Hands On Hands Off

Neck Manipulation Myths, Risks & Evidence with Roger Kerry

Professor Roger Kerry joins the podcast to unpack one of the most debated topics in musculoskeletal care: the risks and benefits of manual therapy for people with head and neck pain. Roger is the lead for the physiotherapy program at the University of Nottingham, an interprofessional curriculum designer, researcher, PhD supervisor, and author of the new textbook The Head & Neck: Theory & Practice. His AAOMPT keynote focuses on cutting through decades of misinformation and helping clinicians understand what the evidence actually says. IN THIS CONVERSATION: • Cervical manual therapy: what’s risky, what’s not, and what’s misunderstood • Why head & neck pain is still surrounded by outdated ideas • The problem with the way we teach manual therapy • How educators can break restrictive traditions • What emerging PhD work is revealing about the future of physical therapy • Roger’s personal journey from failed rehab patient → world-class academic This episode is essential listening for anyone who treats neck pain or teaches manual therapy.

Is Physical Therapy Worth the Cost for Plantar Heel Pain? A 3-Year Answer

In this episode of the Hands-On, Hands-Off Podcast, Dr. Trenton Rehman sits down with Dr. Shane McClinton to discuss plantar heel pain and the role of physical therapy in both clinical outcomes and healthcare costs. Dr. McClinton walks through a series of studies stemming from his doctoral research, including a randomized clinical trial, a detailed case series, and a three-year cost-effectiveness analysis. Together, they explore how adding physical therapy to usual podiatry care impacts pain, function, quality of life, and long-term costs. Key themes include manual therapy, impairment-based exercise, proximal contributions to heel pain, interdisciplinary collaboration, and why plantar heel pain may deserve the same clinical mindset as low back pain. Key Takeaways (Listener-Facing) Plantar heel pain is a multidimensional condition with local and proximal contributors. Adding physical therapy to usual podiatry care improved outcomes and reduced costs over three years. Manual therapy and exercise were delivered pragmatically and tailored to impairments. Strengthening may be underutilized in plantar heel pain management. Collaboration between physical therapists and podiatrists benefits patients and reduces downstream burden. ⏱️ TIMESTAMPED CHAPTERS (YouTube + Podcast) 00:00 – Introduction to the episode and guest 00:01 – Dr. Shane McClinton’s background and research focus 00:03 – Why plantar heel pain referrals to PT are low 00:07 – Rationale for studying cost-effectiveness 00:10 – Study design overview (RCT + pragmatic approach) 00:15 – Description of podiatry-only vs podiatry + PT care 00:17 – Inclusion and exclusion criteria 00:22 – Case series: why eight different heel pain presentations 00:26 – Manual therapy strategies used in the study 00:30 – Clinical practice guidelines and decision-making 00:32 – Pain mechanisms, education, and chronicity 00:35 – Proximal vs local treatment decisions 00:38 – Three-year cost-effectiveness results explained 00:44 – Implications for referrals and collaboration 00:48 – Final take-home message from Dr. McClinton

Low Back Pain Doesn’t Have to Be Confusing | Andreas Remis

Andreas Remis joins the podcast to unpack low back pain in a way that finally makes sense — bridging APTA CPG classifications, real-world clinical diagnosis, and the confusing world of radiographic findings. As faculty across multiple fellowships and residencies within the Duke Health System — and an educator shaped by his own poor rehab experience as a patient — Andreas brings a thoughtful, grounded approach to one of PT’s most complex conditions. IN THIS EPISODE: • LBP classification: CPG vs imaging vs clinical reasoning • How expert clinicians simplify diagnosis • Why radiographs often mislead clinicians and patients • The turning point when PTs begin to feel “value-confident” • Teaching LBP across OMPT pipelines • Lessons Andreas learned from being a failed patient It’s a must-listen episode for clinicians, residents, and fellows treating low back pain.

Directional Preference When Time Matters | Josh Kidd

When the cost of delay is measured in millions of dollars and operational readiness, guesswork isn’t an option. In this episode, we sit down with Josh Kidd, physical therapist, researcher, residency director, and embedded clinician working with special operations personnel and fighter pilots. Josh shares how directional preference plays a central role in clinical decision-making when time, performance, and safety all matter. We explore what directional preference actually is (and what it isn’t), why it should be viewed as an assessment rather than an exercise, and how inconsistent definitions in the research have led many clinicians to misunderstand or abandon it altogether. Josh also walks through real-world data from a tactical setting, where his team has used directional preference to help service members return to duty 36% faster, while empowering patients to self-manage and reducing recurrence. This conversation connects research, clinical reasoning, and performance-based care—challenging clinicians to rethink not just what they do, but how they think. ???? IN THIS EPISODE, YOU’LL LEARN: * Why directional preference matters beyond the spine * The most common misconceptions clinicians have about directional preference * How inconsistent research definitions affect real-world practice * How directional preference can guide prognosis and return-to-duty decisions * What clinicians can learn from high-stakes military performance environments * One mindset shift that can immediately improve clinical reasoning

Trauma-Informed & Psychologically Informed Care in PT with Faith Stokes

Faith Stokes joins the podcast to talk about treating the patients many clinicians feel least prepared for — those navigating trauma, addiction, suicidality, chronic pain, pelvic health conditions, and complex biopsychosocial presentations. Faith practices in rural North Georgia, where she blends manual therapy, psychologically informed care, and lifestyle medicine. As a residency coordinator and adjunct faculty across multiple programs, she’s passionate about helping clinicians develop clarity when treating patients whose stories involve trauma, fear, avoidance, social instability, or chronic stress. IN THIS EPISODE: • Simple vs. complex PTSD in clinical practice • Why trauma-informed care is essential in OMPT • Yellow flag screening and why it’s our responsibility • The PT’s role in addiction and suicidality • Integrating pelvic health with orthopedics and manual therapy • Using lifestyle medicine without shame or judgment • How experts reason through overwhelming complexity This is a deep, human, and incredibly practical conversation for every PT.