Click Here to get Fundamentals of Sciatica while it's FREE.
There are 3 key questions every PT should be asking when assessing breath — especially in chronic low back pain.
The answer to those questions directly influence your next clinical decision.
In this episode, we unpack how the relationship between thorax position and diaphragm position drives intra-abdominal pressure, pelvic diaphragm control, and ultimately core function.
You’ll hear a breakdown of the clinical logic behind thorax–pelvis integration — how to “create the canister” — plus how to coach breathing when building real core endurance (not just bracing).
This one dives deep into misunderstood breathing principles, its ripple effect on Intra-abdominal pressure, and the reasoning behind it all.
If you’re the kind of PT who loves understanding the “why” beneath the “what,” you’ll get a ton out of this one.
To learn more about breathing and how to blend breath work into your clinical practice, check out Spine PT's top performing episodes:
E29. Breath Work & The Central Nervous System
E64. 3 Ways Breath Work Controls The Nervous System
E67. Breath Work & Back Pain: It's NOT Just a Relaxation Tool
Click Here to get Fundamentals of Sciatica while it's FREE.
If you find yourself frequently, getting overwhelmed and frustrated with acute sciatica & low back pain evals then you have to listen to this episode.
In this episode, Mez breaks down the basic principles of the most important, non-negotiable skill every master clinician has polished… Pattern Recognition.
This is the most important skill that needs to continual upgrading as you learn. Its the skill that allows you to actually make use of your experience, knowledge, and other clinical skills.
You need to be obsessed with pattern recognition ff you want continual growth & clinical excellence as a sports rehab professional.
Exercise progressions and programming can get messy once your LBP patients are “out of pain”
You know they need strength and load, but the number of exercise options can feel endless & overwhelming.
This episode is a clip from a live coaching call where Mez breaks down the exact framework he teaches inside his new upcoming course Back to Gym (B2G) After Sciatica™ for organizing exercise progressions and regressions with clarity.
You’ll hear how he uses a simple 4-pillar system to make exercise progressions less intimidating:
1. The Progression Principles Framework
2. Controlled mobility & motor control buckets
3. Load tolerance and strength categories
4. The “martial belt” ranking system of progressions
This system will help you guide patients from the treatment table and back to heavy lifting in a logical way without all the noise.
This one’s straight from a live coaching call and its packed with structure you can apply right away in the clinic.
Click here to learn about The Low Back Pain Intensive
Ever felt drained by that one difficult patient?
If you’ve ever taken that emotional baggage home because you didn't meeting that patient's expectation of “fixing them” fast, then listen to this episode.
If "those patients" make you feel bad & make you question your clinical skill despite knowing what you're doing, then definitely listen to this episode.
You’ll learn:
What I wish someone taught me at the beginning of my PT career.
How I let my "people pleasing" habits break my confidence even when I knew what I was doing and how to avoid the same mistake yourself.
The framework that helped me stop the bullshit, start setting boundaries, protect my peace, and reclaim my confidence.
Why another con-ed course will NOT fix this problem.
This episode is raw, honest, and hopefully exactly what you need to hear if you’ve been silently struggling with patients who are hard to help no matter what you do.
Tune in now and forward it to a colleague who might need it too.
Click here to learn about The Low Back Pain Intensive
In this episode of The Spine PT Podcast, we’re blending two of the most powerful tools I use in rehab:
The OMNI Scale (0–10 RPE), and
The Traffic Light Pain System.
Too often, we either underdose or overdose our back pain patients — especially when symptoms linger and confidence is shaky. And without a clear system, it’s easy to keep yo-yo’ing between pushing too hard… or not pushing at all.
In this episode, I’ll show you how I blend these tools to build trust, scale loading, and help patients get stronger while getting out of pain.
Why “training hard enough” means physical + mental effort, especially early in rehab
How to use the OMNI Scale to find each patient’s challenge threshold
How to use the Traffic Light System to track symptoms before, during, and after training
Why RPE 2–3 might be the perfect place to start — and how to safely build toward RPE 6–8
What to do if symptoms stay in the yellow zone for >48 hrs (and when to adjust)
A real 8-week deadlift progression that brought one of my sciatica patients from pain to power
This episode is especially useful if you’re:
Tired of guessing how hard to push your patients
Looking for ways to bridge rehab and strength without flaring symptoms
Wanting a simple, visual framework to teach patients that “hurt ≠ harm”
What You’ll Learn:
Why “training hard enough” means physical + mental effort, especially early in rehab
How to use the OMNI Scale to find each patient’s sweet spot for challenge
How to use the Traffic Light System to track symptoms before, during, and after rehab &/or training
Why RPE 2–3 might be the perfect place to start for certain patients (esp chronic pain) and how to safely build toward RPE 6–8
How I used the OMNI + traffic light during an 8-week deadlift exercise progression that helped a patient completely rehab acute sciatica and deadlifting for the first time pain free.
This episode is especially useful if you’re:
Tired of guessing how hard to push your patients or how much "back off"
Looking for ways to bridge rehab and strength without flaring symptoms
Wanting a simple, visual framework to teach patients that “hurt ≠ harm”
Click here to learn about The Low Back Pain Intensive
In this episode, Mez breaks down a simple framework to help you decide when to push, pause, or pull back while rehab and training a patient with low back pain.
You’ll learn how to use the Traffic Light Pain System to interpret symptoms by first creating clear language around acceptable vs un-acceptable symptoms.
The traffic light system also allows you to strategically adjust your patients exercise program in a collaborative way which helps build patient confidence and self-efficacy without fear of flare-ups.
Perfect for performance-minded PTs who want clearer decision-making and smoother transitions from rehab to the gym.
Click here to learn about The Low Back Pain Intensive
Most physical therapists want to know what "corrective exercise" or manual therapy technique to use solve back pain.
In this behind‑the‑scenes clip from one of The LBP Intensive live calls, I flip that question on its head.
Instead of giving you another “X‑Y‑Z” method, we zoom out to the principles that sit beneath every program, every exercise, every manual technique, the stuff that keeps your patients (and you) in the game long‑term.
You’ll hear:
Why focusing on “what” exercises & manual technique can trap you as a clinician, and what to do instead.
The 3 overlooked pillars of spine health that no rehab or training program can out‑train
A personal story about how missing these principles almost derailed my own recovery
This episode will change the way you think about "solving back pain" and exercise programming before you even prescribe your next exercise.
Click here to learn about The Low Back Pain Intensive
In this episode, Mez walks you through a real patient case study breaking down the exact progression used to take a patient from an acute sciatica flare-up to confidently deadlifting pain-free.
You'll learn key clinical decisions made in the acute & performance phase that made full recovery possible for this patient.
Acute Phase:
How diagnosing the specific pain pattern helps you know exactly where to start & avoid flaring symptoms
Why traditional PT makes it worse and how to avoid making that mistake.
Performance Phase:
The small hinge tweak that turned everything around for this case
This episode is packed with clinical gems you can implement with your next sciatica patient — whether they’re still
🎧 Listen now to get the full case breakdown.
Click here to learn about The Low Back Pain Intensive
Ever work with a patient who just can’t seem to get it, no matter how many cues you give?
In this episode, Mez shares a powerful clinical story that flips the script on traditional verbal cueing and exposes one of the biggest blindspots we have as PTs when it comes to motor learning.
You’ll learn:
Why more cues ≠ better motor learning
The power of “silent sets” (where the idea came from)
How closed environments, not just changing your cue, can unlock motor learning even with your most uncoordinated patients.
Click here to learn about The LBP Intensive
Click Here to enroll in last round of The LBP Intensive™ 2025
This episode is a direct clip from the end of a webinar where Mez shares all the details of The LBP Intensive™ 12 week program including:
Click Here to enroll in the last LBP Intensive™ for 2025 | Limited Spots
To learn more & enroll in 2025's final round of The LBP Intensive™ Click Here
Enrollment doors officially close Tues Sept 16th 2025 at midnight.
In this episode, Mez sits down with his first PT mentor, longtime clinic owner ,and coach Todd Houghton for a raw conversation on what happens when the passion fades and how to find your way back.
Todd opens up about the hidden weight of being the go-to PT, the emotional toll of trying to "fix" every patient, and what shifted for him in his evals/POCs... even after 30 years in the game.
Todd’s is a licensed Physical Therapist with over 30 years of experience and the founder of Houghton Physical Therapy, a full-spectrum PT & wellness center based in Attleboro, Massachusetts.
Since launching his PT clinic in 2003, his clinic has grown into a thriving team of 16, offering a powerful mix of traditional PT, regenerative therapy, and mindset coaching.
They operate on a hybrid model—serving both insurance-based clients and those seeking personalized, cash-based care and coaching.
Todd spent over a decade racing triathlons, completing everything from sprint to Olympic, half Ironman, full Ironman, and even double Ironman distance events.
He's a blue belt in Brazilian Jiu Jitsu, an expert downhill skier, and an avid mountain biker.
You’ll hear:
How Todd got to where he is today.
What Todd really thinks about the current state of outpatient orthopedics
How he built his clinical confidence with LBP/sciatica (His clinic is known as "the back pain experts")
What helped him scale his clinic to a 14-person staff and 5,600 sq ft full spectrum PT & Wellness clinic
What changed when he stopped trying to "fix" every patient
If you’ve ever looked around your clinic and thought, “I’m supposed to feel more fulfilled than this…” — this one’s for you.
To Learn more about Todd & Connect with him 👇🏽
To learn more about The LBP Intensive™ program Click Here
In this episode, Mez pulls back the curtain on one of the most common (and costly) mistakes physical therapists make with sciatica patients & what PTs can learn from strength & conditioning principles.
You’ll get a sneak peek inside the second core curriculum of The Low Back Pain Intensive™, where Mez overviews the 3 key phases of a strength and conditioning he teaches clinicians to help patients transition from pain to performance.
If you’ve ever wondered:
“When should I start loading my patient?”
“What’s the right entry point into strength training after acute sciatica?”
“How do I avoid re-flaring someone… without babying them?”
This episode will give you clarity.
You’ll learn:
The 3 critical phases of a post-sciatica S&C program
The first step to long-term spine resilience
The difference between concentric and eccentric cardiac adaptations (and why it matters)
How to avoid jumping the gun with heavy loads too soon
If you’re a performance-minded PT who wants your patients to walk out stronger than when they came in, not more fragile & de-conditioned, this episode is for you.
_____
🕰️ Timestamps:
[00:00]
Why loading patients too soon can backfire — especially with sciatica
[00:17]
The real problem: patients leave PT weaker than they started
[00:36]
Why sciatica patients return to the gym more fragile than before
[01:06]
3 questions every PT should ask before discharging a patient
[01:27]
Common mistakes with load progression inside the clinic
[01:43]
Clip context: this is from the Strength & Conditioning core module inside The LBP Intensive™
[02:00]
Part 1 vs. Part 2 of the LBP Intensive explained — from acute care to progressive loading
[02:18]
Why most PTs were never trained in strength & conditioning (and why that’s a huge problem)
[02:34]
What “pain-free performance” should mean in the clinic
[03:01]
Program overview: a 12-week roadmap from pain to performance
[03:27]
Benefits of offering a rehab-to-fitness bridge (even in insurance-based care)
[04:03]
Cohort 6 of the LBP Intensive opens soon — waitlist details
[04:19]
The goal: breaking down the 3 S&C phases post-sciatica
[04:47]
Who influenced this framework: Joel Jamieson, Boyle, Cressey, Cosgrove
[05:48]
Phase 1 (Weeks 1–5): Aerobic capacity & tissue tolerance
[06:25]
Why Zone 2 training matters for spinal rehab
[07:33]
Vascular adaptations & slow-twitch muscle fiber development
[08:18]
Phase 2 (Weeks 6–7): The transition phase (low-load → moderate-load ramp)
[09:13]
Phase 3 (Weeks 8–12): Strength, tension, and anaerobic loading
[09:54]
The biggest mistake PTs make post-discharge
_____
To learn more about The LBP Intensive™ program Click Here
To learn more about The LBP Intensive™ program Click Here
This episode is a live clip of The LBP Intensive™ where we overview the 3 basic steps to quickly assess lumbar spine & pelvic mobility in all 3 cardinal planes after an ACUTE sciatica/LBP flare up.
There's no need to make this a complicated checklist. I hope you find this clinically useful.
Click Here if you're a performance PT looking to learn more about The LBP Intensive™ program.
To learn more about The LBP Intensive™ program Click Here
In this episode, Mez sits down with a brilliant chiropractor, Dr. Sean Nealon, DC for a raw convo on what it really takes to evolve as a clinician in this day and age.
They unpack:
Sean's interesting take on "finding your passion" in sports & orthopedic rehab
A "con-ed trap" clinicians need to avoid at all cost.
His thoughts and struggles trying to blend various rehab approaches like McGill, McKenzie, DNS, PNF, neurodynamics, and others into a practical system that logically made sense.
How he finally learned to reconcile these various models instead of getting sucked into unproductive debates.
If you feel overwhelmed by all the rehab approaches or excited about them but unsure how to put it all together, this episode will hit home.
Click Here to follow Dr. Sean Nealon's on Instagram @sean.nealon.dc
To learn more about The LBP Intensive™ program Click Here
Time Stamps 🕰️
[00:00] Intro — Mez sets the stage for a raw conversation with Sean about rehab silos, blending models, and evolving as a clinician.
[01:30] Why Sean as a model for open-minded, critical thinking in rehab.
[04:30] Sean’s backstory — from uncertain chiropractic student to passionate clinician through reps.
[07:00] Navigating burnout, doubt, and early-career grind in high-volume clinics.
[09:30] Mez and Sean reflect on real-world clinical doubt and the need for critical thinking over formulas.
[11:00] Sean’s stance on "rehab silos" (Motion Palpation, McKenzie, DNS), how he uses them AND moves beyond them.
[13:30] The “rehab echo chamber” and how systems can become too myopic.
[15:00] Sean shares how mentorship and exposure to new frameworks reshaped his clinical thinking.
[17:00] Blending McGill, DNS, PNF, and Neurodynamics — building a logic-driven framework.
[19:00] McKenzie & Neurodynamics.. its so much more than just "press ups" & "nerve glides"
[21:00] Mez breaks down the Neuro-Ortho Sensitivities framework — why it’s a practical lens for evaluation.
[24:00] Sean’s current caseload and patient demographics — and how expectations have shifted around rehab.
[26:00] Real talk on outdated orthopedic tests — Kemp’s, Spurlings, etc.
[29:00] Sean’s real-world case story — connecting breathing, leg cramping, and thoracolumbar pain.
[32:00] Discussing pattern recognition and how to “reverse engineer” symptoms.
[34:00] The Bruce Lee mindset — take what works, leave what doesn’t, add your own style.
[36:00] How The LBP Intensive helped Sean integrate everything into a practical, logical system.
[38:00] Mez explains how the program is now a two-part system: acute care + strength bridge (rehab to performance).
[41:00] Sean on applying B2G (Back to Gym) principles in an insurance-based setting.
[43:00] Another patient case — thoracolumbar pain + functional breathing limitations revealed through assessment.
[46:00] Mez and Sean nerd out on gait analysis vs breaking down motor control fundamentals.
[49:00] Advice for early-career rehab clinicians: don’t get stuck in your echo chamber.
[50:00] Where to find Sean online + Mez’s final wrap-up.
To learn more about The LBP Intensive™ Click Here
In this episode we zoom in on an ancient yet powerful tool for low back pain rehab: The Breath 🫁
This is a raw, behind-the-scenes clip from a live LBP Intensive™ live call where we dissect how breath work directly influences the autonomic nervous system.
You'll learn why it’s foundational for relaxation, reducing muscle tone, and helping your patients come back stronger & more powerful than before.
Whether you're a performance PT trying to take athletes to elite levels of performance or a PT just working with the general population... this episode is filled with actionable take aways.
To learn more about The LBP Intensive™ Click Here
Learn about The LBP Intensive™ & join the waitlist--> Click Here
When you first realize that one of your clients REALLY needs to understand the fundamentals of pain science it can be very overwhelming. In this episode Mez shares some helpful tools that have helped him start the, sometimes difficult, journey of Pain Neuroscience Education (PNE).
We start with screening the patients' beliefs about pain using true/false statements and progress to specifics about their history, subjective, and objective exam using the orthopedic sensitivity framework.
Click Here to learn more about The LBP Intensive™ & enroll before doors close on Tues Sept 16th at midnight.
Turning “non-specific back pain” into a clear plan, without overcomplicating your eval.
In this episode, Mez shares the cognitive framework he teaches inside The LBP Intensive™ to help clinicians evaluate and manage acute low back pain with clarity, especially when patients present with vague symptoms and “non-specific” labels.
You’ll learn:
How to pinpoint environmental and mechanical triggers that actually matter
A step-by-step process for organizing subjective & objective findings into a functional diagnosis
Why this approach helps patients shift from fear and frustration to action and control
How to guide self-care without overwhelming the patient or second-guessing yourself
🎧 If you’ve ever felt stuck during an eval or unsure how to confidently coach patients through flare-ups, this episode is for you.
👉 Listen now on The Spine PT Podcast | Available on all platforms.
Learn about The LBP Intensive™ --> Click Here
In this episode Mez dives into the neuroscience behind how breath work physiologically stimulates a parasympathetic response. He shares his experience as Tai Chi practitioner while combining the neurophysiology behind using breath work as a cognitive anchor to improve not just mobility/balance/stability of the body but also how the breath enhances the stability of our mind, our aerobic capacity, recovery, and sleep so much more..
The breath is such a practical tool for not just relaxation BUT also extreme levels of performance/strength/power….
He dives into research from cognitive neuroscience to support a mindfulness meditation practice as well as going back to basic physiology to explain how proper breathing instructions can stimulate baroreceptor & chemoreceptor reflexes to target the vagus nerve.
At the end of the episode Mez shares practical advice to take the science of breathing into practice. If you're interested in The 12 Coiling Movements of Qigong that he refers to at the end of the episode check out that playlist on our Youtube channel.
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Visit our website www.SpinePTuniversity.com
To get on the waitlist for The LBP Intensive™ Click Here
Why do so many patients flare up 2 weeks after getting discharged from PT & getting back to the gym even when your clinical care was solid?
In this episode, I break down the real reason this keeps happening and how to apply the 80/20 rule & a deeper understanding of aerobic capacity to stop it for good.
Spoiler: it’s not about better manual therapy or another mobility drill. It’s about building a SOLID phase 1 of a 3 phase Strength & conditioning program.
You’ll learn:
Why patients aren’t actually ready to train after PT (even if they’re pain-free)
How resistance training builds aerobic capacity resilience at the tissue and metabolic level
What Joel Jamieson’s energy systems framework teaches us about programming smarter
The exact volume, tempo, and RPE I use in Phase 1 to reduce flare-ups by 80%+ (aka a lot) even for high advanced athletes like powerlifters & martial artists.
And how to reframe strength as a byproduct of aerobic foundations in rehab
If you’ve ever felt stuck in the “rehab–flare-up–rehab” cycle with your patients, this episode is for you.
Click Here to learn more about The LBP Intensive™
Getting back to lifting after an acute sciatica/LBP flare can be really messy and a whole different clinical game.
In this episode, I break down how to deal with the fear of re-injury, one of the biggest mental roadblocks performance PTs & patients face when returning to training.
This episode isn’t just about the psychology behind fear, it’s about what to do when that fear slows progress in the clinic or stalls your strength plan.
I’ll walk you through:
Why so many patients (and coaches) hesitate to lift again after sciatica
What to notice in the clinic that may be that fear rearing its head.
The 12-week S&C progression I use to rebuild trust through smart progressive training.
You’ll also hear the exact high-level structure I teach inside the Low Back Pain Intensive to transition patients from sensitive to savage without guesswork.
⏱️ Timestamps:
[00:00] Intro + why fear of re-injury after sciatica still gets overlooked
[01:40] How poor S&C education fuels hesitancy in PTs and patients
[03:10] Why fear sticks around even after the pain is gone
[04:40] Subtle signs of fear in the clinic: hesitation, overbracing, breath-holding
[06:20] A common mistake: overfocusing on movement instead of readiness
[08:00] Patient story: hinge progression flopped, aerobic work saved the plan
[10:15] Building trust with fitness — not just “corrective” exercises
[12:30] Overview of my 12-week strength & conditioning strategy
[13:30] Phase 1 (Weeks 1–5): Build aerobic base + tissue tolerance
[15:00] Transition Phase (Weeks 6–7): Begin ramping up load
[16:30] Phase 2 (Weeks 8–12): True strength training & bone adaptation
[18:30] Breathwork as a threat gauge and nervous system readiness tool
[20:00] Coaching cues to reduce bracing and restore trust under load
[22:00] Reframe: fear of re-injury isn’t a clinical flaw, it’s a training gap
[24:00] Why most post-rehab flare-ups are actually S&C programming issues
[26:00] Your job: build trust through reps, time, and progress
[28:00] Reminder to join waitlist for The LBP Intensive™, who the program's for and what the goal is.
Click Here to learn more about The LBP Intensive™