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2 Things PT Students Do That Drive Me Crazy

Over the years I have worked with countless physical therapy students, who have all been outstanding.  We have a pretty strict process to accept students at Champion PT and Performance now, as we want to assure that each student is a perfect fit.

There are two main points I try to drive home with all of our students over the course of their clinical rotation that I want to discuss.  I have been getting emails and seeing a lot of PT students on social media that are doing these two things…

And they are driving me crazy!

Once these two concepts “click” for our students, you can literally see them take off with their effectiveness.

 

1. Don’t Get Caught Up in Specific Systems

As a physical therapy student, I get it, the road ahead is a bit daunting.  You’ve learned so much in school, how do you apply it all?  And I would bet most still lack confidence in their skills.

The internet has really been sensationalizing systems.  However, you really need to be careful and avoiding selling your soul to one specific system.

I love systems.

In fact, we are working on making an educational program teaching you our systems at champion. But…

I’ve yet to find a system that is perfect and works 100% of the time for 100% of the people.

It’s easy to be influenced by the sensationalism, but realistically, you don’t have the clinical experience to know if a specific system is appropriate for you patient.

I see so many students going deep into a complex theoretical system, and then blindly defending it without the knowledge or experience to justify.

Take this as an example, imagine we have an athlete that strains their hamstring. I’ve heard people discuss all of this for treatment suggestions:

  • Educate them that it’s a perceived threat when elongating tissue
  • Work on improper breathing pattern and diaphragmatic function
  • Give exercises to help with asymmetrical pelvic orientation and rib cage position
  • Use corrective drills for lack of thoracic rotation

All of these things may have some merit, but you know what?

You forgot about the hamstring!

The athlete was rounding first base and considered going for a double when the outfielder made a great play, so they had to change direction quickly and accelerate back to the base.  They overloaded their tissue.

Want to know my system?

  1. Fix what’s broke
  2. Fix what’s suboptimal

Too many times we jump to the suboptimal and think working on the hamstring is ridiculous, as it’s not the true “cause” of the injury.  Well, it’s still injured, and that player wants to get back on the field ASAP.  Your job is to help them accomplish their goal.  If you spend more time on diaphragmatic breathing than facilitating healing of the injured tissue, you have this all backwards.

Realize I mentioned the athlete, as I work in the sport medicine and orthopedic world.  A general population orthopedic patient with chronic hamstring pain may benefit from working on the suboptimal first.

But I am seeing people literally mocking others for working on facilitating healing of the hamstring.

Keep an open mind and don’t sell your soul to one system.  You still have a lot to learn by experience what does and does not work for your patients.  Every patient population is different.

2. Learn How to Connect with People

The second thing that drives me crazy with physical therapy students is when they have no ability to connect with people.  Again, I get it.  You just had your nose in textbooks and practical exams for several years.

We’re all dorks.  Me too.

But you can’t talk over the heads of people.  If your primary focus is showing how smart you are, you are going to be in trouble.

You aren’t in a practical exam anymore, you can’t talk like a robot or scientist and expect to connect with people.  If you’ve ever worked with me, you know I fool around a lot.  I’m rarely serious.  But I know when I need to be serious and I know how to educate effectively.

You need to speak in a language that the patient can understand and relate.  I talk to my baseball pitchers about “throwing pens” and “pain in layback.”  I don’t ask if they have pain when they externally rotate their glenohumeral joint to end range of motion.

Remember the classic quote:

“Nobody cares how much you know until they know how much you care.”

That really applies to the field of physical therapy.  If you don’t connect with your patients, you won’t be as effective.

Read these books and think the whole time, “how can I apply this to working with a patient:”

 

Start Your Career in the Right Direction

PT students, read all the above one more time and let it sink in.

I promise, if you work on both, you will become a much more effective physical therapist.

I have an Inner Circle webinar that dives deeper into this topic, “5 Ways to Start Your Career in the Right Direction.”  These are the points I try to drive home with our students, and honestly, are things I wish I knew 20 years ago.

 

5 Ways to Start Your Career in the Right Direction

The latest Inner Circle webinar recording on 5 Ways to Start Your Career in the Right Direction is now available.

 

5 Ways to Start Your Career in the Right Direction

This month’s Inner Circle webinar is on 5 Ways to Start Your Career in the Right Direction.  In this presentation, I talk about some of the important things that any student or new physical therapist or strength coach should focus on early in their career.  I’m amazed at some of the things I hear from students and see online.  

This webinar will cover:

  • Why you shouldn’t sell your soul to one specific “system”
  • The ONE most important thing you need to work on to be effective
  • How to always be learning but also gaining skill, not just knowledge
  • Why you shouldn’t rush into starting a private practice

To access this webinar:

Live Q&A Recording

The latest Inner Circle webinar recording is now available. We did a Facebook Live Q&A session in the private Inner Circle Facebook group. I thought it went awesome! It was a great platform that we tried for the first time and we’ll definitely be doing that again. We had a ton of great questions about rehab, fitness, starting your own practice, and more.

If you are an Inner Circle member and not part of the private Facebook group, go to the Inner Circle dashboard to find out how to join. It’s been great.

If you weren’t able to join us live, be sure to watch the recording.

To access this webinar:

What the Top Fitness and Rehab Experts are Doing Differently This Year

At the end of each year, I love to reflect back on the year.  I look through my calendar and tasks lists to see all the things that I accomplished and then plan the upcoming year accordingly.  But in addition to this, one of the things I do each year is look back at what I have learned and what I am doing differently.

This is something I recommend everyone also perform.  If you can’t think of anything you are doing different, you aren’t growing.  Make that your priority for the upcoming year.

This year, I want to share a little bit about what I am doing differently, but more importantly, I decided to ask a bunch of my friends in the fitness and rehab industries the same question.

Notice the underlying themes below.  Plus, notice how many of the people you look up to and would consider “experts” have done so much growing this year.  If they are always pushing to learn and grow, you should be too.

Before we get into what they are doing, I have personally put a lot of emphasis on personal productivity.  We are putting together systems at Champion for almost every aspect of the company.  From the behind the scenes admin work to our actual clinical techniques.

There are two books that I read this year that I thought were outstanding and impactful:

  • Ego is the Enemy – This book blew me away and really made me re-think a lot of what I do.  “Ego” doesn’t have to be a negative thing, don’t take it that way, but prioritizing what you do in life by the outcome has been very helpful.  There are many things we do because of our egos, this book really helps.  I wish I read this book 20 years ago.  This is now something I tell all young people to read ASAP.
  • 15 Secrets Successful People Know About Time Management: The Productivity Habits of 7 Billionaires, 13 Olympic Athletes, 29 Straight-A Students, and 239 Entrepreneurs: I read a lot of productivity books and websites.  This book nailed it.  The advice given is some of the best I have ever read and in a quick and easy format.  If you want to make the most our of your year, start here.  People always ask me how I get so much done.  Besides just simply working hard, this book summarizes many of my techniques.

But more importantly, let’s hear from everyone else.  I simply emailed all these people with one easy question: “What are you doing differently this year?”  Their answers were outstanding.

Thanks to everyone that participated!

 

What the Top Fitness and Rehab Experts are Doing Differently This Year

Greg Robins

greg_robinsOn the training front, I am spending a lot more time having youth athletes build up a work capacity before writing more traditional programming for them. I have found that 3/4 kids I assess would most benefit from 30-40 min of glorified manual labor 3-4x per week.

With more specialization, more technology, more home work, etc., they never move.  Every day is the same. The kids are vastly ill prepared day 1 to see progress with basic weight lifting.

Furthermore, the last thing I want to introduce is more black and white structure. Move it, drag it, carry it, throw it, have fun.

Greg Robins

Strength Coach, Cressey Sports Performance


Dean Somerset

More semi-private training options compared to a couple of years ago. Many people don’t need me counting or correcting every single rep for them, especially if they’ve worked with me for a couple of years, plus the group dynamic tends to push people more than I ever could. Everyone is still working on their own individual program, but just in a group with me running the show.

Dean Somerset

Strength Coach, DeanSomerset.com

 


Tony Gentilcore

tony_gentilcoreNow that I’m on my own and officially a business owner, I’ve become more aware of what it really means to be client-centered and not coaching-centered. I’ve become better at not defaulting to my own biases.

It’s never about me. It’s about the client/athlete. What are their goals? And, does my programming reflect that? To be specific, something I have always been cognizant of, but am now much more aware of is the notion of respecting people’s differences; namely their anatomy.

No one has to deadlift with a straight bar from the floor. No one has to back squat or use a low-bar position or maintain a symmetrical stance. Everyone is different, with acetabulums pointing this way and that, femoral necks with different lengths and angulation, not to mention other things like femur and torso lengths.

Being more aware of not marrying myself to ONE way of doing anything because a textbook told me so has been a nice revelation on my end.

Tony Gentilcore

Strength Coach, CORE


Erson Religioso

erson_religiosoHere is what I’m doing different lately:

In the clinic

  • Using more isometrics and PNF to enhance movement patterns and in many cases restore pain free end range without the need for more complicated manual therapies. Also messing around with blood flow restriction training

Social Media

  • Posting regularly to instagram, one of the last social networks where all of your followers see all of your posts, very different than facebook’s “curated” timeline. Facebook’s reach is at an all time low and bottom line, it’s great for advertising, but not so great for organic reach. Also started a media company with some podcasts, Therapy Insiders, and short form Podcast, Untold Physio Stories. Lastly, my blog posts are A LOT shorter, mostly shorter videos, instead of 5-7 minute videos.

Learning

  • Listening to more podcasts, Health Fit Biz, #AskMikeReinold. Still using feedly to keep up with my regularly read blogs.

Business

Teaching

Erson Religioso

Physical Therapist, TheManualTherapist.com


Erwin Valencia

erwin_valenciaOnce described as “A Google Guy trapped in a Sports Medicine Body” by a fellow Major League Baseball Athletic Trainer, I’ve now added the word “Spiritual” to that phrase, as I began my third year in the NBA.

I’m grateful everyday for the opportunity to run my truly “whole-listic” platform here in New York, thanks to the unwavering support of my idol, my guru, and my team’s president, The Zen Master himself, Phil Jackson.

As an organization, we’ve been at the forefront of innovation in realm of Sports Science in the US for almost a decade, without needing public accolades or press to validate what we do. With that being a status quo for us, we’ve added other elements to our sports performance algorithm, this time enhancing more than just the 5 senses of each of our athletes, allowing them to truly be the best versions of themselves, Mind, Body, and Spirit.

Erwin Valencia

Director of Training and Conditioning, New York Knicks


Pete Dupuis

pete_dupuisI don’t know if I’d call it different, per se, but I’m getting back to my roots a little bit and scheduling routine “fitness tourism” so that I can have an ongoing feel for what’s working elsewhere. I tell almost every consulting client I work with to get out and see other facilities in action, but tend to forget that this information applies to me as well.

Just because CSP is attracting a ton of observational guests doesn’t mean that I can stop taking my own advice and seeing others do their thing.

Pete Dupuis

Co-Owner, Cressey Sports Performance


Ken Crenshaw

ken_crenshawWe have continued to evolve our understanding of PRI / DNS / FRC methods for muscle activation / inhibition based off individual assessment.  We have added in manual therapy options  (FDM-Fascial Distortion Method and FM-Fascial Manipulation per Stecco) to aide in finding balanced posture and movement.

We have been using Blood Flow Restriction units in extremity rehab which seems to have some good promise.

Tim Brown has given us some really nice options for using kinesiotaping to help function.

Our Performance staff has had the luxury of being in association with the ALTIS  training center in Phoenix, this has given us some great movement training.

One of our biggest pushes has been personal development / team development / communication. The Landmark Seminars for personal development have helped several of our staff members. Leadership development is always one of our foundations and the article link below may give some insight on our philosophy behind it.

http://pbats.com/the-culture-of-outstanding-leadership/

Ken Crenshaw

Head Athletic Trainer, Arizona Diamondbacks


Pat Rigsby

pat_rigsbyThis year what I’ve done differently…

  • I’ve spent my first full year in my ‘new’ business after selling my stake in a number of other ventures. During this time I’ve really narrowed my focus to ‘helping entrepreneurs build their ideal business’ rather than just helping people grow businesses. While it may not sound like much of a difference – it’s given me a lot of clarity on who I’m trying to serve and how I’m trying to serve them. From my perspective (and hopefully from the outside) it feels much more like being a specialist versus a generalist.
  • I’ve also enforced pretty rigid guardrails as far as my business is concerned, saying ‘no’ to more things that ever before. What I’ve come to find is that the more things that are a wrong fit that I say ‘no’ to, the more opportunities that seem ‘right’ tend to come my way. Whether it’s the length / amount of travel or the type of client I take on, selecting the right fit has actually caused me to be more creative in how I reach my professional goals – yielding really good results.
  • Along those same lines – I’ve narrow what I do to: coaching, connecting, creating, strategic planning and idea creation. Everything else gets outsourced to people who are better at those respective things. By rough estimate, I’ve spent about 85-90% of my professional time doing things I really enjoy – a much higher percentage than in any year previous.
  • From a tactical perspective, I’ve worked a lot on growing my platform. I’ve written one book and have two others that should be complete by March at the latest. I launched a podcast. I (continue to) email my audience daily. I’ve spoken at a few new events this year and done more varied  ‘list building stuff’ than in any year previous.
  • I added another layer to my coaching offerings – which grow the enrollment by about 75 clients while being a real success by any measure.
  • Finally – after kind of mailing it in from late March – mid July as far as work goes (working about 15 hours a week most weeks), I created what I called a 100 Day Sprint where I mapped out about a dozen pretty aggressive goals spanning every fact of my business from revenue growth to writing progress. I just wrapped it up on 11/4 and hit 11 of 12 goals…with many being exceeded by a significant margin. Now I’m going to turn the whole process into a course.

Pat Rigsby

Business Consultant, PatRigsby.com


Dave Tilley

dave_tilleyHere is what I have been doing a lot differently

  • On the clinical side, one thing I have been doing is playing devils advocate with myself a lot in regards to newer concepts/research. I saw in myself that that my pendulum was shining way too far between topics and just like many others I don’t want to get carried away. Finding the mid ground in contrasting areas like include “functional” approaches vs importance of isolation/basics, neurological vs biomechanical/histological approaches, set movement patterns vs motor variability, and so on. I find it really helps me map out my approach but also keeps me on my toes when reading new research. I’m spending a ton of time in hip micro instability research and treatment, so having this opposing sides view is really interesting to develop new ideas.
  • I have really been trying to build up my strength and conditioning knowledge and apply to my whole rehab approach. I have always felt decent in this area, but in working more with high level gymnasts/Olympic Weightlifters, I found that I was dropping the ball a bit for advanced rehab. I’ve been reading a ton of newer strength books and energy systems training research to get up to speed, but also approaching my rehabilitation through more formal strength and periodization models, even with the acute or post op patients.
  • More for myself, a lot more reading in personal development this year. Reading books like Ego is The Enemy, Legacy, and Extreme Leadership we eye opening to some personality flaws I didn’t even pick up in myself. Swallowing some tough pills was necessary, but ultimately I think it’s helping make my job and life better. Also has allowed me to make some really large positive changes in trying to change a sport so stubborn as gymnastics. Another personal note, I’ve also been way more disciplined about following my calendar weekly to stay on track.
  • Definitely writing a lot shorter, more concise blog posts for my company SHIFT Movement Science  I put out more content based articles less often, but make them full of relevant points and get right to the point. It’s been really helpful for me to deload but readers enjoy it much more. Moving more to educational products and items people can utilize to learn on their own vs my pumping out regular articles.

Dave Tilley

Physical Therapist, Champion PT and Performance


Dan Lorenz

dan_lorenzThings I’m Doing Differently:

  • Been inviting local physicians to our monthly journal clubs and “co-author” blogs on my website.  Has been a great addition and really surprised how many have expressed interest.  I had not done that previously.
  • Inviting more local physicians in to do inservices for my staff.  Surprised how many actually pull themselves away and want to do it.  Been great for education and interaction.  
  • I meet once a week w/ my clinicians that are 0-2 years out of PT school to review their cases.  Fridays, noon over lunch.  They go over struggles, the others put in their two cents, then I swoop in at the end and tell ’em they’re all full of s**t. Lol.  Just kidding, just help them round out their plans.  They rave about it and I know in the end, I “lose to win.”
  • Clinically – using BFR more, but I find I have more questions than answers.  Also using dry needling as an adjunct.
  • I have tried really hard to stop arguing with idiots on social media. After a while, it’s hard to tell the difference.
  • I have decided that I’m not that important.  My clinics will be fine.  So will my patients and they’ll find a way to see me.  I go in to work a little later to take my son to school and leave two days early to pick him up.  That matters way more than an extra visit or two.  
  • Agree w/ Pat Rigsby big time – taking stuff off my plate and saying “no” a little more often.  It’s a struggle because I have a tremendous passion for my profession, but have to make sure everything else doesn’t suffer.

Things I Wish I Did Differently:

  • Now that I’m not involved formally in pro and college sports like I used to, although I still see elite athletes, I don’t have all the cool toys so many of you get to use.  Sigh…maybe someday.  Love to tinker with innovative tech products. 

Things I Haven’t Changed a Bit:

  • Read a ton.  Research guides practice. I can’t get enough. I love this stuff.  
  • Engage with people that are on lists like this.  Seek people that have earned trust,  Seek people who walk the walk.  
  • Be an expert at the basics.  For all the fluff and different approaches, I make sure stuff is mobile, stable, and strong like freaking bull.  Everything else – power, reactive strength and speed – follows nicely.

Dan Lorenz

Physical Therapist, SSOR


Michael Boyle

michael_boyleMy first thought was ” I haven’t done much different”. However, after reading everyone’s responses I was moved to write.

Most of what I’m changing has already been alluded too

  • Giving more responsibility to my staff. My goal is to make myself non essential.
  • Putting more thought and energy into staff development. I have established this as my ” one thing” from a business standpoint.
  • Trying to work less and be a better dad and husband. This is a never ending battle.
  • Also learning to say no. I coach who I want to, when I want too. I refer a lot of speaking options to staff members.
  • Taking advice from Alistair McCaw and focusing on 20 minutes of thoughtfulness every day. Also a 20 min nap.

Michael Boyle

Strength Coach, Mike Boyle Strength and Conditioning


Wil Fleming

wil_flemingPrioritizing things. As a coach and business owner things can get out of whack.

For me the ranking is 1) family, 2) business, 3) coaching.

Family: Making sure I am raising my son the way I want to. He’s only 18 months old, but getting out everyday to play with him for at least an hour of completely undirected free play (per good LTAD guidelines), keeping the TV off at all times, and making sure that I spend each morning with him before hitting the gym. It also means being a better husband and spending equal time on developing that relationship as I do my business and coaching.

Business: Re-vamped our core values this year to reflect what I truly believe (they were outdated when my former business partner left). We are in the relationship business and I wanted the core values to reflect as much. Just updating these has been so impactful to my business.

Coaching: Getting better at programming, I am good at seeing complex movements and breaking them down. The question I asked myself this year was “am I applying these stresses in the most optimal way?” When the answer came up, maybe, then I decided I needed to look again at what we have been doing.

On that note, I have been trying to look at different sources for more knowledge on programming, less to the traditional guru’s and more towards people that are putting up results with similar populations. Do you have the best collegiate weightlifters? Then I’m going to look at what you’re doing. Do you produce really good high school baseball players? Then I’m going to look at what you’re doing. Surprise, surprise, these people don’t have the most instagram followers, because they are out there actually coaching people.

Wil Fleming

Strength Coach, Force Fitness


Regan Wong

regan_wongAs previously stated amongst the group, balancing being a father/husband with a successful career has been something to continue to work on. As a father of 3, it has been somewhat challenging for me to do so in the past but I have made it a priority this past year to do so. I will continue to work on it. One of this funniest activities I enjoy getting my kids into is rock climbing and tae kwon do. I have found great motor development patterns develop from the rock climbing and great kinesthetic awareness/balance/proprioception in all my kids…especially in my middle son who is deaf in one year and was just “clumsy”  as toddler.  Great to see the confidence and single limb balance develop from his martial arts.

At work, I have identified and trained 2 staff clinicians to take on more managerial roles so that I didn’t have to feel like I had to be in the place 12 hours a day and be afraid the clinic would fall apart. Working on implementing the culture and systems in place to have the business run while the head guy wasn’t on the floor was a strategy to allow professional growth amongst select staff and allow me more time to spend with family etc. It also allows us to identify leaders in our clinic to eventually open and run satellite clinics when we are ready to do so from a business prospective.

I have taken the time professionally to learn the ins/outs of running a Motion Analysis lab for our pitcher biomechanical analysis to give me more of an understanding of the whole process, interpretation of the data, and provide feedback to the pitchers and coaches. Baseball medicine is always evolving as we try to tackle and decrease the pitcher injuries of the elbow/shoulder. I am currently doing research between simple balance and core tests using the LevelBelt app and comparing to the biomechanical data of the lab on pitchers that have come through the lab.

I have used the KAATSU blood flow restriction training and have seen some pretty good results with regaining quad strength and hypertrophy in post-op conditions that were limited weight bearing for initial 6 weeks post-op. Seems to be promising.

Regan Wong

Physical Therapist, TMI


Jon Goodman

jon_goodmanMy business has achieved monumental growth this year and it came as the result of an unlikely reason: I relinquished control. This year I became more comfortable establishing systems, operations, and guidelines for operating aspects of my business and handing off those elements to skilled members of the team in full trust. Instead of working in my business every day, I spend all of my time visualizing how I want it to grow and finding the people, developing the systems, and setting the wheels in motion to make it happen. As a business, my team and I have grown faster, built better stuff, made more, impacted more, and had more fun all at the same time.

Jon Goodman

Owner, ThePTDC.com


Patrick Ward

patrick_wardI think what I have been trying to do differently — mainly over the past several years, really — is attempting to use mathematics and statistics to understand some of the processes that we go through with our athletes. This could from a training, rehabilitation, or performance standpoint.

There are lots of approaches out there that people take but understanding how they work, what is meaningful, what types of changes/improvements are actually real versus random biological variation, etc. That is really the challenging part. At the end of the day, we deal with people’s health and my thoughts over the past several years have been towards trying to understand if what we are doing is truly making an impact and what the magnitude of that impact is.

Patrick Ward

Strength Coach, Optimum Sports Performance


Lenny Macrina

lenny_macrinaI’m working on time management…calendar reminders to plan my life have helped guide my ‘to do’ list despite a 9 month old that has little routine

Learning the basics of powerlifting and olympic lifting. It’s a new world but an important one to understand for the clients that we see.

Trying to enjoy family life and dedicate time to baby/wife.

Continue to improve my stock buying/selling strategies and not always going for the ‘big one’ that will give a big pop… being slightly more conservative despite the fun of the big hit!

Easy to get complacent after 12+ years of being a PT…trying to fight that complacency and stay engaged.

Lenny Macrina

Co-Owner, Champion PT and Performance


Charlie Weingroff

charlie_weingroffThings I am doing differently:

  • Always trying to understand the psychology of “what motivates a man” and understanding why others do what they do, particularly using methods and techniques that are incomplete and inferior to best practice.
  • Reconciling buckets of techniques based on their earnest physiology and neurology.
  • Reverse engineering thought process of successful individuals.
  • Continuing to find common targets of physiology and neurology that link the methods that are typically classified as training and/or rehabilitation.
  • Developing scalability of methodology allowing clinicians to maintain their individuality using models that have already proven to be successful
  • Studying links of the 5 W’s of athletic performance across long-term time frame

Charlie Weingroff

Physical Therapist, Drive 495


Jeff Blum

jeff_blumOne thing I’ve been trying to do is take as much time with my kids as possible. They are getting older fast (or so it seems) and so am I.

Trying to make sure that I spend time with my wife in what she wants to do.

From a professional standpoint, we’ve been increasing our knowledge about the neuro aspects of the body and the best ways to effect it. Affecting fascia, Parasymp/symp, central nervous system, peripheral nervous system.

Using blood flow restriction training (KAATSU), US imaging, cryochamber, hyperbaric chamber. Looking into neuro “priming” for our rehab (Halo Neuroscience).

Trying to make a concerted effort to really start to grasp volume for our players. Sleep, nutrition, exercise, stress, hydration, and its cumulative effects.

Every once in awhile, just pulling back and making sure we are still looking at the basics and not getting to wrapped up in the “new” gadgets. Making sure we are looking at how the whole body is moving, if the joint is supposed to be more mobility or stability, fascial lines and how they are moving, etc…

Jeff Blum

Director of Rehabilitation, Kansas City Royals

What Are You Doing Differently?

Lets keep it rolling, reply below and comment on what you are doing differently.  I’d love to hear, I’m always looking for new ways to grow!

 

 

Layering The Basics For Optimal Movement

This week’s post comes from my friend and colleague at Champion, Dave Tilley.  Dave is no doubt one of the most impressive up-and-coming PTs out there right now and we are thrilled to have him part of our team at Champion.  In this day and age, I’m seeing more and more students and young professionals skip the basics.  In this post, Dave talks about how he focuses on some of the basics to achieve optimal performance.

 

Layering The Basics For Optimal Movement

Within my first few weeks of working at Champion, I remember one day Mike Reinold said, “Over the years I think people have overcomplicated things a lot. I’m actually trying to get back to the basics, and just do them really well.”

This stuck with me as I reflected back on my first few years coming out of PT school.  After graduating, I dove into a lot of continuing education trying to catch up with all the new information available. I found myself swimming in a ton of really complicated material related to evaluation, treatment, and research concepts.

I think I let myself get into the complex material a little too much, and I found myself missing a lot of basics when working with clients. The more I learn and gain experience, I am finally able to find the balance. Overall, I have drifted back into making sure the basics are done really well before utilizing more complex approaches.

Coming from my gymnastics background, it’s a sport that is built around mastering the basics and revisiting them constantly. The gymnasts I coach do 45 minutes of basics daily in their workout.

The highest-level elite athletes I have worked with do the basics better than anyone else, and this it what makes the sport so hard.

These same high-level athletes tend to be the best compensators on the planet, having nervous systems that “get the job done” even if it means sacrificing tissue health.

When treating them, it often comes down to revisiting basics first. These “basics” include soft tissue or joint mobility, baseline strength, fundamental dynamic control, and more. It’s only once these factors have been addressed that we can start tweaking the complicated variables of program designed, complex movement patterns and high-level performance.

Here are a few “layers” of categories I consider for the maximizing movement, performance, and rehabilitation.

Layering The Basics For Optimal Movement

Performance / Competition Level Basics

  • Does the person have a well-structured program design, which utilizes appropriate work to rest ratios and a periodized model that fits their goals?
  • Does the person understand the basics of nutrition, hydration, sleep, and recovery methods to maximize the training effect from the point above?
  • Is there some form of athlete monitoring (ideally subjective and objective) for understanding what is happening physiologically and psychologically during the training?
  • Does the athlete have tools or strategies for competition planning, stress management, and mental preparedness?

Sport / Skill Level Basics

  • Has the athlete grown up in a sporting environment that allowed a large range of sensory, motor, and movement based fundamentals to develop. With growing rates of early specialization and year-round training, this tends to become and issue in older athletes?
  • Does the athlete understand a large range of fundamental movements  (squat, hinge, run, push, pull, jump, etc) and are they equally represented in the program. As skill specific training increases this may drop off but it should never be completely lost?
  • Do they understand and show the basics of sport specific movements being trained. Examples include fundamental shaping for gymnastics skills, basic mechanics for pitching, or mastery of barbell only clean/snatch movements in Olympic Lifting?

Movement Level Basics

  • Within the skill specific patterns, does the athlete possess the basic movement components required to complete them. Examples for this may include having adequate overhead mobility or squat depth to hit the Olympic lifting positions, having basic lumbopelvic strength during the gymnastics drills, or adequate single leg stability to transfer dynamic force during a baseball pitch?

Joint Level Basics

  • If the basic movement patterns are not demonstrated, we have to work backwards even further to check the joint level basics within each movement pattern.
  • Within the overhead mobility example, does the person show adequate thoracic spine mobility, glenohumeral capsular and soft tissue mobility, underlying scapular or rotator cuff strength, and basic dynamic stability? For the stride mechanics, is there adequate hip, ankle, and great toe mobility present, along with glute strength and internal hip co-contraction to tolerate the high forces being generated?

 

Where to start for checking off the basics depends on the client. It depends on if they are rehabilitation or performance based, their history, and their evaluation.

It’s important to remember these categories are not mutually exclusive. They are very much interactive. If someone is week 1 postoperative from an ACL surgery, I’m not really worried about his or her power clean mechanics just yet. But, I still may be considering sleep, nutrition, hydration, maintaining metabolic capacity, and training the uninvolved areas of the body to optimize their rehabilitation.

A gymnast or athlete who is not injured but comes to me for performance goals, we may spend more time on the skill specific movements and overall training concepts. However, if they are missing some fundamental strength and joint mobility we may consider that within the treatment sessions.

With this said, I do think that reading and trying to understand complicated concepts is important. After all the human body is pretty complex. To make progress in the fields of human movement, I think we need to break down these larger usually more theoretically constructs.

With that said, we have to always remember that basics and foundational concepts will always need to be in place. As people say, a house built on sand is doomed from the beginning. When troubleshooting a client’s lack of progress in training, rather than spending 30 minutes trying to correct their 3 degree tibial internal rotation asymmetry maybe we should consider the fact they averaged 5 hours of sleep and worked 10 hour days last week.

It’s good to take a step back and make sure we have addressed the low hanging fruit before we scale the entire tree. Only once the basics are covered can we start tackling more complex concepts to help optimize their movement or performance. Just a few thoughts from my point of view, but I hope people found this helpful to think about.

 

About the Author

Tilley-Headshot-400-widthDave Tilley, DPT, is a physical therapist at Champion PT and Performance. Dave comes from an extensive gymnastics background, being a former competitive athlete for 18 years and having 12 years of coaching experience. His unique background as a former athlete and current optional level coach gives him a one of a kind approach to the performance and rehabilitation of gymnasts.  Along with his clinical work, Dave is has a website, http://shiftmovementscience.com, that helps teach coaches, athletes, and healthcare providers about optimal performance and injury reduction concepts.

The Best Fitness and Rehab Podcasts: My Favorite New Way to Learn

It took me some time, but I can finally say I’m hooked on podcasts and I think they are a great way for fitness and rehab specialists to learn.  I’ve spent the last few months slowly developing this opinion and must admit, up until recently, I simply didn’t “get it” with podcasts.

I thought podcasts weren’t for me or my preferred style of learning.  But what I didn’t realize is that I was doing it all wrong!  I wanted to share with you some tips that I picked up to really get the most out of podcasts because I really do think they are a great way to learn.

 

Step 1: Podcast Player 

To get the most out of podcasts, step 1 is to find a great podcast player.  I think the primary reason why I originally hated podcasts was iTunes.  Wow, iTunes stinks for podcasts!  The software is bloated, slow, and glitchy.  (I don’t get why I click the “subscribe” button and nothing happens 50% of the time!).  I’m not even sure if this is a function, but I could also never get my podcasts in iTunes on my Mac to sync well with my iPhone.Pocket casts logo

I tried multiple times the last few years to get into podcasts and I really do think iTunes is the reason I always stopped.

So I started to search for better apps.  My criteria was simple, I wanted an app that was easy to find, listen, and sync podcasts on my laptop and phone.  

There are a bunch out there, and I tried a few.  By far my favorite podcast app is Pocket Casts, and it’s the one I recommend to everyone.  It’s not free.  That was probably why I kept trying to use iTunes as I just didn’t see the rationale to pay for a podcast player when there is a built in app.  

But trust me, the app is so pleasant to use, it makes learning from podcasts so much better.  I believe using Pocket Casts over iTunes was the primary reason I started enjoying podcasts!  It is easy to find podcasts, sync with my laptop, play at faster speeds, star podcasts to come back to later, and even download for when I am away from wifi.

It has a web app and mobile apps:

Fig_2_-_pocket_cast_apps

 

Step 2: Audio System to Play 

The next step that I found to get the most out of podcasts is to figure where and how I was going to listen to them.

Another big reason why I think I couldn’t get into podcasts in the past was because I was trying to listen to them off my laptop at my desk.  This is fine, but when I’m at my desk, I’m working.  My brain is thinking about something and the podcast becomes background noise.

So I started listening to podcasts in the car.  If you don’t have a cable or bluetooth to connect your phone to your car audio, find one now!  For those that commute with public transportation, this seems like a no brainer, I just don’t so I can’t comment.

But you’ll never guess where my favorite place is to listen to podcasts???  The shower!  Now when I am getting ready for the day, I listen to a podcast or two.  It’s been great as I love to think in the shower.

bluetooth podcast speakerI got this really cheap but awesome bluetooth and waterproof speaker for the shower from Amazon, It has a suction cup and a clip that you can use:

My next favorite place to listen to podcasts is during my morning conditioning.  I still need loud music to lift weights, but podcasts during my conditioning have been a great way to learn and pass the time during intervals!

 

Step 3: Subscribe to the Right Podcasts

Ok, great.  We have a podcast player and we bought our waterproof speaker…  What podcasts should you try?

This was another big reason why I stopped listening to podcasts – I kept trying the wrong types of podcasts for me.  Everyone has different tastes and interests, but formatting of a show was also important to me.

The podcasts that are 60+ minutes are just way too much for me.  I don’t have the time for this long of a podcast.  I much prefer quick 10-15 minute podcasts that give me a burst of knowledge or tips that make me think.  Listening to a 60-90 minute conversation is great if you have time, but more entertainment in my mind than educational.  I’m also not as much of a fan of interview-based podcasts.  I listen to many like this, but much prefer an educational podcast from someone I want to learn more from instead.

That’s why when we started our podcast, I wanted it to be short and filled with knowledge.  That’s why we chose the format of answering your questions instead of telling you what I want to say.  I want to hear what you want to learn!

I recommend you start off with a small group of podcasts and see which ones you like and what types of formats you prefer.  Here is just a small group of podcasts that I subscribe to and I would recommend (comment and let me know your 1-3 top picks too, I’m always looking for more).  There are so many that I could recommend but want you to start small.  Search for these in Pocket Casts (or whatever podcast player you try):

 

My Favorite Rehab Podcasts

  • The Ask Mike Reinold Show – How could I not recommend my own show!  I join my team at Champion to answer your questions.
  • Therapy Insiders – A nice podcast led by Gene Shirokobrod, Joe Palmer and Erson Religioso.  They feature a lot of great interviews and provide of ton of insight themselves.ask mike reinold show
  • Healthy, Wealthy, and Smart – A podcast from Karen Litzy featuring a variety of interviews.
  • PT Inquest – A weekly podcast from Erik Meira and J.W. Matheson that reviews recent journal articles.

 

My Favorite Strength and Fitness Podcasts

  • Strength Coach Podcast – Mike Boyle’s StrengthCoach.com podcast.  Has great interviews with Mike but also content from the Cosgrove’s and EXOS, so always top notch, though I think the episodes are often too long.
  • The Movement Fix – Ryan DeBell’s podcast discussing, well…  How to fix movement.
  • The Physical Preparation Podcast – Mike Robertson’s podcast featuring awesome interviews.
  • The Industrial Strength Show – Joe DeFranco’s podcast and one of my favorites as it combines great interviews with excellent content.
  • The Fitcast – Kevin Larrabee’s long running fitness and nutrition podcast.

 

My Favorite Personal Development Podcasts

  • Asian Efficiency – I’m a productivity enthusiast, these guys have really influenced my workflow and systems.
  • The Ask Gary Vee Show – Not many better than Gary Vaynerchuk.  He shares his business advice with us by answering questions.  The model for what we built with the Ask Mike Reinold Show.
  • The Owner’s Mind – Chris Brogan helps you build your business and personal leadership skills.

 

I know I am a bit behind to the party but I am happy that I finally made it!  Learn from my mistakes and follow these three steps to start exploring the world of podcasts.   

I wanted to keep my recommendations of podcasts short, there are many more.  I want to hear from you, though, comment below and let me know your 1-3 favorite podcasts!

And don’t forget, click here to view all our past podcasts, subscribe, and ask us a question for the Ask Mike Reinold Show! 

 

 

6 Things You Do That Your Clients Hate

6 thing you do that your clients hateIt’s funny, over the years you start to accumulate several thoughts on a subject that one can only do through experience.  The old saying “if only I knew then what I knew now” is certainly true.  I often laugh at some of the things I did and say to my clients when I was less experienced.  We were having this discussion with our students at Champion the other day, and I consider this a normal part of your career advancement.

In addition to reflecting on your own personal practice, I think there is also a lot to learn about from your clients when they tell you their past experiences with other professionals.

I tend to see a lot of clients that have tried other health care and fitness professionals and for whatever reason find themselves with me after not achieved the results that they wanted.  In my experience, this is often due to a few reasons:

  1. They didn’t listen
  2. They didn’t connect
  3. They didn’t put in the time

 

Notice how none of these things are “clinical” in nature.  Sure, I see my fair share of clients that were not diagnosed well or treated properly, but in all reality, I’m not perfect either.  But I listen, connect, and put in the time.  This allows my the luxury of being able to call an audible with my clients when I feel we may have started down the wrong path.  They trust me.  If they didn’t trust me, they’d move on to the next clinician.

How about these two comments I received recently from clients about their past experiences with other professionals.

  • “All my therapist did was tell me what I was doing wrong.  I know what I am doing wrong, that’s why I went to therapy.”
  • “I left my last therapist and always felt bad about myself.  They made me feel bad about myself.”

 

For the young clinicians (and I guess the more experienced one’s too!), I want to share some of the things I have picked up over the years that clients hate.  Remember, you need to connect in order to do you best with your clients.  Learn from my mistakes and errors and avoid these 6 things you do that your clients hate!

 

Stare at Your Device

I can’t think of a worse way to start off your experience with a healthcare professional than having them stare at their computer and typing while asking you a series of questions.  Not a great way to connect and help your client feel like your are compassionate about them, rather than just trying to finish your “task” of their evaluation.  I still take notes briefly when pencil and paper and do my documentation afterwards.  Sure, it takes more time out of my day, but it’s the right thing to do.

This also goes for staring at your phone their whole session.  You could be responding to a highly urgent and work-related email, but realize your clients will just assume your are posting pics of your kittens on Facebook.  Excuse yourself and respond to an urgent message if you must, but don’t do it right in front of your client.  This looks like they are not important to you at the moment.  Otherwise, keep your phone in your pocket.

I’m not sure if the Apple Watch is going to help us here or hurt us, we’ll see!

Your client needs to feel like they are the most important person in the world to you during their session.

 

Don’t Listen to Them

Your first interaction with someone is really important for several reasons.  Obviously you need to determine where to start with your client, but it’s also the most critical interaction to development a connection.

This starts with letting them talk.  You want to hear their story.  Some will want to get right to the point, while others will want to elaborate.  Let this happen.  Don’t interrupt if you can, and let them lead the discussion.

As I get more experience, the subjective portion of my exam could really only last 30 seconds for me to have enough information to start looking at the client.  However, I have learned that a big part of connecting with your clients is listening to your client.  You need to provide the platform for them to share what they want with you.

 

Force Feed What You Want Instead of What They Want

It’s not about you.  Starting with this simple concept is a great start.

As an example, perhaps a client comes to you and says “kinesiology tape really makes me feel better.”  How do you think they’ll respond when you say, “Your shoulder pain is coming from signals in your brain, kinesiology tape won’t help that and doesn’t really do anything.”  Ummm, probably poorly.

You said that kinesiology tape “doesn’t do anything” and they said it “really helps.”  That sounds like conflict, not connecting, to me.

In all honesty, we don’t know as much as we think we do about the human body.  I have no problem providing a treatment, such as kinesiology tape, if there will be no harm, no long term consequence, and there is no definitive research saying it is ineffective.  Obviously, if scientific evidence is available to completely say something is ineffective that changes the topic.

Don’t get me wrong, I will do what I want to do with that client, but may also try some kinesiology tape as well.  Perhaps that makes my treatments even more effective.

Another great example in the fitness world is the focus on movement and corrective exercises.  I think this is great, but don’t lose focus.  If someone comes to you for fat loss and all you talk about is how poor they move and how you want to fix their asymmetrical 1 on the FMS straight leg raise, you are forcing what you want on the client, and not focusing on what they want.  They don’t give care at all about what their straight leg raise looks like.

Again, I think you should work on that movement pattern.  But that can’t be the focus of the program.  It has to meet their goals first.  Sure, we sneak our goals into our programs too, but be careful here.

 

Tell Them Everything That is Wrong with Them and Nothing That is Right

I think we all get carried away sometimes with finding “deficits” during our assessments and evaluations.  That is normal.  But we need to be careful with how we present this to our clients.

Some people will focus too much on the little things, while others will seem just feel bad about themselves.

Every client should leave your facility feeling better, more optimistic, and in a good mood.  You want to be one of the best parts of your clients’ days.

I’ve actually talked about this in the past in an article on The Dale Carnegie Approach to Assessments.

 

Talk Over Their Head

As you can see, communication and people skills are pretty valuable in our professions.  Another area that I often see as being an issues is not bringing the discussion to your client’s level.

Just like you should be trying to match your clients’ energy levels, I also try to bring my discussion to their level as well.

Students and young clinicians are often guilty of this for a few of reasons:

  1. They are used to talked scientifically to justify what they are doing to their professors
  2. They haven’t accumulated that database of analogies we all use on our heads
  3. Unfortunately, they are a little too egotistical and trying to impress the person with how much they know

Confusing someone and talking over their head is not going to impress someone.  Some people like to hear all the detailed scientific things, while others just shut you out.  You need to feel this out and adjust.  However, your ability to convey your points and messages in a manner that connects with each person will impress them.

I use several different tools to accomplish this based on how I feel the conversation is going, but my go-to methods are:

  1. Using pictures and videos during my evaluation
  2. Using analogies to compare a complicated point to one they understand.  Car analogies work well!  Things like, “it’s like driving with your wheels out of alignment, eventually your tires are going to wear down unevenly.”
  3. Using a whiteboard to express thoughts.  This doesn’t always just mean drawing a picture.  I also often write and make lists.  Some people are more visual learners.  You can usually tell when they whip out their phone to take a pic of the whiteboard when you are done!

They key is to give them the science but don’t stop there, back it up with something they can understand.

 

Criticize Their Other Healthcare Professionals and Past Experience

I’m surprised at how common this point is in our professions.  I have many clients that have commented on how other professionals they have worked with in the past just criticize everyone else they have and had worked with in the past.  Like a personal training putting down their physical therapist or their physical therapist putting down their chiropractor, as a couple of examples.  Realize that your client has probably built up a lot of trust and respect over the years for the other people they are working with, which have not currently built up.

Not only does this make the person feel bad about their past choices (see above), but it’s also very transparent that you are just slamming someone else to try to make yourself look good.

I have a general rule of thumb that I developed over the years after seeing many “prestigious” people commit this error – Don’t make others look bad to make yourself look better.  It may work in the short term, but always catches up to you.

Yes, you are a genius when you have the power of hindsight.  Everything is clearer in retrospect.  Be respectful of their other people your client is seeing and has seen, you aren’t always right.

 

In reality, I probably could have listed another dozen, but these are a great start.  Avoid these 6 things that you do that your clients hate and focus on connecting, listening, and putting in the time to maximize your own effectiveness in helping people achieve their goals.

 

 

 

7 Habits of Highly Effective Rehab and Fitness Professionals

The latest Inner Circle webinar recording on the 7 Habits of Highly Effective Rehab and Fitness Professionals.

7 Habits of Highly Effective Rehab and Fitness Professionals

7 Habits of Highly Effective Rehab and Fitness ProfessionalsI’m always getting questions from young professionals (and older ones too!) about what they can do to get ahead in our profession.  It’s one thing to simply want to get ahead and another to actually make daily habits designed to help you get there.  It takes effort.  Here are what I consider 7 of the habits that I see many of the top rehab and fitness pros stick to in their lives to get ahead.