This episode is about a weightlifter who suffered a T1 avulsion fracture, had surgery to remove the fragment and still had symptoms. Why? Because the avulsion was not the cause for this patient’s lingering symptoms. Neuromuscular holding strategies as well as poor motor patterning were still there post-operatively. Think about what a weightlifter does before he performs a heavy lift and it will give you a clue as to what we needed to change.