Bob Donatelli

- Chris Johnson

Research

- Changes in muscle activation patterns when running step rate is increased (Chumanov et al 2012)

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7 months ago
1 hour 24 minutes 1 second

Perfecting PT
12. Upper Extremity in Baseball Players with ZACH LEAL

Zach Leal, PT, DPT, CSCS owns Forged Physical Therapy and Performance inside baseball training facilities. He has two locations near Los Angeles and specializes in treating baseball players of all ages and skill levels along with other motivated athletes. Zach was a student with Mike Reinold and does 1-on-1, hour long, cash appointments. We discuss the most common goals and injuries associated with each age group, research for baseball players and overhead athletes, the biggest "buckets" he makes sure to hit to generate the greatest outcomes, and his very clearly delineated system for evaluation and intervention. See resources below for people, products, and research mentioned.


Resources

People

-Kevin Wilk, PT, DPT, FAPTA

-Mike Reinold

-Dan Pope - Fitness Pain Free

-Shirley Sahrmann, PT, PhD, FAPTA

-Eric Cressey

-Keith Meister, MD

Products

-Vald Dynamometers

-Lafayette Dynamometer

Research

-The strength characteristics of internal and external rotator muscles in professional baseball pitchers


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8 months ago
1 hour 30 minutes 26 seconds

Perfecting PT
11. Diagnostic Ultrasound and EMG Utility in Conservative Care w/ BART MCDONALD

Bart McDonald is the owner of Superior Physical Therapy in Idaho. His clinics specialize in diagnostic ultrasound as a means to provide greater insight into diagnosis, treatment plan, and progress. In this episode, we discuss the utility of diagnostic ultrasound and EMG and how you can use that information to determine prognosis and provide more efficacious treatment. Below are some helpful resources!


Resources:

Bart's Personal Email: bartmpt@gmail.com

Instagram: Superior.physical.therapy

Website:Superior Physical Therapy

Mohini Rawat Ultrasound Textbook

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8 months ago
1 hour 24 minutes 56 seconds

Perfecting PT
10. Low Back Pain and Measuring Spinal Stiffness with SEAN M. HARRIS

What if there was a way to measure how much stiffness you are generating around the spine and correlating that number with how much weight you lift to determine your risk of pain? That's exactly what Sean is researching and the topic of our conversation. Sean is a DPT, PhD, OCS, FAAOMPT and we cover how he measures spinal stiffness using a Tindeq scale and a modified lifting belt. We discuss his current research, some of his views on low back pain, his approach to assess it, and more. Below are resources to get access to more of Sean's content. Please check it out!


Resources

Instagram: @dr.sean.m.harris

Sean's Website (Various service provided)

Tindeq Scale


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9 months ago
1 hour 24 minutes 8 seconds

Perfecting PT
9. Transitioning Between Rehab and Performance with EMILY FERREE

Emily Ferree is a Doctor of Phsyical Therapy affiliated with multiple MLB organizations to assist in pitching analysis as well helping multiple players with the Chargers organization. She is also a biomechanist who trained with Christ Powers at USC.

Topics of this conversation include thoughts on both upper and lower quarter biomechanical assessment. Posture, and exercise progression tips to help you understand how to get your athlete back to full performance effectively.


Resources:

- Instagram: ferree.pt.lab

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9 months ago
1 hour 33 minutes 15 seconds

Perfecting PT
8. Starting a Cash-Based Practice with RAY GORMAN

Ray Gorman is the founder of Engage Movement. He specializes in helping providers who want to work with active populations to create cash-based practices that include both in person and online clientele. We discuss Ray's process step by step to make it as easy as possible to understand as well as addressing my most requested questions. Something to know: investing in the future you want will require a lot of frontloaded work and sacrifice, but with effort and guidance, it is achievable. If you are interested in contacting Ray's group or seeing if they could be right for you, follow the links below.


Links:

Instagram: @raygormandpt

Website: Engage Movement

Free Training Courses: Here

Free Business Starter Checklist: Here

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10 months ago
1 hour 25 minutes 8 seconds

Perfecting PT
7. Chiropractic Systems of Intervention with Strat Poulson

What and why do chiropractors do what they do and how is it different than other methods of intervention you may receive? Strat and I cover that question and more in this conversation, including the original theory behind chiropractic care, his personal views, and what some of the current evidence suggests about chiropractic care.

Dr. Stratton Poulson is the owner of Apex Chiropractic in Dallas, Texas, and the founder of Apex Chiropractic Education, an international seminar company that provides in-person and online courses to improve the hands-on skills of students and  seasoned clinicians.


Resources:

- Apex Chiropractic

- Instagram: @stratpoulson

- YouTube: Dr. Stratton Poulson

- TikTok: @dr.strattonpoulson


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10 months ago
1 hour 47 minutes 23 seconds

Perfecting PT
Long-form conversations with rehabilitation and fitness experts to provide additional insights and perspectives required to improve your practice.