Does a torn rotator cuff always require surgery? And if surgery is necessary, what really determines a successful recovery?

In this episode of KIMEcast, Tony Mikla and Russ Dunning welcome back Dr. Sean Robinson of Revolution Orthopedics for an in-depth conversation about rotator cuff injuries, shoulder surgery, and the evolving science of rehabilitation.

From understanding why rotator cuff tears develop to exploring the intricate decisions surgeons make in the operating room, Dr. Robinson offers a perspective on the complexity of shoulder injuries—and why no two repairs are exactly alike.

The conversation explores:

• Why rotator cuff tears develop and when surgery may be necessary

• The role of strength, movement, nutrition, and tissue health in shoulder function

• How modern surgical techniques have changed recovery

• Why physical therapy is critical before and after surgery

• The differences between partial and full-thickness tears

• How biceps pathology and shoulder mechanics influence treatment decisions

• Why patient engagement, communication, and individualized rehabilitation matter

Throughout the episode, the discussion reinforces an important principle: surgery can repair the tissue, but the body still has to heal—and the patient has to do the work.

Dr. Robinson and the KIME team also discuss their collaborative approach to orthopedic care, connecting surgical expertise with progressive rehabilitation to help patients restore movement, rebuild strength, and return to the activities they love.

Whether you're dealing with shoulder pain, considering rotator cuff surgery, recovering from a procedure, or working in sports medicine, this episode offers valuable insight into what it takes to achieve a successful outcome.

KIMEcast | Breaking through the noise in sports medicine, rehabilitation, and human performance.

What does it really mean to perform better?

In this episode of KIMEcast, Tony Mikla and Russ Dunning sit down with KIME Fit Lead Coach Jamal Albini to talk about training, competition, coaching, and the relentless pursuit of getting better.

Jamal shares the experiences that shaped his approach to performance—from working with professional and youth athletes to discovering just how meaningful strength can be for someone simply trying to move better and live independently.

The conversation explores why more training isn't always better, the problems with year-round specialization in youth sports, why recovery and adaptation matter, and how intelligent programming can build stronger, more resilient people without simply beating them into the ground.

They also dive into Jamal's background as a high-level competitive martial artist and the mindset that continues to drive him today: Get better.

Because performance isn't reserved for professional athletes. Whether the goal is running faster, getting stronger, moving without pain, staying healthy, or simply doing the things you love for as long as possible—everyone has something they are training for.

This is the vision behind KIME Fit: bringing the principles of high-performance training to everyday people and creating a connected system where physical therapy, performance, fitness, and human development work together.

Train with purpose. Find the limiting factor. Get better.

Police officers, firefighters, military personnel, and first responders are asked to perform at an incredibly high level—often without a warm-up, under fatigue, carrying significant load, and in unpredictable environments where their own safety and the safety of others may depend on their physical readiness.

They are tactical athletes.

In this episode of KIMEcast, Tony is joined by KIME Tactical Director Joseph Mielke, DPT to break down the unique physical demands placed on the tactical population and what years of testing and working with these professionals has taught the KIME team.

They discuss the impact of sleep disruption, stress, heavy equipment, cardiovascular demand, strength endurance, mobility, and explosive movement—and why simply being strong isn't enough.

The conversation also explores how objective testing using force plates, dynamometry, movement assessment, and performance measures can identify potential red flags before they become injuries. From the prevalence of low back problems among firefighters to the ballistic demands placed on police officers and the cumulative load experienced by military personnel, training has to reflect the realities of the job.

The goal isn't to replace what tactical athletes are already doing well. It's to identify the missing pieces, improve operational readiness, reduce injury risk, and help these professionals stay capable throughout a long career.

Tony and Joseph also preview the upcoming KIME Tactical Challenge on October 24 in El Dorado Hills—bringing police, fire, military, and tactical professionals together for performance testing, competition, camaraderie, and an individualized look at their own readiness.

Because when the call comes, there is no warm-up.

What actually makes someone better — experience, repetition, or feedback?

In this episode of KIMEcast, Tony and Russ break down the power of feedback loops and why the speed and quality of feedback can dramatically change how we learn, coach, rehabilitate, and perform.

They explore how auditory, visual, and kinesthetic feedback influence movement; why external cues can be more effective than telling someone which muscles or body parts to move; and how creating the right environment can allow athletes and patients to discover better movement rather than simply being told what to do.

The conversation expands into clinical practice and the importance of having repeatable systems. If every patient is treated completely differently, how do you know what actually worked? Tony and Russ discuss how consistency creates a feedback loop that allows clinicians to recognize patterns, identify exceptions, and ultimately develop better clinical judgment.

They also take the concept beyond healthcare into sports, business, and life: fail fast, fail small, gather feedback, and iterate. Waiting for perfection can actually slow improvement. The goal is to create opportunities to test, learn, adjust, and keep moving forward.

In this episode:

• Why faster feedback accelerates learning

• Auditory vs. visual vs. kinesthetic coaching

• Internal vs. external movement cues

• Creating exercises that teach through constraints

• Why protocols can actually improve clinical reasoning

• The difference between experience and wisdom

• Using small failures to accelerate development

• Why perfection can become the enemy of progress

• Applying feedback loops to business and performance

• Measuring what matters — and getting the information fast enough to act on it

Whether you're a clinician, coach, athlete, leader, or simply trying to get better at what you do, the principle is the same:

Do. Get feedback. Adjust. Repeat.

What does great rehab actually look like—and have we let the pendulum swing too far?

In this episode of KIMEcast, Tony sits down with longtime friend and colleague Dr. Jess Elis of Rehab Code for a wide-ranging conversation about clinical decision-making, professional sports, manual therapy, exercise, technology, and the importance of understanding what is actually happening beneath the surface of an injury.

Jess shares lessons from his career working in elite performance and professional sports, including his time with the Portland Trail Blazers and New York Knicks, and pulls back the curtain on some of the realities clinicians face inside professional sports organizations—from load management and return-to-play decisions to the politics and pressure surrounding athlete availability.

The conversation then turns to a growing divide in physical therapy: manual therapy vs. exercise, research vs. clinical experience, and technology vs. the fundamentals of being a great clinician.

Tony and Jess challenge the idea that clinicians need to choose a side. Instead, they make the case for understanding structure, pathology, biomechanics, load, and context—and using all of those tools to make better decisions for the individual in front of you.

They also dive into:

• Why working in professional sports isn't always what young clinicians imagine
• The role of manual therapy in modern rehabilitation
• Why “all roads lead to exercise”—but getting there matters
• The danger of copying exercises and trends from social media
• How pathology changes mechanics and should influence rehab
• Meniscus tears, Baker's cysts, cartilage lesions, and tissue-specific loading
• Building systems and progressions without becoming trapped by protocols
• Why technology and data should support—not replace—clinical reasoning
• Developing better return-to-run and return-to-sport progressions
• Why the best clinicians learn to operate somewhere between the extremes

At its core, this episode is about learning how to think.

Research matters. Experience matters. Technology matters. Manual therapy matters. Exercise matters.

But none of them replace the ability to understand the person, understand the tissue, and make the right decision at the right point in the rehab process.

Special Guest: Dr. Jess Ellis | Rehab Code

How do elite athletes actually improve?

Former Major League pitcher Ryan Mattheus, founder of Optimum Athletes, joins Evan Hauger to explore what separates great coaching from great player development.

Drawing from his MLB career and years of developing high school, collegiate, and professional baseball players, Ryan explains why objective assessment, biomechanics, movement capacity, and individualized programming have transformed the way athletes should train. Together, Ryan and Evan discuss why many so-called "mechanical" problems are actually capacity problems, how collaboration between rehabilitation and performance creates better outcomes, and why the best coaches know when to lean on experts instead of trying to have every answer.

Whether you're a physical therapist, strength coach, coach, or athlete, this conversation offers practical insights into developing athletes through evidence-based coaching rather than guesswork.

• Why player development is a long-term process
• How biomechanics and movement assessments improve performance
• Capacity vs. mechanics: solving the real problem
• The importance of collaboration between rehab and performance
• Using force plates and objective testing to guide programming
• Why individualized coaching outperforms generic training plans
• Building athletes who become self-sufficient, not coach-dependent
• The relationship between performance and injury prevention

In this episode:

Why do some clinicians consistently earn trust, build stronger patient relationships, and achieve better outcomes—while others with the same clinical knowledge struggle?

In this episode of KIMEcast, Tony Mikla, DPT, and Evan Hauger, DPT, explore one of the most overlooked skills in rehabilitation: building patient buy-in.

Clinical expertise matters—but knowledge alone isn't enough. Great clinicians understand how to communicate with people, not just diagnose injuries. They know how to create trust through empathy, establish authority through education, and develop clear plans that patients actually believe in and follow.

Throughout the conversation, they discuss:

• Why communication is one of the biggest missing pieces in healthcare education
• The relationship between empathy, authority, and trust
• How to inspire hope after injury
• Why patients often fail to follow home exercise programs
• Building individualized treatment plans instead of generic protocols
• The importance of understanding each patient's goals, identity, and lifestyle
• Helping athletes return to sport without losing their identity
• Using objective testing to increase confidence and engagement
• Why elite rehabilitation is about guiding people—not simply treating injuries

Whether you're a physical therapist, athletic trainer, strength coach, healthcare professional, or student, this episode offers practical strategies for creating stronger patient relationships and better clinical outcomes.

Because great rehabilitation isn't just about fixing injuries—it's about helping people believe they can become themselves again.

What if the goal wasn't simply living longer—but living stronger?

In this episode of KIMEcast, Tony Mikla sits down with family physician Dr. Sam Robinson to explore what modern longevity medicine actually looks like—and why most people are focusing on the wrong things.

Rather than chasing the latest supplement or health trend, Dr. Robinson explains the three evidence-based pillars that have the greatest impact on your healthspan:

• Reducing visceral fat
• Building muscle and strength
• Improving cardiovascular fitness

Together they discuss why these metrics matter more than the number on the scale, how advanced testing like DEXA scans and VO₂ Max testing can personalize your health plan, and why preventive medicine should begin long before disease develops.

They also dive into:

• The difference between lifespan and healthspan
• Why muscle is one of your greatest predictors of longevity
• The role of protein, creatine, and nutrition
• Continuous glucose monitors (CGMs) and metabolic health
• The truth about GLP-1 medications like Ozempic and Wegovy
• Why obesity should be treated as a chronic medical condition—not a personal failure
• How to create a sustainable plan for lifelong health

If you're interested in living with more strength, energy, and resilience—not just adding years to your life—this conversation is for you.