Clinical PT Talks

Author: Dr. Mark White, PT, DPT, BA, OCS

Clinical PT Talks offers physical therapy tips, pointers, how-to, and stories about unique, important, or transformative clinical cases. Clinical PT Talks is a mix of Podcast Shorts that provide brief, user-friendly and easily digestible bits of useful information that clarify concepts, illustrate problems to be solved, and offers solutions to issues physical therapists, and physical therapy assistants, deal with every day. Here you will also find longer Stories that highlight a variety of critical processes in dealing with patients in distress in the real world. Some stories need to be told because they can shift our perspective in ways that are useful. Often, this is of equal or greater value than what can be obtained in any other way.
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Language: en

Genres: Health & Fitness, Medicine, Science

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Psychopathology and treatment effect interference, PART 2: Are we all now psychotherapists?
Wednesday, 31 December, 2025

Psychological factors are always and irrevocably present in any clinician interaction with patients. They can be a help or a hinderance. In PART 1 of this series I spoke about common distortions of thinking that can get in the way of our understanding examination and treatment of patients and of what to do and why. In PART 2 I discuss a common underlying factor present with all treatments which threatens to undermine our ability to discern mechanisms of action, and more. Consequently, we may find ourselves facing uncertainty regarding both treatment choices and interpretation of our results. Join me as I discuss emerging science, important past works, and linking these ideas together so that we can better understand how to help our patients, as well as ourselves, in the presence of new information. REFERENCES Bishop MD, Price DD, Robinson ME, George SZ. The mechanisms of manual therapy in the treatment of musculoskeletal pain: a comprehensive model. Man Ther. 2009;14(5):531–538. doi:10.1016/j.math.2008.09.001 Clifford C, Challoumas D, Paul L, Syme G, Millar NL. Effectiveness of isometric exercise in the management of tendinopathy: a systematic review and meta-analysis of randomised trials. BMJ Open Sport Exerc Med. 2020;5:e000760. doi:10.1136/bmjsem-2020-000760 Di Fabio RP. Disablement: the patient's problem no longer matters. J Orthop Sports Phys Ther. 2000;30(6):304-305. doi:10.2519/jospt.2000.30.6.304 Ezzatvar Y, Dueñas L, Balasch-Bernat M, Lluch-Girbés E, Rossettini G. Which Portion of Physiotherapy Treatments' Effect Is Not Attributable to the Specific Effects in People With Musculoskeletal Pain? A Meta-Analysis of Randomized Placebo-Controlled Trials. J Orthop Sports Phys Ther. 2024;54(6):391-399. doi:10.2519/jospt.2024.12126 Filbay SR, Bullock G, Russell S, Brown F, Hui W, Egerton T. No Difference in Return-to-Sport Rate or Activity Level in People with Anterior Cruciate Ligament (ACL) Injury Managed with ACL Reconstruction or Rehabilitation Alone: A Systematic Review and Meta-Analysis. Sports Med. 2025;55(9):2191-2205. doi:10.1007/s40279-025-02268-5 Hancock MJ, Maher CG, Laslett M, Hay E, Koes B. Discussion paper: what happened to the ‘bio’ in the bio-psycho-social model of low back pain? Eur Spine J. 2011;20:2105-2110. Doi:10.1007/s00586-011-1886-3 Harris SR. How should treatments be critiqued for scientific merit?. Phys Ther. 1996;76(2):175-181. doi:10.1093/ptj/76.2.175 Katz JN, Brophy RH, Chaisson CE, et al. Surgery versus physical therapy for a meniscal tear and osteoarthritis. N Engl J Med. 2013;368(18):1675-1684. doi:10.1056/NEJMoa1301408 Lederman E. The fall of the postural-structural-biomechanical model in manual and physical therapies: exemplified by lower back pain. J Bodyw Mov Ther. 2011;15(2):131-138. doi:10.1016/j.jbmt.2011.01.011 Nudelman Y, Pincus T, Ami NB. Association Between Physical Therapists' Attitudes and Beliefs and the Functional Outcomes of Patients With Low Back Pain: A Multilevel Analysis Study. Phys Ther. 2025;105(4):pzaf007. doi:10.1093/ptj/pzaf007 Simonetta R, Russo A, Palco M, Costa GG, Mariani PP. Meniscus tears treatment: The good, the bad and the ugly-patterns classification and practical guide. World J Orthop. 2023;14(4):171-185. Published 2023 Apr 18. doi:10.5312/wjo.v14.i4.171 Zadro JR, Ferreira G. Has physical therapists' management of musculoskeletal conditions improved over time?. Braz J Phys Ther. 2020;24(5):458-462. doi:10.1016/j.bjpt.2020.04.002 https://www.scientificamerican.com/article/breakthrough-prize-winner-gerard-t-hooft-says-quantum-mechanics-is-nonsense/