Intermittent Fasting What a Physical Therapist Needs To Know
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From the medical studios, a are US medical dot com leaders in Hashtag travel pty. Say we're live from the medical studios also my bedroom. Welcome to my room everybody. That's what we're doing this from everybody's at home. Subscribe to the podcast you don't Miss Anything in physical therapy. Do it free on itunes spotify Google podcast and as we mentioned in the video casting mom said I had the face for Radio Youtube facebook and twitter at pine cast on the socials. got a great show for you today dig into something which might come alive i. feel like is one of these concepts that comes up. And you want to be informed right. So you want to know how to respond and what you should tell people we're talking intermittent fasting. We'll be talking with our guest today but intermittent fasting get into the conversation though drop a comment below interact with us on social media maybe we'll be able to field your question. Live during the show without further Ado I do love me some ado our next guest physical therapists working in orthopedics. She kinesiology nutrition diabetics as an undergraduate student at the University of Rhode Island and received her dpt from Stony Brook. University let's welcome to the show Keira Lo Bianco. Moving when there's like a crowd in the background even when you know it's fake this is fake. Like. Hey, this is Kinda cool here. WHOA. Thank you. Thanks for having me. This is great. I didn't prep you for this. We're going to get into intermittent fasting, but I didn't prep you for this. I want to tell the story about how we like met. Do you remember this? It was at. What city we were, and it was a conference where were we Boston. Boston yeah. They think. Maybe honestly, they're all they're all a blur to me I just never it was a conference center. It's all I know. Or many I go to a few. So so what happened it's been a a a minute correct me if I'm wrong with this is how I remember it. I ordered like a million pint glasses to be shipped I'm talking these were the glasses these the glasses right here. Okay. Chip cases of I shipped him to the. Little. FEDEX KIOSK in the conference center and I went to pick them up. And the guy was like, well, first of all, he was like is going to be twelve hundred dollars to pick those up and I was like the glass is only cost like eight hundred dollars and he's like, yeah, there's a receiving fee and I was like I don't have twelve hundred dollars to give to receive the glasses I just paid so you can keep them if you want. Or I could leave this hundred dollar bill here and you can take a fifteen minute break. There's a hand truck in the back I'll be back in fifteen, but then I started panicking because I couldn't physically carry them all by myself a million miles across the conference center, and that's where I did I run the hallway like a literally just grabbed someone's like who who can help me I looked at year strong. I look really struggle. I forgot about that actually by all I remember is logging them in and out of elevator. Yes we were doing Hawass we carried them across the Conference Center and the reason I needed to do it quickly because that guy was gonna come back and I was like my love, he'll ask for another one hundred bucks and I didn't have it. So I was like, let's go. So that teaches you anything from today's podcast. So far is a hundred bucks can save twelve hundred bucks if you're. A long way. Well Hey. Thanks for jumping on the show since twenty seventeen you were a student still there right at Stony Brook yet. Yep. I graduated in eighteen so you're later Congratulations you've got that going for you and are you still on the Long Island? Where are you I? Am I I'm actually I just got put out east in Southampton. So that's been my my home base for why We likes the Hamptons Hi Al Maybe, one day I'll get out to the HAMPTONS. Yeah. Don't don't threaten me with a good time. So the reason I bring you on today as we found in your intro, you did a little background, your undergraduate work in nutrition dietetic talk about that briefly. What drew that way. What did you learn? Yes. So when I was an Undergrad I, I knew right off the bat I wanted to go to PT school part of most kinesiology programs has been taking either one or two, maybe three nutrition courses and I took my first one and fell in love with it and I felt so torn up on my gosh do I continue with PT, which has been my dream to be or joy mixing up and pursue nutrition. So I actually just couldn't design and I picked both. I mean we had. We had an interview on when we're at CSM with Sarabeth Burke and she talks PhD and hybridity, and she's talking more and more mixing of things is actually more valuable versus where my parents generation was be really super good at just one thing and engage into that thing and stayed there for twenty years and now that's not the case. Yeah absolutely I mean I I always found an Undergrad and even still now like you really can't talk about exercise without talking about diet vice versa, they're so interrelated that I, think it's important to have a well rounded view towards it plus. Everyone's getting. So specialized that it's being, it's harder to collaborate. It's harder to mix everybody together because hearing. So many different viewpoints bottle so. Important to know a little bit about both. And that's why I got excited to talk to you about this this particular topic, intermittent fasting today because it's come up a lot people ask me and I. My my my standard response is I. Don't know if I'm educated enough to speak to you in depth on that like I literally have that verbatim because when I don't want to say is I don't know. because. That's the kind of like but I don't but I want to say educated enough now if you're asking me to get more educated, I can do that for you. But since you had, you have this this this this nutrition background this is this love for I was like Hey care is gonna come on the show. Let's talk about intermittent fasting I'm sure it's come up with in clinic for some people out there in the audience right now. So let's dig in. Let's go big small macro micro what the heck is intermittent fasting. So I actually, before you asked me but I really it was kind of on my to do list research because I do get a lot of questions about it in clinic. So I really wasn't too sure what the pros and cons of it were what the benefits were. So I've done good research at this point and it's actually pretty simple in terms of like the basic terminology of it. So people are using the word intermittent fasting in place of something called restricted eating. So people are this is usually Looked at in a ratio. So time spent eating. Then time spent fasting but intermittent fasting, really an umbrella term in the literature for a bunch of different types of fasting you do prolonged fasting, which has shown its own benefits that's typically fast in greater than forty eight hours. But this time restricted eating component is really Ah Tool that you can use to match your circadian rhythm. So. Basically, what that means is eating in a time when your metabolism is at its peak and not eating when you're. At a slower rate. So timing those things out. So a couple of different types of in terms of intermittent staff, your prolonged. prolonged. What was it again? What was the term fasting prolonged fasting? So. Yeah. So I mean I know some people who had the concept of they can eat anything they want for eight hours but it was only this eight hour period anything else it was like they were from the movie gremlins like you do not feed the person outside the eight hours or you don't you don't want to know what's going to happen and they treated like that and. These people will swear by results and when you were looking into, you know intermittent fasting as buzzword term you know, what were you finding in terms of what works for whom does one thing work for everybody or you need to try different things out as you mentioned with rhythms? Well. So that's actually funny that you say that because this is basically the the main reason I decided to start my blog is I feel like especially in the medical field, you really can't have black and white like if I say to every single patient, Hey, you should stop using start intermittent passing. They're gonNA look at me like well why they started, and then they decide hey, this doesn't really fit my schedule. This isn't easy for me. It takes a lot of planning makes me feel like garbage whatever their complaint is like I can't say that it's going to be good for everybody. But. I. Think the body truly needs. Like a routine schedule, your body. If you. Eat whenever you feel like it or whenever it's around or whatever your body kind of goes into this region preserving everything. So if it's not sure when it's going to get its next meal, hold onto ebbing. Whereas if you know that if your body knows that you eat at nine twelve and five o'clock in the afternoon, then your body Kinda dumps what it doesn't need an hold on is up at actually needs and you kind of get rid of waste that way. So the best thing is kind of a nice tool for people to use so that they had that schedule, they had that routine available to them. All right. So now we're getting terms I want to start macro to micro before forget though I forgot to ask the I always like to get the hardest question of the early I forgot to ask you what are you drinking? Rosaiah all day. I'm probably GONNA, take some heat for this. I have been having IPA's on the show and I'm trying to knock back a couple of I'm just doing a white cloth with ice cubes. Okay. But. I wish we were told me. Out to blackberries my flavor. So cheers, and now that we know the the the big terminology, the idea behind intermittent fasting, which is we least be knowledgeable up because patients either doing it or asking us about it and clinic. Absolutely. So, let's go into more specifics. You alluded to it a second ago intermittent fasting pros and cons what are they? So. Right. Now, the research that I've done has has shown is actually like good amount of pros I am very much like a Nada Diet Person I don't typically record things like that just because I, always find that they're very temporary and a diet shouldn't be that way. So always skeptical, but the research is showing some pretty good benefits so. There's this protein called IGF one and it's job in your body is to build in regrow. So for all our exercise people out there, that's obviously very important to build strength right? So. They've been finding that during the fasting period that protein in the body has been elevated so that Your body's Kinda using whatever's leftover to rebuild. which they'd been showing has. Had Good Effects Towards a breast cancer and longevity especially for growth for neurons in muscles which for us is huge like that's great to be able to use. So. That's one of them. The other obviously people talk about the most is weight loss. So I. Biggest part of this has been fact that you're not eating at midnight. When, your body's at. No good notes you know. but I mean it's crazy when you're schedules are so wacky I mean I work in outpatient you could be at work till eight nine o'clock Mike commutes an hour. So I don't get home till nine o'clock sometimes ten o'clock might eat. Then I'm starving I worked for ten hours. You know so I I get it's tough and it's Something that requires a lot of planning. So I think be more towards a con. The intermittent fasting can be kind of problematic in that you have to have a schedule and you have to be consistent with it if you're working outpatient or even impatient, your schedule can vary from day to day. So it's hard to kind of get that like. Permanent. Short. Yeah. It in terms of pros and cons I think that definitely is the thing that brings looking for his terms of like. Well, this could jump start my weight loss in in your research that it did it did it say anything about in terms of well I mean I feel like I feel like this term creeps up in pt and everything now, right? It's coming up it depends where two two people. With different genetics to dig same plan. If you watch this on like nutrition twitter, you watch people rage on carnivore diet or plant diet or intermittent fasting, and literally these people just raging at each other and what I've done. I've done minimal research into a book that was good for me was David Epstein 's range and what he was he's like, honestly, genetics plays a really huge part like we know that. And then we say do this. It'll definitely work in every situation. How can you say that with a straight face you know that genetics is a giant component of how exercise and food and sleep affects each us. Absolutely one hundred percent agree and there's a lot of research to going into the gut genome by ohm not genome. so That is. An actual phone? Yeah we're landline phone history. Oh my gosh. Do you want to show the audience 'cause? I don't think half of them know what it looks like. People, that's a phone. It's attached to the wall. and. Had to stand near it. There's A, there's a court and everything. I mean, this is off topic because that's me You know the younger people in the honest. They have no reason have no concept of why we call it hanging up on someone because he used the phone used to be on the wall hanging up. Oh Yeah. It's very difficult to emphatically hang up on someone by just pushing an iphone but all right well now I, don't know. Someone important you. WanNa. Take that call in the middle of the shot on a your your call I picked it up and hung it up. All right. That's also what you can do when you have a regular phone. Up We'll skip the phone education but yet genetics. As the most I've researches it depends and that's what we find impeach old frustrating. It was as it wasn't as a student but a lot of the things are going to depend and you alluded to it a second ago, which is if I told everybody to do this, they'd want to know more. But also if you told one hundred people to do this, even if they all definitely adhered to, it could get one hundred probably get one hundred results. and. I mean in terms of intermittent fasting it's very depending on what you're eating to. You already talked about people who say, Oh, I can eat whatever I want in this eight hour period if you eat nothing but chocolate cake the entire time like you're gonNA. Be a bad shape you're not going to be feeling. And I think in this busy fast paced lifestyle that we've all been living which kind of Kobe's has been a blessing for his slow everything down a little bit. But people. Are Not really aware of how their bodies feeling until it's too. Though? I mean if you're eating if you have an eight hour period in your eating potato chips in whatever you can find eight are period especially during a busy workday or travelling or whatever it is, you're not going to be feeling your best even if you're doing intermittent fasting. So you kind of have to find that balance of okay. I need to plan out bite meals and I'm not going to be eating for eight hours straight. Fills a couple of questions come into play, who in terms of genetics what are you eating and then yes. If you're talking about timing several different types of intermittent fasting, that's the went. So it really is the those three who wasn't win come into play. Pre importantly when you're talking about intermittent fasting. Yeah. The independence is so huge I mean we see that day in and day out you can't take somebody with that. He's a cap slightest intrigued in the same way across floor. Plans on what sitting in front of you. So frustrating. Though Impeach scored center what the answer it's like I. Just thought it was my professors in school then I realized Oh my gosh, that's a thing. I feel like I should start pens dot com just because everybody's eventually going to go there. You know what? Jumper or someone steals pets car. Let's get. into the show. So. How do you applying this information clinic? You know you you bring in nutrition indicted work and information with your patients patients in clinic. How else can people bring sent? So usually. A lot of what I talk about with patients has to do behavior change. So I kind of have to meet the where they are just like everybody else's. So somebody's coming to me and saying, Hey, I've between the intermittent fasting. What do you think about that? You agree disagree on like we'll how do you feel first off? I I don't really love to talk about weight loss in weight gain while unless it's like extreme amounts but I don't like I don't like your gold to solely be weight loss because that really I mean, all the research is showing that BMI is relatively irrelevant. So. You really want like, how are you feeling? Do you feel like crap when you will need for eight hours like do you need to eat right when you wake up in the morning and you have to make it work for work it all it depends on who sitting So When people haven't started it yet, I usually say to try it on a day that you don't have anything else going on. So. On a Saturday afternoon. Okay Sunday try this and been a wake up do whatever I have to do in the morning. I'm going to start eating at ten o'clock and then dinner's going to be at five and then I'm done for the day and see what happens. Monday feels you know and try it that way the research is also showing that the prolonged fasting. So that's greater than forty eight hours has shown some pretty powerful benefits too. So I mean, you're not going to do that on a weekly basis. That's something that. How often? How often are people trying that going without eating for forty eight hours is that is that a once a week or you? You go without any for forty eight eating and tried again set up been It depends. Well I don't know anybody personally who's done it. But The podcast I was listening to that we could talk about There was a researcher. His name is Vaulter Longo. He's been studying it, and it's he said that you could do a once a year once a month it's not something that you do weekly. But. That's something that you can play around with also. So it's basically just trial and error in you figuring out what works for you it takes a lot of planning. So it's something just like, okay this is what I'm GonNa do tomorrow you have to kind of make a plan for doing that. Yeah Yeah, I feel like a lot of this is going to be trial and error. A lot of people are looking for a quick fix and exercise or nutrition calling it a diet looking for that quick fix what's the fastest path and the more we learn the more we learn from you know the experts are out there saying the real experts who actually understand this stuff are. Saying there is no quick fix and Everything is going to depend on you and how you react to these things and planning your genetics. What else you doing besides just eating your are you active or you inactive? You know when you eating so all these things are fortunately if you're here for a quick fix, it's GonNa be. It depends unfortunately, there's never a quick fix. Quick question from the Audience Rachel wants to know typical fasting schedule for someone trying for the first time I know it's going to depend. But if someone were to, as you just alluded to, if you're going to say, Hey, you know what try them to Sunday when you when you can control most of the things that you're going to do? What would you suggest? I mean from what I read in the literature. Typical. Time restricted eating time would be an eight hour period of. Overeating got it and then sixteen hours off which sounds like a lot but really half of the sixteen hour period you're sleeping. and. Before you're going to bed it's not like you're doing anything too strenuous. Just Kinda like that warning period where you're someone might be grumbling but once you kinda get onto a schedule, I think that it's relatively easy to maintain. Of course. Yes. Yes. A lot of different things that come into play I went on a hiking trip in the middle of school went when hiking in north of Seattle and up in Alaska for a couple of weeks and I was really nervous because we were essentially carrying. The jet boil will propane little fuel and you boil a little the Cup of water and you mix in your like Maris and I was kinda nervous. I'm like word that's what we're eating. Stuff. A couple of power bars are just to make sure because there's no food out there on the mound and I'll be honest. You're a couple of weeks. My body was just pretty used to it like that, and that's that's me knowing myself I mean looking at the tiny little bowl that I would eat a food we were done. That was all we could eat because we were on the carrying a certain amount for a for a trip. So we realized that we we needed to make sure what we're eating was planned. We knew how much activity we're going to be doing but the variable was our genetics in our body and you know I lucked out in terms of after a while just kinda got used to eating. You know a couple thousand calories a day and hiking all day but I also got great sleep outwards. Yeah you're probably exhausted. No? Yeah, right. Out. Did anybody in your group not like the restricted eating it was a small group. No I was the most inexperienced. Hikers the group by far, and that's why I was. Kinda, like can sneak a couple of Hojo's in here like you know, where am I going to put these things? So so no, but it probably took two or three days before I was actually like this I'm fine but it was probably like the second or third morning waking up where I was. Like man I could just go for some. You know just a big old omelette instant toast. Let me get some of that but probably worth day my body was just like okay this is all we're getting. We'd better deal with it and I adjusted. So everything you're saying I agree with yeah. Yeah. That's Super Interesting Jews anyway weight whilst Hanoi it really yes. I stayed I. Stayed Very hydrated because we were I mean that was like a big thing but I wouldn't. Men there. It wasn't a ton of way I probably would say between five and ten pounds, and this is over three weeks. Okay. That's actually like a pretty decent amount of weight loss, right but as soon as I. Put. I put four pounds back on like in the first week of of getting home because I hit every every a restaurant in northern northern Virginia as soon as I got back. So what's cool how you reply in that in clinic any good resources use you you could suggest for people to to read more for themselves always wanted people to educate themselves beyond what our guests are telling to. So where'd you go? So I've actually found some pretty good podcasts have been weirdly obsessed with this podcast called the school, of greatness. How and he interviewed This path. Rhonda Patrick. And she is like the nutrition guru of Gurus like she is probably one of the most brilliant people I've ever listened to I'm. Sorry. and. She just she so up on all the research she. Gives you the big picture like everything you need to know but then is able to kind of tone it back so that if you're not With all the chemicals or chain reactions. Kind of brings it down just Average person's level which is awesome because I haven't been in school for three five years now in. Off Up she is phenomenal and she actually works very closely with Volta, Longo, who studies the intermittent fasting and things of that nature. So she was an awesome resource. Cool. Cool. WanNa talk to you about something else will bring it on screen. What's that? What is this? That's founding bicycle my blog. All right. So so you started a blog I always liked it when somebody asks what they say I started a podcast or a youtube channel or blog I was just go hey, what was your inspiration? Why did you decide to create? So I actually have been wanting to do this since I was an undergraduate because I have been so passionate about combining exercise nutrition. And I am obsessed with A Albert Einstein quote is like riding a bike in order to maintain your balance, you must keep moving. So I feel like that's so important. I say all day long clinic to keep going keep progressing. That's what life's about you have to make it better for the next day. Oh. I've been kind of trying to inspire people to make good changes to keep their bodies moving forward and grout. When? SOMEONE GOES TO BALANCING BICYCLE DOT COM. What are they going to find? What are you talk about this blog because it's your thoughts? Out in the ether on the Internet. Yeah. So it's bit so far. It's been kind of a combination of exercise advice nutrition advice but it's pretty much full-body collaborative type thoughts that are on share people I'm. Pretty interested in behavior change in actually getting people to make that actual change I don't know how many times I've given. ATP Out and nobody does it and I asked him how you're excited at home I, didn't do them or I did them and I look at them like actually I didn't do them and you know it's I mean I love hanging out with my patients but to see them three times a week for their entire lives is obviously not feasible. I want you to be able to make a change in your life without me. So. I think on my blog, I hope that people will get that vibe in find tools that they can use to make their own lives better without me babysitting madman. Checking up on them. Yeah. Yeah. When I was when I was a younger clinician are still in school I remember thinking man, there's no one's listening to me what you WanNa do is you want to blame the audience, but I went back to my broadcasting days, which is if the audience likes something, they're being honest that you can't blame the audience you have to blame yourself as the center of the creator of the information whether that's h. e. p. whether that's a you know it's a diet routine or something to get into in terms of fasting So I think going back to what your method of your your favorite quote is. Einstein is George Bernard Shaw, which is. The greatest failure in communication is to think it actually occurred. So I told care something so and she didn't do it which means that she didn't do it. She fail. But what if I would if I didn't say right way or if I said it in a moment, you weren't listening. So I think behavior change puts it back on us as clinicians as as a profession physical therapists, physical therapists. Assistance anybody in the healthcare field and saying, we need to own this. If they're not doing it we changed our ways. Our job is to continually find different ways to help usher in behavior change not just tell but usher them through. The good thing about our products is that we're trying to work ourselves out of a job as you mentioned, three to five three times a week is not. It's just not good. You want you initiate behavior change absolutely. Yeah. I mean. That's exactly right. I take it. So personally when they don't do my agp like what did I do wrong? You don't WanNa do it. Let's talk through it and find that obstacle that is preventing you from doing it and let's chain. I don't want to give you something that you're not gonNA use. That's not going to help you like let's make better you and. Let's keep pedalling like a bicycle. The best exercise you can give someone to do is the one they're going to do care. Are you ready for three questions? Yes sir. Remember. Three questions brought to you by from medical staffing. Find Them Online. At AU are US medical dot com. It's a you are US medical dot com. If you're looking for a position, all different settings, inpatient outpatient specialty settings. Women's health. You can go all the way from Alaska or Hawaii all the way the tip of the Hamptons they need physical therapists out there right Cara. Out on out, she says. Especially this time. A lot of people graduating passing the. Earliest today he was a lot of people on there. Yeah. There was a bunch people south taken it today it can. Kovin. But listen if you're looking for a place that do to thing, you've been studying your whole life. You are US medical dot com. All right three questions. First Question of course is aware question care. Anywhere in the US states, you can go for three months and be a bring your bike with you go. I'm going. Alaska. Jimmy. Bring your food. Great Yeah. Absolutely. Intermittent fasting their core part is they do people just assume Alaska Hawaii or like just crazy cool places. Abbas probably know positions there a Lotta Times shorthanded short term assignments could also turn into a long-term assigned. So Alaska not too Shabby Watch out forbears. Second question is a what question we alluded to the. I. Think your answer before what's something you've watched read Listen to podcasts. Audience Benefit from. So I already talked about the school of greatness podcast but doctor. Rhonda Patrick has her own podcast and it is absolutely phenomenal. She is such a great resource and not not even just intermittent fasting but just everything nutrition around she has some sort of insight on and will at least point you in the right direction by research. So she's helpful. last question as we begin with WHO. Who is some in the audience should know more about very open ended I love asking open questions. I mean I guess Rhonda Patrick. Can I say that again? You're the guest you can do whatever you want. You can really hammered on her you're really fan girl growing her. I like it. Yeah. If I she listens to this album. So pumped shutout under. Like quiet there for cycling if she listens to this, I'll be so excited. Aren't. Let's do I lasting. Would you on the show we call it the parting shots. Parting. Shot no pressure here Keira it's your mic drop moment to leave with the audience. So in doing the research for intermittent fasting what would you wanNA leave with the audience for the parting shop? To find balance it's going to be about you and you have to trial and error and practice and listen to your body find your balance. I like. It depends everybody party shop brought to you by our friends from the Academy of Orthopedic Physical Therapy of leaders in orthopedic PT Level Up Your Game. Why not do it with the Academy of Orthopedic Physical Therapy find them online at or so PT. Dot Com we're also doing a contest right now contests with the Orthopedic Academy to win any of their course access to any of their courses online, follow us on social media to get that joined the the PT Pint cast unfair advantage that. So we can get our emails and you can find out stuff before anybody else thus while we call it an unfair advantage I before we go cookie loves it. She read the complete guide fasting with Dr Jason Song. He explained things she said, she was doing it twenty four hour fast in twenty four hours a week for six weeks didn't think it would work. She was wrong. Feels great as PT's need to help our patients understanding. We'll follow not for everybody and that's exactly what care was saying it depends try works for you So love the resources you gave me insight on intermittent fasting Cara. Appreciate you stopping by to the show. What's have back again, bring your bike next time. Thanks for having me Jimmy Love PT Pine. Cast yes. Yes. The show by telling a friend or by weaving a review on one thousand, nine, hundred Google play. Brought to you by the Brooks Institute of Higher Learning Innovator in providing advanced post professional education. Brooks IHL offering continuing education courses in numerous specialty areas, six residency programs and. Fellowship, as well as challenging but rewarding internships, the I h. l. specializes in the translation of information from evidence to patient management learn what they can do for you to support your professional development at Brooks I H, l., dot org. Our home on the Internet. PINT? CAST DOT COM created by build. 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