Tough to Treat

When The Driver Is Not The Pelvis

April 11, 2024 08:00 - 47 minutes - 30.8 MB

In this episode, we discuss the case of a very active woman grappling with SI (sacroiliac) joint pain. These symptoms manifest while walking and with hip external rotation. Furthermore, the episode unravels the complexities surrounding assessments, especially when individuals seek consultation for a single visit. We also delve into why and when using a pelvic belt is helpful. Also, for the non-pelvic health therapists out there, we discuss how you can palpate relevant muscles externall...

Physical Therapy Examination and Intervention of GI Dysfunction

April 04, 2024 15:01 - 20 minutes - 15.1 MB

In this short episode, Susan presents a good algorithm for the examination and interventions in clients with GI dysfunction. Follow along as she discusses different nuances and considerations in the presence of pelvic and abdominal aspects of GI dysfunction. A glance at this episode: [0:01] Interventions for GI dysfunction and abdominal pain [2:03] Manual therapy for abdominal and pelvic issues [6:19] Abdominal massage for constipation and pain relief [9:59] Breathing, abdominal...

Overactive Bladder and Hip Dysfunction

March 28, 2024 08:00 - 40 minutes - 27 MB

This episode presents a client with a seemingly straightforward diagnosis in pelvic health of overactive bladder (OAB). The history and physical presentation tell a different story. Join Susan and Erica as they explore why often a regional approach will not help the client progress to their highest levels of function without symptoms. We discuss the various drivers viscerally and MSK regionally and why tendon function and the client's stage of life require the utmost consideration. Joi...

Exploring Open Chain vs Closed Chain Exercise in Upper Extremity Dysfunction

March 21, 2024 08:00 - 19 minutes - 13.4 MB

In the episode, Erica explores the strategic use of open and closed-chain exercises for upper extremity dysfunction. She discusses the distinct benefits and applications of each type of movement, shedding light on how these exercises can be tailored to meet specific needs to enhance performance. She uses an example of a tennis player who suffered from right shoulder pain with radiculopathy. She also tackles the critical question of when to load open-chain versus closed-chain exercises, of...

The Push Up: 2 Individuals, 2 Different Drivers and 2 Distinct Treatments

March 14, 2024 12:51 - 43 minutes - 26.7 MB

In our latest episode, we explore the fascinating stories of two individuals navigating the challenges of mastering the push-up despite their unique injury history. Both individuals had different pain experiences with this movement. Remember-What set them up? What kept them there? We explore why the push-up experience varied greatly between these 2 people and why it was so unique in these 2 individuals. "Push" is a part of daily life whether we realize it or not from pushing open...

Outcome Measures and Pain in GI Dysfunction

March 07, 2024 09:00 - 16 minutes - 13.1 MB

This episode is a short compilation of an algorithm in looking at basic outcome measures and pain in GI Dysfunction. Susan explores the basics of the history which can give great insight into the addition of more sophisticated outcome measures and pain exploration. Start with the basics and then expand! A glance at this episode: [0:01] Evaluating and managing pain in people with GI dysfunction [1:18] Abdominal pain and its relationship to GI dysfunction [4:47] Visceral pain and myof...

The Balance System As A Driver

February 29, 2024 09:00 - 48 minutes - 31.5 MB

Join us in episode #200 where Susan and Erica explore the potentiality of the balance system as a primary or secondary driver. With a client's history of injury or illness, there is an event that sets up their system for adaptation. Oftentimes, in regional-specific rehab, the balance system is not considered as a driver. What keeps the client in this adapted pattern may be the primary driver; however, the balance system adapts to keep the entire body and physiology upright against gravity. T...

The Body's Story: Finding Out Why You Hurt Through Your Story and Movement Patterns

February 22, 2024 09:00 - 17 minutes - 9.23 MB

In this episode, we explore the profound connections between personal narratives and the origins of someone's injury. Join Erica as she delves into the stories of individuals who've experienced persistent injuries, and learn how to find clues in their narrative to help you prioritize the movement assessment and eventually find their driver(s). You will learn how to make the connections between the story and their movement patterning. Through the lens of their injury and movement history, we ...

Chronic Low Back Pain and an Underlying Pathophysiological Change: We Adapt Until We Can't

February 08, 2024 14:27 - 22 minutes - 16.1 MB

How important are past events to present movement patterns and restrictions? What about past events of herniated lateral discs or hypermobility on the current presentation of the movement system? Clients can heal with faulty movement systems that can show up as new and different presentations in the future. This podcast is from a presentation that links the neuromuscular systems together and provides insight for evaluation and interventions. A glance at this episode: [0:01] Lumbopelvi...

Overcoming Fear-Based Movement Patterns

February 01, 2024 09:00 - 40 minutes - 23.7 MB

In this empowering episode, we dive deep into the realm of fear-based movement and explore strategies to help patients conquer their anxieties, helping them move towards a more confident and pain-free existence. Anxiety and fear of movement are real things and can prevail even when we are termed "fit to play", "fit to move" or "pain-free". Just because someone is pain-free, it doesn't mean that they can move well or move without fear. We discuss the implications of movement anxiety and...

How To Find The Driver Through Patient-Centered Listening

January 25, 2024 09:00 - 35 minutes - 21 MB

Discover the art of being an active listener who can pick up clues in your patient's narrative to help you find their driver quicker. This will save you lots of time in your movement assessment. Listen in as Erica discusses how to reframe your patient's story to help you maximize your time with them in the clinic. She discusses clues in their "subjective" that can aid you in prioritizing regions of the body to assess in your movement analysis. This is done with 3 case studies from her practi...

Take Back your Mental Fitness - Part 2

January 18, 2024 16:26 - 18 minutes - 12.3 MB

Welcome to the New Year and one of the topics always discussed by Healthcare providers is burnout and imposter syndrome. Join Susan in this short podcast - Part 2 Taking back your mental fitness. Learn how to identify the voices of your inner Judge and Saboteurs, how to limit their voices, and find a pathway to your Sage Brain! A glance at this episode: [3:21] Mindfulness techniques for neural plasticity [6:48] Mindfulness and neural pathways for busy people [10:33] Cultivating self...

Take Back Your Mental Fitness - Part 1

January 12, 2024 00:03 - 24 minutes - 17.2 MB

Welcome to the New Year and one of the topics always discussed by healthcare providers is burnout and imposter syndrome. Join Susan in this short podcast episode - Part 1 Taking back your mental fitness. Learn how to identify the voices of your inner Judge and Saboteurs, how to limit their voices, and find a pathway to your Sage Brain! A glance at this episode: [4:38] Saboteurs in the brain and their impact on decision-making [9:11] Personality types and their impact on work performa...

A Case of Lateral Hip Pain

January 04, 2024 09:00 - 48 minutes - 38.2 MB

Hip pain can be brutal. And more often than not-it's chronic. Not like an acute ankle sprain or even acute low back pain. People who suffer from hip pain, for whatever reason, sink into the chronic side of musculoskeletal pain. Let's face it-consideration of lateral hip pain requires a thoughtful clinical reasoning process to discover the physiology/movement patterns as well as neural contributions required to make a diagnosis and successfully build an intervention that lasts. One si...

Stress, Exercise and Sleep as it Relates to the GI System

December 14, 2023 09:00 - 17 minutes - 13 MB

Many times, clinicians find that people with correlative GI system dysfunction are very overwhelming. The complexity makes it difficult to know where to begin to intervene. Join us as Susan discusses some very simple mediations to help improve the GI system with stress, exercise, and sleep. Complex clinical pictures can often change when we address the foundations of health with simple interventions. A glance at this episode: [1:38] Stress, its effects on the body, and exercise as ...

A Complex Client With Medical Red Flags

December 07, 2023 09:00 - 43 minutes - 32.1 MB

Susan and Erica welcome Kelly McClain to the podcast to discuss a very complex client with pelvic health, orthopedic, and neurological issues. Follow along as the client case is presented and we pursue a rich discussion of tying together the systems involved as well as the red flags. Digging deeper into the client's story is key here to help with obvious referrals and also to recognize other systems and issues deeper into the client's history to gain insight. A glance at this episod...

How To Diagnose A Young Soccer Player's Groin Pain

November 30, 2023 09:00 - 18 minutes - 17.9 MB

Why doesn't my groin pain go away? When someone is an athlete, you must understand what regions of the body are challenged with their sport. With soccer, you think of the thorax, foot, hip, and pelvis from the get-go. Listen in as Erica discusses the movement she and her patient chose to assess and what they discovered. Short-term treatment of someone's symptomatic region may help in the short term, but getting them back in the game is another matter entirely. When a person has an i...

Why Does My Foot Hurt? What's Going On?

November 23, 2023 09:00 - 36 minutes - 28.9 MB

Why would someone who is 3 months post-fibular fracture get worse after a basic theraband ankle exercise? Not everyone needs inversion and eversion theraband exercises. Right? This is an in-depth clinical discussion on understanding the "why" hidden in the patient narrative. And a specific process for assessing the whole foot, not just the ankle. We also discuss why this patient's center of mass is biased toward her involved side and what implications this has for treatment. ...

The GI System - Food intolerances vs. Allergies

November 16, 2023 09:00 - 21 minutes - 14.6 MB

We continue with our GI dysfunction theme in this podcast about food intolerances/sensitivities vs. allergies. Join Susan as she takes you through the algorithm to understand how to recognize what is the underlying information behind why certain food bothers us and when we should eliminate food. A glance at this episode: [3:49] Elimination diets for digestive health [7:42] Gluten sensitivity and its effects on the body [11:56] Gut microbiome's role in IBS symptoms and behavioral ...

The Role of the Diaphragm in Chronic Low Back Pain and GI Dysfunction

November 09, 2023 09:00 - 41 minutes - 29.9 MB

How similar are the neuromuscular responses to pain with chronic low back pain and GI pain? Join Susan and Erica in a great discussion of the role of the diaphragm and how this changes with pain and inhibition/over-recruitment in the system. In chronic low back pain and abdominal bloating/distention the diaphragm becomes a postural control muscle which greatly limits the respiratory ability along with an ineffectual model for spine stiffness and visceral organ pusher. This is an ex...

When Do You Treat The Viscera?

November 02, 2023 08:00 - 18 minutes - 16.7 MB

When do you treat the viscera? And why? This episode discusses a bit about the abdominal viscera. It is certainly not all-encompassing by any means. We just want our audience to be aware of the possibilities. Erica relays some clues in the patient's history as to why you would screen for GI dysfunction. She uses 2 case examples of when the abdominal viscera was the secondary driver in one case and when it was a significant impairment in a patient with a dural driver in the other. ...

Back Pain, Thoracic Outlet, Post Cancer Recovery - Where do I go from here?

October 26, 2023 08:00 - 47 minutes - 36.1 MB

In this episode, Susan and Erica welcome Darcie Pervier to the mic! Darcie is a pelvic health and orthopedic PT who practices a fully integrative approach to complex client care. Susan, Erica, and Darcie really delve into "brainstorming" various aspects of examination and intervention in connecting some dots on this complex canvas. Dural issues, fracture healing, bone health red flags, thoracic stiffness, neural tension, and GI visceral systems are tied together to help guide more mean...

Colorectal Sensory Motor Integration

October 19, 2023 08:00 - 23 minutes - 18.3 MB

This episode captures a critical aspect of integrating sensory and motor aspects of colorectal rehab from constipation and IBS to fecal incontinence. The information is categorized under the hyposensitive vs. the hypersensitive quality of symptoms and the motor control from decreased muscle capacity, tissue quality, and motoric coordination. A glance at this episode: [3:27] Rectal balloon therapy for bowel dysfunction [7:58] Rectal muscle exercises for constipation management [12...

Post Partum: Urinary Incontinence, Abdominal Bloating and a Return to High Intensity Exercise

October 12, 2023 08:00 - 1 hour - 45.7 MB

In this episode, Erica and Susan welcome Julia Rosenthal to the mic. Julia is a physical therapist in NYC. She brings a complex case of a postpartum patient of hers who has symptoms of urinary incontinence as well as other bowel and bladder issues that were made worse after giving birth. The patient is a personal trainer and used to high-load exercise, so the need to get back to this is strong. She also has complaints of abdominal bloating along with occasional musculoskeletal pain wit...

How To Increase Patient Adherence To Exercise

October 05, 2023 08:00 - 14 minutes - 12.8 MB

How do you increase patient compliance with their exercise program? This can be very frustrating for both the therapist and the patient. In this shortie episode, Erica discusses how she helps keep her patients on track with their movement program. She often says, "If it's not trialed, then the chances of your patient doing the exercise are reduced at least 10-fold." What is the goal of exercise? Ultimately, it's about training the brain and optimizing movement. You need to ...

Unraveling the Web of Neuralgia: Navigating the Cervical Spine

September 28, 2023 08:00 - 49 minutes - 35.1 MB

In this episode Susan and Erica welcome a Tough To Treat listener, Megan Barclay. Megan brings a case of a patient who continues to suffer neuralgia after a bout of shingles, along with persistent neck pain. Listen to the client's history, significant findings, and differentials as we navigate this client's journey and discuss relevant findings. There is also a rich discussion on possible interventions targeting many points of the trigeminal system and cranial region. A glance ...

Breath, Voice and HRV as Predictors and Interventions in Pelvic Health - Part 2

September 21, 2023 08:00 - 22 minutes - 16.4 MB

Look beyond the traditional regional approach of the pelvic and pelvic floor and understand how discovering and addressing dysfunctions of the trigeminal and respiratory system including the voice and heart rate variability can have an impact on pelvic health. HRV is a well-researched indicator of the balance between the Sympathetic and the Parasympathetic nervous systems. The balance has a large impact on the performance of the GI system and can influence pain, motility, and inflammat...

Breath, Voice and HRV as Predictors and Interventions in Pelvic Health - Part 1

September 14, 2023 08:00 - 19 minutes - 14.1 MB

Look beyond the traditional regional approach of the pelvis and pelvic floor and understand how discovering and addressing dysfunctions of the trigeminal and respiratory system including the voice and heart rate variability can have an impact on pelvic health. HRV is a well-researched indicator of the balance between the Sympathetic and the Parasympathetic nervous systems. The balance has a large impact on the performance of the GI system and can influence pain, motility, and inflammat...

The Mystery of This Man's Struggle With Pelvic Girdle Pain and the Breath

September 07, 2023 08:00 - 47 minutes - 35.1 MB

In this episode, we dive into the often overlooked and misunderstood world of male health, exploring the complexities of groin pain, the challenges of taking deep breaths, and the impact on his pelvic girdle pain. The history will give you the answer. This is a complex case with many parts but listening to his story helps you to prioritize which regions of the body you need to rule out. Visceral connections are key to this presentation. Join Susan and Erica as they unravel the po...

Shoulder Pain- A Motor Control Problem?

August 31, 2023 08:00 - 34 minutes - 25.6 MB

When does motor control come into play when someone has persistent shoulder pain? Is it soft tissue related, a joint problem, or a neuromuscular repatterning issue? Or something else? How does our nervous system adjust? In this episode, we talk about the multiple sources of this person’s shoulder pain and how retraining his arm lift was the key to his recovery. And we mean retraining, the right way. A glance at this episode: [7:27] Assessing symptoms associated with cycl...

SI Joint Pain - An Updated Approach

August 24, 2023 08:00 - 44 minutes - 29.9 MB

Here is the clinical story of a client that is presenting with pain/sensitivity in the area of the (R) posterior pelvis. A common area of symptoms for many patients. But there are many potential drivers and the need to differentially diagnose is crucial. Why? Because you won't want to miss the hidden connections that are so often present in patients, that when missed, can make the difference between a successful outcome and a patient who walks away unhappy. In this episode, we ...

Finding Hidden Connections In Functional Movements- Why They Matter

August 17, 2023 08:00 - 18 minutes - 14.4 MB

In this episode, Erica explores the intersection of functional movement and persistent pain, offering a comprehensive blueprint for understanding and addressing movement dysfunctions that may contribute to ongoing discomfort. Join her as she discusses her insights and tips with examples from her patient caseload. Erica also speaks to functional movements that will help you find "hidden" drivers in other regions of the body. Whether you're dealing with persistent pain or are a health...

A Stiff 1st MTP Joint can Affect Everything!

August 10, 2023 08:00 - 36 minutes - 24.8 MB

One of the most overlooked joints in the lower quarter is the first MTP joint unless that is the primary complaint of the client. How does the stiffness of the 1st MTP joint affect gait and lower quarter movement of all kinds? We spend some great time with discussions of differential diagnosis, and practical interventions and share some new discoveries. Hint: the exam and intervention do not always center around the stiff 1st MTP - there is likely a primary driver elsewhere. A ...

HRV as A Predictor and Intervention in Sleep and Stress

August 03, 2023 08:00 - 27 minutes - 18.4 MB

Heart rate variability is getting a lot of press recently. Join Susan as she presents a webinar on HRV as a predictor and intervention in sleep and stress. It doesn't take complicated interventions to make real changes in our health! A glance at this episode: [1:59] What is heart rate variability [4:07] Inhibition of the flight or fight system [6:26] How you measure heart rate variability [8:58] When to measure heart rate variability [13:38] The cycles of sleep [15:31] Memo...

Pain Without a Diagnosis: The Complexities of Managing Medically Unexplained Symptoms

July 27, 2023 08:00 - 42 minutes - 28.5 MB

In this episode, we delve into the perplexing realm of medically unexplained pain and the challenges it presents for healthcare professionals. Join us as we navigate the complex landscape of patients who continue to experience pain despite thorough medical examinations revealing no discernible underlying cause. We explore the frustrations and uncertainties faced by both patients and practitioners in these cases, as well as the importance of validating patients' experiences and concerns...

Decoding Persistent Hip Labral Tears - It's Not Always What We Think

July 20, 2023 08:00 - 20 minutes - 13.8 MB

Have you ever had patients with "diagnoses" of labral tears on MR only to find out that the hip was not the driver? Of course, you have. In this short episode, Erica responds to a case sent in from one of the listeners regarding persistent hip pain. She asks Erica what would be important to look at and how to proceed with the information at her disposal. There was not a lot of background on this case; so listen as she highlights what's important to rule in and rule out. Rule o...

Chronic Low Back Pain and Constipation - Why it Matters!

July 13, 2023 08:00 - 32 minutes - 22 MB

Clients often have chronic low back pain as a primary or secondary issue. It is often combined in complex presentations where addressing one issue is usually not going to generate optimal results. In this episode, Susan and Erica discuss the obvious and not-so-obvious drivers in this client with chronic low back pain and constipation/bloating! They discuss the varied evidence that helps to determine not only the main drivers of this presentation but also the reality of utilization of...

Pelvic Girdle Pain: Current Concepts Part 2

July 06, 2023 08:00 - 14 minutes - 9.6 MB

Clinical practice guidelines provide the practitioner with the most up-to-date research on a certain diagnosis or condition. Join Susan in a two-part interview about Pelvic Girdle Pain in the Antepartum Population. In part 2 there is a discussion around systemic vs. biomechanical drivers and the effect of cortisol and stress. The clinician is asked to review their confirmational biases, consider changing from the relaxin conversation, and listen to the client's story. Interventio...

Unraveling a Compression Fracture in a Young Male

June 29, 2023 14:11 - 22 minutes - 15.8 MB

Compression fractures are commonly associated with osteoporosis in older adults. However, what happens when these fractures occur in young males? In this episode, Erica and Susan discuss a patient who sustained a T6 compression fracture. It is intriguing to note that it is a young male in his 20's not an older woman in her 70s. Do they require different treatments? Detecting a compression fracture is not difficult thanks to musculoskeletal imaging. However, considering the radi...

Meeting Patient Expectations- Navigating the Journey to Progress

June 22, 2023 08:00 - 13 minutes - 10 MB

This is an excerpt from Erica's DCP course call in February of 2023. In this episode, she delves into the crucial aspect of meeting patient expectations and facilitating their progress. She explores the dynamic relationship between healthcare providers and patients, discussing effective strategies for understanding, managing, and aligning expectations throughout the treatment journey. Join her as she navigates the complexities of patient satisfaction, communication, and empowerment,...

When Shoulder Pain is Dominant, but Not the Driver!

June 15, 2023 08:00 - 32 minutes - 22.5 MB

Shoulder pain, like any other joint can present as primary pain and be the #1 reason a client may seek help! In many cases, treating the apparent joint dysfunction (because it checks all of the boxes) may not result in optimal outcomes. Join the conversation as Susan and Erica explore the reasons and important timelines in the client's history that led to her shoulder pain. Most importantly follow the clinical reasoning that led to the real driver of this issue. Bonus - we also o...

Pelvic Girdle Pain: Current Concepts Part 1

June 08, 2023 08:00 - 12 minutes - 8.72 MB

Join Susan in a two-part interview about Pelvic Girdle Pain in the Antepartum Population. Clinical practice guidelines provide the practitioner with the most up-to-date research on a certain diagnosis or condition. In part 1 there is a rich discussion of what Clinical Practice Guidelines are, risk factors for developing pelvic girdle pain, and most importantly, the language change around the pelvic joints' stability and instability. A glance at this episode: [2:16] What is pelvi...

From Neck Pain to Shoulder Pain: Unraveling the Links Between the Two

June 01, 2023 08:00 - 40 minutes - 27.6 MB

Does stretching work when a muscle is over-recruited? Not if you don't change the movement pattern. This is an excellent follow-up to episode #162, showing how you clinically reason through another weightlifting injury. Join Susan and Erica as they discuss a patient who sustained a shoulder/neck injury during a "basic" tricep extension exercise. The main takeaways are twofold: You must assess the connections between the 2 drivers and treating one region alone will...

Unique Release Positions for the Shoulder: Positioning for Optimal Results

May 25, 2023 08:00 - 11 minutes - 9.37 MB

The purpose of release is to train. Remember that. Long gone are the passive release positions for patients. Think about the connections in the regions of the body to each other and then design a position that engages those long vectors connecting one region of the body to each other. An example, is the use of head rotation and the GHJ, to engage the barriers BETWEEN those regions of the body to each other. Join Erica as she discusses a unique way to achieve end-range shoulder fl...

Complex Chronic Low Back Pain - When A Regional Approach Will Not be the Best Option

May 18, 2023 08:00 - 37 minutes - 26 MB

Where do you start with a client with complex regional pain that has full-body implications? Listen to their story, look for the change talk, and gain active participation by allowing them to lead the way in a judgment-free zone. Sometimes, clients know what they need to do, they just don't know how to implement the changes and find simple action steps. Join us as we talk about this interesting case of a surgeon hijacked by his work environment, which has accumulated sever...

Trigeminal System Referral Pattern

May 11, 2023 08:00 - 16 minutes - 10.6 MB

What is the referral pattern for the Trigeminal System? What does that mean for our clients? The cervical nucleus of the trigeminal system can have profound effects on multi-body symptoms Join Susan as she describes this unique and vital phenomenon. A glance at this episode: [1:45] Trigeminal system as a sensory experience [3:06] The interconnecting cranial nerves [3:51] How the trigeminal system affects the voice [5:17] Trigeminal ganglion and the spinal nuc...

Pelvis Driver In A Male Weightlifter

May 04, 2023 08:00 - 39 minutes - 26.8 MB

This episode is all about low back pain with a pelvis component in a 33-year-old male weightlifter. Erica and Susan discuss how his history of chronic low back pain along with some bowel issues played a significant role in how he recruits muscles under load. Some highlights include why pelvic taping helped in this case, how to perform the same movement pattern in different positions, why assessing the pelvis was necessary, and the clinical reasoning as to how to differentiate w...

Assessing The Knee Differently

April 27, 2023 20:00 - 10 minutes - 8.88 MB

In this "shortie" episode Erica discusses different ways she assesses the knee. There are 3 parts to the knee joint and assessing a movement pattern that takes into account all these regions is key. It's not all about patellar tracking, right? More often than not, one part of the knee is being compressed because of some overactivity in the muscles surrounding it. The main takeaway is that evaluating these regions takes precision and it's worth it to spend a few ex...

Foot Drivers - The Prequel to the Foot Progression Exercises

April 20, 2023 08:00 - 37 minutes - 25.9 MB

Erica and Susan have presented several podcasts discussing the exercise progression of the foot as the primary and secondary driver. Today they discuss the idea of taking the movement pattern down a couple of steps in preparation for the foot to handle loads, change the body posture, and progress to appropriate AP sway. The clinical reasoning process is key for understanding how the foot should be working before strengthening and challenging movement patterns can be improved. A g...

Anatomy and Physiology Interactions of the GI System - Part 2

April 13, 2023 08:00 - 15 minutes - 10.7 MB

This is part 2 of a short webinar on the interactions of the functional anatomy and physiology of the GI system, presented by Susan Clinton. This will give listeners a nice story of these systems in aspects of digestion and this affects other systems. A glance at this episode: [1:25] The importance of good digestion and intestinal mucosa [3:!7] Chemical digestion of food [5:51] Digestive enzymes [8:05] The village of Villi [9:59] Mass movements in the large intestine [11:38...

Episodes