Mark Shepherd

@Retlouping "The magic happens at end range"

Wonder what his directional preference is 😂

@DrSethPT PNE is also viewed like a one-and-done thing, or a sit-down-let-me-educate you type of treatment. Pain science is a communication approach - it is infused within how I engage with people moreso than a "teach me about pain" kinda thing, which is usually how it is done in research

@ShepDPT So that they could participate better in things like exercise, in which case pain and function should improve. Ultimately I think the movement to a more person centered adaptable educational approach makes more sense, which is what seems to be happening lately

Pretty remarkable title. So while A+B vs A is a concern with other trial designs…adding PNE to other tx doesn’t appear to enhance the tx effects for pain or function tandfonline.com/doi/full/10.10…

@Retlouping This seems to be consistent in the literature showing that people with an intact annulus tend to show a more clear DP and centralize. I wonder if more inflammation around the DRG/nerve root causing more sensitivity = less tolerance to loading in general = less clear DP, etc.

Mechanical diagnosis and therapy as a clinical diagnostic approach in lumbar disc herniation: association with radiological findings tandfonline.com/doi/full/10.10…

Supervised physio after a distal #radius #fracture delivers real short-term gains 💪 ​ This #MetaAnalysis found that short-term post injury supervised physical therapy was superior to home exercise alone, especially in #OlderAdults #Review ➡️ ow.ly/1fJH50YyTEG #yourJOSPT

New publication in the Journal of Manual and Manipulative Therapy: tandfonline.com/eprint/5IEYG25…

@Retlouping Thanks for sharing. Any key observational clues you have found to key you in to a DP (i.e. lordosis/hinging at upper lumbar, etc.)? Curious to see what you think.

McKenzie 101 a thread

@Retlouping @TaiwanOzPhysio I like the Rosedale study - there are some limitations, but def points to modulating extremity pain (esp. proximal) with spine movements

@ShepDPT @TaiwanOzPhysio I was surprised they didn’t mention the McKenzie EXPOSD study.

Interesting Grand Rounds this morning. Right up my street. Listening to some of the treatment suggestions, I pondered should I step back in the education ring locally?

@Retlouping @TaiwanOzPhysio Thanks for sharing. What would be your approach - if neck main nociceptor, would think repeated dorsal glides (maybe with tennis balls at upper t-spine) to target lower neck. Have seen changes clinically w/ that in schneck pain.

@ShepDPT @TaiwanOzPhysio Nerve glides, chin tucks ( my pet hate) , deep neck stretching, general ROM , SNAGS not much logic to them, a bit of an after thought really

Thrilled to share results of a tremendous effort to define competencies and graduation milestones for fellowship training in OMPT. I thank all those involved in these projects. tinyurl.com/4defujns tinyurl.com/2jjbh5tk tinyurl.com/y3mpwjwu tinyurl.com/2xcv9rw3

@Retlouping @TaiwanOzPhysio What were some of the exercises suggested?

@TaiwanOzPhysio Manual therapy in clinic, unrelated exercise, no real self treatment or logic to the proposals

Thank you @JOSPT for publishing our editorial on why studying treatment mechanisms is so challenging. Preprint open access here: jospt.org/doi/10.2519/jo…

@PhysicalTherapy Love your posts, Larry. I 100% agree with this. So many of our fellowship grads - some of the best clinicians I know - get promoted to non-clinical roles cause that is where the money/growth is. Thoughts on how to realistically allow for incr. in $$/promtion while treating?

Healthcare platforms keep misidentifying their leadership problem as a talent shortage. The talent is there. The problem is what they're selecting for — and what they're promoting out of the clinic. New post on The Operator. Healthcare Concepts We Keep Getting Expensively Wrong, by @PhysicalTherapy open.substack.com/pub/benzoperat…

@Retlouping I have thought about this a lot. @jeffmooredpt might have some too as he and I have talked about this. Maybe repeated motions act as a pump changing the environment (i.e. inflammatory cells) around the nerve root/DRG???

If Mckenzie’s centralisation phenomenon is real (not just a semantically primed response to clinician coaching) how do we explain the mechanism, with modern understanding of pathology and pain neuroscience?

New open access paper in @MSKPhysioJnl Self-management is widely recognised as essential in musculoskeletal care - but implementing it in everyday practice remains complex. This paper reflects on key gaps and challenges, and highlights the need to move beyond intervention-focused thinking towards greater attention for context, alignment, and sustainability. 🔗 doi.org/10.1016/j.msks…

ForceNET webinar tomorrow at 2PM EDT with Dr. Ken Weber from Stanford. Free to all. duke.zoom.us/j/93863584020

@Retlouping Maybe if you taught the McKenzie approach.....🤣🤣

Meanwhile over on LinkedIn “I love the smell of “McKenzie-splaining” in a morning” 😂 😂

Our proposed hypothesis framework for MSK-related pain conditions. Pathology doesn't always tell the full picture. We believe this can address many factors that a person may have when presenting with pain.

@MikeReiman Thanks for sharing, Mike! If anyone has questions about this framework we propose, feel free to ask!

Person- centered hypothesis framework (Shepherd et al. 2025)

I worked with Terry for a period of time. Great PT who has a great vision for post-professional PT training! @RoyFilmDPT