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💡 In this episode of PT Pro Talk, host Mariana Parks speaks with Audrey Long, a seasoned clinician and 30-year McKenzie Institute instructor. This interview breaks down the clinical application of Mechanical Diagnosis and Therapy (MDT) through three real-world cases where initial diagnoses and imaging completely missed the mark - ranging from misattributed lumbar stenosis to a refractory tennis elbow hiding a joint restriction.
From overcoming confirmation bias and spotting history clues that "don't fit" to applying end-range passive overpressure and testing joints above and below the site of pain, Audrey shares actionable insights on how to systematically screen mechanical derangements, avoid jumping too quickly into tendon load management, and refine patient communication in everyday practice.
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💭 "Even if you think you have a firm diagnosis, your history and physical exam should always be looking at what doesn't fit." - Audrey Long
👉🏻 Audrey Long has 40 years of clinical experience ranging from work in hospitals, chronic workers' comp multidisciplinary programs, and private practice. For the last 2 decades, she has enjoyed working in a private practice owned by MDT-credentialled therapists. She completed her MDT Diploma Program in New Zealand in 1993 and was promoted to Teaching Faculty in 1997. She went on to publish 4 peer-reviewed papers, qualified to order diagnostic imaging, and completed the Canadian Orthopedic Clinical Specialist (MSK) program.
Audrey is now enjoying semi-retirement mode: no current research, 3 short clinic days per week, teaching half the number of courses, serving on a few Committees, and keeping up with her 2 Labrador Retrievers. She enjoys her work most when she encounters patients who are not simple extension responders.
📚In this episode, you'll learn:
How to spot symptoms and information that doesn’t match a patient’s referral diagnosis, and what to do next.
The specific subjective and objective findings Audrey used to arrive at the real diagnosis in each of the three cases.
A model for clinical reasoning that prioritizes assessment findings over the diagnosis already written on the chart.
How 30+ years of MDT training and practice shape the way an experienced clinician approaches an ambiguous or misleading case.
📲 Audrey's contact information:
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🎥Link to interview on Youtube
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📩Email: mariana@ptprotalk.com
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