OCS Field Guide: A PT Podcast

Fracture Screening Practice Questions

Sun, 18 Jan 2026 13:00:00 -0500

As a follow-up to our last episode, today we look at a few sample cases and practice questions related to fracture screening.

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DISCLAIMER: The information in this podcast is shared for educational purposes only and should not be regarded as medical advice. Always consult with an appropriate licensed provider if you have medical questions or concerns.

Fracture Screening: Neck, Knee, Foot, and Ankle

Fri, 05 Dec 2025 17:00:00 -0500

We're back after a busy break to review everyone's favorite fracture rules from the Great White North: the Canadian Cervical Spine Rules, Ottawa Knee Rules, and Ottawa Foot and Ankle Rules. We're giving special attention to common misunderstandings and misapplications of the rules.

Some sources mentioned in the podcast:
Canadian C Spine derivation: https://pubmed.ncbi.nlm.nih.gov/11597285/
Ottawa Knee derivation: https://pubmed.ncbi.nlm.nih.gov/7574120/
Ottawa Knee in pediatrics: https://pubmed.ncbi.nlm.nih.gov/19307383/
Ottawa Ankle original refinement and validation: https://pubmed.ncbi.nlm.nih.gov/8433468/
Ottawa Ankle in pediatrics: https://pubmed.ncbi.nlm.nih.gov/19187397/
Awareness among clinicians: https://pubmed.ncbi.nlm.nih.gov/37957570/

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Hip Osteoarthritis CPG (2017 Update)

Sat, 02 Dec 2023 15:00:00 -0500

Austin summarizes the latest hip osteoarthritis CPG, highlights some of the changes from the previous version, and explains one of the more surprising recommendations.

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Greater Trochanteric Pain Syndrome

Sun, 12 Nov 2023 18:00:00 -0500

We're back from hiatus to discuss diagnosis and treatment of greater trochanteric pain syndrome. Hint: it's probably not bursitis.

Articles referenced:
Consensus statement: https://pubmed.ncbi.nlm.nih.gov/37275836/
Classification system: https://pubmed.ncbi.nlm.nih.gov/35391855/
ER de-rotation test: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6990389/
ITB foam rolling: https://pubmed.ncbi.nlm.nih.gov/30140558/
Cadaver ITB stretch study: https://pubmed.ncbi.nlm.nih.gov/28217413/

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Lateral Ankle Sprains CPG: Interventions

Wed, 25 Jan 2023 15:00:00 -0500

Today we wrap up the 2021 Lateral Ankle Sprains CPG by covering the interventions section.

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Lateral Ankle Sprains CPG: Course, Diagnosis, and Exam

Tue, 10 Jan 2023 11:00:00 -0500

Today Austin takes us through the 2021 update of the lateral ankle sprain CPG, also called the "Ankle Stability and Movement Coordination Impairments: Lateral Ankle Ligament Sprains Revision - 2021" guideline.

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Midportion Achilles Tendinopathy Treatment

Sun, 27 Nov 2022 18:00:00 -0500

Today we wrap up the mid portion Achilles tendinopathy CPG, but we also take things one step further by summarizing a 2015 article by Karin Silbernagel and Kay Crossley called, "A Proposed Return-to-Sport Program for Patients With Midportion Achilles Tendinopathy: Rationale and Implementation." For further reading, we also recommend taking a look at Silbernagel's "Current Clinical Concepts: Conservative Management of Achilles Tendinopathy" from 2020. If you haven't been using these principles, doing so could really level-up your Achilles tendinopathy rehab.

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Midportion Achilles Tendinopathy CPG: Pathology, Epidemiology, and Diagnosis

Tue, 08 Nov 2022 10:00:00 -0500

We have a ton of information on midportion Achilles tendinopathy, which means it is likely to be an ankle/foot diagnosis that shows up quite a bit on the OCS exam. Today we walk through the first half of the 2018 CPG, including pathoanatomic factors, epidemiology, risk factors, clinical course, diagnosis, and outcome measures.

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Plantar Heel Pain CPG

Wed, 12 Oct 2022 17:00:00 -0400

Today we transition to the foot and ankle with a review of the 2014 plantar heel pain CPG. Since this CPG is showing its age a little, Austin augments the recommendations with some research updates.

The Foot Posture Index noted in the episode can be found on Physiopedia here.

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Low Back Pain CPG (2021 Update)

Wed, 24 Aug 2022 12:00:00 -0400

We're back! This is the first time we have had to revisit a topic due to a CPG update, and the relationship between the 2012 and 2021 LBP CPG is complicated. To make things worse, the 2021 CPG was pretty controversial when it was released. How should you use these two documents to prepare for the OCS? We cover it here.

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SLAP Lesions and AC Sprains

Sun, 13 Feb 2022 20:00:00 -0500

Today Austin takes us through types of SLAP lesions and AC sprains with a special focus on relevant anatomy, classifications, and testing.

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Shoulder Instability and Dislocations

Tue, 01 Feb 2022 21:00:00 -0500

We're back with another shoulder diagnosis: instability and dislocations. You should definitely be able to recognize complications and know what kind of imaging to request following different dislocations. We also review the Beighton score for assessing general hypermobility.

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Calcific Tendonitis and Parsonage-Turner Syndrome

Wed, 05 Jan 2022 04:00:00 -0500

There are a few uncommon shoulder conditions that might mimic more typical orthopedic conditions and could trip you up on the exam. Even though you may not see very many of these patients in the clinic, we would expect them to show up on the OCS. Today we cover calcific tendonitis and Parsonage-Turner Syndrome and how to distinguish them from more common conditions and from each other.

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Rotator Cuff-Related Pain: Impingement and Tears

Wed, 29 Dec 2021 15:00:00 -0500

Now that Austin has covered a framework for classifying and treating shoulder pain, today we'll take a closer look at what is classically known as shoulder impingement and rotator cuff tears. This episode describes the standard model for these diagnoses as well as the problems with those models and the current push to leave them behind.

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STAR Shoulder Pain Classification System

Mon, 13 Dec 2021 15:00:00 -0500

There's currently a hot debate going on about how we should categorize, diagnose, and treat shoulder pain. Classic diagnoses like impingement have been sharply criticized, so Austin takes us through an alternative system that may serve you well in the clinic and on the OCS: the Staged Approach to Rehabilitation Classification: Shoulder Disorders, or STAR-Shoulder approach, proposed by McClure and Michener in PTJ in 2015.

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Thoracic Outlet Syndrome

Sun, 14 Nov 2021 20:00:00 -0500

We've got a messy diagnosis this week: thoracic outlet syndrome. David breaks the diagnosis down by anatomy and compressed structure to help make sense of a syndrome that has poor evidence and little consensus.

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Adhesive Capsulitis CPG: Examination and Treatment

Mon, 25 Oct 2021 19:00:00 -0400

Today we finish up the adhesive capsulitis CPG by covering examination and treatment.

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Adhesive Capsulitis CPG: Clinical Course and Differential Diagnosis

Mon, 18 Oct 2021 18:00:00 -0400

Since adhesive capsulitis is the only shoulder diagnosis for which we currently have a CPG, it's worth spending two episodes to cover this in a bit more depth. Today Austin covers part 1 of the adhesive capsulitis CPG, including the sections on prevalence, clinical course, and diagnosis.

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Knee OA Pathophysiology, Diagnosis, and Treatment

Wed, 22 Sep 2021 10:00:00 -0400

Since there are not yet any PT CPGs for knee OA, we pull together information from textbooks, articles, and two physician CPGs to cover what does and doesn't work for knee OA. We also review physiology, diagnosis, and an easy little CPR at the end.

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Patellar Tendinopathy and Other Knee Conditions

Tue, 31 Aug 2021 19:00:00 -0400

Today Austin covers a host of knee conditions, including jumper's knee, clergyman's knee, carpenter's knee, and just about any other profession's knee. Listen in to learn about various knee tendinopathies, bursitises, growth plate disorders, and more.

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Total Knee Arthroplasty CPG

Sun, 08 Aug 2021 20:00:00 -0400

We're back with a new episode covering the APTA's 2020 TKA CPG and with a new MedBridge promo code! Use code FIELDGUIDE for a discount on any of Medbridge's individual plans. Contact us if you want a link for a discount on group plans!

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Patellofemoral Pain CPG

Tue, 23 Feb 2021 21:00:00 -0500

The CPG on patellofemoral pain is both long and dense, so Austin takes us through an information-packed episode with a very helpful practice question at the end to tie it together and explain how you should expect to use this information on the OCS exam.

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Knee Articular Cartilage Lesions CPG

Tue, 16 Feb 2021 17:00:00 -0500

We finish the Knee Pain and Mobility Impairments: Meniscal and Articular Cartilage Lesions CPG (2018 revision) with this episode focused on articular cartilage lesions and surgeries. Additionally, we include an overview of the 5-stage decision tree model this CPG recommends and how the OCS exam might use information like this on the exam.

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Meniscal Lesions CPG

Sun, 07 Feb 2021 15:00:00 -0500

Today we cover the meniscus portion of the CPG also known as the Knee Pain and Mobility Impairments: Meniscal and Cartilage Lesions Revision 2018. Additionally, we pull in a CPG from the British Journal of Sports Medicine and some extra material to explain the CPG's recommendations.

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ACL Injury Prevention CPG, Copers, and Non-Copers

Sun, 24 Jan 2021 15:00:00 -0500

ACL injuries are one of the most studied orthopedic injuries, and we just couldn't get everything we'd like to say about them into the knee ligament sprain episode. So in this episode, David covers mechanisms behind non contact ACL injuries, the ACL injury prevention CPG, and ACL-deficient copers and non-copers.

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Knee Ligament Sprain CPG Overview

Tue, 19 Jan 2021 14:00:00 -0500

In this episode, Austin covers the highlights of the 2017 Knee Ligament Sprain CPG, including diagnosis, outcomes, and treatments. He also covers the Ottawa Knee Rules, which are bound to show up on the OCS exam.

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Types of Arthritis

Fri, 08 Jan 2021 17:00:00 -0500

The variety of rheumatoid disorders can be daunting, and pulling information together to tell them apart is challenging. In this episode, David covers osteoarthritis, rheumatoid arthritis, ankylosing spondylitis, psoriatic arthritis, reactive arthritis, septic arthritis, and gout. After discussing each, the conditions are contrasted for easier recognition of clinical features.

For more information on rheumatoid disorders, we recommend hopkinsarthritis.org.

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Headaches: Cervicogenic, Tension-Type, Migraines, and Cluster

Thu, 31 Dec 2020 15:00:00 -0500

Headaches can be tricky to diagnose and treat. In the headache section of the neck pain CPG, the authors recommend consulting two additional resources: the IHS's International Classification of Headache Disorders and the NICE's Headaches in Over 12s document. In this episode, David pulls the most important information from those documents together to help you distinguish some of the most common types of headaches.

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Neck Pain with Movement Coordination Impairments and Radiating Pain

Tue, 22 Dec 2020 10:00:00 -0500

This information-packed episode finishes the 2017 neck pain CPG by covering diagnosis and treatment of neck pain with movement coordination impairments and neck pain with radiating pain. Additionally, Austin covers a CPR for cervical radiculopathy (and points out where it needs to be updated) and a CPR for intermittent cervical traction.

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Neck Pain with Mobility Deficits and Headaches

Tue, 15 Dec 2020 14:00:00 -0500

After providing an overview of the cervical spine treatment-based classification from 2004 and how it fits into the 2017 neck pain CPG, Dr. Austin Kercheville explains the diagnosis and treatment sections for neck pain with mobility deficits and neck pain with headaches.

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Neck Pain CPG: Red Flags, Imaging, and Outcome Measures

Sun, 06 Dec 2020 17:00:00 -0500

The neck pain CPG expects physical therapists to screen for red flags, but it doesn't give much detail on how to do that. Dr. Austin Kercheville fills in those gaps with this discussion of neck pain red flags and indications for imaging.

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Neck Pain CPG: Risk Factors, Clinical Course, Prognosis

Mon, 16 Nov 2020 20:00:00 -0500

Dr. Austin Kercheville begins our series on the 2017 neck pain Clinical Practice Guideline by covering neck pain prevalence, risk factors, clinical course, and prognosis.

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Low Back Pain Practice Questions

Sun, 08 Nov 2020 18:00:00 -0500

Guest host Dr. Kim Richards, PT, DPT, OCS helps go through some practice questions on low back pain. Like the OCS, these questions are case-based with a couple surprise twists. See how well you've been learning your lumbar spine material by testing your knowledge on these questions.

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Low Back Pain Treatments, Stenosis, and Nerve Tension Testing

Sat, 31 Oct 2020 12:00:00 -0400

As we wrap up the 2012 low back pain CPG by covering the treatment section, David discusses two topics the clinical practice guideline doesn't cover well: lumbar stenosis (as well as how to distinguish it from intermittent claudication) and how to bias nerve tension testing for various branches of the sciatic nerve nerves.

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Low Back Pain Treatment-Based Classification

Mon, 19 Oct 2020 09:00:00 -0400

With the lumbar spine comprising 20% of the OCS exam, knowing both Fritz's 2007 treatment-based classification system and Alrwaily's 2016 update is essential to passing the exam. Dr. David Smelser breaks down these systems and includes a case study at the end.

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Low Back Pain CPG (2012): Red Flags and Outcome Measures

Thu, 15 Oct 2020 16:00:00 -0400

How is the OCS going to approach low back pain differential diagnosis and red flags? Dr. David Smelser discusses low back pain red flags using the CPG as well as a recent JOSPT article by Finucane et al. You can bet your bottom dollar this will be on the exam.

Find the Finucane article at https://www.jospt.org/doi/10.2519/jospt.2020.9971.

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Low Back Pain CPG (2012): Prevalence, Risk Factors, and Clinical Course

Sun, 04 Oct 2020 17:00:00 -0400

Dr. David Smelser introduces the 2012 low back pain Clinical Practice Guideline and covers the sections on prevalence, risk factors, and clinical courses. A couple case studies reinforce how this information might be used on the OCS exam.

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Research Part II: Hawthorne, John Henry, and Pygmalion

Wed, 23 Sep 2020 12:00:00 -0400

Dr. David Smelser discusses psychological pitfalls of human research, including the placebo, nocebo, Hawthorne, John Henry, and Pygmalion (also called "Rosenthal") effects and some ways to mitigate them.

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Research Part I: Basics and Statistics to Memorize

Sun, 20 Sep 2020 08:00:00 -0400

A large number of exam takers who fail to pass the OCS exam report that the section on research was one of their lowest-scoring sections. Dr. David Smelser discusses research basics as well as statistics and important values you will need to memorize to ace the research portion of the exam. In this episode, David covers levels of evidence, types of variables, p-values and alpha levels, type I and type II errors, effect sizes, Cohen's kappa, and likelihood ratios. And just to keep things interesting, these values are reinforced with real data from studies that could be relevant for the exam.

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Introduction and OCS Study Tips

Fri, 11 Sep 2020 17:00:00 -0400

Meet Dr. David Smelser, PT, DPT, OCS and Dr. Austin Kercheville, PT, DPT, OCS—two very busy Board-Certified Specialists in Orthopaedic Physical Therapy. We're here to help you pass the OCS on a tight schedule like we did. In this episode, we introduce ourselves and give you a few tips to get you started with your study plan.

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