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An important expectation to set with your patients after prescribing an exercise is the understanding of effort vs. outcome. Sometimes, some  is good, and more  is not better —like a patient with knee OA you recommend to walk. A bit of movement can ease stiffness, but overdoing it can aggravate symptoms. Sometimes, some  is good and more   is better —like stretching, where more time under tension often means greater flexibility. Sometimes, less  is more —like strength trainin

Skills fade when they’re not used or refreshed—just like muscles.  Taking a weekend course on cervical manipulation is a great start. But unless you have a plan to get in the reps, gather feedback, and seek mentorship once you’re back in the clinic, that shiny new tool will start to lose its edge.  5 Questions to ask when learning a new clinical skill: When will I practice and refine it? Who will I practice with and how often? What patient(s) will benefit?  What does the evid

If it challenges you, it has the opportunity to change you. Injury? It sucks. But it’s also your chance to slow down, say no, and learn something about yourself. A patient failure? That sucks too. You can point fingers- at them or yourself- or you can lean in and learn. The discomfort is the teacher. Embrace the suck, and listen to what it’s telling you.