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Not All Research is the Same: The Difference Between Good and Bad Research

On this episode of the #AskMikeReinold show, I’m joined by Phil Page to discuss the current state of scientific evidence and journal articles in the physical therapy world. Not all evidence is good evidence. Here’s how to stay current with the best research.

For those interested in learning more, Phil has a presentation for my Inner Circle Online Mentorship group that digs in really deep on these topics.

To view more episodes, subscribe, and ask your questions, go to mikereinold.com/askmikereinold.

#AskMikeReinold Episode 211: Not All Research is the Same: The Difference Between Good and Bad Research

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Show Notes



Transcript

Mike Reinold: Welcome back everybody to the latest episode of the Ask Mike Reinold show. I am with my good friend Phil Page. Phil and I just spent the last couple hours or so now kind of filming some presentations for my Inner Circle on research, which is one of the areas that I think Phil is awesome at. He’s obviously one of the people I’ve looked to over my career on how to learn, how to read journal articles and digest information from them and understanding good research and bad research. And I’ve seen him speak and do a bunch of things over the years. So Phil’s the man for that and I’ve been trying to get what for like, what was it two years you think Phil?

Phil Page: Two years.

Mike Reinold: Yeah, two years. I’m just like, “Hey man, you got to fill in these presentations for my Inner Circle. I think everybody would love them.” So anyway, thank you for doing that. If you’re not a member of my Inner Circle, you’ve got to check it out. But I also wanted to do a special podcast episode because him and I were talking and I have a lot of questions. So Phil, before we get started a little bit, just tell everybody a little bit about yourself.

Phil Page: Yeah, thanks Mike. So I am Research Director and Assistant Professor in physical therapy at Franciscan University here in Baton Rouge, Louisiana. It’s a new program. We’re just finishing up our second cohort. So it’s a new school and I spent the last 20 years working with Performance Health as their Director of Research and Education. And I’ve been a research geek since my first year of college. Many, many years ago as an undergraduate student athletic trainer, I did a research project as a freshmen, believe it or not. And I got the research bug and I’ve had it ever since. And so it’s really just been a fantastic ride for me to now be Research Director. It’s like a kid in a candy store, right? So I’ve got 40 students every year, they’re doing independent research projects. So at the end of the cohort, I’ve got 80 students involved in research at one time. I just I love, I just love this. It’s so much fun.

Mike Reinold: One of the things I give you a lot of credit for though is that you’re a PhD and you’re a research based kind of person here, but you’re very clinical. And I think sometimes we don’t have both of those put together. So I think you get to see a research article and the things that are being published from multiple perspectives because of that. And I think that’s super helpful. So that was neat. So I’m going to start off with this question.

Phil Page: Okay.

Mike Reinold: I want to go from here. I’m going to kind of ask you the questions, I think.

Phil Page: Sure.

Mike Reinold: I don’t know what this is. This is a weird episode, but we’re going to go with it. I remember when we were first getting started and we were younger in this profession, journal articles were golden. They were evidence, they were science. Everything about it was always perfect. So you went to a journal article and said, “This is perfect.” I feel like nowadays where I don’t know if things are becoming so diluted or we just have so many journals, but I feel like there’s a big difference now between a publication and evidence. Right? There’s so many publications out there. I’ve read so many articles over the last several years, especially the last five or so, that I just think this is not good research. This is bad research. This is not helping our profession.

Phil Page: Yep.

Mike Reinold: This is not helping us. What are your thoughts on this? Is it just me? Am I crazy thinking that?

Phil Page: No Mike, it’s tough. And I keep up with the literature. I’m fortunate enough to do that as my job. Right? So everyday clinicians that are out there working eight to five and seeing patients, it’s tough to keep up with the literature. And I get frustrated that there is so much out there first of all, that you have to sift through. Right? And a part of it, Mike obviously, is that there is that, I’ll publish or perish.” Right? So there’s this big push for academics to have to publish their works. I will tell you that, at least in the physical therapy world, it’s not that big of a push because in the [inaudible 00:04:15] criteria for physical therapy school, I think we only need two publications every five years or something like that. So in a way that’s good because it’s not flooding the market with all this stuff that may not be good. Right?

Phil Page: Now at what you’re seeing the other part of this, which I think is the bigger driver, is there’s two things. One is the international side of things where there’s more global influence with the internet that then ties into those journals that are for-profit journals. And you may call those predatory journals or I think there’s a subgroup called pseudo journals if you will, pseudo predatory journals where there’s now a market fee for publication. Right? Now, I’m not going to say that fee for publication is a bad thing because it does offer free access. But there are people that take advantage of that and that they allow articles to get through with very shoddy peer review. Okay?

Mike Reinold: Right.

Phil Page: So that’s one side of it, is that these articles these days, pseudo journals. You look at them and they’ll have very close names to the things that we’re reading every day and they want to make it look good. All you need is a word processing thing and an internet page to make it look like a journal. Right? The other thing is there’s a lack of quality reviewers out there. And there are some articles that get through the review process and I’m not sure how it does, but again there’s a shortage of people that are volunteering to review. Because a lot of us that are actually over here writing and teaching and clinically working, we don’t have time to add all these reviews. And I get review requests from journals I’ve never heard of before.

Mike Reinold: Right.

Phil Page: Like, “Would you mind spending a couple of hours to help out my journal that I’m profiting from?” Now I review all the time for our journals because I think it’s a service that we have to do. So there’s a lot of factors going into it Mike, and it’s really tough. But now what that means, Mike, is that you can’t rely on that article. You’ve got to be the one that actually looks at it and is able to evaluate it.

Mike Reinold: Right. And it’s funny because I was going to ask you about these predatory journals a little bit here too. From my perspective, I think you’re being nice. So you can be, you’re the guest on the podcast. You have to be a little bit nicer. There are, I agree with your sub tiers, there are predatory journals that are just terrible. They are just awful. And I mean, there’s typos. You can tell them it’s like really obvious when it’s a predatory journal. But I will say that yes, I like the for-profit journals. I like that they offer free access to the things. The peer review process is terrible-

Phil Page: Yeah.

Mike Reinold: -even for the best ones. Absolutely terrible in the peer review process. So even some of the bigger name ones from reputable journals that are now doing an online version, I’m getting away from because I continue to see poor methodology. So look at this point in time, there’s a zillion research articles out there. Remember we used to hoard those JOSBTs.

Phil Page: Yeah.

Mike Reinold: And that was like, you know what? You’d get that for the month and you’d read the whole thing. There are so many articles there right now that I just feel like we can answer any question we want and get whichever answer we want the harder we look. If you’re looking, does A do B, you can find yes and you can find no. Right?

Phil Page: Yeah.

Mike Reinold: So that’s why I think we just got to take a huge step back and just start sticking to the main journals. Right? Like the top ones in our profession. So based on that, what are your favorite journals that you read? Because I know a lot of my listeners and people that watch the podcast actually want to know this. They want to say like, “Alright. If there’s some good journals and bad journals, what are your favorites?” We won’t talk about the bad ones, but what are your favorite journals?

Phil Page: Again, it goes to … I think it goes to your interests. Right? So I am not treating patients every day. So my interest is maybe more on the biomechanical analysis side. Right? So journals like Journal of Electromyography and Kinesiology. I mean, that’s not something that every clinician is going to want to read but I’m using it as an extreme example. But I love, I’m biased, International Journals for Sports Physical Therapy. Full disclosure, I’m an Assistant Editor of that. But what I love about that journal and what Dr. Voight and Barb, we put together this journal that was practical and it was applied.

Phil Page: Now there’s that balance Mike, right? So the problem is if I want to do a really good internally valid study, I call those petri dish studies. They’re sterile and they’re well controlled, but what’s the external validity? There is none. So you have to give and take, right? So sometimes these articles may not be very strong scientifically or internally valid, but you’d give it up with that externally. So a lot of what we do with the IJSPT is you’ll see, it’s not a lot of hard science, it’s practical science. And there’s going to be bias, there’s going to be some issues with that.

Phil Page: And quite honestly we get a ton, I can’t tell you how many people, how many article submissions we get. I think Ashley Campbell had told me that we get like a hundred a month. Mike Voight could probably tell us. I mean, the numbers is insane. Do you know why I think we get so many? Open access.

Mike Reinold: Yeah. Because people can read it.

Phil Page: Pub med.

Mike Reinold: Right well, so pub med open access. But I think you nailed it. It’s a more clinical journal.

Phil Page: Yes.

Mike Reinold: And there’s a lot of differences out there. Over my career, I’ve seen the transition. I remember when PT Journal, which I haven’t read in over 15 years. Right? So I remember when PT Journal made that transition. I remember when JOSBT started to make that transition of less clinical. And I remember … so like Kevin Wilke and myself, we used to write tons of current concept papers and we’d always go JOSBT or something like that. And every CSM, APTA meeting, we would … like Gee Seminole, the editor at the time, he would always come home and be like, “Hey, Mike you had the most read article of the year again.” Right? Like everybody loves your article. And I was like, “Thanks Gee.” It’s clinical implications.

Phil Page: Yeah.

Mike Reinold: And I remember now JOSBT is kind of starting to get away with that. In the discussion, if you start talking like, “Well, I think this means,” or, “The clinical implications of this means this,” sometimes the editors say, “Hey, let’s not talk about that.” And I think people miss that, I think they want to get that and that’s why International Journal of Sports Physical Therapy is fantastic. I think sports health is doing a good job with that.

Phil Page: Yes.

Mike Reinold: That’s become one of my favorites now. For pure science too, for the people keeping track, I think AJSM, General Sport … excuse me, Journal Shoulder Elbow Surgery, Arthroscopy, The British Journal of Sports Medicine is doing a really good job. Those are some of our go tos. And look, there’s a million articles out there. You can read articles all day every day if you want. None of us have time to do that. Just pick like four of those and just stay current and you’re going to be in the upper 99% or 1%, whatever the good percent is. You’re going to be in the one of our field. Right? Does that make sense?

Phil Page: Yeah. And it goes, I also like more of the science stuff. Right? So MSSE, Mid-size Sports Exercise.

Mike Reinold: Yeah, good one.

Phil Page: Journal of Strength and conditioning Research tend to have some good stuff in it. But one of the things that I do is I just play the field. Right? So I actually subscribe to the table of contents for a lot of different journal articles and then I just look through every month and I go, “Yep. No, no, no.” And then that way I don’t really have to focus on one journal per se, with having a wide variety of them. But you do want to make sure that, as you said, that you’re focusing your topic. That’s the key thing.

Mike Reinold: Right.

Phil Page: I get all over the place, man. I got, “Oh, there’s a shoulder article. Oh, there’s a ankle. Oh my gosh, there’s an EMG article over. Oh my gosh.” But going back to what IJSBT does, and I agree with you 100%, they have that wide. We’ll do anything from an EMG study to an epidemiological study and some journals like JOSBT have focused in on these specific topics. So be careful in what you choose and don’t limit yourself. And again, follow Twitter with these updates too because there’ll be journals out there that I’ve never heard of or articles that I’ve never seen. And I’ll see one tweet about it and I’ll go, “Hey, I would’ve missed that if I had just stuck with one journal.” Right?

Mike Reinold: Right, right. Yeah. And getting together with some like-minded people on Twitter, for example. It’s like they’re helping you because we’re all going to read research together and tweet the articles you like. Right? So that way then you’re getting some help from others. And I always find things that yourself or Dan Loren’s or somebody like that is tweeting out and I’m like, “That’s amazing.” So one question, or another question I have for you, because I have a lot of questions, but for this episode at least. I want to talk about some of my disappointments in research with this episode a little bit.

Phil Page: Okay.

Mike Reinold: I am currently getting very sick of systematic reviews-

Phil Page: Oh.

Mike Reinold: -and metaanalyses. I’m getting very sick of them Phil. We are starting to dilute information and have these gigantic reviews that always end with no findings, right? I’m not kidding. I’m going to slightly make this up, but I’m dang close. This is close. There is articles that look like, “Does a special test mean you have a rotator cuff tear?” And then you’re like, “Okay.” And then you look at the methodology and there’s 40 studies and subjects range from age 20 to 90. Right? And you’re like jeepers there’s a big difference between a 20 year old and a 90 year old. Right? And then pathology goes from impingement to a full thickness tear with retraction. And then their conclusion is always like, “Well, we didn’t find anything.” Right? Well of course you didn’t find anything. Your subject pool is gigantic. Your pathologies are gigantic. It’s just, it’s a lot. So what can … tell me about this, am I wrong here?

Phil Page: No.

Mike Reinold: That there’s just way too much dilution going on.

Phil Page: I’ve done quite a few of these, actually.

Mike Reinold: The good ones, there’s good ones. I’m not saying they’re all bad because Mike [inaudible 00:15:45] always gets mad at me on Twitter when I say this. Because people feel like I’m talking about them. I’m not talking about them, but kind of if you put a lot of bad studies together, you just have one big, bad study.

Phil Page: I know. Well, the first time I heard this was at ICAS with Mal and Tim. And they were bashing systematic reviews left and right.

Mike Reinold: Oh no way. Really? So you said Mal with you and Tim.

Phil Page: Yeah, this was about three years ago. So I go, “What’s wrong with them?” And it’s because what had happened was systematic reviews became, they didn’t became, they are level one research. Okay. What happens is, and this is level one, which in your Inner Circle presentation I talked about how just because it’s a level one of evidence doesn’t mean it’s a good study. You have to have quality of a study. You have to go beyond the level of that, right?

Mike Reinold: Right.

Phil Page: So yeah, you will have very poor level one studies, meta analyses, all these kinds of things. Because if it’s built out of poorly designed search criteria, poor quality studies, it’s going to give you crap. Crap in is crap out. Right?

Mike Reinold: Right, right.

Phil Page: That’s what’s going to happen with a lot of these. Why are there so many? They’re relatively easy to do, right? So we all know that a clinical trial is not easy to do, right?

Mike Reinold: Yeah, takes a long time.

Phil Page: Systematic reviews are … they’re not easy, but they’re not as hard because you don’t have so many things to control. Right? Second thing is, again … let’s say number one is that they’re level one. Number two is they’re relatively easy. Number three is that they tend to be the most cited types of articles.

Mike Reinold: I know. Yeah, the journals love them.

Phil Page: And that’s why you get a lot of publications because the journal index factors are based on the number of citations. And so is your, sometimes your author index. Right?

Mike Reinold: Right. Yeah. It helps. It helps. I think you left out one too is a lot of times, and this is one of my problems with systemic reviews … systematic review. It’s been a long morning. I can’t wait to read the transcription of that. One of my bees or one of the things I’ve identified here is this is oftentimes a resident that’s doing this. And the senior author, like a well known orthopedic surgeon or something like that might have his residents all doing something and they’re doing a project, but they have no clinical judgment. So they don’t even understand that some of the methodology is poor or the implications they’re making are a little bit off. So I also think this is something where we’re seeing a lot of younger people also doing these types of projects too. And not that they’re not ready for it or they shouldn’t do it or anything like that, but they just don’t have the clinical judgment to say like, “Oh, the way that they measured range of motion may have not been valid.”

Phil Page: Right.

Mike Reinold: For example. So, you know what I mean? So I’m seeing that too, but.

Phil Page: Well no, you’re exactly right. It’s not as easy, and people confuse it with a literature review. Right? It is not a literature review. And actually there are different types of systematic reviews. And the problem is in order for you to do a good systematic review, you really have to have this … a pretty homogenous kind of grouping, right? Because what you’re doing is you’re creating a bucket of evidence. What you’re trying to do is make a conclusion based on similar studies-

Mike Reinold: Right.

Phil Page: -or reviewing these types of things. But to your point, you do have to look at those factors. And if you don’t know what you’re looking for, you’re not extracting the right information. Maybe you’re not even choosing the right articles. So where I’m heading Mike, where I think a lot of people need to be going, are scoping reviews. People don’t know what a scoping review is, but a scoping review is really a broader picture of the literature that really captures everything from our metaanalysis down to our narrative reviews down to our case studies, they include everything. We usually use scoping reviews with a body of knowledge that’s smaller. Okay?

Mike Reinold: Right.

Phil Page: If you don’t have five or ten articles that are worthwhile including in a systematic review, don’t do it. It should be a scoping review. You should expand that out-

Mike Reinold: Right, right.

Phil Page: -because you don’t have enough information to make a good conclusion from a systematic review. A friend of mine is an orthopedic surgeon in Texas, Brad Edwards. He’s done a lot of JSPS and he, I remember a couple years ago, he did a nice little editorial in there that talked exactly about what you’re saying. Is it’s time to stop publishing these systematic reviews that don’t tell you anything. It’s like they should be rejected.

Mike Reinold: Right.

Phil Page: I mentioned that you should not reject an article that’s not significant. A lot of times, sometimes articles are rejected because there’s no difference between the groups, which I think is wrong to reject. But when I have a systematic review that says, “We can’t make conclusions.” Don’t publish it. That’s the way I feel about it.

Mike Reinold: It’s actually, it’s a good point. If you can’t come to a conclusion, I think what happens sometimes is they come to the conclusion and the conclusion is that the body of the evidence is limited and more research is needed. Right? That’s what we see. But again-

Phil Page: Every time.

Mike Reinold: -using that example again, I’m not kidding. “Does manual therapy work for shoulder pain?” Holy smokes that’s a terrible clinical question because it never defines what manual therapy is. You don’t know the experience level of the person applying it. They’re grouping a bunch of interventions as one thing. And then again, you have patients aged 20 to 90 that all have different pathologies. And then they say like, “No.” You know what’s worse? This is what’s worse Phil. We’re going on a tangent here. Here’s what’s worse. Not only is it going to say that, everybody in social media is going to say this study says manual therapy does not work.

Phil Page: Yep. That’s right.

Mike Reinold: And that’s not what it said. That’s not what it said. It just says they couldn’t find anything. They’re going to say manual therapy doesn’t work. Well of course manual therapy, whatever on earth that means in that study over a wide variety of people with a wide variety of pathology, will do a wide variety of things. Right? Is that pretty accurate?

Phil Page: You can’t have it both ways evidence-based people. So evidence-based remember is not based on just a research paper. That’s a systematic review that has a bunch of bias in it. It’s not about articles that confirm your bias, that you think that manual therapy doesn’t work so I’m just going to stick with this one. It doesn’t mean that this article is against you so I don’t talk about it. Right? And it’s about adding the context of the situation of the patient and your experience. So manual therapy might work in certain people. Don’t throw it all out. I love the arguments with ultrasound. I’m a proponent of modalities in certain situations still.

Mike Reinold: Of course, of course.

Phil Page: There is evidence that supports it and then people will turn right around and go, “Well, this one doesn’t.” And I’ll go, “This one does.” Just like you said earlier, you can find something that supports you all day. But what you said earlier, which really hit home for me was the little things that you mentioned Mike about age range, definition of manual therapy. That’s what’s missing from clinicians to be able to look at those things and point that stuff out. Because like you said, a lot of times these articles aren’t written by clinical people. But at the same time, don’t throw it all out. It’s still good information for us to have. We just have to, again, as clinicians be a little bit smarter and learn how to be better critical thinkers. That’s where we need to do a much better job as clinicians.

Mike Reinold: Right. And I think you nailed it right there. That’s why I kind of wanted to hit this podcast episode with this as a little bit of saying like, “Look. Their evidence is amazing, research is amazing. But it’s not all perfect.” Right? There are some flaws in the system. To really be able to get the most clinical implications further we have to understand the good and the bad and stuff like that. So awesome Phil, thanks for joining us on another amazing podcast. Phil is actually a repeat customer now, a repeat guest.

Phil Page: That’s right.

Mike Reinold: Right? You’ve been given in the past. I stole him when we were at one of our society meetings in the past and we did some episodes. So it was good to have you back Phil and thanks again for your presentations for my Inner Circle. I know they’re all going to love it and I really appreciate it. If you have any questions for the podcast, for myself, some of my amazing guests that we have every now and then since we’re Zooming from home during all this stuff, head to mikereinold.com and click on that podcast link and fill out the form to ask us more questions. Please head to iTunes, Spotify. Rate, review, subscribe, all those crazy things you do to podcasts nowadays. And we will see you on the next episode. Thanks so much.

Phil Page: Thanks guys.

Starting Your Physical Therapy Career Off Right

On this episode of the #AskMikeReinold show, I join the DPT class of McMaster University in Canada to talk about starting your physical therapy career off right. I answered a lot of great questions from this group that I think would be very beneficial for all to hear! To view more episodes, subscribe, and ask your questions, go to mikereinold.com/askmikereinold.

#AskMikeReinold Episode 210: Starting Your Physical Therapy Career Off Right

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You can use the player below to listen to the podcast or subscribe. If you are enjoying the podcast, PLEASE click here to leave us a review in iTunes, it will really mean a lot to us. THANKS!


Show Notes



Transcript

Mike Reinold: On this episode of the Ask Mike Reinold Show, I am joined by the physical therapy students of McMaster University in Canada to talk about some of my best tips and career advice for starting your physical therapy career off in the right direction.

Dianna Moulden: So I have three questions to start that the group has asked me throughout our time, and I thought I’d get your opinion on it. And then Brianna has some questions, and then we can kind of open it up to you guys using the raise your hand button. Okay. So the first question, in I think the first session I did with the group I had talked about saying yes to opportunities that came my way professionally. And so often now we hear, “You got to get better at saying no and protect your time and always say no.” But I mean, so much of my sport experience and my experience with teams was in exchange for a free meal and a tee-shirt.

Dianna Moulden: “So looking back in your experience, do you think of one opportunity that you said yes to that kind of changed the trajectory of your career?”

Mike Reinold: Wow, that’s a deep question too. That was actually a well-written question. That was really good. Yeah, it’s actually funny. We usually think about this from the flip side where we should say no more often, right? One of the probably most impactful books that I read in the last few years on that kind of topic was Ego Is the Enemy. Ego’s not necessarily a bad thing. Everybody thinks the word ego means bad, like the egotistical and the negative sense like that, but it’s about just why we do things. One of the big things I got from that is that we probably should say no more because oftentimes you’re saying yes for ego. So you could argue right now I should’ve said no to you when you were like, “Hey Mike, can you talk to my students for a half hour, right?

Dianna Moulden: Yeah.

Mike Reinold: But I don’t why I said yes. I just always say yes to things like this. It’s easy to give back and do little things like this. So we’re all home. We all have some spare time, so this is the type of thing that is helpful to do. But you’re supposed to say no more often, I think, is the key to life. So in terms of saying yes, I mean that’s I don’t know, that’s kind of interesting. It’s amazing as you go through your careers and you guys get a little bit more advanced how things layer on top of one another and a decision you make turns into a sequence of events. Actually, I sought out to work in baseball as a physical therapist because that was my passion at the time. I know Brianna has some questions about passion and stuff, but I wanted to do that.

Mike Reinold: I got lucky. I got my dream job. I got my dream job in my 20s, which is crazy. It’s sad that now it’s not my dream job anymore, but you never want to lose that dream. I got my dream job in the 20s and I think you could argue there, I remember specifically what happened, it’s again a sequence of events. But I put myself in a position where the Red Sox were looking for somebody like me. I remember I was speaking at the APTA Combined Sections Meeting. It was in Boston. It’s currently in Birmingham, Alabama, if you’re working at ASMI.

Mike Reinold: I remember I agreed to speak at CSM. You guys all know APTA. You’re all in Canada, right? But you know, APTA is still cool to you guys. I don’t know. But so the APTA, CSM’s a big meeting. There’s like 10,000 people at some of these meetings, but it’s funny, they don’t reimburse you for anything. You still have to pay. I’m not complaining here, but literally when I go to APTA CSM, they put me to work. I’m doing two talks a day. I’m jumping all around, and I have to completely pay all that out of your pocket. So sometimes you start to get annoyed at that process, but I said yes because it was like, all right, this is a good opportunity. It was free trip home, let’s be honest, going back to Boston.

Mike Reinold: It was a weird opportunity, but I gave a presentation. And in the audience was somebody that was affiliated with Mass General Hospital and they’d just started working with the Red Sox. They grabbed me afterwards and they were saying, “Hey, we want to talk to you.” So if I didn’t do that and I didn’t say yes to that opportunity, I think I may not have had the sequence of events that happened. To give you a good lesson from all this here, I think is it’s okay if you don’t know your master plan and your dream job right now. You’re not supposed to know that.

Mike Reinold: It’s okay if you don’t, but you try to have as much of a plan in place as you can. And when you have a decision come in front of you, should I do this or not, you just think, will this help me get to my endgame goal? I think that’s an important concept right there and that’s how you can make some decisions. That’s what I learned from that book, Ego Is the Enemy. As you can tell Dianna, I’m a terrible question answerer.

Dianna Moulden: No, that was great.

Mike Reinold: Go off on tangents a little bit, but hopefully that helped.

Dianna Moulden: No, that was great. Okay, next question. Depending on the specialty of physiotherapy you want to work in, there can be lots of gaps in knowledge within the educational program. Overall, I think exercise rehabilitation is very poorly done in our program and even just surrounding building programs and even exercises to give and prescription and that type of thing. It’s something that’s not discussed.

Dianna Moulden: “What do you think is important to know about programming and periodization of programming when you’re building a rehabilitation program for someone and do you think this is where your CSCS filled that knowledge gap for you?”

Mike Reinold: Yeah, good question. I feel like our brains as individuals have surpassed what is in a PT curriculum nowadays. If you flash back 20, 30 years ago and you said, what’s physical therapy, I think most people think of it as the acute and subacute type things. And everything in our world’s based off insurance and stuff like that, so most people get discharged before they get to advanced phases. So it was like our profession just didn’t really care about that end. It’s like once you get your range of motion back, once you could take a bath, once you can walk, you’re discharged; you’re out, and the physical therapy is over.

Mike Reinold: I think that was physical therapy maybe in the 70s, the 80s, something like that back in the day as our profession’s evolved, but now as we’re working with more active people, especially when you talk about even athletes trying to get back to sport or something like that, they’re nowhere near ready for sport by the time they meet discharge criteria all the time. So I feel like our curriculums and our college educations aren’t really there to get us to that level, and you probably do need to seek some outside education to get yourself better at that.

Mike Reinold: Trust me. So yeah, I’m a couple of different societies of other physical therapists and we meet every year and we talk about things. One of our big meetings that we do every year is probably about 40 of us in this group. It’s called ICUS. ICUS was the first athletic trainer in the Greek Olympic games I guess or whatever, but anyway. We meet every year and we talk about things. Tim Hewitt, big ACL researcher, is in this group and stuff. We talk about different trends in our field. The big one right now is return to sport after, let’s say, ACLs. Everybody looks like crap at six months and we’re still letting them go back to sports. Then we’re wondering why we’re getting some of these failures.

Mike Reinold: When we ask our group and we look around and be like, “Hey, are your guys weak? Is your quad weak in your athletes after surgery?” Everyone in that room says no. But if you look at the systematic review that’s published that looks at things, everybody looks poor quality. I think what happens is certain groups of people that work with athletes have gone above and beyond their basic curriculum to learn advanced strength and conditioning and periodization schemes. To make a long story longer, you have to seek that outside right now because I don’t think our PT curriculums are getting us past three sets of 10 phase and talking about advanced periodization.

Mike Reinold: I would say your first step in this education process is probably a CSCS through the NSCA, which is just becoming a certified strength and conditioning coach. But trust me, that in no way is going to really make you that good of a coach. You can’t call yourself a coach or be a coach with that because you have to experience it. You have to actually train people and work with people. If you find yourself in a generic outpatient setting where you only work with people for six weeks after surgery, just realistically, you’re probably never going to get good at that because you don’t get to practice it every day.

Mike Reinold: If you’re not in that environment, then what you need to do is you need to get some friends that are in that environment. So maybe you know some personal trainers down the street or strength coaches at a gym nearby and you collaborate back and forth and you try to work with them a little bit. CSCS is like your book smart version of that, but then you still need a practical application. Ironically, we have a strength and conditioning internship at our place at Champion, which is mostly for strength coaches. I can’t tell you how many PT students or new grads we actually get that come and work with us for three, four months, depending on the season, as a strength coach. They’re not doing PT with us. They’re doing it as a strength coach. I think that makes you a more powerful physical therapist as well.

Dianna Moulden: Definitely. Okay, last question. So one theme we’ve discussed every week with this group is the importance of watching people move. And irregardless of the injury they came in with, just watching how they move and looking for compensation strategies within this movement. I’ve told the group the shift in my own practice when I first graduated. If you came in with a shoulder injury, I treated the shoulder and then injury was over and they left. I was getting referrals from a strength and conditioning coach for asymptomatic athletes and I was like, “You don’t have any pain? You’re fine. Get out of here. I’m too busy with people who have pain.” So I’ve talked about in part in taking your course as well, but the shift in my thought and treatment over the last 10 years.

Dianna Moulden: “In your own practice, are you seeing a lot more asymptomatic people seek out treatment, and do you think this is what’s going to be what we see going forward in private practice?”

Mike Reinold: I mean, I hope so. I mean that’s what we’re doing. I would say I don’t even know the percentage, but maybe half of probably the clients that we see are probably what you would deem healthy. So we’d like to call them suboptimal, but that means they’re not in pain. They’re not injured. They’re not postoperative, but they want to get better at something. Maybe they want to improve their mobility or their strength or whatever it may be, especially in the athletic world.

Mike Reinold: I worked for a lot of baseball players, obviously. Every time you pitch, you kind of hurt yourself. So it’s like you have a micro-injury every time you pitch because that’s just the nature of the sport. Our job is to mini-rehab you back because you’ve got to throw again in five days, that sort of thing. I think it’s the future. We talk about this in the spectrum of our healthcare models. Different states, different countries have different probably scopes of what they have here, but oftentimes the therapy, if this is the baseline, I can never tell in Zoom which is left and right, if this is a mirror or not a mirror, so I don’t know.

Mike Reinold: Let’s say this is baseline in the middle and let’s say this is the bad way. You have somebody injured. Our job in physical therapy is to restore them to their baseline. Well, what if their baseline’s crappy? Great, we just restored them back to their crappy selves and they’re probably going to get back to where they were before. So we got to go past baseline. Did that work left or right or was I backwards? I don’t know exactly where it was.

Dianna Moulden: No, that was good.

Mike Reinold: So our goal is to get people better than baseline because oftentimes their baseline is poor and that’s why they’re probably having symptoms over time. That’s how we start talking about performance-based stuff and optimizing things is we want to make sure that we’re not just getting people out of pain, but we’re optimizing them. We teach our students this at Champion. It’s a couple things. When somebody comes in with an injury for an evaluation, we’re going to do two things. This is how I talk to the client too. I say, “We’re going to do two things.”

Mike Reinold: First thing, I’m going to look to see what’s broke, and then I’m going to say, “What’s suboptimal?” You’re coming in with shoulder pain, so the first thing I want to do is okay, is there anything structurally wrong with you. Is there a pathology I want to find? We’re going to do a specific evaluation for that, but then I’m also going to look to see what’s suboptimal. Many times people come in with shoulder pain and I’m like, “Hey, good news. Your shoulder looks fine. Calm down. You’re going to be okay. There’s nothing structurally wrong with it. You’re just a little overwhelmed.” But boom, I’ve got these four things that are suboptimal on our checklist and we’re going to start working on those. And then we’ll see what happens to your pain as that gets a little bit better.

Mike Reinold: I think that’s the future. Now, Blue Cross Blue Shield and insurance companies disagree with me. I also think part of the future of our profession, this is probably going to be more towards cash-based models as well. And not necessarily exclusively cash based, but just realizing that look, some things are covered by insurance and some things aren’t. When you go get your car worked on, if you have a major issue with your car, it’s probably under warranty. It’s covered, you’re fine. But stuff like an oil change isn’t covered. Rotating your tires isn’t covered, stuff like that. I think we have to get out of that mode where people think physical therapy or physiotherapy is just when you’re broke or injured or post-surgical and that’s the only time you can go see a physio.

Mike Reinold: That’s going to take a while. That’s going to take years of reform for us to get that across, but I think you can make that difference in your community when you settle down and you guys graduate and you get jobs because you can start to just get the word out there. Seriously guys, you have to live and breathe that. That has to be your motto. That has to be your byline for your business when you’re in there and that’s what we do at Champion. We help optimize people. That’s what we say. We’re trying to help optimize people. Then you become known for that.

Mike Reinold: Trust me, everybody goes through physio and they all think it stinks. You go four weeks straight leg raises. You work with the therapist for five to 10 minutes and then you beat it. We see that all the time, so it’s very underwhelming. They come to you and all of a sudden you’re looking at them more globally. Then you’re working on this, you’re working on that. Boom, they tell everyone, especially if you’re in sports or something like that. A golfer comes to us and their shoulder hurts. And then all of a sudden we increase their rotation and then they can hit the ball further. They’re telling all their friends and that’s how the snowball happens over time. You have to breathe that a little bit.

Dianna Moulden: Awesome. Go ahead, Brianna.

Brianna Bethune: Yeah, okay. You actually touched on a couple of my questions, so that was perfect. We’re on the same page there. One question I really wanted to ask, and I’ve asked other people it as well because I really like getting their input, but the question, the way I worded it was would you encourage a new grad to specialize in their area of passion right out of school or do you think it’s more beneficial to get exposure to generalized, say, ortho for maybe a few years first to get that foundation?

Brianna Bethune: And just to add a bit of a personal touch on it, for me, I feel like I’m starting to really find my niche and I’m excited by it, but I have that anxiety of jumping right into it out of school just because I’ve loved all my clinical placements. I’ve loved being in ortho, sports, the hospital, so I don’t know. I’m not sure if I want to take that leap right away. You know?

Mike Reinold: Yeah, no. I agree. And if anybody else’s name rhymes, like we have a Susanna or a Joanna or anything, they should all just jump in and ask questions. My opinion on that question has changed over the years. When I first got started, especially when I started my website, I started my website well over 10 years now. I’ll be honest with you, I got lucky. Dianna gave me some good praise with her introduction, but I got lucky.

Mike Reinold: I was just first to market with being a prolific PT online with social media and a blog and stuff like that, so I kind of got lucky. But when I first started that, I definitely got criticism from people that are just like, “That guys not a good physical therapist.” I’m like, “What do you mean?” It’s like, “Well, you’re not good at spine.” I’m like, “Yeah, no. I’m terrible at spine.” They’re like, “You’re not good at geriatrics.” I’m like, “Yeah, no. Yeah, I hate old people.” No, just kidding. Yeah. No, I’m not. So somebody would actually call me a bad physical therapist. It’s kind of funny, as I grasped that concept and I said, “I don’t want to be generic at everything. I want to be really good at a couple things.”

Mike Reinold: If you even just look at my website, I don’t teach things that I don’t feel like I’m really good at. There is no articles on my website about foot and ankle. Feet stink. It’s not a big passion of mine, so you’re not going to find some articles about foot and ankle because that’s not me. It’s shoulder and knee performance, basically. That’s what I do. I think you should do that. That being said, Brianna, though, you do have to learn some of the basics.

Mike Reinold: What I often tell people to do, you guys are probably too new at this. This is too big of a topic for you, too big of a scope, but maybe when you get three, four or five years into your practice, here’s what I want you to do. I want you to take a step back and I want you to do an audit of yourself. You’ll want to do your audit of your skills and your knowledge base and then figure out where you want to go from there, okay. I think that’s really important. The first thing you can do is you can look at joint-specific stuff. You say, I’m going to go through all the joints. What am I comfortable with? What am I not comfortable with? Then figure out if you even care.

Mike Reinold: For me, I actually, same thing with me. About 10 years ago, I thought to myself, I’m not good enough at spine. I’m not comfortable with spine, so I went to every freaking course I could go to on spine. You know what I found out? I was probably pretty good at spine. Nobody’s good at spine. There’s no magic that you’re like, wow, I mean am I missing something? It’s not that. It’s more of a confidence thing. But go through each of the joints and say, what do I need to get better at? But if you’re in a practice where you never, ever, ever treat a spine, then you don’t have to focus on that. That’s your mode you’re in. That’s number one.

Mike Reinold: Then two is you go to activities. Maybe that’s sport. Maybe that’s like I want to work with football, soccer, baseball, whatever it be, that activity. I think you can do that. Then the third audit is skill. So it’s like hey, I want to get better with manipulations. I want to get better with soft tissue work. I want to get better with exercise prescription. So I want you to do a self-audit at some point at time and say, what’s your comfort level with joints, activities, and skills. That’s where you can find out where you want to go with your continuing education, but make it specific to the population in front of you.

Mike Reinold: To answer your question about passion and getting back with that here, I think you have to get to a point where you feel comfortable with your basic skillsets. And if you’re there and you’re comfortable and you want to stick to your passion, then I would definitely say, do that. I do not think we’re going to do any of ourselves or our profession justice if we continue to be generic physios and we can do a little bit of everything. I want you guys to be awesome at something or some things and roll with it. That’s fine. Let your coworker deal with all the spines, or let your weird PT friend that likes feet, let him work with that. You don’t want to deal with that, right? Think of it that way.

Mike Reinold: I think that’s how you want to get there. You may not be ready day one because it’s overwhelming that you have very little self-confidence probably that you’re going to be able to get people better, but once you start getting there, I definitely think we should niche out and we should be a little bit more passionate about where we go. Otherwise, life gets really boring, to be honest with you.

Brianna Bethune: Thank you. That was a really good answer. I have more questions, but I know Will has a really good question that I think he should ask. I’m going to pass it.

Mike Reinold: Nice.

Student: Put me on the spot. I like it.

Mike Reinold: What’s up, Will? This better be good or you’re going to be in trouble.

Student: Yeah, really. Well, I have a couple questions. I don’t know which one Brianna’s talking about, but I’ll ask one. One thing that I find a little bit tricky just on clinical placements is patients are often looking for a specific diagnosis and sometimes can’t really pinpoint what that might be. It’s more of a generic kind of issue. I was just wondering if you could touch on the role of patient education when there is not really that x-ray that says this is the cause or anything like that really?

Mike Reinold: Yeah, no. Good question, Will. You’re going to find that probably more often than you think. It’s really, I don’t want to say it’s rare because that’s not fair, but it’s not every day you’re going to say, “Oh, boom. It’s your meniscus. Your meniscus is the cause of all your trouble.” Because especially too, if you do, let’s say you come in and you diagnose it is a meniscus, well, what do you do? You’re going to do the same thing you were going to do anyway even if you didn’t have that meniscus diagnosis. It’s the same kind of concept.

Mike Reinold: What I always tell people, again, this goes back to what I was answering with that other one. You do two things. What’s broke? What’s suboptimal? And you educate them with that. You say, okay, let’s look pathological and be like, “You know what?” All right, let’s say a shoulder pain, person like that. “You know what? Looks like your cuff’s a little inflamed, but it doesn’t look like you have a rotator cuff tear. It doesn’t look like blah, blah, blah,” all those things. It looks like maybe you just overloaded. Your workload increased too much. You’re suboptimal in these areas. Let’s just focus on that. You don’t have to give them a diagnosis.

Mike Reinold: Now, if somebody does have a diagnosis and when you go to that what’s broke, what’s suboptimal, and you do have a what’s broke, like, “Ooh, your anterior capsule looks torn. You had that dislocation episode.” Then that’s different. You can have that, but I would say the vast majority of non-operative people are going to be nonspecific pain. So your goal is to get them just again that suboptimal checklist more than anything else. You just have to educate them with that. But trust me, from my experience, they may come in wanting a diagnosis, but you’re going to give them a plan, not a diagnosis. You know what I mean? You’re going to give them a, oh crap, that was awesome. Will just said that my shoulder hurts, but it’s because of A, B, C and D, and we’re going to work on all four of those things. And they’re going to be ecstatic.

Student: Awesome. Thank you.

Mike Reinold: What’d you think, Brianna? Was that the one?

Brianna Bethune: Yeah. That’s good.

Student: No. She just texted me and it wasn’t really the one she was asking, so can I ask it?

Mike Reinold: Yeah. What’s your other one, Will? Let’s get that one.

Student: Okay. Just as soon-to-be new grads, a lot of job descriptions or whatever say two, three years experience and so forth. How do you navigate going about that? Obviously, we don’t have experience applying for jobs, so what kind of… I don’t know. How could we sell ourselves to those types of job offers?

Mike Reinold: I think you’re giving the employers too much credit. They’re all probably googling a physical therapy job description template and just throwing it on a website. I think you’re giving them too much credit. I think everybody knows as a new grad, there’s going to be some work with you. There’s going to have to be some mentoring. There’s going to have to be some con ed that you get through. Most physical therapy clinics I know of tend to embrace that, probably more just because you’re cheaper labor, but they know it’s an investment in you over time. I would say don’t be intimidated by that.

Mike Reinold: I think what you can do for yourself is talk a little bit more about what you’ve done yourself to make yourself better than the other new grads. Does that make sense? You can say, “Hey, I’m… ” Especially if you’re finding a job that is in a realm that you’re really passionate about, like a clinic that works with, let’s say, a lot of high school athletes. You’re like, I love that. I just went to this seminar, or I’ve learned from these three people online. That’s how you set yourself apart with that. I wouldn’t be too worried about that little clause in the job description, Will.

Student: Nice answer. Thanks.

Mike Reinold: Yeah.

Student: All right, I’m done. I’m done.

Mike Reinold: That’s awesome. Well, we kind of said it before, but if you have a question, I think you can raise your hand, right? I’m always the host, so I don’t know. Is there a button to raise your hand? They’re like, “Raise your hand and then we’ll unmute you and you can ask a question.” Love to get some more. If nobody has any, maybe I know Brianna may have another one or two up her sleeve. You guys are quiet. This is your time to shine, right. Usually, what happens, somebody will nervously jump in and be like, “Mike, what do you think about the shoulder?” You’re like, “You didn’t prepare well for this meeting, did you?” Too broad, too broad.

Student: I have one.

Mike Reinold: Yeah.

Student: When you started, and Dianna already went through your long list of accolades, how did you really work to prioritize and balance trying to do everything and achieve your goals?

Mike Reinold: To be honest with you, my goal was always to work in baseball at the beginning, so that was my primary focus. I was trying to put myself in a position to do that. The first thing I did was… How many of you guys have heard of the American Sports Medicine Institute? I see a couple of nods in there. This was in the early 90s. This is before the internet, so I’m older than I look. I’m just really short, so I look youthful. At the time, they were the leaders in baseball sports medicine, so I said, “I got to figure out, how do I get in with that group?”

Mike Reinold: At the time, you literally just called people on a landline. So I called up Dr. Glenn Fleisig. He’s the research coordinator. He’s probably the number one expert in baseball pitching biomechanics. I just called him up and I didn’t know what to expect. Called him up and he’s just like, “Hi, this is Glenn.” I’m like, “Uh.” I was like, “Whoa, I didn’t think you were going to pick up.” I wasn’t prepared for that and I was just like, “Hey, I’m a physical therapist student. I’m from Boston. I really admire you guys.” I just put myself out there. So he’s like, “Come on down. You can do a research project with us. You can do an internship with us.” Great. Then yada, yada, yada.

Mike Reinold: That escalated. I remember, I did that and they’re like, “Hey, when you graduate school, do you want to move down to Alabama and work here?” I’m like, “Hell no.” I don’t want to live in Alabama. That’s a big difference from Boston. So I said no, but then they’re like, “Well, how about a fellowship with Kevin Wilk and Dr. Andrews?” I’m like, “Okay. All right. That’s pretty good. I’ll do it for one year.” And then again, yada, yada, yada. I’m there almost 10 years as it was just a good experience over time.

Mike Reinold: So yeah, for me, I sought out the people that I wanted to learn from and who I wanted to be a part with. I put that together. I’m getting off topic here again, Paula, but here’s a good nother funny story you guys can make fun of me about. I did the same thing with the doctor of the Red Sox, the Boston Red Sox. Again, I’m just an idiot student like you guys. I literally did the same thing. I called up. This is the 90s. He answered the phone. It was crazy. It was like, why is this guy answering the phone? He was so taken aback that I just called out of the blue to try to say, “Hey, I’d love to learn from you and meet you.” He’s like, “Tell you what, I want to bring you to a Red Sox game. Friday night, come with me. Come sit in my seats and we’ll talk.”

Mike Reinold: Here’s the mistake I made. This was later in my college career. I already had tickets to that game with all my friends and it was going to be a party. So I actually said, “Oh… ” I made up an excuse where I couldn’t do it because I wanted to go to the game with my friends. And then I called him back next week, never answered the phone ever again, so I lost that opportunity. Total side thing right there, but it’s like try to grasp your opportunity, but pick opportunity over your friends, maybe. I don’t know the life lesson from that, but hopefully you can learn from my mistake there.

Mike Reinold: All right, I promise I’ll have more specific answers going forward. They’ll not be so vague. Who else? Anybody else want to raise their hand? I don’t know if I can see anybody with raised hands. I don’t know if you want… Is that Benjamin’s got a thumb up? We’ll do that. Here, I’ll unmute you there. I think I’m unmuting you. Awesome. What’s up, Benjamin?

Student: Not much. A lot of people talk about walking and gait analysis as a really good way to functionally assess. Obviously, that’s something that takes a lot of practice. You focus a little bit more on the upper extremity. What’s a good functional test that you like to use and, obviously with your expertise, to try and see what might be going on with around the shoulder or upper spine? If someone comes to you with nonspecific pain or even to try and find how to optimize them?

Mike Reinold: Yeah. I would say in my background when I was probably where you guys were, I got really into biomechanical stuff, especially with my interaction with ASMI and stuff like that. So I’m a big fan of biomechanics and how that works, but the more I learned, the more I realized that there are so many variations in the way people do things that it’s really hard to say, “Oh, you’re walking wrong,” or “You’re not walking right,” or whatever it may be. I’m trying to think of obvious examples in sports, but like a baseball pitcher, even a golf swing. There’s so many different ways people do that and they’re all successful. So it’s super hard to say what’s the best way to do things.

Mike Reinold: I’ve seen a lot of new grads also go through this assessment. Somebody’s like three weeks out of ACL reconstruction. They try to do a gait assessment. They’re like, “Yeah, you’re limping.” And the other person’s like, “Yeah, no crap, I’m limping. I just had ACL surgery three weeks ago. I know I’m limping. That’s not why I came to see you.” I look at those things, but what I started to do, Benjamin, I started to do it a little bit different. I started to say, “What do I want to look at in terms of a mechanical assessment or a movement assessment that will directly impact the way I treat somebody?” So not just look at somebody to look at somebody, but what will I do?

Mike Reinold: We took a big step back and we reverse hacked that thought process. We said, “Okay. When we write somebody a program, let’s say a comprehensive program.” So this is blending into performance therapy now too and performance training. We say, what do we do for exercises? We categorize things by movements. We don’t train muscles. We train movements. We broke it down. We have hinge, a squat, a forward lunge, a lateral lunge, a step, multi-segmental rotation, overhead reach, push and pull. That’s how we program.

Mike Reinold: If that’s how we’re going to program and that’s how we’re going to write your program, I want to assess how well you do in each of those categories. We came up with just our own little movement screen, and we did that in our Champion Performance Specialist program that we put together. This is how we look at those movement patterns and then if it doesn’t go well, this is exactly how I program. This isn’t a negative of some of the other systems like FMS and stuff like that. Those do a good job at looking at movement, but I don’t think they do as good of a job at telling you what to do if somebody’s not moving well.

Mike Reinold: So we tried to come up with an exact system. We say, “All right, if you can’t hinge, we’re going to do this manual therapy, these corrective drills, yada, yada, yada. Here’s how we’re going to load you, that type of thing.” I would say take a giant step back and there’s two things, gross movements like we just outlined, and then when you get past that, you can get specific. I don’t know if I’d go gait necessarily, but maybe running mechanics, throwing mechanics, hitting mechanics, sports-specific mechanics. That’s upper level stuff. That makes sense?

Student: Yeah.

Mike Reinold: I mean hopefully that wasn’t too vague, but I would say is take a big step back first and before you start nitpicking how somebody walks, for example, why don’t you nitpick how they move first and then see if any of that correlates to their out… Walking to me is the outcome. You have to look at their capacity to be able to walk before you even get there.

Student: Yeah. Thank you.

Mike Reinold: Then remember, you see somebody walking weird, you’re going to be like, “Yeah. Definitely not walking right.”

Student: Yeah.

Mike Reinold: And then have no idea what to do. So still, you have to figure out what you need to do. Awesome. Good question. Nice. Let me see. Oh, I see Brett. We have some thumbs up. Let’s go, is that Mara? Did I say that well, Mara? Nice.

Student: Yeah.

Mike Reinold: What’s up, Mara?

Student: So my question is, are there any major mistakes in programming that either new grads or PTs make that we should avoid?

Mike Reinold: That’s a good question. I’d say one of the biggest mistakes I see new grads make is we tend to under-load. I think that’s our bigger thing. Not that you want to go crazy and break people down, but I think we tend to under-load and not emphasize strength development enough. That’s again going back to what we talked about earlier with some of the questions. It’s like understanding different loading schemes and periodization schemes to try to get more strength out of people. You can’t just do three sets of 10 forever.

Mike Reinold: I think that’s the biggest programming mistake we tend to see is we just don’t get advanced enough. We’ve had athletes come to us from other facilities that are three months after ACL and they’re still doing straight leg raises. I mean I’m sure their hip flexor is ridiculously strong now, but there’s more to life than straight leg raises.

Student: Great. Thank you.

Mike Reinold: That sounds like a tweet. Should we tweet that, there’s more to life than straight leg raises?

Dianna Moulden: Sounds like a tee-shirt.

Mike Reinold: Yeah, exactly. We can do that. All right, who else? Anybody else? Maybe we’ll take a couple more. You guys got anything more exciting you want to talk about?

Student: I have a question. I just unmuted myself. I hope that’s okay.

Mike Reinold: That’s aggressive. I like it. That’s good.

Student: Sorry. I’m wondering, if you were interviewing someone for a job, what’s one thing that they could say in the interview that would make you want to hire them on the spot versus one thing that they would say and you would send them out the door?

Mike Reinold: Trust me, there’s a lot you can say that I would send you out the door for. Well, when we see students, I predominantly look at one category. It’s their growth mindset. That’s a buzzword now. That’s up there with change the narrative. Trying to think of all the other cool things I see on Instagram. This growth mindset concept here is believe it or not, I’ve seen a lot of students that have come in with opinions. That blows my mind. For example, we’re at Champion. I do ultrasounds sometimes. How many of you people think ultrasound’s awful? Right. Right. Most of you are just preconceived to think ultrasound’s awful because 20 years ago Blue Cross said it was awful, so now everybody says it’s awful because they don’t reimburse for it.

Mike Reinold: But there’s studies that show that if you can tweak the settings and you can do an ultrasound on a ligament, and it may promote healing. So if I have a baseball player, he has a partial Tommy John sprain and we’re trying to get him back, I want to throw the freaking kitchen sink at him. Why wouldn’t I do an ultrasound on his ligament if I can show in a rat that their MCLs healed faster if I did a pulse ultrasound on their ligament?

Mike Reinold: We have a justification for why we do it. We’re a little bit different because we don’t really care about the insurance model, but we’ll have a student come in and just be like, “I can’t believe you’re ultra-sounding them. You can’t do that. That’s stupid.” And we’re like, “All right, you’re fired.” But no, they come in with preconceived opinions that they have because social media right now is super influential. A lot of you guys are learning from social media, which blows my mind. It’s just not a good place to learn. It’s more like edutainment than education, but they come in with those preconceived things.

Mike Reinold: So if you come to me with a growth mindset and say, “Look, in the last six months here’s the two, three things I’ve done to grow and I can’t wait to grow more. I want to learn how you guys do things. I want to be mentored by your staff. I can’t wait to grow.” But with confidence. Not like, “Ooh, I’m afraid. I’m scared. I don’t have self-confidence in myself. I need to learn more.” It’s more like a, “No, I’m excited to learn. I want to grow.” That’s the key to me. If you come in with a fixed mindset where you actually think with your one, two, three years experience that the last 80 years of our profession was all wrong, that’s not going to fly. That’s not going to go very well, so be careful with that mindset when you go in there.

Mike Reinold: I find too if you have two strong of an opinion too early in your career, you tend to try to justify that opinion in your future thoughts rather than having an open mind about whether or not you were right or not because you don’t want to be proven wrong. So keep that in mind. To answer your question, growth mindset I think is the way to do it, but an excited growth mindset. If you look at our staff at Champion, you look at our people here, I think we’re all studs. Everybody there is an exceptional person at their job because they choose to. Nobody’s a nine to fiver. Nobody’s just trying to get in and out. They want to be the best they can.

Mike Reinold: You guys know Dave Tilley, shiftmovementscience.com? He’s one of our PTs, a big gymnastics guy. You should see the crap this guy is reading. It’s insane. He’s like chemical reactions in brains. This is during his lunch break. It’s insane. We all just laugh at him, but he’s just such a leaner that he wants to do that at all times. That is what we’re looking for in our young hires.

Student: Thank you. That was a really good answer.

Mike Reinold: You guys are going to think, wow, this guy is really not professional. I’m too casual.

Dianna Moulden: They’ve heard me every Friday, so they know.

Mike Reinold: For me it’s trying to help. It’s trying to help, right? This is the reality of what’s real out there. Even the little things you learn in school like special tests and stuff you learn in school, half of them don’t work the way that you think they do because it’s not all text-book based. So you got to get some experience with those things. You have to keep a growth mindset. It’d be pretty important. All right, how about one more? What do you got? Who’s going to be the finale? Better be a good one. We’re going to end on a good strong one. What do you guys think? I think we should randomly pick somebody that has their video off and just unmute them and see what noises we hear. That could be good. What do you think? Dianna, I’ll let you pick someone.

Dianna Moulden: Okay, gosh.

Mike Reinold: Oh boy, everyone’s flipping their videos off.

Dianna Moulden: I know. Everybody is going to drop in numbers.

Mike Reinold: Everybody’s like, “Got to go.” Leave meeting, leave meeting.

Dianna Moulden: Does anyone else have a question? Brianna, do you have a question that you didn’t ask?

Student: I think Daniel raised his hand there.

Mike Reinold: Did you see one? I didn’t see it.

Dianna Moulden: You know what’s funny? So Julian unmuted himself. Julian, do you have a question? Because you would’ve been the person I would’ve picked to unmute.

Student: Man, I have my camera on.

Dianna Moulden: I can’t see you, but I was just going to scroll through list and find you and unmute you.

Student: I’m in a new house today, by the way.

Mike Reinold: I like it. I like the background.

Dianna Moulden: He has a new house every week that he’s in.

Mike Reinold: That’s funny.

Student: I think Daniel did have a question though. I saw him raise his thumbs, so he’s saying his question.

Mike Reinold: I don’t see Daniel. Let me see. Oh, there we go.

Student: Right, unmute.

Mike Reinold: Oh, okay. I got you. What’s up, Daniel?

Student: Can you hear me?

Mike Reinold: Yeah, I can see you now. What’s going on?

Student: What I was wondering, so you have obviously strength and conditioning experience. You’re coming in or working as a PT with the CSCS, which not necessarily everybody will have. So what I’m wondering is if you can speak to working in a team environment with, let’s say, the strength coach for the Red Sox or whoever it is, is prescribing programs to athletes and there seems to be a discrepancy. Or based on your experience, your knowledge, you feel there might be a conflict with what they’re being given to do day in, day out in the training versus what their rehab might entail and how you might go about dealing with those conflicts if they even arise, or if at that level strength coaches just kind of know what they’re talking about and you take it as is.

Mike Reinold: Well, you would hope they do. I think that’s the key. Because when you build a team, you have to build a team of like-minded people that all bring a different skillset to the table. Hopefully, you’ve built the right team and you’re close, but collaboration’s the key. And that’s part of some of our core fundamentals at Champion that we built here is that we wanted to have a bunch of multidisciplinary skillsets working together. That’s why we have a gym. That’s why we have PT and we kind of integrate the two together.

Mike Reinold: Could I write somebody’s training program? Yeah, absolutely. I mean I’ve done it plenty of times, but I’d rather hire a coach that’s really good at programming to be that person. But the key comes down to this, it’s collaboration. This is sometimes where young physical therapists, physios, get into trouble a little bit, especially with sport coaches versus strength coaches, start to step on toes and all of a sudden you think you’re a golf mechanical expert and you’re trying to tweak somebody’s grip or swing or something like that. Oftentimes it’s about stepping on toes a little bit.

Mike Reinold: The way we do it is pretty simple. At Champion, it’s pretty simple. If I have somebody that’s working with me exclusively and they want to start getting into the gym, I don’t go out there and say, “Hey, do A, B and C,” because then I’m telling them how to do their job. What I go out there and I say is, “Hey, I want you to focus on this and I want you to avoid this.” I don’t tell them how to get their job done. I just say, “I want you to focus on… Let’s get some good glute development and we need some posterior chains cranked,” or something like that and then let them run with it. If the team’s set up well and you have the right people in place, then that is going to work itself out.

Mike Reinold: What you’re going to get in trouble as a young clinician is you come in there and you start overstepping a little bit and you start telling them exactly what to do. That’s going to really be stuffy to them and it’s not going to really go well, especially in a collaborative team environment like collegiate or pro sports or something like that. Just surround yourself with good people and I think that helps. Awesome.

Student: Thank you.

Mike Reinold: Yeah. Good question. I like it. Tell you what, I want to leave you guys with this one thing because this is what I’ve been telling my students a lot here. And I’ve done this a little bit online, but I probably need to get a little bit more formal. I’m trying to put together a free course for students and new grads that go over even some of these questions we’re talking about, because everybody has the same questions. But I want to leave you guys with this. This is the development process that I see and where you guys see in this phase.

Mike Reinold: As you progress through your careers, you go from… Everyone wants to be an expert right away. You have to develop in this order. It starts with knowledge, then skill, then experience, and then judgment. That’s the big, big, big key right there. You’re never going to be an expert at your craft, even if it’s just a niche type thing or a diverse thing, you’re never going to be specific to that.

Mike Reinold: Let me explain. So knowledge, you’ve learned that in school. You got your book smarts. You have that. You have knowledge. You could always get smarter. Don’t get me wrong, but you have knowledge. But you don’t have a ton of skills yet, assuming you guys don’t. Maybe you guys are starting. You’re starting to get a little bit of skills in school and your clinicals, but it takes you a couple years to get some skills out in the clinical setting too.

Mike Reinold: So knowledge comes first, then skills, but you still have no experience. Then in your head you’re going to be like, “Oh, okay. All right. Geez, last time I saw something like this, it went like that.” And you can start making some opinions a little bit stronger based on that. So you need some experience and then finally you have judgment. Everybody wants to proclaim expertise on Instagram nowadays and seem like an expert, but you have to go through those four phases, knowledge, skill, experience and judgment. That’s how you become finely tuned with your craft and you start feeling good about yourself.

Mike Reinold: Just remember what phase you’re in right now. I would say the biggest phase you guys need right now is skills and reps. We say that all the time is just keep trying to find what skillset do you think you’re most deficient in? Do that little mini-audit and get better at that skill while you’re getting reps. Then in three to five years you’re going to look back and you’re going to be so confident in yourself because now you developed those things. You’ve got a little bit of judgment, and then you can start becoming a little bit more of an expert in a small portion of our field. Then that keeps just layering itself on.

Mike Reinold: So just keep that in mind with that development because I think then you can really focus on what you probably need most right now, and for now it’s probably reps. So just get out there. Remember, when everybody graduates, they all feel unsure of themselves, right? They’re not truly confident in their skillsets, but you guys know way more than you think. You just need experience. You need to like, okay, let me get this person out of shoulder pain, and then you’re like, “Yeah, I did it.” And then you’ll know what to do next time and then that’ll get better and better every time. Make sense? Awesome.

Mike Reinold: Well, thank you so much for having me. And obviously, for Dianna and Brianna for being a part of the organization of this and all the great questions, all the great videos. I’m not bitter about half of you that never turned their cameras on, but thanks so much for doing this. Heck, I’m easy to find online. So if you guys have questions down the road, just reach out and good luck with your upcoming careers once this pandemic ends, right?

Dianna Moulden: Yes. Thank you so much, Mike. This was invaluable to the group.

Mike Reinold: Awesome. Cool. Thanks, guys. Take care. Have a good day. Social distance bump. Let’s do it.

How to Load Athletes at End Range of Motion

Athletes often need to perform their sports at end ranges of their motion. Here are some tips on how to safely load athletes at end range of motion. To view more episodes, subscribe, and ask your questions, go to mikereinold.com/askmikereinold.

#AskMikeReinold Episode 209: How to Load Athletes at End Range of Motion

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Transcript

Mike Reinold: On this episode of the Ask Mike Reinold show, we talk about loading at end range of motion with our athletes.

Mike Reinold: For this week’s episode, we have a pretty cool question. I kind of like this one. Kind of excited to hear what Pope has to say, but Zach from Detroit asks:

Mike Reinold: -When dealing with athletes who have extreme range of motion demands for their sport, which is a lot athletes, how do you go about loading them in their end ranges of motion? So great question, Zach.

Mike Reinold: You can’t say that all athletes are hypermobile because that’s certainly not true. We’ve all dealt with a lot of hypomobile athletes out there. But I do think athletes tend to be more mobile than the general population. Even the people that feel like they may be a little bit stiff or something that may be a little bit more loose jointed than we think.

Mike Reinold: Dave Tilley, everybody. Welcome to the show. Awesome. Mid-episode. I love it. It’s a good one for you.

Mike Reinold: So Dave, I want to send a huge apology to the crowd since I’ll have to repeat the question again for Dave. Just kidding. But all right, so Dave, this is a good question for you actually.

Mike Reinold: Zach from Detroit says: “When dealing with athletes who have extreme range of motion demands for their sport, how do you go about loading them in their end ranges of motion? So great question.”

Mike Reinold: Pope, why don’t you start this one? Because I know you have some good experience in this area and then Dave, gosh, I know you’re going to have some really good experience with this with gymnasts. And then obviously, Lenny and I with baseball.

Mike Reinold: Why don’t we start with Dan and Dave can start getting his blood pressure down and get him prepared for… Hey Dave, thanks.

Dan Pope: Well, I guess the athletes I have the most experience with is going to be with Olympic weightlifters. I don’t know that people often that Olympic weightlifters need extreme mobility, but we kind of do.

Dan Pope: We have to have a ton of overhead range of motion. You have to be able to squat super deep. And then you’re also at end range when you’re catching heavy, heavy loads. Right? So I do think that end ranges of motion are a little bit more stressful on the joints than say the mid range, right? So those end ranges tend to be the areas where people get hurt. So catching a snatch, sometimes the shoulder gets hurt, sometimes the hip, knee, whatever it is.

Dan Pope: The survey data even shows that. People come out of the hold and squat, that’s where people tend to get hurt. Right?

Dan Pope: So two things:

Dan Pope: 1. We have to be really conscious of the total exposures in those positions. I’m talking more from a coaching perspective when you’re trying to prevent injuries and not necessarily rehab. We have to be really conscious to amount of exposures, right?

Dan Pope: So we make sure that we have a consistent amount every week. We don’t have big spikes and we’re not putting ourselves in position. We’re overexposing that area, overusing that area.

Dan Pope: 2. The other thing is that you have to get super strong in those positions, too. So I think it’s a big time-balancing act for these folks because they have to get really, really strong in these positions. It’s important for performance and also injury prevention. Right? But if we overuse those positions, we also run into trouble as well. Right?

Dan Pope: So for me, I think that’s a good opportunity to take advantage of periodization. So maybe you’re off season, you’re temporarily unloading these positions and then you start ramping up over the course of time. You might have accessory programs once or twice a week where you are trying to strengthen the end range of the shoulder.

Dan Pope: Let’s say you’re working on waiter’s walks or you’re working on snatch bounds or something along those lines where we’re really strengthening the shoulder at the end range We’re working on things pause squats, we’re pairing the bottom position of the squat really well; But we’re also being very judicious with the application of these exercises.

Dan Pope: We’re not just throwing a ton of these movements without thinking about how the entire program operates together, I guess.

Mike Reinold: Keepers, Dan. You always come in very humble, like, “Well, I guess I could answer this,” and then you just lay the law down. Right? I mean just pure wisdom right there. So yeah, I mean, that’s amazing. I think Dan’s got a very… From the Olympic lifting section of this, that makes total sense to get some strength at end range in these positions and stuff that. That makes total sense.

Mike Reinold: I would include that as extreme end range to an extent. I think that’s super important. Gymnasts, on the other hand, may be a little bit different, right? Maybe a little different approach.

Mike Reinold: David, how do you approach getting these athletes stronger at their end range of motion?

Dave Tilley: Yeah, I’ll go with the lower body because Dan covered the upper body so well. So in gymnastics, the two ones that are most commonly thought about are like lower back and then the hip, right? So the spine being overextension causes the facet joints to become irritated and you get a spinal fracture, a stress fracture.

Dave Tilley: I think for that, it comes down to exposure, which is a huge one that Dan talked about too, is like when you add up how many times did gymnast may back bend during a practice or during a training week, it’s crazy.

Dave Tilley: It’s just with you guys and throwing. I think Dan probably has that too with overhead positions. Like you can quickly stack up way more than you’re ready for. So exposure is a big part of it.

Dave Tilley: But for me, I think that it’s all about trying to find other joints to try to take some of the load off, right? So maximizing the hip, the thoracic spine and the shoulder are going to help de-load that area.

Dave Tilley: The one that’s funky in gymnastics is the hip because if you look ballet or gymnastics or dance, they have really extreme ranges of motion. And the types of injuries that you get with the femoral neck full coming on the superolateral edge or kind of causing some labral stuff is compression based.

Dave Tilley: So for those athletes, it’s really about maximizing the soft tissue flexibility and trying to spare the laxity of the joints, the iliofemoral capsule and stuff that. That’s where people get into problems. They aren’t aware that you can be loose and tight at the same time.

Dave Tilley: Something I learned from Mike and Lenny in the baseball world is you can have a very stiff adductor complex and a very stiff rectus fem while still have a super lax hip capsule and that can cause micro instability of pinching on the wall.

Dave Tilley: So I think those are… We can’t screen the hip we can the shoulder, but we have to really have a good idea of radiology and some different things so we can look at what’s what.

Mike Reinold: That’s awesome, Dave. Great tips there from probably a sport that has the most extreme ranges of motion; because they have the ability to use that range of motion and then that’s part of that competition. They have to do that. Right?

Mike Reinold: Len, how about you in baseball? What’s your approach to loading people at end range in baseball? What do you think?

Lenny Macrina: Yeah, we do some. We definitely, I think for us in baseball, the shoulder is inherently a loose joint, so it’s a little easier than the hip. So we use a lot of rhythmic staves at end range, even starting off early postop putting them at end range, external rotation, internal rotation, different degrees of abduction and really working on the rhythmic stabilization to try to, “Don’t let me move. You stabilize that ball in the socket.”

Lenny Macrina: Because of that micro instability that Dave talked about that occurs in the hip, it happens even more so in the shoulder joint. So we’re trying to do everything we can to keep that humeral head within the glenoid.

Lenny Macrina: So whether it was a closed chain position, again, doing some rhythmic staves or don’t let me move you. So closed chain position is going to really approximate humeral head within the glenoid and then progressing to not a closed chain position. So open chain, so to speak some rhythmic staves.

Lenny Macrina: Then even I like to take an approach from Dan or even what Dave would do for the gymnasts and crossfitters and powerlifters is use some kettlebells and maybe get into an overhead position and in a stable position.

Lenny Macrina: So I’ll put them supine, maybe lying on the floor and holding something. Or if they’re doing some kind of kettlebell walk and then maybe doing a little rhythmic stave in that position as well. So again, you’re getting the approximation of the joint and then they have to stabilize. So that’s some ways that I to do it as well.

Lenny Macrina: But then we’re also doing some pretty heavy lifts. I’m not doing Olympic lifting with our guys, but I think anything that involves some kind of pole, some kind of deadlift, I really love. And I think the cumulative effects of doing all this stuff is going to cause just overall strength within the system.

Lenny Macrina: So just all that combined together I think is critical.

Mike Reinold: All right. So I’m going to be a bit of a contrarian here, although I think nobody said no, but then you all kind of said something else, which is kind of interesting.

Mike Reinold: So I think I’m going to be a contrarian yet agree with everybody, which is going to be, does that make sense? But how about this one right here? Here’s what we learned in baseball a little bit here about loading and end range.

Mike Reinold: This is what we’re seeing a little bit here. A lot of people in baseball right are loading an end range with weighted balls, right? And what they’re doing is they’re applying that loaded end range with weighted implement to try to get more load at that end rage, to build strength at that end rage, the build some load right there.

Mike Reinold: You know what I think we’ve noticed happening is that it actually destabilized them because it was the end range of the motion and they work on either loosening or damaging their static stabilizers or desensitizing the GTO or whatever it may be in that position.

Mike Reinold: It just makes me wonder:

Mike Reinold: 1. The concept of strength training in general;

Mike Reinold: 2. The concept of end range.

Mike Reinold: We’re seeing things where people are getting the end range and then forcing into more range of motion, which man, that’s like, like Dave kind of mentioned, it’s really… You’re going to have Sarman’s whole concept of the relative stiffness where you’re just going to get compensation, something’s going to happen. You’re going to jam. It’s your end range, right?

Mike Reinold: So we’ve learned things with the concept of striping where if you strengthen throughout a good amount of the range of motion, that’s when you’re going to get carryover. That’s where you’re going to get it.

Mike Reinold: But in this position, I don’t think I necessarily need strength. I think I need dynamic stability and I need end range control, not load. I think that’s a big difference right here. And believe it or not, I think all of you said that even though you didn’t. So how do you define load? Right?

Mike Reinold: But I think everybody wants to load, they want to get to end range using baseball. Let’s use gymnasts because this is absurd, right? That’s like getting them into a max prone extension and then trying to extend more.

Dave Tilley: Yeah.

Mike Reinold: It makes no sense. We would never do that. It’s not that they need to develop load in that position. They need to be able to control getting into that position and stabilized if they get into that position.

Mike Reinold: So I actually think we’re overdoing the concept of loading at end range. Dan probably said it best, but I also think, that’s the least end range. We’re talking about overhead. That’s the end range of your normal motion. Right? So you should be strong and stable in that position.

Mike Reinold: But again, even when you snatch, there’s all a generation. Right? And then control. It’s load control. Right? You got to think of it that way.

Mike Reinold: It’s not necessarily how strong can I get here? Can I jam it back into more extension, but can I stabilize in this position. Right? I mean, am I wrong?

Dave Tilley: I have just one thing I know that Dan-

Dan Pope: Dave’s, yeah, you are right. You’re right.

Mike Reinold: You could be wrong.

Dave Tilley: There’s something I know we all do that I think we missed over. Dan and the gymnasts do this a ton. I know in baseball, it is crazy how much prep drills and technical work and strength.

Dave Tilley: But there’s so much prep work in Olympic lifting before you snatch. There’s so much temple pause, e-centrics with squatting and overhead pressing that I think Olympic lifters and gymnasts do a ton of e-centric to prepare their joints for end range.

Dave Tilley: Guys will do slow tempo dips from the age of four to 30, before they ever do something crazy. Right? There’s so many years of extreme preparation that goes before they would just bounce dips at end range to further their shoulders. So that’s all I want to say.

Mike Reinold: Yeah. It’s a great point.

Mike Reinold: I feel like just right now, the trends right now, at least in social media, it’s getting the end range, forcing it into more end range and I think, yeah, definitely.

Mike Reinold: I think a lot of people that know me know that I don’t love the sleeper stretch for baseball players because you get the end range and just jam you, just torque the thing out of it.

Mike Reinold: So I think a lot of people are going to regret all this end range of motion torquing they’re doing on their hips in a few years. I think that’s going to come back to bite a lot of athletes. I think we’re pushing that a little bit too much.

Mike Reinold: I think the same thing would happen in the spine and the shoulder if you’re doing that. Right? So I feel the concept of loading and end range is a bit overplayed, right?

Mike Reinold: Let’s get as strong as we can within the functional range of motion and then be able to control and stabilize end range. I don’t know. That would be my goal.

Mike Reinold: Dan?

Dan Pope: This is probably just too much here, but I think for a lot of folks, stiffness is protective. Right? We are talking about getting stronger, stronger, stable back here. Of course, we need to be able to prepare the positions and need to be loaded. But the other part is like, we might want some stiffness. That might be a good thing, to have a little bit stiffness. It protects the joint.

Mike Reinold: It’s end range for a reason. Right? It end range for a reason. Right? So it’s either osseous or it’s protective from capsulate or something that.

Mike Reinold: We’re not talking about somebody with a restriction in their mobility in mid range and we’re trying to get him back to normal. We’re talking about end range. And I think that’s the big difference.

Mike Reinold: So I may be wrong. I may change my mind. If so, we’ll do a future podcast episode. It will be fantastic, but I don’t know. Maybe that’s just nomenclature because again, I think you guys all talk about loading end range, but I think we all said the same thing, even though it’s loading. I think it’s more about control and stabilization than actually loading and getting there.

Mike Reinold: What I don’t want to see is people laying on their stomach and trying to get end range load. No, I just had a cramp. I don’t even know what muscle cramped right there. You’re not supposed to do that. Right?

Mike Reinold: So I don’t know. Something to keep in mind. So great question. Thank you so much.

Mike Reinold: Another good episode. I appreciate it. Good feedback from everybody. Thanks Dave, for joining us. We appreciate that. And keep asking.

Mike Reinold: Head to Mike Reinold, click on the podcast link and fill out the form to ask us some questions, anything you guys want to talk about. Rate and review on Spotify and iTunes, and we will see you on the next episode. Thank you so much.

How to Get Athletes to Buy Into Your Treatment Plan

On this episode of the #AskMikeReinold show we talk about working with high-level athletes and ways to get them to buy into your proposed treatment plan. To view more episodes, subscribe, and ask your questions, go to mikereinold.com/askmikereinold.

#AskMikeReinold Episode 208: How to Get Athletes to Buy Into Your Treatment Plan

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You can use the player below to listen to the podcast or subscribe. If you are enjoying the podcast, PLEASE click here to leave us a review in iTunes, it will really mean a lot to us. THANKS!


Show Notes



Transcript

Mike Reinold: On this episode of the Ask Mike Reinold show, we talk about some of the strategies we use to get athletes to buy into our treatment plan.

Mike Reinold: Oh, well here’s our question today. Let me see. I’m my own question answerer. Let’s see. All right. Corey, from California, from Chapman University actually, which I got together with recently, Corey had a question I thought was pretty cool. He said, “When working with athletes who are very high level, and potentially have a lot riding on the therapy you’re giving them, and have expectation that they’ll get back on the field ASAP, how do you get them to buy into your treatment and plan of care that you’ve outlined for them? Especially if maybe it doesn’t fit with their own timeline? What are some strategies you’d like to implement?” This is a good one. I like the way I liked the way you phrased it too.

Mike Reinold: We’ve got high level athletes, they want to get back as fast as they can. A, how do you get them to buy into your plan? But B, how do you do that if it doesn’t fit their plan? I think that was, I think it’s a good way of rephrasing it right here. Who wants to start this lovely question?

Dan Pope: There’s so many ways to go with this.

Mike Scaduto: Yeah, I think that’s a pretty loaded question. I think first off you should have an honest conversation about the timeline that the athlete wants, and why are the two timelines not really lining up? Is it a postop patient who has unrealistic expectations coming back from surgery, and they think they had Tommy John three weeks ago and they want to start throwing it month two, and be back on the field at month six?

Mike Scaduto: I think that comes down to setting expectations for the patient, and I think that conversation you have to have early on, hopefully even before surgery, before they undergo surgery, if it’s something like that. If it’s another circumstance, I think you have to remind the athlete that you’re working for them, and maybe you have to make compromises in the plan to try and work towards their best benefit without putting them at risk for reinjury or anything like that.

Mike Reinold: Nice. Two things I liked from that, Mike, one is probably trying to set some clear expectations at the beginning of all this. Establish that early. That’s something we usually do with our athletes on their first visit or so, and we say, all right, all right. You strained your hamstring. All right, well what’s going on? We’re in season now. You got anything coming up? Oh, you’re a freshman, you’re not even playing on the team, all right. Let’s put together all the factors together, like oh, this is the senior year, and you sprained your ankle, and your last football game is this week? You got to put those factors together. Getting together and having those clear expectations.

Mike Reinold: I like what you said there, Mike, a little bit about maybe we got to, I don’t know if meet in the middle is the right term, because that’s not always the right answer, but I think I would say that nothing’s completely black and white. Unless it’s postop and you have some clear healing guidelines, nothing’s black and white. I see a lot of young clinicians and students get caught up on this where we’re like, “Oh no. Nope. You have to take two weeks off from running because I read that in a book, it has to be two weeks.”

Mike Reinold: Nothing’s black and white. People heal at different rates. We’re always trying to play with that spectrum of go as fast as we can, but not too fast to help them. There is no definitive answer. I got that thought while you were speaking, Mike, but I think that’s one of the things that, if you’re a therapist, and you’re developing your treatment plan, and you’ve got this hardcore thing in your head that, the way it should go, maybe it’s partly you that’s at fault. Maybe you need to be a little bit more like, let’s play on the fly. What else? What other strategies or tips do people have? What’s up, Dan?

Dan Pope: Going backwards, but I think this is … there’s a variety of things you can do. First and foremost, and she may be beyond this point, but I think that you need to win people over before they even come through the door. What I mean by that is that if you’re in a specific population, so I worked with Tom with fitness? A lot of times people are coming in to me because the coaches recommended, or they read about me online, or they see the background that I’ve had, and then the report is going to be that much better just because they trust you. I think that’s very, very important.

Dan Pope: What I was going to try to add to the conversation was, I think the listening is going to be extremely important, because the end of the day, we’re not here to get our own agenda accomplished, we’re there to help the person that’s in front of us. You really have to listen to that person and see what their needs are, and what their desires are, and from that point, we can start to develop a plan of care and maybe say, “Look, if you want to get back at this point, your risk of injury is potentially here, but if you follow my plan, it’s a bit better.” You’re not necessarily contradicting people, you’re just giving them the pros and the cons, and they’re trying to make a decision together.

Mike Reinold: I like that. I think you phrase that really well, Dan, too. I think that feeds into a lot. What I said too, where there is no black and white, everything has a risk reward ratio. You just got to put that together. I think you said that really well. Len, was that you?

Lenny Macrina: Well, I think a lot of it comes, you have the conversation and you’re like, “Oh, let’s look at you now. Let’s see how you move. Let’s see how you present. I like your thoughts. I think we can do a lot of that, but let’s just see how you move.” Then you start doing the assessment or the evaluation, and you start seeing objective stuff, or even they start reporting some stuff and you’re like, well, for me, I do a lot of muscle testing with the handheld anemometer.

Lenny Macrina: If I see a loss of strength, but particularly in a baseball player who’s coming back from Tommy John, because I got a bunch right now that are … they think they’re ready to throw, and it’s four months out until they can throw, and then I start doing some of my assessments of them, and they’re presenting with a pretty good cuff weakness, I don’t think it’s time to throw.

Lenny Macrina: Then I have to figure out, all right, let’s maybe wait a month. This is why I think we can wait a month. You see the numbers here. You feel the difference when I resist you. Let’s buy more time, because let’s calculate if we add an extra month of strengthening and don’t throw, how does that affect the backend? How does that affect your time to come back? Well, it really won’t because I’ll be ready now in February, versus January. It won’t really affect me for my spring season. Perfect. I think we found some stuff that we could work on, and I think it’s still not going to affect your season.

Lenny Macrina: I think a lot of the times that stuff falls into place perfectly, and believe it or not, you end up finding a happy medium, and you can justify it by some of your assessment stuff that you do. I think getting the person to buy in, like Dan said, and really get a good conversation going, and you’re listening, and you’re open to it, and you have to justify it with something objective if you’re going to really, significantly change their program. I think it oftentimes comes out in some of our testing that we do. That’s how I can oftentimes get around that.

Mike Reinold: I think that’s great. I think then what you would do there, and I think we may all do this, but I think this is a huge component to it is that you then have a criteria-based approach, and you go backwards, and you say like, “All right, look, you want to get back into football after a hamstring screen, okay. Well, here’s what we need to do first. Let’s go backwards. To play football, you need to be able to like sprint, cut, and run and jump. Right. Great. You’re limping right now. Just walking. We got to get to there. Great. All right. What’s our criteria to sprint then? Let’s get to that, like all right, well, we need to be able to jog with a one out of 10 pain, or something like that.

Mike Reinold: Great. Okay. What’s our criteria to start jogging? Well, all right. You need good range of motion without pain, you need decent strength, that type of thing. Here’s where you are, here’s our criteria to go through these phases. If you do it with a phase-based approach like that, then I think what you can do too, is you can say, “Look, in my experience, this takes four to six weeks, but I don’t know. Maybe you’re a good healer.” Whenever anybody says that, that’s always the scary … or no, that’s more pain. I have a really high pain tolerance. Those are always the worst.

Mike Reinold: Sometimes people heal at a faster rate. Look, this usually takes four to six weeks, but we’re going to go by the criteria, and here’s your objective measurements that Lenny just took, and I found some issues. Once these go up to here, then we can start this. Then once we do that, we can do that. Is that make sense? I think that’s pretty neat. Lisa, I want to hear from you. I’ve got an interesting thing for you too. As a pretty high level athlete yourself, collegiate and stuff like that in the past, you’ve done a lot of cool things. Maybe you hear it from your perspective as the athlete that then turned into the physical therapist, but I wanted to hear your thoughts in general.

Lisa Russell: Yeah. I’ve been there. It’s how I met Lenny. Rowers generally are this athlete. Generally, people come to me when they’re on the brink of breaking, They come to me because their back is hurting, and their hip is hurting, and their knee is hurting, and they’re scared about their ribs starting to hurt. They have to go down to Princeton to race in a selection. We got to try and make the national team in two weeks, and it’s like, okay, how do I do this?

Lisa Russell: The challenging thing is, typically, they’re not the only athlete involved in the decision of training plans and everything. Typically, people are in a boat with somebody else. It adds just another layer that you can’t just say, “Okay, you need to take a break for X amount of time.” Because then their partner also can’t do the work they need to be doing in that way. Telling a rower to just stop doesn’t happen.

Mike Reinold: I feel like Dave would say that with gymnastics too. It’s not always about stopping, it’s about, okay well, what other things can we work on?

Dan Pope: Yeah. I had the most success with what Dan was talking about. Just talking to the athlete and figuring out, okay, what’s their expectation? What do they want to get back for? Then I usually show them how they’re moving, and point out to them, “Hey, you can’t do X, Y, Z right now, and that causes pain. We need to get these things at least a little bit more under control before you can really be able to accomplish what you want to.” I think one of the hardest things to do as an athlete, when looking for that rowing race day, you’ve trained for years to get to this point.

Dan Pope: I find that it’s best to have the conversation, depending on how much time you have, of like amending their workload, and displacing some of the particular pain causing stresses into other things, and just giving them ways to still feel in control, and to still feel like they’re making progress, whether it’s, you got to spend every night doing this foam rolling, or this mobility drill, or different things to improve their body feel and decrease their pain while you’re trying to figure out what to do with their workload and training plan.

Dan Pope: I definitely, while Dan was talking, I was like, “Yep, that’s a hundred percent the conversation I always have is like, where are you at? What are you trying to accomplish? Let me tell you the things that you’re putting yourself in danger for.” This ultimately is the athlete’s decision, to go and try and race, and do what they need to do, knowing that they’re at risk for injuring themselves, but to the point where they’re going to really be out of it. I always like to give them that power and give them that information to really understand their body, and understand the risks, and to give them some tools to try and fix it, bandaid it, or if you have some time, actually fix it.

Mike Reinold: Yeah. At the end of the day, I think you just said it there at the end a little bit here. We work for them. We’re here to help them achieve their goals, and if they’re like, “No, look, I’ll take the chances. I know I only have a 20% chance of getting back pain free, but I got to play this weekend.” Then all right. Make sure everybody’s on board, the parent, the coach, the athlete, all those things. You do your best. If you’re adamant they can’t play because you think they have a 0% chance, then it’s your ethical right to bring that up. Otherwise it’s, let them help make the decision, but we’re educators, we need to help educate them a little bit with that. That’s good.

Mike Reinold: I think Lisa brought up some good perspectives too from the athlete that they’re letting their team down a little bit. We talked a little bit about this, the mental aspect of injuries, a bunch of episodes ago on the podcast, but yeah, there’s probably some other things going on too. Maybe this timeline doesn’t fit because they have this pressure from the outside. Maybe trying to help them deal with that in those concepts too, or maybe still finding ways that they can make themselves better. Scaduto’s low back hurts when he’s golfing. Well, that’s a little different. He’s just trying to break 90 every weekend. Where somebody training for the Olympics, man, this is it. If you get injured the week before the Olympics, you’re screwed.

Lisa Russell: Luckily, you got a whole another year this time.

Mike Reinold: Yeah, because this year we have five years. It’s a lot different. Mike can just stay at home and put and chip in his basement. Somebody else that’s been preparing for a long time is, we got to be careful. Just be careful we’re not on this high horse, I think, as physical therapists that they can or they can’t do certain things. I think there’s a bit of a spectrum we should consider. Awesome. Great question. Thanks so much for submitting. If you have more questions like that, head to MikeReinold.com, click on that podcast link, and we will keep doing it, either at home or at Champion. If it’s snowing or raining, what’s the post office thing? By-

Mike Scaduto: Rain, sleet, snow, fire, and ice. Something like that.

Mike Reinold: Fire and ice. I think that’s Game of Thrones. You just threw in Game of Thrones somehow.

Lenny Macrina: By land, by sea, or by air.

Mike Scaduto: That’s FedEx, isn’t it?

Mike Reinold: No mailman is delivering your mail if your house is on fire, Mike. They can come back tomorrow when the flames are out. Awesome. Hey, thank you so much, and we will see you on the next episode. Let’s social distance elbow bump.

Mike Scaduto: Boom. Wipe it off now.

Mike Reinold: Boom. Yeah. Then Purell it, and go wash your hands.

How to Build Your Social Media Presence as a Physical Therapy Student

Getting started with social media is a great idea while still in physical therapy school, but there are some good ways and bad ways to do this. Here are our tips to be successful, while staying authentic. To view more episodes, subscribe, and ask your questions, go to mikereinold.com/askmikereinold.

#AskMikeReinold Episode 207: How to Build Your Social Media Presence as a Physical Therapy Student

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Transcript

Mike Reinold: On this episode of the Ask Mike Reinold Show, we talk about some ways that you can start building your social media presence as a physical therapist, or even a new grad.

Mike Reinold: So our question today is from Ben from Maryland. Ben says, excuse me, “What is your recommendation for students who want to build their social media presence with educational content before they graduate? Is there a way to do this safely and ethically?”

Mike Reinold: So, man, I’m sure. The group of us has a decent social media presence that I think we can give you some good advice. I’m going to jump in with the first part of that before you guys go, and then we’ll ask you guys. I’m going to talk about the safety of that. Yes. I think it’s completely safe. I don’t think anyone’s shown that you could catch COVID by posting to Instagram. So I do think you’re completely safe. I don’t think anything’s going to happen to you.

Mike Reinold: No, in all honesty, I think what you asked in terms of the safety question of that, maybe there’s some liability issues, or maybe there’s some things about using some images of people like your patients or something like that. I would say what the safety thing is, is I think most people think social media is not medical advice, right? I have seen some people that have put a disclaimer at the bottom of their Instagram posts. I still haven’t. Right? But I kind of refer everything back to my website. I do have disclaimers there, but I would say right now, don’t let something like that bog you down. If you want, you can always end with a sentence that just says, “This is for entertainment and education and not medical advice,” but I’ll knock out the safety question.

Mike Reinold: But now I want to hear from you guys. What do you think is the best approach for physical therapy students to start their social media presence? Popester, let’s hear it.

Dan Pope: I’ll answer this one. When I actually started doing this, when I was in PT school, and it’s because I just really, really loved physical therapy, fitness, wanted to share what I was learning, and I think it was also additive to my career. So it just really fit well, right? So for a new student that’s similar to where I was at that point, I think it’s a great idea. I think one way you can accomplish a couple of different goals at once is to use your social media as a way to learn yourself, and then share that information to the world. So I think, and this is where I was when I first started making social media, I didn’t want to put the cart before the horse, right? You have someone who’s, I don’t know, like a Mike Reinold of the world, who has a ton of experience, putting out a lot of information. Right?

Dan Pope: And you’re like, how do I put out my own information? I have no experience, right? I’m not even a physical therapist yet. What am I doing here? But you can use that as a learning experience. You can help people by producing, let’s say, social media post that reviews a specific article on a specific niche topic that you like. Let’s say the concussions or something along those lines. You can go through, find what you find is relevant. You’re learning a ton. You’re sharing that information. You’re bringing it to the world. So, you’re not necessarily saying you have all this experience, and this is the right way to do things. You’re providing value. You’re building yourself. You’re building your brand, and you’re helping people around you as well. So that’s kind of how I would go about that.

Mike Reinold: I love it, Dan. I think that’s the best. That’s the best approach right there. And I think we say this all the time, but it’s worth repeating all the time. Our social media presence, our blog posts, our blog presence and all that stuff, I still say to all of us, it is primarily for our benefit. It’s yes, we educate others and stuff like that. But it’s to keep us fresh. It’s to keep our minds growing, right? And there is no doubt in my mind that I am better at my job and what I do because of how much education we do. It just keeps you sharp, right? That’s why you go to a huge conference and presentations, and you see all these speakers, and you think, man, how are these guys on top of all the research? How do they know everything? It’s because they love it. And that’s what they do all the time. It’s for them. They’re cutting edge, because they’re always on top. So I love that. Who else wants to add to that? Mike? What do you got?

Mike Scaduto: Yeah, I would say we obviously have a lot of students that come through Champion as clinical students, and I end up following a lot of them on Instagram, and some of them do put out content while they’re a student. And I think, what’s the one thing that you’re an expert at while you’re a student is being a student. So I’ve had a couple students that put together posts that are aimed at other students. Maybe it’s advice on how to study for the board exam. Maybe it’s how to avoid being stressed as a clinical student, and how to manage your stress over time. So those are things that you’re currently going through. You may not be an expert at rehabbing a post op shoulder right now. So maybe you can put out content about that, but maybe that’s not your expertise. Right now, you’re an expert at being a student, so helping the students around you is kind of a good way to go around it, go about it and putting out content relevant to that.

Mike Reinold: Man, that’s that’s excellent, Mike. I mean, you speak to the target audience that you can relate to, I think is amazing, right? We’ve seen so many students try. We kind of talk. It’s like the proclaim or the fake expertise, right, when you have no clinical experience. Right? So they fake this expertise and try to come across like it’s a definitive post, right? Or when they start a big change the world initiative type thing when they don’t have any clinical experience, right? Those are going to be really challenging if you don’t have enough to kind of go about it, so share your experience with us. I think that’s amazing. Talk to the same group of people that you’re peers with. I love it, Mike. That was good. What else? You guys got anything else? I got a couple things, but Len, what do you say? Anything?

Lenny Macrina: No. I mean, I think what Mike said was great, because I think as you become a PT, you evolve, right? And your blog posts will evolve too. Your blog posts, your social media. And I know Mike had said it, but we say it to students all the time is what you’re learning now, people want to hear about it. Believe it or not. You think it’s useless and wasteful, and maybe you think you’re way behind everybody else, but you’re not, because trust me, there’s a lot of people that are in your similar boat. More than you ever, ever would think. So, if you’re not, like Mike said, you’re not a post op shoulder expert, but what are you reading right now to help you to become that? And then write about it.

Lenny Macrina: And then in two years, you’re writing about what you do to treat a post op shoulder, right? And then in five years, you’re going to look back and be like, whoa, I can’t believe I did that. This is my evolution. This is what I’m doing now. So I think it’s a great way to show, and you can look back and look at your evolution as well, but it’s a great way to show what you are doing to help yourself, and it’s going to help others.

Mike Reinold: Yeah. And be humble. Be humble about it, right? That you are growing, and you are learning. Don’t proclaim false expertise or try to trick people, because people with clinical experience like us, we can see the lack of authenticity. We can see right through it. And I’m telling you, some prominent people on Instagram right now, I look at some of their posts and I’m like, I can’t wait for three years, for them to look back at this post, because yes, it’s like textbook right, but it’s not clinically right. It’s just not what you see in real life. So Lisa, heck, you’ve kind of just started up trying to booster your stuff. What’s your strategy, because I think you’re in a similar situation of building right now. What’s your strategy?

Lisa Russell: Yeah. I mean, I feel like I’m kind of doing sort of a lot of what Dan was saying. I mean, I’ve been doing a lot more research than I usually have time for and learning a lot of more of the actual need for what rowers need in particular to work on injury prevention and the science behind it and not just the, oh, my teammates always have this problem. And I mean, I think it’s exactly what everybody’s been saying. I’ve been kind of going through sort of this process of reading a lot of articles and pulling it together and being like, okay, so based on this chunk of articles, all these people with low back pain, here’s the problem that everybody has. And here’s what we do about it. And it’s been fun for myself to discuss what I’ve found and why it matters and how to relate it to rowing, and then how to relate it to masters rowing and juniors rowing and just everything in between.

Lisa Russell: And I mean, I think the social media side of it has been a lot more challenging than I expected it to be. It’s way more time consuming than any of you all make it seem. At least at this point. So I mean, I think at this point it’s been really valuable for me. I think I’m going to come out of this whole quarantine period way ahead of where I would have been if I hadn’t had the time to do all of this and built the pattern of looking at research more and all that kind of thing. So I think for that reason, it would be interesting as a student to start that pattern, that habit almost.

Mike Reinold: Yeah. And don’t forget Lisa, right? You have a lot of experience with rowers.

Lisa Russell: Yeah.

Mike Reinold: Especially with yourself. You are not just going out there and talking about plantar fasciitis. You’re talking about rowers, something that you have some expertise in. So I think that’s great.

Lisa Russell: Right.

Mike Reinold: Mike, did you have something else? Yeah.

Mike Scaduto: Yeah. This is probably tying back into a previous episode, but I would say probably one of the first things that a future employer does is search you on social media. So just make sure that what you’re putting out there is appropriate. And if you’re putting out information that may be very controversial, that just be prepared to maybe answer questions about that in an interview, and, or, just keep it in mind that people are going to be looking at that, potential employers. And you want to put your best foot forward on social media.

Mike Reinold: Yeah. Be prepared to answer questions about that. If you even get the interview. Because your social media presence can certainly turn people off. So, awesome advice. I think that’s the biggest thing, is share people your experiences. I’ve had this conversation with many students that try to proclaim expertise or have poor authenticity with their posts and stuff like that. It’s be humble. Stick to what you’re good at. And we always talk about this with the evolution of us to become an expert over time. Everyone wants to be an expert next week, right? They want to get it in here, right? But it goes through these phases, right? You have to gain knowledge. You have to gain skill. You have to gain experience, and then you finally get judgment, right? Are you sick of hearing me say these things yet? Right?

Mike Reinold: But those are the four things to do. So you have to figure out which phase you’re in. If you’re a student or a new grad and you just have knowledge, you better not be making posts about skill or judgment, right? Because you don’t have any of that yet. You make it about knowledge, right? So share you just did a lit review on the best special test for rotator cuff tears. You can post that. And you can say, “Here’s some tests,” and tell us what’s the specificity? What’s the sensitivity? Right? Because those are knowledge based things that you are going through at this time. A new article comes out, EMG of the rotator cuff, right? You can make a post, here’s the top three exercises for the superspinatus based on this article. That is a knowledge based post that you’re sharing as you learn.

Mike Reinold: Don’t jump steps and start talking about experience. I always tell this to everybody, but don’t. Again, your call. This is not how I educate. And maybe I’m biased, because the people that email me, no one’s going to yell at me via email. They email me and say they connect to my education style. But my education style is just to share with you what I’m learning and what I’m doing and what I’m currently going through. What I don’t do is spend my whole social media presence telling you what everybody’s doing wrong, right? Because I humbly don’t know any of the answers. Right? I’m just giving you our best guess at what we’re doing right now. And hopefully it can be something to help you.

Mike Reinold: So, hopefully those are some good tips for you to get started with your social media presence. I recommend you do it, right? This is the whole if a tree falls in the forest and nobody’s there, it doesn’t make a sound, right? But that’s okay. That’s fine. There’s a difference between starting this and then building a following. Those are two different conversations, to be honest with you. That’s a whole nother episode, right? Starting it is equally as much for you and your patients as it is for your potential audience down the road. Keep that in mind. It’s still for you, even if nobody’s listening yet, but they’ll get there.

Mike Reinold: So, awesome. So, great question again. Thank you so much, Ben. I hope that helps. If you have a question like that, head to mikereinhold.com. Click on the podcast link. Please go to iTunes and Spotify rate and review. I don’t even know if you can rate and review us on Spotify, but if you can, do it. Otherwise, do it on iTunes. I think that’s helpful. I don’t know why I say that every episode. And we will see you on the next episode. Thanks so much.

Finding a Physical Therapy Job During the COVID-19 Pandemic

With many physical therapy clinics closed due to the coronavirus and COVID-19 pandemic, physical therapy students and new graduations are struggling to find a job. Here are some things you can do to land that job after graduation. To view more episodes, subscribe, and ask your questions, go to mikereinold.com/askmikereinold.

#AskMikeReinold Episode 206: Finding a Physical Therapy Job During the COVID-19 Pandemic

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Show Notes



Transcript

Mike Reinold: The question for today comes from Joe from New York, so good example from Joe being from New York too is definitely one of the hardest hit, if not the hardest hit place in the United States. I’m sure Joe’s kind of feeling it here, but Joe from New York says, “Considering that the COVD pandemic may make it hard for a third-year PT student and new grads to obtain a job due to the increased applicant pool from the amount of lost jobs, what are some suggestions you have to try and stand out during this time? I have a strong interest in sports physical therapy.”

Mike Reinold: Man, oh, Joe, you are not the only one in this boat right now, right? Man, all our students that just kind of graduated or are getting close, I think they’re all struggling to find jobs. I think one found a job, right? Did Trey get a job? I feel like somebody just recently-

Mike Scaduto: Yeah, I think he did.

Mike Reinold: Which is great. So I guess it’s going to depend a lot on your state and stuff and how shut down you are, but I see Joe from New York really struggling here. This is going to be an interesting time, so what advice do we have, guys? Late PT school students, new grads that are entering the field, what do you do right now to try to get a job when jobs are going down? Who wants to start? One at a time.

Mike Scaduto: That’s a tough question. That’s a really tough question.

Lisa Russell: Yeah, it’s very hard.

Lenny Macrina: Yeah, I would say you’re pushing your connections, you’re getting in touch with your CIs that you … Even if you’re not going to work with them and let them keep their ears open if there’s any jobs that open. I would also use the time to better yourself, so whether or not you get some kind of … you take some more con-ed courses. Unfortunately, I think because you weren’t working and you were in school you’re not eligible for unemployment, so you can’t really file to try to create some revenue for yourself, but I think it’s making yourself better somehow and taking the concepts that you learned in PT school and some of the concepts you used to study and you’re using it on friends, family, trying to practice your assessments and get used to that comfort level of interacting with people again. I think just trying to take classes, online stuff, and like I said, just using your connections.

Lenny Macrina: I think that we always say that, right, is, “Use your connections and get to know people.” If not, you’re going to have to start volunteering and shadowing, and hopefully, PTs are going to allow that, but they’re probably not going to want too many bodies in their facility, so I do not envy you guys right now. Because we’ve had people reach out to us asking if we were hiring and we’re not, so you do not have to send me your resume because we are not hiring right now.

Mike Reinold: Yeah. That was good, Len. What do you got, Mike?

Mike Scaduto: Yeah, I think overall, I mean, obviously, the unemployment numbers in the entire nation are pretty bleak right now. Right? We just hit a high since the Great Depression in unemployment, so everyone’s kind of struggling to find a job in all different industries. A lot of people are out of work right now. I actually was looking at some statistics just before this episode, prepped a little bit for the question, but PT was projected to grow by 22%, PT jobs, from 2018 to 2028. So I would be hopeful that we are going to make a return and we are going to get back towards that projection of growing by that amount, but it may take a couple years after this. This could’ve set us back like, I don’t know, a couple years. I won’t put a number on it.

Mike Scaduto: So I would be hopeful that you will find a job in the type of clinic that you want to work in, but you got to set yourself up for success when that opportunity arises so that you are a good candidate. That kind of goes back to what Lenny was saying. I think maybe being a little patient and just preparing yourself for the future, but I would be hopeful and I wouldn’t lose all hope in the entire profession.

Lenny Macrina: It’s very scary, right? Because, I mean, in theory, your loans are going to kick in, what, six months after you graduate. I know the government will probably … Well, hopefully. Not probably, hopefully, do the right thing and give you a little bit more leeway. Right? I think they already have with current loans, so people that are graduating that weren’t in a loan situation have loans kicking in, I think it’s, what? Six months right after you graduate you’ve got to start paying them. I mean, everybody’s in the same situation. Mike and I, we’ve had a gazillion conversations about our businesses.

Lenny Macrina: Everybody is in the same situation, right? It’s not just you, so it’s not like they’re going to put 30 million people that are not working plus all the new grads and just kick them out in the street and say, “You owe us money even though you don’t have money.” There’s no way they can do that, right? The government is doing what they think they can do by giving stipends to people, and helping with loans, and even rent. You don’t have to pay. Some states you don’t have to pay your rent and there’s no penalty right now. You have to pay it eventually, but you can delay things, so I think they’re going to keep delaying stuff because this is an unprecedented time.

Lenny Macrina: Like Mike said, this is comparable to the Great Depression in the 19, whatever, ’30s, so don’t freak-

Mike Scaduto: In terms of job loss, yeah.

Lenny Macrina: Yeah, don’t freak out somehow. Even though we still freak out because our businesses, we’re a fraction of what we normally do, and just try to separate yourself. Try to be different than all the grads that are coming out somehow by practicing and learning your skills and just be ready for that time because it’s going to come. Right? The economy’s going to come back at some point, so be ready.

Mike Reinold: Nice. Dan, Lisa, you guys got anything to add?

Lisa Russell: Yeah, I mean-

Dan Pope: Lisa, you want to go?

Lisa Russell: Yeah, I feel like it’s a matter of what you’re looking for. Right? If you’re just anxious to start on the job market and you just want to get out there and use parts of what you learned I feel like you just can’t be picky. You might end up in a setting that you aren’t looking to go to. You might not get into that sports clinic right away. You might have to start in a hospital, but that doesn’t mean you aren’t gaining really important skills that you can then use later in whatever sports clinic and whatever.

Lisa Russell: I feel like no matter what the first few years out of school it’s like learning how to interact with people, and how to listen to people, and how to just be a PT. It doesn’t super matter what setting you’re in because there’s a lot to learn in just doing it, so I think it’s a matter of what your priority is. If you’re just stubborn and you want to be like, “Yes, I’m a sports PT and that’s all I’m ever going to do,” you’re probably going to be stuck home for a while.

Mike Reinold: Right because there’s no sports.

Lisa Russell: Or make a lot of …

Lisa Russell: There’s no sports happening anyway.

Lenny Macrina: Yeah. I always-

Lisa Russell: Maybe take a telehealth continuing ed. I don’t know. But …

Lenny Macrina: My first job was acute care. I was an acute care PT in Durham, North Carolina for like a year before I got a sports job or outpatient job, so, I mean, you do what you do, right?

Lisa Russell: Yeah.

Lenny Macrina: This was in 2003, so-

Mike Reinold: I saved Lenny. I remember calling him and being like, “Hey, we have some openings in [inaudible 00:08:02] and you were like, “Man, I like North Carolina.” I’m like, “Do you? Do you? I mean, you like acute care that much?”

Lenny Macrina: No.

Mike Reinold: Pope, what do you think? Anything? I mean, honestly, so this is … I’m kind of liking the Zoom thing. I’m taking notes. This is a great answer. This is really good. Dan, you got anything to add to that? I mean, that was wisdom right there.

Dan Pope: Well, I do think there’s some weird opportunities in a time like this. I think it’s very obvious just to say, “Man, this stinks. I’m not going to be able to get a job. No one’s going to be able to get a job,” and a lot of that’s very true. But what I will say is that I know some people in some industries that are similar to us … I mean, I’m big time in the fitness industry, but a lot of personal trainers that were full-time personal trainers obviously can’t train anymore. Some of them started their own online businesses now and they’re doing well and they’re thinking about not going back. You know?

Dan Pope: So what I will say is that, I mean, if you’re in any sort of position as I am that really enjoys fitness and if you can maybe embrace the telehealth, I don’t know how that works from an insurance perspective, what’s going to happen in the future, you may find the opportunity to do some part-time work, kind of start up your own business, that type of thing. If nothing else, it’s a really good time to start branding yourself. If you want to be a niche practitioner, if you like the out-of-network cash-based thing, it might be a good idea to maybe start your own website, kind of figure out what you’re looking for from a professional perspective, and continue networking. Maybe not just networking with physical therapists but maybe with coaches, trainers, whatever other specific niche or sport you want to get involved in. Just keeping those open and then being open-minded because you may find a funky opportunity presents itself and you like it and you go for it. It takes you in a better place than maybe you would be otherwise.

Mike Reinold: Awesome. Again, awesome. This is turning out to be a fantastic episode because I think there’s a lot of good wisdom here that probably applies to new grads in general, right? But, obviously, in this situation, I think it’s the need to really stand out because of the competition has really escalated. That has really kind of risen to the top, so, heck, I literally have nothing to add, which is fantastic. But I’m going to summarize a little bit here because, like I said, I took notes and I think this was fantastic. I think if you kind of put it all together it’s amazing.

Mike Reinold: So if you’re looking for a job it sounds like we recommend you do this. Connections. Connections first. Lenny started with that. I thought that was awesome. We call it shaking the tree sometimes. Just shake the tree a little bit, see what falls down, send a text out to everybody you know. Emails, Facebook posts. Now is not the time to be worried about your ego. Just say like, “Hey, looking for a job.” Shake that tree. Get as many connections as you can.

Mike Reinold: But as Lisa kind of said, probably now not the time to be picky. Right? You probably need to be willing to go and do something else and make the best out of it. Lisa said that really well. Make the best out of it because there’s tons of learning you can do from all the different fields that you can apply to sports. You know what I call it? I always say this, and I think as a physical therapy student you guys are in a very unique situation right now, I call it your plan A, your plan B, and your plan Z. We talk about this all the time.

Mike Reinold: Your plan A is to work in a sports PT place, right? But you got to plan for everything. Plan B, okay, acute care, home health, I don’t know what it is. Plan Z is probably home health we’ll say, especially in the COVID situation, right? But your Plan B, working in a hospital system, is not bad. That’s not a bad plan, right? There’s really not a terrible situation if your plan Z is just doing some home health. It’s health. It’s really not that bad of a situation, so you’ve got plenty of things you can do.

Mike Reinold: I think Lenny said this here. Volunteer if you can. Right? Go to the clinic that you want that doesn’t have an opening just in your spare time, if you have it, go clean tables. Go put on a mask and gloves and clean tables and be a resource for them so that way they know it’s a no-brainer to hire you afterwards. But, again, probably more than anything else is take this time to better yourself, right? Because a lot of your co-students and your co-graduates are probably just sitting around with their hands, right? They’re sitting around on their hands not doing much, right? But if you can just get as much con-ed in and you can stay in touch with the local clinics around you and say, “I’m dying to get in. Let me know. In the meantime, here’s my plan to be ready for you. I’m going to go through this, this, and this, and it’s going to be amazing.”

Mike Reinold: I think that’ll put yourself in a great position to succeed, right? You’re setting yourself up for success and focusing on bettering yourself. The worst thing you can do is come out of this neutral. Somehow come out of this ahead and I think that’s the only thing you can focus on right now. Right? Make sense?

Mike Reinold: Awesome episode. Great input from everybody in a really timely topic that I think hits home to all of us here because we feel for you. Trust us, we’re all employed here, right? But we’re employed with no patients. Right? Remember this, this is healthcare. Right? There’s going to be a need for healthcare when things open up. It’s not going to go away. Right? Just like Mike said with the statistics, this will open back up and you will get opportunities because it’s healthcare. Right? It’s not like you’re a student for a cruise management system or a cruise management company, right? It’s not like you’re trying to work for Carnival or Norwegian right now, right? There will be PT jobs in a couple of months when things open, so hang in there. Right?

Mike Reinold: Does that make sense? How’s that for a good ending, which is good? I wonder what are attrition rates are over the episode are too? How many people actually catch my last sentence, but keep that in mind we are not-

Mike Scaduto: Hopefully, not the CEO of Norwegian.

Mike Reinold: Right, exactly, but I think when things open up and elective surgeries start coming back this I going to kind of filter itself out a little bit for PT. Great question. Thank you so much, Joe. Good luck to you and the rest of your class and fellow new grads out there. This is a tough time. If you have a question like that, head to mikereinold.com, click on the podcast link, and fill out the form to ask us something. Hopefully, we’ll get to it in a future episode. Thanks again. We’ll see you on the next episode.

Reopening Your Physical Therapy Practice or Gym After COVID-19

On this episode of the Ask Mike Reinold show, we talk about the 5-step system that we are following at Champion to prepare to safely re-open our physical therapy clinic and gym during the COVID-19 pandemic. To view more episodes, subscribe, and ask your questions, go to mikereinold.com/askmikereinold.

#AskMikeReinold Episode 205: Reopening Your Physical Therapy Practice or Gym After COVID-19

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Transcript

Mike Reinold: On this episode of the Ask Mike Reinold show, we talk about our systemized approach to how we are going to handle the re-opening of our physical therapy clinic and gym from the COVID pandemic, and a bunch of tips on what you can do as well.

Mike Reinold: We have a nice question today that’s probably going to be timely for a lot of people. I know it’s certainly going to be timely for us in Massachusetts at Champion, but our question today comes from Lisa, from Indianapolis.

Mike Reinold: And I wonder what her situation is, but she asked, what should practices be doing now to prepare to re-open after the COVID shutdown? And it’s a great question. I love to answer to this from the physical therapy perspective, maybe we’ll throw in some pearls from fitness here and there, but yeah, what can people be doing now? We’re shut down. That’s the scenario. And we’re going to get ready. Hopefully our government, I know in the state of Massachusetts, we’re talking about some guidelines. Hopefully we’re going to get plenty of heads up on some of the restrictions that we’re going to have to follow. But that’s what you have to follow. I think there’s a bunch of other things we can do to best prepare as well. So who wants to start this one?

Lenny Macrina: I guess I will. Because you and I have been talking multiple times a day, trying to figure this out. We are scouring the web. We are trying to read what states around us are implementing. We are way behind on this stage because our situation in Massachusetts has been so bad. So we kind of follow New York, New Jersey, but New Hampshire and Rhode Island and Connecticut are opening. And so we’re trying to see what their government is doing and then seeing how it can affect us. So with that, I would say, look around at states in your area, states that have similar caseloads of viruses and try to figure out how it can apply to you. With that, it looks like masks, some kind of face covering is going to be critical. So your staff is going to have to wear them.

Lenny Macrina: You’re going to have to have new practices in place in your facility where people coming in are going to have to wear something. You’re going to have to have hand sanitizer, clean hands all the time, a ton of soap. You’re going to have to maybe consider taking temperatures. I think airlines are doing that right now. So we have purchased some infrared thermometers that are arriving soon. So we’re going to try to monitor people, try to monitor their symptoms. You may have to update your paperwork. So now people may become…

Lenny Macrina: Yeah, there you go. Perfect. You are a human, you are the average human temperature. Although I thought they increased the temperature of the human, is now a little higher now, but I don’t know. So we’re using CDC guidelines and what airlines are using too. I think it’s 100.4 is considered a critical number, but you do your own research.

Lenny Macrina: What was I talking about? Oh, we’re talking infrared thermometers. So you’ve got to monitor that, monitor their symptoms, you’re going to have to monitor your staff and how they feel and you have enough supplies for them. What happens if somebody gets sick? What are the implications if a client gets sick, if a staff member gets sick? You’re going to have to be cleaning. Do you shut down? You’re going to be planning for that. So there’s so many different things that you’re going to have to really consider. That’s just the tip of the iceberg. I got off my train of thought.

Mike Reinold: I hope you’re taking notes Len, because we’re going to have to do all those things ourselves. So I know that was a big brainstorm session, which was probably pretty helpful. But, yeah, Lenny brought up a lot of points. I think a lot of them are going to be regulation based. So I think one of the first things you need to decide right now if you’re trying to open up a place, is your level of comfort with the minimum regulations. So say for example, you’re in a state that says masks are optional. I think you need to then consider yourself, that what do you think is comfortable? I think it’s completely okay for you to require a mask if you want to. So at Champion, where our physical therapy is open pretty restricted now, but we’re open a little bit.

Mike Reinold: And in the state of Massachusetts it’s recommended, or it was at the time a little bit, I think it’s not now, but it was recommended you wear a mask, but you didn’t have to, which it super vague. So we just required it because we thought it was the right thing to do. So be prepared to be looking up your state regulations, and Lenny kind of said this right here, is look at your surrounding states, because I know in New England, they formed a pact because if you’re Mass and Rhode Island and New Hampshire, and you’re those states, you’re all different recommendations, we all live within a half hour of all those states. So people are going to be bouncing around and it’s going to be super confusing.

Mike Reinold: So look at your surrounding states to start getting some heads up on the regulations and then decide if you’re comfortable with that, or if you want to make your regular regulations even tighter. So I like that. What else, anybody else have anything for this? I know this is kind of a business question and Lenny and I have been doing it. And heck if you guys have comments as employees, like what you want to see employers and stuff doing and stuff, let us know too. But Dan, what do you got?

Dan Pope: I know we’re maybe a little bit different situation because we’re out of network providers, but I think it would also be important for in network as well, is that you probably want to make sure, if you haven’t been doing this already, checking in with your patients, checking in with maybe some of your referral sources, how the surgeon’s doing, what’s going on in terms of you guys seeing more patients eventually just to make sure that when you open the doors, you actually have hopefully some business. You’re not just prepared against COVID, you’re also able to make some income, I guess is the ultimate goal. Yeah.

Mike Reinold: That’s great, Dan. And you should be using this opportunity to stay in touch with people, to see how you can help. We’re a service based industry. You got to kind of keep that in mind here. And remember this, there’s going to be two things that your referral sources and your patients are going to want to see. One is, are you open or not? That’s it. That one’s pretty easy, but this is healthcare. They have issues, they need to come in. Are you open or not? That’s easy. But what they really want, they want to see that you have a plan in place that they are going to be safe in your facility. And that you’re going to have to figure out a way to articulate that to both your referral sources and your potential patients, both new and returning. So that’s one of the big things you should be preparing for now is how can I get this message across that you can be comfortable at our facility when we’re allowed to open again? I think that’s huge. So Mike, did you have some tips?

Mike Scaduto: Yeah, I was just going to go along those same lines. I think there is going to be some level of anxiety from the patient’s perspective, going back into a healthcare setting, whether it’s an outpatient physical therapy clinic or just a regular doctor’s office. So I think you have to have policies in place that are clear and be able to articulate that to the patient, to put them at ease and then follow through with those policies when you’re there. And sometimes it can be a little bit difficult and you have to be strict with the policies. And I think that’s in everyone’s best interest and it’s in the company’s best interest in the long run. So, having policies, communicating them to the patient effectively, communicating them to the other employees effectively. And I think that’s something that Champion did a really good job throughout, was the communication aspect of what’s changing and what’s still unknown, I guess. So you can still have some questions, but you’re working to address those.

Mike Reinold: Yeah. And remember we’re a service based industry. You got to have a little empathy here with these people here. And everybody’s in a different situation. If you’re one of those people that think this is all fake and nobody’s going to really get sick and stuff like that, you better not be articulating that to anybody because your clients probably think the opposite. So you got to be really careful. And like Mike said, this is the time to be harsh.

Mike Reinold: Two scenarios again, we haven’t talked about this yet. We’ll assume this is us talking about it right now Mike. So we have one scenario, one of my patients, we got the mask situation, and just I’m in the room, I’m working on one person, they’re super conscious of this and already a little skiddish being there, and a patient just walks in and walks right by us, like two feet by us, and just walks in, no mask or anything like that. I’m like, “Hey, you got a mask?” And he’s like, “Oh yeah, yeah, yeah, no, I got it right here.” I’m like, “Okay, well, are you going to use it?” And so, we kind of chewed him out a little bit.

Mike Scaduto: Yeah. And I think that’s appropriate to do. I think definitely remind people of the policies. I will say that potentially people don’t read signs that are on the door. So, even if you text them beforehand, it may be a good idea to remind them as soon as they get there. Yeah. It’s a tough situation because people maybe breeze through the signs and stuff that are on the door. And I guess it’s up to the clinic to enforce the policy at that point.

Mike Reinold: Yeah. But hopefully you tell them once and if you make it stern or strict enough. Like that, for example, that patient’s been completely fine. Now, on the other hand, I had a similar situation with a PT student that will be nameless. We only have one right now. But he did the same thing. He walked right in and he didn’t have his mask on. It was in his backpack. So I was just like, “Hey, you going to put your mask on?” He’s like, “Oh yeah, yeah, yeah.” I’m like, “Ah.” Especially as a PT, it’s not your first day, no excuse, you got to be careful. So we’re going to be in that. So, this is the first time we’ve talked about that. I was going to slack you that Mike, sorry. But yeah, it’s okay to be snark. So, all right, I’m going to let you in on Champions five step system for reopening. Ready? This is how I think. But we’re doing five things to prepare.

Mike Reinold: One, we’re preparing our facility. And that’s the big thing. Do you have cleaning supplies? Do you have appropriate spacing? Do you have everything you need to be able to start business? When this first happened, we had a staff meeting. We were still in person because it was just so brand new, but one of the first things we said, Lenny and I were talking about it to the staff, and we said, “Hey, if this is like a zombie apocalypse, in a zombie apocalypse the number one resource is probably going to be food. Well, we’re in a pandemic, a health pandemic right now. Our number one resource right now is cleaning supplies. If Champion runs out of cleaning supplies, we’re going to starve. And then we have to close.” If we don’t have hand sanitizer, we don’t have cleaning supplies, we have to close, because then we can’t conduct our business. So prepare your facility and get that stuff ahead of time. If you haven’t done it now, it’s probably too late and good luck. But prepare your facility. That’s number one.

Mike Reinold: Two, prepare your systems. So what is your cleaning system? What is your inventory system? What is your staff check-in system? Where they come in, we’re going to answer three questions. Do you have a fever? Do you feel ill? Were you around anybody that feels ill or has COVID? It’s got to be no, no, no, temperature check, sign, you get to work today. Those sorts of things. Prepare your systems with clients. Same thing, prepare updates to your professional liability waivers that you’re going to have. Because we’re going to now have to include viruses and pandemics to our liabilities. We’ve never had to do that before. So prepare your facility, prepare your systems.

Mike Reinold: Three, prepare your staff. Don’t assume that your staff knows that A, the patient needs to come in with a mask, and B, that they have the power to yell at them if they didn’t wear the mask like we were just kind of saying. Prepare your staff on the protocols, the cleaning system. Everything you need to know so that we are top notch. We have to convince the outside world that you’re going to be safe in our facility.

Mike Reinold: Four then comes up to that, prepare your clients now, your patients. So that’s sending out emails, sending info out to your referral sources. Here is how we’re going to assure your safety. That’s an important one.

Mike Reinold: And then lastly, this is the curve ball, prepare to act quickly when things change. And I know Lenny and I have learned several lessons in the last few months that we will definitely do differently next pandemic. Hopefully that never happens. But we’ve learned a lot and you have to prepare to act quickly. Okay.

Mike Reinold: So that’s our five step system to prepare for this. And trust me, there’s a lot that goes into each one. But hopefully that all makes sense. Mike, did you wave, did you have a little something?

Mike Scaduto: Five steps.

Mike Reinold: Five steps. That’s our five step Champion, COVID, reopening activation plan, systemized fashion system.

Dan Pope: So, a lead magnet. That’s awesome.

Mike Reinold: I know. Do I always think lead magnets? I always think blog post headlines, but…

Dan Pope: Got to sign up.

Mike Reinold: That’s how I think, we’re doing a free webinar tomorrow. That’s just how I think. I’m very systems mindset based thing. But if you do that, you cover all your bases. So, Joe, no that’s not Joe, that’s Lindsay. Lindsay, I hope Indianapolis isn’t as bad as Boston, but hopefully you do the right thing and you introduce this well. And hopefully some of these tips can be applied really to anybody, both fitness, physical therapy, I mean all the same stuff for the gym too. So great question. Thank you so much. Everyone be safe. Thank you so much during this time, to continue to listen. Be sure to rate or review us on iTunes, Spotify. Head to our website, ask us more questions and we will see you on the next episode. Thank you so much.

Special Episode on Golf Rehabilitation and Performance

On this episode of the #AskMikeReinold show we are joined by our friends at Pure Drive Golf in Boston to talk about golf injuries, performance, the body-swing connection, and collaborating with PGA pros and swing coaches. Adam Kolloff, Pat Bigelow, and Zack Morton join us for a great episode. To view more episodes, subscribe, and ask your questions, go to mikereinold.com/askmikereinold.

#AskMikeReinold Episode 204: Special Episode on Golf Rehabilitation and Performance

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Show Notes


Transcript

Mike Reinold: On this episode of the Ask Mike Reinold show, we have a special episode on Golf Rehab and Performance. We’re joined by our friends at Pure Drive Golf up in Boston: Adam Kolloff, Pat Bigelow, Zack Morton they’re joining us to talk about how to optimize your body, how to optimize your swing, and even how to optimize your equipment and really collaborating together as a team to get the most out of golf.

Mike Reinold: Welcome back everybody to the latest episode of the Ask Mike Reinold show. I am up in Boston, not at Champion PT and Performance, we are still social distancing, and trying to get through the current COVID situation up here in Boston. So we are coming to you from our homes now. I’m joined as usual from Champions, Lenny Macrina-

Lenny Macrina: What’s up everyone?

Mike Reinold: … I’m not sure how it’s going to look, this is like the Brady Bunch. And Mike Scaduto down at the bottom.

Mike Reinold: But, more importantly, because we’re doing these distance-type podcasts now, I thought it’d be really cool, we have a lot of really smart friends that we know that could really help give value to some of the people that listen to this podcast. So we’ve invited our very good friends, the teaching pros from Pure Drive Golf up in Woburn, Massachusetts, which is just outside Boston, just like we are. But these are the guys that do it all.

Mike Reinold: So down on the bottom there we have Adam Kolloff, he’s the founder, the owner, he’s Massachusetts PGA Teacher of the Year, former New York Teacher of the Year, he’s a Golf Digest top pro, just one of the gurus out there. So Adam’s here, teaching us some good stuff. Pat Bigelow, over on, I think he’s on there on everybody’s, I don’t know what’s-

Pat Bigelow: What’s up?

Mike Reinold: … recording. Pat’s over there. Pat as well, another PGA teaching pro, works at Pure Drive with Adam, obviously works in the summer with a bunch of great pros at his course as well in the area. And then Zack Morton down below, Zack is here joining us as well. Zack again another PGA pro, working with Adam at Pure Drive, and specifically is their club fitter. Does a lot more than that, but obviously has a lot of good experience with helping people with their equipment and stuff like that.

Mike Reinold: So, we thought we’d do this really cool episode on golf, and golf rehab and golf performance, but coming from a perspective of collaborating with this huge, multi-disciplinary approach.

Mike Reinold: So I thought we’d get started. Welcome, thank you everybody.

Lenny Macrina: Great to be here.

Pat Bigelow: Thanks for having us Mike.

Mike Reinold: So why don’t we start with this. Because we have a combination of rehab, performance and swing on this podcast episode, why don’t we start with you Mike? Mike’s our golf rehab specialist at Champion, tell us a little bit about the concept of the body-swing connection, and how that is the guiding principle behind everything we do together.

Mike Scaduto: Yeah, absolutely. I think that’s a huge concept in looking at it from the 1,000 foot view, the general overview, body-swing connection is really a reflection of how your body moves, and how that manifests itself in your golf swing. So the first thing I tell a golfer when they come in to work with me at Champion, is your golf swing is a reflection of how your body moves. So if you tend to be stiff, and you have limited range of motion, your golf swing is going to reflect that. You probably have a shorter swing. Or you’re going to create compensations elsewhere to generate the movement that you want, that can lead to decrease in performance or decrease in efficiency.

Mike Scaduto: So from my perspective, I’m very concerned with the movement that that person’s able to display. There’s certain things that I’m looking for you to be able to do, and that lies on a spectrum. I’m not looking for the exact range of motion of thoracic rotation for every single golfer and if you don’t have that you’re doomed, we can always work with you but it’s going to guide my advice to you from a movement perspective. It’s going to guide the collaboration that I have with your golf coach, based on the result of your physical movement screen.

Mike Reinold: Got it. So hugely important, obviously, understanding how the body is involved with what you can and can’t do with the swing. So Adam, how about from your perspective, from the swing coach, the teaching professional. What does the body-swing connection mean to you, and how does that input what you do with your athletes that you work with?

Adam Kolloff: Yeah, it’s huge. This is coming to light more recently, I would say in the last few years people are starting to get more aware of it, which is great. I went to TPI seminar several years ago, and that was pretty eye-opening to me to understand more about the body-swing connection. Because I’ve been teaching for many, many years, and I never really realized.

Adam Kolloff: I’ll give you an example. I would teach people and I felt like I couldn’t get them into these positions, and I was always wondering, “Okay, is it a drill, or is it something I’m missing here, I can’t get them into these positions?” But now, understanding more about the body, I realize no, these people are limited. They physically can’t do certain things in a golf swing. So lately, past few years, I love connecting with other fitness trainers like Mike who understand about the body. And when I work with students, I can tell them, “Hey listen, I can help you as much as I can help you, but you also need to work with a trainer, because I can take you only so far, but if you work with a guy like, Mike he can help. And then we can push you along and accelerate the learning process.”

Adam Kolloff: So I think it’s huge. It’s a huge thing in my teaching.

Mike Reinold: Yeah, it’s hard to think that people always want a quick fix for their golf swing. They always want to come in and say give me a couple drills, but they don’t realize that there’s often a reason why their swing looks the way it looks.

Adam Kolloff: Sure.

Mike Reinold: So from a teaching professional perspective, how do you guys approach that? So when you’re looking at somebody’s swing analysis, and you want to improve something, just something generalized, not something specific. Do you usually attack it real quick with maybe like, “Hey, let’s work on educating you on what you’re supposed to be in, what position you’re supposed to be in and some drills to groove that?” When do you shift folks like, “Hey wait, I wonder if this is a body limitation?” How does that trigger in your guys’ head? I don’t know who wants to start, maybe Pat? I don’t know, Pat seems to have more swing faults than all of us, so maybe, just kidding.

Pat Bigelow: Totally. I can relate to all these issues. I think the information net, and I think Adam alluded to that perfectly with TPI coming out the last couple years. So players now have the ability to access all this different information. Different stretches, different drills, and it’s been great to meet you guys, where I’ve had students who are in their 60s and 70s and have limitations. They can’t turn a certain way, they have limited flexibility in their hips. And sending them to Mike, and seeing them come back two weeks later being like, “Wow, I can actually make this move now and not be sore, not have it feel uncomfortable.”

Pat Bigelow: Obviously the more reps the player is doing, the better it’s going to be, but now there’s different ways to attack it, where before, from a golf standpoint, we might not be able to get that player to ever do that move. But if we send them to Mike, or to Lenny or you guys, now they can actually start to make that correct change.

Mike Reinold: Right. It really speaks to the power of collaborating, right?

Pat Bigelow: Totally, totally.

Mike Reinold: We’re guilty all the time, as the PTs, I don’t know if you guys are in your profession, but we love to try to step over the line sometimes, and then try to look at somebody’s swing, or do something like that-

Pat Bigelow: Totally.

Mike Reinold: … where that’s never our philosophy at Champion. We’re always very specific to say, “You need to work with a swing coach and we’ll collaborate.” Mike, what’s up?

Mike Scaduto: Yeah, I think just going on that, I think my role as a golf performance specialist from the movement side of things, I understand movement. So my goal is to create context for feelings that you should have in the golf swing, my goal is not to create drills that mimic the golf swing. So a lot of the drills that I have golfers to look pretty basic, but they’re working on key areas that that person’s limited in. But we’re not trying to re-create the golf swing with a lot of our drills. There may be some that look similar to the golf swing, and I find myself telling the person I’m working with, “Look, this is a drill to create a feeling for you, that feeling may help in your lesson, this may be part of the feeling that your swing coach or Adam, Pat, Zack are trying to work with you on, but we’re not trying to swing a golf club right now. We’re breaking things down into its components from a movement perspective, and then building them back up.”

Mike Scaduto: So maybe that includes eliminating joints from the equation, so instead of being in a standing position, we have people go to kneeling. Sometimes that’s easier for people to learn pelvic rotation, and disassociation of the body. And then we build them back up, and I think that is my role, is create that context, and then let Adam groove the swing, and really teach that person how to swing a golf club.

Mike Reinold: Yeah we all have the same goal, right? We’re trying to help the person in front of us, so our clients, our students, our patients, whatever they may be in our world, we’re all trying to help them achieve their goal and probably get better at golf. So it’s an interesting way to do it, and it just shows you the power of collaboration that I think is so important.

Mike Reinold: All right. Let’s do this. Let’s give some examples of this stuff. So Lenny, Mike, we’ll talk this way first. What are some of the top impairments that you tend to see in the people that come and work with you that are trying to golf, but they’re struggling a little bit. Not specifically injuries or something like that, that’s a whole big topic. But what are some of the impairments that you tend to see?

Lenny Macrina: I can start, and go pretty basic, Mike can dive deeper, he’s the specialist in this. But obviously the thoracic spine is the biggest one we see in most people. That’s going to be, right exactly, me too. So everybody, we sit a lot, we get tight in our mid-back, back gets tight for some reason, and then it’s up to us.

Lenny Macrina: The thoracic spine, for those who don’t 100% understand, it helps with rotation of your upper body. So a big portion of the golf swing is getting that turn, so you can only have so much rotation in your thoracic spine before other segments need to kick in and assist with the rest of that rotation. But if you’re limited in your thoracic spine, so that mid portion of your back, then the motion’s going to try to come from somewhere else that may not necessarily have the motion, but you’re going to force that motion. Which means that joint, maybe your low back, or your hips, or somewhere else may begin to break down. It’s not ready for the motion you’re trying to give it.

Lenny Macrina: And I’m a prime example. So I get lessons from Adam, full disclosure, and he’s really helped my game. And I struggle with thoracic rotation. I’m relatively loose jointed, but there’s certain areas of my body that are not used to the swing that I think I need, and I know I have the potential because I have that underlying joint laxity. To me, I think it’s a product of just being not strong enough, and my joints now have become a little tighter than they’re supposed to be.

Lenny Macrina: I’ve actually made a conscious effort to work out a bit more, and work on some of the mobility drills that Mike has mentioned and Adam have mentioned, and I definitely see a difference in my swing, a feel in my swing. So for me that thoracic spine is that top one that we go after.

Mike Reinold: Nice.

Lenny Macrina: And I know there are others too.

Mike Reinold: The concept of relative stiffness I think really jumps out at us right there. The concept of an area being stiff, and the other areas around it having to make up for it, I think that’s fantastic. What else, Mike, what other impairments do we see?

Mike Scaduto: Yeah, absolutely. I think thoracic spine is definitely a huge one, being able to turn through our upper thorax. Disassociating our upper and lower half is another big one. And that’s almost a little bit different, gets into motor control. But I think big one thoracic spine rotational mobility, hip rotational mobility, and core and pelvic control. And I’d put that more into a motor control category.

Mike Scaduto: I’ve actually had the pleasure of evaluating, in person, Pat, Zack and Adam, and I think they’re actually a good example of different movement capabilities. So Pat is tall and lanky, and looks like he should be someone who’s loosey goosey. But he’s actually really stiff, you’re a stiff guy, right? You have a stiff thoracic spine, stiff hips-

Pat Bigelow: Big time.

Mike Scaduto: … and stiff shoulders. So the big focus of Pat’s program is going to be mobility, getting him able to extend through his thoracic spine, get him able to turn a little bit more. And then we layer things on top of that.

Mike Scaduto: But if you look at Zack, Zack has really good mobility, but he was, I don’t want to be vulgar, but kind of a motor moron when it came to controlling his hips and his pelvis. So he had a lot of difficulty disassociating his upper and lower half at baseline. So a lot of our focus for him was creating context for that type feel, and building awareness of how he’s moving his body in space, and then laying some power development on top of that that reinforces that.

Mike Scaduto: And then Adam has a flawless golf swing, sent from heaven, so not much to work on there I guess.

Mike Reinold: Nice.

Mike Reinold: Is it nature, or nurture, how old were you Adam when you started golfing?

Adam Kolloff: 12 years old was when I really started playing all the time. I’d always play with my father here and there, he cut down a club for me when I was five, six years old. But I was never really into it. He wasn’t one of those helicopter parents, but he’s taking me to tournaments, watching me hit balls at the range, telling me what to do. So I didn’t really start till 12, but when I started I was playing all the time. So I got involved real early, just loved the game. I didn’t get a ton of instruction, but I was an athlete, I was doing a lot of other sports. Soccer, basketball, baseball, so I developed some good fundamentals in that sense.

Adam Kolloff: And then I just want to go on with what Mike and Lenny were saying. When I first work with somebody, I’m always asking them questions at the beginning like, “Hey, do you have any injuries?” That’s one of the questions I’ll ask, and I’ll sometimes get answers, and sometimes they won’t say anything. Because they don’t really realize how important it is for me to realize if they have any injuries.

Adam Kolloff: And then I’ll go into the lesson, I’ll start working on some things, and I’ll try to get them into a position, let’s say it’s in the backswing, with this right arm position. And we’re trying to set the club at the top. And then all of a sudden they tell me, “Oh, I’ve had shoulder surgery there.” And I’m like, “All right, well you should have told me this, because now I’m going to have to take this lesson in a totally different direction.” So that’s an example of something I see.

Pat Bigelow: I just wanted to follow up with what Adam said. One of the things I’ve learned from him is what he talked about, pre-interview of the lesson and getting as much information about the student as possible. Background in sports, injuries, because this all relates to the swing. And I think the more information that we can get, the better we’re going to be able to help our students. Even post-lessons, feelings that work for them…

Pat Bigelow: So yeah, and I think that’s one of the great things you guys do at Champion as well, is when I sat down with Mike and went for my TPI screen, a lot of it was just him and I talking. Granted we were doing a lot of moves, and giving me the TPI screen, but a lot of it was just questions and him getting information from me. And I think the more information that we can get from our students, their background, deficiencies they have in their body, the better we’re going to be able to help them.

Mike Reinold: Yeah, I think that’s a great way of saying it. Adam, tell us a little bit about what you’ve been doing with Zack, and Zack in particular with his swing mechanics, and how you collaborated with Mike on that, because I think that’s a good example for the listeners here to see how you’re collaborating with someone.

Adam Kolloff: Yeah, for sure. So I’d say this is more rare than other cases, usually I’m working with people who are tight at thoracic spine like Lenny was saying. So with Zack, what I was working on was trying to feel like his shoulder turn and his arm swing were more connected. I don’t know if you could, sorry I got a phone call there.

Adam Kolloff: So he’s trying to feel more connected with his turn and his arm. Because what would happen is he would turn, about 90 degrees, even a little bit further, but his arm would just continue going back, and he couldn’t really stop it. I think it’s related to his shoulder mobility, so it was hard for him to stop his arm swing. As soon his shoulders turned, it would stop. So we were trying to get that synced up, and for him he had to feel like the swing was only going to hip height.

Adam Kolloff: So that was one of the keys that we worked on. I’d also just hold something under his arms, around shoulder height, so if he went back and he hit it, he’d be going too far back. And there’s other ways I was working on him, like a little more width in his right arm. If his right arm starts to fold more, then it’s going to cause a longer swing. So feeling more width in that right arm, you physically can’t go farther back, plus it helps keep that connection between chest to arms. Those are just a few ways.

Mike Reinold: Yeah. So what was it that you and Mike talked about that made this click with you, with Zack a little bit?

Adam Kolloff: Actually, Zack mentioned, I think Mike mentioned around the same time, and it just was a light bulb for me. I was like, “Oh, man. He’s hyper-mobile, that makes sense, we can’t shorten his swing.” That’s why he’s got this arm run-off at the top. So then I just, I went a different route to try to work on this. Because for a while I was just telling Zack, “Dude, what’s wrong with you?”

Zack Morton: Yeah.

Adam Kolloff: “Why can’t you just shorten your swing, man? Look at the video, just shorten your swing.”

Zack Morton: Yeah. 100%.

Adam Kolloff: And that’s how I used to approach other lessons. I’d be like, “Gosh, just turn your hips, come one.”

Zack Morton: That’s right.

Adam Kolloff: He couldn’t do it.

Mike Reinold: This sounds like me trying to teach my first grader how to read right now. Just read it.

Zack Morton: Yeah, just do it.

Mike Reinold: So Zack, from your perspective tell us about that. Because I think this is a great example of the collaboration here, where understanding the body can help the swing. So tell us from your perspective, as the golfer, even though you’re a pro, but as the golfer going through that.

Zack Morton: Right. Sorry, I got my technical difficulties all sorted. But yeah, kind of what I was saying before, it’s really difficult for me to feel, or at least when you see Tour players and everybody, or you even looked at Adam or Pat’s swing, you look at the top and I’m like, “That’s not my top of the swing.” But they’re feeling of the top and mine are completely different, and just working to make it shorter and I guess more efficient has definitely been, probably since day one, day two, working with these guys to make it. But I think it’s, even the people that I fit, don’t really have, it’s not common thing.

Zack Morton: So it’s definitely difficult to figure out ways, or to at least apply these ideas towards the swing. Because you need to be able to generate power, and I guess I’ve learned to generate a lot of power with it, but it’s definitely a difficult thing for me to look at my swing and look at my body and see where it needs to be and then actually doing it.

Mike Reinold: Yeah.

Pat Bigelow: But here’s a great thing though. Without Mike and without Adam, we would have really had no, these guys would have no real sense of how to attack his issue. Now we know he’s super mobile, Mike figured that out. Not Adam can create a plan for Zack to shorten his swing. He can attack those areas that Zack is super-mobile, and he can figure out ways to restrict him. And without the information and this tag team effort, might have not have ever known. And that’s why I think it’s such a cool thing that you guys do, that we do.

Pat Bigelow: And I teach a lot of guys at Winchester where I work, and I’ve sent them to Mike, and they’re like, “Wow, my body feels totally different, I can actually do these moves and not feel awful doing it.”

Mike Reinold: 100%, that’s great. So Mike, tell me a little bit about this, because I think what these guys brought up a little bit, I think it’s a pretty interesting point. Tell us about how different golfers look throughout their playing careers, and what we’re dealing with as players age.

Mike Scaduto: Yeah, and I’ve touched on this before, but I think golf is a super-unique sport in that you can play it for basically your entire lifespan. And compare that to other sports where you’re really looking at youth, high school, college, and a lot of people tail off then, and you’re not really playing a ton of baseball in your fifties. Gold you can play throughout your entire life.

Mike Scaduto: When we examine these golfers and do an assessment, we tend to see some differences throughout their lifespan. So younger people, naturally they’re a little bit more mobile, maybe a little bit more hyper-mobile. They often don’t have a great awareness of body position and joint position throughout the swing, or just in regular movement as well. So a lot of that is teaching people how to control their body, through different motor control drills. Also the injuries and movement patterns that we see are a little bit different in younger people than they are in older people, and that may be a consequence of being a little more hyper-mobile, putting more stress on different areas of the body.

Mike Scaduto: And then as we age, it’s pretty natural to get a little bit stiffer. That can be compounded by our daily habits or our lifestyle, and that can lead to movement restrictions and movement limitations that we tend to see. So our older golfers, speaking generally, tend to be a little bit stiffer in rotation. So the big focus for them is mobility, and gaining a little bit more mobility.

Mike Scaduto: That’s going to do a few things for them. One, it’s going to help them move a little bit better, it’s also going to ultimately improve performance if they have good, solid coaching. It’s going to enable them to get into a good position in their swing. It’s also going to, if we can get a bigger shoulder turn and develop a little bit more disassociate between the upper and lower half, that’s going to give us a little more time to create club head speed.

Mike Scaduto: Pretty much every golfer that I work with wants more speed and distance, and that’s usually the primary reason that they actually come to see me, is they’ve heard about how strength training and flexibility and mobility can help them hit the ball further. And then they come to me and they’re like, “I want to add 10 to 15 yards to my drive.”

Mike Scaduto: And that is 100% a case where the collaboration is absolutely key. Because I can address it from a movement standpoint and gain a little mobility, gain a little bit of strength, teach them how to develop power, teach them how to feel the ground a little bit. But if they’re not hitting the ball in the center of the club face, that’s not really going to go very well. They’re not going to see the increase in distance, they’re going to see a big dispersion so their accuracy’s going to go down. So then I need to work on it from a movement perspective, and then Adam and Pat and Zack teach them how to hit it on the center of the club face, and teach them how to swing a golf club.

Mike Reinold: Yeah, I think that’s great, and that’s, I’m sure everybody knows this here, but so Mike and Adam have teamed up, they have an online training program called Fit For Speed, which obviously is designed for golfers. But I really think for the people that listen to this podcast too, seeing this program and seeing what two experts in their fields do is going to be an educational thing for you as well. But also, you should probably go through the program a little bit and feel it yourself, so that way you can see some of these changes. But it’s a good combination of how the body moves and how the swing moves with those two working together.

Mike Reinold: But the really interesting thing that I think you said as you age here, is that it’s not like as a rehab specialist, or a performance coach, or a swing coach, it’s not like you can say, “This is what a golfer looks like.” Because Zack has far different issues than I would. I’m I don’t know, 30 years older than you, how old are you Zack? So I’m a bunch older than Zack, so I’m the complete opposite end of the spectrum. So if you’re a coach, if you’re a rehab specialist or something like that, and you think this is what a golfer should look like, then you’re going to miss the boat on a lot of people.

Mike Reinold: And if you’re a golf swing coach or a physical therapist and you’re just blindly giving corrective drills or corrective mobility strategies, we call this the corrective exercise bell curve. 20% of the time you’re probably going to nail it, you’re going to look like a super hero, like wow Pat’s the best coach in the world. 20% of the time you’re probably going to make them worse, and you’re probably going to hurt their wrists, or their back or something like that.

Mike Reinold: And then everyone in the middle we’re just going to waste time. But if we combine that and put it together, we won’t just be throwing random correctives at them, we’re going to be specific to them.

Adam Kolloff: Yeah, I think, can I jump in there, Mike?

Mike Reinold: Yeah, yes.

Adam Kolloff: So what’s cool about you guys is you have the PT foundation. So I think that really sets you guys apart. I’ve worked with other PTI certified trainers, and they’re good and they know a lot about the body, but you guys, Mike especially, with that PT background, you know a lot more about the body, how to rehab the body, how to make joints move a little bit better.

Adam Kolloff: I just think with that foundation, you guys can attack issues better. I think you can attack issues with more knowledge, and you can really personalize the training a little bit better. That’s just the experience I’ve had working with other trainers, and now working with Mike. It’s not to pump your tires or anything here, but I think it’s good.

Pat Bigelow: No, it’s cool. They’re awesome. I came in last year, and Mike alluded to it, called me out, I was super, super stiff. And the plan they created for me worked. I have much more mobility than I had a year ago, my swing feels better, I’m not as sore at the end of rounds. My game has gotten better, all because of the stuff that I was doing off the course. Not even working on my own swing, just working on my body and getting it more mobile made a huge difference in my game. And it’s cool, it’s really cool to see.

Mike Reinold: Yeah, I think –

Lenny Macrina: I think there’s some concepts that people, people come in looking for help if they have back pain, that’s what we do, we help them with their back pain. But they key is, that people need to understand, is why is your back hurt. There could be other areas of your body that we have to look at, and that’s what we do. Because your low back might be hurt or sore, which is very common in golf, or very common in the regular population of golfers, but why? So we take them through an assessment that we do, we take them through the TPI, and we figure out that yeah your back is sore because your hips are tight, or your hamstrings are tight, or your thoracic spine that I mentioned earlier is tight. And so the stress is all becoming focused on your lower back, where the movement is going to occur, but maybe not as much as you think you should have.

Lenny Macrina: So I think people need to understand that if you come in with back pain or hip pain, the reason why is probably somewhere else in your body. Maybe you have ankle mobility issues, you broke your ankle as kid and now your ankle doesn’t move well. So your ankle, which is huge in the golf motion, to be able to get in a squat position, to be able to get some rotation, if that’s not moving well then your motion’s going to come from somewhere else. And then you start compensating that we talked about earlier.

Lenny Macrina: So I think we need to understand that yes, that area might be tight and it might seem like your issue, but I think us as PTs at Champion, we take a holistic approach and really look at all the joints. I know that’s what Mike does, and that’s what’s in his Fit For Speed course with Adam as well.

Mike Reinold: Sweet, so, sorry.

Zack Morton: I think, sorry Mike. I can plug in Mike.

Mike Reinold: Yeah, yeah.

Zack Morton: I think I can definitely speak to that. When I started coming in, I mean playing competitively, and when I first came in on my TPI assessment I was complaining of my back was killing me, and my hip mobility definitely causing me probably a lot of different movements causing a lot of strain on my back. And I can speak that I have virtually no back pain since, just having targeted exercises towards, I’ve just learned a lot about myself, and just collaborating with everybody on here. I think I’ve just, I work with all you guys, and it’s just been great. I think if you’re not doing those types of things, I don’t think you’re really bettering yourself in ways that you definitely could be. Everything here goes hand in hand, and I think I’m a pretty good example of that.

Mike Reinold: Yeah, you guys make me think too, I think the reason why we all get along, so the six of us here, and even this whole podcast episode exists, is because we all like geeking out over this stuff. We all enjoy this. So Adam’s won every award possible in teaching, and I think he would humbly admit, I think he just did, that he’s learning still from other disciplines.

Pat Bigelow: You have to.

Adam Kolloff: All the time.

Mike Reinold: Yeah, right?

Zack Morton: You’ve got to learn.

Mike Reinold: It’s so hard to innovate, right? If you’re a golf swing coach, or a physical therapist, to innovate as a physical therapist and come up with something brand new nobody’s ever thought of it, it’s super hard right now.

Pat Bigelow: Well it’s funny, sorry to interrupt.

Mike Reinold: Yeah.

Pat Bigelow: I was listening to Adam and Jim McClain the other day talking and here’s Jim McClain who’s one of the best teachers in the history of the came, and all he does, and Adam can attest to this, is talk about learning. Keep learning, never stop learning. And I think we all try to do that on here.

Mike Reinold: Yeah, and try to learn from other disciplines, I think that’s the key. I always say that myself, I’m a better physical therapist because I’ve learned from so many strength coaches, and I’ve learned from so many skill coaches like you guys. So I think that’s why we get along, we have a lot of golf pro friends that we get along with, but I don’t think we collaborate as well as we do with this group, because I think we all share the same qualities on continually growing, that growth mind set, and collaborating. So awesome.

Mike Reinold: So golf coaches, the pros on this call now, so I guess here’s my question. We’ve talked about our top impairments, it’s probably t-spine, hip, motor control, core. It’s really the center of the body, it’s kind of interesting. Those are our top impairments we tend to see. From your guys’ perspective, what are the top swing faults. And we don’t have to get into a million, but what are the big ones you see in most amateur golfers, and how do they relate to these impairments we just talked about. What do you guys think?

Adam Kolloff: So I’ll jump in and start with, I’ll just start at the beginning of the swing. What I typically see is bad posture. Whether they’re weak at the core, maybe the glutes or something, there’s just a variety of postures that I see, and not getting into a good posture is one thing.

Adam Kolloff: How they take the club back, they start to rotate on a flatter shoulder plane is something that I typically see. Possible because they can’t get into that left bend, that side bend as they’re turning, that could be related to something around the mid-spine.

Adam Kolloff: Another biggie is this trail arm external, internal rotation. So if somebody’s never played baseball, or have specifically has thrown a ball, or played some sport where they’ve had to throw a ball, they might not have that external rotation. And so because of that, they’re not going to position the club correctly at the top, or they’re going to have some compensations at the top. For example, their right arm’s more internal, and then the club could be in a really bad position at the top because of that. But it’s hard for me to go in there and change that, because they’re limited there so I can’t make a difference. I’ve got to send them to Mike, and it’s going to take a while.

Adam Kolloff: But right away, I’ll have to adjust the lesson plan, talk about other ways to shallow the club for example. So those are just two examples in set-up and backswing that I commonly see.

Mike Reinold: Huge.

Pat Bigelow: Early extension’s a big one. I think that we see a lot. Yeah, especially among amateur players, not using the ground effectively. Pulling the club down, Mike mentioned it, not being to disassociate your upper and lower body. Those are all, improper tilts.

Mike Scaduto: Just to tie that in together, I think there is some research studies that looked at our physical screen and swing characteristics, and tried to look for a correlation. Two biggest ones were hip hinge pattern, so being able to touch your toes. If you are not able to do that, it was high correlated with early extension in a golf swing. So not being able to maintain a hip hinge pattern, which is Mike’s swing fault there, you’re going to come out of that posture throughout your swing. Or it’s more likely, I guess.

Mike Scaduto: The other one was overhead deep squat, again correlated with early extension. Part of that, when you look at research particularly in gold, is a lot of people tend to early extend, and a lot of people tend to move pretty poorly. So-

Adam Kolloff: Sorry about that, baby wants to get in here.

Mike Scaduto: … it all become individual.

Mike Reinold: That’s awesome. No, this is a family thing Adam, my kids are dying to get on a podcast too.

Adam Kolloff: So Mike, talking about Reinold’s golf swing quickly, he’s definitely got some early extension on the way down. But as a golf teacher, you have to attack some of the causes that would translate into early extension. For example, if you’re coming down a little steep, which actually is not Mike’s issue, his club comes from the inside, but his club face is really open. So if that club face is really open, that’s going to cause you to release early, and as you release early you’re extending the club away from you. So your body’s going to stand up to make space, and prevent you from hitting behind the golf ball. So you’ve got to attack the technique, and at the same time Mike needs to get in the gym and work on those things so he’s physically stronger, more mobile. But he’s also working at the technique at the same time.

Mike Reinold: And I think as an example of this person here too, I can get into pretty much what I want to be my impact position, physically. But I’ve mentioned this to Lenny and Mike all the time, it is a struggle for me. That is my end range of motion. And we know how hard it is to get to that end range, so I can slowly, deliberatively get into that position, but when I then get into my swing and I try to increase speed with that, that’s really challenging for me.

Mike Reinold: So another good example of how that connects a little is if somebody is struggling so hard to get into a position, it’s going to be really hard to do that with fatigue, it’s going to be really hard to do that with speed, and all these other things. So that’s awesome, and I think we really nailed it with how all that stuff correlates.

Mike Reinold: Let’s maybe pitch this to the golf pros first, maybe start with Adam, but if you were putting a plan together for somebody that’s coming to see you. We’ve always said there’s three buckets, right, and this is a TPI concept too and everything. But physical, mechanical and equipment. So we’ve talked a little bit about some of the physical stuff, how you have to address some of these impairments. We’ve a lot about some of these mechanical drills that we’ve talked about, in how to get into these new positions. Tell us about the equipment concept. When do you start going as a golf pro’s perspective, when do you start going like, “Let’s make some equipment modifications to help your game?”

Adam Kolloff: Yeah, great question there. And I’ll let Zack, if he’s still around here, to jump in. I would say obviously I’m trying to work swing mechanics first. I don’t want to just fit them for, let’s say it’s a regular flex shaft because they are missing to the right. So let me explain that quickly. If you have a soft, flexing shaft, it’s going to kick and release better at the bottom, which helps square the club face.

Adam Kolloff: For somebody that’s slicing to the right, their club face is open. Instead of just going, “Okay, you need to go into a regular flex shaft to help square the club face,” what I would want to do is work on their technique so that they are improving the impact position with a more square club face, basically.

Adam Kolloff: And then from there, try to fit them into something. So you’re not really fitting a fault. What’s cool is Zack and I collaborate about that stuff. If I have a student who asks me about fittings, I’ll say okay come to me first, take some lessons with me first, and then go get a fitting with Zack. And the cool thing is I’ll collaborate with Zack, and I’ll give Zack a blanket thought about, “Hey, this guy’s got this speed, his typical miss is here, his trajectory is high, low, and just go with that.”

Zack Morton: Absolutely.

Adam Kolloff: And Zack will fine tune from there.

Zack Morton: Yeah, definitely. And from a fitting standpoint, the first part of the fitting is me going over with the student just general ideas of any previous score backgrounds, and also looking at how they are physically, and how they impact the golf ball. Because in the equipment world, especially nowadays, there’s so many great advancements on, not necessarily that you’re a stiff flex, you could be stiff flex in so many different range. You could be a stiff in a graphite even, you could be a stiff in a certain weight. And that’s where we really get down and really go into exactly what works best for your swing.

Zack Morton: You definitely have to take into consideration though your physical limitations, especially with all the different types of equipment available nowadays on the market. But yeah, definitely collaborate a lot, if you’re taking lessons with Adam especially, we collaborate a lot with the player. It’s almost that extra benefit you see, and determining the right fit for the right player. But yeah, a lot of the fitting is actually about the physical aspect of playing.

Zack Morton: Because if you swing a seven iron 90 miles an hour, doesn’t put you at one thing. If you swing a seven iron 90 miles an hour, used to play baseball, and then you come in and you say you have shoulder surgery, that greatly changes the shaft, that greatly changes the lie angle. And it shows on your ball flight or whatever, all of those things matter significantly, and that’s definitely where I come in and we figure out what works for you.

Mike Reinold: So do you guys things, should anyone get off the shelf clubs from Dick’s Sporting Goods?

Zack Morton: You are wasting your money if you do that. 100%, you are wasting your time.

Pat Bigelow: If you’re a total, total beginner or a junior, sure.

Mike Scaduto: Yeah.

Pat Bigelow: It’s about just getting some swings.

Mike Scaduto: Right.

Pat Bigelow: But if you’re playing on a regular basis at all and trying to be good, I think it’s in paramount to get fitted, and to do it the way that Adam and Zack just suggested it, where you go take some lessons first. Because hey, you could go right into a fitting at one of these places and they don’t give a you-know-what that your swing is all messed up, and that the reason they’re fitting you for this shaft is because of a compensation in your swing. There’s still that issue in your swing where if you go see Adam, he fixes that issue, works on your swing, now you got the club delivering in the right way. Then you go get fit, you see Zack, that’s the way to do it.

Mike Reinold: That’s awesome.

Zack Morton: Absolutely. Absolutely, if you’re, especially with us, you purchase clubs through us it’s free, you might as well get an in depth analysis of what exactly is going on in your golf swing.

Adam Kolloff: The fitting’s free right, not the clubs.

Zack Morton: The fitting’s free.

Mike Reinold: Wait, wait, slow down.

Zack Morton: The fitting is free, yes. On my own thing. But you might as well get an exact, the total picture about what is going on in your golf swing. It’s not this equals this, it’s there’s so many things that need to be taken into accounted into. Especially in this game, this game is brutally hard, make it easy on yourself and get the right equipment for yourself.

Lenny Macrina: That process is so neat.

Pat Bigelow: Because people, the-

Adam Kolloff: Yeah, it’s so cool.

Lenny Macrina: The process is great, because you go in, you hit a ton of clubs. And I know I got fit with you guys, and in my head I was getting Titleist AP2s, and that was what I getting. And then I went through the whole process, I ended up with TaylorMade 790s, and I love them. I would have gone to Dick’s Sporting Goods and bought Titleists because Titleist makes a good club, and I would have hit a couple balls in their simulator and said, “Wow, I like let’s go, because it’s all better than my 10 year old clubs.”

Zack Morton: Right.

Lenny Macrina: But when you really break the process down and use the track man, and get some objective data, and really see what swing changes occur with the different types of clubs that you hit, whether it’s a Titleist, a TaylorMade, a Mizuno whatever, and you really get, it’s a feel thing too. It’s a comfort standing over the ball, what does the club face look like standing over the ball? You know what I mean, the different types of clubs that are out there, there’s a gazillion different types of club, so to me it was a game changer for me, it was huge to get fit with new clubs.

Mike Reinold: How’d your handicap respond Len?

Lenny Macrina: It has come down, it’s a work in progress but it has come down.

Adam Kolloff: He’s hitting 300 yard bombs now.

Lenny Macrina: Yeah, exactly.

Mike Reinold: That is amazing, I’m struggling to break 240. That’s crazy. But awesome.

Mike Reinold: Hey, thanks everybody. I really, this in and of itself was almost like a master class on how to collaborate between rehab, performance and skill coaching, right? Because we all got on together, we all talked, we all geeked out, we showed you that. So indirectly, you learned a lot about golf hopefully, but I think this was also like a class on how to collaborate and how to work well with other professionals. Because you see the benefit. It’s not about us, it’s not about you looking smart by knowing about the golf swing, it’s about knowing the right people to collaborate to help your client achieve their goals. I think that’s the key.

Pat Bigelow: Well said.

Mike Reinold: So great episode, thank you so much everybody from Pure Drive Golf. If you want more information on these guys, they have both local options if you’re in the Boston area, but they also have some online programs as well. Adam’s got some great educational content, Pat has really stepped up his Instagram game during this quarantine, it’s been amazing. They got a bunch of good stuff, online courses, Adam’s doing online swing lessons now.

Pat Bigelow: Skill-its, go see them.

Mike Reinold: Yeah, Mike and Adam have the Fit For Speed program. So I’ll put links on everything in the program here so you guys can see that, but I think again if this is interesting to you and you’re trying to get into the golf world, then I think you’ve got to embrace some of this and experience it a little bit yourself so you can understand the perspective that you’re about to recommend to your own clients.

Mike Reinold: So anyways. Thank you so much guys, everybody from Pure Drive for joining us.

Mike Scaduto: Thanks Mike.

Zack Morton: Thanks for having us Mike.

Mike Reinold: Yeah, my pleasure, thank you guys. If you guys have more questions like this, head to mikereinold.com and click on the podcast link. We’ve been getting a bunch of golf questions, so instead of just answering them one by one I was like let’s have this really cool episode. So thanks so much, be sure to head to iTunes, Spotify, wherever on earth you listen to podcasts nowadays and rate and review us, and we will see you on the next episode.

Adam Kolloff: Thanks Mike.

Lenny Macrina: Thanks Mike.