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No Plateau PodcastAuthor: Henry Hoffman
Henry Hoffman, licensed Occupational Therapist and Co-founder of Saebo Inc., always believed there was no such thing as "plateauing" in stroke and traumatic brain injury recovery. When survivors stop seeing progress in their recovery journey, they're often told that they've "plateaued" and have no choice but to accept this reality. If you ask Hoffman, he'll tell you this "It's not the patient that plateaus, it's their treatment options that do." It's why he co-founded his company Saebo (a medical device company focused on stroke and TBI rehab) on the mantra "No Plateau in Sight." So, how exactly can survivors keep pushing to overcome the fate of plateau? Hoffman is on a mission to speak to anyone and everyone out there defying the norm in neuro-rehab. This is the No Plateau Podcast the podcast for stroke and brain injury survivors, their caregivers, and the therapists helping them to break boundaries in their recovery journey. Language: en Genres: Education, Health & Fitness, Self-Improvement Contact email: Get it Feed URL: Get it iTunes ID: Get it Trailer: |
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Spasticity Without the Plateau: Science, Access, and the Path Forward
Sunday, 22 February, 2026
In this episode of the No Plateau Podcast, host Henry Hoffman dives deep into one of the most misunderstood and impactful challenges in neurorehabilitation: spasticity. Joined by nationally recognized physiatrist and researcher Dr. Monica Verduzco-Gutierrez, the conversation goes far beyond definitions to explore how spasticity truly affects function, quality of life, access to care, and long-term outcomes for stroke and brain injury survivors. Dr. Verduzco-Gutierrez breaks down why the classic, textbook definition of spasticity falls short in real-world practice and explains how clinicians should think about spasticity as part of a broader upper motor neuron syndrome. Together, they unpack how spasticity actually presents in daily life, how to explain it clearly to patients and caregivers, and why functional assessment matters more than a number on a scale. The discussion walks through the full spectrum of spasticity management, from therapy and home exercise to oral medications, botulinum toxin injections, neurolysis options like phenol, alcohol, and emerging cryoneurolysis, and when surgical interventions may be appropriate. Henry and Monica also explore why spasticity treatment must be goal-driven, revisited over time, and always paired with rehabilitation rather than viewed as a one-time fix. The episode closes with an eye-opening look at disparities in access to spasticity care, cost-effectiveness research, and why treating spasticity early and appropriately can reduce hospitalizations, complications, and overall healthcare costs. This is a must-listen for clinicians, caregivers, and survivors who want a clearer, more practical roadmap for managing spasticity well. In This Episode Introduction to the No Plateau Podcast (00:00) Meet Dr. Monica Verdusco Gutierrez (00:59) Understanding spasticity: Definitions and misconceptions (02:59) Assessing spasticity: Tools and techniques (08:35) Treatment options for spasticity (12:38) Neurolysis: Phenol, alcohol, and cryo (16:23) The importance of functional goals in spasticity management (22:43) Introducing the AAPM&R consensus guidance (24:39) Getting feedback from patients and therapists (28:37) Botox and other toxin treatments (29:07) Exploring cryotherapy for spasticity (29:57) Disparities in access to spasticity care (31:10) Cost efficiency in spasticity management (36:56) Caregiver challenges in managing spasticity (42:14) Communication between therapists and physicians (44:47) Future directions in spasticity management (51:20) Conclusion and final thoughts (54:51) Our Guest Monica Verduzco-Gutierrez, MD Dr. Monica Verduzco-Gutierrez is a board-certified physiatrist specializing in neurorehabilitation and spasticity management. She is a Professor and Distinguished Chair of Rehabilitation Medicine at UT Health San Antonio, Medical Director of Neurorehabilitation at Warm Springs Rehabilitation Hospital, and lead author of the AAPM&R Consensus Guidance on Spasticity Assessment and Management. Dr. Verduzco-Gutierrez is widely published on spasticity, health equity, and cost-effectiveness in rehabilitation medicine. Resources & Links AAPM&R Consensus Guidance on Spasticity Assessment and Management (2024) UT Health San Antonio – Department of Rehabilitation Medicine Monica Verduzco-Gutierrez on LinkedIn Monica Verduzco-Gutierrez UT Health Henry Hoffman on LinkedIn Saebo On YouTube On Instagram On LinkedIn Saebo’s Stroke Caregiver Support Group Saebo’s Stroke Survivor Support Group Stroke Guidelines 2023
