Episode 112 - Lee Poston , part 2: Making Your Patients Worse

Lee Poston PT, Dip MDT, CSCS

Lee Poston, PT, Dip. MDT, CSCS, is a small town guy who was raised on a Cotton farm in Maury City, TN and who knew early on farming wasn't for him.  He did his undergraduate PT studies at Austin Peay State University("Lets go Peay!") and achieved a B.S. in PT at Tennessee State University in 1994.  Lee worked as a traveling therapist eventually landing in Hawaii and accidentally discovered MDT due to taking a continuing education course just to refresh his outpatient skills.  He went on to become credentialed in Mechanical Diagnosis and Therapy in 2002 and diplomaed in 2009.  He’s co-owner of Therapeutic Associates of Maui and of owner and coach of Maui Crossfit Extreme.  Lee is supported by his wife, Michelle. Together they 4 children Zachary, Josh, McKenzie Mckenna.  He enjoys time with his family, outrigger canoe paddling and coaching and participating in Crossfit and he feels blessed to be living in paradise and to have been so lucky to stumble on MDT. 

Working with Athletes

Lee shares a story about a high level Crossfit athlete who responded well to MDT and fully recovered function in 6-8 weeks. He remarks on the frustrating advice that other fitness and medical professionals had given him. He goes on to talk about a followup email from another Crossfit participant from Sweden, speaking to the global reach of not only Crossfit, but the importance of education within fitness worldwide.


More memorable patient stories

“How can it be this easy?” Lee’s memorable story involves a patient with a 20 year history of chronic LBP, and he goes on to share the importance of patient education.

Lee tells another story about a patient with significant comorbidities, and the differences between Lee’s treatment plan and his student’s potential plan of care based on what she had learned in school. 

He reminisces about an experience using a lateral traction unit to help manage a patient with an Ipsilateral shift. He talks about the importance of the advanced problem solving learned in the Parts C and D 


Lee’s favorite analogies and teaching tools

”Tissue responds to load, as well as lack of load.”

Lee frequently utilizes the analogy of a sprained ankle and it’s response to loading over time

”All joints need full range of motion. When you lose full range of motion, you start having problems”

”Bent finger” and “cut knuckle”

“Shoveling Dirt”

Lee uses the physics of shoveling dirt to explain the changes in load on the spine without the use of proper body mechanics.


Poignant Advice

“Don’t be afraid to hurt your patient.” Lee recognizes the importance of moving the patient to understand their symptomatic and mechanical responses. 


Lee’s Favorite Resources

McKenzie Texts


Social Media


Important Studies

Head flexion angle while using a smartphone. Lee et al. Ergonomics. 2015;58(2):220-6.

Does it matter which exercise? A randomized control trial of exercise for low back pain. Long et al. Spine (Phila Pa 1976). 2004 Dec 1;29(23):2593-602.

A prospective study of centralization of lumbar and referred pain. A predictor of symptomatic discs and anular competence. Donelson et al. Spine (Phila Pa 1976). 1997 May 15;22(10):1115-22.



Reaching Lee

Lee invites clinicians to problem solve, and specifically to look into the ability to utilize telehealth to help reach a broader patient population. If you have interest in contacting Lee, he can best be reached by email at outrigger70@yahoo.com