Hands On Hands Off: Manual Therapy & Orthopedic Physical Therapy (AAOMPT)

In this episode, Seth Peterson talks with Josh Funk, founder of Rehab 2 Perform, about private practice ownership, business growth, staffing, reimbursement, clinical education, and the future of physical therapy.Josh shares how his own rehab experience at Ohio State inspired him to build a more active, performance-oriented community rehab model. He explains how early entrepreneurial experiments, side hustles, personal training, coaching, and customer service roles helped prepare him to launch Rehab 2 Perform just three years after PT school.The conversation covers practical resources for clinicians interested in business, including SBDC, SCORE, local accelerators, and the Goldman Sachs 10,000 Small Businesses program. Josh also discusses what it takes to grow from one clinic to 17, how to understand payer value and internal economy, and why practice owners need to treat staff recruitment with the same strategic attention they give patient acquisition.Josh also describes how residency programs can serve as attraction magnets, career accelerators, and company-wide education engines. The episode closes with a forward-looking conversation about healthspan, diagnostics, wellness screening, and why physical therapists should become more proactive in risk stratification and prevention-oriented care.Key TakeawaysGreat business ideas often come from bad personal experiences.Josh’s own contrast between high-level rehab at Ohio State and community-based care helped spark the Rehab 2 Perform concept.Microdose entrepreneurship before you cut the cord.Josh emphasizes side hustles, coaching, training, and customer service as low-risk ways to build business skills before opening a practice.Free business mentorship exists. Use it.SBDC, SCORE, local accelerators, and Goldman Sachs 10,000 Small Businesses helped Josh build business literacy without draining early-stage cash.Practice owners must understand reimbursement.Josh argues that owners need to understand payer value, administrative burden, MPPR, billing differences, cash services, and the internal economy of the practice.Staff acquisition needs a funnel.Many practices have a patient marketing funnel, but no talent funnel. Josh sees this as a major missed opportunity.Residency can raise the floor across a company.A residency program does not only benefit the resident. It creates a pourover effect that can improve the whole clinical ecosystem.Build a process-dependent company, not a people-dependent company.High achievers may leave. The owner’s job is to operationalize their genius so the organization keeps growing.PT needs to move into healthspan and diagnostics.Josh believes the public is ready for proactive screening, risk stratification, wellness, and physical capability conversations.Find Josh and Rehab 2 Perform:https://rehab2perform.com/https://www.instagram.com/drjoshfunk/

In this episode, Seth speaks with Tim Fearon, a respected leader in orthopedic manual physical therapy, about the role of exercise in manual therapy practice.Tim reflects on retirement, mentorship, and the clinical evolution that led him to place exercise and patient responsibility at the center of care. He shares how early mentorship shaped his manual therapy skills, but how recurring patient problems forced him to ask a harder question: if symptoms improve but the problem returns, did we really fix anything?The conversation explores Tim’s shift toward active participation, PNF principles, the Maitland model, reassessment, and exercise as a reasoned clinical intervention rather than a generic home program. Tim also challenges clinicians to stop treating exercise as the less important part of care, stop overdosing patients with too many exercises, and stop outsourcing the very thing that helps patients take ownership of their recovery.The episode also looks toward the future of physical therapy, including remote therapeutic monitoring, exercise apps, online programs, and why skilled clinicians who can integrate passive care, active care, and patient psychology will continue to matter.Key TakeawaysManual therapy alone may not create lasting change. Tim describes realizing that he could improve symptoms manually, but patients sometimes returned with the same problem because the underlying functional capacity had not changed.Exercise should be reasoned like manual therapy. Tim emphasizes using reassessment after active interventions just as clinicians do after passive techniques.Patient psychology matters. The best exercise is not just biomechanically appropriate. It has to match the person’s behavior, motivation, tolerance, and readiness.Do not overdose the home program. Tim warns that giving too many exercises can reduce adherence and cause patients to abandon even the most important pieces.Exercise should not be treated as lower-value care. Handing exercise off too casually can signal to the patient that it is less important than the manual treatment.The patient must own part of the outcome. Tim repeatedly returns to personal responsibility: patients need to experience that what they do can change their symptoms and function.Generic exercise apps will help some people, but not everyone. Tim sees value for people in the middle of the bell curve, but warns that more complex patients still need skilled clinical reasoning.Skilled PTs integrate passive and active care. Tim is not dismissing manual therapy. He argues that passive care and active management work best when they are both delivered with skill and intention.

In this episode, Seth sits down with Jess Ellis, fellowship-trained physical therapist, former NBA health and performance leader, founder of Rehab Code, and consultant for professional athletes.Jess shares his career path from early burnout in high-volume physical therapy to mentorship with Tim Fearon, fellowship training, EXOS, the Portland Trail Blazers, the New York Knicks, and his current work in mentorship, consulting, and concierge care.The conversation explores the realities of working in professional sports, including the pressure of return-to-play decisions, reduced clinical autonomy, team politics, athlete relationships, and the lifestyle tradeoffs that come with elite sport. Jess also discusses his PhD work on athlete buy-in with wearable technology and force plate testing, raising important questions about trust, data, ethics, and shared decision-making.This episode also gets into the deeper professional questions many PTs face: Are you actually getting better? Are you pursuing mastery or professional FOMO? Are you being clinically honest with yourself and your patients? And are you relying on theory, or producing meaningful change?A sharp, candid conversation for clinicians interested in OMPT, sports rehab, mentorship, career development, and pragmatic clinical reasoning.Chapters: 00:00 — Welcome and Jess Ellis intro01:34 — Burnout, mentorship, and fellowship training03:00 — EXOS, NBA roles, and Rehab Code06:23 — Career growth and owning your opportunities09:11 — OMPT in pro sports11:01 — Imaging, structure, and pathomechanics12:55 — Why fellowship changed Jess’s reasoning14:54 — The reality of working in pro sports17:01 — Return-to-play pressure18:08 — Leadership, politics, and athlete trust20:10 — Lifers, burnout, and leaving sport23:43 — Athlete data, wearables, and Jess’s PhD27:50 — Clinical bias and shared decision-making30:00 — Pain science communication problems31:43 — Mentorship and PT career paths34:15 — Professional FOMO vs mastery35:54 — Clinical honesty and getting better37:47 — Pragmatism, listening, and results40:11 — Where to find Jess Ellis

AAOMPT Fellow and educator Laura Wenger joins us to explore the future of membership, community, and belonging within orthopaedic manual physical therapy.Laura teaches foundational clinical reasoning at the University of Utah’s hybrid DPT pathway, treats patients weekly in a rural outpatient ortho practice, and serves as Co-Chair of AAOMPT’s Inclusive Membership & Engagement Committee (IMEC). Her work sits at the intersection of education, patient care, and organizational leadership.In this episode, Laura shares what IMEC is working on, how AAOMPT can better serve clinicians across training levels, and why belonging and representation matter for the future of the profession.In this episode, we cover:???? Who AAOMPT members actually are — and who we want to reach???? The biggest opportunities for member engagement year-round???? How AAOMPT supports professional + personal growth???? The value of SIGs, committees, and leadership pathways???? Fellowship pathways & mentorship: where they shine???? Why DEI work is essential for OMPT’s long-term health???? How Laura teaches clinical reasoning to a new generation of DPT students???? Practicing in rural settings + hybrid education insightsThis one is essential listening for current AAOMPT members — and anyone curious about joining.

Damian Keter joins the show to unpack manual therapy treatment mechanisms and how our profession needs to evolve its education around MT.Damian is a clinician specializing in complex pain at the VA and a clinical researcher whose work centers on MT mechanisms and manual therapy training paradigms. If you’ve ever wondered what actually happens when we deliver manual therapy — and how to teach it more effectively — this episode delivers clarity.Topics:• Manual therapy mechanism research • Contextual effects and clinical reasoning • How MT education needs to evolve • Helping clinicians move beyond outdated models • The future of manual therapy in PT

What role does IFOMPT play in global manual and musculoskeletal physiotherapy?In this episode of the Hands-On, Hands-Off Podcast, leaders from AAOMPT sit down with IFOMPT President Dr. Paolo Sanzo to discuss international education standards, evidence-informed practice, and global collaboration. The conversation explores how IFOMPT supports clinicians, educators, and researchers worldwide—and why global consistency ultimately improves patient care.00:00 – Introduction to the AAOMPT–IFOMPT collaborative series01:29 – Introducing Dr. Paolo Sanzo and IFOMT leadership03:19 – What IFOMPT is and its role within World Physiotherapy04:12 – Paolo’s journey through IFOMPT leadership roles05:21 – IFOMPT’s growth since 197407:11 – IFOMPT’s vision and mission explained09:47 – Education standards and member organization requirements12:10 – International monitoring and maintaining consistency17:49 – Evidence-based practice and global context20:16 – IFOMPT as a research and collaboration conduit23:14 – Challenges and opportunities of global collaboration26:18 – Working with international organizations and regions30:35 – Strategic priorities and future direction32:46 – Advice for clinicians pursuing excellence34:02 – Final reflections and closing remarks

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 guest00:01 – Dr. Shane McClinton’s background and research focus00:03 – Why plantar heel pain referrals to PT are low00:07 – Rationale for studying cost-effectiveness00:10 – Study design overview (RCT + pragmatic approach)00:15 – Description of podiatry-only vs podiatry + PT care00:17 – Inclusion and exclusion criteria00:22 – Case series: why eight different heel pain presentations00:26 – Manual therapy strategies used in the study00:30 – Clinical practice guidelines and decision-making00:32 – Pain mechanisms, education, and chronicity00:35 – Proximal vs local treatment decisions00:38 – Three-year cost-effectiveness results explained00:44 – Implications for referrals and collaboration00:48 – Final take-home message from Dr. McClinton

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 spineThe most common misconceptions clinicians have about directional preferenceHow inconsistent research definitions affect real-world practiceHow directional preference can guide prognosis and return-to-duty decisionsWhat clinicians can learn from high-stakes military performance environmentsOne mindset shift that can immediately improve clinical reasoning