Tom W.

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Aavash@123 The decision to move from one phase to the next is based on your symptoms and ability to perform exercises with full range of motion and good control. If you can perform all of the exercises in a given phase with mild or less pain, full range of motion and good movement control, then you are probably ready to move to the next phase in the program.

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Posted

19 Jul 11:19

01:00

👉Soft tissue mobilization works by stimulating mechanoreceptors in muscle and fascia, which can decrease nociceptive signaling and reduce protective muscle guarding.

🔎This neurophysiological response, combined with improved local blood flow and tissue elasticity, often helps lower pain sensitivity and restore freer, more efficient movement.

🧠Soft-tissue mobilization of the lumbar extensor muscles (erector spinae group), which run along your lower spine can be a helpful strategy for reducing low back pain. In this video, I show a technique using a peanut massager tool, which works well for targeting the lumbar extensor muscles.

✅More techniques like this and other mobility and strengthening exercises can be found in the low back pain program here in the app.

Posted

17 Jul 08:47

00:23

👉Scapulothoracic mobilizations are a valuable manual therapy technique for improving movement of the shoulder blade and relieving pain around the shoulder and mid back.

🔎In this technique, the patient lies on their side while the clinician reaches their fingers beneath the medial border of the scapula to gently lift it away from the rib cage. This helps mobilize the scapulothoracic joint — the interface between the scapula and the thoracic wall — which often becomes stiff in people with shoulder or upper back pain.

🧠Restoring mobility at this region allows the scapula to move more freely during overhead and reaching motions, reducing compensatory stress on the glenohumeral joint, rotator cuff, and surrounding soft tissues. By improving scapular motion and control, this mobilization can help decrease pain, enhance posture, and restore proper mechanics for functional movements like reaching, lifting, and pressing.

✅If you experience pain around the shoulder blade or upper back, restricted scapular movement may be a contributing factor. Manual mobilization, combined with targeted exercises for scapular control and thoracic mobility, can be an effective approach to restoring comfort and function.

I’m glad the video was helpful and that you are enjoying my book!

👍👍

Posted

15 Jul 07:13

00:37

📚The interphalangeal (IP) joint is the only joint between the two bones of the thumb: the proximal and distal phalanges. It functions as a simple hinge joint, allowing the thumb to bend (flexion) and straighten (extension).

🧠Although it has a relatively small range of motion compared to the other thumb joints, the IP joint plays an important role in precision grip. Every time you button a shirt, write with a pen, text on your phone, or pick up a small object, the IP joint helps position the thumb with accuracy.

🔎The primary muscle responsible for bending the joint is the flexor pollicis longus (FPL), while straightening is produced mainly by the extensor pollicis longus (EPL). Together, these muscles provide the fine motor control needed for everyday tasks.

✅Pain, stiffness, or arthritis at the thumb IP joint can make even simple activities surprisingly difficult. Maintaining mobility and strength throughout the thumb can help preserve hand function as we age.

2

14 Jul 13:50

That’s great to hear!

Posted

14 Jul 10:27

Image from Tom W.'s post

A new video on movement tests to help identify frozen shoulder is available here in the app. Here is a link for the video.

https://membership.rehabscience.com/programs/frozen-shoulder-tests?utm_source=product&utm_medium=share&utm_campaign=content_share&utm_term=4267668&utm_content=mobile

Aavash@123 Great question. The main difference comes down to the fact that when someone works one-on-one with a physiotherapist, the exercise selection is based on an individualized evaluation.

During an in-person assessment, a physiotherapist looks at many factors, including your symptoms, movement patterns, strength, mobility, irritability of the condition, functional limitations, and your goals. Based on those findings, they choose the exercises that are most appropriate for you at that specific point in your recovery. A patient may be given one or two exercises from Phase 2, a couple from Phase 3, and perhaps one from Phase 4, while completely skipping Phase 1 exercises if they are not needed. The physiotherapist is essentially creating a customized program by selecting the “best tools” from different phases.

The reason my programs are structured differently is because they are designed to help a larger number of people who I have not personally evaluated. Since I cannot assess each person’s unique presentation, I need to create a more general progression that is appropriate and safe for the majority of people experiencing a particular condition.

The purpose of the phases is not that every person must complete every exercise in every phase. Instead, the phases represent a general progression of rehabilitation principles.

Phase 1 is typically focused on calming symptoms, improving tolerance to movement, restoring basic control, and introducing exercises that are appropriate for people who may be more sensitive or irritable. Some people may not need this phase, but for others it provides an important foundation.

Phase 2 generally progresses toward building more control, and addressing any range of motion impairments that may be present.

Phase 3 introduces more challenging exercises that require greater strength, coordination, and load tolerance.

When you work with a physiotherapist, they can often start you somewhere in the middle because they have already evaluated you and determined where you fit in that progression. They are selecting the exercises from different phases that match your current needs.

With my programs, the phased approach provides a structured pathway that allows people to gradually build capacity while reducing the risk of doing exercises that may be too advanced too early. It is a more generalized roadmap rather than a replacement for an individualized assessment.

Think of it like learning a new skill. A coach working with you personally may immediately identify that you already have certain abilities and start you at a higher level. A general training program has to assume a wider range of starting points, so it builds a foundation and progresses step by step.

The goal of both approaches is the same: choosing the right exercises at the right time to help you regain strength, confidence, and function.

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Posted

10 Jul 11:19

Image from Tom W.'s post

Hi everyone, 

Here is a replay from today's office hours session. We discussed several issues, including cervical disc injuries, patellofemoral joint pain, IT band syndrome and nerve referral from the low back.

https://membership.rehabscience.com/programs/071026-9e23bc?utm_source=product&utm_medium=share&utm_campaign=content_share&utm_term=4266612&utm_content=copy