Fitness Pain Free

06/19/2026

Comment "DISCGUIDE" for a free evidence based cheat sheet on Radicular Low Back Pain

In this video, I break down 4 crawl variations I frequently use with patients recovering from low back pain, athletic pubalgia (sports hernia), and other core muscle injuries.

You'll learn:
• Bear Crawls
• Inchworms
• Lateral Inchworms
• Seal Crawls

These drills challenge the core in a functional way while integrating the shoulders, hips, and trunk—making them excellent options for both rehabilitation and return-to-sport training.

06/18/2026

Comment "HIPOA" to receive an free evidence based cheat sheet on hip osteoarthritis.

One of the biggest myths in orthopedic rehab?

That every THA patient needs strict precautions.

The latest evidence suggests otherwise.

How are you handling precautions in your clinic? I personally follow the surgeon's guidance and if not precautions are recommended I'll still be a bit cautious pushing end range but careful not to scare patients either.

06/17/2026

Comment "Anserine" to receive a free evidence based cheat sheet on Pes Anserine Pain

When it comes to diagnosing pes anserine pain one of the most important factors to consider is, Who is most likely to develop it in the first place?

The patients I think about first are:

✅ Women over 40
✅ Individuals with knee osteoarthritis
✅ Patients with dynamic knee valgus or frontal-plane control deficits
✅ Athletes participating in cutting and pivoting sports

Why?

The pes anserine muscles (sartorius, gracilis, and semitendinosus) help resist excessive valgus and rotational forces at the knee. When these demands become excessive—whether from osteoarthritis, altered movement patterns, or sport-specific loads—the pes anserine complex can become symptomatic.

Understanding these risk factors can improve your clinical reasoning and help you differentiate pes anserine pain from other common sources of medial knee pain such as knee OA, MCL pathology, and meniscus injuries.

👉 Which patient population do you most commonly see with pes anserine pain?

06/16/2026

Comment "HIPOA" to receive a free evidence based cheat sheet on Hip Osteoarthritis

❌ No running
❌ No impact sports
❌ Protect the implant at all costs

But modern hip replacement research is telling a more nuanced story.

Highly cross-linked polyethylene has dramatically improved implant durability, and some studies suggest that higher activity levels may not increase revision risk the way we once feared.

Does that mean every patient should run after a total hip replacement?

Not necessarily.

The real question isn't:

"Can they run?"

It's:

"Are they physically prepared to run?"

As clinicians, our role isn't simply to clear or restrict activity.

It's to help patients build the strength, capacity, confidence, and movement quality needed to safely pursue the activities that matter most to them.

👇 I'd love to hear your thoughts:

Would you clear a patient to run after a total hip replacement?

If yes, what criteria would you use?

06/15/2026

06/14/2026

💥𝐏𝐨𝐬𝐭𝐞𝐫𝐢𝐨𝐫 𝐇𝐢𝐩💥 Thanks to for this great video! Also thanks to for showing me the post and for the description.
——
👉The gluteal region is much more than just the gluteus maximus. Beneath the surface lies a complex network of muscles and nerves that play an essential role in hip stability, movement, and lower extremity function.

📚The large superficial muscle shown here is the gluteus maximus, which primarily contributes to hip extension and external rotation. Beneath it sit the gluteus medius and minimus, which help stabilize the pelvis during walking, running, and single-leg activities.

🔎Deeper still are the six short external rotator muscles of the hip: the piriformis, superior gemellus, obturator internus, inferior gemellus, obturator externus, and quadratus femoris. These muscles act together to provide dynamic stability to the hip joint while assisting with rotation and controlling femoral movement during functional activities.

🧠One of the most important structures in this region is the sciatic nerve, the largest nerve in the body. It exits the pelvis and typically travels beneath the piriformis muscle before descending through the posterior hip and thigh. The sciatic nerve supplies motor and sensory function to much of the lower extremity, making it a clinically important structure in conditions involving buttock pain, posterior thigh pain, numbnes, tingling, or weakness.

06/11/2026

Comment "HIPOA" to receive a free evidence based cheat sheet on Hip Osteoarthritis

How many times have you heard that from a patient?

For decades, many people delayed hip replacement surgery because they were told they would inevitably need another replacement in 10–15 years.

The problem?

Modern implants aren't the same implants we had 20–30 years ago.

Recent long-term data suggest that modern total hip replacements may last far longer than many patients (and clinicians) realize.

In fact, survivorship has been reported at:
✅ Greater than 93% at 20 years
✅ Over 90% at 30 years

That doesn't mean every implant lasts forever.

Patient factors, implant selection, activity level, surgical technique, infection risk, and complications still matter.

But the old "10-year rule" may no longer reflect the reality of modern hip replacement surgery.

This is especially important when counseling:
• Younger patients
• Active adults
• Athletes
• Patients delaying surgery due to fear of revision

As clinicians, we need to make sure we're giving patients information that reflects current evidence—not outdated myths.

👇 I'm curious:

What's the most common misconception you hear from patients about hip replacements?

06/10/2026

Comment "HIPOA" to receive a free evidence based cheat sheet on Hip Osteoarthritis

Here are 5 clues that should immediately raise your suspicion for hip OA:

✅ More common in women
✅ More common with increasing age
✅ Pain in the groin, anterior hip, medial thigh, or buttock
✅ Morning stiffness that improves within 30 minutes
✅ An antalgic gait pattern

Of course, no single finding confirms the diagnosis.

But when several of these findings cluster together, hip OA should move much higher on your differential diagnosis list.

As clinicians, recognizing these patterns early can help guide your examination, improve patient education, and lead to more effective treatment decisions.

👇 Which finding do you find most useful when screening for hip OA?

06/09/2026

Comment "HIPOA" to receive a free evidence based cheat sheet on Hip Osteoarthritis

Anterior.

Posterior.

Lateral.

Ask 10 clinicians which hip replacement approach is best and you'll probably get 10 different answers.

The reality?

Each approach has advantages.

Each approach has tradeoffs.

And each approach creates different rehabilitation considerations.

For example:
👉 Direct anterior approaches may lead to faster early recovery and less pain.
👉 Posterior approaches remain the most commonly performed and have an excellent long-term track record.
👉 Direct lateral approaches may offer lower instability risk but can create unique challenges related to hip abductor function.

The good news?

When performed by experienced surgeons, long-term outcomes appear remarkably similar across approaches.

Which means the question isn't always:

"Which approach is best?"

It may be:

"How does this specific surgical approach influence my rehabilitation plan?"

As physical therapists, understanding the surgery helps us:
✓ Anticipate common impairments
✓ Guide exercise selection
✓ Monitor potential complications
✓ Better educate our patients

👇 I'd love to hear from you:

Which hip replacement approach do you see most often in your clinic?

And have you noticed meaningful differences in recovery between approaches?