Hands On Hands Off

About Hands On Hands Off

The Hands On Hands Off Podcast from the American Academy of Orthopaedic Manual Physical Therapists explores the debate at the heart of modern rehab: How much treatment should be hands-on… and how much should empower patients to move independently? Through conversations with leaders in manual therapy, orthopedic physical therapy, pain science, and rehabilitation, we break down: • clinical reasoning • manual therapy techniques • patient education • exercise-based care • evidence vs tradition in PT If you’re a physical therapist, manual therapist, DPT student, or rehabilitation professional, this show will challenge assumptions and sharpen your practice.

Publisher

AAOMPT

Category

education · health & fitness · health & fitness

Language

en

Explicit

No

First episode

1 Nov 2018

Latest episode

17 Sept 2026

Latest episodes

225 episodes in the feed.

1. 

   17 Sept 2026

   Environmental Physiotherapy: A New Lens for Patient Care

   In this episode, Filip Maric, PT, PhD and Emma Swardh, PT, PhD introduce the field of environmental physiotherapy and invite clinicians to think beyond the walls of the clinic. Rather than limiting sustainability to recycling, energy use, or clinic operations, environmental physiotherapy asks a deeper question: What do health, environment, society, and physical therapy have to do with each other? The conversation explores how environmental factors influence patient care, including heat waves, air pollution, unsafe walking routes, access to movement spaces, health behavior, physical activity, and adherence. Philip and Emma also discuss the role of physical therapy in sustainable healthcare, including prevention, health promotion, lower-footprint care, and avoiding unnecessary or low-value interventions. For clinicians, the takeaway is practical: start asking better questions about the patient’s environment. Where are they moving? What has changed around them? Is their environment helping or limiting their recovery? This episode offers a timely and thought-provoking look at how physical therapy can contribute to human health, planetary health, and more complete clinical reasoning. Key Takeaways: Environmental physiotherapy is broader than clinic sustainability. The patient’s environment can influence movement, adherence, pain, access, and recovery. Physical therapy may be a lower-footprint healthcare option compared with more resource-intensive pathways. Prevention, health promotion, and avoiding unnecessary care are part of sustainable healthcare. Clinicians can start immediately by asking more curious questions about where and how patients move. Physical activity can support human health and planetary health, but context matters. Links: Environmental Physiotherapy Association: https://environmentalphysio.com/

2. 

   28 Aug 2026

   Josh Funk on Scaling Rehab 2 Perform and the Business Future of PT

   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 Takeaways Great 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/

3. 

   21 Aug 2026

   Dr. Thomas Ibounig on Incidental Rotator Cuff Abnormalities and Shoulder MRI

   In this episode, host Leda McDaniel speaks with Dr. Thomas Ibounig, shoulder and elbow surgeon at Helsinki University Hospital and researcher with the Finnish Centre for Evidence-Based Orthopaedics. Dr. Ibounig discusses his 2026 JAMA study, “Incidental Rotator Cuff Abnormalities on Magnetic Resonance Imaging.” The conversation explores how common rotator cuff abnormalities are on MRI, including in asymptomatic individuals, and what that means for clinicians interpreting imaging findings in patients with shoulder pain. The study used a representative Finnish population sample, bilateral 3 Tesla MRI imaging, shoulder surgeon clinical examination, and extensive questionnaire data to examine the relationship between imaging findings, symptoms, clinical tests, and broader patient factors. Dr. Ibounig explains why MRI findings and isolated clinical tests may not identify the source of pain as reliably as clinicians often assume. He also discusses why terminology matters when explaining imaging to patients, how structural findings can become over-medicalized, and why future research needs to look beyond anatomy toward psychological, occupational, metabolic, and longitudinal contributors to shoulder pain. This episode is especially relevant for orthopedic manual physical therapists, surgeons, sports clinicians, educators, and anyone helping patients make sense of shoulder MRI findings. Link to referenced study: https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2844659 Key Takeaways MRI abnormalities are extremely common after age 40. Dr. Ibounig reports that nearly every shoulder over 40 in the study showed some abnormality on MRI. Abnormal does not always mean pathological. Findings such as tendinopathy, partial-thickness tears, and even some full-thickness tears may be part of aging rather than the clear source of symptoms. Symptoms and imaging do not map cleanly. Full-thickness rotator cuff tears were more common in symptomatic shoulders, but many findings were also present in asymptomatic shoulders. Clinical tests may not add as much certainty as clinicians hope. Even a thorough clinical exam did not clearly improve the ability to distinguish symptomatic from asymptomatic rotator cuff findings. Language matters. Telling a patient their shoulder is “torn” or “broken” can create fear, even when the finding may be common for their age. Shoulder pain needs a broader explanatory model. Dr. Ibounig emphasizes that future research should explore pain mechanisms beyond structure, including psychological, metabolic, occupational, and longitudinal factors. Clinical humility is essential. One of the episode’s strongest messages is that experience often brings less certainty, not more.

Who has been a guest on Hands On Hands Off

Names identified in recent episode analyses. Showing up to five guests.

• Jason Beneciuk
• Alex Bengtsson
• Dr. Gail Deyle
• Steve Rodriguez
• Dr. Mark Shepherd

Reach and audience

Public platform figures. Ratings count people who left a rating, not total listeners.

YouTube views

65,788

Score snapshot 15 Sept 2025

Apple Podcasts (US)

5.0 / 5

4 ratings

Podcast Authority Score: 60 / 100

A composite of feed quality, social presence, YouTube performance and engagement. Read the methodology.

Quality

77

Social presence

0

YouTube

76

Engagement

32

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