20 Episode results for "PT Podcast"

Disabled is Not a Bad Word says Marcia Darbouze

PT Pintcast - Physical Therapy

45:34 min | 9 months ago

Disabled is Not a Bad Word says Marcia Darbouze

"Hey before we get started I, just wanted to say thanks to our longtime sponsors are es medical staffing, helping you physical therapists or physical therapist assistants find jobs all over this country with position. All settings in all fifty states find out what they have for you at a U. R. US medical dot Com. That is a you are e US medical dot com. Follow US online at PT Podcast, and subscribe on I tunes spotify or Google podcasts. Yeah, it's its. Own It says, pizza podcast is in fact live look at that. We'll do that. It must be true summer cell phone. How you guys doing? I'm Jim McKay. Nice, to meet you. I'll be your host today. This is pine cast a podcast that saves physical therapist for missing out on amazing insight remarkable ideas, motivational stories here in the world of physical therapy. Welcome to the show broadcasting live from the Arias Medical Studios Look at these gorgeous studios also known as my bedroom. That's other other use I have for this you are a US medical dot com. It has a U. R. E. US MEDICAL DOT COM HASHTAG TRAVEL PT. They're the leaders if you're looking at, do what you WANNA. Do speak great therapist where you want to do it somewhere in the fifty S. Arias who you want to contact. So find them now go there a U.. R. E. US medical dot com great show for you. Tonight we're talking to Marzia DR booths connected on twitter, which is where a lot of these interactions in my life happen for better for worse this one's going to be better. But I love when you trip across someone who's got something great to say then you get a little poking in their backstory and they got a really cool back story that I think the audience can learn from you're going to do some learning tonight. With Marquette make sure you subscribe to the podcast. I tuned spotify Google podcast. Now, of course, video casting on Youtube facebook and twitter at PT Pine cast on the socials and make sure you comment questions during the show. If you say, you WanNa Interactive Podcast, which you've said before. And now challenge you comments or questions or the word replay. If you're watching the replays, let us know you're interacting. Let us know where you're watching. I'm always curious where this podcast actually gets to on the interwebs. Let's bring in our guests today. Our next guest powerlifting strong woman black spooning, living, playing, lifting, and practicing physical therapy in south Florida Look Marcy Dr Booze to the show. Hey we bring our. Marcio welcome to. Know. How're you doing today not too shabby pretty high hyphen spoons or doing good. It's going to be great high on spoons and I had no idea what that would have meant before I did a little work and your background poking around because I saw that come across I'm thinking to myself what is what is spoon house like I'll ask her winning a on the show but then something brain said poke around a little bit force you get some context. So for the audience I, want you to walk us through this. You say your high on spoons you describe yourself as a spooning what's that mean? while. It's basically a metaphor F- to explain how people with chronic illness feel. So or disability of any type visible or not visible. So started by woman named Christine and she kind of use it as an analogy to explain. How she feels so let's say you as the normal able bodied person wakes up every day the world hands you a hundred spoons no matter what and then it costs five swings, Cook Breakfast and spoons good work spoons this whatever whatever for me Maybe. Maybe I will maybe I won't get one hundred spoons every day they don't roll over they don't collect some days. I might feel like I'm in the negative in. So I might wake up one day and half to decide. Am I, washing my hair today or am I staying in bed? So, high on spoons we're good to go already. It's a way for and I loved how reading the backstory behind you. LEGIT Google. What's a spoon? I WanNa see what she's talking about. Care it was it was really used, and now that we're discussing here in this podcast, hopefully, other therapists if they hear their patients describing it, they understand the language of the person they're working with but really it was it was a way for people living with chronic pain to discuss amongst each other. It was a language they were using to to to communicate say, Hey, today I'm hind spoons or you know that's going to be too many spoons worth to do I'm going to push off to tomorrow otherwise because what happens or what was described I was reading would be if you go into the negative. That's going to carry over for you. To the next day in terms of you're GONNA now suffer the effects of going into the negative spoons. Am I walking through that right definitely, and there's also a couple of not at one likes that terms people like to call themselves unchargeable. There's also like a battery theory in terms of like you have a faulty battery and I don't know as much about that one. But there are different words and terms and analogy but at bare minimum just to get the point across that everyday, we might not have it. Yeah, it's a good way to explain it I. Mean It's pretty clear you. It's I like it because it's visual I'm. Sure things visually and yeah. But going into like getting out of bed that's going to be one spoon right. But also like you know getting ready for work and you're late right now you're you're amped that's going to cost you more today because you're late than it did yesterday when you weren't late and if you only get one hundred a day, you might have to skip some things. Hey I can't. I can't do that today because I'm low on spoons today after Martina's high on spoons and we liked it. I didn't even have to take a nap today. I mean, unprecedented. There we go. Your story, I wanNA find out how how did you come come to the professional physical therapy brings you here to you know into it and and we'll find out about you before we get into some other cool stuff learn. Yes. Sure. I mean I've always been into medicine in general but as a child of patient immigrants, all you know about medicine is doctor nurse and at nursing maybe not maybe doctor I, think about it. So I always had pre MED programs in school like Middle High School I was always doing those Saturday science field trips like dissecting pigs seventh grade like all of that stuff, and then I got to high school and they let us take field trips and explore different parts of the hospital and I got to the physical therapy room and I was like, all right I could buy but this. This makes sense in the kind of felt like. The MD was a little more boring to me people came in and out and you there a right person great high what or rent does down next okay. Person High what or retinas now next and I was like It's not for me. You gravitated I mean used the word in there. That's really the tale to me, which is person and connection is what I'm getting out of that is, is you said, Hey, listen sciences. Cool. That's super broad, right? Yeah. In the how can I connect in science or how can I connect with this with this field and people and you decided that along I'm guessing a longer because you also talked about time which is hey, how you doing right this leave. Longer connection. So physical every where'd you grow up? I'm from south, Florida through through. So pretty much Miami, Fort Lauderdale area, and that's pretty much start finish have been like it. All right. So see you decide that that's what you're GonNa do and you go through that and you know when did you become a PT? So I shot straight through high school knowledge straight through of. So actually end up going to Nova southeastern, which is in Fort Lauderdale driving distance There's a couple different schools I wanted to go to in things are the timing is weird which no-one no-one explained to you. You could apply for five schools and they all start in five different stopping points and you have to decide okay I. got this acceptance to wait to miss do I do this. Played it safe. Stayed home. Yeah. I like that good experience at PT School. Yeah overall Lia good yeah. Blood. Sweat and tears a lot of tears. But we all got out. We all provide. That's one thing we all have in common. You some other stuff you look real comfortable holding a microphone with a set of headphones. Why is that? Why do I have these headphones I? I'm one of three women disabled girls who lift but gassed. Yeah. About. That why'd you start it because I'm always curious rue the why did you decide to do a star show and then who he aim at what he talking about? What's what's the give their because that's what podcasting is all about being give right. Yeah. Skits always like telling a story you feel like hasn't been told yet. So that's kind of where we're at. So for me I wasn't. Wake Up. I, was born at deal with disability and illnesses whole time it was new to me. So I went through school quote unquote normal able bodied and I learned about, Rehab? No Neuro Oh man that's them. That's not me I'm cool and then I hit about twenty fifteen. So. Almost, five years ago now that things started to go a little wild and started to grapple with me so. I started have a lot of fear. A lot of anxiety Megan I. Am I going to be wheelchair bound is gonNA suck? Where am I gonNA end up and you know you're treating patients and seeing the end The far bottom the rock bottom in it's it's a little scary. So then I started having trouble with my lifts as a competitive athlete that messes with your identity also. And then I found Mary Beth who someone who really founded disabled girls who left and she has a she was born missing a hand and so I would just message her about these random feelings ahead disability bad. How should I feel about this and we kinda just ranted and just went on and on and on with and after a while like what? More people are having this conversations. Let's let's go somewhere with this and that's kind of weird. So we also have Khloe who's like. Strong AF actually top you three, she's like top ten. Times how? I'm forty eight pound weight class like she looks I mean that is I would not question that with. Aggressive. Yeah. So you guys all have that thing in common in terms of lifting disabled lift. So what are the kind of conversations? What can people? Expect to listen to because I. Love the fact that there are so many podcast. Now, yours is a prime example. Of of of of physical therapists listening right now who? Really, prescribe listening to your podcast. To do after or outside of the clinic as something could get complete value out of you could start to prescribe physical therapy podcasts or this is a physical therapy podcast in terms of its put, it's a conversation that you might think a patient could benefit from. So what are the accommodations that you guys get into you guys got more than thirty episodes already so Kudos on that. Yeah. We're moving along. We're moving along and it's it's a lot of the conversations are things that her and I talked about in the beginning. you know how do we treat people that are disabled? What does it mean to be disabled desert look is there something should be able to see and we get to have a lot of conversations with some awesome people. Some people have a spinal cord injuries. Some rare things I've never heard of like halt Orem Syndrome just. Everything blindness everything and they just tell us about the lived experience and how they make movement work. Some of them are new to movement. Some of them were already lifting before something happened and the Cup lifting owing. You. Mentioned something a second ago which when you were going through an experience like this Max's with your identity I'm a runner. I had a leg injury to three years ago. I didn't know what I was going to do like it. I wasn't I didn't lose the ability to walk. Everything was pretty much fine except that one thing was out of my life was. Yeah, that was a big deal to me and I didn't know where I was going to fit or how was I going to identify what do you do? Well, I don't want anymore and that was all I could think of is like to tell you what I didn't do any anymore. So really I'd say the overarching message for your show is Hey, first of all disabled, it's not a bad word. Yeah not at all, and so when I first started having issues it it really mess with the identity and my performance and I just denied it. So it could pushing and pushing my body and myself So like one year went to raw nationals. And just total absolute trash performance and that was kind of my wakeup call it. What are you doing? Something is wrong with you. You need to sit down and sit with this figure out, get through it and that that's where I finally started addressing the issue because I couldn't hide from it anymore. Had you already connected to these these ladies from simple girls who left at that time now? How did you did you come across them? I love those stories of like meeting people just like. Just, loving loving chillers vibe and wanted to talk more. Yeah How did you meet these? How'd you meet these ladies and get involved instagram? Him and a time where are, we suppose was over social media. It's skits. A lot of superficial gets a lot of you know just like happy go lucky whatever messages in highlight of it but. There's real people on here. Yeah. The and there are a lot of times. In the Oxford debate a couple years ago it's a highlight reel and like. I have a lot of wins in my life, but I have probably just as many losses or maybe more, and if I only see your highlight reel or everybody's highlight reel, I almost said and start feel this big and what am I doing wrong with my life. But if I really took stock I, could say, wow, look at these look at what I. Do Have Right. But I agree with you on social media you a couple of laps and you can get burned out on that and just desensitized to that companion. So it was was almost out and then somehow came across I don't know what? Hashtag I was going through or whatever, and I just saw at the time Mary Beth lifted for four Federation that. Doesn't allow adaptation. So she was doing one armed lifts and I looked at the videos like okay. I need to know who this person is that that's pretty much where it started, Ou-. That's a great picture I mean one arm deadly that is crazy and she put his picture up on on that website where their description and again that website is disabled girls who lift dot com. So when we go with that first topic to talk about now disabled is is not a bad word when you when you bring us into clinical practice, how do approach this? How do you? How do you broach the subject to begin to to let people know like hey, there's something that there's a limitation you gotta get over, but it's not a bad thing. Yeah. Yeah. That's basically it. This is this progress. This is this is a process. Sorry this is a journey. Than the destination is moving better in feeling better things will be the same maybe they won't. But you know you're still you. You're still one hundred percent of the same person. Matter what happened I like how you instantly flip and make it a narrative journey destination maybe it might go this way it might go that way but that's a better way saying of well, medically speaking. Joint. Isn't that doesn't tell me anything that makes you. That makes me feel like you're you're backing away from me rather than bringing in excluding than including so. Net Journey. have you had any of those moments? I had one of those moments where I was a PT student and I had a patient in a clinical rotation. Google me. And she came in the next time that she was scheduled and she was like I've listened to seven of your podcast episode and I was like, this is weird. Have you had not where? You're like. Post and now you know me as the clinician like have you had that So I do adults cash and then kids insurance. So the adults for the most part that's how they know me they know me through the lifting community or they found me on instagram so they're coming in like like Oh. Yeah. I know what you're about? Yeah we're coming in. We're GONNA DISH WE'RE GONNA talk about this like I'm ready to go there. Comfortable. But if one of my parents came in and found out that Kinda weird because they don't, they don't see me as anything but my kids physically. I had that pedes PT ahead. One of the DADS who I was like that's kind of like for me. It was cool because it was like a parent who actually was like a researcher WHO's this guy? WHO's GonNa treat my kid. Came in we actually brought me craft beer because he was you do a podcast where you drink beer. You know my kids pizza pt to be happy. Make make sure We're good terms and I was like bringing the bureau you on. But of course I didn't accept it 'cause that'd be accepting gift so at no, except leave that I give extra didn't take that but But yeah. So so really what you just did was I noticed about you you you you built party practice. Socially Responsible, you're saying like lifting community in social media building relationships. So those people are seeking you out or. Meeting you on content you already creating and bringing that in. That's kind of feel like a really. It's really empowering type of practice. Yeah. Definitely, and the thing about it is that I'm not Well, before I used to be inside of my gym running a small clinic, but at this point Kobe nothing. But in general, I'm not pushing numbers in like Oh, you know I'm. Living, and this is the job that I'm doing and who comes to me are the people that I want to treat and I want to help and they want to be helped they wanna be treated by me. So just flows a little easier the problem of. Working in some other facilities where they are numbers driven. Some of these, some of these patients are like cute little ladies and they just want to hang out managed on the couch and live their life when you have a rehab manager saying, Oh, well did you walk into the room We Bill Patient Education did you did you go to the bathroom? He'll go to that like. I can't live the life anymore I won't play that game either. So how did you? How did you build this like? What was the jump was the jump? Did you start this read at a school or this to that type of life? Not at all it's very much related to my chronic illness because at the time when things first started happening, I was working three different jobs. One full time to premiums end some every once in a while seeing somebody cash on the side and then I started having symptoms in issues and not enough spoons and I'll straggling along just dragging and dragging and dragging. And also, along the way my mother got leukemia she didn't make it so. Once. She died. I was like, okay. If this lady could have everything in the world and it's gone in two months like, why am I wasting my time? Wasting my time right now like I'm dragging myself through the mud like I was. It was not a great time mentally physically medically just trash all around. So that was kind of the bigger turning point for me any to clean this up and do for myself, and then expect that the money will come. And it'll follow. Gosh that is such a cool. That's such a cool mindset. Of taking several things again I'm Charlotte if found out about your mom I'm sorry you had to go through that. but you. You use that as a thing, this spring forward, you know your chronic illness situation with losing your mother I can't imagine what that would be like. And you said I'm going to use this to put in perspective not GonNa Wallow. In this, I'm going to put this in perspective and I'm going to redesign what I want to be my future, really easy to say, right look how easy. Probably. Not. Not that easy to do, but you were bold enough to do it. No matter how hard you knew it was gonna be. Yeah. Yes. So that's that's where I'm at now and it took me some time and it took me I. Don't know maybe a year to be totally. Self employed and there's a little bit of luck and there's a little bit of networking obviously especially as a black woman is hard to get capitals hard to get business accounts. So it definitely helped that I. knew people that understand who I was as a commission and really believed in my skills you say luck all I hear is a again you. Knew people who believed in you all here. relationship-building how did you find your patients all this network this community I was in relationship building. Why do people trust you with their time their care and their money? Yeah you build a good relationship. So I mean you can say look I'm not a huge fan of law because I'm like I don't know Luxy. Luck seems to favor hustle a lot and really care what they're doing. So it just so happens those people are super lucky a lot. You know some things can happen appear lucky something along the line you you obviously doing that was showing up and it might have felt like luck but I think we all know has some do with hustle skill and talent. Aright. That it wasn't luck you can be humble or it was a little bit of luck but. That's a great. That's a great story advice. We just had students from university Lynchburg on last week and one of them brought them right onto the show and I said, what's your dream job and she said, I, want to go out and I wanNA treat gymnast and I don't WanNa work in a clinic I want to go from you know gymnastics group or or school program to program but that's probably three five years away and I probably need. So what would you say to someone? Who literally could draw could write down what their dream job would be but had that fear probably that you've tried something similar would you say to someone like that a student like that? The hardest part is making the dream. So you got the hardest part down. Really, and you don't have to know anything you. If you have the big picture down the details, you'll figure you don't have to know anything to start something. I feel like that's where a lot of us I don't know what I'm. GonNa do I have to Chill out you have the idea you have your passion start somewhere maybe find the youth group that nearby and just hang out with them. Build a relationship. That's what more do. You get a boom shock locker. And that's that's kind of what I was telling her I kept asking her I was like well, have you been around gymnast your whole life? Yes. Are you passionate about this? Yes. Do you think a DP dpt education is going to give you enough skills to be able to help people I'm not saying you'll never progress I'm not saying when you start as a PT graduate, you can't learn more but are is. Valuable and she was like well and I said then unity give me a reason why you shouldn't do this. Because I think a lot of times and tell me if this was in your life and then you came overcame it somehow sometimes, we feel myself included. Were waiting for the world or someone to give us permission. It's this. It's in your own head but you're like I can't wait for someone to pat me on the back and tell me that it's OK. Jamaica crazy decision and to be honest the only thing holding you back you did you experience that that that looking for permission? Definitely definitely always, and you feel like i. mean I am I good enough. It's like What's the word validation? You need somebody to validate that you? You are worthy of doing something. I'm guilty of that because it can agree I guilty that I literally run around with an idea that I'm like I. Really think this idea is going to work and I tell five people and if I all five of Mart yes let's go. I'm like. Am I not good enough is the idea not good enough but I know I'm doing it. Cookie watching right live and she said she sharing this with Katie Hickey Lucas and an heart from the asap disabled athletes are you in the sports section? Did you know there was a cig- for? Disabled athletes you know that. Nope as far as community in physical therapy very new to this. Very very now, it's not something that was really talked about in my program, and then as where I work in where it lives nobody talks about that, people wouldn't go home with an I love the triangle here because cookie was episode Numero Uno on this show and cookies just let's personality she's just been around she knows people and people like her I mean with name like cookie how you're not gonna like someone. But yeah, there's a disabled athletes sick man if she's and we'll talk about this off the air but that's a great little community relationship builder Oh. It's a bunch of those people who are literally talking your language some of the time I want to change subjects just a little bit shares with this means. We need access not inspiration. So what does this phrase mean to you? So. It. Just. So you know you get on on the Internet and people love sharing videos and memes and you see I don't know maybe a cute lady Anna Wheelchair and she's like lifting Dumbbell and then the tagline is like, oh, she can do it. So can you? Like we're not, we're not here to serve as inspiration for the able bodied to do better for themselves. That's kind of gross. Like us doing normal things should be normal. So you know it shouldn't be like, Oh, you're so brave for being a relationship with someone that has a disability. Now that just should be normal to us somebody telling me like, Oh, you're so brave you have nerve pain and you're still wearing shoes and lifting weights no that that shouldn't be your source of inspiration. We don't need pity. So that's kind of where that comes from inspiration. Point is like a big cringe in the disability community, and then what access where where can we get better as a society where where, where, where we just had an episode just the other day celebrating the thirty years of the Americans with Disabilities Act and tone of our episode. Then recommend taking a listen because we had a guy on who was at the Capitol building when those famous pictures of the children getting out of their wheelchairs and climbing the. Air That I mean, he was we had those pictures on the screens like I know her he's like this person and I was like, wow. But the tone of that interview was really. Ada Thirty years ago. We need to keep going like not wrath by all means celebrate something that was that was monumentous occasioned thirty years ago. But now it's twenty twenty we gotta keep going. So what does access? What does access look like to you in the future that would be better will be greater. Well. There's little things. So on on a personal individual, little things that we do every day that we can think about people that are not like us it's a hard sell. Sometimes, you have to consider that my life my lived experience is not everybody else's. That's where you need to start. So when I upload a picture Instagram, somebody might be on their phone using a screen reader. They can't see my picture, but they're still enjoying social media, and if I don't put all exit says Marcy is sitting on a bench laughing. The Sun's shining is just gonNA say image might be a person. And now they're experiences. western yeah. So they're simple little everyday things like the adding all techs and video descriptions or when you're uploading trying to get captions and subtitles all of these kind of little things that you might not really think about. Yeah I I mean you're right. As you're saying this, these are the things I don't think about one of the producers of the show makes it a point to share American sign language focused on healthcare providers and she'd smartly does it you know one or two phrases at a time and sure she understands there's people like us out here with short attention spans. Making. That's doing this more than it's doing this or not even doing this not even consciously excluding but not thinking enough of how can I include more? Don't see as you mentioned if there's a disability, you don't see and you don't know what it's like to look at a website, you know an and have to rely on an all text description of a picture. How are you going to be inclusive if you don't know and that's what we have people like you Sam Chairman and Disabled Athlete Geriatric Therapists here. One of my colleagues at Fox rehabilitation and yeah, he agrees with you. He hates being someone's inspiration because he's living his life. Exactly. I'm just existing and I could be thriving if I had a little more access that's it. Yeah. Yeah. Cookie going back pre Ada and remember teaching young patients wheelchairs how to go up and down curbs and stares right I. mean we we all hopefully did that one. AFTERNOON PT School and keep in mind a lot of us is just one afternoon of taking a wheelchair around our local community and PT School and realizing if there's no curb, cut those really obvious ones if you're looking if you're pt but if there's no curb cut if you trying to use mass transit and there's no elevator, the elevator is broken it's okay. Only one stop away that elevator functioning. But that's like ten blocks like one stop away ten blocks. So making sure that there's access and not just inspiration. Definitely and even as it relates to PT School, you know not everybody's program is built the same. Program we brought in you know who are learning neuro they just brought in people from the community like, Hey, these real people this is what they look like this how they live talk to him. In a when we're doing these kids, you go play with them. At marymount university are I remember this one in neuro are Professor Julia Reese several times in in the neuro semester bringing people who were you know had limb loss or people living with different conditions and you WanNa talk about having the full and complete attention of forty PT students. In drop you hear crickets from a mile away when there's a human being sitting in front of you telling a story about how their life is changed. That's different than a video that's different than reading a textbook that is different perspective, and that's when you that's learning moment when you have someone like that. So your podcast talking about that. That's those are learning moments validation for other people who are saying, you know what? Yeah I don't have to. Do this or not do something because I want to. So that's that's acts as an inspiration. Yeah. So and here's the thing that word inspiration in isn't bad. You know there's somebody else that is living their life they're undiagnosed and they see me in no Cool. We're okay there. But when we get to the, you're using something that I'm doing. That's really regular to fuel your own personal motivation. That's when it gets Kinda. Gets, Kinda Weird. Yeah I could see about that intention think of the person this is a person is not something to put on a on a shelf or inspirational poster guess. Y- also wanted to talk about this because you've got personal experience chronic pain doesn't stop people from being a bad ass there we. A that's a nice sound effect. Yeah. Not at all not at all and I it's taken me a couple years but strength wise. I'm getting close to where I was before and it's like you know just an asterix like you can have deadly Pr Asterix if I have enough sleeping on a fresh that did it enough stretching or? From kt tape from muscles that were specializing, it took my meds today. So there's just a little more that I have to do to get there but I I can still get there. You're spending more spoons now. The more the more you use an analogy like that. This is a great way to speak because. I understand why people adopt that whole battery mindset. But I I like the fact that it's in a different using your own term like spoons doesn't make any sense until it makes sense. To us if it's a battery analogy I don't know like now we're talking about energy but you're talking about. A limit on what you can do, and there's X. amount of things in spoon is just this random tangible object that you can picture. That but it doesn't. Somebody, just handing you you're just waking up open your eyes here you go this all you got today. Table and be like I'm super-low today or looking at a table and going, hey, I'm feeling great today and this is this is what I'm able to do. I can't wait. Sam Chop as well. Saying more healthcare providers that have disabilities. It's something that's needed. I. Mean Talk About being able to understand your patient population definitely, and it's it's interesting because I was on that side and I was big treated tons of adult neural spinal cord injury. You know John. Beret all of this life changing life altering kind of conditions in just on one side of it. But now on the other side of it, you know I could see you. Certain ways that we interacted with people that could have been better. And there's certain things that we have looked into. That would have helped somebody out considering the time of day that we're treating them considering what did they have to get done before they see me or figuring out what their goals are and understanding whether or not it's practical or there's something they need to do before that. These are all things that I know now? And that I don't know that I would have known to ask you know after just reading a little bit about the the idea of a spoon any anybody who's working with someone with chronic pain in any capacity one patient on your on your schedule a bunch. Maybe. Even if they don't use this terminology bringing it in being able to utilize that as a way to communicate about this thing, which is hard to verbalize unless you have this abstract term that you get to bring it and say, well, Hey, where where do you have the most spoons? What Day of the week? What time of day after what activities do you? What activities do you have to spend the most to complete, and then how are you doing today right? What what we're supposed to put our notes like a patient was was great at beginning of session doesn't say anything Nation told me they were at fifty percent spoons or fifty percent of what they what they normally would be on a good day at the start of S- at the start of our session. That's that's a more objective way to do as as abstract spoons are it's a more objective way to do it definitely and it also it also it holding encompasses the. Fact that pain is just multifactorial like it's not just you sprain your ankle and the pain is in your ankle these receptors now it's it's deeper than that. If you are hopeless, you're gonNA feel worse if if you feel like you can't fix what you've got going on or you can't make any progress gonNa feel worse if if you're scared if there's fear of All around worse. All important. All important to pay attention to as we go towards the ICS model paying attention to the entire individual art. So your your podcast hosts, right? Chance to pitch you got pitch like what's coming up or why should people tune in You know that's typically what we do is we always want to pitch so I'll give you some background music. Brought you know one. Girl lift available on your favorite podcast platform. Why should people tune in and again for me your podcast is perfect to prescribe for patients with chronic pain people who lift this. Perfect. So, what are some things coming up with the podcast that you've got going on you want to listen to? Our last couple of episodes we went through kind of the big issue of the error rate racism and all of that. So we kind of talked about that a little bit and that was that was pretty great. It was just amongst ourselves. As we interview people with all sorts of different disability. So we just did one with something has a. Spinal cord injury and she's in adapt powerlifter. Skis. And also hikes. So that's pretty awesome and it's every two weeks but I will say bare minimum bare minimum. If you rely scrolling hard I, don't know where to start what should I do just head episode twelve how to treat your disabled friend able bodied not able bodied visible invisible disability like that's. That's kind of our our our touchstone episode right there like that. Check it out disabled girls who left. Dot Com and you're saying recently, you guys got into talking about one of the issues that. Pretty prevalent right now discussing racism. We cross paths on twitter and you said, you know what you know what you need. You need more black and Brown people on your show and I said great yet. Now, you gotta sign up and you got show up and you. Think. That's a good example and I started looking back at past episodes and I was reflecting our profession, a bunch of white people mostly dudes in fact, on our show and and leaders of profession. We made a conscious effort a couple years ago where we need more females in here. And another wakeup call now are saying, hey, why aren't we seeking those things out because we're just GONNA continue to be a reflection. On on saying, Hey, you need more black and Brown people and then thank you for showing up in teaching us about all the things you taught today. What did you guys into what? What was the some of the things that you talked about some of the sentiments because you got a great mix of CO host as well? Yeah, right. So I'm in south Florida Mary Beth is in California and close in Iowa. So we are in a totally different wavelengths myself and Mary Beth while I'm the child of Immigrants Mary Beth Immigrated from the Philippines close born and raised. So we're like all over the place in lived experiences. And the thing that we all came down to really realize that our education has failed us. We don't really know what happened. We don't really know who we are where we came from a to me I just learned like Oh slavery end and then everyone was free. Martin Luther King you just fast forward. How many years? What happened to be tweeting? So understanding how that plays into everything and how that plays into. Even me today trying to go to a doctor in understanding why doesn't a doctor take me seriously I'm literally medical professional sitting in front of a doctor like, Hey, listen I have neuropathy. Kind of drops in they're still not taking me seriously. Why is that? There's a history there. There's a reason. Whether whether whether it is. Recognized or not, and we had an episode earlier there's bias whether you recognize it or not. Exactly. Exactly. So it's the biggest thing is just understanding that how we live in whether or not it doesn't matter who you are. It doesn't matter if your child vibrant immigrants as man if you're black, it does matter if you're white. We are living in a coordinated system. This was the world was created to benefit a certain people old white dude's it own slaves right and we kinda jumps from there and just acting like that's not a truth is just destroying any future. So the claim that and understand it. That's where we came from. That might not be who we are today. That's all right. Like. That well, good on you guys for for for tackling that because it's it's not the easiest thing to talk about and do it well, because you want it to be productive, you want people to walk away and learn and say, well now, how can I be better? You don't use for continuing that conversation and I wanted to make sure we got a chance to mention that because I think it's important which episode was that was that a recent one? Yeah. That was the recent one. So that would have been I think twenty, six and twenty, seven, two separate ones on it actually. Perfect. Are you ready to play three questions? Sure pressure. Here we go. Let's. Three questions brought to you by our friends at Arias medical staffing. Again, if you're looking for a position graduating from PT school a lot of people post today about passing, they're taking the empty I'm jumping ahead to pass in the N. p. t. e. because I think he did I feel good about to do what you WanNa do you WanNa? Do it a? You are a US medical dot com hashtag travel pt all different settings to a lot of times people think travel physical therapy outpatient. Ortho. That's a frequently asked question they get it's not all different settings really specific when he women's health, do it in Idaho I don't know maybe you do you are a US medical dot com travel PT's typically short term assignments, but they do hand turn into long term assignments to use as I say, use it as a test drive around the country wherever you want to go and test in different locations you can work again you are a US medical dot com are here we go quite a three questions. First question is aware question. You said You are south Florida through and through. PT, school living there. But if you could go anywhere, you want for three months and do your thing where would you want to go in the US? And the US. Listen I'm the goldilocks when it comes to climate can't be too hot I'm photosensitive can't be too cold then I'll get Rena so. who's perfect San Francisco, San? Francisco have you been yet been there just right sweater weather carl the fog. Yeah. Go. Yeah. All right. That's number one number two is a what question. What something you've watched listened to or read that you think the audience he gets value out of movie podcast book quote whatever watched or read. Well into short stories lease lately, and there's a book called disability visibility by Alex Wong and that is amazing. So was a short stories of lived experience people with different. Disabilities just came out like a month or so ago I like it, we're GONNA. Put It on the list we've got we've got Amazon that we collect these answers from everybody we ask and we make us rest responding is helps build realis- Third GonNa Mention we start, and we end with people who is someone the audience should know more about. I don't know I mean I guess they already know about me so I can't say me. Yeah but who else? One of your co host. yeah. I'd say my co hosts? Breath in Khloe there some boss bosses man drilled website just read those BIOS very interesting disabled girls who lift dot com that is three questions you off the hot seat from Arias medical staffing and you are a US medical dot com leaders travel not Last thing would you on the show is your parting shot? Nine party shot is brought to you by the academy before the pubic physical. Therapy. Leaders in both though PT fight him on lead Ortho PT Dot Org contest right now. They've got all these courses online two months ago we gave away any access to. Any of their Ortho OCS prep course throwing my brain went there. Prep course now, we're giving away access. If you win you to pick, they've got like twenty thirty offerings you find out online Ortho P. T. DOT org. So parting shot is your last chance at your mic drop moment. What do you want to leave with the audience as we end the episode last thing last night. Let's see. Well to expand on disability is not a bad word higher disabled people. Hire disabled people near your therapist teachers, your fitness trainers, your everything like that. Appreciate you stopping by with make make sure we share a socialist one more time just moved therapy dot com that your therapy page, disabled girls who lift dot com that's the podcast as well as just moved therapy on the instagram and on the twitter. Thanks so much for coming by. Let's make sure it's not the last time. Maybe next time we bring in the CO host with a a big big old group. Thanks sure. Appreciate you coming by. Okay. We'll talk again soon. Cheers. Love the PT Pine. Cast yes. Yes. Support the show telling a friend or by leaving a review on nineteen or Google. Play all right shooter they brought to you by the Brooks Institute of Higher Learning in Innovative Providing Advanced Post Professional Education Brooks IHL offering continuing education courses in numerous specialty areas, six residency programs and. Fellowship as well as. But rewarding internships the 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 H. L. Dot Org. Our home on the Internet. CAST DOT COM created by build. BUILD PT provides marketing services specifically for private practice. Website Development and hosted inviting content marketing solutions PT clinics across the country. See what good pt can do for you today build dot com. The PT PODCAST is a product of PT Podcast LLC. Poured, fresh by me physical therapist Jimmy McCain ingredients are sourced by our chief connections officer Sky Donovan from Marymount, university. Brewed fresh by producer and physical therapist Juliette Singer. Producer and creator second year student Frigid Nolan from sacred. Heart University PT Pint cast is a podcast saves physical therapists missing out on amazing insight, remarkable ideas, and motivational stories. 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The Future of Amputee Care with Danny Keller

PT Pintcast - Physical Therapy

44:08 min | 7 months ago

The Future of Amputee Care with Danny Keller

"Do you want to be a great physical therapist or physical therapist assistant? Of course you do you WanNa help your patients where do you WanNa do it? Well, that's personal to you. Let your PT or PGA license. Take you were you want to go travel physical therapy positions in all fifty states and D C in all settings where a U. R. E. US medical dot com that's a U., R., E. US medical dot com go there and pick out what's important to you. Let your license take your career where you wanted to go arias medical staffing a you are US medical dot. com. Follow US online at PT podcast and subscribing dunes spotify or Google Catholics. Love Yeah, it's it's awesome. Here we go live the happy hour everybody. C. Walk into PT Pine. CAST. A show that saves physical therapists for missing out on amazing insight, remarkable ideas and motivational stories. You guys were looking for. Broadcast live from the Arias Medical Studio also noticed living here man I call it a studio just sound fancy. With you guys, leaders, Hashtag tribal pizzas. If you're looking to have that PT license move about the country do what you WanNa do you WanNa do it Find them online a U. R.. E.. U. S. medical dot com that's eight. You are US medical dot com go there during the Cam your host make sure to subscribe to the podcast, the ears addition and I tuned spotify Google podcasts, and now video casting is well on the Youtube facebook twitter at PT podcast on the socialist great show for you. Tonight, we're talking physical therapy with persons. Amputations our guest clinical professor at ucsf where he treats the orthopedic sports at amputee populations. The also works on the interprofessional specialized amputee clinic team to get to that including something called the OSTEO integration program. I don't know what that is but the easiest way to find out is to ask him Let's welcome in our guests right now. Guinea Keller Danny Welcome to the show? Jimmy Bridget. All right. First question is always the hardest. We get the first questions out of the way. We're we're drinking what's what's on tap for you tonight. Time to prep between work. podcast so he's the. One of my favorites. It's got one of the best taggart's liquid aloha. That's a great beer tagline especially right now nowhere. I'd rather be than on the beach drink beer so I'll have to take just the latter portion of it. Yeah. I like it I, I'm staying close have had this on the show before this is the juice bomb. Doing it, and we just started selling these things on online and we got some more. It's the I drink and I know things favorite line from tearing Lancaster and game of thrones and my buddy designed the official PT PODCAST PD? Glaxo. Cheers to you. Danny. Welcome to the show. Thank you. Thank you. Here's. Our first round brought to you by our friends from Owens Recovery Science single source for clinicians looking for. Certification personalized blood flow restriction rehabilitation training and the equipment you need to apply properly I always pause for a dramatic properly in your clinical practice owens recovery science dot. com. We've also got their own podcast where they go really deep. On, far training with Johnny. Owens Cow Kimbrell and the rest of the team out there. So check them out owens recovery science dot Com. Danny, pretty cool intro. You do some really interesting stuff. You're. You're on the twitter at everybody your your twitter handle. At the bow? Tie. And when you popped on just before we went live I was like I'm thinking I'm like if he's at the type. That's his thing. He's not on podcast now we do video. And I can attest to the listeners at home who are just listen to the pod. Danny wearing the Bowtie. So you got a couple different roles right in a professor at UCSF and we were talking just before we went live as well. Things out there you know unprecedented as well in terms of fires are going to be a bad podcast starts didn't ask that. I mean it's it's wild. It's. The conversation was every patient has audited star Veld. same way out. You. Know it's It's pretty crazy. It looks like set the tone up window. Some call, it can like you're in an old western Um. So it's pretty wild. It's it's crazy out here California whole west coast really I feel for all people there in their homes. And lives in their families on its is pretty roughly at a patient earlier today whose family She's from Paradise, which obviously has a bad history with fires and as big fire in that area right now, Scott friends just got evacuated in tears of the beginning of the session. So it's affecting a lot of people in and I just you know so thankful for the for the firefighters out your work let's try to to the DC under control in it's tough to watch but. You know all we can do is try to stay positive and move forward. So the. Out that, we talk about a lot on the show within the profession, which is you need to take into account things. Outside outside of the clinic but it but inside the patient's lives where if people are if you're saying, Hey, I'm not really sure I'm getting I'm getting no progress or while this person you know is seems distracted. There could be some pretty serious things in this person's life. Yeah Hassle. You know looking at that patient's whole conversation we had a lot whether we're in you know with students are working. Talking in twitter right as long conversations about treating the patient has a hole in a huge part of that component is was there psychological health liking unfortunately right now with everything that's going on I mean the other day we had power outage hundred nine. Earthquake is all fires they can't go outside the air quality is horrible and you know people are isolated. They can't. If you can't even go outside and you can't go anywhere like it's just it's it's very, very hard on people in and we'll talk about how that affects depression and anxiety and pain right the emotional aspects of pain. Is playing a big role and is oh, it's pretty tough. Why do hope the best for you guys? You're you're working remotely right now? You said you're one hundred percent remote talk about that like the reasons behind it, and then how you're adapting because you're also a clinical instructor remotely what I didn't think about that. Yeah. Yeah. It's been pretty crazy. It's been pretty wild ride. You know I I've never worked this much telehealth before. So for me, it's You know I was kind of forced into it early on had cancer last year in zone went through treatment for lymphoma last year. Luckily, he's doing great. He's in remission. soberness try and keep them healthy in. So right around the time, Kovin. Really starting to hit our I talked to my clinic inside listen you know not feeling super comfortable about this. This thing certain get a little crazy the MDA's canceling games and there's something serious happened in here so. I need to call out and we had a discussion, the dean of our program Amber Fitzsimmons. She's amazing. She emailed me immediately and said, Hey, listen, we want to try to find a way for you to start doing telehealth mostly working on it. We have been able to do it from clinic previously. So had done a very small amount up until that point and so are playing was pretty great ucsf though right in and said, let's do this in. It started a hit. We were basically one hundred percents l. health throughout our practice everyone was doing some form of telehealth You know parents whose kids were going to school had to go home and they were doing telehealth from home. So it was they were able to work and. I'm so thankful to to have that support in have job at that point and so we took that and because of that I really said hey listen I you know. I'm GonNa take this serious and I'm GonNa make a run with this and so we dove into the health component of instead half we make this better. How can we make this the best for the patients we make this the best clinic. So we started putting together telehealth surveys and getting satisfaction and We actually have a paper that's about to be printed needed a PC journal on patient satisfaction action for Toco Hill well, not so good. You know it's it's a learning curve and the also very. Different than being in the clinic So they were just be like that student is complete remote that person that students not coming in to your physical space with me. So I, it's a splint. It's a split right now and so I have one colleague who is also working with her and he's part time in clinic part-time Telehealth no-one's fulltime in the clinic yet. So because we have to maintain space and our gyms wanted area so So he's part time so she goes into the clinic. Once to once in a half a week. But she's living not today's week full days tower days until also it's on the health well. Can you've learned from that being a CI? By a telehealth. Funny you know. So it's been a long time being see I. Am I am one of those therapists that use therapy. I. Know It's dangerous lookout but again, a lot of the exactly. Yeah So you know generally I am doing about. Partly manual therapy in than Milan exercising education. This is this is forced me to row in the sense of how I educate evasions educate and work with student to be able to transition what the patient how exercises are prescribed, and so I actually think I'm a stronger therapist now having to go through all this process in also teach other people how to do this and so it's been kind of exciting for me to really change it up because when you you've done, see I work in the clinic for a long time it's pretty much same thing every time right your work when you're going through the same things teaching same things. and. What this has been like or all getting used to this new for me new for us is new for everybody. So how do we learned this together? So I think it's been. It's been great. My students fantastic. She's really good. She's totally all in about learning this stuff and so It's it's been interesting but it's been been fun and I think she's learning a lot about how you can use technology and how it can transition listen to eventually hydrated situation where we can I, mean. It it double time you know podcasting telehealth. These things are not they're not. They're not technology. Saviors rather they're transmitting spoken word Yes it it can make it go further it can break down barriers, but they're still needs to be the human component. What are you gonNA put into this computer thing here what are you going to send through this microphone? So I think you know for a minute a tickle teachers right now you know how many people are home right now you know be become a math teacher. For a fourth grader for the first time in twenty five years. It's going to be ugly first, and then you're gonNA start to figure it out and you're gonNA. Get a rhythm and that's what we need. Right what do we know about neuro, Rehab its reps reps, and the better the more you get where you're going to be. So that's cool that you guys I didn't even think about that. Could be a CI telehealth that's an option. That's pretty cool. It is while let's talk about You know really wanted to share information about amputee. What are some things about working with patients with amputees amputations you know you'd think are important to know what were some of the information you pass along to your students? Yeah. I, think it's a good question. Know Amputee Rehab world is not a huge world right outside of the va most people don't see a lot of amputees and even me for years I didn't see a album until I came you see You. Know we have a pretty amazing groping. So I got asked to be a part of it and I dove right and I was excited about it. I had seen a couple of agencies as a student at UCSF with another one, my colleagues roaming Weinberg and so you start to see these patients in. So inspiring I mean, it's such. It's such an amazing population of the all I absolutely love with entities. And I think the biggest thing to realize is a lot of people dive into going. Well, this is just like rehabbing anybody else. They just maybe have don't have full limb or they don't have a couple of times, but it's different you know and you really have to be able to have that conversation with the patient and say you know let's talk about this. Tell me what's going on with. You tell me what the biggest struggles you're having, and you really have to understand what the common struggles with the MVP's whether it be socket fit issues or working with the. Process getting really close to the process so that they can make adjustments and understanding what can go wrong with a prosthetic if it falls out of alignment and how that's going to affect their gator, how it's GonNa. Affect of some sort of pain that they're having So those components of understanding the mechanics of it of the prosthetics themselves, and then understanding the emotional side of it is really important. You've got to be a little bit of. A mechanic sometimes, they might not you might be in with their process. They can't get an appointment for a couple of days or a couple of weeks you understand how can I improve this fit I'm sure skin breakdown probably skincare cares is another area that that is important. Educate on not long ago two weeks ago we had Ryan Hendrickson Jose a United States Army Green Beret took a really serious blow to the leg. And then wound up coming back to full duty and he talked about going on twenty thirty mile hikes and not wanting to take his socks off 'cause. He's like I know if I was going to see a chunk of skin fall off. So he was like I just wanted to keep the boot on because if that were to come off I'm done. Many locked out because he said, and he he he thanked Johnny Owens who I mentioned at the top of the show. That's actually how I got in touch with Ryan and found out about his book tip of the Spear by the way great book and he talked about how the great education from his PT's from his Ot's from his medical staff saved his leg and ultimate his mind saved his identity as you just alluded to because he's I was a green beret man and if I couldn't do that, I, didn't know what I was going to do. So I it's part of. Saving their identity and paying attention to that I'm guessing comes up a lot as one of my favorite parts is being able to take someone who just recently had an amputation and I mean that's a big change in your life especially if you've been somebody who is high level like Green Beret or a veteran in general who was a high level military personnel or any of those people that have lived their life at this very, very a elite. Or just wanted to walk and we're just normal walking analysis on account walk that's a big cut, and then there's the combined topic of why did they give you beautician was a dramatic was oncologic what's the West issue there? You know when it comes to on college east side of things there may still be things that are going on with the amputee that aren't gonNA stop right away they're gonNa be chemotherapy is GonNa be radiation. Is there potentially another surgery that they're gonNA lose another limb? So there's a log conversation that goes on, but the idea of being able to say all listen, I, know right now is really hard for you. But in two years three years, there's so much potential there. So many things you can do showing examples of these people they can go out and do these things is like my favorite part because it's like I'm GonNa, get you there. This is where we're going to be the. End Stay with me and this is going to be hard. We're going to have these conversations they're going to be challenges, but at the end of the day, this is my goal for you. My goal is not just get you walk in my goals doing what you WanNa do, and that's the most fun part. Yeah. Yeah. Johnny talked about when he worked at the Center for the intrepid talking about, Hey, you're sitting in a room. Full of people who have suffered limb loss and you get two point two people say well, that you know how bad you've had it. This person's lost three limbs. Travis meals has a Travis Mills Association. Foundation up in the northeast and they said Travis was great and he lost four limbs. Still going and they're like, Hey, whenever travis is in the House I don't care how bad you had it. All the therapist is travis lost. Four. And then Travis would come on over and go. I'm still having a good day. Go. So that was really good example of how do you use the people around you as a springboard for Success Let's talk about the interprofessional team in an empty rehab. On it obviously, we we're we're partial to the PT, but let's make sure we know who else is on the team and how they join in and help that it's been a it's been a pretty interesting situation for me. I've never worked in such big INTERPROFESSIONAL team. I've always believed in inner professionalism in working together with the Stop but you never really get the opportunities, even medical center, and so we brought on when we when we started this group which started as the authorization which journal talk about a little bit. It started out as a orthopedic oncologists. who was the surgeon working with the Osceola degration patients and that he brought in my coworker Rami then brought me into this to physical therapists. Nurse Practitioners There's a pain management specialists. Now we have Hala Gist, you have a case manager we have prostitutes on the team We have a mess befall psychology we have exercise physiology some lab testing We have researchers researchers who are doing research on the topics, and so you get it's a little overwhelming for some. Beijing slim journey people walk into a room You really have everyone there who can answer any question that that person has just pretty amazing to watch when you see go around the circle and everybody's kind of jumping in China in and the patient walks on this, I didn't expect to get all the answers that I had today answered. So. How's it? So how does that work? Do they have a standing appointment with do they make new appointments with or how does that in your particular location? How does that work when there's the patient? How does the team? Operate? Yes. Good question. So we we do a monthly clinic and so again, it started as an Osteo immigration clinic has become more of a specializing pt clinics because we started people who maybe aren't GonNa do the awesome program for one reason or another interested in the candidate for it, but we still try to help them out with whatever problems they're having in. Their infancy function and so being able to have surgeons and plastic surgeons prostitutes who can maybe adjust the prospect maybe they haven't had the prosthetic fit that hasn't really worked for him in our our processor. Amazing. They can do some then they haven't had regular physical therapy. We say let's get you into pt and we'll see what we can do with you. So basically, they can. They Kinda here about us where mouth physicians and then they can. They can get scheduled with us for a monthly clinic, and then we see a bunch of patients in a row we meeting afterwards and discuss each of the patients in what the plan is for each. From there they kind of follow up maybe next month maybe two months out maybe they're just GONNA go over pt or sex both navy PT and process is GonNa do joint session with them it kind of spreads out from there and becomes his flower where starts with one visit in kind of becomes whatever it is the diverse needs. That's great I mean that's the kind of thing. We all know people ask about on social media and in discussions like wouldn't it be great if insert it sounds like. They're. Also integration what is that? Yeah. So traditional amputees, right one of the biggest problems with an amputee if you've ever seen entities skin breakdown like you talked about and sought soccer fit there's a ton of change in fluid volume over the years and especially in the first year or so not volume of really changing lot of prostate have been issues for a lot of MIT's especially they're shorter amputee they're transparent, but it's really high really small residual limb hidden in a sock. It's really difficult in. So the idea behind OSU integration, there's a few groups have done it. But we worked with the group who the implant based on tooth implants and so initially through integrum. And what we do basically as they go in and they put an implant into the right now we've been transplant role. They also do it Trans tibial entrance funeral in other places us which. Are, Sweden, and and so they put the implants in and it's basically just a screw that goes in to the implant and there's a little abutment piece that sticks out at the end of the FEMUR So Stage one Tuesday's surgery that I put the implant in into the bore into the FEMUR and they he'll take some bow six months or so and then they. Go back in, and they actually take all the musculature around it. So it down to the end of the bone and put the screw. He's in what that does is by sowing the law soul in some fashion to the bones, the end of the Femur, it actually reduces infection risk, but it also gives you function out of those muscles that a lot of amputees don't have. So now they can use their hamstrings, they can use their claws can user adopters to get a little bit more function they get more appropriate section because they're getting feedback through the implant actually into the bone, and you don't have the socket because there's a connector called the acts sword that connects straight onto the to the tip of the implant that sticks out and just allows him to quit connected on and they can just put it on screw tight wad. So it's like, I. Mean you're making kind of like an like a a an adapter. ASAKUSA. So it's no longer a a socket where you're trying to get a a a fit where you might go up or down a couple of. Imply you're literally plugging in going right into that bone waiting for it to heal, and then you're able to fit the prosthetic to that, and now there's a really really good connection. To, worry about the sock in itself going around the limb item worry about sensitivity of the limb don't have to worry about skin breakdown other than just where the actual. Opening like. What's what's what's that that area around that that that socket? Yeah. It's one of the questions we get the most isn't that a big infection risk and it was one of the big questions that I had initially have this thing sticking out of the FEMUR is in their big infection. was there what I'm saying you actually have a fairly low percentage of deep infections that come about very low. Percentage of the superficial infection it happens fairly regularly most people will get at least one superficial infection that the treat with just oral antibiotics. But basically, the skin penetration site where the implant comes through the ideas that it kind of scabs around that area in creates this this Barrier to bacteria getting in there, and so the majority of time as long as the heels around there pretty well, it's no big deal. Occasionally, people won't fully healed through the metal that was Kinda scab around it, and it always going to be a little bit more mobile on there. They might dream a little bit. We just tie some ause above the at the top of it, but the most part people do really well. It takes a little bit to get used to. It's a pretty sensitive thing in the beginning when you start messing with the implant and your stress in the bone Lee. Sure. We have a very stepwise progression. We start with a short prosthesis where they're on their hands and knees working on weight shift. We work them into longer prosthetic with mechanical medium and we walk into a microprocessor man if they're gonNA go there. Let's and I'm looking for a specific number but. What's the percentage of people who are getting infections from skin breakdown when they're using traditional I what happens but you know ballpark it for me HAP- less than half. Less than half I don't think that there's a lot of of infections from skin breakdown with traditional sockets at happens for sure depending on hygiene those types of things you notice the person how take care of it how will they manage that of things can happen you know I would say superficial infection you're going to see a higher percentage of. Superficial infection probably in the aggression group. But again, it usually happens once or twice during the actual kind of healing process the first year or two, and then from there on out, we don't see a lot of them even factions fifteen patients go through the program at UCSF. So are you see was the first program in the United States to do this? And we've only had one even faction got complicated. And deep infection you're talking about at the level of the bone or deep in the muscle, not at the superficial site. Yeah. Generally around the implant within the bone and so that the problem with is it can cause loosening of the implant and so either has to be ex planted or a fracture. So we have to be careful with that but we don't have one person have it. There was a hygiene issue there while some dental issues and so that probably affected it while in he was able to X. Plant he's still he can still use the socket. So that's the Nice thing about it pulled implant plan you can still use the socket. He's right back to us this was before. You mentioned some of the advantages in terms appropriate section, naval ability to use that muscle. Ease of use putting on and taking on your dining and dolphin that prosthetic I'm guessing is it a better get better? Get better integration is better that are dealing us for that prosthetic as well. For sure. The ease donning doffing is definitely bear We had one empty, who was one a single extremity empty and Contra lateral lower extremity, and so she only had one hand to do with, which could be a little bit challenging because it's screw tight type of contraption an actual has worked with the design over the last couple years to try to improve it based on the feedback that we've given them but for the most part donning doffing so fast so easy they just slide it right on clicks they lock it in snug tight go they just walk away. His socket where you're like trying to get it on the pin pin pin might not line up and so it's a lot easier. Yeah. I've seen some Paralympic triathletes really show what a transition is like when they go from there there cycling limb to they're running blade or whatever they happen to be using some of those I mean they're crazy I mean how their engineering and how they're able to do that. Oh by. The way they might just biked fifty miles and I've gotta run a half marathon and there panting and they're still putting this thing. You know this technology on there. So it's good that it's the technology is now starting to progress and it really is that integration into the bone with with with the patients. That's great. What have what have you learned the most working with patients with living with amputation? Were they taught you? Perspective probably more than anything You know just having conversations with patients about how they were before and how they are after One of the stories will never forget was the first real empty. I ever worked with when I was a student, he was bilateral amputee. Transplant roll. This guy is amazing and he said to me you know before I was T- I was selfish I live my life for me. I didn't care about anybody else I did what I wanted to do for me. That's how it lived my life. He's like now this I could have gone downhill with this I'm so depressed but the fact is I'm GonNa turn this into a positive talk to. People I'M GONNA become motivational speaker I WANNA go run I'm. Going to be pair of the athlete I'm going to do all these things because I'm a new lease on life and for me it was like Oh my gosh that's amazing. Right like guy lost both of his legs and this is the attitude that he has and so perspective for me it was pretty huge able to see that and go. This is an amazing group of people. That I would love to work to be able to help people who are going through this maybe not having as easy of a transition through it. That's huge. Yeah. I mean you mentioned earlier taking the the the entire patient to account and one being here you have an amputation but how that happened is going to be a big deal and I remember my neuro class I. Mean you just think about it all the hair? is standing up and we had a gentleman come in and he lost one leg he was he was like changing tire for someone else side of the road and somebody ran into the back of his car with his you know his tailgate up and and completely severed it right there and you WanNa talk about learning a lesson pt school and that's where like professors are really good. They know the patients that they can bring in time and time again. I. Mean there is you could. You could pin-drop mile away and we were just like, yes. Paying attention to how that occurred that never left me. Yeah. Yeah. It's amazing. You remember all the stories that year right and like I remember law stories that people have told me as far as patients goes on a lot of amazing patients with a lot amazing stories but the MVP teaser. One of those one of those groups that you just never forget you said Air Olympic athletes, those people are amazing. and. So when you start to work with a few of them, you're like this this is impressive. That's. Something that's going to be. Engraved in my brain, the rest of my life when you send students out to to work with with persons with amputation, we're what are the three like you have to pay attention to that. You hit a break because if you get if you give students or new clinicians, twenty things remember remember zero. If you give them three, you got a shot. So this this hit list for you the three things to pay attention to a hey, you got a patient on your schedule amputation in your mind is gonNA million directions pay attention to these three. What are they? I mean I would say number one is subjective. Right? Listen to what they say listen to what why they're ear listened to what is actually going on. So this objective portion for me but they vision especially especially important on number two is don't be afraid to touch them There's a big fear with students in kind of like a weird odd Can I touch? The lamb cannot let the land and it makes everything harder both for the student and for the patient the patient feels like somebody's afraid to touch me that's that's not helpful and say just another patient like you gotta says you got upset everything got feel a patient feel. Lynn feel the scars on the end of it and you need you need to really make sure that you're assessing Asian. So so not being afraid to hit some put hands on Ganz on is, is another component of and the number three watch a move right? Because the only way you're GONNA learn how amputees are supposed to move the compensations that they have. What can be leading to what brings a man is to watch him move you. They can do see how they can transfer and get off floors walks the don prosthetic all that super important. So for me, it's it's those three things objective. Don't be afraid to touch the patient watch watching. Yeah I, the second and third that you. You mentioned I was completely guilty of in the lab that I just mentioned PT School Right Guy told me a story. So I believe me I got subjective and that actually caused me to literally kind of just be further arms lengths Emma. Assess this I just didn't want to you know they he had an accident this was years ago but now he's sitting in front of you. Yes. You have to be able to put your hands on them and then Washington move I remember a lot of it was talking and she's like well, he says, he wants to walk up and down stairs. So have you thought to bring in outside to the stairs and I was like? It was. I didn't. Yeah. It was like this thing I didn't want to get too close because Oh my gosh you have an amputation they're like, yeah. But your physical therapist you need to help me those number two and number three were definitely I was completely guilty of in my first experience working with someone. Common. All run into it. I did it when I first started working with amputees like What do I do this totally new situation in so I think it's a natural thing. I always say, let's jump in. Let's go 'cause. They're not gonNA. Wait for us. So let's go. Yeah. Any any other advice for people who would like to get into this to this patient population, and that comes a allow people just I. I don't even know people just hear about all sudden. They go into PT School and they're saying, Hey, I'm GonNa do this and then all of sudden they go to a neural lab they come across a patient or to like whoa mind blown somebody wants to be a little more information or you know get get some hands on and watch a move. What would you suggest? Housing Justice, going volunteer with them. You know go go to these locations that work with ABC's regularly go to the go to the neuro labs goto any of these Paralympic training centers pity we can go on to your at the Paralympic Center in in in Colorado Springs new apply for it can go and work with them for a week or two. You know these types of things that you can do what you're just getting more experience with it is an early repetition repetition repetition, right? So just go and Get comfortable with it. No, it understand it take con Ed with it I taking some amazing con Ed classes in if you tease with people that have done it longer than knee and work a lot more than me, and so I learned a lot in this tuition. So just take all that Khaneh go out get the experience in in a really think that that's the best thing that people can do as they start to work into that I, tell tell students all the time play that student card man Ham demystify. Shadow come here whatever I'll ta for your class right I'm not going to get credit but I can you get knowledge so I used to put him a student card all the time. So, Osso degration. That's kind of bleeding edge right now, what's down the line? What something that maybe isn't in here in terms of working with patients were living with amputation that you're like, Hey, into five seven years I'm going to be site for these things. What is it I? Think a lot of what the future looks like is how we're going to integrate like e. m. g. into the actual prostitutes themselves. There's a lot of sensory systems coming out right now MIT is working on one out with Rimon Women's as part of art. Group A, little bit actually integrating some of these sensors in sued the. Nation patients, and so we think they look at a measure. What's what sort of sensors are they? So it's more utilizing the muscles that you have to function the like motorized prosthetic, right. So being able to close your hand without actually having to have a cable strap around your back being able to have a motorized need an ankle, it's not so heavy combat it listed but can integrate into the muscles that you have there. That's going to be able to function out of it and not. Have the weight in the craziness of trying to whip that thing through or you know the complexity of the microprocessor knees have been amazing to see les is one of the greatest knees out there an extra when it comes to the military things water for you walk through the water with it's amazing but you still have to have a strengthened a lot balance and lot function to be able to do it and so It still takes a long time to train. So these these microprocessor. integrations into the muscle system are GONNA be something. That's GonNa be pretty amazing in the future I think and I think we're GONNA. See a lot of really cool saints come out of these labs that are that are working with these patients. Yeah. The futures really interesting when you start to get. I mean I. Don't know I'm forty and I remember like you know just gone from intendo to Super Nintendo like this is amazing. And then you just just leaps and bounds the things that we're talking about right now we're saying five years, but they're probably GONNA make us look bad and do it in the year, which is fantastic. Absolutely I mean I remember I went to take a class out in Chicago Ryan's. and and they were they showed us a lab and they showed us one of the likes that they were working on. That had this EMC activate these sensors surfacing g sensors in the in the socket, and we watched a patient go up and down the stairs and may look like nothing right and I've watched many patients go down with the prosthetic and it looks like they didn't even have prosthetic on it was mind. was or five years ago, and so now it's like low. Okay. This is this is changing quickly we're GONNA see amazing stuff coming out of these smart people his labs. Yeah. Yes. Sam chime in and say lack of lack of feeling touches. The biggest reason he never wears a prosthesis. Hey I don't I don't know I'm not going to rule anything out in terms of what sensors can do or what sensation can do not gonna put a pass technology and and an invasion because you never I mean this is the direction we're were were heading a lot of times it was as you mentioned based on cables or was physically possible, and now a lot of researchers a lot of people way smarter. Me Are sitting there and listening to people like Sam. And saying what's your? What's your biggest pain point, and then it just okay I got it and they go away and they go. Let's think about that and that's a lot of times what people you know pooh-poohed research this person randomly researching this things because you never know what that person's going to figure out and be able to integrate it into something completely non non connected to that, and that's where we have advancement. So. Looking forward to some really really cool stuff in the future are you ready to ready to play three questions? Three questions brought to you by our friends at our es medical staffing, find them online at a U. R. E. US MEDICAL DOT COM leaders in travel physical therapy. We're talking about people looking for positions all across the country, and there were there are people. There are needs for physical therapists, central worker. So find out where you might be able to do that. You want to do where it's needed, which is a great physical therapists anywhere in the fifty states, all different settings because a lot of people your travel and they just think. Outpatient Ortho. Talking inpatient and outpatient or Ortho neuro peach geriatrics you name it Yes. Hawaii has been on the list. Yes. Alaska. They had people are there that need pt so find online a you are US medical dot com again that is a U. R. E. WESTMEDICAL DOT COM. Go there and find out what is available for you. First Question Danny's aware question you're in California but if you had carte blanche, you can go anywhere. You want in the country for three months, which is the typical length of travel assignment. Where would you go? Let's get question anywhere in the country I did a rotation in Seattle when I was in Grad School London attack North West is one of my favorite places. So I'd probably go Seattle love Seattle good. Some good good areas up there. It's great hike north of there as well. second questions of what question what's something you've read watched or listened to book movie podcast whatever that you think the audience could get value from in any way. Old Man this is GonNa. Sound. Funny. But I actually love this podcast by DAX Shepard. ARM expert yeah it's an amazing amazing podcast. He brings in people who you would never think that the conversations would happen and I've had my mind blown by actors that I've seen movies at that. I wouldn't think anything would go that deep even that's I mean he's amazing guy. So that's been one that I recommended the most or two thought DAX was essentially like the plant from. From punks writing the Guy, who's always under the bus in punked. DAX Shepard now married to Kristen Stewart. You Know Kristen Bell I. Know about my politics. Come on. Sorry I'll let it go. Third question is a WHO question who should the audience know more about? All Man. That's a hard question. It is so many people right? You Jimmy more people should know that you don't know about. You know I mean there's so many people that influenced me that I think deserve a lot of credit I gotta give credit to to my mentor therapy doesn't really job trying to put evidence behind the use of suction cups in therapy is a big hot topic obviously controversial topic but he really science behind it does MRI studies at UCSF on it. and. So I got to give them a lot of credit dinky somebody. A lot of people should know about and I think he's got like it information I think we found another future episode because I don't know a ton about no this much. But beer might learn more art. That's three questions again thank you to friends from Arias medical staff for keeping the show on the air. Travel physical therapy a U. R. E. US Medical Dot Com last thing would you on the show Danny? Is the parting shots. Party shot brought to you by our friends from the Academy of Orthopedic. Physical. Therapy, fund online at four. So PT Dot Org. Doing, some contesting with these guys to. These independent study courses, the I. Se's independence said of course. Yes. We're. Con Ed. So if you look at a level of orthopedic game who better to do it with the Kadam E of. Physical therapy tissue tolerance was one that just released running athlete and of course, all the CPI they got g's coming out your ears mant CPG's CPT's CPT. So. Look look for them their leaders. So Ortho PT Dot Org parting shots any your last chance for a mic DRP moment. Some sentiment to leave with the audience as we wrap the episode up. Oh Man. Put me on the spot. People but really you know what's what's it probably simple for you in terms of my job moment for people who are either getting into working with persons navigation are looking forward to it. What do you? What do you think? What's what's your mic drop? I think now this population is that arrested and I think a lot of people are nervous to go out and go work with them and I think it's one of the best things you can do take a chance, take a risk jump out side your comfort zone. In everything they do in PD but really go out there jump in and try it out with these people get to know and I think you're GonNa love it at the it's going to be super exciting. Love it s perfect advice. Great advice is good to hear like and I think you need to hear not a lot. You need to be pushed and pushed and pushed. Hey, this is comfortable. This is GonNa feel weird at first and then you can do it more. It's GonNa feel less weird. So if you're interested at all jump right in reach out the Bowtie. On twitter any appreciate your time. We'll get into some more topics later. Definitely think we should do the cupping episode. Do you like that? You know about. So we'll talk about that but thanks for your time. Appreciate it. We'll talk again soon. Okay. Jerry. Love the P. T. Pine cast. Yes. Yes. The port the show by telling a friend or leaving review a nineteen or Google play shooter day brought to you by the Brooks Institute of higher learning an 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 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 IHL DOT Org. Our home on the Internet. CAST DOT. COM created by build. PT. provides. Marketing. Services specifically for private practice PT's website development and host inviting content marketing solutions, pt clinics across the country. With PT can do for you today, build dot com. PODCAST is a product of PT Podcast LLC. It's poured fresh by me. 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Intermittent Fasting  What a Physical Therapist Needs To Know

PT Pintcast - Physical Therapy

35:00 min | 9 months ago

Intermittent Fasting What a Physical Therapist Needs To Know

"Hey before we get started I, just wanted to say thanks to our longtime sponsors are es medical staffing, helping you physical therapists or physical therapist assistants find jobs all over this country with position. All settings in all fifty states find out what they have for you at a U.. R. US MEDICAL DOT, com? That is a U. R.. E. US medical dot com. Follow US online at PT Podcast and subscribe on I tunes spotify or Google podcasts. Yeah, it's it's awesome. Shovel. We're live. Here we are. What's going on I'm Jimmy. Cassidy podcast that saves physical therapists for missing out on amazing insight remarkable ideas motivational stories here in the world of physical therapy we are excited you're joining us easier watch a live stream or you're listening to the podcast or you're watching the replay on youtube or facebook or twitter periscope whatever. Welcome. Welcome. Welcome. Peachy podcast brought to you by our friends from Arias medical staffing. Rely. 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. BUILD PT provides marketing services specifically for private practice PD's website development and host and inviting content marketing solutions pt clinics across the country. See what good pt can do for you today at build dot com. The PT PODCAST is a product of PT PODCAST LLC it's poured fresh by me. Physical Therapist. Jimmy McCain ingredients are sourced by our chief connections officer Sky Donovan from Marymount University. And it's brewed fresh by producer and physical therapist. Juliet data. Center and by producer and Creator second your PC student Bridget Nolan from sacred heart university PT Pint cast is a podcast that saves physical therapists for missing out on amazing insight, remarkable ideas and motivating stories. Follow US online at PT podcast and subscriber. spotify or Google Catholics. Left. Yeah. It's it's awesome. Thanks so much for listening, and if you found value in the show, all we ask is that you tell a friend. This has been another poor from the PT podcast. 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60-Second Research  Concussion with Becky Bliss

PT Pintcast - Physical Therapy

15:15 min | 8 months ago

60-Second Research Concussion with Becky Bliss

"Hey before we get started, I just wanted to say thanks to our longtime sponsors are es medical staffing, helping you physical therapists or physical therapist assistants find jobs all over this country with position all settings in all fifty states find out what they have for you. At a U. R. US medical dot com that is a U. R., E. US MEDICAL DOT com. Follow US online at PT Podcast, and subscribe on I tunes, spotify or Google podcasts. Absolutely Yeah it's it's awesome. Ladies and gentlemen we are live welcome to PT pint casted as a podcast that saves physical therapist for missing out on amazing insight, remarkable ideas and motivational stories in the world of physical therapy. Hi, I'm doing McKay I am your host. We have got a a little bit of a different type of show for you today focused on research and by focus I mean enough focus that even I can focus because it's sixty seconds we're doing a special edition of the show that We are calling sixty second research, a breakdown, an article by we I mean one of our guests is way smarter than me is GonNa, break down a research article in just sixty seconds want to say thanks to our friends at various medical staffing leaders in Hashtag travel physical therapy find them online at a U.. R.. E. U. S. MEDICAL DOT com. Let's bring in our guests. No Stranger to the show been on Multiple Times becky bliss becky welcome back. Thanks so much for having me. I'm used I'm used to being like in control and I feel like I'm a little edge with this type of what type of show because it's like, Hey, we're going to break down. An article in sixty seconds I reached out to you not long ago and the idea was, hey, everybody everybody's a lifelong learner and we need to be reading research, and if you're on twitter and PT twitter, you see people sharing links to to articles. People try to like end arguments with a with a citation or or a link to how you do it but the idea is. We actually reading the things that people are sharing a lot. We actually getting out what we need to be to put it in clinical practice that often cited times. It takes seventeen years for something to go from research. That's the thing that all the time is that even true they will do that in a future episode but the idea here was our attention spans are getting shorter and shorter. Instagram stories are pretty much sixty seconds kind of industry standards if you can hang out for a minute and we can break down an entire article in sixty seconds that would actually help with knowledge. Translation is the science term for sharing information quickly, and that's where we come in with this kind of like merging of communications and physical therapy research. All right. So for your background for people who don't know, you haven't seen him or her John Show before give people your superhero backstory because it's it's quite Superhero he oh, thank you I don't know about that but I've been a practicing clinician for nineteen years. Physical Therapist went to Ithaca College up in upstate New York. Yup absolutely gorgeous. Hof Ll. for those of you who have been to, EPICA will understand that and then fifteen years of clinical practice really love my job but love being with students even more and so had an opportunity to jump into academics and there is where I've been since two thousand fifteen My specialty is neuro board-certified neuro therapists but my even more sub specialty is concussion research and so I have been blessed here at the University of Missouri, I've got a grant that we are looking at a more utilize. A tool that can be utilized on the sidelines in clinical practice, a little bit more portable, accessible, objective measurement of some of the things we're GonNa talk about today in this research articles. So we have been granted that money to try to develop that tool and so I am actually just it's awesome. What I'm doing here at Mizzou. I can actually be in clinical practice I can be in the clinic I can be seeing patients are SEC e one patients with concussion teaching it, and then you know doing all this other stuff too. So I have the mess job. Couple other a academic programs as well. We've kind of followed your tour around the country ear. Yeah. So got started at University of Saint Mary in Kansas City Awesome. Awesome place got recruited out to Charlotte North, Carolina at winger, and then got recruited back here to the Midwest. My family is a big midwestern family. We absolutely love it here my husband funny thing was like if you're going to be academics, we need to be at a School that I can have fun watching sporting events. So now I'm here in the SEC so you know you got it. All right. So the the setup for this I reached out to you and said Becky you pick one article and break it down and sixty seconds and you're like I don't know and we do that and I said, let's try. It never wanted to do it live and see if we fail. So people could not chime in with us. We'll go through the article that won't be included in the sixty seconds. So all everybody Nova title and it's a long one because I feel like this title ix sixty. Second. Serene. Tightness up they need they need a marketer communicator guy to help them out, but the title is. concussed athletes walk slower than non concussed athletes during cognitive motor, dual task assessments, but not during single task assessments. Two months after sports. Concussion. On a single breath right there Radic Review and Meta analysis you can find it in Bj sm from January twenty twenty supreme reason and the authors butter and Howl at Al. so that is what Becky is going to break down. All right. Did I miss any of that up now great introduction just for those listening Howell is absolutely a Rockstar in concussion specific to these dual task assessments that are that linked to the higher level neuro motor control that has been postulated put athletes who have returned to play post conclusively at an increased risk of lower extremity Musco skeletal injury. So he is out of Colorado. Following him on twitter go ahead and follow him He posts some great stuff and that's actually where the article came from was better. So you bump into stuff but we gotta make sure people go in deep right they don't just over title and read the conclusion you gotTa go through it so we've got several. Benchmarks for you to hit along the way things free to do but at no point. Over sixty seconds because becky my attention span. At. With. Honest best. Do you need anything to start or are you ready to go I'm ready to go. Let's put the visual effect on the. I like the ominous drone in the background. See if she can be this. All right I will man a banner so we can. We can keep along and keep track but here is sixty second research here comes the intro. Okay we're private and go live timer clear. Repellent tax auditory meter is clear research dominant hot now. Current concussion assessment tools may not be difficult enough to identify residual neuro motor control deficits and athletes that have sustained a concussion, and that's where we get at this evidence could be the postulated reason for why the Athletes Post concussed of our two to three times greater have a greater risk of subsequent lower extremity musculoskeletal injury. So this poses to question current return to sport decision making tools in injury mitigation strategies for concussed. Athletes Are we doing what we should be doing to mitigate this. So in this systematic review Meta analysis, slower walking speeds and Greater Frontal Plane Center of mass displacement was found during dual task activities to include cognitive motor challenges as compared to single task activities up to two months. Following injury gain impairments persisted beyond reported clinical recovery timelines. Incurring assessment methods may not be sensitive enough to identify these residual deficits prior to return to play. Dual task assessments with motion capture may be a useful clinical assessment method to evaluate. Motor control following concussion injury. Studies that included individuals. Who who was included studies that included individuals with sports concussion and non injured controls how did they do it systematic review and Meta analysis looking at inclusion criteria that included concussed in control participants with steady state walking or static balance task as the primary motor task and dual task performance was assessed with the addition of a second cognitive task. So what do task motor cognitive assessment showed residual neuro motor deficits. In concussed athletes as compared to match controls as a single task was not a discriminating condition, which is what our current assessment levels are looking at. This indicates that current assessment tools may not be sensitive enough to identify residual motor control impairments. What's it mean for us? It confirms that Higher Level Neuro Motor controls specifically dual motor cognitive may help identify residual deficits following concussion up to two months months post injury. So now what clinicians should be employing dual task higher level cognitive motor assessments in athletes following concussion in prior to return to play what went wrong with this study continued investigative investigation of what is best assessment tools unknown. We don't have best practice, but we know we should be doing something with dual tasks and cognitive assessment. So. What does this mean athletes need to be able to cognitively make decisions react and performed during gameplay assessment tools that can mir. These skills needed for sport may help identify higher level neuro motor control deficits that are currently undetected with our static single task measures and mitigate the risk of subsequent lower extremity musculoskeletal injury. I think it was a little over a minute. That's okay. Here the music. So I was like graph. All right. We did well, and you learn something we're going to drop the other link to to this title. This article could cost athletes walk slower than non-customs cognitive motor dual task, but not during single task assessments two months after sports can custody systematic review. Learn something and we'll see how far this can go on the twitter they broken it down. How'd that feel trying to bring all that research together in in just one sixty second chunk right there. I feel like for the US and user, right WHO's trying to get what do I need to know? How do I implement this? What can I do better? I think It's GonNa work, but we'll have to see kind of based on some feedback and we're like seeing that testing out but that's really what it is. I always tell people like you know whenever you're working with the patient or you're just talking to someone at Dinner Party and you're stuck with something to say you were armed with six things at all times who what? Where when, why, and how ask a question This is how I appear smarter than other people. I am not smart but I just ask questions and when ask questions at dinner parties or social gatherings or patients you're GONNA, get more information and Nazi idea. So So I think asking these questions in going through articles. This is this is a breakdown you. Should be asking yourself what is it? Who's WHO's at looking at? How did they look at it? So what does it mean now what comes next and how are you GonNa apply into clinical practice what went wrong and then what's the conclusion when taking away from us? So and that's what you were able to do with the sixty second research will try it again. Agreed agreed all right anything or yeah. Before we let the audience go now. But if you have questions reach out to me, I've got a yeah resources that can share your way. If you're trying to figure out how do I like what dual task measure should I be doing? What should I be having my athletes doing There's a lot of good. Yup Absolutely, there you go. There's how you can reach me but there's some really good. Early evidence of what we could be doing clinical practice. Some happy to share those perfect and would love to have you back when you've got a little more information to share about your project that you're working on it. We'll see if we can take that. That's hard when you work for for months and months and years and years, and you're like, you get a break it down to sixty seconds you're like can't possibly do that. But that's literally what they were taught us journalism school is You walk into class everybody all my roommates were jealous ozone journalism major I'd walk in at nine. AM In my class would be alone dry race board not even professor in the room, go out and turn a story into me by noon about a person on this campus and you're like, that's great and it'll be like a thousand words and you. You'd submit a thousand words by noon. You'd get an email back that said, that's great by five PM I want five hundred words. And that's when you realize that you have to write for brevity. But maybe we need to do that as clinicians as well. In terms of let's let's get to it. We share because people's attention spans are getting a little shorter but get to it don't dance. Let's get the answer. Agreed Alright. Thanks for thanks for taking a shot with us in this very first edition of sixty second reese. Love the P. Pine cast yes. Yes. The port the show play telling a friend or by leaving a review a nineteen or Google play all right shooter day brought to you by the Brooks Institute of higher learning an innovator in providing advanced post Professional Education Brooks IHL offering continuing education courses in numerous specialty areas, six PT residency programs, and. Fellowship as well as challenging but rewarding internships, the H. L. Specializes MMA translation of information from evidence to patient management learn they can do for you to support your professional development at Brooks Ihl Dot Org. Our. Home on the Internet. Dot Com. Created by build. BUILD PT provides marketing services specifically for private practice. PT's from Website Development and hosted content marketing solutions, PT clinics across the country. See what? We can do for you today. Dot Com. The PT Podcast, is the product of PT Podcast LLC. It's poured fresh by me. Physical Therapist. Jim McKay ingredients are sourced by chief connections officer Sky Donovan from Marymount University? and. It's brewed fresh by producer and physical therapist Juliette Death Singer and producer and creator second year student bridget. Nolan from. Sacred Heart. University. PT. pint cast is a podcast that saves physical therapists from missing out on amazing insight, remarkable ideas and motivational stories. To follow US online at podcast and subscribe on Itunes. Or Google. Casts. Last. It's it's. Thanks so much for listening and you found value in the show. All we ask is that you tell a friend. 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How to communicate science without sounding like an ass with David Putrino

PT Pintcast - Physical Therapy

39:26 min | 2 years ago

How to communicate science without sounding like an ass with David Putrino

"Hi, I'm Alexa. You can now. Hear PT podcast using me. Just say, hey, Alexa, launched PT pint cast or you could be nice and try saying please for lunch. What is being polite dead? These days to your episodes, just say, hey, Alexa, launch PT pint cast, maybe throw in a please. At the end when you'll goal is to stimulate learning. Passion about a topic and stimulate curiosity and all of those positive things associated with actually being additive to a field. When you kept chillers things. It's always about community engagement, creating a conversation. Not creating the final word or the mic drop, really even engaging people that you disagree with in things that matter in the questions that matter jazz talk to you, David Putra. No again, he's a PT. That's also a director of rehab innovations at Mount Sinai, just super fun guy. Super smart about PT and rehab tech cut. You talk with him about communicating in public about science. He and I actually both her the same. Joe Rogan episode where two guys were debating. Talking about health, but really the conversation David, and I wanted to talk about was how that conversation kind came across and how we might use that when we're talking with patients in the future. Plus we're talking about a few of the things that David's into super smart, dude, check him out on Twitter at Katrina lab. And of course, has a book called hacking health, which you have to read first round brought to you by owns recovery. Scientists single source for looking for certification in personalized blood flow restriction rehabilitation training and the equipment you need to apply. Take out Johnny Owens and the crew at Owens recovery. Science dot com. Broadcasting to physical therapists around the world heard in over one hundred thirty five countries with more than one million downloads and counting is is. This is the PT pint cast the best conversations happen at happy hour. Welcome to hours. May I introduce me to introduce you to here's your host physical therapist Jimmy McKay. Thanks for coming back on the show. All right. So we were talking about Joe Rogan podcast and to bring the audience up to speed. There was a conversation with Joe Rogan hosts of the Joe Rogan experience. One of the biggest podcasts in the world had a neuroscientist on the show and a journalist talking about diet and weight gain in how the brain comes into play. Correct. And these guys already have a beef. They already have a beef with each other. Yes. With h so there's been a few arguments and hurt feelings into it was. But so so you you would tweet it out about this about this particular episode because of how they were communicating exactly these guys started talking about. And I think it's it's a giant two huge buzz topic on any form of social media eat this not that superfoods. Detoxify all those things so I think people gravitate towards them. It's on the Joe Rogan podcast for for Moore. And these guys have a history, not only. Banging their own drum and tooting. Their horns in terms of their ways the way they've got a history with each other going at each other either online or at conferences. Yeah. So what was it? Again. The neuroscientist was big into the neuroscientists result surprise surprise was all about the fact that the brain controls everything and the journalist has been a proponent full lacob diet for really long time. And and again, you know, who knows who's right? And personally like if you look at the literature. I I would I would actually edge toward the neuroscientists point of view. But what was striking to me was how unlikable he was how difficult it was for me to actually see past his clear bias against the person. He was debating the fact that he was very combed ascending. He was very sort of dismissive of anything that this other person was saying, and I think that it really sparked in may something about. Like how how we change people's minds is a very important issue. Right now, you can you can tunnel it into any any sort of field that you want for instance, Cairo's vis physios, or, you know, vaccines versus no vaccines. Trump vis is not Trump any anything you want. You can you can build this in and what we saw on the putt cost was you know, shining example of how not to do it. Yeah. So I'm not going to ask you, which which one you thought was right because that's not why we're talking. Yeah. We're talking about the stuff that you just mentioned which is. Hey, you actually you actually had, you know, lean a little bit one way. But it was the way in which we were talking. They were talking to each other you start to fall into things like logical fallacies like straw, man arguments in attacking each other. Now, you're going towards attacking the human being versus. Okay. Let's debate this idea or this arguments talk it out, and I said before on this show. Show is is usually the smartest scientists I noticed that this is what we know now, or here's what we can learn from this study that was done, but anybody who says I know everything about this topic. I mean you have that's giant red flag. But it's super easy to fall into online, or or at least, even if your wise enough not to say, I know everything about this topic to throw up the sort of come on dining, even argue with me, I know more than you, which PT's are super guilty of by the way, we should take ownership. Yeah. For sure I think I think you see it a lot in the healthcare profession. Yeah. Someone someone says I read this on you know, I read this on the intimate, someway, I googled this. And it means I have cancer and ever- unrolls there is and it's like, well, one of the thousand times probably person saying, I have cancer has cancer. But either way rolling your eyes, isn't helpful is not helpful. No matter what even if they're wrong. And you know, they're around the fact that you're dismissive isn't going to help that person or our profession or healthcare in general. Oh, your relationship with that person is as we know terribly important, even if you might be understanding what the person is explaining is not one hundred percent, correct. So all right. So these guys raged back and forth. And you know, the the neuroscience you want to listen to this podcast. It's a recent episode from Joe Rogan the neuroscientist started on like he was at about one hundred and fifty degrees when he started. Yeah. And by the end, they were both pretty much just taking it was just taking shots at each other. Yeah. It just devolved by the end of. And it really struck me because I think in science we have a problem with this massively. We have this idea that oh, I I've done so much already people should just listen to what I say. And take it as gospel, which is like, basically, anti-science what? Now, we're talking about religion. Right. Good point this. This is a massive issue. And we see it at all levels of science as well. And we see in the way that scientists communicated to young scientists. So there was a. Study that was done that showed that if you were a good thesis adviser that made sure that everyone that you a teaching fully on the stood you, and you would kind and you took time to answer the questions nicely you a perceived by you'll students as less intelligent than the individual who would be rude and brusque and Walkin and Tolkien jogging in lectures and stole amount and not answer anybody's questions. And that was to me that was like such jarring finding because I I always would observe things like that. I would observe the fact that I was easy to understand and people in science thought that that was undermining they thought that what that meant was. I was thinking simplistically. But when the reality was, well, it's much hotter to give it a Alexa. Everyone can understand. Right. Clear communication is actually terribly difficult because it means you need to know the topic. Very well. Whereas I can walk into almost anything. Give a lecture in jogging buzzwords, and then get angry anyone who else could question and stole him out. You know, that that's a very very simple thing to do. But somehow in the sort of Stockholm syndrome that is the sort of scientific environment. We've created this environment whereby we perceive, you know, it's just like the dating world. Right. You know, like someone Tracy main. You you go out you chase them all the hotter. I it's exactly like that in the scientific world as well. It's like, oh, if they had talking in woods, the I cannot stand that means the I need to like re work harder. And they must be super position than they are clearly superior. 'cause I don't even understand what they don't even understand the basic words, they're using xactly. I can see that. So. Okay. So now, we've set the table, right? There was this podcast interview. It's an example, one of many the fact that it happened on Joe Rogan's podcast. You know, amplifies the issue where I forget who said it, maybe it was like P T Barnum. So so Barnum said it's easier to fool people than convince them that. They've been fooled. So this gets into like, no wonder why society at large is like kinda confused on what to do or why they're looking towards either pseudoscience or why they go gravitate towards the very edge is because those are the things we're kind of presenting them with like we talked down or we dismissed. So we were all our is like, so that's the reason I wanted to bring this up as like, so that's what happened. These guys were going at it. And I think what happened. What's happens is people? Listen to that. And they just picked whichever side they probably already had or whichever side they felt like closer to instead of looking at the science, exactly. And I mean, my my first thought when I was listening to this debate was when I when I was listening to the way the neuroscientists was interacting with gentlest. I was just like, well that guy's not changing anybody's mind. Right. And that that's that trip. The whole point what's your point for coming on this podcast? It's too if your goal well, his problem. I think they're trying to when they come in there throwing haymakers verbal haymakers. They're trying to convince. Everyone to see their way, and that's impossible. I'm not even sure I when I hear someone, you know engaging the level of discourse the that this guy was engaging in Stephon Stephan was his name. It's really about showing people. How smart you are? Okay. That was that was it. And I think a lot of people out very mindful of their mission when they Wilkin and the question is do you want someone to hear you, talk and go. Wow. That person's super smart. I could never be them. Or do you want someone to hear you Tolkien go I'm going stop like really following up on what that guy said. Because what that person said because I think that what I said had merit and I'm going to read about this. And I'm inspired to learn more. And really he was full. He was falling into the Fulmer. He was just like I wanna walk in wipe the flow of his the Mike and walk barris, the sky, and then have ever on think. How smart I am my dad my dad through this at me once when I. Took over radio station. And I was I was so nervous 'cause like twenty four and I had to be the boss, right? And after he's like, what's the problem? I'd as a firefighter very pregnant, but something on fire put it out. So he's like do you want to get it right or be right? And the same thing, and he's like another not think about it. Do you want to get it? Right. Or do you want to be right? And I wanted to be right. I wanted to be the boss when really ultimately, I really deep down inside. I wanted to get it. Right. But I didn't know how. So I think that was all right. So so that's what happened what what should happen or give example because you've got all sorts of different kinds of conferences. What's it? Look like, what's it feel like when people do it? Well, I guess in all cases when you're when you're goal is to stimulate learning. When your goal is to stimulate passion about a topic and and stimulate curiosity and all of those positive things associated with actually being additive to a field rather than being your own personal brand when you capture those things it's always about community engagement. Creating a conversation not creating the final word or the mic drp, really even engaging people that you disagree with in things that matter in the questions that matter, and, you know, every time I go to a conference that I really enjoy that that I feel like I've grown Oland something from it's always about exposing myself to something I've never been exposed to before doing it in a vulnerable way where I've I've got trust with the people around me. So I don't feel like anyone's going to judge me for not knowing, you know, this'll that fact all, you know, not not necessarily being the full bottle on on this topic. Oh that topic. Just exposing myself completely lively to a whole new group of facts being open to it and then going off and doing my own research and coming to my conclusions and having conversations with friends about it is it is it more difficult to do that in science and academia because it's like higher Arkell. Like, it's like if I. Look, look where I am you run a lab at Mount Sinai, shouldn't, you know, you should know everything like, you should never be like, I don't know that's difficult or must be. I would think if I were in that position be difficult to be like, I honestly don't know this. But I will look into it to say that. Now that's downs. Most intelligent. That's gotta be hard. Yeah. I think it's all about ego. You know, I I think I was I was schooled early on because I was a PHD student at age twenty three finished my PHD into an hoffy is so like super-quick, and then I was lecturing medical students PT students neuro anatomy neuropathologist things like those. I was really young. And it was funny because I used to notice that if I had shaved no one would take me seriously. And if I hadn't shaved a get a little bit more respect, but only a little bit more. There's a book about that. Just read it called. Rebel talent. And the whole book explains exactly that or most of that one one of the things I realized was that a whole bunch of people just prejudging me because I was five years younger than them. And they were coming to learn, and they were paying money to learn, and and they were just like not a lot of money because it's a stray Liam college. But you know, they were really sort of. I Don t they went they went upset, but they were kind of like what who's this kid, and Why's he teaching me, and what I learned from the experience was to walk into a room. And the first thing that I started doing in all of my lectures was when I was meeting a class for the first time. I would tell them who I am tell them my background, and then tell them my job is not to know much obvious to facilitate. So there are going to be things where I'm not going to know the question and my only commitment to you as you teach. You is I'm going to go and find the answer. And I'm going to give give you the you'll never not get an answer to the question unless they is not currently unknown answer to the question, you're asking, and what I realized was once you so to sit that level as opposed to because people were coming in with the the sort of traditional expectation of our his another arrogant lecturer except for guys five years younger than me. Like, what does he know? And he probably, you know, probably hung over probably doesn't shit, you know, like and as soon as I just stepped in. And I was like, well, you know, like I've done a PHD. And and he was what I did. And it was pretty involved. I know a little bit about your anatomy by the stage bought, by the way, I don't know everything. So let's learn together as soon as you sorta like extended that olive branch. It was stunning to me how quickly people sort of got it. And you know, wanted to be friends, and you know, they were starving. For community because ordinarily there is that hierarchy Asian. Yeah. I'm up here. You're down there. And I was just like, nah, we're all gonna learn together and less, you me, less more we yeah. Yeah. And what I'm really good at because I mean, in my opinion, the only thing that really teaches you how to learn things quick. And that's what I'm good at. So I you know, I could learn things quicker than them because I knew at a look, and I knew how to reference and I knew how to do all of those things as a research. So that was my commitment to them. If they asked me a question, I couldn't answer out find it. So that's where these guys really failed. And that's where I think a lot of these conversations online. That's the thing. Like, literally anybody can have a podcast like you. Don't need a license to have a blog. You can start a website about anything and you can spout off and on. Fortunately, these things get referenced and cited and shared, and these people, you know, for for better or for worse. Get put on these pedestals or they get shared. They get follows. Like just just that word, right like followers like who wants? He wants to be a phone line up and follow them. So all right. So what what would be a suggestion? How we anybody listening? Whether they're a PT student or anybody listening this. How do they do it better? You know? I mean, like, I think your example, right? There is definitely number one which is walking like be honest and be vulnerable. Like, hey, I do know this, right? But I I don't know this like honesty, transparency should be I instead of stay in your lane, bro. Which of no, I mean, I think always, you know. You know coming into it being humble is is number one like most people who are authentically being humble at the beginning. It's hard to fake. And so as soon as someone sees you being open being ready to take on a different point of view being ready to just genuinely engage in a conversation that is two sided, and you're not waiting feel minute to speak. You'll actually listening actually listening your reading it back to them. You'll saying did I understand you. Right. His what I think about what you just said having a proper compensation that that's crucial. If you do find yourself like hitting a point where you absolutely cannot agree with this individual like, let's say, for instance, I'm sitting across the table from an antibody. So right. That is someone whose opinion I cannot reconcile. I do not agree with. But if you're sitting there being asked to have a conversation with one another. Find some common ground like that's why you gotta stop it. Because and this is a bit of a loaded question because sometimes I think it actually is. But is the point of view to sitting across from one another to engage in a screaming argument where you've got fan bases and both of your fan bases. Just disagree of who won the screaming argument. And also you've got a Konami like your livelihood some of these people's livelihoods, so there's a reason for them to net to dig their heels in a never listen both of these dudes had books ambulatory. Yeah. Am both of the books were on opposing views. And you know, there's a massive conflict of interest and. When I was a slide in presentations, or or or paper here in my conflicts of interest, neither of their, you know, both of their opinions was suspect just because of that just because of the fact that they both got books, and they have book sales, and they have, you know, an I shouldn't say too much because I've got a book, thankfully, my book is is bipartisan, but. But the point was, you know, they walked in that thinking that it's life or death because of economy because of like if this if this guy gets one over on me, people go down sales, go down and that does complicate things. And that does make it less likely that you're going to be open minded about stuff. So everything you just said really is like a hate to go back to that. They've everything you need to know. You learned in kindergarten, right? Be nice be open be transparent. Listen actively like him. So there wasn't a wasn't a technological or a super Vance 't solution to this people problem. It's communication solution to a communication problem. Really? Absolutely. Yeah. I mean, it's community. It always ends up coming down to communication. I mean, these guys it was it was a disaster. I mean, again, everyone can listen to podcasts. But it was like they wasn't a lack of character. I mean, Joe was pretty funny. She always which twice. Got one of the biggest podcasts. Yeah. But I think everybody lost on that everybody lost yet. Because I like I mean, I can't imagine here it like if I were a fan of either one of them, I kinda of hearing what happened in that pug cost not thinking, you're both pathetic like because they really sort of broke down into name calling and being condescending. And it was just like this isn't what could discloses, and that's why I wanted to converse about and really the ultimate takeaways like, okay. Think about how you do this. And believe me, I'm thinking about how I do stuff. Listen, I've degree in communications and my bad communications with people. I know absolutely. Like, I can be terrible at it. But being open and being honest about it. That's the only way to get better. Yeah. So I thought that was a good example, we could at least find something good in it in terms of like pay. Maybe we'd if you're in that position to represent a point of view the way to best do it, isn't that? You know? It's it's this it's open. It's active listening and stuff like that quick break. That I want to talk about where you've been. I wanna talk about games show. I want to talk about video. I mean, this is the funniest thing we talked about when you were nine your parents. They go to, you know, study do your homework because you're not gonna have video games in the future. And here we are. Podcast. We'll be right back show's brought to you by Arias medical staffing that single source for PT's. Wanna do what you wanna do which is be a physical therapist where you want to do it? They've got positions anywhere in the US. All fifty states. Yeah. We get asked this allot Alaska Hawaii Colorado you want to do some mountains you like rivers lakes ocean. They got you covered. A you are a US medical dot com. It's very simple to explain what they do. It's why I love working with them. They find jobs doing what they wanna do where they want to do it. You put yourself through school. Lots of blood, sweat, and tears now, you decide where you work are as has you covered a U R E, U S, medical dot com. No obligation. Just check them out and see what they have to offer. They've been doing this for a couple of decades, a U R E, U S, medical dot com. This is the PT pine cast wanna thank Brooks rehabilitation there institute of higher learning for sponsoring the show. Residency and fellowship opportunities is what they. Offer check them out at Brooks, IHL dot org. Also hosting their fourth annual scholarly symposium that's going on June twenty second in Jacksonville, Florida information about the symposium can be found at Brooks. I h l dot org. Keynote presentation this year by the editor of Jay, Alan jetty. I'll be on hand doing some talks and some live podcasting. Looking for see us into expand your knowledge base? Look, no further than Brooks, IHL dot org. And let's get back to the show. All right. So you were a GD C which stands for game developers conference. And that was where west coast. Yep. San Francisco, so what goes on there? And why the heck was invited to kind of hang out. And we you talking out there too. Yeah. And and it was fun. In fact, well, first of all my MO is showing up a conference is that I'm blowing like I that's where I learned the most because. You know, what more we should do it more? Yeah. We we've discussed conferences before. And it's like a whole bunch of people having the same arguments having the same opinions, and it can get a little bit. You know, a little bit annoying. Whereas I often like just showing up places I don't belong and hearing what how other people in other industries solve problems that we probably have in this particular case, a friend of mine who is a game developer who also helps to organize this big conference in San Francisco. She had heard about some of my work where I'm using virtual reality to treat chronic pain. And she said, you know, what you should you should give token this thing and come check it out because it's an experience and sure enough it was it was at the Moscone center in in San Francisco, it's like like three massive buildings across multiple straits. There were tens of thousands. I don't know how many tens of thousands. But I think about forty or fifty thousand people at this conference who were is this like gamers developer is the mix of everybody. Everybody the people who make games they were people who like I was swamped by people. Look Amazon Mozilla Google, you know, like all of those people. They were game is just interested in what's next big thing. And what's going on? They will tech vendors. They were you know, people show. Seconds a lot of different intersections. Yeah. So so real briefly, we can't skip over this talk about your research with chronic pain and VR like the reason you're out there. Yes. I mean, we we started this a little while ago speaking, primarily to physio audience, we all know about mirror box therapy, which is this way of treating chronic neuropathic pain, specifically usually people who've lost a limb, you you put your your missing limb into a box, and there's a mirror on the side of it. And you put you intact limb next to the Mira. And then when you look in the mirror, you see a limb that looks a lot like the limb you missing, and you can get it to do all sorts of things by somewhat your intact limits doing wildly successful in trading, chronic pain and wonderful except for a it's an always that practical to walk around with a mirror box to be in the population. I was really thinking about which is spinal cord injury Amirah box doesn't do so. Well, because you don't have a agency and. And you know, ability to move your limbs. So we just saw of playing around with this idea of what would happen if we started creating virtual reality environments, where you look down you saw an arm that looks like kind of like your arm, and it it's doing things and this was based off of the literature around mirror box therapy and also the literature in chronic pain in general showing that if you can visually improve the relationship that someone has with their painful limb, you can usually decrease the level of pain, and we ran a short pilot in a bunch of people with a spinal cord injury who had like longstanding chronic pain, and we noticed that everyone responded, positively to the victory environment. Every single person was experiencing significant, you know, thirty five to forty percent reductions in their the chronic pelvic deal is a deal. Especially for, you know, looking at something on a on a iphone screened in our that's the kind of you're going to be in. Now. I mean, we've got fancy ones, but we were using Google cod board because we wanted this to be ultra low cost ripe. So the cost of a million bucks. Who cares? Yeah. But if you can get to anybody, then it's a political. Yeah. Cool. And so we kept playing around with it. We recruited more people in the the findings kept holding. So we have some funds to run some research on this. And and look into who response who doesn't what soda comes and gets the strongest responses how immersed do you have to be to actually get a response from this? And yeah, we we've we've started building a lot of three hundred sixty degree video content. We've started studying the sort of psychology of people who respond vessels as a psychology people who don't respond, and it's a really interesting area of research and turns out the the crew out there J D C, we're really interested in it as well. Because again, you know, you're in you're in a conference that you don't necessarily belong at but people hungry for that so to content. So what was interesting was I I was I was in a half half full room. Because it was a massive conference. Like, I said like tens of thousands of people rooms all around and and things like that. And a million events happening all at once, and I was in this half full room. And I started talking, and I started a because I knew I was talking to a crowd that didn't really necessarily know much about neuroscience. I started off with a basically an entry level. This is near a science wanna one. This is how you brain, you know, creates a representation of your body and reception and hunky lie, right? And he's like that. And I was a little bit too disheartened at the beginning. Because like those a lot of people on their phones. And I was like, oh, man these nuts. No one's even listening. But I just kept going and what I realized what was people would take the friends and the room filled up, and then the organizers had to send us off to a breakout room where we with like an hour and a half off the woods because there was so many people that will like. I had no idea that the games. I was making could have social impact could have could do good in medicine. Thank you so much for your talk. And I was like this is why conferences where I belong because you just get put out that point of view that people haven't thought about apple and they were hungry for it hungry. Yes. Absolutely. They they wanted to him. All I couldn't get away from him. So it was good tastic. So what's coming? What's what's the next party there in your research? You're I'm sure you know, you were there for a little while and your bumped around, and you know, your brain you turn that off. And you're looking at what other people are doing you're saying how do I add that to what we're doing? Yeah. You know, it's interesting everyone's trying to get more massive. Everyone's trying to say like how can we how can we create a real experience? That's not a real experience us as well. You know, like what we're noticing in our research is that there is definitely a link between how immersed you are in the relationship and how much pain relief you experience. So the obvious next step is what strategies can we built in to make? Hugh, more must the flip side to this which I find super interesting, and I sit on there's a a law school here in New York, the condos I school of law, and I they pull me in once every six months twelve months to sit on a board where they go over new law cases that are related to to reality. What? Yes. So and these things ranged from property disputes, so virtual property virtual property dispute games. Yep. Whereas someone has like get I put a Bill vote up on someone else's land. Or that they paid for now and lawyers have to like deal with that all the way through to. I went to a reality exhibit that was showing a horrible Torri -ality film. And now I have PTSD and who who has to do with that. Oh, actually, an another one because we've got a physio population here been on paroxysm. Oh positional vote ago. Beep TV happening as a result of develop his spending too much time in via is on the rise. So these are all things that we need to think about these are all things that are happening because you're exposing your brain to this second reality firemen, a new environment that the, you know, the body's not used to that. How young is too young? How old all of these things? Yeah. How that's. Wow. That's cool. So that's I mean, that's some stuff. I even thought about it's it's coming. So what are they doing? All right. So virtual reality. You can see you know, there's there's there's a third dimension. Because you've got you've got purpose space. Of course, you can you can put something over the ears or sound. But now you're going into things like like, touch and those like happened up have to suits and stuff like that. I mean, I mean just as you were saying when you brought law up I'm thinking, we have have haptic that's like touch. Can you have improper touch like I'm slightly that's already happening. So that's already happening where people are being sexually assaulted the avatar being sexually assaulted, but they're feeling if this is pre haptic, you know, what our preempt sorry. This is before we have had systems, but people are still the already so embodied an invested in the avatar that if someone comes along and like disrespects them, they feel that they they like that. It's like it's happening to me. And that's not airy-fairy liberal nonsense. That is that is scientific fact we've we showed in monkeys in fact in a previous life when I was a monkey physiologist. We showed that if I did a if I vote -cially tapped a monkey's hand in virtual environment. I could see his sensory cortex light up in at the same rhythm as tapping stimulus. Even though I wasn't tapping him in real life. So he was feeling that he was looking down in his victory. -ality looking down at the hand that looked like his hand seeing an object into his space and touch him on the hand and his sensory neurons were responding to. So we know that that sort of mind body connection exists in inventory -ality even in animals, so it's a it's a genuine legitimate consume that what you do in virtual space can affect you in real in real. Well. All right. So I'm not going to hold you. This prediction, but make some make prediction that is five or ten years out. That is going to seem insane to me. But it's not that far of a stretch like something in this world in terms of games and and rehab or any any of these intercepts intersections that you got it at UD. See I oh, there's there's a lot going on. I hate sounding boring. But honestly, I feel like ready play a one was the extreme version haven't read that or sorry movie came out to read the book, the a snob or anything, but the way better. But it's kind of like it's where we're going. You know, we love screens completely immersive. And we love screens more than we love regular life. Many many times companies have a lot of reasons to keep us looking at screens rather than keep us looking at regular life and build haptic s- into that. And you know, I would you leave? Why would you leave it just stay at home, and then you can leave home, but through the screen? Yeah. I mean, Corey doctor always seems to write stuff that you're like that would never happen. And then a couple years later, you're like that's pretty much happening. I mean, look at gene Roddenberry right with Star Trek like short of beaming, people places like most of that stuff's kind of happening yet. And we're the next tells came out the walkie talkies cell phones like that was that was the communicator device. I mean, we're getting there with all that stuff. Yeah. And there's a lot of interesting literature out there about how science fiction informs technology development, because we we. Watch those movies, and you go wouldn't that be cool? And so it inspires invention. Where if there isn't a hover board a four I'm able to use a hover board I'm going to be so pissed like if only comes around when I have grandkids, and I can't get on it. I'm gonna be pissed off. I'm just putting that out there. Oh, man. It's a bunch of broken promises. A now last thing we do parting shots. This is the parting shots. The parting shot is brought to you by rock tape. More than just a tape company. Rock tape is a movement company, tools and education for medical professionals. If you're looking to help your patients, go stronger longer checkout rock tape dot com. We talked about two big topics really science communication, and and really like gamification, and where's that we're going? So your parting shot can be on either of those or neither of those. What's the last thing? You wanna leave the audience for with this episode thinking about oh my God, be kind. I think that has to be translates all. Like, you're never gonna change someone's mind, if you don't kind to them, and we saw it in this podcast, and it just keeps coming up in the current political climate, and in any work conflicts that you you kit to think of always you've got to be kind. You've got across. You know, you've got across the barriers you've got to find some common ground. You got to just have good meaningful NAS conversations with people. Even if you having a debate with someone no one's gonna no one's going to be on your side. If you just attacking the other posts, and, you know, listen, be nice, disagree nicely and be friends with people you disagree with difficult to to upon that David Pacino. What's your Twitter? It's paternal lab at between alab. All right. So fall guy puts out good stuff and mortgage stuff. I think we need another episode about stuff because you mentioned some stuff before we hit record. That's coming soon. Then I think deserves its own conversation super excited for that. So it's not. Where I live. Yeah. We'll pull that. But that is very very cool and PT's around the world to geek out about this stuff. Appreciate your time. Man. I always appreciate the beer to. We haven't fat tire. Love it. PT cast is a product of PT podcast LLC. It is hosted and produced by PT pine Casio, Jim McKay and CBO sky Donovan from Marymount university. We talk PT, drink beer and recorded. This has been another poor from the P T pint cast, the PD casts intended for educational purposes, only no clinical decision making should be based solely on one source. Lump care is taken to ensure accuracy factual errors can be present. More on the show at PT podcasts dot com. Now, we're home on the internet t- broadcast dot com. Created by build PT, build PD provides marketing services specifically for private practice. PD's website development and hosted inviting content marketing solutions PT clinics across the country. See good PT can do for you today. Build PT dot com. The pint cast proudly supports the Travis mills foundation on April tenth twenty twelve. The United States army staff sergeant Travis mills of the eighty second airborne was critically injured on his third tour of duty in Afghanistan by an while on patrol losing portions of both legs and both arms. He is one of only five quadruple amputees from the wars in Iraq and Afghanistan to survive his injuries. Thanks to his amazing strength, courage and incredible will to live the heroic actions of the men in his unit the prayers of thousands and all the healthcare providers at the Walter Reed. Army Medical Center Travis remains on the road to recovery. He found. Travis mills foundation, a nonprofit organization formed to benefit and assist. Combat injured veterans. Travis lives by his motto never give up never quit to support the Travis mills foundation or to find out more. Visit Travis mills dot org.

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From IED Back To Active Duty with US Army Green Beret Ryan Hendrickson  Tip of the Spear

PT Pintcast - Physical Therapy

47:00 min | 8 months ago

From IED Back To Active Duty with US Army Green Beret Ryan Hendrickson Tip of the Spear

"Hey before we get started, I just wanted to say thanks to our longtime sponsors are es medical staffing helping you physical therapists or physical therapist assistants find jobs all over this country with position. All settings in all fifty states find out what they have for you at a U. R. US medical dot Com. That is a you are e US medical dot com. Follow US online at PT Podcast and subscribe on I tunes spotify or Google podcasts. Absolutely. Yeah. It's it's awesome. Let's. Welcome, as we do a little bit of a liquid lunch year episode, the middle of the day Welcome to PC podcast to podcast that saves physical therapists for missing out on a mazing insight remarkable ideas, motivational stories here in the world of physical therapy. I'm Jim. McKay or hosts were broadcasting live from the medical staffing studio. Also known as my bedroom will call it a studio sounds fancy. When we do that check him out on a you are US medical dot com leaders in Hashtag travel physical therapy. Let your pt license take you where you WANNA go want to be a PT and all different settings all different places. Settings positions available in all fifty states plus Washington DC again a U. R. E. U. US medical dot com great show for you today. We've got. We've got an incredible story of an injured Green Berets return to battle I got the book you should get it to you. Right here if feels the jets got a legit story inside be careful with this book, it'll open your eyes. It's called tip of the Spear Ryan. Hendrickson. Is GonNa join us in just a second we want to welcome into the program I gotTa say, thanks to who hooked us up and one of the sponsors of the show Johnny Owens team from Owens Recovery Science single source repeats he's looking for certification and personalized blood flow restriction, rehabilitation training, and the equipment and the clinical practice and research to apply it properly. In your practice with your patients let's get the cool serious music in here. Here we go. Yeah. Let's bring a in right now. Servicemember author current Green Beret Right now, Ryan Hendrickson is coming into the Studio Ryan Welcome to the show my man. Thank you very much appreciate being on here cheers to you. I like to to make sure we always say thank you for your service with anybody who is in the the armed services. Thank you for your service. I really appreciate that. Thank you very much. I. Feel like I'm GonNa say it three times because I want to open up. You've got a really interesting background you served in three branches of the US armed services. Tell us about that. That's a little unique. Yes. It's Yeah. Yeah. Unique I guess you can say like that. So I Growing up. Small town in Oregon My Dad basically when I graduated High School my dad you know he gave me a few options you can You can go out to the workforce you can go to college, but let's face it. You're not college material. You're good point or you know you can join the military I highly recommend you join the military. Serve your country do four years come back figure out what you WanNa do with your life? Okay. So what's the navy? That was the first thing? First thing hopping? Recruiter gap me with the with the normal things you wanna you WanNa be a navy seal Charlie Sheen's like Yolk you want the F Fourteen Tomcat pilot like Tom Cruise Yeah. Sign here you got it and none of that happened but. Join. Join the navy. Did did for years in AV got out. and. Tried my hand at civilian life in just you know not really a civilian minded Canada? Guy. So. Ended up joining the Air Force in at at at blast great career. In the career field, so love Miami troops, but it just there is still something missing. There was a sense of. I don't know I guess. being on the front lines. Known what it's like for I guess someone shoot at you. Wanted to find out of a switched over to the army and became a green beret that was a fourteen months of training. And Deployed Afghanistan shortly after within three days in Afghanistan figured out what it was like someone shoot at you. Pretty addicting. Yeah, well, your your book I WanNa make sure that he knows it's called tip of the spear the book jacket alone I left this around my I'm living with my brother right now and I just want to read a little bit from the pages, the back five minutes or so after stepping on the I. E. D. A. New I was hanging on for dear life I could feel myself slipping away. I heard many stay that your life flashes before your eyes just before you go. But that wasn't happening. I didn't know if that was a good thing or a bad thing and my brother was the united. States Navy he talked talked about you know picturing what would happen next what what your family and what the public would see. You talked about that that army photo, the death photo, the the death photo as their as they're and my brother pick this up. He said, yeah, that's what they tell us when they're taking that picture is make sure smile because that's the thing they print I mean all this is going through through your mind saw I love the book all thank you for writing it. I'm a main is when I, actually read a book never mind you wrote a book and had a really interesting story. And that really came from something your Dad said, which is you've got an empty you got an empty book, right so what do you want to put on the meat is of your life and that that really was the first I'd say third of this book was you trying to figure out where you fitness world talk about where you grew up at a lot about your family the flip the first of the book was a lot of this and that and this and that but I'm guessing that's how that's it felt like that read like that because that's what your life was like. Yeah I mean yeah. Definitely. You know you start off with a there's two things in life you don't control you don't control life and you don't control death. Everything in between blank pages and and you do have control over them. and. So my dad had also told me about the what ifs in how dangerous would if were in? If you know as far as the two old men sitting sitting on the porch in in one guy miserable because he'd let life pass him by and he never took a chance he never failed. He never got out of his comfort zone. He always just stayed in his comfort zone in now that he's older sitting there and I wish I would have done. This I wish I would have done. That would if I would have stepped out and then there's the other old man. Who you know? He failed a lot. Any succeeded a lot in southern world. Any did everything there was to do and he has no what if he has no I wish I would just sits back and he remembers the life that he lived in he's content and so he said you know which old man do you want to be a mess stick with that stuck with me for well, I mean forty almost forty two years. So. Yeah. That comes across in in the book and you talk about failure you talk about trying different things and and going through through through the process to become a navy seal and you're really open with, Hey, I didn't make it couldn't figure out why and you're open with the different paths that your life were going through your mind when you were taking these different paths and I think ultimately that's a great. Lesson because you know on our phones, we look at this highlight reel. Everybody's Success Success Success Ryan Your Green Beret right now. But to get there was a really difficult path took a lot of twists and turns mom talk a little bit about becoming a green beret. You say I was just fourteen months of training. It's really easy to sum it up there but fourteen months it was not a walk in the park. No No, it was not Yeah. So I I did I I failed a lot And I I guess. Part of my story in my book was I used to use my failures as as as a victim mindset like you know poor me or you know it's everybody else's fault but my own. And but I needed a victory like I needed. You know something under my belt in Q. Course. In training selection key course it happened at. All I can really say is God's perfect timing. Mean Tell you the truth because I was at a point in my life where I needed a w and there was. I didn't care what it what it took in for me. I was coming from the Air Force. So I didn't have the infantry background in have the ranger background or nothing like that, and so the the Q. Course was completely selection cucumbers for me was a complete eye-opener but. Every time I would pass a phase in succeed it just it just kept building up my confidence building up my confidence in in. Yeah I just I needed that w but it took me while it actually took me getting blown up the realize that It's not. You don't really fail unless you feel like unless you adopt the victimization mentality that you're a failure, you don't really fail you just. There's different assets that wasn't right now you learned that it wasn't now you're moving onto another path in it took me. What like I said getting blown up in. Slowly. But surely getting out of the victimization mind said about the poor me. Yeah. Yeah. Yeah. You pull that. Well to stuck what you just said the the exact phrasing is actually one of my former baseball coaches. You know if you're in a slump, you just you just need a w and some people don't understand what that means, but it's like if you're going through and you're getting your ass kicked, you just need one little thing to go. Right And that's when you really start to out of yourself and say, okay, I can control just one thing here. What can control you know maybe I'm going to get up a little earlier make my bed like, did you see W need a couple of things to go your way and the other was when you're going through training, you talked about tying yourself to a competitor and my swim coach used to tell me to do the exact same thing which was. You don't have to beat everybody here. You've got to look for one guy who's a little bit faster one girls little bit better and just say, I'm GonNa time myself to you and I'm Gonna I'm not just going to stay with you eventually GonNa pass you. You really got a little games like that and have a good mentality. I'm guessing when you go through training like this to become a green beret. Yet. I mean I I had a mentality that I've I've heard some people they. They don't necessarily agree with it, but as people would quit. I would I would feed off that weakness is I'm still here in in, we're in a training environment I would never do that. You know that's not a combat mentality because you make it through training, you're not going to quit combat. But as people would quit or the training was too tough it would. Gate would get strength from that and And I I mean it's just it's a controlled environment. So I'm not. You know not really. I don't really feel bad about it. I'M GONNA I'M GONNA. You mentioned a second ago you didn't come from an infantry backgrounds. You knew you were you're you're outgunned in in that sense didn't have the hands-on weapons training other people had experienced. So you literally took this mindset of work you. The one thing I got is now work. You was going to be my mental game and you talked about in the book tip of the. Spear that that is a big aspect. There are a lot of people who are physically strong who have the experience, but it is a mental training and we'll get to a really good example coming up. But in the book, it really begins and ends with the incident that that change you. So we'll talk about that that incident with an explosion that really changed your life. Yeah. So Now I had made it training and everything like that and within within a few months of graduating. We were on our way to Afghanistan and you know. So I was I was getting everything that I wanted the whole reason why came in SF and But I still I I still had my struggles and everything like that. But we we started off on her mission on September eleventh two, thousand, ten and. Through the night game September twelfth in we're clearing through these compounds in. We we we got predicament where. We you know we were trying to get our Afghan counterparts to go into instead of and they were. Now we're not moving in. So you know our interpreted went up to the main breach point and I went up to get him away from the main breach point in essentially stepped on the ID, pulling him out of the I'll just call the doorway for the for the viewers. But stepped on an ID. And I couldn't I couldn't quite figure out what happened. I didn't know if I hit it because it didn't hurt and it didn't look like the movies and it didn't sound like the movies but I remember I couldn't grieve I was the dust cloud in the ammonia from the from the homemade explosives in. Our I remember thinking like I gotta get fresh air. I'M GONNA SUFFOCATE IN HERE And but I kept I kept trying to stand up in a kitten. Getting. pissed. Why can't? I. Stand up what is going on here and so obviously, my first instinct was getting my weapon system and get it towards the unknown, which was the doorway And then I'm laying there and I'm kind of like halfway set sat up because all my body armor in the backpack had on and everything like that. And as the dust slowly started to settle, I looked down in my boot was off of my leg and I and I thought I was like I remember taking my booed off. And then as the dust cleared a little bit more i. saw these like the whitest objects of I've ever seen in my life and there were two pearly pearly white late. I. Don't even think pearly white really explains if they were sticking out of my leg and I was like. That doesn't look right. So I grabbed behind my knee and I pulled my leg up to see what was boot flopped off and as like oh That's my leg. So. Yeah pretty much I had Halloween costumes for the rest of my life pirate now is going to be me. Ask Your job in your team and your your role in special forces within your unit was eighteen sees eighteen Charlie's that. The Ordinance So you're the guy who's your you say like you, you took on a pretty big role in your team, which was you know making sure other members and you were securing your your interpreter there in that situation but your goal was to to go out and destroy or identify and destroy. And explosives. Mean as Eighteen Charlie you have a mine detector in your clearing the route for your counterparts. Self oftentimes, you'll have couple Afghans up there with you also. I. I've been on multiple missions where I've ended up in the front and it's like, Oh, this is a little period you know predicament here but. Yeah. You're you're clearing the path for for your counterparts behind you because if a guy if one of your teammates ad that's on you. You missed it. Yeah. So in that situation. You I just. Sarah. So you're. So you're laying there. You had just assess the fact that that's actually what this is. You have an intimate knowledge of these explosives. That's what I wanted to kind of bring in. Once you're trying to start to get your bearings, you realize Oh man I'm hit this isn't like the movies. What happens next? So. When I was when I was laying there and after the the dust cloud kinda settled. And I I know it's me. I just remember I looked back towards my teams aren't as. A I'm hit I'm hit and and then I started panicking because I I didn't know what was going on I mean not I mean is wears it sounds but no one's ready to look down in NC, hamburger leg you know and so I started. I started panicking and They were. We were in a situation where there was I all over the place, and so he couldn't directly get to me because I mean there was no one to clear that when when guys eighties most of the majority of the time, you got a slowdown in in it sucks. It's it's really hard after I've dealt with it a lot but you have to slow everything down and then you get security and then you clear up to the casualty. Because there's one idea either five that's the best thing. The Taliban are correction The enemy rarely uses just one I eighty or there's one their side, Ryan. So. Predicament. Going through your head and you're laying there your team wants to help but they got to secure the situation and I, love how your little explaining this in the book and what's going through your head you know that they can't come right away. But all these things are going through your heads because you're you're feeling yourself hanging on for dear life and you're wondering. What's going to happen next? Where's this GONNA go you're still talking to us today. Thank you. Thank God and we you know the care of everybody from that moment until now. But getting you out of there was just the first step of a long a long chain of events. You know what happened after they immediately secured you and got you out of there. So once. Yeah. Once they got me gone out and we could actually find an Chelsea where the helicopter could land because of the eighty threat and And the Taliban they were on I com, which is their radios. There on. com, saying, Hey, we're GONNA WE'RE GONNA ambush these guys they were celebrating that I got hit I'll never forget them cheering over the radio that I got hit. So they. Finally. Got Me on the bird in. Got ME TO T K, which was Taryn cal. That was the first I wanNA save three. But they got tk and that's when. That's when everything really started to come to People were rushing out to get a hold of me cutting close off The panic of. Of you know. This guy is messed up. We gotTA. Get backboard you were still with enough to ask them to to not cut something off. Weren't you? So. What I remember is a nurse game out and they just they they started cotton and I had my lucky Oregon ducks t shirt on. And she wanted to cut it off. I. Remember China fighter for. And finally a doctor came out and he's like, Hey, man I don't I don't mean to be the party pooper here but look at you like how lucky is that shirt and he like we're cutting off and then I was like, okay, got it off. The in ensuing who are physical therapists, physical therapist assistants and students we're bringing image on the screen. So this is this is not immediately after no images from immediately after, but this was from a from a from how long after the initial blast can talk about what actually happened in terms from a rehab situation. So how long after the the explosion with this image naked? I could you know obviously be off but I think it was at least three weeks after maybe maybe sooner. My Johnny owns even have a better idea, but it was it was a little while after because they had a bad hard time getting me out of Afghanistan 'cause I wasn't stable enough to fly lives. Okay. So let's take a look at this. Wow. So I think you had said earlier was this didn't sound like or feel like the movies I think when you see explosions in the movies La Times you don't really see this. They keep this out of the movies and the reason we wanted to share this images. This is what this looks like if you're working with people with traumatic injuries. that's a traumatic injury. So walk us through. What happened to your leg from this explosive device? So would I would I remember is? Basically. When I was laying on the ground, my boot was at a ninety degree angle to my leg and when I lifted my when I grab behind my need a lift my leg up and get a better look. I'll try and detail it out the best I can. But My boot just flopped off to the side. And so I was like, Oh, well, that's you know I'm not a doctor, but I that's not right. So. Basically, what I gathered from it well, after the fact, but the blast wave went up through my foot in an exited at my cash. So it blew my tip and my fifth out. But when it blew my out, my sip took A pretty good amount of meat with it. And so in the next picture, you'll see like there's a lot more open. Yeah. Wow. Yeah, let's see if we can get screen as well. So. You're immediately brought to a hospital not long after that or evacuated as quickly as you could. Wow. Yeah that's the that's the lateral right side of your leg. Wow. Credits you're asking for for making sure you stable to survive this. In the immediacy to making sure seem secure and getting you needed to go. But wow that those are some injuries man. I'd rather not go through that again but. So So I wanNA give too much away from the book tip of the Spear. You check that out. We've got the Lincoln, the comments facebook free to grab that too. It's a great read of a story. So congrats for you for putting that together being an author. but most people would become with their injured like this to that level. What happens? Will a lot of people that that get injured to that level? they they medically retire from there, and then whatever you know whatever path they choose after medical retirement, some people will stick around but deployments are that's that's really not going to happen now with an injury like that. So. but majority of the time injury like. Immediate you're going to be medically retired. You're done so not you had a lot of people close to you. family friends, I'm imagining you had. You you were taken and how did you come across a path with Johnny? I WanNa talk about that for a second. So in the beginning, I was medically retired but I fought. To stay on active duty through a through a continue on active duty waiver and But how Johnny came into my life of that. So the CFI out will correction. So when I finally got out of the hospital. and. I was able to move over to I don't know what you'd call it like a permanent. Physical therapy dorm or whatever. Yeah I remember I. I started going to physical therapy. I'd put a couple of Fitna lollipops in and I would wheel over there and just like flop around like an idiot because while I'm high as a guy basically just at allegria attached. But it was cool. But I met Johnny through pain. Johnny knew he knew what my goal is my goal was. So when I was still in hospital, my son major commander and all those guys came out. There you know we had the talk and everything like that and I said, you know basically what every soldier says I need to get back to the flight. Need you back to my team? My Sarah Major told me probably the most dangerous thing he could have said he said if you can rehab in clear. You'll go back to Afghanistan so well. Okay. So I I know a lot of people. They basically, Hey man, you fight your fight you served your country like take care of yourself. You don't. You don't need to go back but not Johnny. Janis is in the business of getting guys back to the fight. hit not in help helping guys you know just just live. Or just. I don't know survive. Johnny is the you know his job is to get guys back into the fight. Get guys. To overcome. And I will put it to you this way it is not easy Johnny beat the crap out of me. And it was. It was awesome because I recovered. In very, very quick down. There, you know I mean from Flash Bang. Step twelve two, thousand, ten I was back to my company in November two thousand. Two, thousand eleven if. Intact Enough Ghanistan March two, thousand, twelve. From this to back to duty in that short amount of time. Off because of Johnny. Everybody. Completely. I don't think shot Johnny because he he you know he just he knows if you put in the work and you give him everything you got, he will make it happen and then also you know with Ryan blackjack in the ideal brace. I. Mean it just it. It gave so many guys second chances in to get back into the fight. But. It's not a give me. You're you're you're you're gonNA give them some pain. You know. A lot of a lot of deep more details in the book tip of the Spear WanNa. Make sure people pick that up. It's just a good story but I wanNA talk about one thing like what you really considered. Your test when you were back because right now you're plywood building your somewhere overseas right now. Right We we know that there's an ending, but you had you had really your first test and I think it was even testing U. and that was hilltop two thousand. Yep. Yeah. Hilltop hilltop teeth thousand back in two thousand twelve. Our mission was to to basically I. I WANNA say it was. Fifteen hundred feet elevation gain in like a click. So it's basically almost straight up. hilltop hilltop two thousand the command element needed to get over of major clearance operation that was happening in in a valley in Afghanistan. This Valley was just known for Taliban Basically running guns and everything else fighters and whatnot. So so we end in twenty four hours prior to the Clarence op and. and. We started going up this mountain and that's when. We had the commanding with us not only did we have the command team but we had my command sergeant major. Bryan Reid who was the one at my hospital bed who said if you can get cleared a sinew backed Afghantistan. So I had to and I. That was the first major test I had for my leg was climbing. That mountain in eighty pounds of gear. and then. Helping. Other guys get to the top as they were basically. I guess I don't. WanNa sound like an ass but failing. So we you know it's combat. There's no room for you can't fail what you do. You put your teammate on your back and you and you Charlie Mike. So and that was that was the sentiment right? You talked about some people actually you know saying it right to your face because. There's no room to hide. I think you highlighted that when you're on a team especially a special forces team. There's no extra guy. There's no extra piece of equipment that you can kinda ditch or a guy that can just kind of slack off a little bit everybody has their job needs to do it and you literally. Being the tip of the spear. Times you're. Out Front. And they've got to make sure the guys next you. Some of them are questioning is this guy who went through this injury going to be able to do that and I think he'll tell two thousand proved more than that. It. Did if I if I if I struggled on hilltop two, thousand, two, thousand twelve would have been my last deployment that's it and I wasn't. They were not gonNa let they were not going to see me struggle. I refuse to struggle in hilltop two, thousand I think is where I really. I understood how? Limited your mind can be. And and when you feel like like. Oh. I have. You reached the beginning your potential. You know what? I mean. Yeah. Y- I. Think it was a it was a great story, a great testament and right now You Know How long has your? How long have you been deployed right now in this current plummet run I've been out here for seven months now. After reading your story and tip of the spear after hearing your experiences want to say it again. Thank you so much for your service you and your teammates. Last night I slept in a place that was real warm and safe, and I did that because there's women and men like yourself who are you know sleeping in places that are not as war, but not a safe. So thank you for doing that I gotta ask a question because you talked about what the military did do for you in terms of letting you see a large portion of the World Central America going over to the Middle East going over to Asia best place to have a beer suggest anywhere in the world since you've traveled about in the military, what do you like to go? Oh Wow best place in the world to have a beer. Island. You talked about that a little bit open my ass, different places that I wouldn't mind getting around. Ryan what's the one thing you want people to take away from your book tip of the? Spear and we'll talk it. We'll. We'll. We'll say it's pointed directly at physical therapist. Is there an overarching message because you you talked about your mindset as a patient which I think was terribly important. But what's one thing? You'd WanNa make sure peas and PTA's hold near. I think the one thing that I that PD's need to understand is is that the work that you're doing It's not you're you're not just working on a patient or a client or anything like that. You're you're changing lives and you're given your you're getting guys back in the fight regardless of what fight that is The physical therapy world You really do I mean if the person will give you what is. Required to get back into the fight. You're giving that person a second chance and so it may it. With as with any job. You know times can get mundane or or a regimented. But again You're you're you're given that guy a second chance or that girl excuse me that guy or girl second chance you're getting people back in the fight regardless of what fight it is. They're getting back in the fight in that is extremely important. Yeah you mentioned as part of your identity. You didn't know where you would go if you were injured and you and you were medically discharged. This is who I am. I've been this my whole life. Questioned from the Casey Klein how did you? Rehab, team approach this mentally is outside of the fentanyl lollipops which I think is something on the outside. But how did you how did you approach it mentally between pushing through and allowing you to rest this balance of doing a lot but maybe not too much. Johnny. Johnny? New. Every. o I had to do was the give Johnny a hundred percent. And he knew when I was supposed the rest, he knew when I was supposed to drive. He knew you know one more rep or hey, you're pushing too hard or whatnot listen to the professionals. In and give them everything you got. Even if it's hey, you need to go get rest give it everything you got, and that's how we approached it. What was it about Johnny that that made a connection because we talk about this term therapeutic alliance, which which really we can tell I mentioned Johnny and your face just lit up rights that means you guys have a strong therapeutic alliance One. What that form that bond because that was actually another theme throughout your book tip of the Spear was bond the bond with your teammates guys you going through training with and Q-school. So what was it about that bond that made you say I'm Gonna I'm GonNA listen to whatever this guy says I'm GonNa give everything. This therapist says one, hundred, ten percent. I was a human being to him and he believed in me and you could tell he believed in you. He didn't. He didn't check the box or or tell you what you have to tell know he legitimately believed in me and it wasn't just me. It was everybody at the CFI that he worked with. That's what it takes to be successful in my opinion I mean I've never been through the physical therapy world as a student. But in my mind, what it takes to be successful is your work in with humans. And if you're in the medical career field. then. One of the things that I really saw throughout my my time at Brooke Army Medical Center and in the CF, if I was was people were legitimately you know these are these are these are soldiers are these are humans are in these guys is lives they've they just been completely changed rip rip the shreds. Now we're going to put these guys back together and we're going to get him the quality of life that. As human beings Johnny. Not just because I'm a soldier but as a human being johnny wanted to give me back to what I wanted. and. So yeah, I was a human johnny and not just a number or a case or anything like that. Yeah. So many times, the basic stuff is seen as as simple in the basics are not simple. But love how you frame that was which which is exactly why you had that great therapeutic alliance with Johnny Owens and want to give him a nod for for for share in the book, and it is out now tip of the spear. Ryan we're going to do something we'd you on the show we do it every time it is called three questions you ready for three questions. Yes do it Three questions from our friends at Arias medical staffing online at a U. R.. E. US MEDICAL DOT COM leaders travel physical therapy all around the country not just outpatient orthopedics do what you WanNa do, which is be a great therapist connecting with humans. WANNA do it so check out what they have available. Now for you to go do a, you are a US medical dot com people ask all the time while they probably don't have places that I'd WanNa go. Well, if there are people there we to make it a connection with a human as Ryan just said, you gotta make a connection if there are people therapist check them online at a U. R. E.. U. S. MEDICAL DOT COM. You can also travel with travel buddy doesn't have to be another therapist nursing placement's allied health. So check out a you are US medical dot com question number one Ryan. You've been around the world y'all been around the country where is somewhere that you think the audience should go in the fifty states somewhere great. The audience needs to visit that maybe it's maybe it's not on the off the beaten path. Riggins Idaho. Can't what's so special? Tell us about Reagan's. Riggins Idaho is it it's like A. It's like a scene out of a book is just there's mountains the Snake River valleys. It is absolutely amazing. So yet riggins Idaho or low Oregon low organs, a small little towns surrounded by three lakes and big trees, and it isn't outdoors paradise I. Like it don't threaten the good time question number two on through walk ins a what's something you've read or watched or listened to that you think the audience could get value from outside of your book tip of the Spear? Obviously it's a good one. Read or watched or listened to move against could value from. Yeah something. Learn from. I would have to say. It's early I mean. Do you read any other stories leading up to two writing kind of model this after any any stories or any movies like that. That told similar stories. So. If you WANNA see the most realistic. Afghanistan documentary I've ever seen before. That would be Bravo. Two Kilo. and. And from the physical therapy standpoint, you could see lives changed by. It's a, it's a British infantry unit in they get they get stuck in a d A minefield in multiple guys step on I, eighty through there in. So I would say that that in I mean that's probably. That is probably molded me the most when it comes to my line of work. I mean. Other than you know. I guess the the inspiration as far as. Writing is. This not not become a victim of your of life circumstances as. Life can be hard. Now that's Yeah no circumstances and you don't don't let it on you. You'd be fine. Yeah great insight. I mean if you're saying that that particular movie is realistic, we'll take that as somebody who's been there can net. So third question is who should who is someone the audience should know more about. Who Someone? Who does great work but maybe flies under the radar. So There's actually there's actually quite a few people in my life that I could point out for that. One of them is you know obviously Johnny Owens. Ryan Blahnik he mean, he created the ideal brace the whole whole reason why I had another six deployment Afghanistan since getting blown up. Dr Xu. Orthopedic Surgeon just. Yeah I mean I Still hear. About. In the book. But then I think a lot of people that fly underneath the radar are the physical therapists in the occupational therapist and the athletic trainers that we have like. Dana at seventh group in Paul at Seventh Group in Tamra as seventh group. Their entire job with the store three program is get you guys back to the fight. That's that that's their life revolves around that and it's it's It's amazing. I mean I don't WanNa give out last names. These guys are. Been Well I. Mean Guys is in guys and girls, but they're they're amazing. They're amazing in in day are like they definitely changed lives. So lumping on physical therapy occupational therapy. All all of that to get people back to the fight whatever your fight is perfect well set. Yeah and you go into, you go into detail on that that Thorpe program talk about that in the book tip of the Spear So can learn a little bit more about that Rilot we do is the parting shot. Parting shot is brought to you by the Academy of Orthopedic Physical Therapy find them online at Ortho PT Dot. Org if you're looking to enhance your your orthopedic skills, the physical therapists why not deal with the leaders pita PT leaders are in the Academy of Orthopedic Physical, therapy orthopedics, or you can find some educational listings there as well. Current concepts of Ortho pt the leading. Prep course running athlete and tissue tolerance just released with more on the way in twenty twenty and twenty twenty, one, Ryan the parting shot is your last chance. We wrap up this episode and your story, the mic drop moment. What's something? You'd want the audience to remember and take away from your well written book and your story tip of the spear. The biggest, the biggest thing that I want the audience to take away in not just the audience. But to also spread the word on is, is basically the theme of my book and that is victimization is it it's a mindset, but it's a choice and it's you can choose to become a victim you can choose. To make your injury or your circumstance, a part of you, and you can be that injury in never move on for a from it or you can choose the own it. You can use that injury circumstance or hiccup in life to make you stronger make you a better person and in by owning it. End, in enhancing your life. You're also going to enhance the people around you. It's just it's just inevitable. So. That would be. That would be my biggest. I guess message is. Refused to become a victim of circumstance is life is full of them. Yeah. I love that. Well said anybody else you WanNa say thanks to that. You didn't get a chance to today that have helped you in your recovery. Yes so not just my recovery but reading that book was recovery in. So I wanna I wanNA thank you know Mike Yorkey and Greg. Johnson is without those two guys that booklet here right now. Wherever. You also WANNA mention. Yet, family but occupational therapist who is really close near to me my wife. So yet I WANNA. Thank her for not letting me. Feel too sorry for myself. I'm good at it. While down, we'll check it out. Right now it is. It is wherever great books are sold tip of the spear The incredible story of an injured Green Berets returned Valeron Hendrickson Thank you so much for giving us a little taste. If you listen to this episode, it's just a little taste a lot more in that book and make sure check it out. Link is available in the comments Ryan. Thanks so much for talking with us today and thanks again for your service and doing what you do a man. Man I really appreciate it and I really appreciate what you guys do because again. You guys back to fight I Ryan. Thanks so much. All Right? Glove? Pine Cast Yes yes. The port the show telling a friend or by weaving review on one thousand, nine, hundred Google play shooter day brought to you by the Brooks Institute of higher learning an innovator in providing advanced post Professional Education Brooks IHL offering continuing education courses in numerous specialty areas. Six residency programs own MP 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 Ihl dot. Org. Our home on the Internet. PINT CAST DOT COM created by build. BUILD PT provides marketing services statistically for private practice PT's website development and host and inviting content marketing solutions PT clinics across the country see what good pt can do for you today at. Dot Com. The PT PODCAST is a product, of PT Podcast LLC. 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Improving Sex For Your Patients

PT Pintcast - Physical Therapy

1:07:03 hr | 8 months ago

Improving Sex For Your Patients

"Hey, before we get started, I just wanted to say thanks to our longtime sponsors are es medical staffing, helping you physical therapists or physical therapist assistants find jobs all over this country with position. All settings in all fifty states find out what they have for you at a U. R. US medical dot Com that is a you are e US medical dot com. Follow US online at PT Podcast, and subscribe on I tunes spotify or Google podcasts. Yeah, it's it's awesome. We go. We're live once again. Welcome. Welcome. Welcome to PT Pining cast podcast safes, physical therapists for missing out on amazing insight, remarkable ideas and motivational stories here in the world of physical therapy I'm doing McKay your hosts broadcasting live from the medical studios. Also, known as my bedroom sexy, just my rep, but we'll call it a studio, find them at a U. R. E. US medical dot com the leaders in travel physical therapy do what you WanNa do, which would be a great physical therapist all settings in all fifty states plus DC again, that website check about now and see what's available for you at a Er US medical dot com. Great Show for you. Tonight with a nod back to the one, thousand, nine, hundred hit from salt pepper we're talking about sex baby. shirl blush no less than five times. Make sure to subscribe to the show him on spotify Google podcasts or wherever great podcasts or heard and now video casting. Yeah. Youtube facebook twitter at PT podcast on the socials during the shell if you have a question or a comment. Don't hold it in. Ask Us if you're watching live make sure you drop a comment. And also let us know where where are you watching from? We love to see where the show actually gets too. So let us know. Let's dig in Our guest today are pelvic physical therapists and work with patients who have issues that affect their sexual function. Let's bring in our panel now. You're cheering section as. The program welcome to the show. Thanks so much first questions we get it out of the way early hardest questions i. What are we? Ariana I. What's what's On tap? beer-drinking approachable blonde. For the summer from municipal brewing from these small town in Ohio. The bottom row PAM would he got? So I'm not much of a beer drinker I know that's kind of a bad situation, but I have my oh, you can't see virtual background my little truly here. You'll background that's very nice is very. Late to do truly never discriminate against those people are drinking. So dumutru that's all right I'm I've got a pint of Vodka Soda. So it's technically school pine on pine cast on. Yeah. What do you got? An Eleven Annella by full circle brewing company, and like a milkshake APA it's pretty good. milkshake Ip happened done that but now I'm alert. Tammy what's up I'm a fruity girl. So I got my strawberry angry I liked it. It's all down hill from here. So cheers everybody will have a drink. Here's. Around prosecute friends at Owens recovery science on he owns Emma team. BEF are the kids are calling it these days blood flow restriction, rehabilitation training, the education, and the equipment you need to apply it properly in clinical practice, find them online at Owens recovery science dot. COM plus they've got their own podcast elbow online tunes who knew it's called the Owens Recovery Science podcast easy to find So we were bringing in panels, our second panel show today and I kinda like it because we're we're going gonNA, focus on one topic and that sex and how that relates to to our patients on my very first clinical rotation. Probably like my third or fourth patient who I was sharing with my ci was male and waited until my female see I walked away and said, can I ask you about positions and he had just had an acl reconstruction I said, appreciate we reviewed all the positions and I wasn't picking up on social. Cues. But his eyes were darting darting back and forth between the door my the I just left to grab something he was trying to what I can see now, trying to slip that question and get the answer real quick, and that's when I realized what he was actually asking. So when you're when you're professors tell you that sex will come up as a physical therapist and that was outpatient orthopedics. It will come up in a lot of different settings even had a sexual question in pediatrics no, not from a patient. On their parents, but then also came up so it will come up. So let's bring in a four physical therapists will have you guys introduce yourself to top row in the Middle Anya just let her know who who you are and where you get to treat. So I'm on I'm the youngest of everyone here. In terms of they were all my mentors So it's kind of like a nice little score reunion right now. But Yeah so I'm appalled the floor physical therapists I also treat Ortho patients about thirty percent of the time during covert I was treating them actually like one hundred percent of the time, which is interesting. But now I'm back to Malik seventy to eighty percent I out of chops. So Community Hospital Monterrey Peninsula, and it is an outpatient clinic, but I also sometimes will cover inpatient like three times a month. I will do inpatient pt where I'm going in the birthing center every now, and then two little mix aren't you what your Superhero back story here? I've been a pelvic PT for fifteen years and I have a private practice where I gotTa have fun a couple of afternoons a week plus we have a pro Bono clinic at the university where I teach at at still university. So we get a go there and mentor our students intriguing Pelvic Health and I'm a fulltime faculty member. To our Ariana. Laid. On. US. I have been publicly for two years so much less. I worked at a practice in Chicago and in the suburbs South side Chicago bears. Treat one hundred percent Pelvic Floor Criminal Warnin Marcos program women but a sprinkling of men and pedes, and I did a pelvic floor residency public health residency in Ohio with a hospital based off mission I'm going to I got to see a lot of things there as well. I just got WCs man letters just. Like. ooh. Well done. Young was letters Arou- well done. And rounding out the panel tonight Pam. So many spam ks I actually work with Dr Rolling, Tammy rolling that introduce yourself just a minute ago and I'm a fulltime faculty member at at Still University and she and I co teach the course that introduces these pelvic concepts to the students in we call it the Tammy Pammy show. and. I've been treating pelvic floor for eight years. I actually started in about half and half Ortho in pelvic, and there was just such a need a wait list for the pelvic patients trying to get in said, do you WanNa do one hundred percent pelvic because we can't find other ways to do this and I said Yeah because that's actually where my interest in passion lies. So I also am involved in the pro Bono Clinic on the campus when that's up and running after this whole Kobe thing hopefully blows over and Yeah I just love teaching and working with. Pelvic patients I primarily, I work with women women with pelvic issues. Perfect are now we know who's who on the show let's dig some topics and I kind of like this because we're GonNa get a great insight from numerous therapists who were treating in this world. Let's start with this. We'll start with laying the groundwork and knowing what we're treating. We know whom we're treating, which is pretty much everybody you mentioned we heard men women, we pediatric patients in all of your Tros. Let's talk about dysfunctions. We'll start with Tammy talk about his functions that you guys are all typically. We'll probably the most common with sexual dysfunction we be pelvic pain. So these are women he'll tell you you know it hurts whether it be upon badge, it'll entry or they might say with deep thrusting. We treat men with public pain. They'll tell you it hurts to get an erection or it might hurt to evacuate also postmenopausal women they start to have. You know as you hit menopause, your vagina starts to change and they'll get vaginal dryness and thereby giant gets shorter are narrow and thinner, and so we do a lot with education and and just Telling them what kind of lubrication to use an increasing foreplay because it takes longer lot of folks with incontinence three embarrassing when you're having sex and you you know you don't pass gas well, you don't mean to are you haven't urinary accident. So we'll treat that I'm in a course with men. If you're treating males, you'll deal with erectile dysfunction as well. So you're doing with things that. Can Be uncomfortable to bring up and what we were taught pcs school. We didn't have A. Class just for this, this is brought up in a couple of different classes was this will be uncovered as uncomfortable and as awkward as you therapist make it and that really stuck with me for five years after I graduated, which is okay. Got It. So you Kinda have to keep your poker face on in terms of okay. Is this something I've heard before but that really stuck with me is that something you guys really have heard or instill before in other therapists? Almost definitely, and you gotta be prepared to hear anything and everything. Right In our section of the show is so let's wait for the end until you guys have had at least drinking your. Come out. We heard about dysfunctions talk about men, verses, women because you Tammy you mentioned that you treat both. Reasons You know what? I like to look at life like ven diagram, right similarities and differences. WHAT ARE THE DIFFERENCES Well, how we treat them you know like for a women, obviously, you have to avenues if you WANNA do internal treatment. So you've got the giants or the rectum for males. It's you've got one one opening their to go through So that's also When you're also treating them. A lot of women are more prone to to have home exercise programs where they'll have a partner treat them internally we can t train their partner how to treat them or use tools to go internally to treat muscle spasms. men are a little bit more hesitant when you show them the wand and say, this has to go up your rectum and. Or do you want your wife or your you know partner to learn how to do some internal rectal techniques? A lot of them are very shy about that. So I'll throw this out to the rest of the panel. How do you? What's the best way to bring this up or with a different ways you can bring that up if if you sense resistance or you sense hesitance from someone that you're trying to suggest for? I think for me I just had a patient today actually whose husband came in. And initially. Resistant his very awkward and very much just like I don't know how I feel about this and was making some odd that I was like we have to not make these jokes here but it was definitely, I explained like if she can be comfortable with you doing these on you on her then intercourse itself will be more comfortable for her. So the fact that she not expecting pain when you're touching her. then. It can help with going into not expecting pain when you're having penile entrance as well. Yes. Brings up an interesting dynamic is the partner. So is there a lot of education? Do you guys often is that something typical where you're talking to members in a couple? A lot of times. I think it depends on. How comfortable, the Coppola's together to do something bold want you involved in some people would rather educate their partner on their own, but I always give it as an option if we're working on something but I also think need to remember that Nex is not just intercourse not just penetration and that sex for everyone is not with the partner it's also Solo. So it really depends goals if I'm going to bring in department. Okay. A little bit off track. But this actually just happen to a colleague in a different state with me when when you're. Initiated the idea of doing something internal. How do you bring that up? How do you carry that through so that there's no. Nothing is misconstrued the situation was actually a male therapist with a younger. Female patient and about a year later, she was recalling that it was something other than treatment. So at how do you how do you bring this up so that there is so that everything is is on the table nothing's misconstrued. I like to be very upfront and just kind of say, here's what I usually do here all the steps and here's why I'm doing it. If they understand why you're you're offering certain options. That, and then I leave it up to their comfort level. Are you comfortable with me doing that? Would you rather way and we do some of these other things and save the more invasive stuff till next session when once you wrap your mind around it some male therapists who treat pelvic conditions I've heard we'll take extra steps for that safeguard they I know one therapist in Connecticut he'll audio record all of his sessions. So it has on record him explaining why he's doing what he's doing catches the person giving their consent that way if Everett's called into question he can refer back. To those, some people will have an extra person in the room and we give I I know I Dr Rolling, and I'm sure the other therapists always give their patient the option of bringing a friend or a family member partner in the room with them. If that would make them feel more comfortable to have a third person in there to be aware of what's going on So I think education explaining what options are and why we're doing what we're doing, and then putting it in the comfort level in the control of the patient is kind of the general best way to go about that. I also like to use a three D. model with all the muscles that are labeled and so as I'm going through the goal. Yeah and they can see I'll say okay you're Elliott Cox's. Little tight here. So they can see exactly what muscle on and they can see. That's my muscle that's giving me problems. Are-. Anyone else had actually had a patient one in residency in two. Recently actually this month asked me about Larry Nassar He was the depot's that abuse the gymnasts and I remember this distinctly my residency of nations like would you for work? That's Larry Nassar did the gymnasts and I said, absolutely that's now but I do. So I think that people are more error of some of you know which is going on in the world. So definitely, the statement feeling exactly what I'm GonNa do in the asked comfortable with that or what pieces of that they're comfortable with and they keep doing they get the fire way. Yeah. The inner communicator me because my background is communications just here here is just communicate open early often and ongoing. Servino? Clear and if you and in read write read them react if you sense hesitancy again. And then the the ultimate is not just asking. Waiting for the response and making sure you have understandings. Re Pretty big aspect. I think the non verbals? It's huge. I. Think all of US Pelvic therapists are pretty in tune with people's non verbal responses. They might say, okay sure. Let's let's try it. But if I'm reading that they're not comfortable let's back up. Let's go over it again or maybe we're just GONNA go less invasive route for today until you go more comfortable with it when those messages are not on when the facial expression, the words are not aligning or the body language the breathing, and then you there's a lot of those those non verbals in parables that that can be telling you different story. All recording never heard but that's a great idea because it's not it's not video, but there is a record of it. So that's actually a pretty smart suggestion I've never heard of before. So I like that for the audience to to have them take that away let's switch. We'll stay with PAM how to treat pelvic dysfunction to improve patient sex life I wanted to hear your insights on this where does your head go in that topic up? I'll be honest and say in the way I approach these situations, I I usually I don't have the goal of improving sex life I have the goal of improving health and function of the tissues in structures and improving the sex life is a by product of that. So depending on the condition whether we're talking about incontinence unusually a generalization. oftentimes that means we need to strengthen and add more support to the pelvic floor and that can improve sex life or if it's pelvic spasm pelvic muscle spasm and there's pain with attempts at intercourse, we need to get those muscles back to a balanced and healthy state so that they can participate insect. So I I usually don't approach it with how are we going to improve your sex life or how are we gonNA IMPROVE Arousal or anything like that I just want to improve health in function of the tissues, restore balance, and then the other things follow. Okay. Let's go. Let's start with this. We'll start with you pam and then the rest of you guys filthier chime in terms of techniques how do you do that? You set it up? Well, which is sexy is something I'd like you to get back to you but I'm going to work on you the anatomy and physiology and what I know. I've heard I've had Sarah. on the show before and say it's this is orthopedics in warmed our place and that's how she approached it. So, we'll talk about specific techniques and things that you use to do this because it is orthopedics, but it's different. Yeah. We definitely have to have an orthopedic understanding approach to how we treat our treatment techniques are a little different given the area of the body we're working on I'll just shoot back real quick to the topics that got brought up about the gymnasts and the doctor that was prosecuted for abusive technique in Obviously, that's a really disturbing situation that happened for the obvious reasons beyond that. What also bothered me is kind of what Ariana brought up is he referenced that he was doing an actual technique that pelvic PT's will actually actually use, but he wasn't using that technique or he wasn't using it in the right scenario he was using it for other intentions so So that's kind of a bad name, but we will use a technique where we use gloved up and intra-vaginal. We have our finger placed in. We're finding muscles that are overly tight, overly tens overly tender and we might use some sustained pressure or some Cross fiction massage type techniques for for those who aren't familiar with some of the terms we use the technique or that, but it helps the muscles that are tight. For overactive helps teach them to calm down with some tactile queuing and we can also use while we're in that position we can assess their muscle strength in contraction and are they getting complete contraction from right to left and deep to Superficial muscles in and assess the balance of muscle function that way. if we're talking about specific techniques I think the most common one where sex comes up as a primary issue is pain pelvic pain pelvic muscle spasm genius. Miss Things like that we have tools such as vaginal dilates or the. Tools that we can use with our patients or teach them to use on themselves to get that tactile input to the tight muscles If we're working on pelvic strengthening because they have lack of support in the area causing discomfort in an instability like the pubic emphasis joint things like that we have things like the pelvic floor muscle educated tool that they can take home with them to make sure there it's a good biofeedback, a low tech biofeedback that. They. Can Use to make sure my doing my home exercise squeezes right. So it really depends on what condition were dealing with, and then we'd drive our treatment techniques based on what that patient needs, and there's different tools and things that we can help based on that patients. Need sounds physical therapy in different settings. There are things that you you bring into the the treatment session that sometimes it's perfect for it and sometimes it's being this thing is inappropriate. The you feel free to chime in in terms of techniques and things in tool that maybe aren't in different settings of physical therapy. So I I mean I think isn't a lot of different settings of physical therapy, but just like diaphragm breathing and that doesn't mean belly breathing in my opinion I use a lot of just like inhalation of external cues. So visual cues like I want you to separate between your set bones, I want you to. Think about like an umbrella opening up down there filling up a balloon on all the way into your pelvic diaphragm because if we can get your diaphragm moving, we get your pelvic diaphragm moving a little bit better too. You can feel the difference like as soon as you're putting your hand on that muscle that hyper tonic little bit shortened it giving the right cues that muscles going to relax a little bit more. It's GONNA improve in terms of. It's GonNa be less symptomatic for that person to as your pal painting it. So I use that almost with all my patients with hyper tenacity at some point. And I'm guessing models use models. I finished say I About physical stuff, I think. A lot of our job is also the psychological aspects not that I am. The health counselor, but some days I feel that way. Because a lot of this pain we're talking about a part of the body that some people ill. She goes out that some people have not had any education on at a twenty two year old yesterday that went to a private school slows there is zero health education other than never have sex ever unless you're married and then just yes have sex all the time if you the eighteen babies but. You get a lot of that where we ought to just do education like I. Feel like education and Communication Iraq did that communication is just huge people's baseline what you know about your genital region what do you feel about it? And then you explored didn't raw and also. Just asking them the other barriers of there's always been penis area and that's scary ins area who throws really important thing who've been sex or huge things in our lives. So I feel like the almost like extra psycological aspects I talk to people the guy at half a recession talking to people, and then I'm like, oh my gosh, I'm going to bill but. Is that too. Greeting and wow, we're doing internal releases but another thing to make offered to write a grant just sitting there on touching a muscle you know sometimes you see. The Earth PD's when you're doing a stretch or when you're doing mobilizations on someone's back, you don't really get to talk to the patient as much. But when you're doing an internal assessment, you WanNa talk about things than you want to try to get the patients at calm down by talking about something that they enjoy. Talking were talking them through breathing. So I feel like the ability to communicate into educate is a huge tool that we have as well. Yeah. It's a pretty good. They your your full attention right there. Yeah. Wait till off that real quick I. Just think it's super interesting talking about that because. So during Cova wasn't trading any pelvic floor patients who are just seeing people post up and then transition back to sitting pelvic floor patients in I. Got a skyrocket of disproven yet in like evaluations in it was insane like I usually treat urinary incontinence, pelvic organ prolapse but the amount of like pain with sex evaluations got right after covid blew my mind. and. Stress, and so that was one of the big things as I was talking with a lot of my patients. It was like winded this start March. How did this progress as this is all going on? What makes it better when I'm have a schedule everything like that all the things that have fallen apart as this pandemic has. Happened and has elongated too. So it's been especially for my mom's especially for my mom's in watching as they don't have childcare as watching as they're starting their works, their work with their kids running around and the amount of patients I've had crying my clinic. Every single day is insane and so just talking with them about like all the emotions that going to that it's been very interesting. Wow. When you get a patient to see that link to because an. Dot Right. there. Like I'm be wrong. I. Do my home exercises I didn't use my want something happens as a woman I guess today in the neck and I said it's two weeks from when you're go back to school she's like Oh. Yeah. We like to go do a zoom meeting with the teachers yesterday figure out the whole schedule. Maybe, that's why you're paid is acting up in wire adding more intercourse. Of Yeah. Like they know it because you know especially with flair up over this before really telling the patient dot and letting them see that was really powerful. Springs we wanted to talk about next and I can prove it because there's a graphic for. Connection I've worked with. Tactical athletes who get nervous before deployment or get nervous before before taking a, you know a a physical exam to to stay in and keep their qualification for their job. So the two stories you guys just told right there, go completely hand in hand but. There's a stigma on top of some of the patients patients that you treat and regions of their body. So what of a different ways Pam? Tammy what are the different ways that you deal with mind body? With with people and how do you educate students as you guys are both in pt education as well. I think this PAM frozen. Jokes frozen she looks like she's Get her unfrozen, but that means. On you know pressure, right? It goes hand in hand I mean when when your stress think about all the stress you're holding in your shoulders in your neck at the pelvic diaphragm, the same thing I, I tell people it's you hold it here. You're going to hold it down there and it's just really working on on helping them deal with stress lot of times you're referring them the to counseling I had one lady who you know was just so angry with her daughter's death and how the son-in-law behaved and you know is amazing when you got her into grief counseling how much better she got with your P. T. so it just goes hand in hand you WanNa you WANNA, make sure they're both in. Balance. Brings that brings something up, which is probably make sure you know a great therapist in your area for to. To make sure that you know exactly where to send these people if you come across. ANYTHING IN TERMS OF MIND body connection that that you do with patients on a regular basis that you'd want the audience to know. To me it's it's diabetic breathing that that's a huge one I know on your totally agree with that. Just. You know that that is the big one for them to be able to connect and see what they're failing and breeding properly. I use. Sense. Focus. which is this is a three phase system that a couple can use oriented by yourself actually. I women were patients that have pain with intercourse. I. Want them to get to know such feels night because think about a couple disuse sexual couple of male female not next in let's say she. Hasn't had sex in year since her baby was born because he wants to to. Try it again. and. They just haven't touched other couple right? They just anything in together and I think that's what we forget to. We're just talking about sex. We kind of forget that Messrs Birmingham next focus that we use. Myself. Colleagues. It's phase. One is. Any non actual non genital touching. So anywhere you can see like if I'm wearing a tank top and shorts, any of my open skin, you can touch, you can get yourself. You can do with the partner. Okay. What does that feel like? Not, like just get into that sensation and then that makes people uncomfortable touching each other we're themselves, and then phase two is genital touch. So but non-penetrative. So astronaut simulation literal stimulation penile, anything like that like your men. Or? Anything like that. That is what does it feel like kind of can we get into that space of touching and having communication between two people or your own? What does it feel like when I? And then phase three is and typically couples or patients do phase one and two While working on like myself and getting down train, their muscles get relaxed their muscles. Until with the partner, they go take three, which is. So touching and then anything they WANNA do internal rectal battling correctly. Face three, an end date, the although census seal. So a lot of times people are just in a disconnect with parts of their body I have. Become such arm army here. But a lot of people feel weird about touch their parenting on where there s or their peanut as. Much. To know like what that since like I think that's a big mind body connection to like overcoming the taboo and it's like just another part of my body, but it'd be skin. So how are you in this report act is this is this through the patient or you seeing the couple together or is this? This is this is what I'd like you to go home with next week come back and maybe write down your thoughts and bring them to me is how how? Usually Homework I. Say. This, but I want you to stay as as one. To. Reasons one to and tried that out. As to before us your dial later like I'll use it with the other tools that we have. Just, to get people relaxing acquaintances their bodies things like. Okay. Great. Can Port back. Had some interesting. Activities. But I hope it'll stay good. Now I told my husband to get off of whatever streaming he was. Saying. We don't want to skip it. We were just talking about mind body connection and in different ways to kind of facilitate that just to make sure you had a chance to kind of just you know throw in your two cents there. Yeah. Everything I heard I jumped in where Ariana was talking and everything was sounded great. I would be disappointed in myself if I didn't mention biofeedback if someone already did but they have like the tech technical biofeedback where we can use a device that we use electro door a sensor. With a patient and it actually measures like emt like surface electrode muscle measures, it measures the pelvic floor muscle contractions and we can see it on a computer screen like graph. So when they squeeze the muscles, we can see it go up when they relaxed the muscles we can see it go down maybe there have overactive muscles to begin with and all are working on his them, toning it down through relaxation in those tactile accuser verbal cues. And what's Nice is the patient can see it. They can see it objectively on a screen or a printout, and then they can see their progress. So not only live as it's happening. Gosh. When I relaxed that way that you kind of told me I, saw it go down on the screen, and now I know better what that feels like and I can try to replicate that more outside of therapy and my real life and then when. They. See week-to-week how they're measures are improving they. They have hard evidence of my Gosh I really am making changes and I am getting better. So we can use that whether it's pelvic floor muscle up training, which would be like strengthening where we can use it for public from us with down training relaxation it can work for both ways. It gives the patient something visible and tangible to to see and work off of and and track their progress. What remind the audience is watching live online if you have any questions or comments, drop them below and we'll see if we can get those toward the end of the episode. But area you were talking about progressing through levels and going from from touch exposed skin to to a level three. So. Let's talk about progressing to return to sex. Let's say you progress pass that. How do you initiate this conversation and that ultimately the active returning to sex if if there's if there's a barrier. Yeah I been telling me what sexiness to them because I kind of alluded to earlier. Is it they? Masturbate isn't it that they want to have sex with a partner and look up sex again, real have our background. Check says, but you have to know that you're anything probation for anyone. So knowing what their goals are, is it bad entry in is rectal entries and is it been an religiously able to? Roll simulation in orgasm without any team because. With Orgasm once I defined what they want to do suze say. Partner and I. See a lot. A lot of women just at the clinic end where a crack this. And a lot of them are terrified especially if it had a deal tear. Remodel Jimmy. Out there we go. So. Here's the China everybody maximum Wayne. A Urethra John Yours the NS. So if a woman has a bathroom delivery, sometimes there is Siri can occur in this area. Down here. So Stitches down here, and then someone's telling you to put something in that area. The on a penis toy more do A lot of women are terrified I. Mean I've not had to be entertaining probably talk about this stuff but. I couldn't have enough very scary and just getting a patient. Against Self touch first, and then also to explain to their partner like you can't make this, you can't rip this not enough first conversation or we all feeling stays a real feeling ready to track. You know we've done all the external work with calm down the muscles everybody on board that's in the team year here. And then talking about accessory things like Uber -cation. So we rotations going to be important and we always recommend a water base lube. We're actually coconut oil rose did everywhere so. People have in their house embarrassed about if you're somebody finds loom hiding around but coconut oil, we'll have that endless. On We talk about adding that I and getting. Some lubrication or positioning I do that a lot so or women especially again, intriguing recent. Most likely right now. I. WanNa Talk About having in control. So a lot of times when they're using way more than like my finger or their partners hand, they're in control of that later, which makes them feel more comfortable. So we talk about sexual positions that put them in control like female being on. Because they know when they can stop right, you can still talk to your husband and say I want you to go slow but it's a psychological aspect. You can change the intensity, the depth, all of those things if you're talking your job. also with having the patient had open and honest conversation with their partner to see what their partner is feeling about things and I always ask my female patients really how their partner is doing with all of this like I know you're the one therapy and you're the one with the physical issues but how is affecting your relationship? So I kind of broke that and see what their communication style is a couple. Minor not mentioned talking he was that said about using a outside therapist counselors. Pentagon a sex therapist on board if the couple's having difficulty communicating. A good plan return to sex anybody else have thoughts wanted to chime in stories. I have an interesting patients scenario right now, a lot of interesting patients now because I take. Medi. Cal. And I'm one of the only people in the Monterey Peninsula who take medical So I see some people after long term issues and one of the patients currently have right now had a failed abdominal surgery that got infected had multiple procedures that same area have has a. Lot of scar tissue a lot of hypersensitivity can't handle like even a percent of lumbar extension all or any sort of anti republic tilt because it's just too much stretch and they have pain with sex pain with eating getting too full of a stomach anything like that. But they are also a dominatrix and that is something that they do on the side just for fun and it's something important come up until the fourth visit and they discussed a lot about. The issues I actually have our win. I'm wearing my strap on and discussions about that and how. The the issue with the thrusting with a strap on on and things like that and so it was obviously conversation I've never ever had. It's something I like to think I know a lot about but I was like Whoa. Okay. I need to talk about what are the things that the wearing the strap on? Is it the having the strap on on you in you or is it the thrusting and everything like that and discussing what is your goal and what is your issue with these and discussing all the different options that they had And how we are going to get there, and what's like their first step what your short term goal is just tolerating wearing ed is your long term goal thrusting with that on your in Lee major long term goal is enjoying it in. So it's just been interesting working with that person about here is there spectrum of what sex looks like to them and what's important to them to get back to? In that, they can't even taller putting their hand on their scar and taking a deep breath and they once were able to tolerate some things. I've just have never been comfortable talking about until I talked to them about it and had to say, Hey, to educate me on what this involves for you on you bring up an interesting gwen is is your own comfortable a- comfortability level as a as a therapist? Your medical provider. So really you're not, you're not interjecting any of your own personal thoughts or beliefs, but you know educating yourself on what that would entail. So you have to become more knowledgeable about this person told you. But going back to what we opened the show with is you mentioned this lumbar extension that's the issue. So we're going back to the physiology, but so you're not working on Dominatrix ing your. The anatomy and physiology. So you can do whatever that is, but you need to understand that from whatever that means to them in that moment. Keep me straight face and not looking confused and being okay with just saying like you know I don't I don't see very many patients with this and I have I. Have My. Like I live right near San Francisco I go and I see all these crazy things all the time when I'm there. So I know about a lot but I don't know all of the depths that go with that and so I need you to explain to me where you're finding a difficult time and what's going on with that and so how we can. Change all of that by improving sensitivity improving mobility of your abdominal wall improving the tone of your pelvic floor because of that so. Do exactly what I, what I tell. You know therapist that I talked to you on a regular basis which is. Six weapons at any at any given moment. Right if you have no idea what to do or say next, you got six weapons who, what, where, when, why, and how ask a question asked several questions if you ever want to sound like the most interesting person at a dinner party, just the person asking questions. But if it's therapeutic setting asking asking questions makes it about me as the patient you can't lose that way and if the asking questions you're going to fully understand yeah and never sounding judgmental I. think that's the biggest thing is just saying like, Hey. What does this mean to you and like what does sex look like to you and being okay with whatever answer they give you because you could be assuming journal inner curses uncomfortable when really on curses okay. It's anal intercourse that's uncomfortable and that's important for them in their partner. So it's just being okay with that and keeping a straight face and then asking the questions if you don't know what that means. Yeah. Yeah, I can. I can say I've never had the other word dominatrix said in this podcast but. For for everything PAM welcome back, we're talking about progression returning are returning to sex. That's okay. You're in Tahoe we understand the background looks good. Know, how do you progress there what your thoughts? Anya said maybe nothing. So she was talking about Halley short term long term goals and she mentioned the long-term will joining it and I think this is something that we all forget about. That I listened to other podcasts and it reminded me of this that we're just getting people back to pain-free. XYZ will get people back to function what is function for them. One of the functions of the pelvic floor is orgasm is class. So getting people back to this man men and women, we can help with distinction as well and. All those things. But we can do. We just don't stop at pain because that's just one piece of it. I always ask when you when we get postpartum. So are you able to the pain? Awesome isn't the same way it was before and where you able I asked all my patients if they were able to. Reach Climax for achieving orgasm, and some of them say like never been able to do that, and then we talk about what goes into magnet orgasm in what the anatomy of that is in why based on what I'm seeing musculoskeletal might be limiting them from getting there, and then we talk about how we can address. These it might be something that Nolan's ever knows irving comfortable with asking them. So. Even though we've got gain I always ask about that next step of onto pleasure and see if we can help with that aspect is well yeah. I think one thing that's come up a lot kind of interwoven with. Is Don't have any preconceived ideas or or lack of information. So assume someone knows a lot about something or nothing about something. So drew you have to, you have to not assume in either direction. To facilitate a conversation. I know it's about body autonomy I. Feel like that's come up a few times but I want to do I wanted to bring that up with you. Badio tell me how's that come into your practice So I think we've already hit a lot on. It is just a lot of education like you. You Look at children body autonomy and not educating them about their anatomy knowing their anatomical terms for their external genitalia, their internal genitalia, what's going on understanding while all these things are. I've had female patients who don't understand what they're clitorises. You don't know where it is. Don't know that they have to holes of three holes. Sorry. They don't know that they have one for paying. They don't know how when for vaginal intercourse think the paying and the bachelor courses, the same wine, and so it's so great to watch. Someone's eyes get wide open when you pull out your pelvic model, but it also can cause too. I've realized it can be a little bit triggering for some people. But I still think it's super important to educate someone about what's going on with their anatomy, getting a full picture asking them like you said, making it about them and asking them all of the questions you're not telling them about yourself or assuming anything. So I think that's just the start of giving someone body autonomy on top of it. It's really just asking for that consent and exactly what we thought we talked about shadow to Dr Corey Manton He was the one who really drilled that ends near like everyone did and pt school but he was my first Ortho professor he anytime he put your hands on anybody before he was just like is it okay but my hands on your hips. Is it. Okay. If you turn around here and I put my hand on my Lope, your blowback and it was never too much. It was always just enough in it was always give giving you control over your body not scenario I think in PT school we can all understand that we're constantly getting touched by classmates were constantly touching other people. We've all touch things we didn't mean to touch and uncomfortable with it so. We're used to it, our patients and our patients aren't used to always being touched all the time in. So by giving them the option to say no and starting off in evaluation anything that makes you uncomfortable. Please tell me you have the right to say, no, we'll move on and then from there getting not consent every step of the way in doesn't need to be in like this overwhelming way for that patient. well-done Just, WanNa remind the audience is washing life questions. Comments have a few that are coming in. We'll get to those after this but the last thing I wanted to talk about we talked about a lot about the patient and the therapist and partner but there's another person in the room or a person's effectiveness, which is society societal views of sex I'm guessing that that plays a lot into either not having enough information or having misinformation. Using sex. Over Actually. That I just mentioned earlier the. Twenty year old young twenty s and had a more conservative raiding and we were talking about society's view of women exploring their body versus men exploring there. And you know I, bet you that any man you ask could pick his penis out of line you put back definitely. Because you coup. But. florio allot more than most of women expect clitoris. So I think I Mentioned earlier about biofeedback being visual, actually use Mir's a lot provisional news to show people. This is some area you should get to know like women. You should be able to look at FAG VOLAS and pick that out of the lineup. And I think that that also makes women risk because. Again Penis talked about all the time but. With. Like what is normal? What is and we all have? You know any the model is so symmetrical and so like short all. I had at this girl asked me yesterday because educating her on her anatomy she asset you have any other questions that cannot addressed anything that you want to know. She's like I just think there's some extras. Era Think. Something is we're as no that's your Labia. That's that's just that's normal. Your face is the same as everybody is different. Everybody's latest different miniature picture. There are an artist it'll of. Yes. Yes. Reddish show her that and she was like literally like Lightbulb went on all my gosh. All of this is normal. So I think it's just sad that women are not. Exposed students that get I was listening to a podcast. On the felt podcast MARKUPS, Mir podcast school but they had UC on there. She has a sex educator peak. PT and she was saying that you know if you walked in on your twelve year old son masturbating, it'll be like it'll be boys got room like if you walk in on your twelve year, old daughter masturbating would be like sending her to a psychiatrist or doctor were like shaming her you know and I think that that's just really upsetting. So I think that needs to change obviously unlike stand on a soapbox here but. I think educating our patients that it is okay to look at that area. It is touch that area and you know after comfort level on that because that is a hurt society thing to get over. Yeah. I don't WanNa skip past like what you probably did in the moment. But what you've done for the rest of that person's life, which is like you all you did right in terms erling co was like patient education but. Do Right I mean, you really did off you blew remind and That's going to resonate with her for a I mean forever right I mean she's not GonNa forget that. And the more you can do that. Well, I mean that's changing someone's view of themselves and we carry ourselves around forever. Proposing. Replogle. A regular baseness because literally how many people know how many times a day you should be how often you should should it hurt with? Should you push them you like I don't know I could all those things are so Florence last they will be doing education I think we can educate everyone bring the whole family on long. Since. Yeah. Societal view. Go ahead PAM. Internet stays connected long enough for me to say this I'd like to piggyback off of that, and this is something I'm really passionate about is you're talking about the twelve year old girl and then how that could affect your moving forward I feel like women when they seek help for pelvic issues particularly pelvic pain. There's this pattern of how they're responded to that. We're acknowledging more and more and we realize needs to change. But it's still happening oftentimes they're told you know you just drink some wine take an Ibuprofen You know you're just dressed or you just have a lot on your play in like no, I'm I'm in pain like I think there's something going on it's all in your head Here's a referral to a psychologist or something and on average women with politics pain they go from onset of symptoms to diagnose the. To takes over ten years on average in the US. So for years or more, that's the average, not even like maximum. That's the average. So for more than ten years, these women are seeking help and kind of dismissed or blown off or told that what they're experiencing isn't real and they start to believe it or testing that it must all be in my head. Maybe I'm crazy up maybe this is my fault what. Maybe I'm doing something that's causing this and all the while they had endometriosis or interstitial cystitis are all of these pelvic pain conditions that could have been treated if they would have been addressed properly to begin with wow. Ten years at the average in the US every surface washing right now it's nails on chalkboard like we could have done something a decade you're measuring it in decades we could have done it ago. Societal views should come into play. Did you guys want chime in on you can tell I want I want to hear a tammy talking about male societal these because I know she traits smell pelvic floor and I do know I've heard a lot of her stories of DYSFUNC- Milk Albacore dysfunctions in males and how that affects her sex life in the looks on that. But real quick offer that before you go into it just off the female part of everything because I only emails at the moment. I think we as therapists just as a society constantly thank like our older adults are not having sex like hush-hush nothing's actually happening But no, that's not the case especially in skilled nursing facilities where STI rates are going up and everything like that. Obviously they're having sex and this is something that needs to be talked about more and i. do know pelvic floor therapists who doesn't ask questions about sex for patient semi five and older basically. So. That's where it really gets to me, and it's just like nails on a chalkboard for me when I have a seventy six year old patient who had pain with sex for fifteen years and finally said, this is enough I don't WanNa Grin and bear it anymore. I actually want to like this because I think this is important and is coming to me after fifteen years of painless sex, and if they had gone to that other pelvic floor therapist. About it, they wouldn't have asked those questions and so that's where it really just gets to me, and the oldest patient I've had who's had sex has been eighty seven years old. So I I don't really see many people older than that in my clinic, but it's that's so important and yes, there are certain things we need to look at like battle atrophy. We need to be very careful with our checking someone postmenopausal if they're not taking those necessary measures to make sure that they're mucosal is up to to par and everything like that. But if they can tolerate a penis I promise you, they can tolerate a very well lubricated gloved finger for A. Assessment as well. Wow. I mean we're talking about in terms of take away with the the topic we're talking about in terms of sex or public or dysfunction. We're talking about treating women differently than men were which were talking about treating people who are older than a certain age different than people who younger that sexism and ageism. Tammy no pressure on just put you up on the The. No pressure has the best stories she. Appears. Dysfunction, Professor Gender, House professor in awesome. You know I I now I'm GONNA blank. I just think it's really it's just so vital. For men obviously to able to to have sex is so important and to women to but I remember I had a gentleman he was twenty two years old just graduated from college and he was having all kinds of pain with I. Mean Even if you urinated is feel like razor blades in his penis. With sacks everything and he just basically you know here's some antibiotics. See if this anything up course it didn't and he was told led the rest of his life starting at twenty two years of age with this kind of pain and I just can't I've seen I've had male patients marriages break up because of things. So Anyway, I'm very lucky that I taught in a gabled guest lecture PTA program and one of my students. They are told him Cozy Tammy rolling he came and it was literally three treatment sessions. That is it. He was this major trigger point took care of it, and now he's twenty two years old and he can go on and urinate defecate and have sex pain-free. So it's just it's so important to get the word out there that there is help and if you're not finding the answers with one provider, go see someone else. Blanket generalization question treating males and females. are is one gender more resistant or is it case to case or is there? Is there anything that the trending like I? Feel like I mean as a guy I think I would be pretty. Awkward I. Mean I'm just this is just me at one but I'd be pretty awkward I. Think I would delay having to go have an issue just because society's said, suck it up and what's your problem? Don't admit you have a problem. I don't I I I. I'm not seeing that with the May. Also I'm seeing that they are coming in and they went to be fixed and me being a female I did have one case was really interesting. It was He was ahead of the Greek Orthodox Church and they wanted me to treat him but I couldn't be in the same room. With him I couldn't touch him. You know I was trying to work with his anyways I couldn't do that but really I mean the bail patients. I. See that come in they they WANNA be treated they WANNA get help they don't care I'm a female you know I. of course, I'm not seeing all the ones who decided not to come. See me. Okay questions from the audience you guys ready to take some Cher. Elissa from Minnesota asking favorite interventions for painful c-section scars showbiz comes up in your line anybody WanNa take this one. Well, I know my first approach is to do a lot of what Ariana was describing. She was describing it for genital and eventually progressing to that level but even just graded control touched the area just like she said, when you have stitches in Utah in their frayed of that area after a C section surgery, they're they're afraid of that area they don't want to disrupt the healing the scarred. So sometimes, they won't touch it. They try to not even let their clothing touch it, and it just gets really hyper sensitive. So just graded controlled I. If you sell just tactile input around the area than maybe we try some different textures on that I might do some manual techniques like mile, fazul release cross fiction massage things to get that tissue mobile and moving and use to movement without. A. Hyper sensation pain response. That's usually where I start. I agree with all of that and then just getting some moat like body motions trunk mobility just to see if we can get that scar tissue without touching the scar to. Delays Franck Cross APPs or cal just to get more extension in the back with the abdomen gets a little bit more mobility is something else I do inbreeding drank breathing. Or belly open everything core breathing is everyone. Talks about males we talked about females toby asking about transgender patients as well. I'm sure this comes up. You know what are you saying there when when this question gets thrown your way? Debate seen of Action Plastic I didn't arrested. In my residency, there was a physician at Surrey at the of me that started doing that lassie's so that's a transgender female. Taking a peanuts basically doing the surgery to make a vagina, which is pretty cool. I got to see someone twelve weeks post op Ed it's vagina looks like if the giants really crazy but. would mostly transgender at least females are coming in for a dilation so. I, kind of think about a career getting purist if you never hear you take IRA ring after years eventually like. It will be more difficult to get Iranian than. So especially post op we need to use dilation to make sure that the giants as functional. Tom, and then I saw. Enacts. transgender patients that go through a gender. Surgery I also saw transgender female that still had male genitals and she was having pain like peanut. We see her male patients a lot with just testicular pain. And I would treat her just like I would treat a lot of people with other pelvic pain like. She needed a lot of hands on manual work a lot of Eliseo as. Work in stretching, but that's typically would have seen transgender patients for so far and I know it's becoming more uncommon for the surgeries to occur really exciting end. There are courses popping up everywhere for treating transgender patients, but it is definitely something that we don't see as much but that is coming more boyfriend. Yeah. My my cousins have nurse practitioner in in new. York City and works with transgender patients. Lot of keep saying we gotta get on the show, but she's busy in New York City, code patients right now. But just some of the stories that should choose talked about would blow your mind and make you upset and make you very very upset in terms of how those individuals are treated. questions dropping below we've got one more for Melissa from Minnesota, pelvic floor dry needling because ever use that. Have you seen results in it? I'm in California are not allowed to dry needle out here. Ironing out for that. I am not trained in it myself, but we have someone in the North Phoenix area. If she's still in that area who is kind of like the pelvic dry needling person and she has really great success with it, and if a patient can kind of give it over the ooh, that seems intimidating that needles in that area if they give it a try people feel like it's really effective in once they've had it in like, oh my gosh that was so beneficial I don't even care if it's needles like, yeah. Keep using whatever works. So it sounds intimidating given the area that we're dry needling, but it can be really effective that is something I wanna pursue getting trained in. needling just just on its own is a little bit intimidating when you look at it, myself included was scared on my mind needles and I took the level one course in I mean after you know a few dozen needle. You kind of get over. It I can see where it would be a little bit intimidating to. But if you are looking for relief as you mentioned, you'll get it by any means necessary. If it's that bad timing where you gonNA say something. I was just GonNa. Say I have so many patients her I'm like at this point dry needling would be super awesome because then we a decrease the town we could get to the we get the symptoms down more so that we can prevent the symptoms from happening again a little bit better and at that point I'm kind of to. Where it and end of your insurance sessions I think at this point, we need to look at Bo talks injections. So that's our limitations are in. California originally. Area. You have a webinar coming up what's it on and? Talk about sex after baby A. Boss would love for me like Singapore burst that. It is on the last. Tuesday of the month so. Four, like doing real that from all right now. Missile. Market Pitch. Comedy does like Free Webinars for patients that actually really anyone whether it's the general population we put it on our. Vitality. And our facebook pages. People can find it there, and then it's just a zoom call and we always record it. So the people can watch it later yet live but yes, it will be the last Tuesday of the month at seven thirty central times in central. Website people to to to share that. Vitality. Women's P. T. DOT COM or follow me on instagram at Rei Jazz DP. Is Understanding bt or DVD. FACEBOOK it'll be. We're training. We got it on the screen so It's it's in the comments below. If you're watching watching the replay on facebook we have a traditional Michelle, will ask thing we do is your parting shoddy guys ready to your parting shots. Cleric disagreement. Party shop brought to you by our friends our medical staffing we mentioned at the top of the show leaders in traveling physical therapy. If you're just graduate looking for a position, all fifty states plus DC all settings, a lot of times people think physical therapy just outpatient, orthodox? Well as Pelvic Physical Therapy neuro sports, the matter and plus if there's people there people of satellites I duNNo. If they need PT's in Alaska for there are people there. And NPT's so decide where your license can take you. Anywhere you want to do it. So a you are US medical dot com. It is a U.. R. E. U. S. MEDICAL DOT COM During your parting shot, we'll start with Anya. It's your mic drop moment. What do you want to leave with the audience as we wrap today show you. Know press much euros sharing. I think it just listening to your patients make sure to never. Never, come with a judgment at all always have a curiosity for what's going on with them always have compassion. And Ask all the questions ask all the questions I. Like it. We'll go to PAM next just while we've got her. Before Lake, Tahoe drips are often screening. Arctic shot what he wanted with the audience today. Similar to what? Said but to have empathy for your patients to listen to your patients and understand that what they're going through. This has a deeper impact on them people who may have an elbow injury or an ankle injury. This affects their manhood or their sense of womanhood, their relationships, really personal emotional things. So be ready to have those conversations and address those uncomfortable topics and get comfortable with the uncomfortable comfortable the uncomfortable words. Tammy Europe parting shot what you got for us. Everyone has a pelvic floor and a lot of people have this functional pelvic floor is so make sure they get the help they need especially after having a baby I mean if. The baby does to that pelvic floor those a woman you to get in and get their pelvic floor healthy. All right area no pressure. You're the closer today. Cami. Renal Function. So don't stop at not N- Gopher function for pleasure and all the women out there will get your voteless you can pay it online. Maybe next time. Basic Principles. Of course. Record that the thanks very much for your time for now we're talking about this The more we talk about this more therapists are armed with information and the more therapists are armed with information. The better a patients are going to be slaves. Thanks so much for for coming on the show and talking with us as we head out. Love PT Pine Cast. Yes. 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Inside the PTA to DPT Transition with Matthew Gratton

PT Pintcast - Physical Therapy

47:28 min | 7 months ago

Inside the PTA to DPT Transition with Matthew Gratton

"Hey before we get started, I just wanted to say thanks to our longtime sponsors are es medical staffing helping you physical therapists or physical therapist assistants find jobs all over this country with position. All settings in all fifty states find out what they have for you. At a U. R. US medical dot com that is a U. R. E. US medical dot. com. Follow US online at PT Podcast, and subscribe on I tunes spotify or Google podcasts. Absolutely Yeah, it's it's, awesome? Rebel, we're live again to impact back happy hours, cheer, Pizza pint casts a podcast, saves fiscal therapists and physical therapists assistance for missing out an amazing insight remarkable ideas, motivational stories in the world of physical therapy. Hi I'm Jim McKay broadcasting live from the medical staffing studio leaders. In Hashtag, travel pt find them online at a U. R. E. US MEDICAL DOT COM. If you'd like to move about the country, let your license you're you WanNa, go Arias's leader to do it. So find a begin that website. Go there you are US medical dot com gotta a great show for you today he said the best conversations happen at happy hour will welcome two hours. We're GONNA talk about a transition from PTA, to DPT. This conversation comes up a lot seed online and facebook groups and whatnot. So if you have any questions or comments during the live taping, we're doing this on the socials at PG podcast. Live video facebook twitter youtube. Drop your questions or comments below if you're watching the replay right now are taking a listen, make sure to reach out to say what's up on social or drop the word replay in there. As. Well, I, want to thank our sponsors Owens recovery science there a single source for PT's who are looking for certification personalized blood, flow, restriction, rehabilitation training, and the equipment you need to apply it properly. Pause there for effect properly. In clinical practice find them online at Owens recovery science dot complex Johnny Owens, and those guys kimberly go deep in their podcasts as well. Can't have too many podcasts you can't. Their podcast is called difficult to find Owens recovery signs. The podcast baseball's the movie So let's get with the show man. Let's get the cool music on. There we go. Yeah. Here we go. Gracia Free Nights. Tonight's guest. Professor Student PTA Scoutmaster. He's not busy doesn't feel like doing enough. Sounds like a lot of people in the professional bring. Bratton is on the program. Welcome to the program Nats. Jerry, how are you? I'm doing I'm doing that and that's a great question that I think that we're asking which used to be as throw it used to be cliche which the how. And now like the world or whatever people like. I think people need to be like, how are you and people? I'm. I'm not okay and that's that's okay. One of those is okay but I'm doing. Okay. So thank you for asking is what? I'm doing good man you know we just started a new semester at school teaching, the PTA program you know the first question those students asked when they come in the door is am I gonna be able to do my clinical rotations. This semester are we going to be able to do have lab in? It's it's it's treacherous time, but we're making it through it just try to keep encouraging keep moving forward and do the best we can. Look out you know in terms of you know who I get to meet and interact with doing this podcast a lot of my friends close personal friends or acquaintances or in academics. And allowed them. I would say how are you doing over last couple weeks in a lot of will go I don't know how we're going to be. So you know and the students you feel bad, we were all students. One thing I was never educator. But like we've all been students, you feel for them, I've never been an educator but I want to just be like, Hey, man, are you guys doing? How's it going? We're going to get it done I. Just I don't know how else to. Get it done. Oh, it's been a struggle I. We have some of our classes that we've actually completely rearranged this semester knowing that we have all this hands on stuff that we have to get in. You know. So we're pushing all front end so that if something does happen down the road, if covid explodes in our area that way we have our hands on stuff in so that the students aren't GonNa. Miss out on that time. It's handwrite there he's. Prepared Haired if it gets changed during the the the boy scout in you absolutely hard. About your superhero extra. We'll let people know if you want questions, comments, filtered drop them at any time during the shell we'll try to get those towards the end. I don't want to interrupt the flow but feel free that those those lines are open whether whether you watch those on youtube twitter or facebook. So Superior backstory you like give it to us. You got a cool collected. So. It's it's I am not the normal PTA DP student. Of started out as a as a chemistry major in college went to music education actually taught high school music for ten years. Transitioned out of that wasn't even sure what I was going to do my wife and I had three kids kind of figure try to figure out life. You know when you're in your thirties trying to figure out why that's different kind of figuring out there. Decided to go back to school as a PA. I. Love Movement Helping People Love Teaching. Always with the intention of going to do the transition at Finley. So when I sat down with books looking at professions, it was a what can I do and not have to move the kids not moves a family. So I looked at I looked at, it was like Elorza PTA in my tau, I'll do that and then philly's got this transition. I'm going to do that. So I mapped it out. I have a seven year plan for education and we're we're we're working through. It had a didn't were running on your eight year nine, but it's You know life happens but we're still moving forward or still added another kid to that too in the Middle Right. Yes we have. We have four children, three boys our oldest as a sophomore in high school. He's fifteen. He's GonNa get his licence in January it's. Teaching, how of dry? Exactly. Right. You know you're. So you're worried about your own education, you're worried about your students. So I taught the back of a second so did PTA school I got offered a job acute care right out of high. School. Worked in acute care for three years working with critically ill patients working in cardiovascular intensive care became a team lead there. They got asked to come back into academics. And that it will that was going on applied to school started DPT's school. Now Director of clinical. Education. For PTA program in my almost my second year of DP t school with boys I'm a scoutmaster for their voice scout troop. And then we just try to do everything else like marching band and A nine year old daughter so Drink man it's you requested always the hardest what we drink. We. We're drinking angry orchard. What's asking this a lot on the video cast a lot of people where you are angry orchard. Where it's mushed I don't know what you. Wall in New York while the New York guess where I am right now I'm in Walden New York so. I, read it on the bottom. Part. During his own from south of the border I figure out with the theme for tonight one I do a corona. You for coming on. Appreciate that now. All right. So that's a hell of a back story I. Feel like you know. A lot of people. Either have very straightforward or crazy like weird radio DJ to. Be. Any or you know your stealth, which is me. So we're talking about the PTA TO DP transition this comes up a lot how many how many about programs are there's not ton right so True Bridge programs to right. There's one in Finley Ohio, and then there's one in Galveston. Texas I believe it's Galveston Texas. Both are I think they're set up a little different Finley's based off of like in every other week approach where you go to campus every other week and you have two days classes and then everything else is online honestly have never really researched Galveston because. For Me Finley's our way GALVESTON's a flight. That being said, my classmates from Texas Colorado California. Florida. So we have people that fly in from all over the place. The class will only there's three from California Washington in Montana. So I mean, these people are making huge investments to be able to to do their academic learning in this in that van nat. Faxon. You went into this. You went into PTA knowing you're GONNA make this bridge program because of proximity. Yes. Why? Why do you hear what are the reasons and other reasons? This was a clear path for you but a lot of people who went in one direction in our saying, Hey, I'd like to change things what are what are some other a the reasons in the motivations behind that? Well, for a realistically a lot of times people don't understand the the the difference in in the classes that do the transition program. We have classmates that have been only in the professional year to. The youngest member of our classes. Twenty, three okay I'm forty five and I'm not the oldest person in my class. There's a one of my classmates has been a PTA for over twenty years. So I mean there's a wide range in ages and there's a wide range in why you know I wanna do it because I want to further my knowledge in the field some people want to do it because I wanna have autonomy in their practice. They've been working in clinics and they they see the way things are done there and they want to be able to different. So they WANNA get the background to be able to make those changes themselves that they don't feel they can as a PTA A lot of people are going in it so that they can help patients better in other going in for the right reasons, they want to be able to make those clinical decisions and and be able to create those plan of care for their patients Good. Friend of mine lives in Virginia She's A. Brain specialist as a PTA loves neuro and knows that by becoming a DP T, she's GonNa be able to help her patients more than just even if she was certified, she got a brain injury specialist. She's going for her stroke into at CS RS survive stroke rehabilitation specialist. She's going to have those by the end of the year and she still even though she knows that by getting her dpt, she's GonNa be on helper patients more. So it's it's just broadening yourself the point where you know you're making the biggest impact on your patients, which is what for all of us our goal. Yeah. Yeah and if it's not reevaluate, right? Absolutely. Calm yet. But what I've seen online people talking about this and you're really and the rest of the people in your classroom in unique positions to speak to this, which is neither one is better nor worse. People need to get that thinking out. It's not like Oh, I don this is worse I wanNA get here. So I want to throw that out of the way right? Right from the start absolutely a we are. We are coexistence partners in a in a patient's progression in the PTA could have just as big of an impact on that patients progression sometimes depending on the setting and how many evaluations in what the team needs to do could have more. You know what an acute care the PT's in the fours I worked on the PT would do evil in that I would do the rest of their stay. You know. So it was as the PTA I was managing that care and still working on. Of The P.? T.. But in our facility, we were allowed a little bit more autonomy than some in we were able to progress and talk to. Get changes to plans of care without having to do Rio thousand rebounds and rebounds agree of else. So I mean we had we in our in our facility we were able to really speak. Progress in but even with that. I would personally I'd still want to get more education so I can be better. One is not, but you have to have both you know we have to have people that are there that they have a passionate about just working with the patients and want to do that and want WanNa work with a PT It's we're interim we have to work together. A lot of times what I see is for frustrations from PT's working with PTA's or PTA repeat. It winds up if you if you question either party enough, it's the system there in it's not the provider it's not even the other clinician like individuals vary professions are pretty static it really a lot of times it's the system to the system. You just described sounds like a great symbiotic relationship, a lot of times I find PT's or PTA's frustrated from that symptom of system. Is that similar system similar? Absolutely absolutely a lot of the P.. T.. As that are in my class come from systems where they don't feel that they have the respect from their experience. I know therapists acute care therapists and other cities that are very much restrained in what they can do you know if the PT hasn't done it I, the PTA can't do at all so you'll have a patient that that the P. T. didn't decide to get out of bed so the PTA can't get them out of bed, but the tech is getting him out of bed. When it is. So it's it's this fresh you know that I. Never. Demeaning. How meeting is that as? Where person with no education can't move them. But you with the with education training in this field arnold out too because the PD. So it's it's you're absolutely right on the nose, the culture in which a person's working has huge role in whether that feels like it's symbiotic relationship this working together or that they're opposed. Yeah. Yeah. That's that's the biggest. It's the most common themes. The similarity that I see is lots it system and listen I mean if you're in a frustrating system and you're not afraid you're not here. So I would people wouldn't WanNa go to a different system or change change their position, and that's really what we're able to do. We'll talk about past experience you mention forty five. person in your class. Our thirty three when I started PT school and I found this to a thought it would be a hindrance 'cause looking around the room. People were ten years younger than me. And I was helping all kinesiology degrees and I had a degree in journalism and I don't know how this is going to help, and then through PT School I started. Hey, subjective exam op super I love this interview I love interviews. Talk about you know the. The the advantage of really harnessing past experience to make the most of either your education and then beyond right absolutely. So with me personally you, you're saying subjective I'm in the same boat as as a teacher I. That conversation with the patient it doesn't matter how sick. Oriole they are to me. You know you can sit down and have a conversation and then educate them at their level. You know I can sit there and talk to a person and and really connect with where they are in there. And change the way I'm teaching them based off by past experience in in school in the. My friend her name's Maureen lives in Cleveland. She'd been PTA for twenty years. You know when it comes to learning the skills and the tasks orthopedics therapist. Stuff for her is because she's been doing it for so long she may not necessarily under got the nuance of that you learned. DPT school. On the why but she knows the what in in a lot of my classmates bring that to the table. You know some of us are neuro- nerve therapists, I'm gonNA, Acute Therapist, most of them orthopedics. So we get into those orthopedic classes. They're not GonNa Alpar in under professor telling us. Wow our traditional students. We're picking this up this quick as you guys are because the experience level, they bring somewhat hands on experience. They know what it feels like. They know it should look like they know what it looks like when it's bad when is going on they've seen all these conditions in now we're learning that nuance on the vow you know which makes it really for most of us much easier at least in some classes. I do neuro cardio poem. Those are good for me Orthopedic Staff. It'd be acute care. and. One more. One More Mirian you know. I think it should be like a special section on. Any application for college do you have any food service or Luke Yell Experience? Be like five or ten points. Nears. Why because sometimes when you see a student or a classmate or clinician somebody who went right through school right and nothing wrong with that hey, you knew what you wanted to do and you plowed through and good for you for having focused I. Don't have any focus I'm all over the place. And I did I did food service I did busboy waiter bartender, the whole nine and it just reminds me that quote that Mike Tyson said was everybody's got a plan until you get punched in the mouth and it's like if you worked in any of those industries. You understand that Hey follow this protocol. This is how I do in evaluation and everything I'm going to go from ADP to see already me and people who have different experiences are like. So this is how this is GonNa work and sometimes it does a lot of times it does now in its. You react to that. That is going to set you up for success. You're absolutely right. When I was in school I delivered pizzas. Now you gotta pay the bills. Food Service and retail. Absolutely. You know you run around to people's houses, introduce yourself, and you know they're they're not necessarily always treated is. A lot of times that man it's all about you got ten seconds. We Hey, how you doing I'm great to be here today right? Absolutely. Yes pants experience it's you know it's not critical but you know don't don't imposter syndrome yourself either, and even though we speak about imposter syndrome I speak about it but I'm completely guilty of having it had had it still have it. We'll have it It's reminder but that past experience is valuable and I'm sure it helps you. As well Oh. Absolutely. Absolutely. You know what guys you. You know your past experience guys what you your your path forward. What makes a good student because you are one and you teach? Flexibility you know I think I think one of the things that students run into in the ones that struggle the most are the ones that are unable to be flexible in the they approach perch information, and then when information is like when you get punched in the mouth, you can't adapt you know you have to be willing to accept failure. You know most of the people in my DP school class currently really really top notch PJ students, and now we get an in dvd school and you get your first be. Yeah he and people freak out and it's like, no, it's it's it's okay. It's we're learning. This is a learning process. We don't have to be no students to be able to graduate with a DVD we have to be able to. Get through our classes in past in the past It, we have to have realistic expectations. You have no walking in that I'M GONNA struggle. I'm going to struggle a lot in that's part of the process what I'm struggling. I'm learning more. Yeah, right. W-. I, attempt learning and stuff like that and. I'll tell you. Asked me like? Just, like Mardi nick fly because like I said he read as straight. Hours everything in school I've got an eighty eight and I hated number. Martin fly everything's eighty eight miles an hour with Jimmy. Ed It was like an eighty eight hey man eight and I look at my classmates who either studied less or more, and I'm like God Ninety six man and I knew my professors would be like dude passing passing I know but I busted my ass I wanted to be a higher number. Six months but I hear right now. and. I can say it to you. But I know students are are you know maybe you're not bill take it to her I'd know I couldn't. It's it's tough. I was the four point. -O PTA suit I had to get as in everything you know but it it takes really getting it handed to your once or twice to really just take a step back and go. It's okay. You know and when you got all these things going on, you know, what am I gonNA? Do I'm I going to not spend time with my kids? So I can for an extra hour? No I, you know if I get an eighty four on a test and a two on a test, it's so passing and I guess go hang out with my daughter. That's a win. You know if I got an A. on the tests but didn't get to spend the time my kids. which which is better to date. You're doing this law brings to I. wanted to talk about. Work School life balance because you're doing our pre again professor in a PTA program student PD program. Run around Rackham here in the background they're doing some no Dad Buick Club. Get loud now. How do you approach it because there's no one there's no one. One fits. But what's what's inside the you've learned being a busy guy. Okay. So when I was a PTA student, I got the opportunity to go to a couple of conferences and you've heard sharing on talk 'cause I. I mean you I've been some of the same conferences together. Sharon done when she was doing her student talks would always talk about crystal balls and rubber walls. You know you have to know what your crystals are. You have to know those balls that when you're juggling things, you can never let drop and you have to know which ones we rubber balls that if you let them drop, they won't break and you can pick them back up in. That's really. What it comes down to is you have to set your priorities on what's the most important things for you it all those can change this week. These are the most important things to focus on next week that may change a little bit and I don't have to focus so much year the the issue with that is some people think they're issue is should be your crystal ball. Going that's running into. Now I became time astronaut January in some of my coat leaders feel that. Scouts is crystal all the time and it's like well now. So. Like before this I had a had eagle, Quarter Monir Eagle Board review that I was at right before this meeting as guys I'll be there for the first thirty minutes and I gotta go because I have I have a obligation that made before this. So I'm going to do that and you know it's setting those expectations they understand I've got all these other things I do so as long as communicate, and that's the key communication. You know I'm GonNa let you know these are what I have to do. And it's going to happen. We're GONNA camp outs in October while DVD's school. So while we're on these camp outs which I I will go to I'll be like all right. The next three hours I have to sit on my computer. Guys what's the kids? Nothing gets? It's now. Look at work but last year last year during right before finals. In the fall semester, we took our scouts caving. So they were in the cave and I, was in my car study. And that's that's the way it is. You know you try to give opportunities where you have to, and then you step back where you need to. But family always comes first there's an issue with family. That's the first thing. It doesn't matter what it is whether the school school. That that always comes I know I've heard share and talk and say that the crystal ball the rubber ball and putting that in perspective I've heard her say that it multiple times but you said something different there which set it up in terms of a timeframe right. So let's say you you started school or you start scouting wherever the the thing that you're GonNa do you actually said what is what does it crystal ball rebel this week That actually change my mindset, which is, hey, sometimes, schools a rubber ball. WanNa time. It's GonNa be a crystal ball, but sometimes, it could be I let this slider I can let go for a day. I've never heard actually someone put it in that perspective before, and that's absolutely I mean because school at times we'll be easier there will be less assignments you won't have an exam that week the content is easier. You know you're getting into an area where you're more comfortable where you're not gonNA have to spend three hours studying for the test or four hours now whereas sometimes you got your light, your minds blowing up because it's so hard that you have to really focus in. So you have to be flexible. Go. Right now, I'm good. This is good. I have to go over here. And I. THINK THAT'S TRANSITIONAL DPT REGULAR DPT. If you're just going for PTA, you're trying to get your associate's degree. I. Mean I have first year. PTA students that her seventeen years old. They're just coming out there just coming out of school. They're taking nineteen credit hours with Amy Math, first-year PTA courses, and they're just completely swapped and they have they've they're used to getting all as in school, and now they're having to sit down and buckle. Never had that kind of stress and did have so a professor go. It's okay if you don't get A. You can take breaks just. Really refocus and thank and be able to talk them through that mental process of being able to go. It's okay. This good right you don't WanNa go through life and I mean crush everything like eventually want to hit some hard hit next. Absolutely. Absolutely I mean that's I mean th that means you're you're you're learning something you being tested and you're. Absolutely. If everything's easy all the time, you're not challenging yourself wrong room the thing you said there you put perspective in terms of setting expectations you know with. So my work someone brought this to me, which is the arc ever hear the triangle, which is the affinity reality and communication. So if you have to, you know you affinity, you have to kind of you know like or at least respected the person you're communicating with reality to be on the same terms if. You if you're on different terms, you're not you know and then when those things are achieves when you can actually communicate and you're saying, Hey, setting expectations listen I'm going to be very clear here. I made this commitment before both things are very important but right now to use the other algae, this one's Chris I can't let it drop right now this one's rob I will be back and I will get it done and that's being thoughtful prepared all scout things thoughtful prepared. There's always the theme that pops up in these episodes. They always come out. Haired and clear in communicating and a lot of times that saves the day not doing more just clearly communicating where you are right. You set clear expectations with people you're working with. So they know where you're at. So that way you're not, you're not disappointing them. You know it's those people that don't know you that have an expectation of of what you are. Those are the people actually run into problems with because they. They think because of all these things that I do that I'm super super responsive in I always on top of things and it's like. No You just haven't seen that side because you haven't had to deal with me personally one on one and understand that things get prioritized on a day-to-day basis and your email you sent me. About Service project two months from now may not be the most important thing today. That's part that's mis mis misunderstand and when you alive. Would also like thinking about those things and go why why why is this relationship really screwed up? Why are we not getting along and usually it's one of those three things to finish a reality and communicating enough I'm saying a lot but we on reality. Okay. Then there's that the warriors or you know what? Like there's this weird vibe between us there's no affinity. So this won't be successful so. The first time I was exposed to that was at Fox where my day job a Fox rehabilitation I had never heard of sat down with the Director of marketing is kind of like my counterpart. About the trial right I'm like, yeah and I was like. Let's review it how you who might be different than how often? have no idea what he's talking about but this work. What. That's great. I shouldn't be more forthcoming and if he's blocking because he washes these be like you didn't know what? Role. But but. You know What's what do you got to have you know? Is there something that someone's gotTa have to make that friends urgency 'cause this comes up a lot this topic especially in PTA facebook groups that I lurk in and I just kind of watch. I feel like you just have an auto reply, but you know what's going to make a good candidate to make that transition. Easy you have to be willing to make the sacrifice because that's what it is. You know you're sacrificing your time you're sacrificing your energy. You're sacrificing your ability to progress it your work. Now because you're not working as much, we're required to work in our program. So we have to work at least twenty hours a week. Most of US still work close to full time if not full-time but it's still you. They know your employer knows that couple years down the road, you're going to be gone for thirty weeks and not be there. So you have to be willing to make that sacrifice upfront when you walk in the door and then there's also as every DPT's student knows there's that financial implication. You know which actually is why the transition is so appealing because you're working. Making close to what you would normally make us a PTA while. Putting out what you would normally. Be a DVD student. So your your your loss, your your the the cost benefit analysis curve curves better financially better by doing that because you're working through it. whereas. The traditional program you're not working. You're. Working. You know something that's you know swim lessons in swim team coach and stuff like that wasn't. Team coach salary. Income who swim team coach talking? Oh. Yeah. But it's really it's all about the sacrifice you know I have I have classmates that have young children single moms. Kids at home They're sacrificing time with kids time with family time at work. To, try to better themselves so that they can better their their career to provide more down the road. And you have to know that going in I have multiple students every year asked me about DVD school should I do the transitions should I do traditional in in? That's that's a tough question. You know if you're coming if you're a a twenty something that has their bachelor's in exercise science that went back to get their PTA, you know an hour looking at DPT's schools should I go to school should I work? Then do the transition you know it's What he wanted to do you know, do you WANNA get working? Do you WANNA spend three more years in school you now, where do you want your sacrifice to lie in your life in because you start working? Now's PTA. Three or four years down the road, you may have a family Mary you may have kids you may have moved in its pleat this little. It's less realistic. You know a most of my classmates married though I how many the five at least five of the thirty six of my classmates have had kids since they started. So if newborns at home. It's it's real fun having zoom class with a baby crying in the background. Thing six months ago man that wasn't a thing. For classes though as we do stuff online zoom for everything. You're doing you're trying to you're trying to do a project guy in Colorado. By research community. Absolutely, Sergey P our research group doing we're actually I convinced my classmates do education based. Research Project. In there in Virginia Texas Colorado. So it's like all right we're even at nine thirty tonight. Down which time nine thirty? Eastern. That's win the mountain persons off work and using meeting at work in his clothes just finished. Like how you answer that question too because I was like you know what goes into the thought of if I make this transition or what you say and you lit, you didn't say anything you ask questions, which is such an educator which you know I give her you know the nod all the time, my my former adviser in Sky Donovan for Marymount University I'd ask her questions what what what tell me, what should I do sky tell me what I should do what should I do and she'd never be a damn answered. Pay Teachers. Professors, wants to give answers. She never answered questions answered the question with a question but. She taught me stuff like that at one. Absolutely. You can't. If if you give people answers, they're not discovering anthony about themselves doing anything. Ear just guiding them the way you think you should Guyq and that. They have to figure it out themselves. Yeah. Teaching fish verses given fish. So she got won't fish and I I. Haven't you're not giving anybody fish, but that's the way. Survive, long after they've left your your school, which is great and I'll tell you an eighteen old does not like those kind of answers. To That answer. I am paying you a lot of money you do. Now I will tell you which book or which website you may go find the answer in and go or even worse. She's Confucius I don't know what would which would have not that choice inspires you. Play twenty minutes. Later you're doing self reflection you like, but I hate syrup reflection. School, I wind up self reflecting dammit. They taught me stuff and. That's absolutely correct. Anything else we're covering anything else. We didn't hit on in terms of religious people out there who would be interested because the goal for me is have a conversation with you somebody shares this in a PTA facebook group. You know a month from now six months from now and could get inside anything. You'd want to say to someone who's like I'm on the fence because you can't tell them anything because they're all individuals right you need to. Watching should they be asking themselves? Really, the question and the question with everything is why if you're looking at this transition, there has to be a why behind it I had a conversation last year with a student. Who when she walked in the door for PTA she was like I am going go to PT school why well that's just what I WANNA do. That's that's not an answer. That's not a why. There has to be a reason why past experience is because you want to do something different you have you wanna be able to evaluations were why do you want to do that? And she couldn't answer me. There was no, there was no Y.. Know and that's really for me. There was always a why because I wanted to be as educated as I can I want to be able to to learn as much as I can so I could be the best I I can be. That's my y. In, but that's not everybody. Else's why you have to know your Y. You have to know why you're GONNA walk in the why are you going to spend hundred and twenty thousand dollars you know or higher thousand, ninety, thousand dollars or whatever it is why are you gonNa, spend that kind of money so you can put a d. in front of your title. You can't tell me why you really need to stop and think the end you know be because I want to be in charge. That's not. Right man. I WANNA be a doctor. Thank Dr. Bob. And that was a big thing in terms of. What I was going through school, which is people saying that well, you know Dr this Dr that Mike I was here and I gave this. I forget what talk I gave us in I was like, I, I showed up for two letters man I wanna be physical therapists right? I mean the the I'll be you know my mom loves to tell people gyms doctor. But that's only if you do something with it right? Right. I mean I'm honestly I'm the same way you know if you're telling people that you're going to school for your doctorate, they step back a little bit they. They respect your education and the work that you're putting in more than. But why? Because there's all right. Well. Want help people. So you have to know your why and then you have to be, you have to really assess whether you're willing to make that kind of sacrifice microphone the at sacrifice name any after make sure that you have the support you know I couldn't do it. If I didn't have a strong support system around me, my wife is incredible. She backs every single crazy thing that I ever come up with when I was in school I wanted to go to South Africa for two weeks. She's not go ahead. Go have fun you know it was but but that's my wife is incredible because she is okay with me being me and running full bore and being completed swamped all the time because she knows that's where my best person. But. Not Everybody has that you know. So if you don't have support in, you don't have a good why you're not going to be successful. So stealth. Before you decided to make that transition. Really. Specifically PTA DBT. So that's all right ready for three questions. Absolutely. Three questions brought to you by our friends Arias medical staffing leaders in Hashtag travel PT. Let your license. Let you move around the country PT's PTA's nurses. They've got a lot of different allied allied health positions and you can never travel buddy. This is a great system. To of you wavering girlfriend girlfriend girl work in friends whatever. You can just go and say, Hey, we want to travel together and they'll make their best shot to have you traveled. So I, say like treat it like A. Test driver, the country or paid clinical rotation. But now you're not a clinical rotation you're doing it. So try that travel thing man a you are US medical dot com go there suits failed. You are US medical dot com. All right. First question is aware question obviously right with our as being travel you're in Ohio. Where would you put three months in the fifty states and you're going to Africa but where would you go within the country? We do your whatever your thing is what you go. At that is a really good question SEATTLE. Washington. Yeah. It's nice out there and it I was there for. Two, we can have two weeks, zero rain I mean people every time on TV it's like rain rain rain. It's it's not nice out there. Second portion is a what question. What is something you watched read or listen to book movie podcast something that you think the audience should would get value from. Oh Gosh, that's a tough question. Because that would take free time. Four kids man. Also something that I've read that watch a movie could be quote book podcast whatever. Okay. So I I am. I think watching any movie on Social Justice Right now is is critical. You know under understanding where other people were coming from. And You could Selma go watch some. If you've never watched some before to understand sort of the strife that's going on our country right now, and how it impacts has been impacting people for fifty sixty, one hundred as long as a country has been impacting people. So you know try to find something that's going to be able to mind you just a little bit more on the struggles that we've had in the passed. Yeah. Say about the ARC triangle. Right you'd need to have affinity and reality. Reality. So if that's where I think a lot of disconnect is to talk about the triangle going to a bigger to the country or worldwide what there's not a shared reality when people say there's no such thing racism it's like, okay we are not on the same reality because I think there you think there is an all respect your decision, but you need to explain why you didn't show examples of there isn't an if I can give you the examples that there are. We're still on different realities they're absolutely. Absolutely helmet that. Great. That's a great answer right now last question as we start with people who someone the audience should know more about. Someone the audience should know more out. It's like some who's doing good work but does one under the radar or you know who someone that you look for? Enlightenment or guidance or reflection whatever. So. Okay. I'm going to do a classmate out because. Not Not every that we don't always we don't always the. Spotlight the our classmates enough. So I'm going to shout out to a good friend her name's Brady Stewart she's a PTA in. Roanoke. Virginia. She's the brain injury specialist was talking about earlier. Loves neuro she set up last summer a hike for one of her brain injury patients. Who used to do runs but? Had other medical things come up. So we'll get into the whole big story of it but she went out of her way to make a difference one patient's life and by doing. So made a difference in whole community by setting up brain injury hike through the mountains of Roanoke Virginia you know and. We have stories like that and every community, but we don't spotlight them enough. Reporting Point. Out there. She gets a boom Shaka. LAKA. I love stuff like that and that just brings back to that quote and it's a cliche. But I still like it's like you know to the world, you're one person. But to one person you could be the world man absolute deal. Good. For Britney, I liked that lasting do on the show is the parting shot. Party shop brought to you by our friends the Academy of Orthopedic Physical, therapy, find them online at Ortho PT, Dot Org leaders, North PDF physical therapy for looking up your game consider joining the Academy of the Academy of Damn it. They know what they're saying also great court course listings. Tissue tolerance is something new running athlete is out there I feel like. Everybody in the last six months that you picked up running or cycling. That's good jump on that but let's make sure that hey, maybe want to just refresh with list evidence and that's what these courses at the Academy of Orthopedic are all about. So we get finally online earth, dot org, parting shot Matt, last-chance mic drop moment what's what's the message you'd WanNa leave with the audience as we wrap this episode. Take when when you're moving forward with life, you know. Really self reflect. Make a decision and then just go for it. You know if if you WANNA make a transition your life, go PTA DP make that commitment really look at it. Make sure it's what you really want to do and then go full bore because you really in the end as that's where you'll be your best self. Yeah. If you jump in the pool man, you can't get a little bit wet just go out I mean that was a great advice lot. Of Vice, I was standing in my bedroom in Scranton Pennsylvania fulltime rock radio DJ right running radio station, and it's called my cousin who's a nurse and I was like, Hey, alison I'm thinking about being pt but it's GonNa take years she literally goes Jimmy five six years go by no matter what you do and I was like damn as right. Right. So what do I want to be doing in five or six years and I quit my job and? School. Wait. You can't. You, can't be half. Pregnant. Absolute. Man. Appreciate. You. On that deep pt a two DP transition just just so cool inside in life. So appreciate by the episode now no problem. Thanks for having me on. Love, the PT Pine Cast Yes. Yes. Support the show by telling friend or by leaving a review on one thousand nine hundred Google play aren't sure day brought to you by the Brooks Institute of higher learning an innovator in providing advanced post Professional Education Brooks Idel offering continuing education courses in numerous specialty areas, six residency programs and. Fellowship as well as challenging but rewarding internships. The 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 Ihl Dot Org. Our home on the Internet. CAST DOT COM created by build BUILD PT provides marketing services specifically for private practice PT's from Website Development hosted inviting content marketing solutions, pt clinics across the country. Good pt can do for you today build pt Dot. com. The CAST is a product of PT Podcast, l? L C. Poured. Fresh by me physical therapist Jim. McCain ingredients are sourced by our chief connections officer, Sky Donovan from Marymount University. And it's brewed fresh by producer and physical therapist Juliet decimeter and by producer and creator second year student Bridget Nolan from Sacred Heart University PT Pint cast is a podcast that saves physical therapists from missing out on amazing insight, remarkable ideas and both stories. Follow US online at PT podcast and subscribe on Itunes spotify or Google podcasts. Absolutely. Yeah it's it's awesome. Thanks so much for listening and if you found value in show all we ask that you tell a friend. This has been another poor from the P.. T. Pike cast the PD intended for educational purposes. Only clinical decision making should be based solely on one source while care is taken to ensure accuracy factual errors can be present more on the show at PT PODCASTS DOT com.

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Disordered Eating & The Psychology of Addiction with Kevin Burciaga

PT Pintcast - Physical Therapy

37:17 min | 7 months ago

Disordered Eating & The Psychology of Addiction with Kevin Burciaga

"Hey. Before we get started, I just wanted to say thanks to our longtime sponsors are es medical staffing helping you physical therapists or physical therapist assistants find jobs all over this country with position. All settings in all fifty states find out what they have for you. At a U.. R. US MEDICAL DOT COM that is a U. R. E. US MEDICAL DOT COM. Follow US online at PT Podcast and subscribe on I tunes, spotify or Google podcasts. Yeah it's it's. Awesome. We are live. Hello. Hello must be live because it on the phone here what's up I'm sure McCain, and walk into PT Podcast this is show that saves physical therapists from missing out on amazing insight remarkable ideas, motivational stories. It's exactly what we do the best conversations happen at happy hour. Well, welcome to our Make sure you subscribe to the other show I, tune spotify podcasts, and now of course, video cast on. Youtube. FACEBOOK and twitter at PT Pint casts on all the social a great show for tonight we're talking to a physical therapist we're going to give the disordered eating. This might be something that I remember when I first brought this topic with the staff crew here they were like sort of eating house that committed claim physical therapy. You're a physical therapist, treat human beings and human beings are going through this. You should know about now it makes complete sense. So we're going to give you that with with Kevin Today We want to thank our friends at Owens recovery science single source for looking for certification in personalized blood flow restriction, rehabilitation training, and the equipment you need to apply it properly in your clinical practice, find them online and recovery science dot. com We just had a great episode. With. Ryan Hendrickson author of tip of the spear he was a green Beret suffered a horrific injury overseas was medically discharged and then actually recovered. With with Johnny crew at the center of the intrepid in Texas recovered back to full active duty as a green beret live fire. This guy's book is fantastic. Again, it's called tip of the spear. So do want to give a nod to the guys from Owens recovery. Science. Let's bring in on tonight's guests Kevin. Is Michelle. And he's got bigger headphones music I need bigger headphones lately. Quite Nice. Those are now. I don't know I can give you the model number after the show just. Look at the gym that were podcast I. Like Kevin. Now, what's going on man? Welcome to the show your physical therapist give us like your your superhero backstory and the whole nine like how what brings you the. Profession. Superhero and miles superhero actually I didn't I didn't want to be a physical therapist grown up I didn't even know what it was. and. Then I got into. Fitness nutrition health in my second half college. That's kind of where my story starts and that person training, and then that's when I stumbled into physical therapy. All you know I can make a career, right? Yeah. I find that Hanshin I than figure out what's actually going to what's GonNa pay the bills and the whole nine. Yards to you have to live a little bit. Yeah. All right. We'll talk about this that we'll go. We'll go macro micro. Disordered eating is what we're going to kind of get into, and then we'll tell your story how how? Played apart into your into your journey into physical therapy. So when someone says disordered eating how do you? How do you sum that up? What does that mean? Major eating. A way that is incongruent with your long term health i. think that's that's a good starting definition, but there is this there are. Eating disorder. Indiana's orders as Anorexia. NERVOSA. Sub engine disorder because those are big three but then you have disorder in which could be preoccupation or too much emphasis on what you eat. It's not technically defined as disorder, but it's definitely taking over your life So there is kind of a technical difference there. So I think. If, you are disordered eater. It's a mindset. Okay. So how do you? How do you see it? Okay. All right. Well, let's not skip passing those terms. I learned them in your health in middle school and high school again in college in in PT Education just a little bit right there were brought up there. But but let's go through some of those right. You've got the big three that you kind of mentioned give people the high level. I'd never think it's I always think it's good to give people to remind them what those things how those things operate. Anorexia, Nervosa. We'll start there. That is deliberate starvation. Now, what weight do you have to reach in order to to be classified in I'm not sure myself. I'm sure there's some number sixteen, seventeen BMI now whatever it is women are Bosa that is. Consuming large volumes. Deliberately, pershing. Him To get rid of the disasters possible binging disorders consuming large amount of food without perky nuts. It's kind of like blinks that the purge right now so that the three big eating disorders but you mentioned some some other things that fall under the disordered eating categorize them once you get past those so so so what are what are those Kinda describe those briefly served the One example is or three and not necessarily. Anorexia, it's not it's not like you are facing life and death, but it is this rigid preoccupation with food in your county everything measuring everything, and you're not necessarily getting any healthier. That's where I was the second half of caused. So it's not a clinical diagnosis, but it is mental preoccupation in it's like the most important thing in your life. About Okay So, let's skip ahead. Do you you alluded to your story and how this came across your journey and lead to for you to become a physical therapist? So read your story on your website you're pretty open about it and I think your openness comes from you work with individuals who have disordered eating you know in clinical practice but also online we'll get into side hustles as well later why you should have one but I wanted you to tell your story to the audience. They can understand why why you're so knowledgeable about this means so much to you. Know I Certainly wasn't my intention in life to do this off eighteen. Billion Disorder. Then show others how to you know that was not that was not the plan growing up just like the plan wasn't become physical therapists either it's duchess how life goes. But like I said that second half of college, I became really interested Fitness Health Tristian. All that never really was in high school I don't think really care I. Remember Eating twinkies in high school I mean if that gives you know how much I cared. But then I just it just came this obsession that second half of college and then I mean the intention was to get healthier but I didn't do that. Huge. I didn't I didn't implement what I learned apparently F-, and then that turned into like I said the Orthodontia and then eventually I started June Mahfoud and then spitting it out. So it's kind of like almost blamed give at all the way and then, but it did end up purging and then it was just binge eating. Then it was like binge eating fast and it was just as John Rollercoaster for ten years. Yeah years. Never formal rehab out never got form of therapy except maybe a couple of sessions that you can consider if therapy. And a realized after nine years tenuously. We've got it fixes but I cannot do what I've been doing. You said on your website when you when you're share your story there and we'll put the we'll put Kevin's website in the other comments section below and in the the show notes that the episode. You. It kind of seemed like you try to solve something and you'd over correct the other way and then you try to solve it the other way it seemed like there was there was this. Recognition of of disordered eating you were aware of it but you just kept over directing and you're you're kind of ping pong all over the place Yeah it's it's just black and white thinking. That that I suffered with it was like, okay I've got to be perfect or I'm just going to be really bad. It's like there is no middle road or I've gotta fix everything in one day. You know. So like tomorrow I'm going to change everything I'm going to be like a butterfly leaving the cocoon something like that but just had this really faulty. understanding of what it takes to change. Yeah and yeah, you mentioned one of those examples which stuck with me after reading website was if you. May missed if you if you ate a little bit too much one day, you would then completely turn the wheel the other way and you'd eat nothing or you'd you'd you'd intermittent fast sometimes for as you said or no you you started counting everything you know you gotta you gotTa scale for Christmas and you were just counting everything Mac rose and putting putting everything on the Scale and Ping Pong and nothing was really working. What do you think drove that? What was the origin of that? Because I think that helps a lot of clinicians people who know people with this ordered eating or people who are treating them are people who might have it what do you think the origins were? No you can only speak to yourself. What do you think it was? You know the origins were minnows twenty or twenty one which is a really vulnerable time. Yes. That's what a lot of these behaviors emerge that seventeen early twenties of whatever it may be. Sometimes, it's because it was sport. And that's dependent. That was not my case I think for me it was. social isolation one and have any friends at the time insecurity didn't know where it was going. Lack of attention. I think it was just a confluence of factors I didn't feel like it was really good anything but then identified this and I thought I can do that like I can be leaner fitter and healthier than anybody else. So what was the? What was the moment when you finally realize? Hey, this is this is something I. I'm not solving well. And then would you do about it when she wants you realize Jim you said, it was about ten years. That's a long time. That's that's a lot of heartache and you mentioned this in your course if someone's. Living with this and going through this, that's a Lotta heartache, an effort and pain. You know psychological emotional physical pain that you're going through. So what really said Hey I do I need to do something Monumental canvas keep keep going over correcting. And then would you do about it? At first I didn't think I was doing anything wrong. That's what's kind of ironic about it. So in my early twenties even my mid twenties I thought I was doing the right thing now it's just seems so bizarre like four or five days Yeah. What do you what they can get out of it but I mean, that was just my my state of mind no, it didn't really change until I was in my. my professional career. And I knew that whatever had been trying ill, I just try again just try harder. You know just you know switch this order be stronger next time. You know that that kind of protests like how many times does this have to fail for? He realized that that's not the solution I don't have to change everything in one go when I just focus on the here. Now realize that I, have everything everything I need to fix this I have all the willpower them ever going to have if it's not now when is it and that was that was a tough realization for me because I couldn't delay that change anymore couldn't just say oh tomorrow that's very comforting. But I realized that no force or no change in my circumstances was ever who went to change it. I was at change I know that sounds kind of like no blue, but it was true I had all the tools and resources that I needed to make those changes and I just have a Septa the wasn't doing it, but I had to do it. Was it was it externally? Who helped you see that? Was it just an evolution in you being able to see that yourself? Sometimes. You can hear the same thing, hundred times and sometimes the hundred and first time it's just like, oh it you know the light bulb comes on or what was it for you for people who might be listening who might be identifying with this or might know someone who's identifying with something similar are there? That's why it took. So long because I didn't have that external voice nobody knew about it Tony Buddy. Yeah I just Kinda like dealing with on my own I've got to figure this out and. Had I had that. Nut Voice or that mentor somebody to. To show me what to do then. I mean I could have overcome this merrily twentieth forgotten about it and. And then I would have just moved on with my life. That's part of the reason why I do this doesn't take this long right wrong. You don't need the waste time doing it. Yeah. You explain in the video on your your website that took you ten years to learn some of these lessons that you share with people. and just to just to Orient People, you have a thirteen week right three month course that you people go through and you kind of walk them through and you say it took me ten years to learn these lessons I'm GonNa share it with you and we're going to go through this in three months. So what works and what doesn't. That's what I wanted to give people the recieve our audience pretty much primarily physical therapists, physical therapists, assistance, and students. What are the things that we should be doing as healthcare practitioners? We recognize some of these disordered eating behaviors in our patients and what works and what doesn't. What doesn't work is? Thinking that you're GonNa Change Everything one day. And that's Kinda like. You're rolling the dice are playing. The lottery is like on this day everything will change, and then you get to that day and you're still the same person. And nothing has changed or you have a change in your background and you're still the same person your habits tend to follow you. Wherever you go. You have to be an active participant in this and a lot of that resistance comes from that idea that if you think you have to overhaul your entire life and in one day, you're going to experience lot assistance because that's that's a tall order. To change everything and one day. Well, I think just wait another one or two months that definitely doesn't work. So I think. If we're teaching change than why don't we focus on the small changes that you can make you know what's what's one thing you can do today that would move the needle a little bit. Can you do that? Great let's start there. Yet. Jamie, just change change disordered eating into mobility or strength or stamina and you aim for the behavioral change. That's where the real change happens and no. You would never have someone you. You would never actually think that that was going to happen overnight right in I I heard i. Forget where I heard this I think it was impeached PT school which was hey, if it took ten years to get to where you are right now do you honestly think it will change in one overnight or one week or one month like it took ten years to get here so we're gonNA take some time. I mean not ten years to to work our way out of this but let's not be naive and say we're going to change things overnight. She's not it's not sustainable or think about what it takes to become a physician. For using diversity for years medical, and then who knows how long residency is GONNA BE? It depends on which route you take or it's Kinda like, what's that joke new? The overnight success was ten years in the making. You only see that. Across the finish line of see the other one, hundred and forty point six. You know that's behind those. Wow overnight success or not really. Yeah. Yeah. All those all those overnights I let off a great radio interview with with a band from Australia once, and they had been kind of knocking around the minor leagues and finally had a breakthrough hit and I started off by saying overnight success and I watched it was doing it on purpose because I had a pretty good report, the lead singer. And my first question was exactly that which is how many overnights do you think it took before you had that overnight success and he he was as I've been working since I was sixteen. He was probably in his thirty s right there and he's like, but I loved what I was doing. But in he's he's like I realized I needed to have. A bunch of micro changes to have a macro breakthrough and that always stuck with me is something to pay attention to So behavior change is definitely something, but that's in our scope physical therapists might be thinking disordered eating. We never really studied that Patrick Berner on the show who's a registered Dietitian and a physical therapist kind of that dual hat. why should physical therapist really pay attention to those who were suffering from disordered eating or any of those eating disorders that you mentioned i? Think I know a pretty good couple of answers but I'm pretty sure you. You got more meat. No, or we have to consider the whole patient because this isn't just physiological issue. It's a mental health issue fact I would say it's more mental health than it is physiological it's to mental health issue with physiological symptoms. Or physiological manifestations. and. If we're going to be the the go-to healthcare provider, then we need to understand these these issues you know we have to go beyond muscles and joints and consider the whole patient. Yeah. When I when I started doing my clinical rotations I remember I thought man I'm going to get in there and I'm just gonNA show those patients exactly all the things I know. Realized really quickly was that patient education. And what you're not saying. When you're listening was actually where I saw the most light bulb moments and I remember just thinking like what we just went to school for a year and a half two years before get our first clinical rotation and what? I'm actually saying the most change on his. The thing that the thing that we should be really really good at as humans, which is asking questions listening to the answers being thoughtful about our responses repeat not discounting clinical knowledge at all but that's where a lot of a lot of the magic happens. questioned from somebody out there watching live cookies bringing up this nutritionist Dietitian or psychologist in your program how much of that of the information that you share? Came from outside sources, you mentioned not having an outside source in your in your story How much of that do you do you bring into either your program or your clinical practice? How much of the? Information on like like research or like I'm sure you know you read it and stuff and you know you're you're you're drawing from personal experience like yours Ori but there's gotta be some more of that I'm sure you're you're you're rooted evidence as well. Yeah. Just, as it does clamor, I'm not a day Titian a trade. So I have to wait I have to stay within might lane correct so I can teach basic principles of healthy eating but if they have really they have something specific to their condition then I have to refer out Now. That is the honestly legal thing to do. And, what thing I would like to do is start making alliances with other Dietitians. That can provide more specific advice for these people because some of them do and sometimes reach a limit to what I can provide. Just. Sounds like building really good network knowing who the go-to people are in your neighborhood. Yeah. It's like the a PT and understanding when to refer out now does it what else is person? For example, if I had a patient I and they had some pelvic pain. And I'm going to contact the person might never understands pelvic pain say, Hey, this is a provider. She really knows what she's doing. Why don't you go see her? Yeah, it's going to get the patient to where they wanna be more efficiently exactly I mean that's yeah. That's a skilled intervention right connecting this patient with the resources that she needs to get the proper care. Yeah. So what what do you do in terms of talking to Tricia with patients nutrition is within our scope of practice you have to buy by again I'll just throw this out there to SCO, practice varies by state. So make sure you know what your state practice actors, but you should know that because you're good licensed physical therapist no matter where you are. So. Talking to Tricia will with patients Why is that important as a physical therapist? No matter who you're working with whether they have whether they're suffering from disordered eating or not. If they're not. Properly they're not going to get the results, right so their results in your results, you want happy customers and you unhealthy customer, our patients have everyone to call it. But sometimes I get questions like what should I do about? You know the weight loss are I don't like for example, the other day I got a question I don't like insure alternatives. You know like my mother's losing weight what can we do to stimulate right? And we can certainly address those. But like I said, if it gets really specific, now you need to refer to the other members of the healthcare team. But like you said, that's that's something we need to talk about more wishy. Emphasize it more in the in the DVD curriculum, right? Well. That's while we have podcasts Kevin so we can. We've got, we've skipped past because there is a lot of information through in two to three years whatever we're doing love that you're out there doing this love that you're making making a point of being that that second person in the room for people who are disorder might be living through disordered eating but you turn this into something else outside of just your practice you turn this into I Louis earlier, which was like an. Online course. So let's start with. They're like, why is it? Why is it important to have an online side business? Why? Why did you do this and then what goes into creating one? You know what? What, what made you get up with one back I'm going to create a course for people that I know our journey or should be on a journey that I've gone through, and then then we'll talk about how to how to actually do that. Originally did not want to do this because I didn't WANNA share my story I just one. was going to be a PT It wasn't GonNa do this but then you're you begrudgingly brought into it. I really did and you know when I when I graduated the certainly was not. My intention but I knew almost as soon as I've password attempts like five years now. That I want I didn't want to just be staff e T. I wanted to go above me I wanted to be entrepreneur I wanted to make a good living doing this I wanted to take some risks and that's what I'm doing. But the problem was his first year and a half in the field stint. What Sharon what? What am I going to do? What am I gonNa provides like yeah, you can want to be for nobody you have to solve a problem. Now that seems so obvious. It was steering me in the face like this is your problem in go solve it, and then show others how they can do the same. So I. Knew I wanted to be the entrepreneur, but then it was like what? Then I found this and it's like okay but then how and I'm still and that's But three years ago I didn't know how to get customers. I. Knew How to get any traction I didn't know anything about Youtube didn't know didn't know anything about anything. So it's kind of like going to school so yeah, I want to do this but there are some skills that needs to be learned. On the way. Like you started from the right spot though which is what problem am I going to solve and you did that. So it's your it's an empowered eating course We'll get link. Lincoln, the show notes. Emma. Lincoln. The comments right there but we'll bring up on the screen and it really if you go through this website, what you're really doing is over and over and over again well, first off, you tell your story in this video right there if you'll take it up. And you really just. What I think you're doing is you're highlighting in different ways over and over and over again multiple. Times. The things the narratives that people are thinking or might be thinking or you probably put yourself in your shoes when you were seventeen eighteen, nineteen, twenty taking like things like this. How did I get to this point? What happened if you're and to yourself ask why do you sleep what if I'm decimal this way forever, and what you're doing is you're showing people with words multiple times over and over and over again. That if you're here. You want to be somewhere else which is not here not living like this. I am the path because I've done it before and you position yourself. We've talked about this before you position yourself more like Yoda unless like Luke skywalker like yes it's great that Kevin has the story that went through this journey. But if if you made your website if you made your youtube videos all about Kevin and how great I. Am I be like that's cool for you about an hour I fit in and I feel like your website with your empowered eating system. you highlighted a lot like, I'm iota done it. I understand where you are I can help you but you've got to do all the heavy lifting. I can just show you how. Exactly, but it doesn't that's that's a whole power of stories. Like this is my story and then I tell it so that not because I'm proud at in anyway or not I, just want to air dirty laundry. No, I do it so that people can read it. maybe it speaks to them. Sure. Speed is it's gotta speak to them like okay. I you you understand me it's like whenever you're about a problem people were kind of looking at like I. Don't really understand that you're like, okay. Well, you can't help me solve if you don't even understand it. which you have to show that authority like, yes not only do I understand what you're going through I've gone through it and I can walk I can help you walk this journey yourself. So put together a program like this you however the problem it doesn't have to be disordered eating for someone for physical therapist listening or watching this. Once, you've highlighted that problem you you WanNa you WanNa cycle pain free You know you WANNA be able to run faster without pay whatever what's the next step actually putting that class together yours is is thirteen weeks but there there are courses of of different lengths where you start. I would start with offering audience before you even build something like this. I, mean, keep in mind that the page you're looking at has been three and a half years in the making sure right when it first started there's no way I could have written that you know and finding the resources necessary to build that come up with an offer Cetera, status of figure out and you can do this now. Says Okay who what problem solving who am I saw him in at four. And then go into your own journey maybe it's not your own personal journey but let's say emission cycling without pain. Maybe help cyclists overcomes fan even though you haven't had it yourself that maybe you're gotten them that result and maybe you're really into cycling you know it's like, let me tell you a story about know Bob and he couldn't ride his bike anymore and to help them that sort of thing right. So who who is your target audience here and then what's your offer I mean? That's Like ninety percent of business and then everything else which is connecting. Yes delve too. Yeah. Yeah I mean we've talked. We've we've we've used this paradigm before on this and I use a lot of different parts of my life, which is what do you do? How's it going to make my life better? What do I need you to get it? If if your audience not you, you need to be able to answer those very clearly. But if your audience after interacting with you or your materials cannot answer those questions very clearly you're doing something wrong. It's never the audience is fall and me looking at your website for five minutes I was like, got it. Sensors all the questions I know what he does. I know exactly how it's GonNa make my life better. If this speaks to me I, know exactly what I needed to to get it. So I thought that was really good example Why should other physical therapists? Why is it important to have an online business or a side hustle? Entrepreneurial and I see a lot I mean I feel like every day physical therapist or branching out and doing things that they were not doing three five seven years wise that getting. Why is it important now I feel like getting even more important. I mean look at the. The. Economic situation were now. We were. Recession proof. A industry. Just. A year ago Yanner nobody saw this was like Bam you know the and outpatient clinics had the close it put surgeries on hold and. Not A it was just a massive disruption human even even our our industry and. My heart goes out to the ones graduating now. I mean I'm sure everything will come back but. This is why may not that's the answer right I mean you have to be a little more entrepreneurial now you can't just be the staff pt who shows up five days a week right? Because paycheck that is more rewarding you're gonNA have is it wouldn't it be nice to have a second stream of income? You know in case something like this happens and so it's just more security more fulfilling right and it's going to lead to a more dynamic career. You'RE NOT GONNA burn out seeing twenty patients a day. So is this completely automated this thirteen week course or they get in time with you know that's a question that comes up a lot there because there are some online courses can be completely video you can record and they're complete automated, and as soon as they go into week one everything just is is stepwise yours work. there. It's a combination. So it's my chorus plus person's action. Which I think is a lot more powerful at. The. Cost of information is basically zero. You May. You can google it or not you can find it. Yeah. You can go to. What is it? You Demi and buy courses for ten or fifteen dollars I think what people are paying more for these days. Is Experiences and in connection. Instead of just the information I don't want people to just consume a bunch of modules I want them to work with me. I want to take them personally through that journey. Yeah, and you're also dealing with something really personal with their which if someone is reading that webpage again and they're saying I, relate with this and your journey you highlight. Was Ten years. If they're seeing that they want a personal connection, they want to know yet but what do I do when? I get stuck on this and I can't figure it out because I've already gotten here because I've already ping pong around and I've done diets I've done this or that. So I think you had an personal touch again, this kind of goes parallel with television. right now, which is there's that personal touch it's not just video. Yes. You can go to youtube and look for a bunch of videos you can. You can find things online the cost of information is. At an all time low and getting lower but that personal touch and that's where I think physical therapists can release succeed him and make a difference. So Love your story, love the fact that you're sharing it. Thank you for doing this. I, think the people that you interact with get a lot out of it would would love to have you back on the show and maybe talk some more about this book before you got play three questions. Are you ready for three questions? Sure. One way to find out three questions. All right three questions. Brought to you by our friends at Arias medical staffing you are. US medical. Dot. com. Leaders in travel physical therapy. If you're thinking about moving the country we have clinical rotations can where you located geographically relive. Central California Modesto, which you went to school. Saint Augustine which which campus you got you. The original one Florida. Rough life. But if you could go anywhere in the country and it's almost like travel pt is paid clinical rotations, you get to pick where you WANNA go setting geographic location where would you go if you go anywhere in the country for just a couple of months and do whatever you want I know it sounds crazy but North Dakota. Yeah. Why not? Just totally like wide open big sky totally new totally different climate. Just isolated I could totally do it for to hack your career. You can do it like, Hey, three months paid to do it. I don't know sounds like a vacation to me I know they've always they've always had this rotation my not just never. I just done it. One of the first ones that they presentiment I. Think it was artists in fact that presented that to me. One might not yeah. Second question is a way. A. What question? What is something you have watched or read or listened to book movie podcast something that you think the audience. Could get value. From. If the in by Kelly macgonagall. She's a Stanford psychologist just she might have a talk. I'm not sure but she's written. Several books on human psychology. So anything by her just read it out the more stuff I dive in psychology the more just like, wow like i. kind of liked psychology when I was like you know an eighteen year old undergrad. And then I don't know what? The more you know grew up listening to read some Adam grant stuff and like you know the Seth Godin Simon cynics a lot like business why psychology wire people driven this way it's just really interesting. It's all rooted in Psych Insi- Collagen in two months. It's really really interesting. So I like when people bring that stuff up. Last question is a WHO question we start now with people who is someone the audience should know more about. I. Guess I just blew my second question. Well Jaakko I mean, he's kind of common mini of everybody. Kind of knows him I mean maybe they don't but. Yeah Daca Willem Yeah, Daniel Lieberman isn't a psychologists he's over there at Harvard. I think you'll. As you enter this profession, you'll learn a psychology is really important. Yeah. Is that it's not just a MP. Believe, one prewar recommended fermented for most schools to get in I. Think I you know I was like intro to psych i. feel like if I were to change something a lot of people want to have more business classes in PT school amount against that Man I. Think Psychology is definitely we should look into as well. Yeah totally. Yeah pick patient patient provider connection. Big thing you can do whole three or four hundred class on that. Kevin appreciate your time. We'll make sure we we share the link in the show notes. For. The audio this as well appreciate your time lasting would you on the show is the parting shot? Party shot is brought to you by the Academy of Orthopedic Physical Therapy. Find them online Ortho PT Dot Org. You'RE GONNA level up your orthopedic game deal with the Academy of Orthopedic. Physical therapy. We've got some courses coming from them. They're contests coming out. They've got tissue tolerance, which is new. That's getting rid the micro level and they've got the running athlete macro level. All things orthopedic finally again online again at Ortho P. T. dot org parting shots is your last chance for a mic drop moment. What's the last thing? You WanNa leave with the audience as we wrap up right now? There's something that you want to change your life changing today start the process and then be patient. I'd like it shortens the point man micro changes for macro breakthrough while I'm gonNA stick through. Kevin appreciate your time. Thanks for sharing and we'll talk again soon then that you've. Pine cast yes. Yes. The port the show by telling a friend or by leaving a review. Or Google play shooter day brought to you by the Brooks Institute of higher learning an innovator in providing advanced post Professional Education Brooks IHL offering continuing education courses in numerous specialty areas six PT, residency programs and Fellowship as well as challenging but rewarding internships, the I H L specializes translation of information from evidence to patient management learn what they can do for you to support your professional development at Brooks Ihl dot. Org. Our home on the Internet. T- cast dot com created by build. Build. PT Provides Marketing Services specifically for private practice PD's website development host inviting content marketing solutions PT clinics across the country with good pt can do for you today build. Dot Com. The PT PODCAST is a product of PT Podcast LLC. It's poured fresh by physical therapist Jimmy Mackay. Ingredients are sourced by our chief connections, officer Sky Donovan from Marymount University. 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There is a Serious Problem with Diversity in Physical Therapy  Mark Milligan

PT Pintcast - Physical Therapy

57:18 min | 9 months ago

There is a Serious Problem with Diversity in Physical Therapy Mark Milligan

"Hey before we get started i. just wanted to say thanks to our longtime sponsors are es medical staffing helping you physical therapists or physical therapist? Assistants find jobs all over this country with position. All settings in all fifty states. Find out what they have for you at a U.. R. US MEDICAL DOT COM. That is a U.. R. E.. US MEDICAL DOT com. Follow US online at PT Podcast and subscribe on I tunes, spotify or Google podcasts. Yeah! It's it's awesome. All right, what's up? PT Nation Walk into PT Podcast podcast that saves physical therapists like you. For missing out on amazing insight, remarkable ideas and motivational stories in the world of physical therapy I'm Jim McKay your host. We are broadcasting live from the medical studios also known as my bedroom. Find them at a you are a US medical dot, com leaders and travel physical therapy. If you are looking to do what you WanNa, do it should be a great therapist somewhere in the fifty United States all different settings. They've got positions for us. Check out. You are US medical dot com, great show for its doing double shows back to back first up. We got a great guest. WHO's going to be talking about well? My presentation gave it CSM it was so great that I had several people reach out and say you need him to talk about this some more, so we're going to get into that about diversity equity, inclusion and kind of the science behind how we looked into his own community, so we're going to dig into that. Let's hear from you. Comment questions below. If you're watching a live video cast by facebook or twitter feel for interact. Let us know where you at where you were you watching from. Drop in there and say hi went up. We'll say hi back. It'll be hysterical and then the challenge I've been doing I've been getting these random text messages because I've literally just been giving away my phone number and people like that's probably Google number. It's not as actual number. challenged me. That's my actual phone number, so if you've got something, you deserves to be on the show. feel free text me. That's my number there. It'll start digging like crazy as we did in the last show, so that's pretty cool so Let's get today. Show on the road our guest today physical therapists usually out of Austin Texas. He's looking to revolutionize his profession through technology empathy connection love. And doughnuts. Let's bring in Mark Milligan. Doughnuts. To get the doughnuts in there. Jomon, Thank you very much. It's an awesome, and I appreciate being here in finally getting connect with you. Live by your show, even killing. This was one thing, my my My professor before professor skied on of information was like. Did you see mark? Millions thing at CSM and I was like no, and she's like you've had him on the show before. It was like yeah, and I was like. Heaven I 'cause, I talked a million times, and I was like Oh shoot I don't think I've had him on the show. So glad you on here. first question's always the hardest. We get this out of the way I. So because I am normally in Austin Texas, but my family and I are decide the physically distance on a small island in Florida for a month. Really had the go. Thank you, thank you, it's amazing. I recommend it. I had to go with a local. This is a key billy in. It's a it a with key lime juice right inside Nan going very goal like that super hyper local, and it's a delicious Nice I. Haven't in a glass. Nice Amber, nice color to it Yeah, so that's what I'm drinking so not too hard enough. I'm make full screen. I'm doing local to living in upstate New York poughkeepsie new. York, this is mill house brewing. I liked the name just when you want a beer when you're just gonNA. Get our tropical. In our official pizza pine class so cheers, do you mark milling? Cheers cheers. Tears. Golo head on that one. Marash For Recovery Science single source for looking for certification, personalized blood flow, restriction, required station, training and the equipment you need to properly apply. In clinical practice, a lot of knockoffs out there Johnny McCain these guys are involved in the research and education in the implementation. Check them out that number text sky there to Owens recovery science. Dot Com Let's get mark socials on the screen. If you want to follow along on how you can find him, so check instagram twitter there as well. You're Kinda. I want to start with this. You're kind of like the CSM. No strings Domus this past year. Sandwich was in February, which also feels like a year and a half ago, but somehow it's only several months ago, but you from presentations at CSM right to write. Found to one was telehealth how to leverage. For more than just treatment. We had to adopt that just a little bit. On was better together in diversity, equity and inclusion transforming society through equitable policies man. If you didn't pick two topics February of twenty twenty, that would literally be pushed to the forefront by a among like less than a month later, those were two topics, and you did presentations on both of those things in Denver Wow. Yeah? Yeah, it's I've gotTA. Say Yes, and. The the telehealth stuff I've been rolling for a few years always paying attention until four months ago. And the I that was. That was a culmination of not me like I just happened to be a part of a group of dog Magnusson. And I'm GonNa Robert in the there was like sixteen people on the I, and just because of our conversations on twitter on social media that I happen to just be included in that it was an on. It was a pleasure and an honor to be a part of the people in the group that. I think we had four or five presentations over the course of two or three days to to try to make an impact on the I in in fiscal therapy so It was not me at by any means I was just a part of an amazing crew that that brought the fire so It was a pleasure, but you are right like. Those two topics could not be more poignant in our profession than they are right now. Maybe address. Right I love when people say well, this is an overnight success. You really you. You picked up on that in February, but as you mentioned discount, these are conversations that were had happening, but needed to be happening more, and that's why we like when those things pop up, see them and you want to. Totally we I mean I've I've lectured on telehealth at a opt. At CSM for multiple state, practices state organizations over the course of the last few years in the conversations. We've been putting those presentations together for a year I. Mean they the backstory on putting together semi? You know CSM presentations there do. Two months after CSM style in right, so they're do by if CSM is in, you know in February like dude. Wait. What was the extent more share? They're doing April or March and April so like you have to plan the stuff out, so I think that the. The rumblings in the bubbling have been there for a long time, and the voices just came together at the at the right time to to make it no so. I mean to be honest like it's a shame that it's taken this long for those type of topics to be at a national conference like it's. We have to step it up. That we want to start was I remember I heard several people walk out of your part of your presentation and say wow. This is a conversation so sometimes. It's not that the topic hasn't been presented. It hasn't been presented either enough right, so you would go back to like my communications background frequency. Assault exercise, prescription, right frequency and intensity, time and so frequency. We talked about it a few times. It didn't land. Would you ever tell your kids to clean their room wants no of course not gonNA. Keep repeating that over and over again so increase. Its. Intensity. Someone who who hits the right message at the right time in the right way. That's really like a good fit principle. If you WANNA see a parallel so you really highlighted it by giving an example in your own home city of also in Texas and you said listen, I'm going to give you real. Practical tactical examples of this, not just saying there's a problem out here in the country which is kind of in the ether, you really line things up in your town and giving specifics, examples of roads and railways like things separating arts of towns. Educate US I think this is. So. In our discovery topics for the speaking on D. I in Denver we we as a group, Eka and dawn. Robert I kind of took on different levels in ways that that said like inherent segregation and racism occurred in our cities and so. Often in the south right I grew up I was like full transparency I was born in Louis I was born in Texas. My Dad was military grew up in Louisiana. Right spent most of my formative years in the deep south got to Colorado by way of. Needing to get out of the south, and then back to Texas right, and so it's been kind of journey of growing up in deep deep southern, ingrained way of like segment, segregation, racism, right, and so getting out and going back in and seeing what it looks like seeing what it doesn't look like. It it opens your eyes right. Because when you're in it, you may not see it. So in this discovery process of our talk for CSM. I've doing research on Austin. It became obvious that Austin had significant. A significant pass in segregation Simic oppression and divisive and And inherently racist policy in so I wanted to bring that to the topic because I think so many people came up to me after this topic, assimilate said Look I look. I'm doing this research in my city. I'm I'm looking at where I live, and seeing the same thing, and so I looked into red lining, which is a in the. In that term originally was about loans for home mortgages. Right it was redlining. They would put districts around highly. I guess highly risky areas that were racially diverse, and so the loans would not be made to those racially diverse areas, so if it was a red line district, you're less likely or impossible to get funded in home, equity loan or some type of loan for property. So. Looking back at Austin. I was like you know what this is clear that these districts are still present like living there in I ride my bike, a ton I ride my bike all around Austin. So seeing in writing neighbors notice differences where sidewalks are. where safe of bike paths are where you know those are, they're not. And so looking at just it really struck home. Like what does it look like today? Because of these policies that were put in place since eight eighteen hundreds around slavery, and how does it look like today? And so I I I there was a great paper and I can. We can send this out to the listeners we can link to it. That looked at the red lining districts, and then looked at income and looked at population kind of diversity over time in Austin and it became very obvious that these redline districts were still an issue both financially. And access, not only healthcare, but two grocery stores physical therapy in other. Just normal things that other people in other races and other. Economic of echelons don't think about right and. The things that you're talking about Mark I. Just want to sum up where. They're they're? They're in plain sight, right? They're hiding in plain sight, so they're very obvious. If you know what you're looking at, and you did, but they're also rooted because you're saying. These policies have been in place for so long, and they're right there. In a lot of us are looking right at it and say it's even everything's equals equitable. It's not and the policies. I can't stress enough for people and TT's in their communities to look back at policies that were drawn and written early on. Look at. Economic diversity within racial diversity within your communities and look where the lines are drawn right in Louisiana. Louisiana in a lot of the south railroad tracks that made the difference between neighborhoods and adequate cliche. Right the other side of the tracks. I mean I know early Cliche I never knew it, and which is something we said it's so painful, but it's true and in Austin it. Was I thirty five, the major interstate divided? Between. Where the where the policies made for very inhabitable, uninhabitable and not very nice situations to the nice situation right. And the the the east side by thirty five. That was the red line district. The West side was not. The east side was where policies were drawn in the crazy thing is is that it was written by like twelve or thirteen people? In the in the early eighteen late eighteen hundreds early nineteen hundreds into the mid nineteen hundreds like twelve or thirteen people were deciding the fate of tens of thousands of people because of their own racial issues, right. And so when you look at how it brought forward, you can look at the map and look at population density. You can look at The the the population race in in all of the demographics, and it just continues through generations or decade after decade, and then you overlay maps which I did for see him of grocery stores, right? There's a Austin started. A whole foods started Austin right whole foods. Would be considered. You know other people call it whole paycheck, but like. I mean it is what it is, but like there's four five whole foods on the west side of I thirty five zero on the east side right? There's one grocery store that's major. That has a as an ethnic name on the east side of Austin. There's a few gyms right there zero. PT Clinics. And so like as it pulls forward, the repercussions of the decision, making and the policy Choices compared to generation after generation. Right and on the east side there's less sidewalks streetlights. It's less safe like you're more likely to die on the east side Boston life expectancy changes, and I think that was one of the things that brought it home less than a half a mile apart. You can have a ten year difference in life expectancy. Wow in one city. I. Mean You talk? You talk about street lights and sidewalks. Talk about food. You Food and we've had this conversation before which is. I feel like I learned the term food desert. And I had no idea what the heck that will never really grew up in an area where there weren't supermarkets within five ten minutes and then Patrick. Berner, who's a registered Dietitian and a physical therapy? Food swamp and I was like what's food swamp? He's like well, so that means like you have outlets to get food, but that food is at lower call is typically like a convenience store or gas station. So yes, you're eating, but what's second, do to your quality of life. What's that GonNa? Do to your healthcare costs over time in your safety and your and your life expectancy all those things. I think one of the most telling things and I saw the statistic a few years ago is the. You know when when people when they put calories on the news, right? What was that like five years ago six years ago? Everybody thought that people were gonNA make better decisions. Right they're gonNA. Look at the menu and say Oh. Wow, that has that many calories I'm gonNA. Buy this right. There was actually one study that demonstrated that the exact opposite occurred in lower. lower socioeconomic. Communities where they needed in. They knew they needed to buy the most calories for the least amount of money. while. They need to feed their family. Right and I think if you look I don't. This quote me if I'd like, please. Fact. Check me on this, but I think that the most calories per dollar. In this country in the world are of McDonalds. McDonalds McDonnell cheeseburger on their menu for dollar. It's like three hundred ninety calories for one dollar. You cannot get. You can't get more calories than any other food source than that one Burger Brian so families were ordering. The most amount of calories for the least amount of money, so they could feed their family. Say Look. You're this in your community. In Austin, Texas and you realize that these barriers exists and the second part of the graphic on the screen. Really it even if you don't think so rights, we're talking about this a lot. which is like I understand. If you don't believe in a virus, science doesn't care. That's very relevant. I don't care if you don't believe in science. Science happens regardless so this is the pair of systemic barriers exist even if you don't. Don't think so, and you're highland those examples all around town any other that come to mind from your talk or any that you heard from other people after people heard your message so I think there was Warren PhD student from Baltimore who was doing research in Baltimore another student from Oklahoma City. He would mention that he was looking into this in his city like I. think that I mean your point. Systemic barriers exist even if you don't think so. I think that speaks more to the blinders that we have on his professional. Like I think that. We really need to communicate to providers in a way that they. Understand that these things exist in it's it's not so. This is a tricky topic. Right because if you try to communicate to somebody that something exists that they don't want to acknowledge. It's probably because they feel guilty about it. They don't WanNa. See it right. So, how do you as a provider who may be white may be effluent. Who may not have issues that you know about? How do you acknowledged them without? Will first of all just knowledge him without feeling guilty right because a lot of people. When you tell them or ask them and say look, this is happening. You have to see it in admitted. There's there's a part of that person that feels guilty about it. You're right and I think that that's one of the biggest barriers we have to get over is that? Right like if you didn't know about something or something is occurring in, it's brought to your attention. You shouldn't get defensive about it right and that is you see right away as well. I didn't do this this me. My problem. I one that I saw. It really was privileged. which it as a communications marketing guy, I'm not saying I would have just switched the name right because you mentioned. You're on a cyclist. And I heard this was someone else's analogy, which put it really good perspective about walked away. I was like well. That makes sense. It's not saying that you is as a white person or someone who is economically advantaged. You'd have didn't have wind at your back. That's not what we're saying. We're things you didn't have wind in your face. That's all. Right that's it and as soon as I heard, that was like Oh, I can picture what it's like Iran with my face, and what am I back and no wins and I understand what you're saying. Totally and then I would also further that that you started halfway through the right. Right! Yes, also valid. Where just start? Right exactly so you may have. Both parties may have one in their face, but you started sixty miles ahead right? I think that is where privilege comes in right, and so understanding the fact that. Even if It's hard to put in there, so many I love some of the videos that are out there on perspective. There's one video of a person who's doing a. they're doing running ranks right like a hundred yard dash, and then he's like you know. Everybody starts on the same line, and then he's like if everybody had two parents in the homes, take a step forward or take ten steps word you know if every, whoever had you know? Food on the table every night. Take two steps for puts it in a place where it allows you to understand that. It's not your fault for having advantage right, but it is something that you have to acknowledge where other people don't in. That's where the chasm is. That's where we have to step in and say look we need to. We need to get people on the same starting line. With the same bike, same pair of shoes, same wind. Same Wind. And let's ride together. Because? That's people aren't writing together. We can do cycling analogy all day. People are not writing together. There's people that are in the League group. There's people that are. In the back group, and that's not in. That's not ok on any level especially on the PT Right. Oh Jimmy like there's this. This has such implications, not only for us as a profession. But also as practitioners in our patients. Right because. Like we have biases that show up right we have. I mean all of the programming that we have from our parents or grandparents. Right like because how we are raised in the information in the in the knowledge that were given shape our beliefs as adults. Jerk might agree on that right. And so like how you? Are Programmed in what you see. Show up in patient care. In those biases, not racism that sexism, all of that shows up in your professional life. And I'm really one of the biggest messages I'm trying to put out there is that PT's need to recognize their own biases. They need to dive into what they do in. One of my favorite examples, I. Mean you treated in the clinic, right? We all. Do we all do we all did? Like when somebody comes in. You, have that favorite patient. You have that patients like all Wait till you know Jimmy comes in on Monday. Dude. He's also He's schedule. We're gonNA talk about cycling. He's dope. He's got a bad ass podcast like he's. He's awesome. Right in the also have the patient. You're like both. Kate believed like frank is coming in. He's so frustrating. He's not like all he does. Is Talk about this stuffy so like? We think those things. But what does it look like in clinical practice? You'RE GONNA get a lot more to it. Let's say you show up at the same time Bryant. Who's going to get attention? is a Jimmy. WHO's awesome. Who has topic to talk about engaging or is a frank? You were going to get a better level of care. Like how? That happens across person race creed color like that. We have to acknowledge that we. Even though we may not see it, or we may have our own blinders on. We treat people differently in the clinic. And after a decade clinic I've seen it and I see the bias. The blinders that providers put on like I don't I I treat everybody the same. High Challenge people to. Really, question is or not, they treat. Everybody notes so that goes into the second part. Even if you don't think so, so I guess like you know. What did they say? You can't fix the problem unless you I identify and actually admit. I've. And that's I think a lot of people are doing that I. Hope they are I. Know I've been doing over the last few months. Either on this show were trying to make a concerted effort to say like. Hey, maybe maybe just as guilty of this as anybody else, and we have a large stage that makes it worse if we're multiplying the problem. A, lot of people that I. Know Myself included are having difficult conversations with people around us. And even not remaining silent sometimes is all right I'm I'm going to be the person to bring this up. I'm going to call the out and trying to do that carefully, but also. Make? Sure you don't gloss over. And say I know it's going to be uncomfortable. Conversation I'M GONNA. Ask you this. I'M GONNA I'M GONNA I'M GONNA. Say a few things that you might not agree with but. Me Not saying them. Is Worse. Yeah complicity guilty is guilt. Right like you have to have. This is when we have to bring in our own. Emotional status in our own comfort level right like Lisa vanhoose slightly do Lisa like she needs to be a guest on if she hasn't been on your, she needs me a guest five times. Like you have to be comfortable. Being uncomfortable and it's in that goes back to my original statement. It doesn't make you guilty. People couple uncomfortable and confrontational conversations with guilt. It's it's couple from childhood. Because that's often how erased right? When you do something wrong, you're guilty, you're. There should be guilt. There's punishment. and. We've got a flip and get out of that mindset and understand that conversation between two people doesn't there doesn't have to be guilty party, right? There doesn't have to be, but there needs to be an understanding in the communication, right? We're both people can be heard. And offer information without getting defensive and feeling guilty, and like that's one of the biggest barriers I see in. This goes back to a conversation I. Have My my buddy. WHO's a doctor clinical psychology on the show every once in a while and he actually we went over shame versus Gill. Were your words I'm like well. They're the same and he's like nomination. So I think a lot of times. It's not even guilt I feel like a lot of times. It's shame and the difference there that Jamie repeat several times because I want you to know the difference these. Shame is I'm a bad person. Guilt is I. Did something wrong and I feel guilty about it? Shame is I am bad. I feel like some people are feeling shame, and that's deeper rooted and they're gonNa Ridge anything. You'RE GONNA say you've done this. They're going to go. I feel ashamed that I rejected. Because you're saying I'm a bad person or I'm feeling that what you're saying is I'm a bad person at the corps when the perse had actually just be saying. Hey, you might be doing something even if you don't think so. You might be doing it not bad on you, but you should recognize early. Perspective. Yeah! Shame I. Think is one of the. Fundamental like shadow feelings and emotions that people purposely or Unintentionally tag into in Thomas. Jersey, because we bad because Shane means, you're not part of the group Shane means you're ostracized showing means that you have willfully done something wrong. There's a deep shame shame. Shame and blame are two of the biggest things that we can look at. As a parent of eight and a half year old that that type of dynamic comes into play all the time. Right like how do you communicate to a child? Because most of the emotions that we deal with are born of our childhood dill. Dill. Like. A generational trauma like it carries through from us into our relationship I consider interesting when you look at relationship, some of the best reading in some of the best information gotten about myself in how I communicate is about relationships right in relationship doesn't have to mean intimate. Every communication every friendship is a relationship, so there's a fundamental people say oh, you're This isn't a relationship, right? There's a we've skewed the information from every interpersonal communication. We have as a relationship. In So, I think that we need to look at how we couple in relationship where the professionally or instantly and see how that plays out and I, think the guilt and the shame play into that and it's a part of. How we communicate Inter personally professionals and with patients so. I think it's a beautiful thing for us to differentiate between guilt and shame and understand that. You don't. You don't have to be responsible for other people's thoughts about you, but you do have to be responsible for your thoughts about yourself and we'll come back. Yeah, absolutely. That's the only I talk about in my talks. There's two things that you control once your spirit control right. You only have your controls you. What goes what comes, animal comes out. It's it. Only little thing on this planet. We have control over. Everything else is a circle of control right like the locus like to. We have to understand that other people's emotions other people's information. That's them. In so hopefully engage in a way that allows that interaction to be peaceable to be safe, because the sooner safety safety is another big word. Safety's off the table. When you don't feel safe conversation then you get defensive. Right in you go into protective mode shirt said. Shot? You're not listening fending beer animal brain your in your lizard brain right. You're in your. You can't. You can't process so like understanding the human brain how it works in how? Like, most people engage with when it comes to topics that are really sensitive. You, Can't change a lot of thought or lot of. Belief! Right as outsider. Like I, always go back to a conversation. I was having with somebody that was in a family circle, not directly family, but close family, and they were very very opinionated views. And? I tried to knock him out. I try to knock out the views. I I tried to get him to like what the F. Thinking, and then that work. Because then they become more robust in their dissension in then. You then I went to a. you know what that's cool. You can be you. I'll be me and then. I went to a like. You know what that's awesome I I appreciate that you feel that way you know here's another. Here's the more information you may want to know about. In wasn't until at final like embrace of them as a person, but still offering them information that there was any kind of resolution. Like you have to, you have to like. It's civil. Has a long play, but also I think Lisa vanhoose does this beautifully she liked. On twitter you can follow her on twitter, but on in conversation she embraces the the most vehemently opposed person with love. She's just like. You know what she always gives. The benefit of the doubt I'm going to get pissed, but like she's like you know what I love that person, but see if I can just educate them around it and he's telling you. That's a skill totally it's. Very learned skill. But it's also shows shows the depth of love that she has for herself in the love in the. When. You Love Yourself, ultimately, you don't have a defensiveness. Make sense like you don't have any need. Don't have any bearing on somewhat when your self worth in your love for yourself has no bearing on someone. Else's acceptance of you, then you can communicate on a level and if we could teach that in. Kindergarten elementary school, we'd have a you know. We have a great society because I mean. That's the root of a lot of issues. Right is insecurity and when you're not trying to win conversation, which by the way I'm I'm not sure. I've ever won conversation in my life. That's not that's not a conversation. Is Conversation supposed a relationship of information between two people, or you can't win a relationship of information? A scoreboard! Win A conversation right, but we all like to feel safe sure. And Safety is the key to winning a conversation Ryan. You feel you've heard. You can take this, too personal or professional whenever you don't feel, heard and feel like you have a valid piece of information. You don't feel safe and you feel like one writer. challenge everybody listening to this in you have a conversation trying to just accept in love the person across from you and just say Okay I. Hear You. See what happens? At the defensiveness comes down. They feel safe. They, don't have to defend themselves anymore and then. Defend Yourself. You can then engage opportunity for someone to learn what you're actually trying to say. Kerry Packer Liana, chiming in. About being uncomfortable, really just say it's more important now than ever to be uncomfortable. That is worthy changes coming from. She says she loves. Michelle I reached out a while ago. We'll get. The, I have skied out of and saying it's very. This is very important for us to cover in their curricula best ways to approach it. Do you put this a lot of different places? I'm guessing? kind of salt all over. Yeah, so I you know doing my own. This guy in a lot of personal stuff from me, so I went hard and heavy through PT School. Right aggressive of progressive as say people fix people getting ready right in residency writing aboard writing fellowship like I just hammered down right like I didn't. Not until I burned out that I really realized a the the Path was not about other people. It's about me in like what I need. Filled in me in, so if you look at PT's as a whole. Were Very. Giving! altruistic. ALTRUISTIC I would call it a actively attached person from the attachment. Standpoint right and in relationship communication. In that we need to be. We need to move away from that right like this. Having people discover because most of the graduating now go. You know grade school straighter gambling. You can graduate PT Twenty one twenty two. Younger if they were aggressive and like. I said here's a forty four year old man saying that I had no idea who I was at the twenty one year old. And I can honestly say that and some kids. Some people have figured out some people who they are, but I think that early discovery an in self work may be a place in PT, curriculum. Right like we need to look at you know what type of family you had your family of origin. What does that look like? Like what does that mean to you because I've. As, someone who had this is going to get really personal as someone. Who had you know? Dad Who is bipolar passed away in a mom who was trying to help him right like I learned how to be a helper I learn how to be a fixer. I like that's how I show got my love in. That's all I. got you know my? Love for my family was like. Kind of shape shifting doing what needed to do to do that. And that bled into patient care. Right I'll do anything for a patient. You only show early. I'll show up early. Like it shows up differently in your job than a dozen relationship. Accents Yelm because you feel valued and the only way unless you understand no, wholeheartedly that you or your own value, someone else will prey on that value. Businesses like that was wrong, so be behind him I. WHO's it? Put like that. I think that's a big deal is because if you don't understand what motivates you, what makes you feel in keeps you safe? That internal love for yourself. That external looking for love manifest itself in doing whatever you need to do for your job without any sat within sacrificing yourself. Right. It's I think that there's a tremendous opportunity in PT School for self discovery for looking into who you are as an individual. What motivates you? Early on in the curriculum. It's scary because that's some deep stuff. And like no, that's that's not easy and you know I was working for. Doing it, and even I was finding some stuff out about myself, but I thought I had locked up. You know I was I'm good at this and I'm I'm good when there's a lot going on and all sudden. Gone. Why are these kids over here? You know getting all emotional I'm like I'm ten years older than I'm super emotional. Right now I. Don't know what's going on with me. So so, where would you recommend like this really is this. Is this bringing in a mental health component more into curriculum? You know in in that way. Would that be good example or one example of how to do it? I think honestly there. There's readings like there's books that give you basic information. Right like not every. PT's a psychology minor. Like. And so I think that there's information that can be given through readings about self discovery. Right I think that that's an easy thing to do and like blended into the part of the curriculum that looks at. I think it, it's university. Colorado we had some professional and self development courses I think that would be a really good place to put that and also offer mental health providers if they need it. Right like I, think that that. Means they we pay enough intuition that or there's also APPs, but I think there could be a great partnership where people have available. There's probably counselors on campuses right. That could be provided, but I think that there needs to be some type of introspective. Look at who you are as a person in where you come from in your development over time in order for you to understand yourself is who you're going to be as professional as a provider. Is, GONNA. Come out right like how do you? Might puppies bargainers. You. Might. Have to let them in, but it's. It's one of those things where if we if we understand who we are then we can not only treat patients better, but also. Keep ourselves safe when it comes to burn out like I think this is a fundamental burnout issue. Reid is not understanding who you are in your. Get you give yourself too much. We all have the ability. We all most PT's don't have any business background. Right in we all assume a certain. Pay Grade all of stuff like all the self worth or were scared to ask for a raise, because we don't have the high enough self worth. Like salary negotiation. Jer is is a big part of this right where you. If you don't feel comfortable, saying you know what this is. What I'm worth. This is the hour I'll put in this. Is that net? Income like. People. Some people have the. Self worth the say, they'd just say okay. Whatever you WanNa, give me. And then they go home and they feel. They feel slighted that it had been her. They're not respected. Them then it needs it them right then it spirals then then. As opposed to being there for the job and feeling valued like you have to feel financially valued in order for you, but people, but a lot of bts like okay, I don't ask for more. They're not hard. I was told I was told. Pay People enough. That money's off the table. Pay People enough and treat them well enough that like I. Just like you know what I don't even know I. Feel like I'm paid enough got it. Everything's taken care of I've loved era. I never WANNA leave. And those people will leave, and they will outperform for you left and right, but a lot of nickel and dime, but the reverses. Don't nickel and dime for ourselves right? Yeah, that's true as true. and honestly it's like when it comes in. You know it's interesting to think about scarcity mindset at this point in like what employers looking at and what other people are looking at like. You know if I pay that person one dollar more per hour. Like I. I won't make as much money. Like it's also looking at it kind of maybe asking pertinent questions to the employer about like what does it mean to you what what a raises look like what if finances look like? What is what is? Money looked like he was as as A. As an employer! Not really ask that. Question Like the scarcity or or a surplus mindset as an employer Ryan. I because of those were real. You're totally right you you need to. Employees need to be paid enough that they don't have to worry about paying bills. And, they'll outperform for you. They do that 'cause when they're not. A lot of this is about a lot of the stuff we've been talking about we started with. city planet and city, right imbedded racism and Segregate a of this is why it's based on fear, I needed to make your a certain part of the population couldn't overtake me. I built in these things that would make sure that that didn't happen and they're embedded in plain sight. In Law in in geography. And now we're saying also. Let's pay attention to the psychology of the individual coming in because that's going to keep going forward, but we pay attention to it. Well I mean I think that you can take that psychology implying on a lot of levels to PT, Andy Reid if you look at the population. In in your area, the population of therapist match it right. We you're saying. There were no clinics on the east side of Austin Texas right man. Those are I guess they don't need pt right. On the they actually considered I went to a city meeting. One of my colleagues. Merom is on. She's A. She's on the city on the public. Health Commission and they considered a healthcare desert. You can literally hit a Golf Ball Del Medical Center one of the premier medical centers in the country in on that side of the I thirty five. It's healthcare desert. So the fear the scarcity. Apply across all. Of everything. We've talked about right, so it's. It's not only the access to healthcare, but it's the diversity programs right? It's the diversity that we see as PT. practitioners are diversity as a profession doesn't match the diversity of the community. In a recent survey that it went backwards right and that's because PT isn't getting. Kids aren't being exposed pt because of systemic barriers children. Become a PT They went to PD or they knew. They saw school, and if you're not getting any of those three things, you ain't showing up. Totally and when P. are caught from budgets at at on on a fundamental level, or when a another program or family can't afford, a seventy dollars co pay to see a P. T. or if like in in Austin there's. There's map. It's the if medically assistance program. In Texas and around Austin they had a seven month. Wait physical therapy. Sky, had acute onset. I had a nonprofit with e side a Ymca on Austin For a while and like this one gentleman is like A. Seven month way to C. A. P. T. for Cuba back. Right, so there's not access to physical therapy for people on any realm that need it, and so they don't see it, so that's another way that systemically people aren't exposed to physical therapy. And so how can you WANNA? Be a PC. Ryan never and then, and then I mean you can talk to. So many people about the systemic. Application process and and loan approval process for PT School because we know that. One hundred and seventy thousand dollar loan for schools. Not Not everybody can qualify for that getting. On twitter looking at MED twitter as they call it. Hashtag twitter, saying like Hey, man, you're the this is going towards physicians, you know what like application fees and everything's gotta be an in person, interview Severe Nells, and you've got ten of these to maybe get into med school. How could afford to apply smartest? You know you'll have the best applicant, but you can't afford to get to the starting line there. You got no bike. You got no chance right right and I. I remember specifically interviewing for PT. Schools I flew I was in Colorado I haven't gotten into Colorado, but I flew to Atlanta. I flew to where else I go like three other places I flew to interview to to What's the just north of Chicago? Roslyn Franklin, so I flew to Chicago. Predator, you flew to Georgia you know like two. Grand whose evenly? Maybe. Hey I'M GONNA pay three grand so I can maybe pay one hundred fifty. Right. Who Can? For that lottery ticket right told. And not only that, but most PT new grads are not making one hundred fifty riot like who have kicker, no unfortunately skies. Yoda by the way. PDF. Focus on this. Because before we let the audience go, we have the power to we have the power to change them and by them. It's systemic barriers. Even if you think they exist. What can someone do today tomorrow this week? In their communities small steps that can lead a big steps that you would tell people to do pt specifically. I think. I think there's a few things one. He's just need to be Percy to wake up. And understand. That this is real. It's not your fault. That you're safe. Right like I think if you can. And then. You need to reach out to colleagues. Who may not look like you? And ask them if they're okay. And how can you help and let them know that they are safe? Right and then you can look at your community and ask what I can do, and if you are okay and let them know that they are say right like there's. It's a simple solution. You just have to take it from new in extrapolated more people. Like? And I was thinking about. On a walk this morning in the thinking about one of the biggest messages like what I'd want to send home for people today on this talking with you, it's really. I think that we all have. Power to change things. It's just how you do it in like if you make the choice to. Make, the change right like. It's diversify your applicant pool if you're hiring for PT position right. It's it's making sure that your forms at your clinic have all of the LGBTQ. Inclusion on your intake form right, it's it's about how you make sure that everyone is inclusive in your practice, and beyond that and so like that's. It's hard to say Jim. It's like it's one of those things where you you know how to change it, but telling someone how to do, it is really challenging. Right but I think the biggest things our. That you are not. You are not at fault. You're not to blame, but it is your responsibility to reach out and understand that you're part of the change. In terms of innovation. To quote this allows. You can't solve the problem with technology solution. You're not gonNA solve a people problem with legislative solutions right. This is this is a person promo warm, and it needs to be solved person to person to person to person to person to person to person right and in. person to person that gets bigger and bigger. And then you have to be the example you have to every engagement that you have has to be example you want to set in the world, because other people aren't going well, they may do, but they're gonNA learn from you. Right it's okay to understand. That other that other people you may not automatically have the most elegant eloquent solution for all of healthcare issues, but you can start with the problem that you see in front of you and the only thing you can control, and you mentioned that the only thing you control minimal comes out and what you do in your sphere, and and what you do with it whilst. Asia to look right into the camera mark. In the Cameron say hi. My name is Mark Milligan and you're listening to PT podcast. Hi My name is mark million and you're listening to P. T.. Pine cast. Yeah held it. That was very very good. Are you ready to play three questions? Sure! Those again I. Guess I'm going to find out what's to three questions right now it's. Are Three questions brought to you by our friends at Arias medical staffing. Jobs across the country. Yeah, People's ears. Perk up because we just graduated tax, you WANNA. Do what you've been studying for a long time. We want to do it where you WANNA. Do it in terms of geography. Setting patient. Aria says the the opportunities. You are US medical dot. com, see what opportunities though you can also travel with a travel buddy. Even other PT, friend nurse friend PTA they'll try to find contracts in same area so travel with a buddy. Buddy program. Dot Com as you are concerned, three questions first question where question where in the fifty states I mean you literally like I'm an escaped to Florida during Pandemic Smart Island in Florida, My Dad If you were to go anywhere in the US for three months, where would you want to go? At such a tough, quite uneasy. Because I, you know. I went to school Colorado so I love the mountains. Love the ocean, so it would to probably be Hawaii actually. Exactly I'm fear, second question is a what question. What something read watched downloaded so like book movie podcast that you think the audience can get is gets value from. Just. Read the alchemist. Okay I've heard of their. I don't know what's about. Though that's a great book, you should read it I will do that. It's on our list The Third question it's. It's got to begin and end with people. is about who who's the audience? WHO's some of the audience should know more about. Lisa, WHO's foreshore KAI? Kennedy Foreshore Meka. Shit. What's Nick's last name? Mitchell foreshore yawning our about most the next. Yeah, me, yeah, Meka. Next foreshore! And then I think more people should know about themselves who I like that that will lead us to our parting shot. That was very good. I like that ourselves Stewart art shot right now. Very intense. Very. Intense graphic parting shot brought to you by our friends of the Academy of Orthopedic. Physical. Therapy orthopedics dot. Org We're actually We're talking to Chris US tomorrow from the. T were dealer contest that got all these You know courses that you can take online to up your orthopedic game and we're going to give. We're going to give one of these away. We've I'm not to say that yet. For supposed to reveal out tomorrow. Potanin say that we're GONNA. Give something away. They're not gonNA. Tell you how you can get it till tomorrow. But if you love your game in orthopedics, why not do it with the Academy of Orthopedic bt? Seems pretty obvious to me. check them out online at Ortho P.. T. Dot Org, a parting shot mark your last chance for kind of a mic drop moment I mean you kind of have when they're gonNA. Go in terms of like who so when she gets to know themselves. What else would you wanNA leave the audience with. Yeah I, you know I Jimmy I appreciate you having me on the show like I really do feel that you are transformative for our profession. And will have lasting ripples in in not only professional development, but also patient care right because that's what it boils down to, and I think that if anything that I could leave people with. Is that understanding that? We're all human. We're all here together. be patient. Be Loving become. But also know that. Above all like love will solve things right if you truly love yourself if you truly love the person sitting in front of you if you think about who you want to engage with how you want to engage with the world, just choose love. Wow, you are like the PT Iota. I like that very much thoughtful. Mark. Let's let's do this again soon. have you back show. will get more key lime. beards Sydney in the system whatever those things are I like those. Key Billy. You Billy Appreciate you coming on here, appreciate you. Talk on on CSM about an important topic, but I think the most important thing is. We can't stop talking about it, you know it was something that you had had keyed on a lot of people at keyed on in terms of having having a conversation on a big stage like CSM can't take your foot off the gas pedal now, so Mark Bill. Thanks so much for coming onto the show. We'll talk again soon, okay? Love your PSA safe and take care love the PT. Pine, cast yes, yes, show by telling a friend or by weaving a review on eighteen or Google play. Brought to you by the Brooks Institute of Higher, learning an innovator 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. Build. PT Provides Marketing Services specifically for private practice PD's website, development and host and inviting content marketing solutions pt clinics across the country. See what goods pt can do for you today at PT Dot Com. The PT PODCAST is a product of PT Podcast LLC. Poured fresh by me physical therapist Jimmy. 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NYC COVID-19 Follow Up with David Putrino

PT Pintcast - Physical Therapy

1:11:13 hr | 8 months ago

NYC COVID-19 Follow Up with David Putrino

"Hey. Before we get started I just wanted to say thanks to our longtime sponsors are es medical staffing helping you physical therapists or physical therapist assistants find jobs all over this country with position. All settings in all fifty states find out what they have for you at a U. R. US medical dot. com. That is a U. R. E. US. Medical Dot Com. Follow US online at PT Podcast and subscribe on I tunes, spotify or Google podcasts. Yeah, it's. Walk to happy hour this podcast podcast. It's as physical therapists for missing out on amazing insight, remarkable ideas, motivational stories. In the world of Physical Therapy Hi Andrew Mackay your host broadcasting live from the Arias Medical Studios also known as my bedroom. It's be honest about this. Final more formation about travel physical therapy at AU R. US medical dot Com. Let your pt license take you where you WANNA go at U. R. US, Medical Dot Com leaders upgrade for a great show tonight. Returning guests had him on numerous times, but the latest was really at the beginning of Kobe nineteen this outbreak. So we're to talk to you what David Trio today and get a follow up with that. Just a reminder subscribe to the podcast I tuned spotify, Google, our video casting as well. Youtube facebook and twitter pt find cast on social during the show questions comments. Let's hear from you. Anything, you want to Chime in about or let us know where you're watching always. Always, confused of a show extra spreads, but it's because of you so feel free to let us know where you're at our next guest today returning to the show. Director of Rehab. Innovations at Mount Sinai in New York City, a PT. and has shown me some great a grip, Our New York City where my favorites David portrayed on the show. Marianne. They done. I'd much rather do this person earls. Cheese which is a hole in the wall. But if you're ever New York City that was where we recorded our first episode that place brought it. Still, doing pretty good takeaways these days. Yeah. I mean you don't go wrong. When you when you combo beer and cheese never never a bad thing and I think we were there for ten minutes before I realized keep in mind like bars or apartments or anything in New York City can be completely tiny and we were there for ten minutes before I. Realized the owner of the bar actually went to the same. University me, which is five hours away and update New York and the university we went to is this big as well. So it was like a weird little like Kismet saying that we just kind of tripped into but the earls beer cheese I should get a little kickback from those guys for mention them so much Michelle So we had you back April, which is about fifteen or sixteen months ago is it feels yes. How are you since then? Yeah. You know getting through It's it's been a really long few months And actually this is my last week before I take a week off completely unplug because. You know. Where approaching a little bit of allow and I feel like it's very very necessary to. Relax decompress. And recharge. Cheers to that I'm drinking doing bullet just doing bourbon. I'm on that way. I've been drinking a little bit too much beer. So I did vodka lascaux doing bourbon this one trying to like tone down the volume of alcohol that I'm having. But what do you got they're? GonNa cider today. which I'm usually the Bourbon guy but I was actually the other whales like I'm drinking too much seven so. I actually. I had Rosie cider yesterday but first time ever and it wasn't too shabby was the first time eyeglass was ever actually that color but I was like, all right I could get used to that submarines light So just a rerun for people and just kind of reframe your job tells director of Rehab Innovations at Mount. Sinai like. How do you unpack that for people? Because it's not a typical job title you do a lot of cool stuff with a lot of cool people. Yeah I mean I think the way that I like to unpack what I do is We. Rapidly accelerating new promising innovative technologies into the healthcare space We. We do that in multiple different centers and we we run the of hybrid clinical research centers where we run experiments, we published papers, but we also deliver clinical services that people can't find elsewhere. And then we try to learn from all spectrums of the world. So we work with we work with kids we work with adults we work with high performance athletes and we work with individuals who you know Like. Completely. Locked in with the allies saw have experienced very high level, spinal cord injuries all with the mission of your enhancing human performance through innovative means. Yeah. I like that last one enhancing human performance or innovative means and I've I've used your I don't know if your ears burned from time to time but I use your definition of innovation in my day job at Fox you know with this podcast and a couple of lines that you said in one is innovation is finding a problem. Everybody says problem and then solving that problem that's innovative. I. Think when I think myself included in a lot of people think. Of Innovation like the highest possible attack in the most advanced robotics everything you know to the nth degree and sometimes it's as simple as last time you were on the show you realize that Mount Sinai, you had a lot of food that was being under utilized and you like if we get a food truck and we take the food, we bring the food to people who need food we help them. That's innovative but that no technology was really involved, but that's an innovation. So I like your definition of innovation as well. I like that you bring up the example that is now the muddle of community transmission and curve. We're not doing that anymore. That was very much. Pre coat was game. When we talked in April Mount, Sinai for people who are out of the new. York. Metro. Area. Hospital system and I mean how many you know how many facilities just mount? Sinai in New York City. It's huge. It's an eight hospital system Somewhere. In the neighborhood of five or six thousand beds. It's the largest employer in New York City. If that gives you an indication of just how big it is And then. There's sort of also adulatory clinic solo ever. That are related to Mount Sinai as well. All right else that's like a scope for people to kind of Iraq and figure out who you are, what you get to do in the world as a as a physical therapist. But as somebody who does a bunch of different things we talked in April and I feel that that was a few weeks in You know we had some phone calls in March when I was like you know I was like is this going to be house is going to be in New York City because that's where I was living at the time and and as you can see, you live in Brooklyn. Got The Brooklyn Bridge in the background. But that is you know that's that's just a tapestry everybody that's actually I'm not actually there. In April, you're predicting it was going to be pretty bad and it was pretty bad but you guys did some you know some hard work and Kudos everybody at the only. Mount. Sinai. But for all the hospitals in New York and throughout the country throughout the world doing great work you kind of give us a window into what you saw experience and heard from all the people you get to work with. Yeah it was it was bad you know we. Are Immediate response. So you know the the immediate Mount Sinai response was. kind of daunting to walk in on because. It's A. It's a place that I've come to so to see as my home and. and. When you walk in and outside I. Especially, Mount Sinai Hospital on the upper side. You know you walk in and it's speak impressive. Atrium and. It's really beautifully designed. You walk through it and when you get to the other side, you're on Madison Avenue just looking straight out on. Central Park. And I think one of the most jarring things and while the first things that happened. As as we were experiencing the surge was you walk into the speak beautiful atrium and is just covered in temporary ICU beds. Because they had. Completely changed the environment. To. Be a functioning. ICU. Slice the age of the entryway entryway. You know it was just this is what we have to do because we're GONNA run out of bit You step out. Of the exit onto Madison Avenue you look unto the pack and Robinson Beautiful Central Park you see tents. and. That I I remember that thing but I. Really. All right. This is this going to hurt a lot of people this is Really really bad and. We've got to get ready for so We you know might my lab is has been focused for a number years on things like remote patient, monitoring, and telemedicine? and. So one of the first things that we identified as a potential weakness in our response was that We were doing whatever on was doing which is. You know teller urgent care I A. Someone calls in and says, I'm not feeling well I. Think I've got covered a doctor on the other end who? Hasn't seen a lot of covid cases at this at this point. Says Hey, what are your symptoms Ula symptoms and I say, well, you know you talking you walking. Drink a lot of water. You seem to be doing our K. if you get worse, go to the emergency department and will admit. And to be clear, this is not a criticism that is the best that we could do at this point because that was the best we could do with the information we had. But. My team and I we saw a clear gap there. So again, this is what situation. It's not anybody's problem. Everyone ever stressed out. Everyone is trying to sort of duck and cover and we said okay. We know that we have a remote patient monitoring program in place to track things of this nature. Way going to quickly change it up. So it's a bit covid focus and we're just gonNA offer it as a service to anyone who dials in. and so in the space of forty eight hours. We just stood up a remote patient monitoring platform for COVID. The hospital could not have been more supportive. You know this was a moment up you're. Pure innovation, impure ed mission driven behavior, the hospital that is ordinarily. So compliance oriented bureaucratic. they was literally point where leadership said to a couple of bureaucrats that we're getting in the way. If a trainer saying we need to get out of his way and let him do it and. That was an attitude I've never seen before because I understand the need for compliance and I understand the fact that in big organizations they usually gonNa site. Well, wait wait to what the law we hear what lawyers site in this guy felt like move you're not important right now. Get. Get the solution out so the people. which was a very inspiring to see Then of course, the floodgates opened and we got hit. Really hard with a ton of people really testing. Out. Capabilities. Out. Technology. Really, proud to say that a large portion about team that fielding the Coles monitoring the data counseling people through teaching Airway, clearance techniques, breathing exercises, her exercises old PT's. A these were. That couldn't wet their outpatient clinic jobs. And we brought them on to monitor and the only debate. Obviously knock it out of the puck because you know often is hung monitoring. Space is thought to be the domain of registered nurses and practitioners. Ju To that proximity in working with medical doctors but. The you know giving physical therapists that opportunity to. Step in. They really you know day by stepped in and stepped up, they will like. We. Know How to do this and we? Wear qualified to give exercise. This is Al.. Way Yeah. and so that was amazing We we treated a little over a thousand patients In the in the space of the very short amount of time. and. The ad that was what what are the first things that we did get get things up and running the next thing go ahead was going to say. freeness because I don't want to get pads skip pass from one or this is such a brilliant idea. So this was done through an APP or through through an ability of of a patient who potentially either did or might have covid to answer like questions to go through a decision tree, but someone needs to monitor that if the answer to x number of questions or more. Is Yes then that would initiate a phone call from a PT, and as you mentioned, some of the outpatient facilities amounts were closed. Now you've got PT's who are qualified to help, but they're sidelined because there's no place for them and we don't want to bring them in. Newark. They were able to monitor patients virtually just through the patients getting this APP and questioned every day. And when that had risen to the level of okay. With this needs more insight sees someone to look at it. The PT were able to do that and if it if it if it warranted. Someone else to take that call and eventually if that person needed to come in, they would that kept a lot of people out of your out of your atrium. Absolutely absolutely, and and that that was the goal and. Yet it was. You know we tried to make the whole experience as inclusive as possible. Safe. You had a smartphone you download an APP. If you didn't have a smartphone, we told you every single day. We entered your data on the back end and we interpreted those data and we move forward. If you couldn't pay don't worry about it we wiped out. It was just making sure that. Everyone had what they needed to be safe We also were you know delivering the hell out of pulse Huck senators. It was one of those things where you know just the the craziest collaborations happen where We need pulse exit as we knew it. Everyone was out of pulse limited so I tweeted at ZAPPA's because they said we're doing this campaign of customer support for anything during COVID nineteen I was like I Work Outside I. Did you get these impulsive? Add. Like before I know at someone's damning me and then They they've located like fifteen hundred pulse images and. Then the they like how much money do you have and I'm like Oh shit I didn't expect fast and I'm like I got I can scrape together like twenty thirty thousand like don't worry. We got the rest and they bought us this massive order of pulse ox Simitis wow and. Then, we got a bunch of pulse ox Simitis. We stopped distributing. So I don't know what my ups bill was that that month the department but. I CATS But. Basically anyone who al Physios. If they said, there was clinical judgment. We need a pulse ox up we got him a pulse ox sometimes. We even just got in the van and hand delivered them and my my job at that point was logistics I was just like. Running around Delivering Shit people and That was what I was doing today But that's innovation right I mean yeah that's innovative. We have something somewhere that we know how to. Well, you didn't have anything I write. How do I get it? You're like, Hey, I see a problem everybody says, now my problem solve it and you said I don't know I'm going to tweet this. And then the connection was made and now is my problem and then we don't have to get it there we drive it there that's innovation. So like I, feel like that's the one thing that I've taken out of the few times that we've talked is I think a lot of people. Especially, myself included see innovation as how advances this technology, and sometimes innovation is a human connection to solve a problem that's innovation. It doesn't need to be lasers by all means laser. Cool. It doesn't need to be lasers vr and everything like that. It's solving the problem doesn't matter how fancy you make it look. Exactly right exactly. Right and and you'll know you sell the problem when the community tells you solve problem. That's when you when you claim victory the full it's. A lot of would be innovators do that they like we made a tech thing. It's definitely gonNA. Make eggs easier and it's like you ask the community and they roll their eyes like right at. You talked about you talked about one project you worked on where everybody in the project was celebrating that they had solved something and you're like, we didn't solve anything like we saw something you like. This won't happen anywhere else because the people who need it to solve it won't have this money technology to do it. That means it's not innovative. Yeah. The innovation could be could possibly that may be a great burr step innovation could come later but that isn't solving the problem just yet. Absolutely. And I mean we could get boring here and discussed the difference between. You incremental innovations this disruptive innovations because I feel like that's where that's how would you describe that? Would you would you briefly describing the arms? Well, you know an incremental innovation is what that lab did they probably. Prefer step. Published the paper and they said my God is a fine hair and it loves I I. Like It. They they they did something that was innovative in the in the basic science sense which is. This lab did the Swedish this plus one. So is an incremental innovation. The NIH would love it. And it didn't help a damn person. And then there is enough, there are other forms of innovation along the spectrum but on the other end of the spectrum is disruptive innovation where. It's just like you know Yuba I. Well, let's lift. Hoover, really nice guy but. Not. Particularly on the tech side. Like a crazy thing non had ever thought. Of before but simply solving a supply demand issue in a creative way. That changed everything. and. If you looked at the data. An incremental innovation expert would not have come to the conclusion that we needed. and. So. You know those those assaults of the. So quick definition. It'd be like incremental or disruptive. It's like if you ask people what they wanted two hundred years ago, they wanNA brighter candles and faster horses as the adage goes, they wouldn't ask for electricity and cars because they didn't know they needed it. So it's like paradigm jumping versus I made this ten percent better ten percent faster ten percent bigger. That's incremental but leaping ahead to something no, one saw coming that's disruptive. Yeah. Absolutely. Yeah. I. Mean like somebody like. Tactical. Is WanNa make sure we give a onto not impossible which is actually how I came across you. I've found not impossible labs in those stories a great podcast to to listen to well done while told stories and well solved solutions. That's why they're well told story is is they take you from Saint someone saying not my problem or in fund in fact, a lot of the everyone's saying not my problem and a team of people or an individual saying I will solve this problem so there's not there. So take a listen to that podcast you can put the link in the the show notes in the comments there. So what else did you want to talk about in terms of what you get did the remote monitoring just brilliant pulse ox in solving that problem also brilliant problem solving and the community tells you on both ends you solve that problem. Yes are the other thing that was really sort of troubling at this point was the. Stress that we were saying the frontline healthcare workers going through. You know from day one basically everyone was you know breaking down lots of emotions lots of. Fear and dread and. Very. Lots of uncertainty about what's going to happen. and. My Home Department about Sinai is is Rehab and human performance. So Dealing with people, who Really never experienced a never expected to experience having many patients die on them. You know it's something that happens. At different points in your career in in that department, but it's not something that is happening. Every single time and so. I was interacting with a lot of my colleagues within the up and they would they would come to my lab where I was there till they bring pulse ox visit mailing should out and they would say. We had ten people don the unit and that's in a day. and. That they would just never. Told that that was going to be part of their job. So it was a lot of emotions was anger there was you know grief they was all sorts of. Anxiety and. And sort of trauma about not wanting to go back the next day And so I actually teamed up with an organization called studio elsewhere And they have actually been. Developing New Center, which is why I knew them but they this sort of Design firm but uses. You know. multimodal multi, sensory experiences they're very into nature and. creating green spices and creating sort of natural landscapes and soundscape. and I said, you know we have been kicking around this idea and high performance sports something we Kota recharger. Basically. An NBA player comes off the court and the completely hyped up, and we put them in this room and the physiologist ramps down. and. So I said to morale who's the founder of pseudo elsewhere said, hey, you know. Three thousand. Square feet of lab space sitting here vacant right now. It's Perfectly positioned because festival it's near the mailroom so we can get a Lotta deliveries. And secondly it's like. Far Away, enough from the main would. You know that. It's sort of a neutral space. It's not like you know. It's not gonNA be like an infection risk to people to come over here. So why don't we create some recharge rooms here and you know? Save. We can help out admiral was dislike insanely supportive. She did all free of charge. She reached out to. A couple of her friends who like. Like, Complex's musicians from the stone cold embassy. And they. Started composing music. That is like specifically designed to calm your physiology dowd dude I just like ridiculous Shit Ad. And then we had this amazing photographer maxim he came in and just like. Filmed, everything in shot everything and documented the whole journey and. We created this experience the people to come into and not only did did we create these recharger inspect it sort of? Created a nexus full a lot of donations. There are a lot of people trying to donate hot meals snacks, right? Didn't donate wanted. And they didn't even know where to get Sir I just started saying, well, my spices open gets my space you know like and. So, we created these rooms, they really beautiful they. They completely transformed my space the just looked like you're in a day spa some night. That I, I mean I've just seen pictures you. It looks like you walked into a that's the best way. It's day SPA and immediately makes your it makes your. Anxiety level just go from here to a lot less than there. Yeah, and you know I feel like. We knew we were onto something almost immediately because the first person that came in satin sat in a chair and just burst into he is. And we will like fuck would return. And then she said these are good tease I needed this. I needed the release Y-. Thank you and And then people just started streaming in Sir. Over the course of ten weeks, we had thirteen thousand people come through the space. Thirteen. Thousand People in ten weeks ten weeks they obviously socially distanced everyone satirized we had a team of incredible volunteers. Who would sanitize rooms after each use? We were initially seven days a week from. from. Nine nine am seven PM And then the most amazing thing in my opinion that happened was. Physicians who were experiencing the reach out drums wanted the after hours colleagues to experience them as well. Buffet outranks so that we were able to be opened from three am to ten PM seven days a week for the entirety of the surge period and you know again, you know in terms getting feedback from the community I'm hearing the physicians say well, I've just. A really long shift and I'M GONNA stick around to make sure that the. the overnight as can get this as well. That really speaks to how important that they thought it was and how concerned they the shift workers might be missing out on this experience. so We were fortunate enough that A. A really great family called the Coleman family. Who they don't a lot to the hospital in terms of improving patient experience. But they really recognize the importance in helping the clinician experience. The frontline experience the essential worker experience really kind we had. Multitudes of people from the the mailroom from from the food services for all the people that would the janitorial services people who are making the hospital run that didn't feel like they had any services routed to obey him. We had the wide open and they could come and experience it as well, and so the Coleman family donated. Enough. Funds for us. To. Build Retailers in eight of the hospitals. At least. In one location in every single hospital, you could have this experience. Then we started going a little wild and converting some of the triage tents into reach out rooms. which was really nice for the people because they got to. Experience something that was really horrible tune into something that was really nice. and. You know the whole idea kind of blew up from that. So you're you're walking into this space and again, I've only seen pictures but you walk in and you're gonNA have different sounds you're gonNA have sound that's that has been proven to actually lower anxiety composed I shouldn't say may a composed to lower anxiety you can have images projected either the lighting just a little bit different the feel you walked into this room into this space and this space felt different and you were taking care of people who at. That time were at or above their limit of being able to control their emotions but those people needed to be controlling their emotions as the testament to the very first person who walk in there just bursting into tears good tears but tears edited come out and they wouldn't have if there wasn't a space like that. So yeah the pictures that I saw I remember seeing you know just a projection projector projecting an image on on the wall of the this. You know like a rainforest space and I'm guessing you know. Rainforests type noises when you walk into a day SPA from the if it's a good one. From. The SEC from second number one from step number one, you realize this is an area of relaxation on, and this is how I will act in this space and the body will now react to this space and that's what you guys were able to create for people who needed that because they were going to go forward and take care of a whole bunch of people who were surging as you mentioned this time of the surge so. That's a that's a smart way of again recognizing problem and everybody says, is you first of all recognizing that problem which is kind of an invisible problem right I mean it's because. It's stress. It's hard to what are these people need I don't know give buy him lunch or something like that. But that really wasn't solve the problem buying on lunch or you know. But you recognize the problem you solve it. Yeah it was Again. Is similar to something you've hit on earlier. It was all about. Connections to make it happen. and. I think that one of the things that I keep. Sort of pushing on as as I get more experienced in this space is that. early in my career as the second guess, myself because people used to say why you doing that project though that project that's very tangential to like. What you should be focusing on and the lane that you should be staying in. And you shouldn't distract yourself ways. Of The wall projects and The more. At the mall of the wall projects, I do the bulk connections on to the point where. You know. Then, you're like, okay. Well, I see a problem. What the hell can. I do it's very easy to sort of stop. Clicking through your mental Rolodex and saying I should call morale I should call embassy I should call. This person and this person and bring them together because. We have the power between. Out Connections. We have the powder actually do something about this. Stay within the lines, you would not have those connections not and you. Say someone else's problem and you'll woke on and. You. Know that's fine. Because everyone. has their own thing but. It's it's that. It is that approach that makes it the the difference between a fluke. And a repeatable process. and. Often people sight innovation is lucky. You Got Lucky you hit a moonshot but the more and more I work in innovation. And I think I mentioned that book where good ideas come from new you took a look at it. You see it's it's it's a process and you see that like. It is repeatable if you know what you're doing, it's and. You've experienced in your career, and if people want to go back to the first episode, which we did which I had to break into two episodes because it was so great. By no mean in my my by no means of my comparing my career to your career think of we're look different levels but like I felt the same I've experienced innomax probably experiencing the same thing which is you get hired somewhere for the things that you've done and have said you want to do. You get brought in and you get told to do something completely different. So I've I've been brought into facilities before while I had this podcast who like we want you to come in and do something innovative and I'm like, okay. Here's what I do I. Find People I find interesting and I talked to them. And then they tell me other people to talk to and in my life is just as big ven diagram of meeting people who are very interesting and I, might and but it's not I don't do this because I'm like I'm GonNa use this connection for something. Later in the moment, it's like I like this this is very interesting to me I would like to learn more. But. Later on you into a problem like Oh you know who can solve this and they're like, no, I have no idea. Oh, I know three people that might actually have something and you bring those in. But ironically, if you tell people, I'm going to go talk to some random person like how why would you ever talk to morale why? Why there's no logical reason to do that until there is which is kind of similar to like there's no logical reason a radio DJ PT, and then launches a podcast until you like oh He brings a skill set to the to the profession that he just talks to people and he does it over a bourbon or whatever. Now other people meet other people. So that's how I look at like my career ironically, like people do push back on that which is. You know something I think in that book that you had mentioned. twenty percent time. That it was that in that book. Google says, all right. You work you work forty hours a week one day, eight hours a week you work on your computer programmer. But if you want to learn the violin or violin or whatever. It doesn't have to make sense and you know people who run the company will say but how is that? What's our Roi on that and they go I don't know. But if we do that enough of venture, the Roi will be net a million times positive because one of those things going to hit. So. Those people will innovations lucky and I don't think I think innovations about connection which is solving the problem that are. The basic definition of what you said, which is solving a problem where because now my problem. Bro. Solve that it's an invasion but the way you solve that which is a different quote that you had said that stuck with me, which is you can't solve a people problem with technology solution. So. If you have a people problem, go to people and dissociate also by a person who knows technology but really the way you solved, it was a people connection. Those things landed with me. So what's on the horizon? I mean, we're we're we're in August now but if it's March freaking eight, hundred forty-seven, it still feels like we'd never left March. You know I mean the surge is over, we're not done. So I don't want people to be listening to vest and be like well a guy in New York City where it was where the epicenter in the United States is saying well, we're okay. Now I don't think that's that's not the message we're trying to send but. What's what was you know? That's what's so what am I guess next now, what what do we look at what's on the horizon now? Well. The. I I've rapidly. become. An expert I'm not ex- petrol, but I've rapidly become Someone who gives talking points to the media about. Long term. Consequences of. which did not come up it was literally like people's argument would be it's as. Deadly as the flu or not even but people literally weren't talking about this. What you're I think you're GonNa talk about which is yes, you survived. But DOT DOT dot. Exactly, you know From Al thousand or so patients in the remote patient monitoring program, they were primarily mild to moderate cases so. You know a few dozen of them required hospitalization which we mediated and facilitated, but for the most part they. Didn't leave the home and we manage some from the home. And we started to notice a trend in now data that around five to fifteen percent of them were not getting better. And all were. Shedding the. Viral symptoms and developing new set of symptoms. and. One of them. was getting really frustrated. and. He said you know it because we went helping him We were just monitoring how crappy he was feeling. And but we're always listening we're always. Getting feedback in soliciting feedback, and he said well have joined the spice. Book that. Really seems to know what I'm going through. Do you WanNa talk to them and I said yeah absolutely? I try to join the facebook group they rejected because. Probably, go talk to people who have carbon and I was like, Oh, I'm sorry like Mr told me to talk to you. I I'm here to listen I'm here to love. Why won't you let me in and they were like all what we've had so many like clinicians denying our experience that we don't want to let you in you're gonNA tell us it's made up. And I was like, well, I assure you. I'm not GONNA do that because I've got like get our. Data from one hundred, fifty people who are experiencing the same thing as you. Like. And they will tell us about these under people. By the way, this is this is a facebook group of six thousand. Wow. Wow, and they also were experiencing the same symptoms and then I stopped to. Chat with more groups before I know I'm talking to communities of ninety one thousand people. Who all have these symptoms And and what are the intimacies knock? These are post Kobe symptoms is post covid simple to knock getting. They are experiencing. Tacky Khadijeh. palpitations. sort of precinct syncope. So like really feeling like they're going on a rare occasion, they think that aren't usually but really feel unlikely. Before, never have previously fit and healthy in allows majority of cases median age thirty, five lab, extreme exercise intolerance and when I say exercise tolerance I mean you woke up a flight of stairs you had done for two days. And a GI symptoms Cognitive fog car difficulty concentrating. joint pain aches tingling down the extremities Just. A real mess and and then of course, completely out of control, they'll have tax Madonna off-road on the attacks they will. Each day of symptoms will just random randomly appear. So it's like you've got your symptom bucket and you put your hand in and you pull out your this is your handful. This is today name right borrowed being different. and. So. You know we started to look at that and. we scratched out heads and we'll like well, this looks a lot like the Soda Mea. So, we pulled together a few disorder Miami experts and they were like Yep. I we also I mean there are dissenting voices slip people are saying look it's chronic fatigue syndrome of people saying it's You must sell issues and you know and a half doesn't other autoimmune. Syndromes being thrown onto the. into mix. My. My. Position on this has not changed I don't think we need to name it I. Think we need to know that it's it's covered. I think that we need to know India's disorder Nemi like. End. I think we need to acknowledge the fact that All of the all of syndromes that have been put on the table and you have a few special interest groups fighting over like which one it really is and I'm like well. I don't have the conditions name in my center. I can tell me as a trust in us. We don't know what it is, and if you took the a syndrome is a collection of symptoms. So they took the diagnostic criteria of all of these syndromes that you saying in the running, these patients fit all of them. So it doesn't really matter at this point we're going to be patient centric we're going to be symptom centric. And we're GONNA stop creating. A protocol to treat them So. We. Pivoted again secre a new remote patient monitoring APP for this new condition. we worked with Mount Sinai sensitive postcode care which is amazing is run by awesome doc by the name of John. they somewhat have their hands tied in terms of policy considerations. They're only allowed to take people who test positive for. Will for antibodies but what does is? He immediately routes anyone who tested negative strikes us so we can. We can treat them because he fully understands that the pcot's suck in our the false negative right is so high. Antibodies was still up in the air as to. Whether or not the tightest fade. So if you have a negative antibody test, does that just mean? They're not at detectable levels. All doesn't mean that. You never had antibodies that there's not a good answer for that right now. So we recognize the need to make sure that everyone gets seen if they're showing these symptoms and so that we you know as you might imagine ninety one thousand strong community with a from like eighty different countries with. A lot of people. Not Being told that it's not a real thing. Hill mouth. Well. I mean, that's the first thing right is is is good on whoever didn't let let you into that facebook group for that reason, which is, hey, we already led a bunch of people in and they're telling us that it's in you know we're making this up it's not real. And then you saying, Hey, listen you know and you. Talking to your way in for better for worse terms but Yeah, that's. That's the thing I don't think anybody's talking about right because I mean. I don't know if you notice David there has been a record number of the epidemiology degrees. On social media in the last few months but there are a revert schooling and all you a lot of it. Honestly, if you if you Google something twice, that's is actually considered doing the research. But. PhD But. Yeah, this is I. Think this is the thing that I think I said this in in April as well. This you know the physical therapy. Profession was in America anyway was really born out of an epidemic, which is the polio epidemic and I said in a couple of months you know I who knows what's going to be happening to these people I think you're listening all those some of those symptoms right now. It's a great place for P. TO INSERT itself but I don't i. don't even think we're seeing the full surge. I. Don't think we're seeing that post-soviet post. Kovic surge just yet because I'm not hearing any of the things that you're saying in mainstream media. Absolutely and We're starting to get a little bit of coverage, but we still have a long way to go in terms of just getting the word out. We. Actively collaborating with anyone who says we believe this and we want to see patients we just going full. CME like his how you do it here's an service go. Where upskilling a great DC, where upscaling a group in New Jersey in Arizona. Because we can't handle the the demands where really struggling with people who contacting us from other states saying we've heard about you. We need to help all. You know I've been kicked out of like every medical practice. And I can go to work. And it's interesting because. Eventually. Once we get a handle on this, you're one hundred percent. Correct. This is all. This is. Going to manage this. And I was sitting in a early, we have these standing meetings with the sentence covered and it was like you know epidemiologist immunologists, Rehab Duck Kadio Cardiologists pulmonologist. Into chronology and we're all sitting around talking about like. You know what's next and we get to. Okay close. COVID. Syndrome A. Cardiac Rehab, all of the pericarditis indicate itis cases. Pulmonary Rehab for all the people without Alexis in lung collapses and so on and so forth. WHO DOES THAT And it was like. Physio does that and it was funny because you know this multidisciplinary team but didn't involve a physio were practising one they lit up at, they'll like. Yes. We can affect their. Learning because because of innovation right. But you ut in the room and you were able to identify hey, by the way. This is what do And So I feel like from an awareness Puerto that was great for all of the in New York City because. They just. told a bunch of very desperate. Specialists who had staring down the barrel of having to active actively manage cases go I can compound this us. So wonderful for them. People who were very excited. Do that because it hasn't seen. He's he's please pour pour that on us. Wow that's a lot and. Yeah, it's it's. A. I mean. That some of it some of it, and then you know there's a whole bunch of other stuff of that. We haven't even touched on like. A WE WE HAD A. Massive Social Movement with George Floyd happening and I think be remiss to say that we didn't all have to sit down take a look. Think about. How we operate and? How much do you know whether we're being allies to the fullest sense of the word and how we can be better allies and and. You'd also like in the midst of it. I think again. It would be very easy to say it's a pandemic I'll do it later. but I think it was really important that. As a as a group. Might Team we sat down and we said okay. What are we going to do? To increase inclusivity to. Support and fight for social justice and really sort of push this agenda as far as go. I've been really fortunate in that Mount Sinai was just incredible like. You know the Ben and Jerry's response to judge Lloyd, which is basically just fuck the police in Utah. They just like. Everyone else was like kind of muted and I will. I. Talk Everything Bona to the grounds. Mount Sinai was not unlike back. You know I was looking at like the the sort of like. Muted responses from groups like Nyu and Cornell. with I will like. Participate in protests if you want but you know. Shutdown stem if you want, but you might get in trouble for. Amount side I was like Nah. Where we're doing eight minutes of silence out, everyone needs to get involved unless you'll like unless someone's going GonNa die if you. Wish shutting down stem. You don't have a choice unless you're doing like less saving code research working tomorrow you're posting your reflecting you'll you'll being in learning. and. So I was just so impressed with that and. Then on top of that That just inspired us to really get active make some direct partnerships with you know minority are in minority visit a minority. Focused organizations and just share resources with them so that they can do what they've been doing for years, but like in silence and Just. To it to better effect. Yeah, I would love to do. I would love to continue the conversation in terms of you talked about upskilling people. I mean if I ever wanted to do on this platform that we could do like cool views like you know like the CNN view or out to call ESPN view, you go to different views but I mean like a class like that how valuable that be for Physios and I'm guessing there you guys are just giving this information away. Giving this information away. My Rockstar PT E. P. T. Gentlemen Cousteau is the person who has written out the protocol lovingly and. She is a phenomenal educator. She should. Definitely. Come on here and community I would love that because that. That's that was the thing when we talked in you and I talked in April we talked about this before we had. Record, which was we feel like we did like eight or nine cove related episodes in a row, and we had done a lap and then I literally was like what else could we do or just repeating ourselves then all sudden everybody's also just saturated with covert everything that I was like okay well, you do something else if only for the sanity I'm like if people listening to us as an escape for something and we can't give them that then bad on me like right I almost needed to. Create Environment where like this is the opposite of that. But now it's the time of, hey of this tax like that's why I think it's strategic. Is One thing I think in April everything was about strategy because we didn't know which way things were going to go. But now if we could be tactical, which is okay. Here's what we're seeing and here's how we respond. Here's what happens in terms of teaching what to do and how we can best sell I would love to do an episode on that. Platform that we're we're we're broadcasting live on, lets us share screens and bring multiple on the show and doesn't fun stuff Salva. One of the doctors who is she's Got I've got like two hundred posts covered patients right now and but she so I would say without a doubt in my mind she is one of the experienced doctors on the planet. With this condition right now. then we've got You know phenomenal Jen is phenomenal PT We've got a great Rehab Doc, well, who's leading the research on this and and interacting with world health. Organisation to settle like share everything that we're learning on a regular basis. And I just a sit around and look good in the presence of that team to be perfectly on set to well look I really do much. They're also and yet they they can. Definitely. Later. Love it. What are we looking at in terms of the next six, twelve, eighteen months you know I'm not asking for a prediction because that would just be. You know this isn't. Just sent? Some to predict. But like we on a we on the We've. Terminology we the curve. You know. I. To Focus that in terms of where right? Wide countrywide citywide. But we on a we we trending in the good direction or bad or we flat Not We're trending in a bad direction. We're still going up the bad states now are. At A. Now, reporting. Record death days are so that that is. Has Been. No. Flattening and as felt she said. There's no way. This is still the first curve. So that is. Incredibly wearing. It's also kind of crazy that you know. We shut schools when. Things were. Nearly. A hundred of his bad as they are now. and. We're talking about opening them just full political expediency I'm not to show. And Y- Y way making some mistakes From a global perspective I think we could learn lessons from. Vietnam from New Zealand from Australia. It was funny because someone who? Who I follow twitter, who is a? Public Health Official for, New York State. Criticized the of the response in Melbourne because basically Melvin had. A series of uncontrolled community transmissions. And so they went into straight up lockdown. They were just like, okay. You're allowed out for one out to exercise. You're allowed out once a week for groceries otherwise you stay in the house. For being too strict. Yes. And you know I. tweeted right back at him and I'm like dude, I don't where you're sitting but like. These guys have done. This country has done really really well. And now they have an outbreak and they're doing the exact right thing to suppress the outbreak. Meanwhile. Fifty percent of your constituents astill arguing over the mosques. Right Sir Dr this country for doing it well. When when you to over a thousand people dying in the United States And we have sturgis motorcycle festival right now. It is beyond belief and it's you know. It's it's hard to watch. and it's it's hard to. Regulate the idea that you going to have to ask. So. Many friends to go through. What they just went through in Mount Sinai Hospital again. because. People don't WanNa put a bit o'clock. In, front of the mouth or They, they want to politicize an issue when it's it's not a political issue like can we just at the very least come together for that? It's just Something, that dates me. It's something that needs to be done because if you just follow the data and look at the countries that said. This is what needs to be done. Let's do it. I must put had that hit Santa get through. Western Australia. Just had a football game with forty thousand people because they haven't had a case in state for. Three months. So we're arguing over oppression, but we're really arguing was inconvenience. But we're we're seeing it suppression. It's a bad bad reframing that's hurting. The good. Refraining from some females reasonably with some outbreaks. In Georgia, we can't really regulate students wear masks or not, and females are saying you've regulated what I can and cannot wear to school for the last. Fifty years you can easily regularly I mean I can't. I can't walk down the street without pants on. Right I get arrested for that for obvious reasons. But you're saying you can't regulate that. It doesn't make a whole lot of the argument. Your argument zero water but we like in especially in this country and I'll say you you know. We love it. We love to white knuckle these rights without immediately saying what our responsibilities are and bitching for your rights without recognizing responsibilities that is adolescent behavior. So. You can't be a functioning adult society and not recognize your responsibilities along with your rights because you have the right I mean. I can drive and I can drink. Can you both those things together? We'll now being oppressed well, no I'm I'm I'm being asked responsible. That's what we're asking so. Public Safety Right you know and are, are you know one of our founding fathers said my right stop at the tip of of your nose, which is if you're doing something that could harm me no way. No, you have to stop doing that which the this you know the argument of I'd like to drink, and I'll let you get behind the wheel my jeep, but I will not do both those things without repercussions because I will hurt someone else. For some reason we like to say we're being oppressed but really we're being inconvenience listen man you can have fun with these things I just got you blocker. All right. I mean I now have a Chewbacca mask. Have you with us for a while I bought someone was asking, why did you buy five star wars mess like well, here's the thing I feel like we're going to be doing this for a while and I'm going to be doing for a while I want to be funny about it. So I'm going to be funny about much hubadoo Masks Sega Yeah Well, we got again in person probably. Yeah twelve to eighteen months maybe twenty four months I don't know. But until then we can do this or would love to do a follow up You know with with that class, you're talking about Nebi great information for this community of of PT's to to learn how are you ready to do three questions you've been on the show multiple times. So you've answered the three questions before, but I'm changing yours I have a different post it notes. Version. Of Three Questions Day you ready for that. Aren't. Let's do it. Three questions brought to you by our friends at Arias medical staffing. That's a you are a US medical dot com leaders and travel PT. We mentioned the top of the show. Your essential workers, some locations of United States need what you're doing, and they're going to need what you're. Do you're able to do very very soon even more. So find them online at you are a US medical dot com go there and see what's available. All fifty states, all settings, a U. R., E. US medical dot com seeing physios doing all over the all of the country in some pictures on their social media count. Your needed and communities. So so do that a you are a US medical dot com right so three questions for throwing out the regular three questions were doing. This is because you've answered these multiple times I question. A lesson you've learned during covert what's the what? What's a lesson that you've learned personally just for you during that Cova has taught you. A positive that of a negative. Oh so I think that One of the. Strongest lessons that I've learned is. Really focused around Interestingly just how important ordinance human connection is. You haven't connectivity like I. I view myself as an introvert. I do not get my energy from people. I get my energy from learn time butts. On the like when when you're in closed learn time you've very quickly understand how crucial human connection is had. It must be for all of these generations that we've been neglecting. And slipping into social isolation and loneliness of the is and so you know that's that's an area I'm going to be throwing myself into. Other the next few months and years to try and make a difference. Yeah. I mean, it's somebody who identifies a complete extrovert. I am miserable right now. I travel a lot for my day job at tribal off for this podcast and I'll be honest. The first month I was kind of okay. You know change in that chain those words were I'm not stuck at home safe at home and I get to be you know working from home and I didn't like a lot of people who didn't. Didn't weren't able to pivot and work from home and lost things, but it's still not easy and you you mentioned other populations Living this really highlights like specifically older adults who were socially isolated and what they go through it's not easy. Absolutely it's a big lesson. All right second question three question something that surprised you. During covert some that surprise you do not see coming and you didn't expect anything that really shocked you. Well, we talking twenty twenty. Yes. The last four or five months. I thought well, I mean. I feel like. Every day. Prince. Of. Are. Actually. One of the craziest one of the craziest moments that I had that was just so shocking and I don't know if I'm going off in a tangent inauguration but. It's. I had this experience of the entire like social inequity of. Of New York. Where it was one day, we were out delivering oxygen equipment that people needed. And I was delivering something to. Individual who you know really. Sort of. Adaptive equipment has a spinal cord injury and Sir. Went to her house and she lives in project housing in the Bronx. and. There was like a guy driving the guy who's driving the cop for me. WHO Like works security for Mount Sinai his day job. Is like a full cop and he was like you can't go in there alarm. I used to I used to whip like we gotTA. Be, careful. And he like jumps in. With me and. Told me what to look out for and. and. You know like we sort of navigated situation got in got out while we were in visiting the individual. So. Sweet. Like can I get you a cup of tea. And she's in project housing so that the house is like in a bit of disarray, she's living with multiple individuals despite the fact that she's a high liberal club and. But just so gracious kind and. and I was like I'd love competition. and. And that was that And then. we had to go make an liberate. We drove thirty five minutes wherein. Greenwich. Connecticut. We roll up to a mansion deadset mansion. And this third watching from the window screens just leave it on the. Leave it on the porch still most cities right there. Right. Yeah I was just like holy crap that that is like one of the most jarring. remembrances. Of. Like. Again, just the system that we gotta, we gotta just break down because. That's some bullshit. Yeah. Wow and yeah, I mean you can drive through a few a few neighborhoods in New York and have a very, very different experience in all of them. Last. Rush question pre questions modified for David. Something you're hopeful for something you're hoping for the next three, six twelve months things you're looking forward to I want to end on a positive note. I am really looking forward to working on uncovered projects going back to regular things we WE WILL BE LAUNCHING AT CENTER? Hopefully in October it is. Entirely devoted to doing everything that we do right now but all a improving the lives of kids. is going to be cold the Charles Lazarus Children's abilities center off the the family that made the really generous donation that made it happen will also the family that founded toys R. US. It's really special the center is actually going to be right next door to. The flagship like I advertise. Stole and. So I just think it's going to be a really special place I can't wait to. Get moving on all the great initiatives that we're going to be doing to be helping kids out and. Much of the programming around the center was focused on telehealth until the Rehab and when we planned it out a year ago, there was a lot of you show the celery have. Big. Fan. Yeah, so so it's never been. It's never been more needed and I'm really excited to get get moving on screen you off the hot seat. That's three questions from Arias that say you are US medical dot com. Let's the parting shot that one doesn't change. We'll do the party shop. Updated the graphics since you've been here, some graphics rice there. Brought to you by the Academy of Orthopedic Physical Therapy Orthopedics, dot org the leaders orthopedic pt they've got the whole Plethora Library of courses to advance your knowledge in the area of orthopedic Pt were Gabba contest right now going on where the winner gets to pick from any of the last last conscious we did you had to you had to pick the concepts of PT that's the OCS prep course. This one you could pick what tissue tolerance running athle- upper quarter low quarter anything you want. So check them out online Ortho P. T. dot org right parting shot is just your mic drop moment just a sentiment that you wanNA leave with the audiences we close things out what is that? Well. You know I'm GonNa. Sort of invoke everyone to. Get in touch with their in innovator because I don't think that we've had. We've ever had so much of a need right now there are a lot of people in there are a lot of people heading. There are a lot of problems that need solving. and Are you know if there's a way that you can get out in the community in good going into it right now because community needs. Yeah. Well, done innovate and again at definition seen a problem that everybody says ED throws my hands, not my problem solve it and you are an innovator. Okay. David appreciate your time as always and let's again soon. Clearly good to see you. Love, the PT Pine Cast Yes. Yes. The the show by telling a friend or by weaving review on one, thousand, nine, hundred, Google play shooter they brought to you by the Brooks Institute of higher learning an innovator in providing advanced post professional education? Brooks IHL offering continuing education courses in numerous specialty areas. 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And it's brewed fresh by producer and physical therapist Julia decimeter, and by producer and creator second year student Bridget Nolan from Sacred Heart University PT Podcast, a podcast that saves physical therapists from missing out on amazing insight, remarkable ideas and motivational stories. Follow US online at PT podcast and subscribe on Itunes spotify or Google podcasts. It's it's awesome. Thanks so much for listening and if you found value in the show, all we ask is that you tell a friend. This is done another poor from the PT, podcast, the PD podcast is intended for educational purposes. Only no clinical decision making should be based solely on one source. Laoghaire is taken to ensure accuracy factual errors can be present. More on the show at PT PODCASTS DOT com.

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Need To Know Info On Physical Therapy Private Practice Start-Ups

PT Pintcast - Physical Therapy

1:01:08 hr | 7 months ago

Need To Know Info On Physical Therapy Private Practice Start-Ups

"Hey. Before we get started I just wanted to say thanks to our longtime sponsors are es medical staffing helping you physical therapists or physical therapist assistants find jobs all over this country with position. All settings in all fifty states find out what they have for you at a U. R. US medical dot com that is a U. R.. E. US medical dot com. Follow US online at PT Podcast and subscribe on I tunes spotify or Google podcasts. Absolutely. Yeah it's it's. Awesome. Welcome to happy hour. This is p.t podcast, a podcast that saves physical therapists for missing out on amazing insight, remarkable ideas and motivational stories. They say the best conversations happen in happy hour. Well, welcome to our something. McCaffrey. Your host broadcasting live from the Arias Medical Studios also known as my bedroom. there. Find them online at a U. R. US MEDICAL DOT COM. They're the leaders in HASHTAG TRAVEL PT if you're looking to let your license. The Country Checkout Arias again, a U. R. E. US. Medical Dot Com. Great Show for you today at Happy Hour, we're talking private practice startups. We're talk to four visuals who are starting in the process or have started private practice startups. You know conveniently located around pandemic and the things that they've faced word learn from them. Make sure to subscribe to the show the podcast I tunes spotify wherever you find podcasts and now video casting on Youtube facebook and twitter at PT Pint cast on the socials and don't forget. Bring those questions, bring those comments, drop them in and anytime. Let's hear from you. Also let us know where you're listening from. We always like to know where the show gets to or if you WANNA drop me a text message people dairy you I dare and there's no way he's possibly giving away his real cell phone number. On his podcast it's a screen right now eight, four, five, three, one, three, nine, hundred, eleven Let us know what you want to know via text during the show or if you're watching the replay, let us know if you're watching the replay. Let's bring in our guests right now, bring up onto the screen as we get the serious music on. We're going to have fun. Let's bring him on Dr Jason The house. Gilman and Lexin Kyle guys. Welcome to the program now. Hang. One is thank our sponsors Owens recovery science a single source for PT's looking for certification in personalized blood flow restriction, rehabilitation training, and the equipment you need to apply it properly in practice did that without even reading guys, Owens Recovery Science Dot Com. They also have a new podcast you can check out Johnny Owens and not going deep into blood flow restriction, rehabilitation training always recovery science podcast, and Itunes Ladies Gentlemen Welcome to the show. Thank you guys for taking some time. What I assume is terribly busy busy time in your life. We're going to go around the horn not to steal something from ESPN. We'll start with DOC. Jay introduce yourself as well as a little bit about your practice that you started. Yes. My name is Ashley Johnson and I just opened my own brick and mortar in. ATLANTA. I'm income-based. I want patients to be able to afford therapy. So I have a sliding scale for all budgets like that different. Let's go down bottom right hand corner Rachel Gilman. I'm down in I in a pelvic floor specialists here in San Francisco and I'm the owner of pelvic wellness and physical therapy, which is a brick and mortar public floor Rehab Clinic. And the dynamic duo here below me. So I'm LEX and I'm kyle and we just started a brick and mortar business cash based business inside of across I feel like the. So like twenty twenty to say like we all have to identify its brick and mortar raised. Right, it's going to be like the the curve ball for You see people remember places we used to go to them. We used to see other people. Were you guys located because you guys traveling around country. So where are you guys now the northeast again right or we settled in new. Hampshire. After like an hour north of Austin. All right we got. Is Out of the way. Now, the hardest questions are always i. SAW WHAT ARE WE DRINKING That's I'm doing an old fashioned because it gets on the. Dock j what are you got? Glass. Selah Rosa only. Can Handle. A nice. Our a nice. Our good and. Not there they say don't judge a book by its cover, but I KINDA WANNA judge this by the by the can because they look. Album Kenner. Any style of an old fashioned hardest. Already out of the way. So everybody can just breathe a sigh of relief. A physical therapy practices. Pre recently. I WANNA, go around the Horn to throw it a question, and then we're just GONNA go around the Horn I want to hear from each of you biggest challenge. You did not see coming I'm sure before you went into this people come before you sought out advice biggest challenge that you did not see coming but it hits you talked. J.. That even though a sweet looks good, it still may suck and you may have to do a lot of. Action like take down all the wall a second that one. So they teach in physical therapy school had a interact with people, the physiology neuro brain everything, and then contracts. You're saying the suite of the location that you're gonNA put your practices. You're still going to do some work well I had to. So we just finished up a week ago but when I went to find a space, of course, we're trying to find something that's financially feasible. We don't have a high overhead, right, but we also don't want it to be to cheat because then you know you're gonna get those things. So I found one in middle range and it was. A Nice Plaza, but inside the tenants that were there previously did not take care of it like they didn't sell the owner they just did what they had to do in just ravished it. So it's like when we first went to we, I went in there like this is a perfect space perfect ceiling high perfect location no-one thought about infrastructure because they don't teach us the think about the infrastructure like. This brilliant. Great. Advice and. Your your social media handle at Dot J. P. T.. I saw the last couple of weeks rolling up the sleeves. gaint you were doing it all yourself but you have to and you mentioned you know you WanNa. Get a decent enough space but you don't want it to break the bank. You don't want to low because you get what you pay for C. Looking for that sweet spot and I like were already taking tactical advice of a away from what you're saying is you gotTa know what questions to ask. Under the carpet was there water damage? Exactly, it's just like when you get a new car, it could be shining everything but you have to have a mechanic go there to check because only the mechanical know you don't know you can't really yourselves. and. That's something that we didn't have done. We didn't have A. Contractor say is this a good viable suite or am I gonNA spend thousands of dollars making it up to code and? Bring a good parallel, which is a I was recently in the market for a car, and if you're buying a used car by all means, bring it to a mechanic why that mechanic represents you. You're in real estate and you're being sold recent looking for an apartment and had to be reminded this. This real estate agent is is representing the place that I'm looking to rent. ME. So you got to make sure that you ask these questions. So that's valuable information did everything turn out okay and that particular aspect I mean gratefully my boyfriend's uncle happens to be a contractor. Think Sweet Baby Jesus. So he was able to come in and Kinda. Save the day to decrease some costs that we are going to have to. We literally had to do a full demolition lower all the wall. Reading put Drywall Backup News Vac. System plumbing was messed up. It was a nightmare Luckily, I had some friends that are lawyers that I was talking to and they're like, Hey, your rental property does have to have you know they're in charge of some of this but other otherwise, you just made a really crappy business decision. So they help me get some rental credits. I don't have to pay rent until January which, wow, which is an upside right. So I was able to breathe a little bit. But why is that is because you're putting something into that? Isn't yours? Well, my friend who is In Law who I was consulting with kind of crying over the phone about what was going on and she was like, well, what's going on in the plumbing suite? Next door was messed up 'cause water to sit here. So we have to take the walls down and she was like will hold up. That's a sweet next door. That's not you in your you know what I'm saying so she was able to talk to the. Rental property for the to pretty much say, Hey, you're giving her crappy deal right now I, could take this further but this is what you're gonNA do. So we don't and I was able to have a bulldog in my corner which I'm grateful for that but I wanted to tell all other PT's because you may not have that person in your corner and you may be stuck with not enough money that even your bills and that's where I was looking at if she didn't step in. Wow, that's a good point you. You know rushing through to sign something you might not be able to you might not be able to open. Is Now, gone right and they try to get you to sign up quick there are. To rents two months free these go fast and I'm like Oh my God I level by Walmart if a high traffic area I got. Not As far as All. Right. You're still standing right now it's always wondering. Swedish beautiful up to code and on seeing patients we made it through the rubble. We haven't used the name of. A nerve inquired. Lessons that. Share because if you miss one of these steps. You could be really you'll never see a muscle bone or a nerve wracking. And I felt that I was close to that and that was really what was getting nervous but. With prayer in. In friends, friends, you gotTa have friends. Worse places any places. That's one thing that I tell all my friends at. It's like, how do you just how do you just do this? How do you just do that and I'm like whenever I see a patient, I'm an open book whenever I see anyone in the grocery store. I'm an open book you have to be open in conversation in love everyone and that's how you get all these sections. Yeah. That's right. Rachel. You know what's what something with something you didn't expect biggest challenge you didn't see coming. Well I knew in California, they make everything more difficult. So in order to open a p practice in California, you have to file as a corporation. And there's just a ton of. Things you have to do is I always prepared for that I wasn't prepared for how long all of it was gonNA take i. made sure I spent money I hired a lawyer so. Much paperwork. I. Feel it in my head I thought that many would go back right and. So I had planned to see patients at a certain date and I had patient schedule but because of the pandemic cure everything was a lot lower. So, I, was ready to go I signed my leave and I was technically not like allowed to see patients. He comes I was nothing. Like, it hasn't been filed yet. You should. What's that? You're still paying him elise. Yeah. Oh so I paid my like my. Yeah, and so that is something to be aware of that. Even if you think like I'm hiring someone to do it for me and it made it seem like this is GonNa. Be still efficient. I'm such a responsible adult having lawyer take on this for me because some of my friends who started a practice is lose legalzoom and they're like, oh so fast and easy and Michael This is going to be even actor because it was in a different state or now they did it. Now I have people who did it themselves But in my head I was like, well, knowing me all make mistakes. I just had a feeling like just knowing the I wouldn't pay attention click. Wrong button. And I'd be heard I hired someone. But I didn't anticipate that the date would just take. So long So yeah. So I had to delay opening reschedule everyone. So. Just being prepared. But if you think it's GonNa take a week I'd add. Who Three weeks I'm lined Yeah. Because yet to remember like some of those things out of your control, the matter how respond no matter how much adulting you're doing being? Hiring a lawyer. Interest aren't gonNA happen. I got a buddy who's looking at open a practice right now. This was pre pandemic an actually. The delay in the state saved him ball talk about later episode. But Hat, he had abe work on through faster. It would've actually put him in the situation where he was in a lease. The delay so that how many times are we like Oh you know what I'm glad. The DMV real slow with kept. In this situation. Kyle. You can have one or two since there's two of you biggest challenge you didn't see coming. On. The though I just want to echo we. Built our own our own space out within the cross. luckily, DAD's contractor in a nuances up. So that wasn't too daunting task set for I. Didn't I learned I didn't know how to do drywall like everything else was fine. Terrible. And the Again. We'll say we did overspend a little bit on And some bit higher I don't deluge also. but then we civil hyperfocused a bigger issue. We were so hyper focused on getting the physical space done. He just opened and be there that we didn't spend a lot of time marketing. Rachel, Stockman already having patients lined up we did not We did have so. No luckily categories us than we had a decent turnout so far for mercy. No Mark. But that's something we got wrapped up in the build and the whole kind of establishing physical brick and mortar space that. We didn't. Oh, we got to let people know we're here. Say. I don't know it's got along the same lines. It's just we had this dream and we knew we wanted to do this thing and we spent so much time planning out this thing on paper in we had an idea that we didn't need physical space we were like, well, we'll just go to a gym and we'll be in the space when the classes are going on. Paul. Yeah. Like Practice and we discovered I talked to Kyle Paxton from I. and he was like, no, like you really need a physical space because people establishes you as a as a clinician. S on we it was like I dunno mid April and we were like, well, guess we're going to build a space in hell. So that was like halfway through and then the Jim started opening up here. So we ended up doing everything just really delayed and because we were so hyper focused on this dream we were like. I would say backup and think about the logistics I should've done. Yeah. Player own plate player on worst enemy in your own devil's advocate. What what areas are we looking at? All right. So that's good. Good expectations based challenges. You didn't see coming varied, but all important and really just shows attention to detail and things you might not be thinking about. But how are you supposed to think about things you're not thinking about? WHO's free next question for you guys all opening your own private practices the eighty twenty rule. The is sort of the eighty twenty rule is this principle where eighty percent of changes come from twenty percent of your efforts. Okay. Eighty percent changes really come from just twenty percent of your efforts. What of a twenty percent efforts that you're focused on now that you've had these hiccups now that you've got to space and now you're focused on okay. We probably should've thought thinking about marketing faster Barbara should ask some more questions or or or timed out things will have better. What are the things now you've gotten over that first hump that you're saying, okay I've learned my lesson what am I going to hyper focus on now? What's that twenty percent we'll start with Rachel? I will fight. For. He's A. Twenty percent is Focusing on right because that little twenty percent, it seems a little but that's where most of the change is going to be coming from. So now we're twenty percent of your efforts re or I should say, where's where are those twenty percent? which is going to make the change where what? What are your efforts focused on? Combination of definitely marketing more I've been practicing San Francisco for a while more just like, Hey, this is where I am. Now I opened my on my own practice and kind of going that route of more like a reintroduction type situation but also seen out there they didn't know. About before spending time. In terms of providers in terms of. You know people I think I would like to work with. So I think that's where we're a good portion of my effort is but also trying to figure out. How I can accommodate I was anticipating not having a lot of patience because of the pandemic and had not been the case so far surprisingly So it's trying to get how to accommodate. Mount. Of People that I did not expect to the wanting to schedule because like I said I, just kind of anticipated it being really slow and that I know have like a patient and that's what I expected. I really budgeted for like a very slow start and luckily that hasn't been the case so it's trying to figure out how I can manage. Amount of people. So you're really focused on number like communicating in marketing. Communicating, and logistics. To those. Not, really covering PT School. So you're starting even before we before we went on Air I said you're gonNA see a theme start to emerge and talking about is a lot of these things. I've never met I've met Alexis Kyle but like I Dot J. and Rachel but like I'm sure you're wonderful clinicians. You're running albums from things that you. You've probably just never experienced before an. Audience to take away which is. To think about those things. So Kyle lex twenty percent and that where's your? Where are your efforts focus? Now you've gotten over that first hump, these efforts that are now looking to actually bring new eighty percent of your returns. So I was there twenty percent right now is focused on definitely marketing and. Like both like what you think of Marketing Riley, putting ads out there stuff on social media and so on. So forth but also lake. Building brand if you will because with any population like you got, Kinda live that life to build that authenticity in that population four so like we're dealing with performance athletes. A big vast majority of our target audiences across athletes. So were right there in the box. So in the one with the people but also planning drop ins and stuff like that where was accepting drop ins given Kobe but to just kind of bill that often through fee and during workshops stuff like that. So it's a grassroots marketing salvaging report authenticity people, grassroots marketing, and you know. That's that's where the get the grass. That's where the rubber meets the road. This is. This is rubber meets early. Shake Marketing Yo, handshake or an actual handshake. So people say grassroots I would say this is relationship building. This is where we're good at this. This is why I used to say PT's were bad. They're not. That is the case Kyle Alexa where you going to say in terms of where, where's your twenty percent focus? Where's where's it going to bring them up best returns definitely the relationships. Building relationships, which is tough right now because typically my number one hey, let's drop into a gym and introduce ourselves right now you can't. So that whole relationships thing is a little bit difficult I will say I will say right now but. That's where we're going to try to keep going with this building their late because you can mark get cold calls or whatever. But you know no one wants to to do business with someone they don't know too. So we WANNA, we WANNA work with these people and. Just make sure that we build a relationship I. Though by trust you eventually Bingo Dot J. You you point to a specific population as well too. Don't you you hyper focus which twenty years ago Now, it's a super good idea, right? So I played former college volleyball and I coached college volleyball in the past already in. So within the Illinois Indiana Florida Georgia area. I was I'm very well known I'm a crazy coach. So if you see me on a volleyball tournament who got cody Bernie she. Buried. Nave 'cause I love volleyball and what I I I was kind of like you guys like Kyle I started in a corner of a volleyball, Jim right my boyfriend's a graphic designer. So he gave me this huge bag drops. So it made it look like it was my own space also I was really just in the corner of Jim with a table but the reason why people came to me was because they wanted their daughter to be treated by a former Division One player by Former D. One coach. ended. That's kind of what brought my people I didn't really have to go get them. They Kinda were already surrounding me So in regards to getting patients that's never really been my issue because the girls are gonNA come 'cause they there's weak players in volleyball everywhere right and it's like volleyball's one of those sports you can perform and be really good on the court and have horrible. The rest. Rhythm. Horrible Chubby girls I'm like, how do you even? Ballou. Using Jesus right now. I it blows my mind and I shall give more PT's look the volleyball players they'll be like, how do they emit so much power. because. We're just degrading our joint at the end of the day, but I would say, my twenty percent focus right now is finding those patients that are too scared to go to physical therapy because of the financial burden reaching out to doctors that are like what patients just aren't coming back in you don't know why. I need to find them I need to figure out the patients that go to care and don't have a primary care. So I've been going to urgent cares in those are open through Cova because you know people's need urgent care and a lot of people choose urgent care don't have insurance, and so my clinic is actually right around the corner from an urgent care and I literally went in there and said, Hey I'm a physical therapist. Here's my income based sliding scale patients that have musculoskeletal issues give him a script in send them around the corner and I opened on Monday and I've already seen about fifteen cash-based patients from the one urgent care around the corner. But it's just so for me, it's like I need to find those patients that like whenever choose PD. Because they're just too scared of the whole medical institute and. Just perfect I wanted nothing to skip passes because you said, a couple of things that I WANNA to highlight number one. A lot of people will focus on I opened a business. Now I need to market. Right. Does completely true except except dot j what you just said people knew you because you're this crazy extroverted and allowed volleyball coach. Marketing Long before you opened your business. I don't care if you're selling cars or physical therapy clinic people knew who you were. You were creating a brand around that. Right Direction you picked is is on you but you're building your brand long before that and you're wearing right now you got Alexa Kyle doing the thing right now. is by a accident but. For people is. The grunt test, you guys familiar with the grunt tested all. Did, you hook. Test. I can't take credit for aiding that's but here here's what you to the ground test. Anytime we interact with the product with a marker with type of Bourbon with a cell phone with a physical therapist without knowing it your consumers including yourselves are asking yourselves, three questions every single time you're doing this without knowing it right because we we get what ten, thousand ads a week or whatever. What do you do? How does it make my life better? What do I need to do to get it? If, you cannot clearly. And concisely communicate those points you will be ignored and being ignored. While was used to that in high school but in in business, it means you do no, no longer exist. What do you do? How does it make my life better? What do I need to do to get it and what I wanted, what I typically tell physical therapists specifically is. There's not a whole lot of room in there for me to tell you for for you to tell me about all the certifications that you got right unless you can explain to me how that's going to the second question make my life better. What are you better be very clear and I tell people all the time on this show. PT PODCASTS as physical therapist for missing out on amazing insight, remarkable ideas and motivational stories. That's what I do. How it makes your life better and I follow up with subscribe and follow. That's better right. Right. That's the grunt test. What do you do? How does it make my life better? What we need to do to get it? If I could communicate that to every physical therapist is I think this world would be a better place but also like I think doc J. going to urgent cares and realizing. Who you want to communicate with and they play in the sandbox and were they don't play in the sandbox right and not at a PCP which is yeah. Looking in their shoes. Mary sparked so smart. All right let's. Harping. On some negatives right biggest challenge and needed and expect. Let's go to a positive right. What was the thing that's been the most? On neck you didn't expect right treating your own patients, your own way on your own time. That's that's pretty expected. But that's that's that's a great thing. I want to get past something that was Super Fun that you didn't see coming like a gem. Lexin Kyle will start with you something you were like madden expect is but how great is this? What is so? I'm not sure fun but definitely. So one of the patients seeing currently only backup. So when you're marketing and stuff like typically try to identify what is your kind of target population, what are they like where they want, and then I guess do the grunt tests and? According rate. So, this is far outside of that demographic. And we wouldn't have expected this person to come to us for our services versus and she stayed for quite visits now and continues to pay in it's it's to the point where she's like. Well, hold on I. GotTa See if I'm going to be paid by that point in time to build Fort Services for the next visit by still WANNA be here. And perhaps we need to look at flying. A toxic stockman wrote but to me that will always be kind of one of the most rewarding kind of experiences that somebody who is could be one out to dinner with this money or could paying their bills are. Choosing to vote with their money right in solicitor if they care for their health that much. So so we've got to be rewarded regatta go deeper, Wad why do you think that is and then follow up have you asked her why that is because that is terribly important. So I've talked to her about the financial side stuff a little bit because it was practical for planning what we're GONNA? Do their care how many more visits can you afford lake stuff like that was practical and something I think that's been kind of resounding theme has been like. So it's going to do like a quick tests on I think it was kept trying something. So it was like you know all you've got to relax whatever I promise. I'm not that strong like just relax. Oleg, something like that and She was like, no ice near I see your scores Sugar Wad like. I know you're strong and. So to me, that just kinda spoke to like being their living the life building the brand and. Being in part of that community. Something that she valued. Dogs are going crazy. I thought that too. She has said to me like. No I think it's cool that you guys are here and can see me while I'm doing the workout. Outside of peaky sessions and stuff like that. So. Interested in life is really been why she's like to these people rather than like the insurance face clamp down the road because they kind of know what I'm doing. Dipping her hand man she's telling you a lot because, yeah, she's looking she's looking you up. Like I get it like I senior scores She's telling you that. She sees who she she knows who she wants to become. May, and she knows that get there is through you know your brand because you're associated. Loki, like sometimes I'm like I'm not gonNA. Go to the work today and I'm like. As soon as I will go to the volleyball gym and they'll be like, oh, coach Aj hit this outside and I'd be like boom the girls like Oh my God. Yes I'm sorry to you girl. That's Like people like strong happy people, they want to be like their PT and that's like that's great. That's great. Yeah. I am from a communicator standpoint from from a narrative, right? So like she's telling you a narrative that she sees something right because I I am the I'm the main character I am the hero in my story you're the hero in your story you're the here on your story and I. The hero in the story is never strong and mighty, and can you know vanquish evil in the beginning? Right. Through the journey they have to they have to be something to overcome obstacles. Finding a bad lease or not to ask him right like you have to overcome mls to then vanquish evil right. where she is in her journey, her journey, this is all user experience on her part. She sees that right now I am here but I think I can get here and that's where I wanna be and I need a Yoda or an. And that's A YODA OBI Wan. You can't do it for me to tell. You. All of on screen you mean iota or the Obi Wan for your patients. Yoda couldn't lift that x wing out of the mud four, luke, he couldn't. He could do it himself. But he had to make sure Luke knew he could do it himself. So like this is like an anonymous get past because this is narrative now. And yes we we know muscles and bones, nerves, membranes, and a lot of cool stuff. But one thing we need to make sure as where do I fit because if I tell you I am I am the best triathlete ever and I've won all these things and that's how cool I am you're going well, that sounds cool for your story but how does that? Help me achieve what I want to achieve 'cause I. Am the I am the most important person in my story I think that's a great success on your part because she is literally doing what you just said. She's choosing, Hey, I want I wanna see you because I could be going out to dinner or bank in this money to frequent pandemic and she's chewed as. See you the big big big deal that. We didn't SKIP LEX DO WE? Yes. I. Can I'm? I'll be honest I. thought documentation was never that bad like I was like, okay. I'll bang up my notes. Okay. I love that I do not have to justify every single inter. Unlike I'm GonNa do this intervention because I know it'll help not because it's going to benefit show the stability of. I love it. It's like the best because you get to do what you want to do. What you know will help are we doing this? It helps you it healthy and it just doesn't matter. Insurance is going to cover it or not. It's fantastic. My lights utter. A you paying for it yes. Great. That's why you came here. What I hear you saying is you're not writing for the third person who is in the room you're writing. In the. I. Don't think I've taken a second analyst this. Is Amazing. I. Love. Writing notes I'm writing to someone in a room or like worse as a guy who has a degree in journalism I'm like I'm writing this for no one. No win ever GONNA. REAP. Radi pitcher way where if someone does I'm defensively documenting and then back up, sometimes they'll deny it to bring in. For Nothing. So. That's amazing. All right. Thing. You didn't expect the hidden jam most fun. What did you not see? Come that you love I actually have two one, the superficial one a forever athlete and I'm built very different. I'm very physical with my patients Khakis. slacks. I was clean of getting written up. We see I'm like listen if my billable good. My patients are coming back. Right me up for my yoga pants bro because like I got moved. So that's one thing that I'm very happy. I went to work today and my little stock Jay Shirt, my yoga pants and guess what every single patient felt better. The vibe was good. It didn't make me less a doctor physical therapy, my yoga pants because we're here and what we're wearing and you patients yeah, Yeah Jim. Right you blend in this, what you weren't blended. Okay and so my biggest thing is that Patients that I'm really feel like the underserved population. So patients that Kinda, they don't speak up for themselves when they're in the room with the doctor but when they would come to me for PT, they would just tell me they would vomit everything that they were feeling and it's like the the ability to help patients navigate their medical situation. So now that I have a private practice I can personally call the primary as their PT. Hey, this is what's going on like let me let's figure out if we need to give them a referral of PT is not working can we look at this? I? Feel like I have more autonomy in ability really held my patient. Because I'm not seeing fourteen day and I can be like, you know what? Let me call her primary 'cause he's not getting better or I can refer them to the proper referral source or they can come in even sometimes where their paycheck didn't get. They don't get paid this week but they paid next week for their in pain today and they have a Labor job that they need to get to get the minority to give money to pay me. So I think that's the biggest Jim just having access the patients and really being able to fully take care of them with no type of boundary or border. We're really truly backers of PT when we're by ourselves. Yeah. Rachel. Most Fun. What is it? There's been a lot. Also do like I have a superficial one, which is my office has air conditioning. The sound does not exist and rarely does not exist because a global warming it will get really hot. You're now and we die. So having airconditioning has been. Amazing especially now, the fires cause your windows. So we have the windows closed. AC on live the dream. That's like my. It's amazing but the bigger thing had been. Because I've done I. You know I paid lawyer I paid for an accountant but I was like I'm GonNa do everything else myself. So, doing the graphic design building, my website and doing, and I even took an accounting class I can do my own books. And doing all these things and I was like there's no never gonna be able to do that. It's like you know how are you gonNa make what website are you gonNa Code but it's been fun and now I feel like I'm cool I'm like Miss Your robot I'm going to happen to your dreams. I made like. And like I in my head like, wow, like I can go to work on valley working goal. I would say, are all things I really Whatever, but it's been so fun doing the accounting even I got a ninety eight percent, my accounting class they don't want to brag ice own. Yeah I'm doing my book. I doing all of it and so all the stuff that I didn't expect I thought it was gonna be like the worrying part of actually been pretty fun. Yeah, this is I mean I mentioned this before a second ago, which is we are the most important person in our own journey right and this is discharge of opening a practice. This is your journey, right? So like you need to constantly at the same time I remember. Where am I? where? Who am I the Yoda four but also like I'm I'm in a journey to or else I'm not gonNA be motivated to do this or. To your life and that's kind of one underlying. integrations. And even watching or listening to this. If they're thinking about this, you have to realize this is a commitment you're jumping all in your either in the deep end of the pool or you're on the deck, there's no kind of waiting into this. Kipruto. Dip. Not Diving Board No. Either you got. but you can have. People shouting advice from the from the sidelines right always to. Think. Ahead, which direction you're going to jump or you can think which which things you're can do. Once you hit the water right paddle hard kick hard So what's Let's start with Joel For our next question. Okay. Here it is nothing that you've purchased since you decided to open a practice for less than one hundred dollars. That has helped you greatly something. For less than one hundred bucks. So it's not it's nothing exorbitant. One Hundred Bucks which you use regularly that you help that helps you get your job done anybody think of anything like that. 'cause I'm looking at the heart one rage I'm I'm. But I, use every day. Every day just helps you. Could act like quick books or something like that for me. That wasn't one hundred bucks, but like, Hey, that helped me a lot. So it's something little. That kind of helps you really have an idea save Rachel. That that's the thing that I. Don't think there's anything your little like got one. We bought models motto on I'd it's like The HIP. The. Pelvis I don't know what it is experiences, but like every other clinic I've worked in. It seemed like I had looked up prices a model. So they it seem like this in exorbitant costs afford more models. So. Why does the rope wine at the? Dollar plays we couldn't have one good shoulder. Twenty, two bucks. Is Not there in two days. From Amazon Right. Yeah I don't know about those models that the bulls newness models or not. I mean I thought A. Bottle. Why Women? I scored my Baltimore was pretty cheap and. But I literally just got him the All A. Model Today On Ebay for two hundred dollars. And I'm only there six hundred was. Allen. Yeah. Model. He was not seeing. The difference between a Nina Penis. There's only one company that the. Anatomy model. That's why monopoly. Husband. Unit model. Yourself. Nurse in a weekend and you got yourself. In pick month if you see me on billboard. Because I'm not I mean I like luckily found with one on Ebay and got it. All right because. I was like man, this is not cheap. Under, a hundred. Google searches. Going computer like what is this chick doing? Google. Half of what I wasn't halfway talk about. Probably not paperwork I realized I just. Desensitize Yeah Yeah. Oh I talk about penis. Vagina. Rectum all day and just a few. Eight hundred bucks. Less than a Sinoe what's helped you greatly? Could be an APP could be a subscription service could be a thing anything hundred bucks or less. What's been word juice worth the squeeze. Let's change it to that. Just worth it really worth one hundred bucks. that. Dot Jay. Oh. Yeah. I found a hidden gem for under one hundred mirror adhesive sheet. A mirror. It was. And I literally have it's like a how big is my wall owners? Say My marijuana is fifteen feet by eight feet. And I literally like eighty four dollars on. You. Just take the mirror sheet and you just put them together and it's like my ears we're GONNA be like fourteen, hundred and. Ninety dollars yeah. See that's that's what we're looking at the gym right there. Who didn't we hit with this one hundred dollars or less. I mean technically passed. I. How about this I actually kicked counterfeits sample. Sure. Man I'm going to throw it out there if you ask people and you're nice and you say like, Hey, like I just opened the practice. So. Thank you for free mice. I hate. All One hundred bucks to me my book. I. Yeah I got. I got so much. For Free because I just asked in terms of what what did you ask for reasons? Hulu samples. the. House. Die Raiders One I'm trying to think what else a lot of stop. So this wasn't necessarily this. This was more relationship building the people at that sending that to you were smart enough to go all right I'm sitting there. Are What's my cat. I've. All the time. All I found what me at Costco once I want this I email them and I was like hey. Can I have this? Built. This. Yeah you better. Where they're going to say, no. Okay and make. The time they say, yes, they send it to you all impeach school. If I didn't want to read a book and want to buy I would just call the author it'd be like, Hey, you got fifteen twenty minutes. Maybe some books. Remember. Mike just released a book and I was like that book is eighty five dollars yeah. You just don't be an asshole and you're nice about it as long as you. Want to know how I did it with Mike Reimann the Grunt Test Hey Mike I'm drew McKay, I'M A. Here's house. Here's what I do. Here's how it makes your life. Better he's like. Well, I don't know five hundred people here that maybe I'll sell to books and give them one I'm still plus one. Your Twenty minutes and he was like, yeah no brainer. So. If, you give them all pitch. Always been my wife. It's not like I'm just asking him. Right I WANNA. Give it to patients. My how can I help samples and their live? Over one hundred episodes miss podcast. I've never had someone really like their lube. That's the first one that. got. Important News. Lube. Drugstore not always so Half Invest in yourself and your role in your peanuts. It's always fun when he has pelvic ptr onboard. Entire Ninety minutes worth every day and I was blushing for most of it but I kept a straight face it did not. But. There is a lot of important points there how we get two hundred bucks or less. Do you WANNA throw it in there to some super worth it what do you think each? All right. I didn't realize models were that cheap. They were treated like they were like, Tesla's. For real getting right. So I guess models mind but a second thing could be like. And I'm partial rocky and stuff because that's part of like. Tate and the Boudoir Band they had one rock bus. Pods Rock your medical provider get him for like thirty five forty bucks. See You bring up a good point no matter what you're getting see if that retail item has a medical program. Membership a lot of times six or shoe companies were scrubbed companies will you know? Ten fourteen percent. Isn't a big deal unless you multiply it by your career then it could be kind of a big deal. That's lying the bottom line All right. We're going to do Let's do three questions. We really do three questions. Requests the hardest three questions will answer I'm only. Three. Brought to you by our friends at Arias, medical staffing leaders and travel physical therapy online at a U. R. E. U. S. Medical Dot Com. All fifty states, all settings, a times people think travel physical therapy just like well. There will no. There's people and there are practices that need therapists for short term assignments, three months or might turn into a long-term Senate. I like to say it's like test driving an area. You guys did some test driving US went to Alaska. Right. Living Alaska I'm like are you sure I don't know go for three months and get paid to do. Physical therapy you can ping pong your way around this country of our. So settings in all fifty states, all settings and Washington DC online at a U. R., E. U. S. medical dot com. Thank Arias for sponsoring the show. All right. So three questions first question will go around the Horn Nice and quick First question is aware question dot J. where is somewhere in the US that you wouldn't mind going to be in a PT in a volleyball. Jim. Three. Months where would you wanna go whereas like Mecca Volleyball? I'm here in Atlanta. Yes. Segment be. He's been Texas. Volleyball. Living it. You're in San Francisco where else would you wanna go in the US that you? Do New York City. Yeah. Out about I would go in and Haton. Yeah. Just lifted. It's you know where the best slice of pizza is I'll tell you seventy four Amsterdam. Yeah I. You did some travel pt did Alaska would you WanNa go and do some time you're in New Hampshire? I would say Wyoming Ronco Yeah. Geography wise Yes sir just outside of ops across New England. So it's actually not that far from. US. For the atmosphere and Jim, at that caliber brings a second question on three questions we'll go. Is a what question. What's something you've read or listened to or watched a movie book podcasts that you think the audience should to get value from. Greg Todd. his instagram anything that he says has really motivated me throughout the time dislike joining his program has given me so many inside scoops so invaluable invaluable. Rachel Tim question what's the Red Watch downloaded? I'm still reading it, but it's called rag better by meredith men and it's all about learning the art of self promotion. Deal like is really hard especially as women I feel like it's hard to talk about yourself and not feel. Like you're being unladylike and whatnot though I feel like so far I've not done with the at, but it's been a really good reason I highly recommend it. Does it go into something like the grunt test where it's like, hey, focus on what you were. Yeah I mean. Bring the. Your conversation. Yeah. Yeah I. Like that out lexical watched. Downloaded read where you got conscious coaching by Bright Murphy Auto. Show. New. Accelerated method by Talgo. He's got them all on. I've called because we're not talk anything about marketing. and. So that's like where I'm. I this though but this is this is my soapbox right? which is all right. Listen if you're a physical therapist near at a backyard barbecue and your friend next door was a graphic designer and it was like, oh, my back hurts every time I play volleyball whatever and you're like, Hey, I'm I'm a PT knows volleyball you ascertain is going to Google and read a blog post out at you'd be so pissed, right Flip that around same barbecue couple of weeks later, and you're like, Hey, I'm a volleyball PT and I'm starting my practice in this graphic I could do a logo for you and you're like, it's how much I could just go to Canada I'll just do it myself. It's like, Hey, people are good at this. Sorry. In my life people artist higher the professionally, it works both ways. So you was books who are guys who know women men know what they're doing do that because they've done it they've also run into all the problems you've earned you and you're gonNA skip those problems because that fifteen dollars book. With our. Last question is a WHO question. Dr Will Start with you who stumbling the audience should know more about. Oh. Not Rachel. Yeah I have to just because they're both very instrumental in me starting my practice and really helpful one is them. He's WHO's an amazing of the therapist and she's actually in Amsterdam now but you be here in the bay area but not Amsterdam and Katie. Just, open her private practice in southern California. The practice we've kind of been co-founders in a way, but obviously separate entities, and though she somewhat I would recommend checking out all taking the same journey at the same time right and. Lucan Laya I don't WanNa bring it back to star wars but I just did. WHO's your? Who? Who should the audience more about? Would say tickle boom for. Say More, time. Jonty. The movie, Maestro Shanta. We learned a lot from her. Finalized and. Things. We weren't getting school about both business and treatment stuff like. this whole field like. About what she knows and Bring a lot. So you know exactly what moved to ensure does right her grunt is pretty clear. It's very specific clear Last thing would you on the show is called the parting shot let's do that right now. Party shot is brought to you by the Academy of Orthopedic Physical Therapy leaders in north. By them online at Ortho P. T. DOT org. We just had people from the academy on the show not long ago talking about their brand new offerings courses on their. Tissue tolerance. As well as Check them out online Ortho PT Dot. Org. Also, if you look at it, the executive document concepts of orthopedic PT, that's the adding course. To preference. So the parting shot is your last chance for a mic drop moment. What's the one thing you want leave with audience and if they're stuck with it since long they're looking to start their own practice, right? So we'll start with J. top right corner. Parting. Shot. Would he got Find, your lane do not give up and be personal. Personal and being a cool and people will come to be cool. And I'm sure stronger faster safer. Cool. Be Cool. Parting shot only with the audience. Believe in yourself like just go if you WANNA start something. So you know I I, I kept talking myself out of it for so long years and years like. It's not the right time I need more time I need more time and I'm like, what? What was I doing? I was just in my way and I obviously that doesn't everyone has their different journey. But if you've been thinking about, for Awhile Kinda, just sit down and think like what am I waiting for because what's going to be different in a year routine years? Something, you want to do you know I say I go for it. And yet also just don't be an asshole like if you WanNa work with if you will be nice to people. And you'll get that back and. Missing Networks Right. Very simple. But I think it's really important. Yeah. What you're saying just go. To ask people people always say what's the worst that could happen to leave like the flip interesting? Hey what's the best that could happen and maybe that's going to happen and if earn enough that will happen Lexin Kyle parting shots what he got fourth. Send it. So I'd like to echo what Rachel said We kind of were forced back Cova to Matt Fourth, but it throng incentivize us to start a practice We had been doing the same thing playing the game like when we have X. amount of dollars see than we. Go on, we know all these things we've done these whatever it was like trying to put obstacles and barriers between us doing the thing. Just do the thing shot, say get the LID off. but you know it's been kind of warnings Like just send it know that you're not going to know everything clearly we all didn't. Know that like if you're just a good person, you're being cool being not astle You will have good people in your corner around you that are going to help you out whether that's people just soliciting your business supporting you people giving you advice and help with your bill though or with marketing, whatever it is. So, just send it. I mean learn this stuff in kindergarten. Be Nice people like how. All right I'm like no pressure but you're closer. So I would say if you're a new Grad watching this. You can do this as a new Grad, I. Think we were told over and over and over again, you can't do this as a new Grad that run out. Of thing don't you you're ready knowing A. Experience here you know everything you need to know just do the thing just to. Thank guys. I love it free. Shaker. Take an assignment timeout to share information with the audience and myself. I. Still. Need follow up like three, hundred, sixty five days from now and see what we've learned. Miguel acid exact. Same questions. See what's changed? What set a date and? Model. Rachel. He gets on the streets surrounded by. Hopefully the price of Muniz. Dropped the next three, hundred sixty. Young. Guys want to say thanks so much for for coming on the show and Sarah Sheriff's inside, right. Jeers club 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 Ihl Dot Org. Our home on the Internet. CAST DOT COM created by build. BUILD PT provides marketing services specifically for private practice PD's website development and host inviting content marketing solutions pt clinics across the country. See what good pt can do for you today at build. Dot Com. The PT PODCAST is a product of PT PODCAST LLC it's poured fresh by me physical therapist. Jimmy McCain ingredients are sourced by our chief connections officer Sky Donovan from Marymount. University. Brewed fresh by producer and physical therapist, Juliet Data Center, and by producer and Creator second your PC student Bridget Nolan from Sacred Heart University. PT Pint cast is a podcast that saves physical therapists for missing out on amazing insight, remarkable ideas and motivational stories. Follow. US online at PT podcast and subscribe on Itunes spotify or Google Catholics. Love Yeah. It's it's. Awesome. Thanks so much for listening and if you found value in the show, all we ask is that you tell a friend. This has been another poor from the PT Pine Cast. The PD bind cast is intended for educational purposes. Only no clinical decision making should be based solely on source while care is taken to ensure accuracy factual errors can be present. More, on the show at PT PODCASTS DOT com.

Rachel volleyball Jim private practice Google San Francisco US PT Podcast Dot Jay Alexa Kyle Alexis Kyle Hundred Bucks ESPN Atlanta Johnny Owens Amsterdam spotify Rachel Gilman
PTAs as Leaders in the Healthcare Community with Eddie Ernst

PT Pintcast - Physical Therapy

59:58 min | 9 months ago

PTAs as Leaders in the Healthcare Community with Eddie Ernst

"Hey before we get started. I just wanted to say. Thanks to our longtime sponsors are es medical staffing helping you physical therapists or physical therapist? Assistants find jobs all over this country with position. All settings in all fifty states find out what they have for you. At a U. R. US MEDICAL DOT COM. That is a you are e US medical dot, com. Follow US online at PT Podcast and subscribe on I tunes, spotify or Google podcasts. Yeah, it's it's awesome. It's official. We're live, happy hour today. Welcome, welcome, welcome back to the show. Shooting McCain. This is P. T. podcast, a podcast that saves physical therapist for missing out an amazing insight, remarkable ideas, motivational stories in the world of physical therapy. Cheers to you! Guys want to know where you're watching from. We've got eyeballs on this. They never were doing a livestream available via our facebook and twitter pages at pizza podcast. Let us know where you watch. And where are you listening whether you're washing? It lives or the? You're watching the replay. Just kind of say. Hi, say what's up and kind of want to feel of where you guys are located a great show for you tonight. Eddie Ernst is here. Yeah. We're GONNA talk about some of the stuff. We're going to get into some PT leadership as well. Do you WanNa? Remind you guys subscribe to the show. It is free when you hear. Subscribe Your Life Well. How much man! PODCASTS are free to subscribe. That just means you get notified whenever there is a new episode, so you never miss anything we don't want you guys submissive. Miss Out, so subscribe on itunes on spotify. Google podcasts wherever you consume your audio. Ever you put the audio in your ear hole Let's see coming up. We've got some shows for you tonight. Marks Yelich answer cruiser at six o'clock PT Health Study. We'll get into more of what is on the Horizon WanNa. Say to our friends. Owens Recovery Science for bringing you the first round Owens Recovery Science Dot Com. You're single source for PBS, looking for a certification for personalized blood flow restriction, rehabilitation training funding online at Owens recovery, science dot, com. Find their podcast online as well. It's called the recovery science podcast. Don't know where they come up with the name for that. They deep into be f are on their show. We're saying hi to to Daniel in dekalb. Illinois, I'm guessing I L I. L it just looks like to get you know what I mean confusing me Daniel. Sit on an angry Orchard Salud Salud Daniel I. Don't have my glass filled yet. We'll do that in the first round is completed, but Daniel for dekalb stepped on the angry orchard. Take a look at that angry orchard. Ask yourself wears that made. It's made in my hometown where I'm located right now. The Pro Walden York all. We got going for us. So what's what's bring in our first guest of the night without further ado? Any speak Ta rise and there is. As. The show man! Thank. Thank you well I'm. Glad to have yawn. Glad to have you on now that we're doing video stuff, which is a little bit new for being a radio guy I was used to, either the person was in the studio and I. Like that a lot or or was all headphones right? It was all like You know. We're just doing things by phone or Internet connections stuff like that, so appreciate you doing this now. We got body language going in which actually comes up award patient communication. We like to get away the heart, the the difficult questions I eddie her. What are we drinking? So my favorite of all time the balloon. Oranges, so if you don't have normally garnished with right orange peel, but if you don't have that. Little orange juice little swish swish. Garnish. That's a professional man of leisure. That is a quality quality. Move Right. Man of leisure I up at the gas station because why not? Use Goose, island Ip. Again it can so I feel like you know like I'm just I'm really drinking a lot today so as I pour this in their make sure we get any social screen Casey climbs in Phoenix Dwell PC client. and. Overly That's abuse right there. Let's they. which was this? You've known as the guy really to up to bring into in terms of vestibular as you get excited investigator issues. What about vestibular patients working with those people really excited you. well I just want a the connection. I don't know if it's my under yours, but it's Kinda scratching in and out so hopefully on at least coming through clear for you need. Make perfect. It started actually on a clinical rotation so I I long term clinical rotation was an outpatient clinic out in Independence Missouri at Blue Ridge. Physical Therapy and I didn't know as stipulated honors, normal outpatient, so got there and religious kind of getting involved with with the PT and probably sixty to seventy percent of my caseload was vestibular in. Just seeing number one was the BP like just seeing how quick you can make a dramatic change. Somebody's life like pretty much the only thing you can like medical condition that you can literally cure with your hands and five eight with somebody. That's the only thing that I can find the you are literally curing somebody. You know in five minutes right, and then the second part was the vestibule treatment right so like the vestibule hyper function people are just dizzy. A car wrecks all that kind of stuff so I was just seeing a lot quicker. Results. And then again just a lot of like the quality of life was turning around a lot quicker. compliance with home exercise plans. Generally speaking was a lot easier to seeing a lot more results a lot quicker with the stipulation. It was with Ortho. and there's healing timelines with Ortho. That definitely we're obviously plays at rolling it biologist loving seeing like the quick results and also you know if I'd be lying if there wasn't a little bit of Sadist Emmy me right normally with Ortho. You're trying to avoid the pain, but when? You have to make him a little bit worse to make them a lot of it better so when you do stuff with them, they're like. Oh, it makes me off. super-busy Disney's do that ten more times for me. You'll feel better so. How'd you pitched that right like you? Do you prepare someone like when you know? Hey, I got someone someone. I can so I'm excited, but I'm also status. You said it, not me. How. How do you communicate? How do you set them up or do you? I mean I'm just honest with them like that, and that's all you have to be like I. Try to had a really good. Mentor at Physical when I was there a lot of good mentors actually, but one of them was more specifically on the chronic pain site. She helped me a lot with really targeting my like no CBO language versus Placebo language, and that kind of thing to make sure that framing things in a way of setting expectations versus telling them that they are going to feel Dizzy Wright's knowing example example of no CBO language and Placebo of. So if I'm GONNA have them do an exercise lie, so the the standard is like a yaw pitch and roll right head movements on there so I'm. Say All right. We're going to do this. You might get dizzy with it. It might stir you up if you do. That's okay. That's normal. That's expected. We want that is that's how we know we're challenging you. If you don't get it number one awesome like that's great that you're not feeling symptoms 'cause. 'cause you're getting better right, but we WANNA. Feel a little bit of symptoms if you don't. That's okay if you do, it's okay if it's too much, that's perfectly fine. You'll let me know what will alter everything that we need to do right, and it's all just about setting that expectation and letting them know that they're in charge. Some people take it to the nth degree, and they just want to put themselves at ten and attend dizziness every time. In those ones can be a little bit more challenging because you have to kind of Raynham in, but most people are are pretty good about saying okay yet, stirring me up, but I'm still like in a comfortable level, and I'm letting it, you know. Settle Back Down so giving them that time to let everything calm down as well. is vitally important, because if you send them home worse just like with Ortho to if you send him home worse than when they came in, you're not gonNA. Get buying. They're not gonNA. Come back, but if you can send them home, feeling better, which you can a lot. Lot of times they'll keep going, so you just WanNa make sure that you're saying. You know setting the expectation that you are going to exacerbate. You know you're expecting to exacerbate their dizziness, but that's a good thing in that data will get better over time. Setting expectations have therapy in clinical stuff in in communications in any relationships setting expectations is really really good. I didn't treat a whole lot of of the similar patients, but in my last clinical as a student I did, and just exactly what you're saying when you have someone walk in who is saying man I just I don't get out of bed. You know I it's. I can kinda suffer through work and when they look at you like. What did you do that you up? Like what did you do I mean I was thinking back to well before I was ever headed into into the healthcare field when I was leaving high school I had a really really great high school physics teacher. And Super personable guy like one of the nicest guy in the world kind of people, and after two years in college and somebody had told me through the Grapevine Ye- ever the physics teacher from high school like he hasn't gotten out of bed in like six months. Admitting that he had contemplated suicide because it was so bad. Wow, he wound up getting the the he met. The right provider at the right time got the right treatment and he was able to. Get. His life back I. mean his life. You know if you some of these patients are life is stolen from them in terms of a stabler issue if you can give them that, or you can mitigate that and give them a few extra hours a day and a few extra hours a day. That's you're right. That's a big deal man so good for you. Yeah, I mean it's. It's really good for a like you said the right time right place, and that's really came 'cause. If I didn't have that clinical rotation with a Blue Ridge, physical therapy, I honestly never would've would have known never would have really been involved in it. Because you know for even for PT's you guys get I. Think a little bit more than we do is PBS, but you know if memory serves in school, I got like a and P on the stimulus system, and like that was about it like none of the. Gosh practical were on vestibular anything because it's not that common that I see that on there, so. If I. Didn't have that clinical I. Really wouldn't have found. Up and doing it. I liked that can't let this. Come and go danielson sweet shirt which we have to acknowledge their wives. The next thing you know this is my. This is my party shirtless. And that. At least a great question what you're talking about right there. Bar Keat. Pta Get certified of Mississippi. It's a great question, because I don't know the answer of so through, can you? Can you get this? So the certification is. Like, using that term is for me. At least it's a funny term, right? It depends on what your definition because certification. You can be a certified. You know whatever anybody can have a certification in there so yes, you can. ABC doesn't have any certifications for like the do for like boards. Board certified specialists and all that stuff that it falls under the neurology umbrella But. Yes, you can't. Emery has a really really great course. That's kind of considered the gold standard like a week long with intensive like. Just a ton of stuff in there, so emory's kind of the gold standard I don't know if they let PTA's because they go over the evaluation part of it but you'll have to double check that other than that. I got mine through American Musculoskeletal Institute. Out of Georgia with Cody Phillips and destiny Hiebert And then I'm working with right now. see you at with Mickey. Shaw and Steven t arena. Out of Chicago, they have a mysterious cert- through them where they have three different parts and then I'm working them to create like a PGA competency. Version of it that way we don't go as in depth with the evaluation portion we really. I still think that PC's need to really fully understand the evaluation portion, and like what the pizzas looking for in that but we won't go as in depth about going through like all the red flags and things like that that need immediate referral. will still go. That's working with them on on changing some of the things, so we have a PTA competency level, one level, two and then they have a three level certification for the Vistula Rehab. And there's the balanced institute. American bounces to has one I think vita. Has One is well not hundred percent sure on that But yeah, there's a ton of ton of places out there that that'll teach it because there's not enough of us that that know it to be honest, amputee ace or netting a great question right there feel free to drop the. The questions or comments below if you watch the stream if you're watching, the replay just shattered US replay. Let us know you're watching afterwards. you you did mention some people you get into to work with and kind of help with you had a foray into this this world podcasting for a little while you made it way longer than than most shows more. Make it like five episodes before they they play now talk about your first show because there in the ether, and that's what the new show that you're going to be involved with sure. Yeah, so the first one that I did I did with my my good friend. Evans Singler at of Florida. so is the PTA PTA tapes podcasts we. Our aim was to have like the only what we didn't want it to be the only, but we were the only Pitchy, lead and PTA specific podcast that we have. Maybe twenty episodes or so out talked to a number of different people. We talked to stabler talk manipulations. We talked to Jeff more which cody we talked, Sean, Begbie just a lot of people out there I think we should have mostly. PTA's on their pizzas Kim, Narcissus her Iowa's fumble. Her name and I feel terrible. but she's in northern United States. She's a PC that owns a clinic We talked to her about you. Know what things that she issues that. She ran into in how she interviews. PT's to make sure that you know hers. The owner of the PT being under under her in the business sense you know how that dynamic works and how? She makes sure that she's GonNa. Work well with them so we have that one on their. Times changed, and we both got Kinda busy so unfortunately that one kind of fell through the cracks by all the episodes are still out there in a lot of great content out there and then right now I'm working with against Stephen t arena to start up the dizzy discussions podcast, so that one is that one's more focused on of a stimulus, so we have A. he had a couple of. Of prerecorded episodes that he had already done in those ones out there and then right now we're working on getting more interviews. We have three so far. I think we're trying to get a stack of them ready to go, so we can have more consistency and making sure that we can put out content for everybody who aren't at school and Dizzy discussions I, tuned spotify the whole. Yeah, usual suspects. That's cool. Another great question coming in feel free to keep them coming in the comments either on twitter on facebook. Casey's got a good one as a physical therapist assistant. How do you stay within your scope of practice and not cross cross-line enduring evaluation I think you kind of tipped off your your or your answer, which is, you should know about it. Yep, you should be informed otherwise like you know. You're assisting you you. You should be actively involved absolutely the great question how you stayed within the scope of practice. What what are the things that you keep in mind? So the number one thing is I'm not making the final determination. Right on anything, so that's like we're really where the evaluation part comes in right. The evaluation is not the objective test. Evaluation is not doing the test. Evaluation is all of this. mean. What do I need to do with it right now? Right so for for me. I'm I. Feel Very strongly that if we're GONNA look at the PTO PCA relationship as its stated by many people as like an MVP. Right? What is the PA PA does do evaluations right, but everything's looked over by the MD and things are going haywire. You diverted empty. Right with for me. You know I feel comfortable doing a lot of the objective tests. The objective measures screening and things like that. I'm not the one making the final decision. Right, so if something's going like I had a lady in home health today who were seeing supposed to be seeing lake, strengthening and balanced and things like that, but I walk in. She has significant cervical pain, and a fall like a day ago so I can either just leave called peachy our ends that hey, she fell and you know she. Her neck hurts, and there's nothing I can do about that and I'm not GonNa treat her day because something might be wrong or I can do what I did. Which is I'M GONNA do a circle assessment right? I'M GONNA to play around with a nickel a little bit gently. I'M GONNA. GonNa test these things. I'm going to ask these red flag questions 'cause if ABC add up, and there's a big red flag like I'm getting on the phone with the nurse that time that day road, MD, and saying. Hey, we need to do something ASEP. Versus leaving it to chance in saying Oh, well the PT can come. Check you out next time, right? Everything cleared out so I'm still going to talk to the PTA. T. and say hey, do you think you do you WanNa? See your next visit. This is what I found you know. Do you WANNA see your check her out fully, or do you think we're good to go? You know states. Where does it saves time right? Listen if it's within your school practice and that I mean that's the thing I want to reiterate which we've talked before. No it no your scope of practice like no it back of your hand. You shouldn't have to say well, I think or maybe I know that thing. Ice Cold printed out. Walk around with it for two years until you know cold because that can save some time and. Save. Save a patient, some we. You're working with issues. What might be you know some some real issues sir? Because you don't know when that next opponent Mike come absolutely, and and that's all it is, it's it's knowing knowing your scope practice knowing your own right knowledge in the T. scope of practice and pretty much every single one of them, it says you know you're delegating tasks to the PTA, knowing what like within their scope of knowledge within their area of expertise like all of that stuff, right so as a new Grad. Coming out the gate still you know I was like still like A. To here. Sure I should have a license right now like my pt is not going to give me you know the insanely complex CVA with although with also ms and everything like that right, they know like okay. He's still fresh. He's still kind of getting his frequent. So you have to know your own knowledge for me I feel very very comfortable with the stimulus Ortho. Because I've been so involved with this in my works so much. Ortho I'm not so much so Ortho I defer a little bit more quickly to the PTA turns up. Hey, come check out the best dealer. I have no problem going through like ocular motor We'll call it. An assessment. Slash exam reporting that back to the PT. Right in that's all it is just knowing what you know and communicating with the PT If. If you ever really good relationship with the PT and they trust you and you trust them like there. There's really no limit on what you can do because they know that you have your back. And they have your back, so no, no your knowledge, no your scope of practice and should shouldn't at least run into issues, and I would say one thing to add if you use that word just if you Sam Joel I'm. Like. Never adjust right if we use just than you know, it's just A. PTA, you know we have to defer to the MD, but you know nobody. Nobody is just right. We all have our level of expertise and our level of experience and knowledge. That that helps us get people better, so you're never just anything because you know something better than somebody with a higher degree, I know vestibular better than ninety percent of end east. They don't treat it now. Fault of their own try. Better than them like a spine surgeon, go ask them how to treat vestibular. They're not gonNA. No, it's not their expertise, right? That's not no brag now. No nothing against them, but that's not their expertise, so I'm not just a PTA to and I know what I'm doing. I'm not going to cut into somebody's fine, but they will because they know what they're doing, so cheers to that The there. You're saying do more than then VR times one. What's that mean to you so? When when you don't treat mistake, often as a lot of people don't right, just be honest, they they don't get it that often treat it that often a lot of people differ to the one thing that they remember no, which is just. Fix target is fixed on the target back and forth, and so we've gotten patient sometimes where they've. Gone to another year there, MD and they just do that. You know fifty three times a day and they didn't get any better. So that's because that's not what you need right. So that's where the having a specialist like somebody that dives into the research that dives into the vascular goes and takes courses. Like really wants to know what it is. really comes in handy right. That's where we have pediatric specialists. We have neurology specialists like the whole nine yards. We have the steelers specialists as well and if you don't know Vista, village, specialists and stabler well and you're not in a rural area where you just have to. jack-of-all-trades regardless refer out. Out Right No, know your limits I don't know some things and I'm not gonNA treat a pediatric patient I. Don't know what I'm doing with. I'm going to defer to appear somebody that treats pediatrics so when it comes the vestibular, a lot of people default to again the the Vr time on, but what are we looking at? Why are they dizzy dizzy because they have neuropathy in their brain is not processing information from their from their walker from their eyesight from their inner ear system. Do they have a concussion? Do they have a history of head trauma Do they have a acoustic neuroma right? Do they have Mir's? Do they have ocular motor deficits do they have neurological deficit right? Is it a stroke? They had right. There's a lot of different things that can cause dizziness and a lot of things that we can treat in a steeler Is it just a habituation thing, right? Do they just get dizzy? Have they been laying down in a bed in hospital for a month? With Kobe and other vestibular system isn't working as well because they've been supine for a month, and now all it is that they're just sitting up and they're getting really dizzy while you know. Is it their blood pressure? No, okay, we're GONNA must be stimulants, so let's work on that naturally aggressive thing going up. Somebody's GONNA habituation starts to in VR. That's going to really really say exactly and if you don't know how to tailor the tailor, the exercises are how to make an objective than you're just gonNA. Make them worse, right. You just say do this and don't give them any way to measure how fast or how far the turning running. Dizziness miserable the entire, so it's like here. You go everybody who walks in only know just do like bicep curls three times like why I don't know it feels good. Curls, so it might work. If maybe not, how could it be? So, so do more I mean. Like really take home messages. Make sure you know what you're prescribing. because. You're I know it looks like well. How BECCA and having their head move back and forth you working with a lot of those systems. You just rattled off right there Milan was things. Come into play, and not all of them benefit from that. The second is if you are not the specialist in this. Refer out exactly just like anything else. If you don't know, refer out like. You do I've seen countless times P. patients say that they and clinicians do they respect you more for saying? I don't know and just throwing Spaghetti at the wall right and that's a lot of what I learned at physical is a lot of their stuff is really trying to target specifically what is causing their business? Where is the deficit versus okay, you're dizzy. Let's try fifty things. See what works and then just kind of go from there. It just doesn't make sense. We have protocols for ACL's protocols for shoulders and hips you. Why not have a protocol for? Dealer looking forward to this podcast again with dizzy discussions Gizeh discussions podcasts any dizzy bat played during I. Mean I'm just going to throw out an idea that could be fun. If you do dizzy bat not a bad idea. Actually, that wouldn't be too bad. You start off each episode, but seeing who could go the furthest after doing Dizzy Badinter Front lawn. Movement from. There to something else that you're really passionate about. And I'll throw this comment. Clinical supervision is not the same as business supervision. Great. So one thing I've seen in the number of. Posts on. Dr. Physical therapy in groups in on facebook in. Physical therapy practice in education groups. Every be times where PTO posts in their that their director Rehab is a PTA in. They're telling them to do XYZ year. They're interviewing for a job and and the directors. PTA and there's some people that are like. Yeah. There's no worries go for it. I'll get to go and other people. That's that's bad can't do that. That's conflict of interest can't do that can't have somebody's. You're supervising. Also supervise them. There's also states that have laws like that as well as like in California. You can't be a PTA and treat and be a director. Run A clinic. They say that that's a conflict of interest. Do Not know that Yeah, there's I mean there's a couple of one or two others I think, but I was I did a clinical in California's. That's where I learned to that. But that that's where it's important to havens and. That's where it's important to differentiate the two right, so I am director of Rehab Right now. It is skilled nursing facility. We have also outpatient home health, the whole nine yards right so I am the supervisor of ot or PT Two PT's and it's prn people as well ultimately what it comes down to like. We talked to poor before is communication on not telling them. What planet care to make right? I'm not telling them how many visits they need that telling them when to discharge everything, I do is on the business end of the the supervision. Right so if they're not meeting productivity, it's my job to address that if they're running into an issue with a patient, not wanting to do treatment. It's my job to address that right if they don't get along with the nurse for some reason which they all do. It's my job to address that right so as the business side. I'm their supervisor when they have a question about what they should do about a specific situation like that's. Should they go through me for that right to ask me that way? I can make the decision for them so that they you know they don't have to worry about that. That's my job as the business supervisor. Clinically I'm still deferring to them right when we have. Have discharges coming up. I'm going to them, say hey, do you feel like this? person's ready for discharge, or if I've been seeing the most. Hey, they've been doing XYZ. I think they're ready to go like. What do you think you the progress note two days ago? Do you think they're good to go right so I'm still clinically deferring to them on the business side. Side, I'm running everything and making sure that everybody's staying on top of their work and completing their documentation in time and everything like that, so you know there's there's a difference between the two, and they're completely separate, you know there's no conflict of interest in and of itself right of having a PTA as director fruit half now are there. PTA's out there that do overstepped. overstepped their bounds and tell people and pt that they need to make people have certain planet care frequency sure absolutely, but how is that any different than a t telling you how to do your job, right or somebody? That's not healthcare provider telling you how to do your job or MD telling you how to do your job. There's just as much if not more. Conflict of interest on that side than there is for for PTA's so there. There's just a difference between those two and. Hopefully people with this will will understand that it's different, right? You're going to have whether that person is a PTA or PTO MD. if they're telling you how to do your job, they would do that regardless. That's just a bad manager over all right or they have a lot of pressure from from up top telling them that they have to do that. It's not. An issue of the license it's an issue of that person and the management. That's the issue. It's not the license. I was GONNA ask them similar Vincent beat me to it in the comments below any pushback from the PT's. No you're. Not Really. We've I. Mean I've only been there a short time so far? But you know everything we get along with. There is a little bit of a learning curve for for me going from outpatient to a sniff, so they great at helping with that and helping me transition there, but there hasn't really been too much pushback, one way or the other you know. I told them from the get go like my job is. Is the manager I'm going to default to you guys for everything. That's not my decision to make I always have my my my litmus test that I. Call it for for PT's I. Always Tell them that I'm your supervising PTA. Just like as a joke and I did that. My other clinic and the PC's loved it but they you know they got. They got that. It was a joke and everything right. With the PGA so You know there really hasn't been any pushback. Thankfully, there are all all been great, and they do their job really well, and they make my job releasing a scare. Great Question Vincent, my follow up or that or the the one after that is. How did you pitch yourself to land in that position? Because it's not typical, the we're highlighting. This is as PTA managing and being a business supervisor. How'd you fall into that? How did you pitch yourself to to land must have been held pitch because it's not typical sure. How'd you get there so I was really wants I dislike. Why was knew that I wanted to move up into management position? Like four minute four months into working fulltime, I knew like just being. Not just being, you know being staff, clinician, sure or me fulltime for the rest of my career I just wasn't fulfilled enough in that position. So once I decided I was ready to kind of move up is just putting out application after application after application and then. Come in prepared with questions about the job about productivity expectations, and all that stuff in outpatient as I've kinda started diving into it in outpatient. It's not very. Common you're absolutely right instilled nursing, it's actually very common to have a PTA as a Dr. Best Bet or best guess on that is. It's a little bit cheaper to have a p. pay the PTA salary plus the Dr Than it is to play the PT Salary, plus the Dr my best guess but it was religious putting application put out probably fifty applications and interviews at maybe five or six so. It's really just about volume at least at that end more than anything. You just putting everything out as far as the pitch you know. I pitched it. I wanted to be a leader that I. It's like I told you i. just wasn't fulfilled. My current position like I wanted more want to help be a change in advocate for patients and advocate for clinicians in a way that you really just don't have the ability to do. Do as a staff clinician and so that was kind of my biggest thing is i. just need more I want more and I want to grow. Did you feel guilty at all? When you send I went through school I got here I'm a clinician. This is what I went to school for recognized. You wanted something different. It wasn't better or worse. It just wasn't what you were doing and you saw an opportunity. Do you ever feel guilty? Guilty, about leaving or yeah or not doing it, you know what I mean and the reason. I'm asking these completely personal. Is Your school to be a physical therapist? I treated for two years and then I decided to go one hundred percent. Communication physical therapy. Zero Percent Clinical. I felt terribly guilty. At first I'm now thinking. Maybe they'll do like eighty twenty because I actually miss it a lot. Any that psychology in there? Not so much, because once I probably halfway through school, if not a little bit sooner I knew like ultimately I always wanted to own my own business as well like I wanted to own a clinic two, so I've always had the desire for more and and. That, so that really never played a role for me at least. Because I, am still doing what I love. Right and ultimately as clinicians. Our number one job is patient advocacy. Right so if you're doing advocacy, you're still doing your job as a work Rizzo on on my end. Now I'm able to. You know I don't always get my way. Obviously, but I'm able to push a little bit harder to get certain things and to get these patients checked out or whatever it may be right, and so I'm trying to work my way up. that. I mean things happen to use a baseball analogy, 'cause. That's what I default. Later you can control the game the game differently, standing on the mound, or behind the plate, or in right field you can have control directly. But where do you WANNA stand, neither of them are better or worse. They're just better or worse for you. If you've got to repealing, you hate it. Sucks, but if you love right field and right fields great, so asking yourself that question you said halfway through school knew I wanted to do it. Great. Run with good for you. Yeah, thank you. Yeah, there's definitely a good good to kind of know that. Just go with it. Yeah Vincent dropping another good question, hardest part learning curves decisions. You've made that you would do differently. What have you learned that the audience can go? Step into that so. The hardest part is picking my battles. A little bit better baby. And learning that like I, I'm not in an outpatient setting where I can just call the DOC and do like. What like my job at physical I had borderline complete autonomy. Be Able to do whatever they want because a PT was there I can say hey. I'M GONNA. Call the because. This isn't doing well, and that will take it off your plate and ninety nine percents. I'm doing find out more about it. So now that I'm in in this part of why I wanted I wanted to see the big picture. Why aren't these things being done? Oh, because there's things going on. Great things are going on that. We can't get these things done like somebody. Just explain that to me and they were all good. So the picking the battles has definitely, I still fight probably more battles than I should but I'm much more selective on how hard I push with them. Especially, when interacting with like the director or director of a nursing the nursing staff themselves. And then my a regional director. So much more selective about how how much I do, and how hard I push with some things whereas when I was a staff member. In My. Clinic director can attest to this. How much she loved it. every little thing that came up like bugging her about it every day until something got taken care of. So, much more selective on on that. Decisions that have made that you would do differently nothing no significant decisions. That I would have made differently yet again. I'm still early into the role, so there hasn't been a lot that have had to significantly worry about it and with unfortunately Cova. Our caseload is just been fluctuating a lot, so there hasn't been a lot that I've had to worry about on that end. But you know I'm. I'm really hoping that you know all the things that I put into like speculation of this situation. I'll do this. I'm really hoping that those kinds of things continue on that actually follow through with. My morals and values are s cool I mean I went from being a you know a staff radio DJ to being the program director which is like Director Rehab. Clinic director. Younger than a lot of the staff, and even the snap that I was older than they were at that station longer than me, so I was the new guy in younger remember my dad, who is a firefighter nothing to do with nothing to do radio or anything and he just goes. Like will put in great perspective. I was so nervous. I couldn't sleep. It couldn't eat. And he's like Jimmy anybody to die. If you screw up and I was like well, no, he's like nothing's going to catch on fire. No one's GONNA believe out. It's like okay. Relax and I was like okay. That actually made me feel better. I was like okay station, but I cared about it. Which is one occurred? And then he said this he said. Do you want to get it right or be right? You did ask yourself then what and I was like well. They're the same because I was twenty five. Well, they're the same. He's like not now. Do you want to get it right or do you want to be right? There are different I was like. What do you mean? And of course he's like drinking scotch and he's like pause. Ensure maximum, remember this. If, you want to get it right. It just means that you are there to get the job done. It's amazing. What can happen when you don't worry about WHO's getting credit? If you WANNA be right, it means you want to get into fights, and you want to win them whether or not whether it's right or not. I should say yeah, not really put things in perspective and kind of similar to what you were saying like choosing your battles. It was like okay, am I? Is this an ego? Thing I? Just WanNa. Be Right, or is this person actually saying something that is right, and now we want to get it right. Because in those situations I learned. The person who argued I'm using air quotes the podcast audience pursue, argued the lease, the person who listened the most waited assessed, and said okay. The person talked the least typically was aiming to get it right versus be right the person who wants to be rather going to talk you with us, so that's great that you recognize this which leads to our this question trace has got a good a good question to Kinda parallel trace. You've reached Retro Rehab. Your second year at a school, which Kudos to you on that one. What's next for you? How do you? Where do you look ahead now? You can halfway through school. What's next, so I'm actually a applied for a Master's Health Administration program it. which toss state. So here's the hoping I can get into that in the next cycle to ultimately, my goal is to move up and I think the freezing US I wanNA move up high enough to be able to make the decisions that have the biggest impact right as a director of Rehab, I have a certain amount of of of impact, but we're also contract company so I don't have like direct impact with a facility that we're contracted with. And see that line again. You want the. Up The ladder high have as big of an impact as possible I think that little bit better, the first time, but. And the reason I wanted to repeat like dude. There's your if you get an interview anywhere. If I was listening to someone across from me and they were like. They said that it'd be like never. Mind canceled the rest of the interviews we got it. Right there we got our gut. Absolutely and that's. That's ultimately what I WANNA do I like the quickest way to do that because I'm. Razi impatient. is to get the masters degree, and then apply for job. You know higher than that hope I would love to stay with the company on that and move up within them. ultimately. You know if if that doesn't work out, you know happy to entertain offers. Impact Dude impact. Any any organization you work for? If they're seeing you grow, and because your goal is impact, and just just revert back what I just said. Your goal is to get it right. Not Be Right. Yeah, you're going to get a bunch of titles. Your goals impact. Any company would be if they're if they're not trying to keep you around. Pay Attention. Yeah and that's and that's ultimately what it is right and that's for anybody out there if you're if you're trying to make a positive impact in your company is inhibiting that or you know actively creating barriers to. Creating a positive impact, you know time to look elsewhere. You know if you can't quickly move up to be able to be that change, you know we like the go. Be The change you want to see in the world, but you know within reason right you can't. Your own mental health. You can't spend ten years trying to work your way up in a company that is just draining an absolutely just tearing you apart in the hopes of getting to a position where you can change it. Work your way up faster somewhere else and then try to come back on top. Okay. I know how this works before I have the experience in education now we're GONNA. Change Yeah so the the big thing that Kinda offer me, too is watching as covid was really accelerating just seeing all the stories of all the MDC nurses and things like that I'll follow on twitter. Talking about how you know. The admin staff would tell them not to wear masks because it's scaring patients, the admin staff is telling them about their productivity and making sure they're doing all the things, but the admins doing all their work from home and safety from home so. So like those those kinds of things are just you know you don't get it unless you're in it right and I I think that. Admin House admin should be healthcare providers first, and then admins second right, because then they actually get it right, and that's what I've had disagreements with Higher ups in companies that have worked for is like they tried to say one thing, but I'm just like I'm a clinician. I'm working with these people every day like I. Know How this directly impacts them and we need to do something different, but they have twenty years of experience in their non healthcare related field so everything that I say just gets drowned out. I think you need to be a healthcare provider first and then a adleman second to actively able to advocate for patients accordingly and correctly and be able to have a positive impact in Jentzsch yet to do as I say not as I, do and and people. Don't listen to what someone is saying. Watch what they're doing, right? They tipping their hand. If you listened someone can talk in circles. Man I talked for living. I can talk in circles, but I will tell you. Don't listen to what I'm saying. Watch what I do, that's and yeah. Would you ever ask them to do something? You wouldn't do yourself if if you're saying if that's the case, then you know. ALL RIGHT Let's bring in producer Juliet. We're GONNA bring her in you. WHAT'S BRUIN? Come, in the studio give your. Own Music own height music. Is. Rock. Medical staffing a you are US medical dot com, trouble, ut, Hashtag, child bt. What's brewing? We've got other shows coming up next week. One of this is called the front cell when a forward teas. So, we have actually just after. This is Sarah Cruiser. Mark Ceelo Eric there with PD. Health study, and they're talking about their wearable technology parables, bulls, and how we can track people. This is operatives. How this is true, and if we hear population, you probably should think of Mike is an art. Yeah, there, it's all there. They're going to talk about him is. I think so. so yesterday we had two episodes well. We had Jamie Schreier and he was talking to us about his target audience with his clinic, and how you defined that and we had nick how? It was. He was so cool and he was with motives Rehab talking about telehealth in robotics. If you WANNA get. Mentioned robotics because. The, technology will side you right them I'll think it's drones. Probably not and I'll just get super excited. That will be like. Yeah, come on the show. And, then Ma, come Tuesday, could even how all right? On Tuesday and Reading Casey Han Larry University. Research going we met them. We didn't show live not long ago. That's what's Bruin. Really. Rights Rodman to post guys, okay. Yeah, that's coming and again you can get all this. The videos on our facebook or youtube and you can get all the podcast obviously where pod cancer down the. Your producer Juliette, thank you so much. What's brewing? Your actual phone number right there. That's my number. Yeah, I'm glad you know. The fact that you pointed the bonus points right there for you. Pick it up. Gary. That's going to be Google number like right. It'll be routed google thing do that's my phone number tested out right now. I want to see if people are actually paying attention, because I'm glad you spotted that because I've actually been putting that on the screen for a couple of days, and no one's texted me. I want to know what you're thinking. We put someone like Eddie on the show, and it's like there you go. That's it when we put someone like Eddie on the show, and then we have questions. Blow Up. I'm like yeah, the audience we just just just peaked nerve. There's precedent of someone's calling own. Ah, I don't know who's from Pomona like it or that's me. I said I said Tech Tally. But I want you guys to deal free like this open. Text me I wanNA know who should be on the show which will be talking about if you're thinking about it if you're bitching about it in your car on the way to or from your clinic, let's get it on a show with solve this freaking problem. That, so that is my actual number will keep sharing it so four, five, three, one, three, one, nine, one one dairy detects, we'll get into a conversation, and maybe it will become an episode back to the show here we go. Let's talk about this. PTA's need to advocate. No one better than US, right? This kind of goes along with what I said earlier in the show, which is like just please do not say well I well I am just I'm doing with my body I'm just a PTA, and this is what I do I'm minimizing myself. Don't do it because language matters. Please don't don't say just and as you guys are texting me I like that. I don't even know who these people are going to find out Don't don't minimize yourself in the conversation. Because that means you're never. You're not even get to see the table. You're not getting the building so. Advocate no one better than us. You're someone who was advocating for yourself a lot, but when you go bigger in terms of a profession of physical therapist assistants. Would you think well number one props you for saying correctly ca a physical therapy assistant physical is. And so on that so as far as professional advocacy light like like. We're talking about before the show you, gotTa! Be at the table and get yourself at the table to have a say right we. We talk a lot about an even for me like I understand that there's a lot of PTA's that don't feel like they have been adequately and I've for myself to feel that that we haven't been adequately advocated for within the professional organization at large, and then also within state chapters right so there's a lot of times where their scope of practice things that come up. That will only affect PT's so I mean just a manipulations dry, needling like the to always the big topics that are coming up in scope of practices. So we we see a Lotta pizzas that you aren't a member of ABC because they don't feel like ABC. F- accurately represents them and advocates for them. You know the only way that changes though is. If you get to the table, right, they don't. They'd will not represent people well if they don't see their voice being hurt right and we have the PTA caucus and they do an awesome job of of advocating for us on the professional level, and doing all the things there, but that's a small portion of the amount of PTA's that are in. The country. We look at just numbers the PTA the goal for AB. Ta was to have ten thousand PTA members like the tens of thousands of PT members, so if we don't have the numbers there why I mean just like any other politician. If you're not showing up to the voting booth if you're not showing up and donating like they're, they're going to advocate for the people that. That are showing up. They're not going to advocate for the people that are not showing because they don't know what those people want. If you're not at the table, and I mean you can go on my twitter, I bitch at the PTA a PTA all the time for all the different things that are you a major? Yes I. AM paying attention so I am a member. I'm. Shot him bag. We that you're talking about talk to you the the other day again or mentors. He's somebody that is. Talk me off the Ledge multiple times when I want. Go on just big O. rants. So he's luckily the cool head to my to my head But you know you have to be at the table, and you have to put yourself out there to get a say in if you don't. You're never going to have one so that when we're looking at that, we're looking at starting with the State Associations Right? You have to inject yourself into the State Association in all the little. Little menial. Meteo roles all the committees everything. You can inject yourself into a pizza do that. Don't do it, and this is stuff that Sean bag and I actually talked about last week. I think that of just opened my eyes. Don't do it as a PTA. Do it as a professional advocate, right? You're not going in injecting yourself in there to say that. Hey, look I'm a PTA I'm doing this. You're saying. Hey, I'm here to help because I want to advocate for the profession as a whole right. purpose like you're saying earlier. It's not about the credit in showing that you care. You. Go in showing that you care about the profession will then. long-term the profession going to say yeah, these guys. And gals actually care right. They want to help us. We should want to help them to right, so you have to interject yourself into those streams first, and that can grow to globally, and again I'm super impatient I wish I could just walk into ABC a kick down the door. Kick down the red tape and say these things are going to change tomorrow, but. That's not going to happen. Awfully this like there's a valid argument for feeling like you weren't represented. Right? Who's even when I was in school? Just a couple years ago was like you guys had a portion of a vote. It was less than it was less than a full vote which I was like. Why would I wanNA pay for something if I wasn't been counted like? This is literally a country where we're like you get a photo that that's the one thing you're actually guaranteed that taxes and death. You're like you get these three things guaranteed. That has changed good. It took a long time for that to change. Yeah, lease, do something with it, so that's actually funny that you mention that because that's one of the most recent things that kind of upset me a little bit. But it's like kind of p so the. Didn't actually give the PTA's vote. What they did was allow states to give PTA's Volvo. States now. Allow PTA's a full vote. Some states that still don't if memory serves correctly, however within the ABT, a self paced still don't have to the PTA. Caucus doesn't actually get a vote on any of the RC's and things like that. The sections just got a lot of vote. subway, the like individual bodies. Sections right they so they get about an then. The pizza delegates vote ever PT PTA still don't get a specific vote, N., p., T. PTA's are barred from serving any role within the state over organizations that allow them to get a vote so president chief delegate vice-president anything that you can have vote with PTA's aren't allowed to have so that's where like in those little nuances again. A PCA that's looking at it. You know you don't know so. That's something where. Me and I'm going to be working for and that I know. The PTA caucus is working for and I know people are working for like. It's those things where if you are or AP T. A member. And you're a new Grad or you're. You've been in the profession for a while, and you're not understanding. You know why there isn't enough. PTA involvement. It's those little things why there isn't an PTA involvement, so you as the. Like those have been a lot of the PC's that I know that our abt members have been really really good advocates, especially some of the new grads that I know you know they're all four pushing for more PTA involvement. You're in really good advocates about you know injecting themselves within the profession to help us out in that in the long run. Yeah, do you want to get it right or be right? Now I WANNA. Be Right I'm just going to yell at you from the Rafters and I'm GonNa give you the finger. and. I'm GONNA I'm. GonNa I'M GONNA. Be Right and we want to get it right. Let's get together, so we can get it right and whatever that right is. Moot. Let's move towards that and then when we get there. We're GONNA to look around and go all right. This is better than it was, but let's let's continue to make this right and you're saying if you want to advocate for US listen bitching about it in a facebook group or on twitter, if feels good short. Typed it out, you hit! Send lots of. will say I agree with you, and if that's your therapy that your therapy but we're GONNA we're we're GONNA. Do about it right, but stand I understand where at first it would say why. Why don't they join an organization if I don't feel like I'm fully welcome at the table, but it's moving that direction. I would say come on in. I would like to welcome you I'm a member. Let's let's let's. Let's let's work on this problem together exactly and that's like the. Thing, you know better. Better together. Better together together and that's you know that's what ABC's aiming for not. A lot of the the higher ups in there like Sharon done I've had multiple conversations with her. She's all about PTA. She really is. You. Know she her. She's not. You know it's not a dictatorship, because you can't just hit the gavel and say okay. We're GONNA. Do everything we everything is equal now. Everything PTA's bts. Everything Eagle right so you can't just do that. She's not a dictator. We don't want her to be dictator. aren't good leaders, so she's a great leader and she's very pro PTA share her hands. Hands are tied as much as they are because of the lack of participation so the PTA show up and and participate more. You know. She has more says she can say like look. We have this huge influx of PTA. They want to participate. They want to be involved. You know. Let's remove the barriers to them. Getting involved in with how strong her leadership is within the profession. Doubt that people would listen I like that We're GONNA. Do Shameless Self Promotion. It's part of the show. Where we have you look into the camera? Look right into the camera and say hey. I'm Eddie earns, and you're listening to podcast. Hey, I'm Eddie and you're listening to P. T. podcasts perfect time for three questions. We're going to do three questions. Let's do that right now. Let's do it's all right here. We go. All. Greek questions brought to you by our friends. At Arias medical staffing that has a U.. R. E. U. S. Medical Dot com going the way are a US. MEDICAL DOT COM leaders in Hashtag travel physical therapy your essential. You're a physical therapist, your physical therapist assistant. You're looking for positions to be essential, so maybe give me your new Grad right now. On your same man. Get a job where I can do. The thing I've been studying for for the last few years. You are a US. Medical Dot Com positions in all fifty states all different settings a lot of times. People think travel PT outpatient outpatients not isn't and a lot of times. They're like well. It's in places. I don't WanNa go all the time. Listen. I don't know where your jam is. Alaska Hawaii. They do a position there. If you're jam is Kansas positions there, so whatever drives you? Let them drive you there. You are us. Medical Dot com first question's aware question he got. You can go anywhere in the fifty states we're. We're GONNA. Go Hawaii yeah one, not I mean. It sounds Cliche, but my reasoning is so I have an intrinsic fear of either stepping on a jellyfish or get eaten by a shark, so I don't like I lived in California I. Don't like that I can't see through the water so sure just like I'll go to Fiji or bore like anywhere. The water is clear where I can. If something's coming after me, that's really all it is, but Hawaii is just the deep. In the US quite. Second questions or what questions something you've read, listen to downloaded a podcast book movie quote, Thome when someone you think with the audience would benefit from from consuming. So to actually so the first one that I read was how to lead when you're not in charge so that was a book and I. Don't remember the other, but it was a book specifically about like starting to try to create change like be who you want to be. in terms of leader do the do as I say not as I, do kind of thing right so being an active leader with an organization when you're. You're not in charge to help. Enact change to increase your influence and then the second one was a podcast that I listen to on my drive from Nevada Kansas. which was the first time manager think it was called, but it was a couple of hours long, but just like little tidbits. Five ten minutes I'm episodes of like. Hey, don't do this do this. This is how you handle this situation. This is how you handle this situation. Now Luckily. I haven't had to use too much of the. Don't do this situation or you know the because it was much on the extreme. That's in your brain now. Your mom sure second I've I've seen this before. I've felt this danger. Feeling before, so you've done it. That's cool. I like that first time manager last thing it begins, and ends with people, Eddie, who someone the audience should know more about. I mean Sean Baggy. You know John Yates. The PTA caucus really just as a whole. I. It is doing so so much good for for the profession as a whole and for as PTA's on a professional level I'll say just anybody on the PGA caucus like go on your State Association website. Who's the PTA Caucus member talked to them? What issues are they worried about? What are they trying to advocate for? You know, get on the same page, is them? Professionally shameless plug would be. the Stephen Arena and Mickey Shaw they're doing really really great things with the vistula Rehab there really diving into it and trying to create kind of the the next emery, essentially of have in that the emery is the five day intensive, and then right next to that as evidence, the EU in terms of stimulus rehab. Who Course is really going in depth with everything so? All right. That's That's three questions as you are. US Medical Dot Com, last thing we do. Is your parting shot. Party shop brought by friends from the Academy of Orthopedic Physical Therapy Orthopedics Dot org for thinking about enhancing leveling off as the kids. These days are saying you're out will be technology skills doing it from the Academy of Orthopedic Physical Therapy is probably a pretty good idea or not dot org. We Have A. WE HAVE A contest coming. You access to a couple of their different their their course offering, so if you're in our in our unfair advantage email, you will have first crack at that. In fact, you're in the unfair advantage email. You're actually registered for the contest. We haven't even launched yet. You're already in just by being to check out. Dot Com parting shot at your chance for a mic drop. Moment was the thing we want to leave the audience. Who Man be you and advocate for yourself and your patients really do that advocate for yourself and your patients right so when you have a goal in mind of how you want to be as a clinician do every invest everything you have into that right and it seeing use Reiko to person courses, not just prerecorded online prerecorded. Online is great, but. But go to those in-person courses connect with other people network right. If you feel like you're not fulfilled in your role, no move up, you know, get extra education. It's it's easy to say hard to do so. Do all the things that you need to do to be professionally fulfilled. Yeah, doing the right thing is always the right thing. Eddie appreciate your time. On the show, we'll have you back again soon. There's the socials right there We'll see again soon. Thanks for sharing appreciated shares absolutely. Cheers, brother, thank you for having me on. Love the P. Pine cast yes. Yes, the port, the show, telling a friend or by leaving a review, a nineteen or Google play shooter day brought to you by the Brooks Institute of higher learning an 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. H. L. Dot Org. Our home on the Internet. By. CAST DOT COM created by build. BUILD PT provides marketing services specifically for private practice PT's. Development and and inviting content marketing solutions PT clinics across the country. See with good pt can do for you today at build. PT. Dot Com. The PT. PODCAST is a product of PT Podcast LLC. Poured fresh by me physical therapist Jimmy McCain ingredients are sourced by our chief connections. Officer skied on it from Marymount University. Brewed fresh by producer and physical therapist, Juliette data, Singer, and by producer and Creator Second Year Students Bridget Nolan from Sacred Heart University PT. pint cast is a podcast. saves physical therapists missing out on amazing insight, remarkable ideas and motivational stories. Follow US online at PT podcast and subscribe on Itunes spotify or Google podcasts. Yeah! It's it's awesome. 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What Can YOU Do? Diversity, Equity & Inclusion in Physical Therapy with Ellie Sommers

PT Pintcast - Physical Therapy

48:44 min | 8 months ago

What Can YOU Do? Diversity, Equity & Inclusion in Physical Therapy with Ellie Sommers

"Hey before we get started I, just wanted to say thanks to our longtime sponsors are es medical staffing, helping you physical therapists or physical therapist assistants find jobs all over this country with position. All settings in all fifty states find out what they have for you at a U. R. US medical dot Com. That is a you are E. US medical dot com. Follow US online at PT Podcast and subscribe on I tunes, spotify, or Google podcasts. Yeah it's it's awesome. Free go and we're live. Look happy hour on Jimmy. I'll be your host. This is p.t podcast. A podcast saves physical therapists for missing out on amazing insight, remarkable ideas and motivational stories in the world of physical therapy. Thanks for joining broadcasting live from the medical studios all snows bedroom, find them at AU, are US medical dot com leaders travel physical therapy will get into us travel stories in just a bit great show for tonight we're talking about what you can do you. Yes you. Can Do to help improve diversity, equity and inclusion in physical therapy and the world that we live. Doing the show via facebook twitter video showed. Now we're like a TV show subscribe on podcasts. I tuned spotify Google podcasts, the whole nine and socials at pine cast worldwide during the show, feel free to comment, drop any questions that thing below if you're watching this video replay dropped the word replaced. So we know you're doing it that way and I challenge you. We've had some people take me up on this. There's no way. He's nuts enough to put his actual phone number on the screen detects questions or ideas for shows. That's my phone number text. Me Don't call no one. We don't call each other in which is text. Drama Line. It's four, five, three, one, three, nine, hundred eleven. We'll see we can do there. We are on the socials and let's get today's show underway. Where's the serious music? Yeah, we go. Our next guest is the team physical therapists for the US afl women's national team run coach and the owner of super performance and physical therapy in Seattle. Washington. She's most known for ranting on Instagram. About the injustices many women face in healthcare specifically in physical therapy, she's been known have an argument or to like that. And get angry about things in generally not Stanford nonsense who wants to stand for nonsense that isn't gentleman. Let's welcome. Ellie Summers there she has. Now thanks for having me thrown applause. Right. There are welcome to the show. First question is always the hardest to get it out of the way I. Do we drinking? Today I am drinking. This fancy Jin alternative called ritual. So it's a non alcoholic alternative and I'm drinking eight version of a GIN and tonic here. We'll cheers I'm doing bacchus soda I drink I drink beer pretty much on every one of these episodes. So I just needed to lighten up and do vox. Oh, cheers to you and I'm. Out of my m. I don't WanNa make anybody jealous out there but I was actually an assistant swim coach on the Holy Mackerel Swim. Team. Might be having some. With technically with with our livestream right now so If we're doing that, but we are still recording in terms of the podcast so. So you're from Seattle Washington. That's correct while I'm not technically from here. But I live here in Seattle Washington, and that's where you have your Redo your work and. A, little bit of the things that you get to do in your work kind of what's your superhero back story in this in this world of physical therapy. Superhero back story I don't know that I have superhero backstory but. I started my small private practice, maybe three little over three years ago and. was searching for just a little bit more freedom in my work and the space to create. As well as to serve people in what I felt was maybe a better way. That has morphed involved in. down. Into work with female athletes, almost specific like entirely not at this point. So that's my superhero backstory your website sue Seattle. We've said that word several times on this show before on other episodes but I want it's always different when you ask people what does that word mean because there is no direct. English translations. So that's kind of it. Kind of opens things up and it's on your shirt. What does it mean to you? Yes see sue is grit. It's like this. Unspoken hardiness that? Some people possess that you know through adversity they can used to harness. Their sort of inner powers I guess you could say, and it's it's finished rights fit from Finland. That's right. Yes. Finnish. Friend of the show Yanni Laurie who's done some great work for for persons living with spinal cord injury. He actually wrote his power wheelchair from west coast. He went from Santa Monica to Washington DC, and it is whole ride in the you know the today show followed along Chris Reeves. Actually is is His son was actually following along great story but he was the first kind. Let me know what that word meant I remember when I what he kept saying we like when we'd hang up the phone or what the emails was singer and I was like what's that mean and he? He did one of the same thing you did which is like Well, and then you go into this explanation I kinda like words that don't have a direct translation into English you can kind of put your own put your own spin. See Su. He just has the more youth. It's just Kinda like that's what it is. All right. So we connected online we mentioned in your intro that you're you'd like to You'd like to get into it. Not Stand for much nonsense say you like you know with into an argument or to. An argument doesn't always necessarily start his argument it starts maybe either a miscommunication or people not trying to see what the other saying it's just are you there to learn or either to just spout what you know and I don't think that's where we started but I was actually I was researching was reading you read this book. have. You heard of Tim Ferriss first of all a million people have heard heard of. So. This is a great book I picked up on Amazon. It's like fifteen bucks and it's like you know like a phone book size. So this is not one of your books where you read cover to cover. Book this What were you like you drop in and what he did was is really smart I thought anyway. He picked twelve questions, any lock, these twelve questions, and and then he just asked a bunch of people that he considered someone. He wanted to learn something from and he created a tribe of mentors and just shared the answers I was like do that's really cool. What if I totally bit off his idea and did this same idea the tribe of mentors because that that mentor word is used a lot in physical therapy much more man graduate in sixteen and I was like, who do you mentor in like a year and a half out you're like I need eleven mentors i. You. Lose that direct connection and and responsibility of having to be accountable for where you're going in the direction you're going if you feel lost. So, that's started so i. was like, wouldn't it be cool if and I have a lot of those moments where like. A book and then like three months later I'm like I just want to read a book. So I heard this idea I was like, who would who would I put in it? He. Put like one hundred and fifty people in there. But what if I were? Did. Ninety nine would if I did like ninety nine bottles of beer on the wall or ninety, nine, hundred physical therapy, and I put a post on twitter and I was like. Physical therapy because I also didn't want it to be just who I thought. You know these are ninety nine people at Jimmy thinks cool. That's idol for a book and and I think. I. Think I pretty much knew what most of the responses would be right. They're going to be the responses that are already out there. They're going to name the people who are the loudest in the room, which near a great leader what I was trying to do is I was trying to find people in between. And I I. Don't know like should I have given more information coming didn't WanNa tip my hand you know even her but you don't WanNa give away while you're doing. But brought up really different discussion, which is who are leaders. In fiscal anything. And it parallels right now it's a discussion that I, think it's great that we're having it bad that exist. But it good. We're having discussion, which is how is bias involved in the question who is leader? So when I asked that house bias involved, what's your answer? I think it's just like it's just always involved from all directions. You will lean towards confirmation bias and bias in certain avenues. And it's really hard to notice it when it's happening. I think especially as it pertains to sexism and racism and equity. Inclusion. Like it really takes a good amount of self reflection holding up a mirror and saying where my bias stemming from you know yes. This this person is putting in a lot of great work and is really loud and noisy but am I consuming their content because it's easy because they look like me whatever. We follow our biased because it's easy. It's like the easy path. Think it exists everywhere. It's even the word right? You follow someone on social. Media. On facebook your friends, but on on twitter instagram followed them. And how do you unpack that or how do you? How do you undo that sink in my in my spin around this question or these types of questions over the last month or two has been the only way to really do it is to conscious to continually say, why am I doing this? Or what is led me here? Why do I think this way? which is probably a good thing to be doing in most facets of your life whether you're a physical therapist or just a human interacting with people. Why am I so rooted in? This is what I. Think. What led me here was Or emotion or bias or both all. To unwind that of where those things. Yeah you're right. It's probably a little bit of all. Yeah. No I really agree with that. I. Think it takes a very intentional practice to undo. The bias our society lives in which leans on, it tends to lean on white privilege white men. Patriarchal sort of standards. And I think that it takes a lot of even even for myself is taking a lot of undoing to sort of see where those biases rest. Intentionally, seek out ways to learn and be better and. Intentionally forced myself out of those biases. So now if created new biases, which is good or bad, I don't know I think it's good but. You're recognizing the old and maybe you're creating new but if you're if you're continually. If you continually. Paying attention to how you've got to a conclusion I. I. Don't think that can be a bad thing and. You know you talked a little bit about. The things that actually wind up happening I mean I. I see it right when you go on social media with any of these platforms when you pick one of these things up, the first thing you see is everybody you follow. Actually heard a a great quote or a great explanation. We've said it before in this show but I think it deserves being said again because I fell victim to the bias as well. When someone said, you have white privilege I was like but you don't know where I come from so. The best. The best example was it's not it was in cycling, right? Because sometimes analogies you lose the point but this one I think helped other people see it a little better including myself, which was we're not saying that. you had wind at your back or saying that you didn't have wind in your face. If you ever ready to throw on a windy day. You can understand that works. So privileges in saying that you are you have the wind you you didn't have the wind at your back. It's that you didn't have this type of wind coming at you in your face. So that was probably the best way to do if you see other analogies to explain that. That's like my strength to remember allergies but I do think that. That's a perfect example of of the feeling that's involved with it, and if you've ever ridden a bike, you know that feeling like of having wind at your back and then going up against the wind and I think that feeling is very real for women in physical therapy in any space and I think it's even more real for. Black Brown indigenous lives and minorities in that sense and so I think like as a privileged white person, I have a responsibility to try and. Ensure that the content than I'm consuming on social media works against my ingrained white privilege that I grew up with essentially with a complete blindness to as well. So that I'm aware of what that privileges when it might show up for me in how I can work to correct it in my own sort of personal world. But as well as externally, and that is very hard to do as well in very challenging in these spaces not easy because the first reaction when you say you're privileged, what is someone do? Become. No I don't you don't know me, which is which which which goes back to what we said which the probably the first thing is reflective. What do you mean by that? Like can you help me? Can you help me understand what you say what you're saying a little bit more is probably a better response that's probably the best response. I've ever someone taught me that on social media, which is you disagree you don't understand right you don't know which one it is at first can you help me understand that a little better and forced to the person to explain to unpack their argument and would out and sometimes when they unpack it? They can. There's the whole. Got It. Also does is it signals to the rest of the people watching because I know it's just you and me talking but we know that especially on medium twitter other people are watching this conversation. So take that take that to heart is people are watching how you communicate, but it forces that person to tip their hand and show all their cards into why they said that. Yeah. And that can that can will hopefully lead to understanding but at least at least the people watching you're saying, Oh, I understand how that person got there I. don't I don't actually believe what they're saying, right? That's spreads. Yeah. Yeah. I. Think it's really especially my younger a younger like a few years ago when I really started engaging in social media in a more professional, Lens. It's really easy to be triggered by what people say and come at it really hard and I think that as a woman there, there's a lot of threat involved there for a lot of different reasons. But I started to learn like, okay. There are certain places for me to insert myself into these conversations in certain places not to and when I'm really like. In doubt in what I want to say, I, lead with questions and I think that it's like it leaves room and space for what you describe like a little bit more nuance a chance for that person to explain what they think they're trying to explain for me to understand maybe where they're coming from. And again, see the thought process written out. You can start to put pieces together about how somebody might think can't communicate. So you mentioned. Having to think about where you could or should insert yourself. We had a Michael Cromartie on and he did a great. facebook live earn a great article and APA. A blog article on his own blog. And he described that he was going to publish this article and people professionally and personally we're kind telling him like rethink this. Because he was saying certain things about how how he fell in terms of code switching that was essentially the. Though, focus of his article and I said Michael I've never I have never especially because I'm a loud mouth I've never had stop and think of where I'm inserting myself. I'm not saying to myself my mouth up all the time but no one has ever had to say Jimmy. You know you're a forty year old white guy like you should be saying something like that ever. Understand is someone who doesn't look like me or different gender or different sexual orientation. I can tell you honestly, I don't know what that's like I've never had to do it. Yeah. I can tell you at least from my experience in that realm it's very difficult. met with a lot of. Personal attacks on your character and. I think gas sliding Zaveri real experiences well, or what we would call see line see Liaoning about of that one before is a pretty common one in the physical therapy round. The repeated requests for evidence show me evidence evidence show me evidence. And you know I have gotten to the point where I don't engage in that type of at least on my own personal pages don't engage in that type of discussion because it's just so much energy and it's me working to try and explain something yet again to typically speaking a privilege white male. And I think fit social media in general it very much favors the loud voices in that context and in that particular context can make a person feel. Like it just makes me feel like I'm crazy or something like you know. Like I'm crazy. I don't think. I, am. Wheels are. Highlighted some some things that come up. What what can we do about it? You? You just mentioned a great tactic right there. Sarah Sarah more more. I'm probably mispronouncing last night, but she's we'll share that a hurricane on twitter. She is like a science communications. Professor. University Southern California, she's got some great tips. One of them is just what you mentioned about see lining, which is like you don't engage. Because that will go around in circles and circles and circles, and that's there's your social media diet as I heard someone eloquently put it. If you are consuming bad stuff, bad stuff bad stuff ou-. So what do you suggest for people in terms of how to effect change on social media? So it's not just as I'm saying stuff I'm bouncing it off the walls and it's a silo. What are some other good tips for people to do? Yeah I think for for a majority of our profession is white, right? Like we know that to be true we have to be amplifying the voices of black and brown colleagues like consistently and really working to elevate them and highlight them in the spaces that we have created that are. Really based in our privilege and I think that is that is the most actionable steps. When we talk about social media, it's it's really simple. Go follow your black colleagues go like their content. You know like learn about what they doing, what can they offer the commute? What are not can they? What are they offering the community and then share it? You know you're post with a good example to me because I think that. You sort of we put these broad brush strokes like share the leaders and you're right like we we bias towards the loudest voices in the room which tend to be white men in it. It's sort of just highlights that. That just privileged aspect of social media and I think that if we work to intentionally call out like highlight leaders but I want you to highlight everybody like you know really forced people to force their their own bias away and say, how can I make who I share here very diverse perspective on our profession. I know for a fact that anytime somebody tags in post where it's something like that I am flattered all get out. You know I think that it's you know you sort of like we we share and we by towards white men and we just continue to coax the Egos a little bit more and I think we need to just shift the vision a little bit and say we'll have we elevate our entire profession. How do we ensure that we are being equal equitable and inclusive and I think the realm of physical therapy has a long way to go in that regard yeah. Yeah. I think you're right which is the the loudest voices in the room a lot of times we default. And I know I'm guilty on this to in terms of. Figuring out who will leader is in you check out there follow count. which is PROB-, which which is more valid way of figuring of someone's right or wrong or if you identify. So they had a great post you decided to see what they were about one hundred thousand followers and you jump in. Wall stacked. Go. One. Hundred thousand people think this person is great. Let's get. Right. In in world history who who've done atrocious things and had large following so. And following does not does not is unequivocal quality so size. Quality Affecting change on social media as as simple as not simple. As paying attention to what voices are we amplifying why and which ones are we leaving out? Are there people on this list I? Mean that's a great question who are the leaders follow up WHO's not on this list that should be right that that's exactly like the questions that you. Yourself can ask when you're looking at posts like that you know who is not on this list that should be. What person is that that's that's maybe not as loud and boisterous. That isn't showing up here and I think that those little actionable steps within your own self to consistently show up for people that need you to show up for them over and over and over again can help unravel some of the Some of the like social structures that oppress them. Yeah. It's some of the inertia right like China. Moving Kudos to I think there's there's been a pretty big movement in the last year that I've seen with this term mantles one. Male panels and it kind of goes along with you know things that are not gonna get political on this, but I can talk about the political. Structure especially in this country, which is there are three, hundred, million plus Americans it it's pretty much come down to two white guys in the history of. What you're saying is you know with the exception of one or two candidates like that. It's just always been to white old white guys. To best. Isn't on this list and why aren't they on this list, right? Yeah and I think asking asking the Y. is really valuable to because of the blindness like why aren't women showing up on these lists will systems of oppression one like baseline raises them to you know like all of those structures that just put white men at the top of the pinnacle on the peak they show up in our day to day lives on social media and I. think that a lot of women they aren't GonNa be as loud and as noisy on social media in particular. But they have a lot of content to offer and raising their voices and raising up black and brown voices along with that can help elevate our profession even further. So we talked a little bit about about a color. Let's talk. Let's focus it a little bit more on gender roles. And Sex on social media and public forums. You mentioned earlier tipping your hand there, which is like sometimes you're you're you're you have to think can I interject here or people know you know it's it's funny how we literally setup our profiles with a picture and a name. Now, people are actually starting to share their pronouns. But how how does the role of gender and sex on social media in public forums? How does that? How's that affected you? I hate it. Fighting the fight fights you mentioned in your intro is Kinda come up. That I've gone through like waves you know and I I think that. Women get bullied a lot a lot quicker on social social media and criticized a lot quicker as well. With for example, will be. Show us the evidence type of intent I think men get that same nonsense to, of course, but I do think that. From from my experience on social media, I never anoc missing never I rarely if ever get heat and pushback on my voice in my message from women or black people, Brown people get he in pushback from white men consistently every time and it has certainly created very much. This ball for me is very scary talking to white men a lot of the time I'm worried that. Something's going to get twisted around and I'm GonNa be left feeling like I'm crazy. So this the space doesn't feel safe and I have done a lot of work to try and create spaces on my own social media that do feel safe like I can't engage very comfortably on twitter anymore just because it feels so. Deeply Negative and I think I think that you know if I'm a white women struggling with that by get, it's only logical to me that black women struggle with it to. Latino women. LGBTQ women, all of all the women. So yeah. Yeah it's it's important. Again, this this is the similar idea but you need to things into account we're talking about race color, sexual, orientation gender. To make sure that. How did you arrive at your conclusion or why are you rejecting person's idea right to possibly because of how you perceive them exactly I think that's exactly like I think that as of women, you're sort of condition to think that you're not smart enough. To, offer new ideas to make loud noises on social media that you have to be in your place you have to be quiet and proper, and in the realm of physical therapy, there's a lot of that professionalism talk as well like be professional. And I think that it for women it creates this constant conflict with. Being yourself and being comfortable with who you are as a person and showing up fully as that, and then I think that's what I try to do and then getting people telling. that. It's not acceptable to them. It can feel very. Tacky. SNOT quality. Yeah. It's very tough. That'd be faces. So. From, what I'm gathering the way to do that is uplift. Others voices, and if you see this, call it out yeah. Yeah I think that's The call outs are really necessary. Or even you know when you're in a discussion with with people, you'll see like like on facebook I think twitter to you'll see people like like certain comments along the way and ignore yours because you're the one woman who came in and made a comment and these sort of subtle ways that you get silence and ignored made you feel invisible I, think liking a woman's comment even on a post that you may not agree with what she's saying. But at Minima you say keep coming back keep keep commenting, keep engaging in this discussion because we need you and I think that that little those little actions on social media are actually very easy to make. But it does take a little bit of attention a little bit of. More than a little bit of attention it a lot of attention. Take, action no matter how small exactly. Yeah. And just in terms of the emojis that we use on the show about three or four months ago we figured out we we're using a lot as you can see right now, the flex bicep that's actually not me. For it, but a lot of times, APP developers, the emojis when they first came out Elliot what color were all day they're all yellow light or white and now. Mop. Subtle. I made a conscious effort like you need to use different color emojis in the flex a because visit. The best. That's my favorite. EMOJI. But you should change it up and if I were professor and that's an Emoji there are two professors, right? There's a male and female version. That's that's pretty much the fan that we have their make sure. You're not using one more than the other you gotta mix it up I love that. Yeah. The context probably matters on that too right like if if I'm coming into someone's post to make a fist bump or something, I may not make that on on a black fist because my fist isn't black, right? I'm white. But. If I'm posting and broadly sending a message and putting emojis in there. Yes. Mixing it up is a great way to shows that you're. Exactly drooping about it. No matter how small very important and we talked about having implicit bias rooted in racism knowing that we have that that that is definitely there and whether you know it or not. Again at like analogy in terms of yes. It insane. There is privileged somewhere where you might not actually know it. It's it's it's rooted Nair. But we're seeing that I think social media. I heard a great a great quote awhile ago. That says like you know crisis doesn't create character. It reveals it and I, think a lot of the discussion on lines. It's not creating racism. It's revealing it. Yeah. I absolutely agree hundred percent. Yeah. It's I mean it's just I think in our profession to it's it's not talked about openly a lot of the time. You know if we take this like tiered approach which sucks because I think that's Again, the structure were in is built on these sort of tears and hierarchies. You know the first people were going to highlight tend to be men white men you know the next might be white women we have to constantly be working to. Dismantle. The Tears of bias and racism and pull away those layers and say, how do we get more black therapists? In our profession like the black therapists doing that shouldn't be the only ones working on that we'll work with they are the only people spit it will not work. Right The people that need help can't be the only people providing help that just. Won't work. That's. Even coming here to talk to you about. Sexism is one thing but then to talk about racism as a white woman feels like I don't know if I should be doing that but I absolutely have to be doing it. You know. Yeah. When the discussion really I mean after George George. Floyd incident when this really got brought to the forefront and people were discussing it believe me I was I was one of the First People that say like Colin Kaepernick kneeling Oh my gosh disrespectful and then I stopped listening stops focusing on what he was doing and sort of focusing on why he was doing it also has you know what I screwed up and I'll say that And I had some people reach out and say are you GonNa? Are you gonNa make a conscious effort to to alter what you do and how you do it and I said yes. I just don't want to I don't want it. I didn't want to come across disingenuous or Jimmy. Because he felt, he had to give him six months it'll go back then I really needed to sit here and be like. And do all the things you were saying, which is like, why? Why have you only and then I look back because there's a there's a living record of who I have on my show. Yeah. What racing what gender they are, and I was literally about a year and a half ago I looked and I was looking at really around the metoo movement same come to come to Jesus moment like Oh man you're doing you're doing the thing everybody's pointing out instead of instead of rejecting it and say, no, no, I'm not I'm okay or I'm going to put an initiative I. Didn't say anything I just started to do that. I didn't do it with race though. It wasn't the first thing that my mind unusual incident like that. Unfortunately. Lights a spark and that's what we're. We're seeing and I hope we continue to see. Yes. Minded Person I. Think I, think that's the important side of things too is like you know it's an evolution and we have to be okay like letting people start where they are in moving the ball forward as best as possible I mean I would love to think that we can just dismantle racism overnight in it's gone it's clearly not going to work. That way. So we have to as white people continue to show up four diversity equity inclusion in all possible ways that we can in any given moment you know little things to big things like whatever you can do to start to work against actively against racism in our society it's going to be key to dismantling all of it. All right. So we're. Right. So let's respect to PT. We won't know if we of achieved a goal unless we define that goal make it objective. Angle. Team. But what was the plus look like. A year from now or ten years from now, you can pick either one because I mean I think we like you said this is going to be tough to dismantle. And again if if people who are being oppressed being. Marginalized, are the only people? Go raising their voices. It's not to change. What would what would a small short-term going along? Sure we'll never going back to PT terms what you're going a long term goal look like in terms of success. Based on any individual, it could be a short term goal of saying you know I'm GonNa Follow five black physical therapist, five brown physical therapists, five Asian physical therapists and start there and just like consume their content. That's. Yes exactly. That's it and like their content. So you actually see it. That's the other key right And long-term, maybe it's you know taking actionable steps in in your community maybe it's taking actionable steps in your clinic and saying what type of patients do we have showing up here? Are they all white? Why? Why are they? All White? Is it something about our structure or something about our culture something about? Our showing up in the community where we're showing up in the community what's going on there and how can we start to move the dial to serve diverse first populations of human beings? Yeah. I mean if you're a business owner if you're a private practice. You know you work in Seattle. Area I'm I'm guessing you know your community pretty well, right. If thirty percent of your community is black or brown and five percent of your patients are that way ask yourself why? Are, you on your about page are you only showing off? A does your staff look nothing like your community if that's the case, maybe that's a good place to start, which is internal and research right? That's that's where I think that that I started to especially with. You know the tests that are happening and it's it. You know I knew I was constantly kind of working towards a better future sort of thought like I'm an intersectional feminist I believe in raising the voices of black. Women. All of that, but I still have plenty of blind spots. All of the photos on my website are me like that's not representative at all I need to change that and it's still part of my action steps that I've put together to change that. You know to just work to. Display what I want to display, which is like this is a safe space for everybody. Yeah. Yeah. All right. So I'd be a bad podcast suspended let people where they can follow you instagram Dr Elliot's Summers Twitter Dr, Elliot Summers, and see Sue Seattle Dot com is the website. This is not a conversation that I think should at anytime stop I like the fact that this is a revolution is you'd said a few times but I think to continue it is to do the things that we talked about today and then reevaluate and do them again. One hundred percent ready to three questions. Let's go through. Three questions brought to you by our friends at Arias medical staffing a you are a US medical dot com hashtag travel. do what you WanNa do where you want to do it. positions in all fifty states and Washington. DC got the district of Columbia in all different settings. A lot of times people think travel just kind of like outpatient worship edicts not a lot of difference. Different settings that they have and COO locations to. Our first question on three questions. So you're in the Seattle area. But if you could go anywhere, you want for three months, which is typically a short term assignment. Where would you want to go in the fifty U S states? So I. Think on the intake form I had said San Diego. But I'm GonNa Change my answer and say I think it'd be Hawaii. Why? Why not? I guess a Michaud who travel pt for. Twelve years and what he and his wife did was they did Aspen Hawaii Aspen Cape Cod aspect. So they always did ask winter in Aspen and I was like little. It was like is that possible and he's like I'm doing it so possible. So you could hack your career term. Hack. Your career do whatever you want where you want to do it and I think it's brilliant. So yeah, there there are people in Hawaii last time I checked so that there needs therapists Netzer man, you are US medical dot com second question is a what question. What is something you read watched listen to that? You think the audience could get value from. I WanNa be careful to answer here. To try and keep it broad but pointed We had one yesterday from one of our guests. Have you seen Crip camp on net a great Memory actually funded by the OBAMAS and it really kind of told the story about this group of people with physical disabilities who are putting a camp in upstate New York and where they went and some of them wound up being kind of leaders in the American Participation Act and that and that whole movement. So that was a that was one that's a couple times last the last couple of shows. But is there something that you think people could get value out of that brought me to really good when? The Documentary Michelle Obama did becoming on net flicks. Incredible. Really touched on I think some of the struggles that black women face. In this country and even in the highest office in the land now that should up for her yeah. Third Question Three questions no pressure here to who question who is someone the audience should know more about. I, think the audience here needs to know about. Or say you see logic. She's a physical therapist in Austin. Texas. She does sexual in Pelvic Health I. Think she is like. Amazing, offering tons of insight and valuable information into. What Diversity Equity Inclusion looks like as well as what sexual health looks like. Yeah, and pay to you suggest to other people. Right and that's what that's the kind of a lot of things that we talked about today, which is payment can do who you suggest by all means if someone asks for a good podcast and within physical therapy would not be offended if you if. You mentioned us but also like why I was asking boarding when they when they say I heard about you from a friend, I, say what they say that made you WanNa come there. It shouldn't just be because he showed up or he was the loudest it might be because he has down effects. I don't know that might be the reason if you were to sound effects. Pay attention to who you're following, what you're consuming and and tried to expand that network. Frequent guests of a show sky Donovan saying that their faculty today was talking about having the DT student organization be about how to create a safe space that allows for calling each other ow when you're acting out of bias and have blind spots but it's challenging any suggestions on how to do that I mean you're you're someone who does that a lot you mentioned it an intro that a Lotta Times, it winds up in an argument remember other people are watching. So just because you feel like you're an argument, doesn't mean that the people watching aren't agreeing with you. So is there a good way you mentioned with leading with questions is probably always good. Yeah. I think leading with questions really helps I can I'll share like my experience when people come to me with conflicting questions or? That challenged my bias. It really helps if they approach it from a very open statement at the get go like I want even the compliment sandwich that helps the time like I love your content. I, think you're doing great work I. saw this post I'm really curious to know more I. Know this could come off as potentially you know. Attacking you in some capacity like if if somebody's approaching it from a very. You can tell they're just trying to like really learn and do the work. It's much easier to have that conversation from the GECKO again, they're usually asking a question in the process. You know show me what evidence. I heard I. heard a great sentiment that helped me my own personal communication to which was make sure you give the person an owl or an avenue to explain themselves or at least you're saying. So what I'm hearing is this is this is this what you meant and that's what I mean by giving them out. Don't give him a re don't give them away. To escape what they said, but give them away to explain it, and maybe if if your friend away one, maybe you're wrong maybe maybe you around from the star but the the the giving them an was always good and and saying that out loud how you said, Hey, this might come across of apologize of this comes across his Fleming Tori. That's not my. Speaking that speaking out loud diffuses it. Now, they can't accused you of that. You said that is the opposite of that. It's also I found best done in private DM's. In the Public Forum. There's like there's a lot of ego wrapped up in there for both parties for sure the end I think that. When done privately, if you really want to have that discussion if it's worth it to you, you will do it privately. And if you're like kind of just wanting to cause trouble oftentimes coming in publicly. Doesn't go. Prominent hot. I believe is. The last year but yeah. So if you're if you're really seeking to. To understand or to be understood. Yelling in elevating your voice like think about this, if we were on all on a playground, right because everything's out like elementary school, we've learned all of our all of our best lessons were probably from elementary school. If you're really trying to understand what someone else was saying, would you start by yelling about it louder so more people could hear no. Right, tabs or in the same question over who are attacking the person. That would draw. Draw crowd in a negative I would draw a credit a negative way while you're right. So that's a great. That's a great piece of advice which is seeking to communicate and understand in private, and that's possible with all these different social media platforms. Yeah it is. The no pressure. But are you ready for your parting shot? Yes. Yeah. Very fancy graphics people you might come for the sound effects. Stay for the graphics parting shot brought to you by the Kademi of orthopedic. Physical therapy leaders North Ott continue education a lot of taking a lot of this time where they can't travel. Maybe not be to advance your career, your knowledge Ortho P., T. Dot org actually running a contest right now with the academy. Sounds Way fancier than the section. I'll tell you that the academy of Orthopedic. Physical Therapy doing a contest with them right now, or you can is going to get to pick access to any of their classes so they've got the. Exam. Kern. Concepts or tissue tolerance running athlete just came out. So check out more Ortho. PT Dot Org. So the parting shot. Is your mic drop moment. but don't drop that Michael. Brown you gotta you gotTa. Yeti. Mike. What's the? What's the sentiment that you WANNA leave with the audience as we wrap up? What's the sentiment but I wanNA leave. Do the best you can to support diversity equity and inclusion every day. Like the that's very good. Elliott appreciate you. You take time out to continue this conversation Hope this isn't the last time we get to to chat. Yeah. Grabbed me and thanks for doing it I. appreciate appreciate doing that I really appreciate. You letting me come on here. Soon. Okay. All right, sounds good love. The PT Pine Cast Yes. Yes. The port show by telling a friend or by leaving review on thousand nine, hundred Google play shooter day brought to you by the Brooks Institute of higher learning an innovator in providing advanced post, Professional Education Brooks IHL offering continuing education courses in numerous specialty areas, six residency programs and PGA 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 IHL DOT ORC. Our home on the Internet. CAST DOT COM created by build. BUILD PT provides marketing services specifically for private practice PD's website development and host inviting content marketing solutions PT clinics across country. With good pt can do for you today. Dot Com. The PT PODCAST is a product PT Podcast LLC. It's poured fresh by me. Physical Therapist Jimmy McCain ingredients are sourced by our chief connections officer Sky Donovan from Marymount University. And it's brewed fresh by producer and physical therapist Juliet Singer and by producer and creator second year student Bridget Nolan from Sacred Heart University pt podcast cast is a podcast that saves physical therapists from missing out on amazing insight, remarkable ideas and motivational stories. Follow US online at PT, cast and subscribe on Itunes spotify or Google podcasts. It's awesome. Thanks so much for listening and if you found value in the show, all we ask is that you tell a friend. is done another poor from the PT Pine cast the PD podcasts in ten educational purposes. 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COVID-19 Long-Hauler Inservice with Jenna Tosto

PT Pintcast - Physical Therapy

46:39 min | 7 months ago

COVID-19 Long-Hauler Inservice with Jenna Tosto

"Hey. Before we get started I just wanted to say thanks to our longtime sponsors are es medical staffing helping you physical therapists or physical therapist assistants find jobs all over this country with position. All settings in all fifty states find out what they have for you at a U. R. US medical dot Com. That is a U. R. E. US medical dot. com. Follow US online at PT Podcast and subscribe on I tunes spotify or Google podcasts. Absolutely. Yeah it's. It's cheers animal live. CAST. This is a podcast savings physical therapist for missing out on amazing insights. MAZING. It's. Remarkable ideas, motivational stories in the world of physical therapy. Hi, I'm during macama physical therapists. I'll be your host this evening joining me live from the medical studios also notice my bedroom welcome find them online at a U. R. E. US medical dot com it's a U. R. E. US medical dot Com. They are the leaders hashtag travel PT. Let that PT License of yours, take you where you. WanNa. Go positions in all settings in all fifty states. You can even have a travel buddy which just talked to some people yesterday traveled as a pair. You can do that Alaska Hawaii. Yes. Positions available there. So you are a US medical dot com during the show please keep your hands and feet inside the show until it comes to a complete stop you can ask questions or dropped comments live if you're watching this broadcast on facebook on twitter on Youtube during the socials at PT Podcast as well. So feel free to to comment. Or drop a question for today's guest or if you're watching the replay just shut replaced. So we know you call it. In the in the after. Today, really, really exciting show on pump. This is something we referenced in a program last week. And we're going to talk chronic Kobe nineteen rehab where PT's really getting gain here with the thing that we've been talking about for awhile it's been taken up our lives, right? So we're going to get into where does the physical therapy profession? Where can we really start to make great strides in chronic coke nineteen rehab, our guest, not a physical therapist who works at the art Not. That are different abilities research center at Mount Sinai Hospital New York City she gets to work with Industry Partners Research Teams, physician teams, innovators, and collaborators to implement new technology into rehabilitation clinical practice PT guests baddest. Additionally, she gets to serve as a PT and clinician on new research studies investigating the of technology to improve Rehab and human performance welcome into the studio right now. Let's welcome Jenner Tosto Mancuso. Geno welcome to the program. Thank you for having me your own cheering section as you come in how of an inch working? In New York's is a big deal and you get to do all that stuff industry partners, research physician treating studies the whole nine that's a that's a big deal. I think it's definitely a unique position as a physical therapist to be by Hey, what better person to be in the space of Rehab in research then and if he say so. We're lucky that. We get the hard questions out of the way I. You know. So first question is always the hardest. What are we drinking today? What's on the hat? So I went for a dry or they fighter it's Rosie exciter. If someone islands I could you not be happy about it so yeah, you're to that I like that I'm going with the summer. I don't know about summer just a corona and we're talking current Syrup before you see what they're Mashburn. All right thank you very much. first round brought to you by our friends from owns recovery science. You WanNa talk about research and stuff like that. Johnny Owens involved in research for far blood flow restriction rehabilitation training. He started for the center at the Center for the intrepid working with those recovering from. Limbless accidents and BEF ART has strengthened. So find out more if you want to bring that into clinical practice during the first round Owens Recovery Science, Dot com, plus our podcast on itunes the recovery science. PODCAST. So generally bring you on the show David between who is on like a week ago two weeks ago I don't know it's covert years. It feels like it's marched eight, hundred, seventy six. We've never gotten past march. And David just kind of give it an update. We talk to him early in March and then just again a week ago about where things are going how how's. How's everything from your perspective? How are you? My question? Well, I thank you. I'm actually doing pretty good. So I'm sure you know David highlighted it early on, and then I've talked last week and you know New York here we got hit really really hard and peak surge right march everything kind of came to a screeching all and then by April, we were peak surge. So our programming at this point has taken a pretty interesting too that You know in the beginning we quickly adopted we pivoted takes of our programming. Remote patient. Monitoring Program where we? were, monitoring patient pre Kobe, looking at patients after having a stroke. So monitoring them from a home base using tech intervention bat way when covert had we've pivoted around redesigned the program to address Q. Cogan. So then we were monitoring keep Kobe patients really tracking symptoms, identifying red flags, triaging the cool part about that program that was mostly physical therapists and occupational therapist. So again, just this idea of taking your self editing and more recently, right. So at this point here in New York Wall. Wondering at this point, we're really noticing that. So this cohort of patients who were in the acute phase, their initial acute back, there is a car horror probably about five to fifteen percent of these patients or developing what we're calling the chronic Kobe. They self identify as long hauler meaning that they are in the long haul of this symptom presentation and with really refounded super unique is that their symptoms are not the. Classic. Obits of so really on our fun at Mount. Sinai we have been hugely adopting for this population. You Know I. David has a mantra and the thing that you know if you have a problem that everyone says is not air problem make it your problem enough innovation. So that's hundred that what we're about one, hundred percent what we're doing. So we're really pivoting at this point for the chronic station. David mentioned last week I had no idea. But these people and I love when people do this, this is real innovation. A bunch of people were having these symptoms and people start talking and people start saying, Hey, you know this sounds like something else that I know a friend, they made a facebook group and he said the number but it was thousands upon thousands of people who identify with these symptoms they were being told by a lot of healthcare professionals. Now now, it's in your head like whatever your spirit this. Is Not it whatever you're experiencing something else. So he actually tried to join the facebook group because he's like, Hey, I wanna like Kinda just kind of be here and see what you're talking about, and they wouldn't let a man because they were having such a bad experience with healthcare providers discounting their experiences that he actually had to be like Haley here's the deal I'm marina. Once he kinda like you know explained what he was doing that they let him in any watch with these people were saying and you're talking about. How does that make you feel as a physical therapist when you hear these people had to group together because people were ignoring? I mean, that's extraordinary to me that this is happening in healthcare system having spoken to many of these patients myself just through different channels of communication to hear about their story and hear that they've been turned away and pulled like it's it's nothing you're fine. When really again we therapist I mean we step up to the plate you're treating what you're seeing identifying what you're seeing these patients have tangible real symptoms that they're presenting with that needs to. Be looked at and, of course we're not going to really understand what it is because Kovin just happened. So we have healthcare community really needs to come together and say, okay I hear what you're saying you're you're story is not in your head I'm I'm here for you I'm listening to you and and that's what I think needs to happen look our yeah. I. I will not turn this into a bitch session Janet but I had heard day which is Overheard someone talking loudly at a public place because they wanted to be heard. Shouting these scientists change in their minds and I wanted to just turn around be like we are learning things. Works but I didn't can inaugurated. Kept my face covering on and went about my way in the store but I was thinking I'm like, yeah, we see online. You see this in public you hear this amongst friends or family, and we're learning things, and that's really what this episode about is about tonight is you you kind of have been starting to to take this information as the abilities research center and really bring it together and say, here's what we know now. If this means later that's what we know later but this is what we know now. So you're Kinda like give an in service I love this we're going technology. Fancy. Graphics thanks the Abilities Research Center. At, Mount Sinai and walk us through this educator's so the petit's listening and watching can learn about this and maybe spot this and help people. That's what we're here for. So take it away Jenna. All right. So exactly the idea all this really fun from was. Dying in need, there's a huge population of people who need our help and I'm going to get into the talk to a little bit about a simpsons that we've seen in these patients some of the members of our interdisciplinary team who are really trying to evaluate this in some and come up with a solution for we might be able to address them so. I'm just a little bit about we had attended earlier on the Erkki Abilities Research Center our ultimate goal, and all of our endeavor is the ability to take new technology and try to understand these office. Better right. How can we take technology innovation and really changed the lives of people? So our primary interest again is usually in mirrow disease one, we banned across to these pathways no matter where we are. and really the unique thing about the approach we take is that we approach things like human performance, the performance training, all of our patients. So we are not a group of clinicians and researchers to say, sorry, that's all we can do. We are always looking for the next step always bringing the next level. Oh a little bit about the background of how I got to where I am right now especially with the chronic cova work I, as I said earlier in my talk, right, we had our precision recovery program, which was our remote patient monitoring program that we were using pre Kobe to monitor patients after stroke when acute cove and hit we quickly pivoted redevelop the program to address the acute Kobe population. So essentially, we have cohort of about a thousand patients in New York City. And it started in New York City ended across the country where they were presenting with symptoms. They were completing daily symptom log on a phone based application that developed from their a team of clinicians, physical therapist, patient therapists, primarily, or monitoring those things some data input, and should they have identified any type of clinical red flag or any type of risk after the patient was then triage and so that triage could've been the homecare stabbing to the emergency, department or two. and. So again, really what we found was. In this initial cohort, we were noticing these trends exceptions that were expanding beyond primary quote, unquote hallmark symptoms of Ed, and we're really more of this chronic coded as we noticed this and I own co were, and we were getting more and more media attention regarding our initially Q. Program we started making. With facebook of long hauler and. We wanted to know more we we wanted to get in there if they dr betray no really led the effort of US making contact with these facebook groups getting in touch with their administrators and we started doing like facebook live with them and we were asking them. You know, hey, what actions you have for us you tell us about your experience now, I think all of us know taking a patient history sometimes you learn more about the. Patient and that initial history than initial sit down then he'd do anywhere else really hearing these patient out specifically those who've been told you know, hey, this is all in your head. You're just having anxiety or having depressive symptoms following your initial acute Kobe diagnosis, but just a nice little INFO graph of the symptom presentation that we were seeing. So we were noticing things like exercise intolerance Tapa. Cardia. Thermo. Regulatory. Now Cause Dizziness and not. Just, Neha, all of these factor that again will really different from that Hugh Code Presentation. So we assembled a team of an interdisciplinary team of clinicians as bachelors from a bunch of different disciplines. So I served therapist. Dr. She now is the physical therapist and and evader we work with an absolutely incredible says `I adjusting and McCarthy who has really been. You're heading athlete from dietary standpoint we work with a phenomenal researcher allure tabakoff. She's incredible. She had their research initiative as well as cardiologists allergist who specializes in default meow we will get into. a strength and conditioning coach abreast work coach, and attraction s core team here when we really know rounded. Yeah, and that was what we wanted to do. Right. So we looked at the symptom symptom chart and we were asking ourselves. Credit Card doesn't have a diagnosis right now. Also, what does this look like what does feel like? What is the smell like right? We feel like we've seen this symptom cluster and other presentations and so really what we've come to is The symptom presentation will very very similar to like a post viral syndrome merrily with a default and Omya overlay. Right. So this idea that there are some sort of automatic insufficient fee going on with these patients that is presenting with these. So that's why we picked the team members that we got everyone together with standing working group and together we are working. We have been working on methods retreating. Oh I point our our little work frame at at this point is a nice little pyramid. Patient comes in front evaluation their first meeting with Tree team we have a chronic survey where we are using outcome measures for us. We're going for it things like anxiety depression. We have a symptom checklist that we've established where asking patients about their day to day habit. What makes you better? What makes her Simpson's feel worse really again, Lauren about the patient. From their goal is to my patient stabilized. So for the patients who have the symptoms they safe to say that the symptoms are not linear not. Right. So one day a patient might have exum. They, maybe go for too long of a walk if they can tolerate walking point, maybe they have a really large meal or they earn a really stressful situation and now the next four days that initial symptom is exacerbated through the roof four. They now present with other symptoms of we've identified anything at this point that there is no straight rhyme reason for this symptom presentation, every patient's precipitated. from there right. Once patient optimizing stabilize, we move into multidisciplinary team coaching We work with a bressler coach who's incredible Josh from safest there apple in the admittedly, this is a whole new realm of work I'm learning about The backing is the was designed by a former navy seal was really found the impact for breakfast coaching specifically rotations and similar populations we've been adopting that nutrition strengthening conditioning I've been working primarily with a strength and conditioning coach who usually works with the athletes he and I have gotten together to do a lot of the clinical practice guidelines that were developing for the chronic chronicle. And from there, the patient coming into the realm, which is our time to shine as far as I'm concerned. So he thinks marathon, not a sprint shot up to Steve Prefontaine? It really is not something that you know if unlike anything I think many of us are treated in the past unless you work in the media chronic fatigue space really pt's we are slated as you know in my humble slightly by and really one of the key buyers and treating the patients because what we know from clinical practice and research and that physical therapists are an an exercise exercise prescription are one of the homework interview and Jones for things like the father dome. Yeah and so that's what I'm super excited talk a little bit further about. SA-. So. SIMTEK checklists. Yeah it's ridiculous and it's ridiculously long This is just A. Prime, simple. Sometimes that were being admittedly we do in our survey, we have an other category where interestingly I feel like we consistently see other and new things pop up and you know we keep adding to that's west as we start to recognize that this is a common symptom among groups of patients As I said, earlier, some of the really really big heavy hitting as that. We've been addressing are things like the brain fog memory problems, concentration changes, things like tax cardio or aesthetic heart rate variability things like I'm breathing factor in normal. I'm not tolerating food or GI symptoms. All of these symptoms together really are painting that picture of this post viral. Syndrome. On the something is actually physiologically intentionally going on and. Something that is within our scope therapists. Oh. What we opted to do at this point is we have divided our patients out until levels or stages, and the reason that we've done that is again the patient. Highly. Symptomatic, and their symptoms stability fluctuate. So our goal and that beginning always. Stabilize the symptoms as much as possible. So we consider every patient starts at level eight because you might feel fabulous the next day if anybody's everybody started at level, like these patients are highly symptomatic really what we're looking for is to identify thereafter stars and going through their comments and some and have them raise them on a visual analog scale. Majority are rating them greater than five. And they have a significant symptom report You know again, we have patients were checking every box and then adding other and this is consistent report. So again, starting at level I and really the goal of level I isn't stabilization. So we're looking who prove activity tolerance and endurance improving tolerance upright right especially when we think about those patients with you know or cartridge ability hack accordia dizziness that's non. Genetic Respiratory Control Activity that breath work coaching that I had mentioned and really again that multidisciplinary team support our multidisciplinary team in terms of the for these patients and everything from cardiac clearance, pulmonary clearance, neuro psychology, brain fog, and those changes in cognition We are really expanding that referral source research way to file. Hey, you would be a great member to be on our team and we're bringing people in as we see fit. So again, stabilizing that patient supine based movement and I'm we're GONNA have this I think next lie Yup supine therapeutic exercise always with the goal of progressing to recumbent upright. Early, making sure that we're encouraging rest says the patient needs them or monitoring those symptoms super super closely, and then trying to identify any of those precipitating factors that might have exacerbated symptoms so. Really. Keeping a very close eye. Change Our protocols and change the exercise that we're able to more closely pinpoint like, ooh, we added an extra. And that was the difference between I feel Okay and hey I'm paying the price and as a PT You know normally I factor in neurology. So I think as the neuropathy I'm very much I think all of us are. Narrow where every idea of like one more arrests like you've got to keep pushing this is a little on the different end of the spectrum where we want to be cautious and we want to really listen to what the patient saying about their. So. Accurately a late change in dot but nevertheless, we're flower holier adaptive we got. Well. I mean I feel like you know. We understand disease pretty well, right I mean you know I've got books or I'll explain it. We're trying to figure out the disease and develop a Rehab Protocol at the same time and that's exactly a hundred and I always say in these talks I say this to questions that I speak to about this I say That we learning as we go and something that you had mentioned earlier that I think is so you're right everyone's like, oh, they're making mistakes but the process right bring it back to like what is by different process and that so much. We do this every day where we ask the question. You do data we learn if we're right and if we're right, we keep going if not we we change course but I think. We The best thing we can do our patience is identify, treat what we're seeing and luke slowly so that we're listening to the patient I you know my theory is, is like I know the human body meditation, no, their body. So let me listen to their story. Let me understand that and I think that's pretty well here. So again, those level a patients really stabilized table I see life. Actually move on Level Day. Right. These are patients where we've gotten through do pine exercise we've gotten through. We've got some progress on our outcome measures and I'll talk about that a little bit extended outcome measures here. They've gotten through them. Everything is looking more stable, the patient and more specifically your clinical judgement. You feel like it's time that we could kick it up in. Australia. So the symptoms are less than a three point change on that visual analog scale similar. We're taking that a lot from like the idea of like the Buffalo, concussion protocol. Right. If you're the free point change on visa that's changing the way that we're approaching exactly where soccer right there. So we're taking. A kind of that same approach here and the goal is really to initiate aerobic exercise. Really why is that so much of the literature and so much of what we understand about things like that thought I, know me chronic fatigue that end of the spectrum is that aerobic exercise is incredibly helpful for these patients. Admittedly, it's tough to start right. These patients have highly symptomatic and aerobic exercise can be a little provocative which why we're taking this very, very stepwise approach so When I'M GONNA share here's what we've developed so far I've been working really really closely in addition to our into plenary team I work really closely with Alex Fun who is a strength and conditioning coach who's generally works with our elite athletes through our performance three sixty program but he has been working with me on this and it's been really fun just because it's like hot me of you know I generally work in a very different setting than elite athlete. So been awesome to collaborate like got don't be afraid to work with other people get into that interdisciplinary mindset. So for the level be patients, we actually looked at what was our ultimate goal. And so the ultimate goal for these patients is to get them onto have called the Levin Protocol which is an aerobic exercise protocol looks to get patients at about seventy percent of their age predicted heart rate now looks to have about thirty minutes of aerobic exercise three times a week. We like at is way too aggressive for patients right now, how do we tell them? What we've done is we've broken it down week by week. So week one until it's really just that initiation of exercise, we're doing everything in intervals. So patients doing one minute interval of walking locations walking monitoring their heart rate variability were monitoring their visual analog cell for their symptoms, and then we're giving standing rock and standing rock with very intentional because of Ortho static problems as patients might be having you know sure well. In relic, lay down for a second or go sit down for a second but that transition from Zip Standard Santa set could be the difference in the sense of exacerbating. So our goal is to have the patient take standing rap break, but we're being really really ginger about it though the patients are he is. Or giving the patient the onus of helping to design that Arabic call reason being number one peripheral. So we can't really use h predict heart rate Max a really reliable source for Arabic zones at this point. So we've opted to P. on a scale of zero to. Make a really patient friendly and go from it. So from here right every week. The goal is to increase the intensity of the load of the exercise where the training. So week one to at one minute interval it. We to a ninety second inner will week four we go to a ninety second interval but our goal is to do more petition that were really playing with how do we lowly and safely and cognizant Louis Change our intervention how do we up regulate? How do we make this a little more challenging without pushing you too far We heat that RPI at to throughout the entire level one of the protocol really with the idea that you know again, we're watching that visual ally how is it making? You feel today how is this making? You feel tomorrow he thinking week down with US still goes to say right if your patients like, yeah, I feel awesome. Let's go. Up Race well that like he how you feel tomorrow, let's see how you feel the next stages. So it's constant constant monitoring. Same thing goes bump to level town. We're starting to slowly progress. Now we're walking in inner whole of minute cumin at walking. Our ultimate goal for this level is to get the patient to tolerate affects minute walk test. Reason for the sex. Minute walk past right as a I'm biased party I think it's a great outcome but also it's really helpful because we can calculate the OT maximum that. So if we're really trying to objectively get at what's my patients tolerant power, they loving my eyes and more. Body. Loving masters is now I'm working our way so that we're making things more challenging, but we're doing it safely. And where we live in level bay. same thing goes here by consistent progression two minutes, six petitions those rest breaks in between as needed. And then last as we move into level safe right out something I do WanNa mention though I before I got there for any of these levels this is not set in stone. So F A patient is unable to tactfully complete the full week it on their until they tolerate right there is no pressure to push advance. There's no like up we're at we gotta jump to the next week. Right? If you're patient is consistently not hitting their targets. There's no shame in keeping them more. They are let them build that tolerance. Let them build that autonomic tone, get them to the point where they can't tolerate so that they are successful in the next level and that we don't throw their symptoms froze. Lastly, again, that level same we were, we met our goal check sex minute walk test raving success next moving on to our more advanced protocols and so this would be initiation of Max test and then initiation of the Libyan Protocol I don't know I'm assuming they mentioned it right the Levin Protocol, Gold Standard for Diff- out an Omya highly, highly the Port Ed for interventions specifically for patients with with pop. We are adapting it for our patient population again, because they're symptom presentation closely next level or symptoms and the population where modifying as we go to make it appropriate for the car product Kobe poppulation fight again, everything is work-in-progress. So here. I. Feel a little bit of a recap. How do we run this up Max Tests I am a really big fan of the YMCA protocol largely because it can be done on a bike or a new step depending on what you have in your facility going for the goal of recumbent base rollback. First and foremost, and then progressing to a treadmill. if you have only a treadmill, right, you might start a little bit more slowly maybe spend a little bit more time making sure US cleared out level the level prior to before you moved them in here right for patients who aren't tolerating talked about the six minute walk test and why we love it, we can going to be oh to Max off with that. So we're a little crash course refresher right YMCA protocol for backs were working in stages. So we are taking a patient, they predicted heart rate masks. We're starting them at thirty watts, the intensity and based on their heart rate. As we go through each stage, we're making that decision. If we should increase the watts that the goal is to get through the four stages to get a better prediction for your patient and. From there yet this is nice. Little broken down explanation of it as well as a nice little length. I can always feel free to share a great article and this is just an example how documented I got. I was like, well, how do I guess not well quick cheat sheet of how I like to throw things and big fan of graph because it makes life easier to check what you did the last time. and then from there we right we can move into the Levin Protocol. So goal three sections a week twenty to thirty minutes each session seventy percent of an age heart rate Max Really what we're still working through is one of your heart rate variability all over the place I definitely argue honing in on the use of the RPG throw that one which is definitely supported in the literature. Other things to consider right. Warm Up. Cool down definitely important and the goal with the Levin Protocol At least what we've seen and the PUCK literature to make this a, you know a long standing thing for patients patients who get on the protocol and even sound this program, and definitely on the goal is always going to be to make the patients more independent with the program so that you can transition them. Out of the clinic and then to a more independence base for completion of the program. Here's the article exam and outcomes. Wise right at this point thinking about endurance strength, cognitive status and quality of life So endurance is that sub Max or six minute walk tests strength and then P. I'm status where using the mental and I didn't see the sun here I must have accidentally race you but quality of life is that basketball keeping it really short and sweet for the patient we are setting are doing this ahead of time. So we're funding these out surveys. So patients, they're not using their therapy time to complete any of the self before I'd once and then we a few teaser are running through the patient outcomes that we can complete. So my final thoughts, my final takeaway, small bat So we got it's five fifteen percent of people, which is A. Significant Co would if I say so myself. there long haulers right their self identified as long as these are patients whose symptoms far exceed the normal length of an acute infection we. Like Our time to shine specifically because of the impact that these types of exercise prescriptions and interventions can have for the patient You know there is no, there is no drug store for this. This is something not really amazing that we can use as the on our side. They're only help these patients I we have our Cova Nineteen Rehab Program Ave conjunction we have our cova nineteen hundred excellence. So we're really starting to think about how can we help this this really unique patient population on like we talked about her unusual future research is always going to be needed to better understand the ideology in the path of Ya'll and that's definitely something in conjunction to research to Rehab rather that our team has also addressing But yeah, you know we are a huge team effort and it's a multidisciplinary. Task. So contact US definitely reach out to. Me As you can tell, I'm super happy to talk about this at any time. Yeah. Absolutely all the time. THOUGHT WE GOT Great presentation. Terribly. Important And just. Half Hour of you of going through it. Wow. How much work had to go into really putting that together recognize and you mentioned Mrs Tubbs show right seeing a bunch of. Singapore. Every says not my problem and saying I'm. GonNa make my problem five to fifteen percent of these people right now that number could go up as as healthcare providers as you mentioned were discounting when people were saying about these symptoms and saying Oh that's on your head and just discount. So that number probably likely to grow right? Absolutely and I think that we are just touching the service of where this is going I. think that you know as more healthcare providers and knowledge that this is the thing and this is happening I'm really interested me how that number grows and how that number changes I think additionally as we learn more about the patient experience and we better understand and presentation but also some of the Path is at seventy. Let's the worst coming from and why is it happening and I think there are some really really interesting provocative strong theories right now that might give us some insight, but this is still A Wire Elaine. Think about this, I mean people have said this about this time we're living through something that researchers are going could in theory, make a career out of if you're if you're a young researcher and you're GONNA study pathophysiology or disease. Progression. You've got you the thing that you probably do for the rest of your career You know civil rights you writing papers right now. Well, you can pretty much say, Hey, I'm GonNa make this my career and you could do that. What's the biggest thing that you think you've learned in this past I mean since March which is seems like about three years What the biggest thing that you've learned digging into this and and working with this the this populist sub population. Yeah I mean you're absolutely right I feel like my career has. Essentially since March, but I think so much what we what I specifically learned just. The symptom presentation is unlike anything that I think we there has generally see again unless you are in a very unique position that you specialize in something like this will be our my personal experience we had previously worked and on and on research. So it kind of like you know I got that I think my real takeaways just this is our time as Rehab right and I think that oftentimes our role sometimes secondhand where we go, let's diagnose. I let surgery then then century how but really now we can. Step into the forefront and you know educate ourselves get that professional development understand what's going on on of the research right? Even if it's outside of Rehab Research to know what's going on and what the disease processes like because this is something that I think in any setting that we work in no matter where you are an extra that continuum of care whether you're in acute care, you know on the front line, we re now seeing patients in outpatient This is something that is going to be present. So it's definitely there. Make. Sure these people don't slip through the cracks. Let's put some the they've recovered from this. Virus Smith recovered fully or is fully with them. Exactly and I think that this patient population, you know especially because the initial reaction to it was this is psychology. This is not a pathological or disease process. So many of these patients they do they did or do fall through the cracks of healthcare systems and I think it's definitely our responsibility healthcare system is a medical field to say, Hey, we can treat this and you know similar to anything that I think our team has done has advocated for his we. Don't say no, we don't say sorry can't do anything about it like we do something about it. WE'RE GONNA learn about it and we're GONNA be a very fluid situation but we're gonNA vote for it and I make up huge you're doing big work you yourself number you mentioned on your team working behind the scenes which is to be able to help. Progress, we have to understand it I that's I mean we need to understand it. So that's where you're doing so. Flashed on if you WANNA reach. PODCAST. Listeners. Jenner DOT Tosto at Mount Sinai Dot. Org more information at Mount Sinai. Dot. Org website. Anything else you'd WANNA leave with clinicians who maybe didn't know there were seeing these patients but now that you're mentioning it, they're saying this sexually. Lock tomorrow or something like that anything that they should. Know or do or what action tag tactical we. And I think that's actually really ironic. You say that I have had that reaction I guess inservice Multiple Times really as we've upscale within the Mount Sinai Network, we have a system of degree how partners which are other physical therapy practices outside the system that we work with really really closely and. I spoke with a clinic probably about two weeks ago and that exact reaction where someone was like you know I was seeing someone for something else I cleared bueller. It didn't really makes sense. But now that you're saying this like this is my patient I think really taking back number one listen to your patient. What are they telling? You might be right in front of you. Without. You even realizing it indefinitely be very, very mindful about the interventions that you're putting out on the table, right thank very much though about what is what's the goal of the intervention don't just prescribe something to prescribe it this is not once I it's all night we can't go with the kitchen sink approach for that. So that's definitely might take away It's just fan. Out. There we're learning as we go. You'RE GONNA. Learn as you go and I think that that's really the biggest thing. For me was you pumping the brakes on yourself right in saying is a neuropathy won't always be like one more Rep. We'd be very careful with these individuals right now. So this is not something. That you've seen before. So now that we've never seen this before, we're just we're learning. A different way, right you can't just push. we'll got some people making some comments best advocate for our patients mazing talk Jenna. Quirk. Doctor the CO Director of the ability research center she they neurophysiologist She's absolutely incredible. So you know I think that's just. Those of where we are especially at outside and at the arc as our patients need us this is what we're here for. So definitely, they'll be afraid to advocate for the profession. They'll be afraid to advocate for your patients. If you're ever on the upper east side, she will shock your brain. Yeah. I mean, come on down with time times I all. Time hanging out with David Marsden. Cool, it was like, yes. We're GONNA be some trans. Cranial stimulation. That's. What could go wrong I mean I up right. To see that it was cool. Are you ready to do three questions. We have three questions coming up. Three questions brought to you by our friends from Arias medical staffing get measurement of top leaders. Travel physical therapy thinking about I. Mean I. Look at it like this. You're you're in the city right? You're where you on Queens I live in Queens work in Manhattan. Yeah. But we did clinical rotations. You know some tour smart and they didn't like Hawaii or Alaska place like that. You could treat travel physical therapy is like you know I'm going to kind of toward the country for a little bit get paid, doing what I WANNA do wherever would. Not to share. Power Move A. R. E., U. S. medical dot com that's the website. So all different settings to sometimes people think it's just alpes north though not all settings off states plus DC A, you are a US medical dot com art. First. Question three questions is a wear question you just mentioned Queens, right but if you had to choice, you give this in-service or work with this over you wanna work with anywhere in the US where would you WANNA go? I mean, definitely vote Santa Monica. But in the middle of New York City winter so I could do like whole snowbird but like in the midst of the winter, right out of the city whenever we talk about this James Spencer's but I'm a show before he did asp in the winter and then he would do like Hawaii Aspin Cape Cod Aspen floor and I was like. He this but. Hey it's within. Within the fifty. Second question is what question? What's something that you've. Watched read listen to book movie podcast that you just think and I hope I make this question open ended you think the audience would value from. Definitely Axel. Veyron. We were talking about this earlier definitely, say David retreat a Tedtalk I jokingly invention I've listened to it on my way into like interview my first day of work more like pop music. So yeah highly recommend that if you're feeling inspired and you WanNa, do some crazy innovation going pretty cool tedtalk That Lincoln the comments below and the last last question. So we begin to them with people. Who is someone? The audience should know more about. I mean, I have to give it all to him and she kind of in and and my thunder there might team at the mark up mark says, Dave for Trina Leyla Erica my whole team we were has i. mean it's just fifty. The way that everyone within the health system has stepped up within a crisis We all you know. Outside of our normal those and I'm sure that this happened across the country and that there is an inspiring thing and all this madness it is that we as health community stepped up and we're in it together. You have we we talked about this before we hit broadcasts and during which is this is a great time for our professions to shine ot. P, like we talk a good game, we got research that now we get to get into game really help didn't want situation, but we can really really help. All right. Last thing would do on the show is called the parting shot. Hardy shot brought to you by our friends at the Academy of Orthopedic Physical Therapy find them online at Ortho PT, Dot Org they've got all sorts of continuing education if you're looking at a level up your orthopedic game, why not do it with the Academy of Orthopedic Physical Therapy Find Them Online at Orthopedic Omar Gee we just had a winner in our last contest we gave away access to any of their Their courses tissue tolerance, the running athlete to the new ones. Current concepts of PT, that's the really great or A. Prep course. So find them online Ortho p dot org, our parting shots, and no pressure you gave. An awesome. In Service but the Parmigiano comes down to this. What's the last thing you WanNa leave your mic drop moment for the audience today. I mean I think we've sent it through the entire talk right this is your time to shine. This is the professions time to step up. So I can play Step off put up, shut up you at you can. And I love how you literally I mean you guys are doing innovative things but you're you're you're you're focusing on the basics, which is listen to your patient tree. What you see what are you? What does it? What else does this look like does this look like? Right. So I like as innovative as you're being, which is innovative you're rooting the basics, which is the best way to actually make that innovative scalable and sustainable. So thank you for that jet appreciate you coming on I say we should probably have you on if we wanted to be as a love graphs, right we should probably have you on in a couple of months to see how this thing has progressed because how so we're asking lovely graph for it. So absolutely more grants but thanks so much for the time. Thanks for joining us and sharing it making a lot of this stuff open source of the rest of us can can partake in and help our patients ultimately. Thanks for having me. Thank you. Love the P., T. Pine cast yes. Yes. 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APTA Aerosol-Generating Procedures with APTA Section & Academy Presidents

PT Pintcast - Physical Therapy

37:55 min | 8 months ago

APTA Aerosol-Generating Procedures with APTA Section & Academy Presidents

"Hey before we get started, I just wanted to say thanks to our longtime sponsors are es medical staffing, helping you physical therapists or physical therapist assistants find jobs all over this country with position. All settings in all fifty states find out what they have for you. At a U. R. US MEDICAL DOT COM. That is a you are E us, medical dot com. Follow US online at PT podcast and subscribe on I, tunes, spotify or Google podcasts. Absolutely. Yeah. It's it's awesome. Gentlemen. We are live. Welcome to happy hour this specie podcast, a podcast that saves physical therapists like you for missing out an amazing insight, remarkable ideas and motivational stories in the world of physical therapy. Hi Jim McCabe your host broadcasting live from the medical studios also noticed my bedroom. Code World find them at a you are US medical dot com. It's a U. R., E. S. MEDICAL DOT COM leaders in Hashtag travel physical therapy. Welcome to the show great show for you today some really amazing work being done by American Physical Therapy Association the people within it and wanted to spread that information. That's what we're doing here today. So stick around for that can get into some covert information subscribe to the podcast spotify Google. Good podcasts are heard even where bad podcasts are. That's where we are now video casting well, on Youtube, facebook and twitter. At PT Podcasts, on the social we've got a busy show for you today. So let's bring in our guests. We're seeing a lot of yes. Today. Let's fill up the studio and wave as you come in. It's like the evil It's like the evil Brady Bunch got going on here. evil. Center Square on Hollywood's. Jokes. Reference Great. Wet. Square Let's do this. Let's let's introduce. Yourselves and let every know what we're having partaking in what's in our glasses. The first question is always the hardest. What are we drink it? So no stranger to the show once you go, I know who you are. Hi, I'm Sharon Gillerman the current president of PTA acute care and today I'm drinking a Conan brewery big wave in honor of not going on vacation Hawaiian Scoop. That gets deserves do right there liquid Aloha. Good pick right there. We'll go around the hordes centered square? D.. Hi, Cornet President of the Home Health section I've got my honorary pt Pint cast glass and I am drinking a mango white claw because all is the law is a law that's really prepared for this Let's go with Angela no stranger to the program as well. Angelo ready to go. She's got her mixing in. Their Angela, Campbell President of the Cardiovascular Palmer section of the AP Ta and I'm drinking what I have made up myself, which is basically I'm going to call an old newell, but it's made with my new favorite Jen Bar Hill. Jen that is distilled with raw honey out of Vermont. So it sounds like we we should probably have a sponsor some linked to ETA remedies. Some of these companies and rounding out the panel today Cindy Miles on the program. Hey I a little boring compared to the rest Lamma Pediatric. Therapists drinking my by. rated. GotTa. Stay hyper. Usually. I usually drink a beer, but we'd be doing so many episodes later deeper stuck at home I figure why not pod that I'm actually switch it up doing three fingers a bullet today I'm doing a little bit difference well, first of all. He. With Yeah Bourbon Thank you guys so much for common. We see things flash across our news feed, which is pretty much how we we get a lot of information these days that I remember. I saw something that popped across it looked really really interesting and my question was who what is that it had to do with Kobe nineteen, which is pretty much a lot of the things that were. Reading about talking about listening about especially in this format as we go around the room with some, it looks like a meeting that you might have attended in the last couple of hours but you guys all work together your your organization components within a PTA. To, produce something for Kobe Nineteen, an aerosol generating procedure guide. Let's start with what is it restart with Angela how you describe what it is. So the audience can can kind of get get into to focus. Basically we've been meeting every week all the different sections and academies to do coordination of our Cova Response and through some concerns brought to us. We've found out that it was really important for us to help describe an official. Statement that exercise and mobility could generate those aerosols and knowing that aerosols. Now, since then has been officially listed as one of the chief modes of transmission of covid nineteen and we WANNA make sure we could make a statement that gives employees and owners the right to the protective peop- either they need for their setting. So. Really a position statement. The statement saying, Hey, here's what we know and it took a while to create this in. My guess was because we were trying to figure things out. We didn't WANNA rush out statement you guys wanted to do it the right way Sharon you're involved in this as well. The rest of as well as the rest of the people on the. Panel. Why did you decide to jump in? So one of the things you know I work at a hospital that's part of my job You know obviously president of acute care we had issues with people and getting the right P P but everyone kind of understood that the therapists and the hospital would need it and what we started hearing on these covid meetings were from. That were saying, Hey, I work impedes and they're telling me I don't you know deserve a mask or I don't need a mask. And then we knew all of these patients were going to be going to other settings to get rehab because so many have lasting deficits after their hospitalization. How can we as a group who maybe works more with P p., e. and as a little more familiar with it helped draft a statement that can be shared across all the different settings to really spell out what we know about protection and who's most at risk because Angela was mentioning you know our patients are coughing they're generating these aerosols and unlike a physician or a nurse who might be in there doing a procedure for a few minutes. You know we're sometimes in there for half an hour or forty five minutes an hour straight really close to the patient. So making sure that we pulled together all the various documents. that. Already existed because I want to be really clear we didn't make up any of these guidelines. We just pulled together stuff that already existed about risk levels and era civilization and exposure times and put it all in one place that we could share it work smarter not harder right he's kind of borrowed standard on my shoulder giant right but making sure you're having the right information putting it together and listen that's that's not an easy thing to do is making sure you have the right information from the right source and sharing it in the right way Let's talk with D D Why was this important for her your section? To get involved as well. Well, first of all being part of the collaborative effort between all the sections who came together to contribute their expertise and resources was essential to moving information out to membership and non-membership alike, really quickly. But in home health, we were seeing a lot of these patients come right home. They weren't going to congregate facilities like impatient rehab or skilled nursing facilities which have had their own challenges and struggles with infection rates, and so we get these people that are coming out of ICU, and that's already challenging enough and then to come right home and many times in home care if we're not directly employed by the. Agency or the organization we provide contract services. So this also really affects private practitioners who sometimes staff homecare agencies or their entire business model is as a staffing company and accessing PPA extremely important. Last thing about home care is we don't have the control of the environment. A lot of these people go home to moldy environments they go home to to second hand smoke they go on to a lot of other challenges that we can't control for like we do in a in in an institutionalized bricks and mortar setting, and so we've already got these environmental issues that may be challenging people with underlying conditions and you put this super. Super Bug on top of it, and it's like you know we really need to get this information out stat and have something that our clinicians can grab hold up and can run with and really can make good decisions about when treating patients a lot of great points that you bring up early in will march although it still feels like marcus was like march 93rd at this. Looking for good information and we didn't want to give out any information right? We're healthcare practitioners we want any misinformation. But there was some some information spreading and that's where we bring in Cindy City work in pediatrics wipe wise pediatrics getting involved in this. Well, as he had said. It was imperative that. Adams Section Because they're all in this together and it was amazing with I really Kudos to Sharon and to Angela because they were in the front line, the beginning whereas pedes we. were out of it in the beginning because most of ours. Tradition to telehealth. But now we're in the midst of it. So the have all this knowledge and to bring it to what it's needed in pediatrics, and some of us are in hospital summer schools, early intervention, and as these deities mentioned too they're not always have access and even Sharon and an at the hospitals have it but they're not giving it arose of us. Now there are in the outpatient and are there in the schools and in other settings like we're told. Oh You don't need an ninety five even though we're in a room with a child or speech therapist for an hour to two hours of they have assemblies, and we recently just had a family that was actually who tested positive for Kobe, our speech that have been in the room with each one of them for an hour at a time fortunately team in ninety five and a fatio. But I think you know in those cases when children come in shelby wearing and ninety five speech Rpt's that are putting the children on the treadmills. That's that's an AGP for sure. Do you want to let the audience know that they can fire way comments or questions as we listened to this live or if you're watching the replay later on just dropped their replay. Let us know. So let's start talking about what's actually in the guy we're going to drop the link to have the audience be able to access that as well for the American Physical Therapy Association. If you're a member or if you're a potential member, that's correct. This is open access. That was really important for all of us actually with a lot of these early covid resources that we were working together to collaborate on we understand that. Members are important and we appreciate our members of like you wouldn't believe. But this is information that need everybody needs. You cannot be hoarding this kind of information. This has to be available to everyone because it's really safety. It's a safety of our communities and our patients and their families. This is important to to remove behind that paywall. So of course, we'll draw that link in the comments for people to be able to access that. So we'll start with you and stay with you Sharon. Watts in this, what are people going to be able to learn give us an example. An example there's Some mention of different kinds of levels of masks I'm sure many people are very familiar with this but again, it's all referenced Is it really you know? Do you need a respirator? Do you need an ninety five? It gives definitions it's a nice resource if you're reading these things and you just don't understand the difference between, let's say papper or a respirator and an end ninety five or are they really different? How are they the same? So that's helpful and it also really has some key things in there that we try to include that also address families. Because you know they're going to need to protect themselves if they haven't been already infected. So there is a little bit of that in their own When we started to talk about PP just in my day job didn't have to actually interact with it. A whole ton before March was going back to school and I got a little bit of the sweats right in terms of what precautions require. What I was. I was I was trying to break out my NPR new manuals to see if I. Start started breakthrough with that. But some confusion you WanNa make sure as you all mentioned in some way or another that you're using the right equipment at the right time with the right patient. It's been really amazing. I've been also at the college where I teach on one of the committees that's looking at the reopening plans and a lot of this has been really helpful with that as well. Because as Sharon was saying, you know we don't have a lot of very well established cove nineteenth specific research, and if you really look the CDC guidelines are late you know they are waiting for the evidence to accumulate. But by that time, it's Kinda too late to protect some of the people that need to be protected. So is really about taking the brand new literature that we could on Covid with existing literature on on airborne transmission. But also, the things like on ventilation ventilation has been key. So if you've heard about any of these outbreaks with going back to school in those kind of things, a lot of it has to do with the quality of the ventilation in the buildings, and so we talk about that the number of Eric's changes in where you are thinking about the environment where you're going to practice, and then on top of that, what are you? GonNa do. So how close are you going to be to the mouth and face of that patient and how long are you going to be there? Are you GonNa do anything that generates deep volumes ventilation or coughing are going to potentially aerosolize that virus your you know for me it kind of reads like a almost a decision making tree based on the intervention that you're using what type of P, p and how far away. From the patient during the carry out of that activity, and when it's also gives you some some feedback, some direction about when we can discontinue Freddie and so those things are really important for those frontline clinicians and not minimizing care in any other settings. But in home care I mean it's it's it's basically we're in the native habitat for our patients. Right? We are right there in their home with them we typically don't run into each. Other. In Home Care we're not tag teaming. We don't have someone else. We can resource or protocols we can. We can mimic. We're we're in the home as like that frontline clinician, and so we have to have a strategy and we have to have a decision making guy. So I think it's a really solid ref- resource and I really WanNa thank a PTA, but particularly Sharon Angela for all their expertise in pulling this together because. It's really helped. You know our frontline clinicians in homecare that basically. Practicing a vacuum in a patient's home. Yeah. Cindy. You mentioned early on pediatrics not being focused or not. You know being lower on the totem pole instead of in terms of getting some of this equipment and some of this information But you Hala very quickly when we spoke a second ago about why this was needed I mean you're not only usually working with just your patient pediatrics also met with patients parent or caregiver, and maybe you're sharing that patient with a along with PT Ot and speech and those sessions are a little bit close when you're the pediatric patient, a lot of times I mean, I spent a year impedes myself just at a PT school your up close and personal so Some welcome information for your pediatric contributors has been fantastic. We definitely need because again, we weren't face-to-face as Sharon. Angela we. Face to face and what D we were. Glad with her with her Academy on a Cova resource for individuals going back face to face and it was fantastic to have one of our members join us to talk about what they were going through in home homecare. So when our IAE individuals are going out to the homes, they knew what to do. So we had all the information because again, this is something we do on a daily basis and vs we just played with babies and. Right but for myself, I woke all babies and they're here right here all the. Year. So we have to have this information for individuals going back face to face, which is now happening. Very frequently in the early intervention is all moving back forward into face to face WANNA make sure that our patients can get the care that is IRV, and this is a great it not an advertisement but a great example of the value of. This got an for this information now, not behind paywall because it's that important and we've actually dropped that the link in the show notes and the comments of this episode but are no stranger to the show carry, Paglia? No. Saying, thank you for all your services and and the resources as well. So let's talk about how this came together. I want to talk about this because I think it's important to highlight. It started with an idea like most great things that we had Sharon Angela on earlier in this this Kobe situation talking about some resources you're putting together. Just talk about briefly the collaboration just getting all the sections and academies together is no small feat. You know Kudos for doing it just getting together and sharing information, but it's a little bit more than that. I WANNA give kudos demand Mesbah from from HBA because he was really good at they also did a lot of the webinars early on about practice issues and not only that, but he really recognized the need to make sure that all these sections academy has had a place at the table on a weekly basis for a while and we've gone to every other week and our kind of starting to roll back a little bit of just you know. because. If you have an issue in place a sinuous saying you're going to have an issue that someplace else and we all have different levels of expertise and we all have different viewpoints and frameworks and not just so much easier to get the work done when we just all bring it out together in China to step over each other. You know I've been a member. I've been a PT for thirty five years in a member for at least I think thirty plus years and you know we there's no such thing as a good crisis. We don't WANNA have to deal with these things but this was probably the best example of a PTA Hashtag better together, the federated model that I have seen in my time Involvement, in the section right in leadership through whether because it was brought about by us, we identified the need we came together. It was very much one mind that this isn't just a membership thing. This is an all of us thing and they selflessness that people volunteer their time, their effort, their talent on Saturdays on evenings regular meetings. All the time to come together and and to make resources and and standards and guidance for for practicing clinicians that choose membership or not I. Think it's strong for the AP faint brand and I can't speak more highly of a house. How how important it was to me at this point in my career as I I moved into my last year of service of the home health section presidency that that membership is so important because it's opportunities like this where you know we just get in and get it done and we figured out we collectively and it's not mine yours or APP you know it's all of ours and thrills me. It just throws me I can't tell it all in your voice. Things that were those meetings really helped was honestly like there's things that I forget I forget that the rest of you don't work day to day thinking about infection control and cross contamination like I do. I. Forgot that and I remember that we heard something from one of the other academy presidents and they're like, well, what do you mean we're going to need different equipment in our outpatient clinics and Angela like you're going to need pulse exhibitors, you're going to need stuff for low level exercise. You're going to need gloves and they were like haw and that's when we started going. Oh, they don't even get it and it's not bad like congratulations for not having to get it but it was like, oh my gosh, we have. People who are really good at this. This is what they do and I'm going to give a shout out to our practice committee in acute care 'cause like they got on board and help and were editing things and throwing around ideas and all of that, and again, this is where the better together really works things. I didn't realize we're going to be a confusion or a stumbling block for other groups. I have people who know how to do that. Let's pull it together and give them something to help. I think it highlights. One with both of you hitting on better together. But it also highlights the vastness of our profession when you mentioned. Charon that you Angela. Well, this stuff we talk about think about every single day in pediatrics probably not or outpatient physical but like it shows the fastest because everybody on screen right ear and everybody in the audience, all physical therapist. But everybody had to kind of drop and say I remember this from PT School Right Pete's. Gabi. Doing this. Value they're putting together a lab value that ask the evolved. Yeah. We need to be involved I haven't thought about lab values. Most of my career. But it's GonNa be so necessary as our children move through this because as you've mentioned earlier, the children are getting just not that we're not and. and. What I worry about with pediatrics is, what are we going to see in the long run right? That we thought that maybe didn't have it but had it. Now, what's going to happen three four years from now we have two detectives I keep telling all of our members. We have to keep our detective hats on because we're going to be seeing things differently maybe that baby that was born from other who was positive and even though they tested negative or they'll be residual effects to defy the ocean now. Believe this Sharon and Angela and talked about this early on maybe April and we had you guys on the show last which was. This is a great. Opportunity to not tell but show the value of the vast minutes of physical therapy and you know there's no good crisis but lining up with the centennial of the American Physical Therapy Association, which really was born out of an epidemic. Highlighting all the different things we had David Katrina, who's a physical therapist at Mount Sinai Hospital System in New York and they're doing some small wouldn't call studies but they're they're they're they're monitoring groups of patients. They're finding that not everybody reacts to this. I think we know this but I think it's worth reminding is survival is obviously of the utmost importance. We want everybody who gets this is a virus to survive. But what is survival look like after this goes along with the medical model, of yes. We're helping patients live longer but what is the rest of their life look like we wanna make sure they have life in their years not just years in their life and I think you're bringing up some great points there Cindy. We've talked about this before, which is what will come down the line PT is poised to pay attention to that. Where you we cover the whole lifespan. We cover everything from a person in the emergency room to somebody in Palliative care and pick an age. So I think we're in a very unique place that and because we're a little more unified than maybe medicine or even nursing around this idea of what we do Some of these longitudinal types of of investigations I think could really be important to have a PT if not running it on that team. Only, we had an outcomes registry to track await renew. Correct recommended outcome measures to. The other thing is that the Yeah, the core outcome measures there you go. That was. There right. So yeah, that one's done. The pediatric version is almost done as well. So Sydney got a couple of people. We got some people with her on the pediatric core outcome measures and so you know again, we're looking forward to that and and the follow up with this one as we have a clinical application algorithm that should be posted on ABC's website in the next couple of weeks that really thinks about you know these are kind of. The core that we're supposed to spend the most number of patients across the most levels of function But we know we're going to have an in floor effects that we're going to have some of those athletes that have these residual problems getting back to sport that need the really high level exercise testing, and we're going to have some of the lower level patients that really need the function and sitting task that people like Sharon Oh pretty well. So. Yeah and you know it was really nice coming together because we you know that sprung out of this collaborative, and then we turn around and representatives from our practice committees. All came together to help with those core outcome measures in. So you know it was simply who from the Home Health Section Practice Committee Rachel Botkin boot you're on and she was part you know about consensus and great just so many moving pieces and so many hands willing to jump in and be part of the process really makes me proud to be a PT Yeah let people who are good at what they're good at what they're good at it out of the way I haven't apologize back though To have checkups for life therapy checkups for life I've been saying that for the last several years I bring you most of my clients back on a yearly basis. They don't need PT. proline. Piatra standpoint forever, but we should be seeing them once a year. So. Therapy checkups for life. have. With more, Tele Rehab happening even easier than it might have been we have. To. Hear to. Highlight. What we're doing right here D- where are you? Geographically what state? I'm in Florida shared California Angela Connecticut and Cindy and. I'm in upstate New York I. Mean it just shows that you can share information back and forth in pretty meaningful ways just by logging this laptop and using this camera and a couple of headsets There's there's some potential there. You know mentioned Matt, Masimov and HBA catalyst. I'll get a chance to work with their Tech Sig and techno Palooza last year not I said last year February. Just. Feels like. Right Denver. Here. For Near. Your mouth. Got There. House was this really really innovative sing, which was well, it's probably years in it'll get here eventually and then necessity that mother of invention said it's GonNa be here now and we spent some things up for better for worse I like to think for better. Hey, we've had in our strategic plan to do webinars for years and just never got around to figuring out how to organize it nothing like a pandemic. Doing two or three a week there for a while. Burning man. Yeah it was great. So I want to say, thank you to this team, and of course, the teams behind this group in this panel across the American physical therapy. Association, for putting a putting out the. Precautions the mobility, the the the the AGP's which I kept seeing coming up on twitter. Google that one, the aerosol generating procedures is what we're looking at. So let's get the information right from the horse's mouth the good information there, and as well as those core outcome measures I really wanted to highlight that because yes, we work on strengths and function and endurance. But what are the best things to measure and I remember seeing emails flying around from from Angela in the beginning asking and you were you were asking you weren't telling which was great. What are you seeing? As the best measure for endurance for strength after this. Talk talk about how that got formed a little bit. Yeah. So so that group. And it was just because of the weekly conversations that we had that we got a lot of the people in research and practice together. We wanted to be able to do those things. You know what we have. That's a lot different than our centennial plague that that brought us together. One hundred years ago is we do have the technology now right now what we can do is we can be proactive and we can say there there's a lot of systems impacted by this virus that we didn't initially anticipate some of the neurologic conditions, for example. If, we can help define what are the recovery stages disease who might need more services than I think it's going to help the patients and it's going to help the practitioners and we really went back to a lot of the literature. There's a very seminal article by Jim Smith Halley's Lesnik and Patricia. Oh. Talkie on picks that came out and it was really pre. Kobe. Spoke a lot to the multi-system facts of that inflammatory process of critical illness and they had a lot of outcome measures there. So we kind of really talked about where did the different contracts that we should be looking at and a lot of it had do with infection control? What can we do in a? Hospital size room with minimal equipment because of infection control. Same thing in an outpatient you know we, for example, the gold standard still really is six minute walk test for endurance even with somebody's Kobe patients. But we know that you can't necessarily do it in home care very well at all because of the space that you have, you might not want to do in an outpatient setting because you don't want somebody breathing and walking back and forth in your hallway. And you know so that we really need something that you can do and and in those small spaces. So that was really a lot of it and then trying to fund the things that were the most robust and didn't take a lot of training didn't take a lot of equipment that you could really do in a lot of settings. Said, we've also dropped the link for the core outcome measure guide as well into the comments below Anything else you got udal would like to add about this process and where we are now or you can vent your frustrations. I feel like it's kind of like festivus just vent your. Careful what you ask her? and. I just make my ever never ending plea for people to wear masks please. I got a little fun with it I I've I've actually went up and and purchased some star wars masks. So I've got I've got Bobo Fat Bounty Hunter of got you baca are to see three. If you're going to wear masks have some fun with it. Can we all laugh a little bit? I'm going to need those because the Covid kittens that I got are named Luke and Leia. All right. So if we if we have nothing left there, we always end with a parting shot. You guys ready for your parting shots. Let's do that. If you'RE GONNA do it have fun with right I mean you got to go. Therapists at Heart I. Some. Why is it? I? Don't know it's a different. Party shot is brought to you by the Academy of Orthopedic Physical. Therapy orthopedics dot org, a lot of great resources there as well. If you look at a level of your orthopedic game, current concepts of Orthopedic Physical Therapy, a great prep course for your OCS exam gave that away last month, and now we're giving away access to any of their online offerings a new ones like tissue tolerance, the running athlete pretty good there. Upper quarter lower quarter. So up your. Orthopedics Game Online at Ortho P. T. DOT org. Alright. So parting shop were to go around the horn. We'll start with Sharon and Angelo because they've done this before but this is your chance that Iraq, a mic drp what's the last thing that you want to leave with the audience today? So we'LL START WITH SHARON SHARON YOU'RE UP I know pry. I'M GONNA. Leave you with a quote from Michelle McNamara I've been watching that HBO series all begun in the dark. And it reminded me of her husband Patent Oswald's comedy and I love him and I loved her and it's chaos be kind. It's chaos be kind if ever there was not something more relevant. I'm not sure what it is. All right. so that's a great parting shot Angela. What are you got? Yeah I I would just go with. With through it through adversity comes opportunity but I WANNA do a couple of plugs I wanNA plug again, the Pacer Courses, and also all of those webinars that are free for aped members and members on the AP Learning Center I think is really important that people still continue to use those resources while they're there. And I also want to give a shameless plug and it's not anything that I endorse or or whatever. But all my pacers speakers I just got in today this is going to be They don't even know they're going to get this in the mail, but there's a an instagram rod girl creations has the most amazing pens. She has that kind slightly dark sense of humor on these medical issues, and she creates the Basque medical pens, and so all of our pacers speakers are going to get the covid nineteen enamel pen. So and part of the proceeds go onto support covid nineteen initiatives. So I WANNA give rat grow creations a little shoutout. You can do that. Absolutely. That's cool. All right. Great Parting Shot D you're up next parting shower you WANNA leave with the audience. So I think Kobe's sometimes get challenged to. Know try to stay motivated incentivizes I. See things happening around me and I think Theodore. Roosevelt. said it best in the man in the arena a little bit longer quote. But hanging there with me it's not the critic who counts not the main points out how the strong man stumbles or where the doer of deeds could have done them better. The credit belongs the man is actually in the arena whose face is marred by dust and sweat and blood you strives valiantly who airs who Comes back sure come short again and again because there is no effort without error and shortcoming but who does actually strive to do the deeds who knows great enthusiasms the great devotion who spent himself in a worthy cause who's at the best knows in the end the triumph Papaya achievement and who would the worst if he fails at least fails while daring greatly so that his place shall never be with those cold and timid souls who neither new nor neither know victory nor defeat. Wow of. I like Batman in the arena, not the first time that's been a shot though. That's right. It's always good. It's a great one. It's good to bring it back. All right sending no pressure you get to follow Roosevelt but. Audience for prepared for this or I should have paid more attention to your ending I always say pedes rocks and. But. I. Just WanNa say abt A and everyone of the academies and all the Chapters Rock and we all rock better together. Yeah. Better together as a really great sentiment right now in this great example of the the ladies on the screen and the people behind you and the teams and the organizations to come together to produce something. Amazing that is going to benefit members never called non-members, their potential members, future members, our profession, and really ultimately you guys created something that's going to benefit our patients. So Kudos to you for doing that we'll have you back on very very soon when this thing is all over, let's do it in person why don't we do that? Let's. Talk about. You as we wrap things up, appreciate your time and I love having a drink with you guys. Thank you. Love the PT. Pine cast yes. Yes. Show telling a friend or by leaving a review on or Google play all right shooter day brought to you by the Brooks Institute of higher learning in innovator 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 translation of information from evidence to patient management, learn what they can do for you to support your professional development at Brooks Ihl. Dot Org. Our home on the Internet. CAST DOT COM created by build. BUILD PT provides marketing services specifically for private practice PD's website development and hosted inviting content marketing solutions PT clinics across the country see what good pt can do for you today. Dot Com. The PT PODCAST is a product of PT Podcast LLC. Poured fresh by me physical therapist Jim McKay ingredients are sourced by our chief connections, officer Sky Donovan from Marymount University. Brewed fresh by producer and physical therapist Juliet. And by producer and Creator Second PT Student Bridget Nolan from Sacred Heart University pt podcast is a podcast that saves physical therapists from missing out on amazing insight remarkable ideas and motivational stories. Make sure to follow US online at PT podcast and subscribe tunes spotify or Google Excuse. Love Yeah. It's it's awesome. Thanks so much for listening and if you found value in the show, all we ask is it you tell a friend. This has done another poor from the PT Pine Cast. A PD podcast is intended for educational purposes. Only no clinical decision making should be based on one source while care is taken to ensure accuracy factual errors can be present. More on the show at PT podcasts dot. com.

Sharon Angela SHARON SHARON Kobe Home Care Google US American Physical Therapy Asso Cindy president twitter Covid American Physical Therapy Asso Jim McCabe New York spotify Sharon Gillerman PTA PT Podcast LLC Youtube
30 Years of the Americans with Disabilities Act with Michael Lewis

PT Pintcast - Physical Therapy

1:00:01 hr | 8 months ago

30 Years of the Americans with Disabilities Act with Michael Lewis

"Hey. Before we get started I, just wanted to say thanks to our longtime sponsors are es medical staffing helping you physical therapists or physical therapist assistants find jobs all over this country with position. All settings in all fifty states find out what they have for you. At a U. R. US medical dot Com that is a you are E. US medical dot com. Follow US online at PT Podcast and subscribe on I tunes spotify or Google podcasts. Yeah, it's. It's awesome. It's a welcome. It's happy hour pizza, Pie cast a podcast saves physical therapists from missing out on amazing insight, remarkable ideas and motivational stories in the world physical therapy. I'm Jim McKay I'm your host broadcasting live from the obvious medical studios also is my bedroom find them online at a U. R. E. US MEDICAL DOT COM leaders travel physical therapy. Again, that's a war e Westmedical dot com great show for you. Tonight following up on an episode we had just a few weeks ago celebrating the. Americans with disabilities act turning thirty years old. It's always good to look backwards. Then see where we are now and then looks forwards in terms of progress. That's how we measure progress. You know this your clinician. Make sure subscribe to the show tune spotify. Google. podcasts were also video casting now high youtube facebook and twitter at PT Pike Casanovas socials comments or questions during or after the show. You cannot chime in common. Let us know where you're listening from. And if you're listening to the replay just dropping replay. Our next guest is a state affairs specialists for the American Physical Therapy Association a UNC Chapel Hill graduate, he worked in state and federal healthcare and disability policy for ten years. Let's bring a mini your Michael. Lewis is on the show. You got you got the crowd cheer in the background but UNC Chapel Hill. took. In a few games, you're used to big crowds. Macaws big game. The Team do glide always. Yeah. The. Big To. Happen all of Tyler. Yeah I'll. Leave. Tala. Back. Above. That Michael Welcome. To the show mentioned in your in your entry working for American physical therapy. Association. So thanks for all the hard work that you do. Wanted to figure out how you got there. You've been working for for a decade in healthcare state and federal healthcare in disability policy for ten years. What's Your Superhero backstory? Well our God you whether you're one. Whole Hill on nine and court trial with the height of do good with them. That would. Be My class a couple of years to landline. Infanta. By Working for A. That neither Raleigh North Carolina. Who would these sheer a the? How Commend My background, my degrade some. Wanted the public how with in how tie went? From there I moved to with the lobby. Of five-year-old the. Doesn't THEMM. Worth. Religious Dom A. Parliamentary on dipped Belletti and. lighten. Allow the word. Melancholy the waivers for? The would enter La warling developmental The while. Abu. Fourth Dumb from. Their idea. Wave. AVAI legislative fellow. Mere Healthca do lobbying firm and Our one of the hot the. APP that from the fame mid bobby. Thing. WHO WOULD Later, Harkin with. into. Mantle. Woking on the But in the late eighty late ninety. and. I actually came to A. I. Applied A. Cloyd in the year a New Year. And finally got the call. down. People. Are. Geared the great heading news. who? I. The Ability. How. Community. And The elated who wrote again for later Tom Hooker. I. Live in a mall world and. Within. Policy. Community Yeah. Food wonderful thing about a guy. And a? People listening. Have figured out by now why I've mild the ribble holiday. I. Have hype muffled. From. Infancy I would. Otherwise would. Twelve. Had Ot. CH-. Goal. A couple down the would thou Me Great Battery the. Back that but Of Mobility and. Now what the father do join kid five bonanza. Congratulations on that. Of Move Kula. S Great. Well, it sounds like you i. mean you have you have the background do you have the background of someone? We want working at the PTA before we get too far in the episode I think skipped ahead I usually like to put the hard questions up I. What Are we drinking? We're doing. EMAM. Ondo. One of my favorite doing my into who may back Hood father is the. One of the guard connor door. And In his dad. Kind of room to do. All. World of Blau N-. Ago, you gotTa Watch that stuff like. that. Yeah. It definitely. Quiet. Day for the. Manhattan Manhattan. Baptism was from. Former guest of his show as well rich West Rick who is a former army pt and he's in charge of the the tactical athletes six in the AP. And we were having dinner one night and I, said, what do you have any sort of Manhattan I said I'll try one of those. You know I'm you know I'm I'm an adult. I can have one and you know two or three Manhattan's later. OP JUST I don't know if I could end the story, but he he pretty much could convince me to do anything at that point 'cause. With Up Your your your thought process. Let's get this. So you you mentioned. Senator Harkin Tom Harkin instrumental in the Americans with Disabilities Act, and that was actually signed by President Bush George H W some thirty thirty years ago we mentioned top of the show. We just had an an episode focusing on that and the AD A and how far we've come and it was great because one of our guests which actually at that famous that famous statement where the climb they call it A. A A bunch of people with mobility issues either on crutches or wheelchairs, and they just got out and climbed up the stairs of the of the capital and he was there. So. He was he was narrating he was naming people in different pictures. So when I saw the the PTA, of course, commemorating this as well you write in the article the Ada turned thirty this year. That's a big deal for PT's PTA's, and you you alluded to your background in terms of your experience with physical therapy and your background in terms of you know legislation and advocacy and working public policy. You know when you when you had an opportunity to write and reflect on the ADA turning thirty, what was your first thoughts went through your head? Then Our D. I S Windy I do would end I. Would Live nineteen, Ninety I. ordered. Hobo. Though For most of my library thirty four, the tell were. I. Live in the area I'm we Think. Thirty thirty five years ago. There were load curb. I. The side while them will. No. DOUBT TO BOO. Me You. Will Bathroom. the now do were all the would. Out The goal will. With. Limited Mobility. I under the while. The heavenly. Do would would. Mexican people with. Bill. Ball. To emerge in poplar Goblin. Would unto Mandolin and the did Bella divide move diner. Nov wetback. Early Devlin. Dollars. Bill through. Even the. He would dip to build. The. Ball didn't come until the early. News the one Woodson Nixon. Would basically saying the into fining do about the nineteen seventy, three after. The nitay, the would be. Fun. The tail you great documentary a net like that. The camera, the code. Croup Cam. Underwater to buy the. Diet and the early the. People would eventually be. Deleted The disability. Movement including. Human. Who a holy would under all. Met. Yeah. And Update. New. York. People would. A followed the development of the flood. The connect. Those alliances? A new early. What happened while? I would go to the. One area. Thalib. came. I actually came from. The only contact? Really would the? World. Underwood, the warm cited they could go with the. Who Wasn't knit? He'll finally won moon yearly. Windy. They said the now that governor be live. Beyond. TIME YOU'LL A. Them said the big done. Go back and do a little. Wave. Making Tang in them being advocates making. Visible. Allowed they are they. Heard. Of. WHO Was the regulation doing hard to have. To really think. He or give. To the we are. Back. Further down the world in the late. Delay Nine you. Are One the after time to landed ability new voted. For the nine to ninety. thion bet. Bill. Good have been to Ability the now. What really the ball. Yeah. You talk about making something invisible visible and you mentioned how old you are and I'm forty. So hearing this. It's very difficult for for you to real to picture what it might have been like without very difficult for me because I don't I don't have to you know you said before before the world was an obstacle for people with body's ability issue. How far we'd actually come. You mentioned Crip camp, which is, which is not only an insightful story that I think every therapist students should see it's just a well done. It's it's a well put together documentary in terms of how Mu-, someone like me realize is because I put together audio, how much audio they must have gone through and how many things they must recorded to make a great story of. The check now. When you were writing this and doing the research into it. Obviously, you've got the background working with organizations legislating in advocating and lobbying How does it make you feel about where we are now in terms of legislation for persons with disabilities? I. Do. A world were from what was formerly repealing the Dow. DOB million. The bill now. Though You're now even though we have the. We have the law I think the. The deal, the lived -bility. That Yellow if you hook. A poll. A Meghan I don't. You would get very loud. It's on the people. That they are. Full. Of. Me Now. Somebody with two column tape them. And then we have delay Mug on. Then alert love with twenty years ago I. A Including my my day Davila. who were still operating. them the analogy would inducing pity book would enter. Devout by the ability. You will now we were conduct fide them to would the. But I'll dare you did. What life to be able would the ability? New Thirteen now. I. Member the defending a big. Advocate for the impede to. The eighty eight did open. Do. night. On the votes of do an alley. Tunneling funded program whether the higher at the turn of what the To twelve. To. Decline night in act the. Federal Build. Them. Play. Hugli did come day ten doubt. Absorb Armor. The. Show. An that than. Have Been. Able. To. Help. The heigthened. Would it debilitating? Improve the Marble I do and out the die lug then `can-do do the dining did Do while. I am one that. Will. Be. Biden's. An halpern people would to be able to get the ups to navigate a college hampered. On. Did. The. By do. A. Poor by them include bill do four American. Abella the within ton. Who quit up? Yeah Yeah you mentioned a lot of things there, which is which is why you're perfect for this intersection of advocacy and legislation in lobbying with working in your position with the PTA Lot of things you were just mentioning there are paralleling a lot of things that are happening around the world and around our communities especially, the United States, with a lot of attention now towards how we include or exclude people based on sex or off their the color of their skin. Movements you know need to continually progress which is why we're yes, we are celebrating the ADA turning thirty. Great. Let's celebrate that. But you're very position in the team that you work with is about pushing those things forward and how can we get more to make sure these people are taking care of so I wanted to talk briefly what's what's your job? What's your role at a PTA like working in legislative affairs I mean that? I'm glad like someone like you exists but like it for someone like me so I can follow what you actually get to do. So I With Dunhill Mark? Out. In. The day defense. Department, and what we do with the we work with all the. He. A. Moving would. Let it let To van to but. They do include how'd of dividing? An what's The The plume. Include the act. To physical therapy weather data. Eliminating the requirement for fill, that Payton this can. Indirectly while the DODD ELIMINATED The. Car. One of a big the one detail without the stadium slower now with an. Open Up. To the. the black backs, on author. Finally The. PT. Path. To include do I need. I would would have been a big fight. And that. Day I was also the thing. The because the the. Impact, I would allow. Now. Easily. Lighten Dan than other. Without having gone through the whole top. Gun Alive and you would if you would. Goal then I'd taken the an PD analogy that. Rap. To do tweeting. But the have to go to. Bat. And now we're actively to twirling a day in. The Cab. Will lining up more into. The twenty one one. To here, we'll. We'll. We'll give that three is right there. So so Mike Essentially when people. For. Better or for worse or online saying the ABC Abtei should be doing this year one of the people doing this. You're. You're no good. The the. The pandemic will cover Whatever been focusing? One detailing the ability. To. The via Oh how? Big. Would Dahmer. Allowed to. Nominate. How could they? Were now closed down our non-elected. Untie. Elective. Would postponed. The now tell. People that might've been waiting for doing replace. Them something of that the. the dealing with a lot of. T. The big hole to alleviate that. Will you in the month of March blow? We were really focus good than audited that could new board lead coming now from the Fifty Day. Vanden the ability you. Tell of. Another matter fact back. The Medicare medic? Into Do. Allow them. How to be covered on the Medicare with with. The fact him. PUT THE ALLOW A. Were only allowing. Out. To be. UNVIABLE A. Allah how the? Bird. After On, the. Of? Going forward. Move. That that. How to Woah. Where we have. Why due to commercial failure. That No. Accountable Merger Taylor how William both men will. Come, land. Though. Detail I'm. Over Will. Did. A. Dude. Open endured would. Out Out of Now, we're married more hard and down the. Ally five months. I've been laugh five years. That that. Dude the whim the. Yeah, you talked about You know how long things take in. You know we're we're talking about lead off with your article available day, Pta Dot Org about the turning thirty. And how far we've come since then but as you just alluded to there, took the words right out of my mouth, which is you guys had to whatever you were working on in February. March happened you needed to be working on something instantaneously and you got telehealth. You know to progress in many different states in federally in about a month and without people like you and the rest of the staff at a PTA I'm not sure if there happens in a definitely doesn't happen as fast without the team at the when people like to say, you know what is the value of a P J a lot of times it is. Invisible. Which is why we like to bring people like you on which is to make the invisible visible, which is our theme pretty much today without knowing it but let's talk about some some recent wins always gonNA wind up on the boards people always like to say what have you done for me lately I guess you know helping telehealth is pretty big especially in the make what about AP recent legislative accomplishments you talk about a few Months we had the the third of dry needling. Hide. Your. PINT. Co. Pay Law. Would basically that the you can no longer. The plug cannot. Be, now be more than it would be. POMMARD. I. Allowed Department. Endured dwell another do. The Opiyo. Pandemic come down? The now, you have a choice between. Dollar to. Him Full Playa of. Nagqu tankerload. or no rid to waive the. Fifty think they even Avenue Dollar visit The Devil, the ability to a food that. The the now. Really not. And? Wanted to big. LONG WE HAVE BEEN LOOKED At the final ORLA dweller. level. To, alleviate. The. Oil And a Vernon. At the conservative NAM McCullough. Turn. Of Your. To into the COPELLO. and. The. Dead include. Hakimi. I. Go the long leg. Team Condello. TWIRLING ONE Dollars the. Rabbit and think. Devon, avenue. That may physical therapy a lot more. Acceptable to people needed and how to levy a deal to your. Dow. Weeping. both the federal law date. Would see he. Would will on a couple of years ago. Unwilling. To advocate. Lawmaker, Dent boomer. You don't need to go on OPIOID. Now the been. Studying defendant the fair they've militarized. By Hunnam me. To. by Komo till. That that. Paid. Provide the LALLA. Of. Improve on opioid that yeah. Yeah I think I mean you've highlighted numerous legislative wins, legislative accomplishments ledge talking to some the last thirty minutes, which is expanding scope of practice bringing things in updating fare payment when when you frame it that way and I've never heard someone frame it that way, which is if you've got ten dollar co pay for a prescription for thirty days, for opioids, Orse. Fifty Sixty, seventy bucks a visit. It's not gonNA take a genius to figure out which way you're gonNA lean. Especially, if you are money, your goal is to relieve pain, and if you see that as a choice and one is the wants fifteen, you're not gonNA PL- plus one requires effort. So that's definitely not going to incentivize it's going to be incentivized physical therapy. A. So just my wedding some of those I want to be able to to make sure you had an opportunity to highlight some of the ABC's recent legislative. Because I. Think it's a lot like Amazon prime used this example before which. People understand a free shipping, right? That's really. There's some things going on beneath the surface. At a PTA like yourself and other people who work in legislative and government affairs that is going on that. If you if you didn't have it, you would notice you might not notice it the first day or the first week of the first six months. But man, if it got a hand, you'd really notice it. Admiral. Ever them. Nadia to flee. The doing contacting. Yellow the more balance. The clutch. Good Book. Our. Goal. To. Provide BELLYFUL TO A. Mamadou Evan Lot over a go. To. Provide ballot. WHO Do. The how Member valid with the. Out More than a holiday, do not have them. The, allow allow them could relate. To the. Content. That impede. Without the values that we provide who a member now thing. Really. Demanding debris apart I. Those holiday come. Now, we are getting mail, from Malala. After. Taft leader about doing now. Hey, the governor signed a bill to. Thou really survived. The man. Vast and will be harder. Provided the backup. Board. will allow member to be the best. Therapists. To provide to have them to provide value to them. Because the Willie Alibi Indiana Whilst Shearson Net I like that very much. Cheers. You're ready to three questions. Good To three questions. Three questions brought to you by our friends at R. S. medical staffing leaders in travel physical therapy. Michael talking about the PT licensure contacts, you want to be a physical therapist New York one day in California? Another. We need Michael, because we need the compact keep progressing. With Arias, finding you position than all fifty states, all settings. And a US medical dot com leaders in Hashtag travel pt again, that's a you are in your westmedical dot. com. Go do what you want to do be great therapist where you want to do it wherever that may be. Alaska Hawaii now a therapist or needed their main Florida where texts you name. See what's available now for you at a U. R. E. US medical dot. com. All right. First question you live not far for maybe two headquarters in Virginia but if you could go anywhere in the country anywhere in the United States. Where would you? WanNa go spend some time with the had three months to spin your wheels. Would you wanna go I would may. My family funding Wonderland I without the born in math. I go up and But multiple. You. The new one mind if you are made the most beautiful sites and they come to A. From about Jones to the end up timbre. I live. Demand. Collared back to Aspen. Dewine. Got About line feed the know. braying up. Who died all of? The. A new would offer. The wouldn't today. Have Been Twenty Years Kid. Which is live in Virginia right now. Give me A. Question one question two is a a what question what something you've watched read or listen to that. You think the audience could benefit from. To repeat my. Cab. What. Back new documentary log with. Dark colored the. About the birth of the bill but the ability to. Movement. And how the within. Tightening in the early. News. Through the downing of the. the Lai nine. very well down guy active. Archive will. Go Could not believable one, the new war, the the thunder them. Though still well done well, done story than I think people you know for good for for for something to point out in terms of good as we don't realize now where it is in terms of persons living with disabilities. But pay attention to where it was because. Where you started, they told a great story, which is, which was about people I think they got the right people together to tell that story I. Love. One. that. BACK IN MY A. The new. Back in the early windy month out of. was. Local news boiler I believe in. Did A. I The food on the Condition Oven Institute. For people. To Bella do look at. The Condition. The, he found the I'm mean it. Anathema no fire. Doors of. Them Wood. Will Win who? That the American public had into the World of heaven popular. Lighter. Allow my pillow baby boomers Google up in the fifty. Eight Little. Having. A good old that are. Out. In what I? Them in clapping. They. Left him off to would do winning. Do them kept? Well. With. DUMB BACK THAT the realized the poor guy. I would would you though ninety eight with thunder lot that will Allow. I only know of would then then. We'll. Do Been. down. With. COP hugged. By. How amid who were mad then? That then A. For the year, they go all of the. That Yeah I can't wait for you know thirty years from now we can't leave. It was so bad in twenty twenty because of how. That would be a great. To doing legislative work, which is, let's focus on how we can include make invisible visible. And that shows how far we can still go. We're not done yet. Right and that's why you that's what your role existed the PTA. Who question who someone the audience should know more about? Our A wall of? Divide. Eighty new. Meyer them. In the the. Details like. The now do would they are back in the eighty I? Finding all the. Way. The Tom Harkin. But. Tom Hologhan people I had the. Bob Dole who would. One. Boom Bum unduly back in the word do. Now. These. Really champion the dipped ability. the Willie. That bill to. They did and. Now. I if one of those. Ball I wouldn't. Be the. that. The People like Katie and Bobby. Within. The. Panel all these. Were Diet. Who really would? Grade? Along with Dude women who? Handed the the. owner. For the movement. We. Really. Did billeted now we really. Though. good and I don't feel like. They got A. Because Off on having. delated line new. Bill out loudly Bob. Funded the view thing comments from bed. Did dicken the cops mood. Chameleon. My bid. Bill, now. Couldn't along. Headed up, it could be done. Good. Bow Down. To new customer back right The one, the log on. it with the. said. The no we we. Would did ability. In the work. We do. On what the Dow? Couple weeks ago when they had the the. The. Only. Little ballot than thirty could San. Of American did. Ovens lower. Than There the long word Gal at late in that last back I mean the now. Like me the mobile on. Was the now united, Web people will call away the will call in I Here is my fee. and. If you bill if you don't know what the I. Don't know. What? They don't know how to. The. The, the played them back away. Now, when I would hire, can the one Lamar Dea the way glide on the High A.. Both. Maternal and Then I'll. Let the. Fall denial. On the the the under the do you. And an employer conniving choir. And killed them now. Let. Me Go to navio allied. Offer. CARE now. So become they can I can't. Leave. Turned into boom. Third think the now a mark. Valley. The mile would theft. That that I have to be the one the. One. Big importantly thumb on New People the. They don't know di I've been been voted money would do I don't know how the blood. That the New Delhi like Rag The allowed, maybe the one area of the ADA. COULD BE INCLUDE To allow both to. Active employer festivals rooms lower. Who Blow? OR I. gathered. In world the guys you know. Among. Afire Bittner John Land Movement in. The allow eilly to know the Hudson new, the do doorway did that they can they will. Do. Then then now. I feel like. Making the Mall tweet. To allow, that to be party to combat. A not. At the. Flute. I. Would how many more people would debility Dutt to A. Become begun. Booed. That they don't know they. Spoke to would they don't know how? From Doubt would be a big big out. And that was really the focus of when I thought your article. ABC Dot Org as well as the episode we did a few weeks ago which is. Ada turning eighty. It was monumental a great. The great piece of legislation to to to progress but. Okay we're not done yet, but we can't possibly do anything for thirty years. They say, if you racked the same way for thirty years and your thirty s year probably can committing malpractice we go more we learn more we need to continue to change, which is why having people like yourself working legislation for the American Physical Therapy Association is not needed by you. You can't live without it. You you you have to have it or you will lose. Including of the Bella a mean, the New York Times. Battle tact in Landy A. On Sunday. One they check. The Thunder, you do the time. Now Mulligan Causton the style was. A renewed focus. I holly. would. To include. act. Would did. hoops like. Have dipped ability Now we had. back to it. I can think of a nine the within. Will have our. Multi. Bad. I can think of the main the main could do y all too. Often done. Burgum Brad. Had We will day in the at the age them? Have you billion live there were really will your arm Meghan flogger. Becoming more stable. Then I'll give you would my my love. How did the Yankees? Probably would how you lead night. Hollywood Bad. My head. I would do Yang good. Of Four Two? Ago. Though I would. I would quite him bowl at the. But Yeah I mean The Work could never dot. tune. The allow Eliminating, attitude of. Now, don't talk about why The room because the WICCAN. Here now for a long time, doubt with the big a big. that. Most of the MERGEN. Dude, did the view As the. Agent if you will. Resume. And how life turned our? What we want to allow them to Dade Day living? and. Live flay nothing about how was. You know a Meghan would do did. Tabet. Individual words American. It's bellied do do Ivan away. In the womb when we're talking about the ability. Yeah and that's why people like you exist in terms of legislation and making sure for our patients. That they're spoken for nothing. About us without us that that really sums up the the movement and celebrating Ada and it said this monument and and celebrating. But making sure we know we're not done yet On. The show Michael is the other parting shot. Are you ready for your parting shot? The tail hang on we'll play the graphics first and then we'll bring it out through the parting shot. All right parting shot we got that for you. Parting. Shots wasn't academy of Orthopedic Physical Therapy. Find Them Online at Ortho T. DOT ORG continuing education. If you want to level up your orthopedic Pizza Game Why not do it from the leaders and p t fun online again at Ortho, PT Dot Org that just announced that they're going to do CSM online at your pig programming online comfort of your own living room. Where you're comfortable sandals and if you want there, we're back bathroom We can contest going on right now as well with the academy to to win any of their continuing education courses. Your pick. For Free again or Dot. Org parting shot is really your opportunity to leave a mic drop moment. What's the one thing? You'd WanNa leave with the audience mostly physical therapists, physical therapists, assistance, and students. What's one thing you'd WanNa leave with them as we wrap today up. Now. Go. To the bill, I get to know someone move. Life. Hot. Because the. Now allow could the the home my? God allow Mago, were not there never do this that. would. How actor land? Do Go From the time. The way under my colleague. Bill now, why would they would do good mobility Allow do thing that People Potala would do. My I got my pilot. Never under after my dumb one would ability because. The will always out. A law that with the other link to Michael's article in the comments, and you can check that out online at AP, Dot Org, Michael Thank for all that you do for our profession for ultimately, you mentioned our patients and thanks for stopping by to tell us about that into the value of your membership appreciate having a drink with us. Thank. You have a good. PT Pine Cast Yes. Yes. Support the show play telling a friend or by weaving review on one thousand, nine, hundred, Google play shooter day brought to you by the Brooks Institute of higher learning an innovator in providing advanced posts, 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 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 Ihl Dot Org? Our home on the. Internet. Dot Com created. By build PT. Build provides marketing services specifically for private practice PD's website development hosting, inviting content marketing solutions, PT clinics across the country, see what God can do for you today. Dot. com. The PT. CAST is a product of PT PODCAST LLC you. Poured fresh by me physical therapist Jimmy McCain. Ingredients are sourced by our chief connections officer sky, Donovan from Marymount University. Brewed fresh by. And Physical Therapist Juliet Dasan Jer and by producer Creator second-year PGA student. Bridge. Nolan from Sacred Heart University. PT Pint cast is a podcast that saves physical therapists from missing out on amazing insight, remarkable ideas and motivational stories. Online at PT podcast and subscriber itunes spotify or Google podcasts. Absolutely. Yeah, it's it's awesome. Thanks so much for listening and if you found value show, all we ask is that you tell the friend. This has been another poor from the PT Pine cast the PD. podcasts intended for educational purposes. Only no clinical decision making should be based solely on one source law care is taken to ensure accuracy factual errors can be present. On the show at PT PODCASTS, Dot Com.

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Spotlight on Research: Translating Rotator Cuff-Related Research Into Practice

PT Pintcast - Physical Therapy

21:39 min | 2 years ago

Spotlight on Research: Translating Rotator Cuff-Related Research Into Practice

"Hi, I'm Alexa. You can now. Hear PT podcast using me. Just say, hey, Alexa, launched PT pint cast or you could be nice and try saying please for lunch. What is being polite dead? These days to your episodes, just say, hey, Alexa, launch PT pint cast maybe throw in a please at the end. What is up new show here to be honest with you recorded this CSM a little while ago in DC, and then thought released it and just didn't. And then saw it sitting there on my computer. I'm like, oh, my gosh it ever got this out. So so getting getting this out of there. We'll call vintage that's what we'll call. We were doing some of the things here at the podcast released. Enter still working on a new spin off podcast, maybe want to check this out. It is called NPT study cast. It's a podcast very very short episodes straight to the point all talking about topics that come up really really frequently on the NPT. We find board certified clinical specialists in all the different areas of PT practice. We have them go through one one path all g one topic per episode. That's it and we go through real slowly. But. Just to the point. Right. So, hey, can you explain Parkinson's disease to me in five minutes while we get an NCIS to do that? And it's free. So take a listen if you're studying for the test, or you know of a student studying for not well, not just the empty maybe just studying for a test and PT school. It's short sweet to the point. And it's online I tunes Google play. Spotify wherever podcasts are heard again called NPT study cast check that out. So anyway back to the episode. We're releasing now now caught up with Amy sites. She's from north western and Laurie Michener and Chuck Thigpen. They were doing a presentation CSM called spotlight on research translating rotator cuff related research into practice. I thought it sounded interesting. So we caught up right there on the expo floor at the Arias medical booth, and they went over there their presentation, and what you need to do take out of it. These these three are very very smart, especially in shoulder and rotator cuff stuff, so take a listen episode. Brought to you by owns Rick. Science. They are a single source for looking for certification and personalized blood flow restriction rehabilitation training and the equipment. You need to apply. It find them online at Owens recovery. Science dot casting. Physical therapists around the world sees this is the PT cast. May I introduce to introduce you to here's your host physical therapist, Jimmy MacKay. Welcome to the podcast the best conversations happen at happy hour. Welcome to hours. My name's John. Mckay. We are at CSM twenty nineteen of Washington DC. I interview we're doing here at the conference excited to have a trio of speakers going to be on the show, no stranger to the program. Amy. What are you doing show me your name like remember, aiming Chuck Laurie or in the Shah got it? And we saw I like to kind of cherry pick in the programming, and it's so hard when you have this many presentations put I look for stuff that kind of catches the eye or catches the year. So what you guys were speaking on. It made me say what? Does that mean, and I wanted to know more so reach out to Amy because I'm gonna show before. And what was the title? What was the time that we're working with chains? Lading evidence to practice for rotator cuff related disorders big into rotor cops. And how are you guys talking about this said that no, no, the rotary cups? How where I think throughout my rotary Cup is my dad every twenty minutes. So so walk me through it who wants to start like, well, I choose their by Laurie which background, and my background is I. I was born and raised in the east coast move to the west coast four years ago. I'm at the university of southern California. I do research in shoulder pain from anywhere from diagnosis mechanism to understanding really the ultimate is what works in what patients and can we define those outcomes because she rubs in them at the university of southern California USC guess just enjoying the sun. And I must say the move to southern California. There's days that I say I wish the sun would stop shining me to everyday east coast guy. Right, Chuck, so I'm in Greenville, South Carolina, worked with TI, physical therapy by research is related to shoulder, but mainly shoulder outcomes and clinical paths. So using the star classification that Lori and Phil published a couple years ago and seeing how when we apply that clinically can we train a group of therapists to do that. And then what are the outcomes and Amy been beco-? Michelle my research at northwestern. University, and my research is related to rotator cuff disorders, I'm looking at a more mechanisms trying to understand what causes pain. What things we might do from an intervention perspective? And then starting to look at a potential ways to diagnose and treat patients with instability. Walk us through this this talk, what are some of the big takeaway points. We'll start Laurie things that people can can pull out of what you guys know since you're also focused on the shoulder. What are some things that the profession needs to know? The key is there's so much evidence out there. I feel like it's a fire hose for students for clinicians. Anybody trying to figure out what to do how to do it. When to do with patients, tell me how to translate that. So the point of this is let's review some evidence in a very short snippet of fifteen ten minutes, and then have somebody present an abstract and put it in context of what we know already and what to do moving forward us that fire hose analogy, and I think Google and the internet is everybody's best friend, but you can get. Swamped in it. So what do you recommend people do where do we come on especially for this? We'll talk about the star classification system. And I think the nice thing is like Lori and Phil McClure who helped put that together. We're all clinicians as well. I'll practice a longtime at this point the thing. I like about is it puts patients in buckets and pretty quickly by ruling out some other stuff that star basically the way I think about it as if it's not a frozen shoulder in it's not instability. Then I pretty much knew how to treat probably eighty five ninety percent of my shoulder patients for the average clinician. So I think pretty quickly you can get to. Okay, it's in this bucket. And then if I know how much they heard some things about their impairments of how irritable they are. I kind of know where to start pretty quick so and we would love to have an hour and a half to evaluate a patient the reality in the real world is I got like fifteen twenty minutes, and I gotta get going because my patient listen to what's going on. So I think quickly you can get to a point and start your treatment and see our patient response. And the overwhelming evidence is across rotator cuff disease, probably the first. Thing should be some exercise regimen. Maybe a little manual therapy is likely to get people better. So I think it gets you to that point pretty quick, and to know sort of how to begin to approach the patients who can do the ten thousand foot view of the star classification system. It's one of the authors that wrote this the star classification is classification using first screening, which we all do do they belong in my clinic or not, and then do they have shoulder pain or do they have something else? So totally already. Do. We just wrote that down on paper next step is pathway anatomic. If they have a shoulder problem. What do we think Pathum anatomically is likely it is? And I like to say in a very simple way is to loose is too tight. Or is it as check said something else, which is likely that rotator cuff slash labor tear. Biceps all of that can kind of fit in if you will. And then I think what differentiates though the next step is the rehabilitation classification. So we see a patient with rotator cuff disease, we say, all right? To don't look alike because one has really high pain and disability and has really a muscle component to it. The other one really has low disability and has more of an instability. So it's driving clinical decision making by their level of irritability as well as the relevant impairments, which I think most people are already doing. I often said when we first wrote this. I thought why write this isn't this what everybody is already doing. But it really put a framework and paper for people to go. Oh, okay. Yep. It's there. But I think it's intuitively what everybody's doing doing what you were just talking about which is translating that evidence and making it very very easy to follow. And you're shaking your head. No, not everybody knew knew about that. We needed to write it down yet. Yeah. I think so I think sometimes we take for granted in our bubble. We've known each other for a long time. Now, we all kind of together we talk about it. And I think we assume because we've seen shoulders all the time. Of course. That's what everybody does. But I think the reality is average practice doesn't see all shoulders average. Therapists, he's probably one in five of their patients or shoulder patients. And by time you start going down. They don't treat all shoulders, and so helping that clinician have something that's easily accessible, I think the the session really will make digestible that word seriously because you wanna be able to walk away with and do something with warning Monday morning applicable love think that's that's what I love about the approach. And I think the session is going to kind of boil down. I mean, Paula wick is it's a ridiculous model that she shows the tourism will stress of on the rotator cuff is looks like maybe what drives tears not impingement and I've worked with the impingement guide little g not big g but Dr Hawkins who trained with Dr near and started that whole thing. And I think I can't wait to show him that and go, hey, hawk what do you think about this? Because I mean, it really is shifting the way we think about how rotator cuff disease develops the you do the mechanistic research. But it's a that paper when it comes out will change the way we think about cuff, I think that I think. I think one thing is really cool. At least from a new concept. Perspective is the fact that internal impingement may occur much earlier in the elevation range than we ever thought more frequently than we thought we kind of always used to think internal impingement pinch the cuff between the Glenroy and the humor head ceased to think, oh, that's only in throwers volleyball overhead people all present some of the data that we that we've collected. And we've published that shows that you know, you start to have trends of approaching internal impingement as early as one hundred twenty degrees. So Paula is presenting some stress strain data that which normally would make me wanna fall asleep. But I think in general to understand what gives you the pain in the pain for is really what we're trying to seek. So that ultimately we can improve our treatments because if we have a better understanding what's causing the pain. Maybe we can target our treatment a little bit better. So that's the gold and tag onto that one other thing people keep thinking about internal impingement abduction external retations. Ninety right. But she showed listen this can start to occur in in affliction position. Without a lot of extra notation when you add extra notation, it becomes more so more likely to be strain and potentially impinged. So that's why looked it could look originally. It's just the overhead athletes, but we're finding when number or not. So I think it's more time under tension is kind of the way I'm thinking about it. And she alluded to that is that because it starts earlier that towards no stress, and the internal impingement it's under that tore general increase strain for a longer period of time. We think maybe for people that are pathological. And then you add into it the effective translation, which was really fascinating is. I think we always think that inferiors better. But in fear is not always better. There's it's like everything else. There's a sweet spot you need to be. And so now the function of the rotator cuff in the ability to have the strength to and the motor control to keep the head centered is really the whole thing. And I think we talk about that a lot. But I think it actually begins to show think we think about that for instability, and maybe. Some other things, but I don't know that we think about that with rotator cuff like should. So it really becomes really important then for that for the sub scap and infra to give you that. Inferior centering glide because that's what her model suggests that that keeping it centered in the right place. Not too far down. Not too far up is what limits or manages the torsion stress. That's what was really fascinating to me about fast and just elevation stress that you get with elevations the school abstract the signal. This star classification. We talked about the rotation or the stress on the superstar Titus and the finite element modeling that Paula week is gonna present. And then the other abstracts going to be about whether or not we should be manipulating people with shoulder pain. And so the overwhelming evidence kind of out there says maybe about that for an answer. What to do? It depends. It depends exactly. And so we have some evidence. It says, oh, yeah. It's helpful. Then we have other Evans says maybe not meaning systematic reviews that even differ. And so this is another study that looks at manipulation plus exercise versus manipulation or just exercise. I'm sorry. And really no difference between that and looks at it from a mechanistic standpoint and doesn't see much differences. And so where does that lead us? Do we think there's a benefit of manipulation? And if so how do we identify those people that may be helpful? And it's likely not so much by mechanical effect, it's likely elsewhere and starting to say who. Be doing this with also I think the big thing is what is the downside. Our danger of doing it, the Rasic and shoulder pain. Could we look at as well, I'm always giving somebody strengthening do manipulation unless there's a country indication. I'm not sure what the answer is a really good also abstracted discuss of that anything else. You guys looking forward to you. While you're at the conference here. Boy, I loved interact with you. Thanks smart to say when I'm on my show. Good answer. Good answer. I like I like the benefits of the pints good social hour. I say the best conversations do happen at happy hour, the after stuff when the bump ability when you're seeing people you haven't seen in a while. And let's grab a beer is a is a giant per projects that kind kinda spun out of conversations that we have. So we've already left one of the sessions with another something to do on the two juleps that'll be fun, lots ideas and networking, singled, friends and really older now. And so then added a while. So it's just great to see people. I haven't seen in twenty years. All of a sudden Joe up we do. On the show thing called three questions. You guys ready for three questions on the hunt seat with three questions on the PT podcast. We got east coast west coast, and and mid west rep represented REO is our sponsors are is booth now recording PT travel positions in all fifty states. All of them people always ask is it. Alaska is a why? Yes, if you could go anywhere and worked for thirteen weeks in the country that you haven't been a PT where would you go fly done? Yes. Colorado Colorado, Alaska, Hawaii are definitely in our top three of the answer's yes. Give me something that you read could be a paper, a, quote, a blog of book, something that inspired you last book. I read kaffir boy about South Africa growing up in South Africa's a black child and into man phenomenal int- interesting and changed my perspective about a lot of things. Some then inspired you unbreakable. Oh, yeah. Yeah. Yeah. Just read it over the holidays. Sort of a it's just it's the resilience of human beings is really unbelievable. What do you got expression? Okay. What do you got your coming maverick sex? He's got you want from Amy. So actually, I met someone that I associate with on on Twitter a lot and the motivation behind the opioid fight against opioid. I'm really being advocate was driven by this person's personal struggles with their family and had family members who died and so to actually learn that about someone, and what drives them makes me so much more passionate about sharing that message and sharing that news. So I I think it's great to number one reinforce that. We're able to interact with folks on Twitter and number two get to meet them. Learn their stories been great for me. It's difficult to fight in against an idea like opioid epidemic. It's easier to fight for a story about a person and not wanting that to happen again. What was your second inspiration? So on the way here, I typically don't watch movies on the plane this time, I've now I tried to work. And so the sounds like, oh, let me just scroll to the movies are GB. Oh, yes. Great documentary phenomenal documentary. I am just surprised in the early sixties. Her ability Ruth, Bader Ginsburg, her ability to look at sex discrimination, which was impressive from a man. And a woman perspective both like she argued for the supreme court for male against sexual sex discrimination because his wife had died. He had a baby like, I wanna stay home. Why can't I have her social security? She died in an so as it really impressive. She's I always knew she was a big deal, but not nearly as much as after seeing that documentary. So highly recommend that my mother said try, not don't raise your voice was one of them. Use less words species Sankt and leave the emotion out of it of like I need to write these down and continue to try to strive to do that of her screen. Our third question is who somebody in the field of of of PT that the audience should know more about. So I would say Carol, Courtney, the more that I learn about pain and pain mechanisms the the the more things make sense from a rehab perspective. We used to think oh, exercise it's great to kind of help people feel better. But the pain modulation aspect of what might happen from a neuro. Neuro mechanism perspective is fascinating. So I think we're learning more and more and more about pain science, and she really has a great approach to it. And a great background from research perspective to kind of provide that would he got some of the audience should know more about, you know, somebody can a young up and coming to his post doc with Steve Georgia Ducas. Trevor Lance is doing some really interesting health utilization influence, a PT and sort of large claims data and stuff, and I think helping us understand what practice patterns are are high value practice, and maybe what practice patterns aren't adding as much value and getting paid for outcomes. It's going to be pretty important when you can figure out which wonder high value, right? That's here. What do you got? So many different people that I think do really good work. But they don't have a big forum with that. I guess a pick Julie Tilson who I work with and she's a neurological PT we have nothing in common from a practice perspective. But we really both have in communist implementation science. Meaning exactly we're talking about translating Evanston practice. They're doing it the academy of neurological PT's doing it from a different perspective. They're saying, listen, let's take all these CPG's that we keep creating and say here's what we need to do. How do you translate that into practice show me that you can do this? So take a single piece of a CPG and do that and Julie has a huge passion for translating evidence to practice will. They'll just went full circle. Right. We started with translating evidence, and you ending translating with evidence less than we do on the show is your parting shot. This is the parting shots. The parting shot is brought to you by rock Tate. They're more than just a tape company. Their movement company brought tape helps athletes at every level go stronger longer with the best kinesiology. She take cutting education and fitness support products. Rock tape wants people to move more and move better. Find them online at rock tape dot com slash medical. You get to leave one mic drop moment. Find a great mentor and don't lose your passion, your the energy. Or we looked pass. Was that yours? Don't lose your passion. Never never forget. The patient is the center of the care you wake up in the morning. You can't use a passionate. I wanna go to work because I wanna help people if the it from research from a clinical perspective don't lose that are Chuck no pressure. You got ended out man which parting shot work hard. And be humble. Appreciate you guys coming out, Chuck Laurie. Amy. Thank you guys for taking the time out to chat with us in doing great work. Every thank you. Go. This is the P T podcasts. Wanna thank Brooks rehabilitation there institute of higher learning for sponsoring the show. Residency and fellowship opportunities is what they offer check them out at Brooks, IHL dot org. Also hosting their fourth annual scholarly symposium that's going on June twenty second in Jacksonville, Florida information about the symposium can be found at Brooks. I h L dot org. Keynote presentation this year by the editor of t j Allen jetty Albion hand doing some talks and some live podcasting looking for C E us into expand your knowledge base. Look, no further than Brooks, IHL dot org. Our home on the internet. Dot com. Created by filled PT build PT provides marketing services specifically for private practice. PT's website hosted inviting content marketing solutions clinics across the country. See with good PT can do for you today. PT dot com. The PT podcast is a product of PT podcast LLC. It is hosted and produced by p t podcasts CEO Jim McKay and CBO sky Donovan from Marymount university. We talked PT drink beer and record it. This has done another poor from the PT podcast, the PD fine cast is intended for educational purposes. Only no clinical decision making should be based solely on one source while care is taken to ensure accuracy factual errors can be present. More on the show at PT podcasts dot com.

rotator cuff Amy PT PT school Chuck Laurie Google Alexa Paula wick Laurie Michener PT podcast LLC frozen shoulder Chuck Spotify Jim McKay NPT university of southern Califor Brooks CSM Parkinson Jimmy MacKay
Clinical Practice Guideline  Physical Therapy Evaluation and Treatment After Concussion/ Mild Traumatic Brain Injury

PT Pintcast - Physical Therapy

40:52 min | 7 months ago

Clinical Practice Guideline Physical Therapy Evaluation and Treatment After Concussion/ Mild Traumatic Brain Injury

"Hey. Before we get started I, just wanted to say thanks to our longtime sponsors are es medical staffing, helping you physical therapists or physical therapist assistants find jobs all over this country with position. All settings in all fifty states find out what they have for you at a U. R. US medical dot Com that is a you are e US medical dot. com. Follow US online at PT Podcast and subscribe on I tunes spotify or Google podcasts. Absolutely. Yeah, it's it's awesome. Heartless Joe welcomed the happy hour. I am excited. You should be excited to you. We're doing this thing live back on the show. podcast saves physical therapists for missing out on amazing insight, remarkable ideas and motivational stories in the world of physical therapy. That's you. That's why you're here. We are live streaming the show now mom said I had to face for radio man she right but I'm sorry we're doing it on the socials on facebook on twitter on Youtube, that is at podcast cast make sure to follow the show there as well as subscribing to the audio only version. Don't think with the face. That's on I tunes spotify Google podcast stitcher radio wherever podcasts are found. We are broadcasting live from the army medical staffing studios leaders in travel physical therapy. So if you want your pt licensed, take you around this great country of ours all fifty states in dc all settings find out what they have to offer a U. R. E., S., medical dot com go there. And it's a you are US medical dot com since do this thing live if you're watching live broadcast makes you drop any questions or comments? On facebook on twitter on Youtube, and we'll see we can bring some of those into the show or hey, if you just WanNa. Text me that's my actual phone number. Let us know who we should have on the show in the future I route is brought to you by our friends who owns recovery science. They are a single source for PD's looking for certification in personal personalized blood flow, restriction, rehabilitation training, and the equipment you need to apply it properly in clinical practice. Now that we got that out of the way a great show for you. Tonight, we're talking concussion CPG. Clinical practice guideline and we've got some great guests. Bring him into show right now Bobby Jean Lee aerial. Cheer Mill Katie Creates Ladies Welcome to the program. Thanks for having US I N give since everybody's working remotely these days right. I actually keep a keep this button like with me at all times if I just meet some motivation if I think, oh Jimmy. Hey, great job taking out the trash I just do that. So that's why you hear the cheering in the background ladies welcome to the program I'm excited when good information like to say that we like to. Make good work well known and you guys are we're all part of and we're GONNA. Be Talking about CPG's tonight and this is a little bit different, right? So we'll talk about all your backgrounds. So we'll introduce a bobby G. late sports PT leading the concussion management program at Texas Health, Sportsman's in pleasure the vice chair for the Concussion Sig of the American Academy of Sports Physical Therapy. So Bob Itching. Welcome. Katie Club in Yates professor at the in all caps Ohio State University conducting health system outcomes to improve research emphasizing concussion rehab. So Katie welcome to the show. Thanks. High and down a professor at the University of Delaware with each treating concussion in practice area. Welcome to the show. And now that we know everybody everybody's properly introduce. CPG This just came out. Part of four components of the PT, we're talking orthopedics we're talking neurologic sports and pediatrics can't forget the pedes a CPG I was introduced the. PT School because it was a great summation but for people who need a little bit of a reminder, a refresher what's to see? PG. Well, it's essentially a roadmap for practice to help assist with. Background information if you don't have a lot in a certain area to help you make decisions around may be. Two different treatments that may be options for you to make you wear the possible treatments that may be available to you to help you decide what type of assessments may you may use and maybe what outcomes expect. For our purposes since it was the first clinical practice guideline in the area physical therapy for concussion, we had a another emphasis which was to help educate others about what physical therapists contract due to help with rehabilitation. So that was a little bit of unique slant for us like a great backdoor Wayne into saying, Hey, look we're able to do when we put together the. Years Ahead. I like that I looked at CPG's and PT schools like borrowing the smart kidding classes notes. Like somebody did all the legwork like, Hey, do you mind if? Borrow, could you just Google doc me all that information and that's really CPG as you guys go and call the literature and figure out what best practices you bring it back together you weigh them, you figured out and then you give us the result is the ultimate cliff's notes of particular area of evaluation and treatment and you can find it online right now we're gonNA. Make. Sure. Would drop the link in the show notes to the episode if you're listening to the podcast or if you watch him a livestream will drop it in the comments below but So all right. So now we know a CB CPG is why did you decide to focus on concussion and evaluation treatment concussion a mild traumatic brain injury why? Why this? Why right now. So, actually, there's there's actually quite a story behind that but the AP TA puts together A. Workgroup, each year in how to come together to write a CPT and the process thereof, and they bring in each academy and or section, and its members I was invited to this meeting. Hosted a decade. And Rama sports, side of things, and at that time we were trying to decide on topic and neuro was interested in mild traumatic brain injury or. Interested in concussion and so we got together with Yoga Ges Sandra. Kaplan. At that meeting and start putting a team together from all the different areas and it's really one of Erst CBGB's to have so many academies Andrew Sections together. It's a great example Yay. Again, I don't get paid. ABC's like sloppy cash on the table. Say That member like that's a great example of like. You're a physical therapist. Yes. There are these these different components you can specialized but look at where these things crossover I. Look at. Van Dyke. So once again you sit in Detroit ten years ago or you just? Start. Working for me, the meeting was about seven years ago. And so we've been working on it for five. Almost. Six Years Gaining Katie said. We've we've we've entered multiple children into the mix you know retirement now. In A. Minority have to start the revision for. We don't want to talk about that. Wow. Well, it goes to show how deep you guys are going to get it with a CPG with something like this a bad podcast host because I completely skipped over something What are we drinking? I'm actually found one of my favorite pint glasses your game throws. But we made these limited edition drink and I know things glasses and I got a magic hat number nine. What are we drinking around the Horn anybody? So. awesome. CIDERS blood orange. Yes. Like insure Texas staple. Only Thursday. So Go eels. Girds I'm Chardonnay. Says only Thursday just Only Thursday. I'm doing the peanut gratiot. Right. Now, we got that out of the way. So that's why you really decided to look into this area Zepa Geno at now knowing that this thing started, you know seven eight years ago when I feel like the discussion around concussion was. Thirty and a hockey stick when I was in school thirteen, fourteen fourteen fifteen, sixteen you guys were in the middle that you're watching that concussion movie come out with Will Smith. And saying, Hey, we're working on this that had to feel pretty good. Yeah except that it was a little bit like we were a little behind the game to start, and then we just couldn't catch up. It was all in so fast and they'd entire paradigm of care sort of changed right in the middle of what we were. Writing. So it made for A. You know interesting time. least kind of reinforced the fact that it was important enough to pay attention to, and we'd rather have you guys do it right and right now, and that's really what a see. PG. Obviously is So could be seen as lazy podcast question, right but when you did this EP. What did you find? What were some of the? Just two people know it's seventy something pages and if the link again WanNa make sure you guys know you have access to this but I wanted you guys kinda hit the high notes something that will grab people's ear grab people's eyes and want to go check this thing out. So some interesting findings that stood out to you have about it. Yeah I think one of. The things that we recognize very, very early on, and hence the involvement from the different academies was the fact that we were dealing with a diagnosis that uniquely cut across many body systems and could uniquely draw upon a lot of are different schools of physical therapists but given the way that we often practice and as we had to draw upon the expertise and sort of. I don't think it was a surprise as much as it was the point of emphasis for us to make sure that we were. Not. Promoting Silos. For treatment of these patient populations, we really wanted to emphasize that you need to incorporate all these elements in order to to treat them well in multiple domains of care. So the G. does provide a little bit of a way to think about the different types of impairments across the body systems that we may be facing and I'll kind of dive in a little bit further on on the specific domains but. Just. The emphasis that we really wanted to make sure that it was. You know multi body system in nature and that we didn't just focus on one. System with our guidelines. And I think that. I think many. Uses maybe many reasons why took us a little longer than some other EPG's to put together and one of them was because of this multi system, our domain topic but also at the time we started we didn't really know if we'd be able to complete a CG. We didn't know if we just have to be able to do a systematic review I in that evidence, what that really there for us to be able to pay we just these with. Hi Higher, high enough level of evidence that we can stand behind it. So often times groups will find that they have to do systematic review or some other type of literature prior to see BG, and as we kept going you know especially with the four domains, it became pretty apparent that we have a ton of literature and as we were going through it more and more is just I think flowing out awesome more than any other area, our body part that we've seen before, which was why it's hard to keep up and it's going to need to be revised quickly. but we have in essence four domains. We have cervical musculus schedule domain so. The concuss the definition of concussion has evolved over time as well when. I WANNA point out that that could be one of our our false in physical therapies. How do we define this in? How can we stick to a certain definition in all fall definition? So we do have a definition in there. but it's not just a blow to the head. It's also a blow to the body. which can exert forces to the head. So keeping in mind with whiplash and things like that So we have the cervical muscles eligible section we have vestibular ocular so how the our inner ear a balanced system coordinates with our Isis, number a lot of people will exhibit dizziness in symptoms because of those systems that are impaired after concussion Intolerance autonomic dysfunction after he cussin'. So we see a pressure and heart rate changes people that exert themselves seem to have increased symptoms, not all people, but this is a category of that. So we looked into that area domain as well and then the last one is functional movement on your Balance Them. So sensory motor and How that's affected which Also compounded by your vestibular noculars systems well. Yeah where do you come into this? You come into this with involvement with the special interest group in the Academy of Sports Physical Therapists when you're taking a look at this work with athletes yourself with jumped out at you. I think what I really appreciate about it is it really just gives a framework for clinicians to identify maybe some areas that they work on in order to fully address the comprehensive nature of a concussion or if it's not in their wheelhouse, identify another clinician that they can utilize to help treat that specific aspect of a concussion since there's so many different facets. intermix normally don't have somebody who just has stated ocular component. We have some years of student academic component, but may also have motor function impairments and the way that this CPG segregates out is really nice because it helps you break down each part, but then also think about them together. So. For me, it's really helpful because clinician who applies this to my practice, but I also think it's great because it came out at the same time that we formulated our new concussion special interest group within the sports section and I WANNA point out like it's in the sports section but we also recognize that this is an intersectional diagnosis right and that's part partly represented from the CPG and everybody working together to put this great document together So I think it's important that we recognize that but also we are started the special interest group to be able to bring clinicians together to discuss saying such as the CPG and helped grow this of knowledge within our practice. I tell people all the time listen. If you don't know where you belong say you you want to belong right you're in the American physical therapy association, it will start to pay attention to the that excite you right go to CSM. Conference join a section give everybody at least. Give give a section one ear right. Go give give him a spin around the sun but while you're there. Focus on this next part. Join every special interest group in 'cause it's free. You pay a little word of being a section and that's fine. You get more but I always tell people join every single sake join every mailing list and just test it out take it for kick the tire career what's special about the the newly formed concussion sick in the academy sports physical therapy we'll be get out of there. All. So we actually just launched our new website earning platform called mobilize. Hopefully, people are getting emails about it literally just came out on the thirty first. So if it hasn't inundated your email box yet hopefully, it will if not go seek it out, but it's a great new platform that combines a lot of different aspects of social media but allows us all to be together within our SIG, and then you can join just like you were saying every sick. So you get updates and messages from every sick and join all the conversations But what's really great about concussions because it allows us to? All come together to identify other professionals who treat this specific population across both sports and neuro and pedes geriatrics, everything and Ortho right. So allows us to all these versions and pick each other's brain create a community because can cussin' is different whether it's between one athlete another or within the same athlete having multiple concussions they're always different and so having multiple people to have as a resource really helpful when you're trading this population. Yeah. Physical therapy evaluation and treatment after concussion or mild traumatic brain injury. That's the CPG about here today I like similarities and differences right into the world like a van Diagram. Crossover doubt. Things that were you were surprised by and things that you pretty much knew is going to we're going to be there but. This is a CPG have to test it out. You can't just assume anything come to mind as you're working on this for a couple of years there things that you do you like this is definitely happened there. So there are similarities than differences things that surprise you only think think pop up there when I mentioned that. Yeah. I I can go with a similar some. Thought, you know there's a lot of research coming out and it was coming out and a lot of different domains. And One thing that was interesting was that. It was a question we had to ask ourselves how does this actually apply to physical therapists in that? You know if there was a sideline assessment for athletic trainers, is that applicable to our clinical practices? Physiotherapists may be an clinic setting or same with the interventions and and likewise there was a lot of evidence out there trying to help with diagnosis but did that really inform our ability to diagnose for the appearance of you're looking for and so while I'd like to say there's a lot of evidence out there. There was a lot of questions about how applicable that was to our line of practice, and so we had to kind of tread that. Territory quite a bit. And I would I would add as far as differences we started our literature search with looking at evidence at least fourteen days or older as far as those African. Cussin' so they were it wasn't going to be in the acute period of time and within the first two years of our leisure search and moving into. Some findings in collection tables and things like that. We quickly found out that even even some of the people that were on our in our authorship group. They're treating them in the emergency department, and so we had to go back. In this large group of evidence in and re look and research for things that were in the acute realm, maybe not on the sideline. But that are also going to the emergency department because we can even do a lot on the education side from the very beginning and these individuals don't understand some of the things that they're going through and feeling and that it is normal for a diagnosis of concussion and so just even having that conversation with them very early on is really important. Yeah. Concussion. Sports myths that comes up things that. Things that just get passed down when they shouldn't in an era when we are very focused on disinformation misinformation what comes up in the area of concussion sports myths in general. Just a Dang. Dirt on it walking. and. You know I truly believe in sports I was an athlete I support athletics in my children and it's a fine line. We don't know enough about what this looks like down the line. There's there's a lot of things out there on. C., T. E.. You know this dramatic encephalopathy that. The Will Smith movie was on and you know some of that is a little. Not Li evidence based I would say we don't know enough about it. They're not. They're not researching everyone that's host high post, high school and NFL and what are their brains look like it's only those that are having issues. So you just have to walk the line there, but we don't know how many hits causes a problem weed on a what type ahead, very difficult to study the linear aspect during a hit with football helmet football helmets are really meant for skull fractures and not to reduce concussion. They're they're moving into reducing concussion in a lot of evidence is coming out there but your brain is still moving around in there. No matter what you do with whatever. HAP-. So we we don't know the answer to that. There's a lot of studies being G forces. You know my nephew has home it on with G. Forces and they pull them out after so long and. We, we don't know that yet. Yeah I think I'll add to that one thing that's a little unique about concussions to especially in the realm of sports or Athletics Athletics a Lotta the impairments that we have or that we see our very subtle and the only way we might know that there is that the athlete reports them and many of the brain injury types of outcome measures. Assessment measures that we have our for detecting sort of more obvious things and so we're. Talking, about, very subtle maybe motor control impairments and so so far that they're kind of sub clinical laboratory great tests can pick them up but even that we're not so sure about at this point. So while someone you know feels better and while they are they look better for the most part, there may be still some underlying. You know deficits that are there that we can't quite detect, and so I think it is tricky and we're still. Learning daily. I think how we're going to navigate that part of it. A great guy to do that. To. The in the CPG to go along with Kiedis, part is not only their definition on concussion but we've we've expanded into a conclusive event, and so it's not just the treatment of the brain, but it's the sequential a surrounding everything. So how's the cervical drastic spine involved mysticism so on and so forth. So we're not concentrating on the brain any any longer? Attack off what you say Ariel as far as the helmets go for sports myths definitely the I can wear this headband or I can wear had an athlete with a swim caps that had some mash unit that was supposed to prevent concussion. That's how it was marketed mild. Yeah. That one special but it was one of those things that you know people want obviously participate and they want to feel safe and so it's easy to manipulate and mark it and currently we don't really have any evidence for any sort of equipment to prevent concussion at this time. So That's a big myth. Parents are really really willing to do anything you know. That's that's a hard one to. Within sometimes, you know they're seeing all the. Things that are happening in it's very upsetting to them and how their children feel and We don't have an answer on on what's too much or too often her. I think any any any see PG one of the best reasons is it's the most informed. We can be at that particular moment. That's CPG's published We know that patient education is a large part of it. So just saying, Hey, this out here might not actually be doing what it says it does here's the best evidence we have. So it arms. The profession with the best evidence that we have and I, one of the Best Pete one of the best phrases I learned in my pt career was an episode we're on episode like almost eight hundred show. It was an episode like five and it was from Eric Mera and he said listen if you ever if you ever WanNa make sure that. You're saying the most correct thing at that moment say this is what we know. Now. Saying this is what we know that can go out of date pretty quick visit. This is what we know. Now, this is what science knows now and when this was published in, you're mentioning took a long time to get the key to get published and we are going to start reviewing. That's a good sign it's saying that we want to continue to know. This is what we know. Now I you know. I. I saw lots in the the cycling world with different types of cycling. Designs and a lot of that was they would market the hell out of that. Those helmet prices went way up. But the more we looked around more. They're really woven research saying that those particular helmets would reduce concussions in the event of a of a traumatic injury that with a cyclist. So. How should people use this? It's a it's a it's a dense piece of evidence, right? Seventy something pages but I do want to share this I. Love Me. A good decision tree. So Katie right there that's getting WANNA walk us through this I mean this is page thirty, eight of seventy, three page CPG. Fantastic piece right here when you guys are putting this together, you're really thinking of the clinician who's got a little bit of time on their on their hands between patients WHO's trying to make sure they're informed but realistically say, Hey, I need I need someone to walk me through this. Yeah I think the decision trees were sort of meant to provide almost a triaging system for your thinking processes. What do you WanNa make sure that you think I the further along. We got in the CPT writing process. The more that we realize we are not gonNA be able to get every little detail and every little thing, and also we don't have evidence to support every little detail. So why we'd like to tell you exactly which tests to do win We just don't have a lot of comparative studies out there to allow us to tell you that but what we can. Do sort of guide your thinking processes through it including right from the start to making to making sure that we're thinking about every patient who's experienced some sort of quote unquote concussed of potential event meaning. They may not have a diagnosis of concussion, but they did experience something that could have caused a concussion that were considering that as part of our treatment processes and screening for the fact that they may have something we need to be working certain about that may either complicate the recovery. For the thing we've been assigned to treat them for and or may need additional workup with other. Healthcare professionals, and so that's the first part of the decision tree. The second part of the decision tree then lead you to your evaluation processes at a really high level. What do you need to evaluate and probably what order really starting with kind of clearing the neck like anything else if you can't clear the neck, we can't really trust our vestibular assessments because you have to do a lot of time in the neck and head, and if you don't have full range of motion there, how do we really trust it? So it's not really as the most important is asked, it's just that logistically. Be Aware of the neck impairments in order to. Fully appreciate what you might get from a vestibule exam that kind of thing. So that's kind of what the the second part of this century as the third part is at a high level really how are we going to manage and monitor these patients over time to the point that they get back to what they want to be doing? So the third part or picker kind of the high level plan of care implementation. Decision Tree. Do WanNa mention the out either co-authors on the cpt you WanNa, give them some some SOM airtime as well. Yeah up to. So we had a number of other authors at weren't able to be here today but Karen McCullough was was operating the senior author on there we had to Pankios our Methodist Rob Mandel. Can Guy Shimomura borrow selene. They gave everybody. Arielle. Yeah. So it was funny because I think of US knew each other in different places at the start. But by the end you know we're celebrating each other's birth of their children and grandchildren ano- Just becoming family over the time of the life cycle of developing a CPG so. Yeah I'd be. Off, Casio's Let people know where can they get it? We're a different places they can get this. Obviously G. itself. Obviously JT. Published are free and I'm working on getting these things also listed on the or to Kademi website, it should be on the neuro. Academy website and then He'd area we will talk the new the issue i. I I don't I think it's going to be soon to be published if not very very soon on E. CRI in in essentially that's the new guidelines clearinghouse where the CPG's that have followed the Institute of Medicine now national NAM, now national, Academy of Medicines guidelines for how to develop a guideline that you can trust, and so the CRI is basically a clearing house and they they go and evaluate based on some criteria, how strong the CPS and they also publish it within the clearinghouse. So that's another they have a nice synopsis of the guideline itself and a link to the guideline. So also just if you're strapped for time and don't have time to dig down, you can go to bed and It's it's free accessible there because it's kind of posted as freely accessible article so. Physical therapy evaluation and treatment after concussion mild traumatic brain injury. Also, I wouldn't be doing my job if I didn't also say that it's actually a one of our resources on our concussion. Sig. What a platform on allies to. So if you're a part of that Sayegh join mobilize within our resources in something that we have started discussing and will probably continue to have ongoing discussions on that platform as well. So sign up for. Anything we didn't cover that. You guys want to make sure people the therapist physical therapist assistance. Out there should know about this or a tribute with people with concussion amounts amounts brain-drain anything I didn't ask I was like to ask that question. I two quick things laid on me is This is a very large and Stockman, right? It's not the cliffnote version it's expanded and so their knowledge in translation teams that are working on documents to help really implement this better into practice we. Understand that it's hard to read a document like that and take out of it what you need to. With your patient tomorrow. So the Neuro Academy is working on this academy is well, our concussion is probably going to have a par- instant documents that will help make this easier for practice, and then my other of my soapbox is matron you know winter refer. So that's one of the reasons we worked with other academies on the sideline Some of us are good if it's dealer, some of us are good. In the cervical spine but you might not know everything and that's okay in just for reading our document, you're not going to know the INS and outs of vestibular ocular exam in treatment and assessment and knowing when to refer. So if those things are above your current level practice, which is absolutely normal, you may be good in one of the four. Then you know have your team together no, where you prefer for those things. Perfect boxes kill free at any many many. Anything else Katie. You're Bobby Jean view wanted to before we am before letter I I missed. I. Think I would just. I I would just add that I. Think we still have a lot of advocacy to do for our profession in terms of advertising what we can offer we do have a of evidence to back what we're doing not just in the area of concussion it much matic Brennan injured, but a long history of things like dealer interventions that we. Can Lean on and I've had clinicians say before I didn't realize that there could be anything wrong with the neck during a concussion or why would I refer to PT? You know they they aren't making those connections and so we still have quite a bit of advocacy to do on our part for what we have to offer for this patient population. And the CPG can help with that. I will say you know it's a robust document when the references are well. I I'm going to get rid spring curtain go. Irish. I learned in school which was You know if you if you want to figure out what to read next take a look at a really well written CPG and then just go through the references I mean we're looking at you know one hundred, almost two hundred references maybe more I don't know. Yeah. More than you'll be out of date by the time you get through them. As per all right. So we've got We got the link for people to get their hands on this g link as well as a show notes of this audio episode. Are you guys ready to play looking to call three questions? The. EARN. Three questions brought to you by our friends from our east medical staffing leaders did not travel physical therapy. PT License take you around the country all positions in all settings all states was Washington. All right. So three. This rapid fire because we usually have one guest we've three. So, quick first question is always aware question. Since you could be at travel physical therapist and pretty much do physical therapy anywhere. We're going to go around the horn. So Bobby Area Katie you WanNa give your Texas. But if you had three months car blotch, where would you WANNA go? probably Europe because I've never been if went on. Air would have got sticking in the US Oregon Oregon Yeah. Nice BMW Katie. I love Colorado hang out there for a few months that one's probably in the top three that gets mentioned during three questions, and again positions in all fifty states plus DC. check online at a a US medical dot com. Second question is what question what's something you've watched for read or listen to book podcast movie that you think the audience could get value out of. It. Ended on purpose because it doesn't have to be pt just just say value. To, skip and come back time area. What are you? I had mine written down and I don't remember the name of the. Nash. Sorry Okay Topgun top. Katie worship. The Lone Survivor Lone Survivor S. thank you tough movie to watch. It's very tough. I'm supportive military fan mom in the nation and I think that was important to watch. Yeah. Movie because it's telling a real. Tough Story Katie. Do you think we'll be podcast what he got. Me Loser at three questions take. We'd lose now. ECHO. The. Last dance on Netflix. Now, I'm Michael Jordan. Yeah last dance from from the Gordon. I don't know if the. Technical. Here. That the rip the. By storm when it was being dropped in pieces on. ESPN. Bobby G., D. You got anything. I think come to mind book movie podcast. The I'm probably GONNA Circle Back to the concussion movie will Smith not necessarily because it's always accurate but because it's relevant to what we're talking about and it does bring up some good conversation points. Both for its accuracy and inaccuracy. For. Interesting question can kind of help you dive into that sort of the conversation with a lot of people who had never thought of that before our last question on the of three questions is a WHO question restarting in with people who is someone the audience should know more about. I'M GONNA, throw one of my mentors under the bus. I guess on this one and I'm going to go with Jason you can tow bler he works out. Cincinnati Children's. He's actually the chair of concussion. and he hates being on video or discussion, but he's always willing to have people talk to him but he's a great mentor if you have questions about concussion or really pediatrics sir anything So I would say go look up he's on twitter instagram everything. Perfect aerial. Who's WHO's who? my previous who when I was with you before was Katie actually. Since. She's here I'll go with my mentors well, in Snyder Rattler, in the East L. World Arcade pressure. WHO's your? Now. Katie. Admitted through most of the show. Might have lost Katie. If, she comes back on, we'll do it. But the last thing would you on the show is the parting job let's do that. Party shop brought to you by the Academy of Orthopedic Physical Therapy leaders and Ortho PT Quantum on Ortho pt dot org got some contests coming out of Me Academy of Orthopedic Pt would just gave away access to any of their monographs sense to a lucky winner. They just came out with tissue tolerances and the running athletes. So if you look up your level level up your game, show one hundred with leaders northop PT Orthopedic Dot. Org All right parting shot mic drop moment the last thing you WanNa leave with the audience, we'll go around the horn with Barbara Jean. What is your parting shot? What I always tell people is to to say, yes. So if you WANNA get involved, say you know when somebody has opportunity always say, yes, really just continues open up further opportunities for you to network to make mentors and friends and colleagues and that's in regards to the concussion round to when you WanNa learn more say yes. Two different courses say as to talking to people about your cases there's really no such thing as a stupid question this world. So really talking to each other Sharing Resources. Love it. So yes, parting shot what he got what your mic drop. I'm going to say something similar along those lines find yourself a mentor I'm a huge proponent of residency training. Mentor. And don't regress to mediocrity so. Don't regret mediocrity I'd like that very much Katie no pressure but you're going to close this thing out the party shot what he got for us. Technology works I would say read widely and find somewhere in the middle to make sure that you you're a great shots. Thanks so much for being a part of not only the C. G., but also the say that's paying attention to an area that's gaining attention it's been around it's always been important but now it's getting attention especially with professional and using the CPG as we talked about earlier as it gateway a conversation piece to let people outside of the world, a physical therapy know. What physical therapists are able to do with this population as well as others lettuce. Thank you so much for your insight and your time we appreciate it. Thanks so much. Thank you. Love the pine cast. Yes. Yes. Support the show play telling a friend or by weaving a review nineteen or Google play all right shooter day brought to you by the Brooks Institute of higher learning an innovator in providing advanced post. Professional. Education Brooks IHL offering continuing education courses in numerous specialty areas six pity. and. Fellowship as well as challenging but rewarding internships, the H. L. Specializes in the translation of information from evidence to patient management learn, they can do for you to support your professional development at Brooks I, H L, Dot Org. Our home on the Internet. Dot Com created by build. BUILD PT provides marketing services specifically for private practice PT's website development and host and inviting content marketing solutions PT clinics across the country see what We can do for you today. Dot. com. PT PODCAST is the product of PT. PODCAST. LLC It's poured fresh. Physical Therapist Jim McCain ingredients are sourced by chief connections officer skied on it from Marymount University. Brewed fresh by producer physical therapist, Juliette daft Singer and producer and creator second year student Bridget Nolan from Sacred Heart University. PT Pint cast is podcast that saves physical therapists for missing out on amazing insight, remarkable ideas and motivational stories. 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Katie WanNa US PT Podcast Google Bobby G. Will Smith PT School twitter American Academy of Sports Phy Texas Academy of Sports Physical The facebook University of Delaware Bobby Jean Lee Joe Bob Itching Jimmy
Examining Strength Training Knowledge, Attitudes & Behaviors of Exercise Professionals with Reed Handlery & Stacy Fritz

PT Pintcast - Physical Therapy

48:57 min | 9 months ago

Examining Strength Training Knowledge, Attitudes & Behaviors of Exercise Professionals with Reed Handlery & Stacy Fritz

"Hey before we get started, I just wanted to say thanks to our longtime sponsors are es medical staffing helping you physical therapists or physical therapist? Assistants find jobs all over this country with position all settings in all fifty states find out what they have for you at a U. R. US medical dot com that is a U. R. E. US medical dot Com. Follow US online at PT Podcast and subscribe on I tunes, spotify or Google podcasts. Yeah it's it's awesome. All right, we're live again. Cheers happy hour, PT Podcast a podcast that saves physical therapists like you. For missing out on amazing insight, remarkable ideas and motivational stories in the world of physical therapy I'm Cam your host broadcasting live from the medical studios also known as my bedroom. Five Arias Medical Dot Com. That's a you are US medical dot com out leaders and travel physical therapy. If you are just graduated, need a place to go through that saying that you've been studying for years and years to do. Not? Travel about the country so traveled PTA you are us, medical dot com, great show for tonight. Read handlery and CC Fritz and university, of South Carolina here. We're GONNA. Talk about strengths. and. How much you know about it! How much we should know about it! We're GONNA study. It took and research to Don't forget described podcast. I tuned spotify Google. Google podcast and we're now video casting. Youtube facebook and twitter at podcast on the socials. Questions comments during the show. Feel free to interrupt. That's what we're talking to. Drop those questions and comments below. We want to hear from you Let's know you're listening from is well. We had some people from across the pond. Cheers. We had some people from Europe and South American viewers and listeners last couple of weeks. So that's pretty cool, or you could even text me. I'm willing to throw my own phone number on the screen. That's my phone number. People like it's like a Google number. It's just it's just gonNA. No, that's that's the number so tests that out. Call my call my bluff. Let us, know questions or comments. However you want to get him in here. WE WANNA do so. What's let's bring our guests? In the studio from University of South, Carolina read Henry Stacey Fritz are here. Guys I would say welcome to the show, but I have to be a a good podcast host and say welcome back to the show because you gotTA program before it's been. It's been a minute as as the kids, Saturday. Especially, you're on a while back. Correct, REX, you said. Yeah it's. been a minute, joined Jimmy A- At least once before not him a few times From the distance from the scenes, yeah, and then we did the live show. University of South Carolina. Because we used to remember when we used to meet in person, we used to hang out with people. We've never met and we used to shake the stuff like that. It's been a minute. We'll get there all right first question. We always like to get the first question out of the way the hardest question of the entire episode. What do you drink? That's the question. Even go I. Piano nor Russian river valley. So I know we're. We're talking strength, but I just ran it. South Carolina Ninety five degrees. With water today. I had the same programs but recent. That one aren't. Near world today so I like to find weird stuff, and this one's actually local and living in the Hudson Valley. New York right now. This one's from poughkeepsie mill house brewing. It's called the grocery getter. Idea what it means, but it's tropical. So cheers to you guys. Water is fine hydro Freebie Hydro. First Round brought to you by our friends owned recovery science. We're talking strength. Owens. Recovery Science guys know about strengths. Recovery Sicom a single. Looking for certification personalized blood flow restriction rehabilitation training, so check them out. They have their own podcast to. If you want to get deep into foreign strength, Owens recovery signed podcast. I have no idea where they can't with that name. So we met you do in your PhD then. You weren't within right. I know it seems like so long, and we joke that my mom every time I talk to my mom, she says you know. How much longer do you have? And she says it's it always gets extended. Really have been doing it for about three years, but I should finish this December and then go find a job, so we're at the tail end of it, but yes, I was pursuant all right. And then stink are how are you, so? We're talking about research release. A reader reached out like as research and you know we could share the link or whatever, and I was like well. Let's talk about it. Let's let's share Berlin. and. We're going to drop that in the comments, too, because we like to say everything's evidence base, you're trying to test something. You have an idea that you're trying to question and the stacy. How are you involved in this whole this whole situation? So. Versus F. ON DVD shootings you research projects, and and it's really encourage. We think doctoring profession than our students to build a ask and answer a research question, some kind of clinically relevant question and I am reads. Mentor and as a PhD student, our program he has, unity. To oversee some of the DVD's dude projects with my help, and so he came to me with this idea and got three DP students on board and. He said are what do you think about this I said? This is not my strength. No Pun intended. If you'll take the lead I'll I'll support. You have your hand so I myself supporting him and helping him out where I can all right well, let's start. Let's start from the start here. Strength is important I mean it sounds like we'll Duh. If you're a student or PTR, even someone who knows around pt, or because this is going to test. We're looking at other professions. Not Jeff Physical therapy correct so strength is important. sounds like a Gimme. GimMe One foot putt right read, but strength is important WH-. Where's your head? Go there? Absolutely, so we know that there's so much evidence to support as a modality, I think second to aerobic training as far as evidence to promote health and well-being. You always hear about the guy guidelines recommendations, but you normally hear that aerobic guideline, and then as a side note, it's like Oh you should also strengthen a little bit too so we wanted to die morons that we know it's not just for athletes, so people might associate barbell lifts Watson with athletes does not the case we know it works for clinical populations back eight five on my. Name the population in probably beneficial for it, so that's what we wanted to examine a little bit further. So when you hear when you hear that Stacey from a research perspective like your, this is my jam, but researches your Jim. It is my jam, so. I think the important thing is that we know is not fair access. To? Religious as like forty one percent of services provided by. Their ex, but we also know that we're not great at dosing inappropriately. We're really good at under dosing at end, certain populations like your people older age or you can. Logical disability were really good at under dosing comes in a little bit more to my jam is is saying. How do we really know for doing the right thing and maybe start with knowledge? Yeah, we talk about under dosing whenever I hear that phrase I think Dale Aver should a white paper a number of years ago and she said. unaggressive tantamount mouth practice if you're if you're not giving someone skilled services, but charging for skilled services, and under dosing is doing that and specifically for older adults, but this is for anybody. Quarter dramatically right. To charge for the entire mouth, top right hand corner so now. What are you trying to question read so now? You've decided the thing you're gonNA. Look into further. How do you start to further narrow down that question of funnel? Absolutely said that the students did a really nice job. As far as the lit review so seeing what's out there as far as we already know strengths important, so that's been proven. We don't want to prove that again. but we know is what specifically as PT's and then other professions as well that we are trained on as far as frank so everyone. Everyone I think has a fax class. At least one course that probably varies across curriculums I know when I had taken their ex. You sprinkle a little bit of strength training, but the concept of a barbell or a caterpillar anything honestly over ten pounds just didn't happen, and we weren't exposed to that and as an exercise science background. That was that was. Was, okay already knew that stuff, but you know coming as history major. If you're not you're not used. That's up and you maybe didn't ever get exposed to it. Which I think is a shame and I. Don't think you go out and continue to practice that Gal if you're a radio DJ coming through school the first time you're like well some of. Of the stuff. Yeah, it's the first exposure to it, but also how much so I actually took the survey and we've got the link. I don't expect you guys to type it on there. If you're watching, but you can check it out in the comments. Blow and give that a click so you're really trying to figure out how much education we're saying. No. That strength is important, right? There's Gimme, but now you're saying. How much education did you get into which aspects and how much how much do we as a collective? They're trying to. You're trying to measure a bigger. We even just one person in terms of how much strength training education you're doing this as a survey want people that click on that link below and take that survey, so we can get a really really big. Lou Big. Sample of to figure out what actually is is no, but you're also looking to compare PT knowledge to knowledge outside of our profession as well. Absolutely, so we know strength is is is not just owned by PT's. It's a universal thing and I think the concept came from. Iran happier blogs all the time. How PT's. Suck at a dosing that we don't know how to touch a barbell. We don't know how to lift things that are heavy We just do therapy and stuff on which is a time and a place for it so I wanted to. We wanted to prove that. Is that actually true? What? How do we compare against a straight coaches or personal trainers? So exercise a universal thing so multiple people are going to be prescribing at so he's compared, so that's what we come to become to this. There's your title of Your survey which is strength, trench, attitudes, behaviors, and knowledge in current and future exercise professionals so going broad. This doesn't say physical therapy. You're saying exercise professionals. And when when you start to say that read in terms of you know, PT's in the attitude of the the the the overall kind of cliche about PT's. We liked it. There's one we like to tout which is anatomical knowledge. There was a say that came out. That showed like orthopedic surgeons and boom PTR. Power like yeah, boom boom boom. Cool on that, but you're. You're starting. You're starting this and saying I'm GONNA. Look into! What is the Exercise Knowledge in our profession? So so talk about this love the fact that you got the word attitude in a in a professional urva that's. Absolutely. So, we wanted to test. We didn't just WANNA test knowledge. Obviously, we demographics. We WanNA. Know you know. How many years of experience are you? A certified strength coaches as well our European an eighth year that combination, so what how does that play into what you actually know and how you view strength training, obviously, if you work in an acute care by your views on straight training and learning and teaching debts may be different than someone who's in the outpatient round so we wanted to. To cast a wide net as far as current and future exercise professionals, because we want students evolve to, because they're the ones who are in it right now, learning it hopefully and so that's where that all came from and going back to the muscular skeletal study. That's actually where the concept of this came from I said. That's awesome. We we are the movement experts. We always say that. Let's let's prove it. We should know at least as much as the next professional on Strength Training And you're you're asking you're you're encouraging? People from outside of our profession to to take this? We jumped into this. I don't know how long ago because I mean I graduated in two thousand sixteen, but. It was this push for evidence based and started a long time ago, and we're saying we'll put it out there. Let's measure this if we're going to say something about us as a profession Measured if it's not true and we don't like it, let's fix it instead of hiding from it and I think this is a good step in that. And I think that's going to be important because we're at t's and Kiki, students along with other professions and their students, so are the students receiving the knowledge, our people gaining more in the clinic. Is there a difference between students and professionals I think that'll help us as well for my and from the educational side on doing hit arbor or different. Yeah what do you think's GonNa? Happen Let's predictions right? I mean you you let something like this up. You're allowed to do that. Is that like you know saying the birthday? Wish out loud or I don't know the rules. It a little bit, so we have some ideas from the first little group on A. Thought, that would have a strong knowledge. In this area, but I'm not sure a redid you even the about the other professions. No so the developing the survey. It was all developed by PT's and then it was sent out to at's strength coaches while 'cause. We didn't WanNa just make pt thing sure invites We use kind of the boards format where it's based on a text book, which is pros and cons behind that, but we wanted something. To base it on of so use a typical fair X. book partly, and then also the strength and conditioning handbook as well so hypothesis. Yeah, I'm. We're hoping that PT's outshine really shine as bright as everyone else but there really was no direct offices. Just we don't know like I said deliver didn't really tell us much we. We have no idea so we're. We're learning a lot from this and we have almost almost thirteen hundred responses though. It's real positive as far. One hundred one I took it this morning. Because I wanted to get in there and I will tell people as a teaser. There's a there's a funny question. I'm not. GonNa say what the right answer is funny question, but there's funny I got I got flack about that from somebody they said you, should it it de legitimizes it, I said No. Awesome I've had that. One I've had that one time when someone was like. You can't mix alcohol and physical therapy conversation I'm like. Have you been to a conference? Separate them. Now there's a crappy way to do it and you're funny question. was funny like. I'm going to be honest. Working there that'd be like. The question is. This a survey. In terms of attitudes and be in well attitudes, beliefs, a little bit and experience, but also it was a little bit of a quiz. Yes, so, that's where the knowledge component comes in, so we WANNA know. Do you think strength is important? How do you prescribe it? Will Prescribe. How do you feel that other people in your profession prescribe it, and then you get into some some knowledge questions which it's. It's completely anonymous, so even if you have bomb it, no one's GonNa Never. That's completely fine. You can gas. That's that's absolutely fine. It's like the boards examiner, right? You'RE NOT GONNA. Leave some blank. You're going to answer molly. Maybe no know correct and by the way anybody studying right now. Do not leave any blank. Take a shot at because it doesn't hurt you. But you went straight guideline questions I. Mean these things sounded? They are testing. This is not A. Tricky questions. These are very very testing direct questions for knowledge. We didn't want to get into. The nuances of had someone how to squat. There's there's too much gray in there, so it's pretty pretty concrete, and pretty what we think or what when we developed the survey pretty straight up concepts because we That's where that's where we needed to start maybe later on with getting this nuanced up, but as of right now i. I like that all right? We'll take some questions from audiences ocracoke, Stacey, go ahead. I really liked the behaviors part because it asks about your own behaviors and strength, training and exercise, and I think that that may play into how we practice. Yeah I! Think I think one hundred percent right I mean I've I've I remember thinking back to my pt school class and just the ferried backgrounds as Ribas talking about in the beginning of of the episode, which is where liberty come from? What's your background? If that's the only class or classes? I don't know how many one one of the first questions was. How many semesters of how long is your is your? You know strengthening her Sarah. In your program and I probably out of thirteen hundred, probably already seeing varied results on that. let's hit some questions from the from the audience. Well first of all someone named Casey is giving a thumbs up I'm. Not really showed up. But didn't think having strength and. Conditioning coach. Which, I heard a lot. I've never heard of it before I went to school, but once I got in there. Everybody was kind of like. Hey I'm gonna I'M GONNA. Take this on a break. I'M GONNA study for this for a couple of months and I'm going to really hammer on this refu- weeks I get my cfcs. Questioned from bridget. Nolan, you think improves a PT's ability to dose Sarah Rex more than just up education. That's really kind of what you're trying to figure out right. So yeah, we should. We should be able to kind of answer that we can compare PT's do not have their strength and conditioning certification to those who do and as I was a former Siesta, so I thought I was going to be a strength coach. Prior to entering PT School Job Job Outlook said that. You should go a different route it's it's hard to get into that realm so I actually read much. Yes, yes, I. was in. A wife, it said you need route. They were they were joined together as far as that. That's. So I let that lapse in a lot of people. I think the knowledge that you'd get studying for that exam. It really teaches you a lot about programming and people was as just for athletes, but I think there's a tremendous amount of carryover as far as exercise prescription and giving you ideas about period ization win to load how to load. Form of a lot of exercises well so I think the knowledge gains in for that is very very valuable I. Don't mess. Your clinic requires it sometimes. A lot of people, obviously now sometimes clinics not required, but I think if you don't need it then. You don't necessarily just the letters behind your name. I think that's just a little addition, but that buries born your at them How if you're not? If you were to teach someone a class, right if you'RE GONNA. Take the textbook that everybody gets for the CSC S and you were to teach that in class. How long would that take? Would that be a semester less? Far As far as the content in the survey, you mean. To be able to effectively. Noxious pass the test because no one wants to take classes just passed the tests, but like to get enough information to be able to effectively implement it, and that's a semester. Right because I feel like is a class if If you have a program with an elective. That'd be a great elective. Absolutely, I had that my Undergrad as well. It was basically a class proper that because it's not just the knowledge, right, it's right. How does that relate to the practice? How do you you know coaching something in knowing how to verbalize it as lot different things? Yeah, and we're moving experts, but I think the content in the survey. Honestly I could, and I could probably have done in a lecture is just the what I consider the basics but then beyond that I mean. If it, remind erupted me and we had you know unlimited credit hours, intuition and all that stuff was not existent. We'd have an aerobic class in strengthening class, and then maybe we'll throw on something else there, but I'm very biased in those two things I think that's that's what we do is. Pizza is a big part of what we do so I. Think can't get enough experience and training with that. Stacey what he's think. I agree I think I think we also understand education the importance of their. We leave out and and. Some of might be because everyone says it's hard to teach I think read would argue that. He's very good at teaching. If now well already say very good. Three would It's so important at so much of what we do. I think it needs to be in there, and it's not just one checkbooks on the nation. You. Keep moving through it and and make sure you have it, and it's not just applied to work. The equations s one of the biggest problems. For pediatric patients, it matters for neuro diagnoses. Everyone has to have a free. I agree with that. I mean I learned that from from two ends of the spectrum I was a pediatric physical therapist a little bit after I, graduated from from PT, school and Remember having my mentor annual Malley would say you got to just sometimes. Some of these kids who are going to be in PT for life. You're Jonathan Tense Macomb sweaty like the making fun, and then make it difficult, so make him sweaty. Make them work, and that's GonNa, help them long term and then I work with Jerry work with Fox with geriatric patients like same thing. Don't hundred notes. Where we may be able to shine a little bit more compared to the other professions, because we have so much education in other diagnoses, not just for the issues or healthy adults were able to really work with different populations and noble underlying causes the Red Flags, contraindications, those type of things it applies for infringing appropriately to those population. Yeah, I, mean this. This comes into everybody's discussion and I'm not to be talking to some students from Lynchburg. College. University in about a week and a half and one of them was like. How do you separate yourself from other professions? And how do you? How do you market yourself a new? The S words? How do you sell yourself? And one of them in you wouldn't think twice. Its argument has comes up a lot of. Is this this setup? It comes up a lot which is people don't think twice about paying a hundred bucks an hour. A personal trainer but people will say I don't know my pt like. Why would I pay for that? This is a way to what I like to say. Improve the value proposition. GonNa improve our strength and conditioning background to be really really really good at that, and by the way our education is only going to enhance back in and improve that. Gets me it's. Interesting. Jimmy I was actually running on the track. The other day is also very hot and the girl had come within sixty to me industry. Stop there, but then. She said she's like I'm. Are you a trainer? I finally I was running fast enough to think. She thought I was in shape or something and I said. Papa's. Physical therapy she goes. Oh, but are you a trainer as a physical therapist and she's like? Oh, I was like well. What are you? What are you? What are you doing? Well I'm trying to train for this FBI test. She there was a disconnect between a physical therapist can't do that. I was like. Oh, no, no, that's that's bad and that's. That's some of the public view it's. It's we don't we don't do we don't? We don't mess with it. We're not masters of exercise so I did provided provide some education, which was nice and I hooked up with PD to help her out with what she was going for. ABC is really right now. Trying to push that a little bit more and saying hey, we are the experts. Thank December the problem US right. We haven't been out there where you've been. Treating appropriately, restraint, training or From the from the research right, but but I think the public perception might have some truth behind it. Yeah, if you're an outpatient orthopedic clinic, let's say you're patient. And we we've been in these clinics before big room and I don't like those big rooms. Everybody can kind of see what everybody else is doing. And you're watching someone you know Kinda short per a little bit. You know like well. That doesn't look even if you have no idea what they're in for right. We're not discussing other people's history in in in in other people's earshot. You're saying that doesn't skilled it all right, but if you get someone who honestly needs to strengthen their lays and you, you make them hold a barbell and they don't. Even better when they look like they've never held a bar before. The patient I mean even better. Show them how to hold a barbell. Trainers are doing it right. Why can't wait? Why aren't we? And it's amazing as you see the per clinics out there that don't have our bells or don't have rebel. Don't wait over five pounds. I will. I will not say who it was with, but one of my clinical rotations was with a very large physical therapy practice in terms of large number of locations and the heaviest thing in the clinic was ten pounds, ten ten pounds and I remember I remember working with an older adult patient, and she says what. Why would I lift the heaviest thing in the clinic and I was in my head I was like you're damn right. We should probably have some heavier stuff. But I. don't need to lift anything I was like well a gallon of milk, seven and three quarter pounds or something like that Mike so ten really isn't a lot over that Mike. Do you want to be able to lift a gallon of milk or like and put it in that perspective? She was like Oh is it so that really was? That was a fail and I. Don't blame the public perception on that one. That's what you're looking at as a consumer. Why would I pay more for that? It doesn't look better. ANDROID! The progressive, how do you progressively overload? The lower extremities with ten pounds I was in a similar clinic, and I bought my own little set of kettlebells because I was like I. Need we need to do something about this so? I remember having legitimately had one patient who was a runner, but this was the closest clinic we were the. We were the closest opportunity for this person to get better. And I literally have I had him lifting stack of chairs because it was the chairs really heavy. I'm like put them all together. Let's squats and chairs and my. I don't know if that's safe. Is it safe for us and not having Rick thing? A I'm weighing I'm doing the pros and cons listener sure if they fall, drop them. Just don't worry about the chairs. Heavy stuff when you look the comment here, actually Jones, say our summer, thanks, Class Shoe surprised to learn how mates didn't have knowledge and or experience in strength conditioning. This I mean this. This is proof of concept for your for your survey here, isn't it? Absolute Prerequisite coming into PG programs. I think the classes so valuable as well. It's because some people who aren't currently. Maybe they're not in exercisers, and we know the benefits of exercise just teaching them how to do things like squatting. Beneficial things that's that's important, too for the poem personal health of the provider you shouldn't. In my opinion, be following the guidelines you should at least aiming for it. You should be trying to excel. Different story I was at a wedding about a year ago and it was like the. Rehearsal dinner so like a smaller right, then you and a a woman. There is a physical therapist and she'd had a knee replacement and she was saying she was, she did. PT Didn't work and I was like. Oh, my gosh, and so sorry I. The long play was a slow play. Physical therapy was going to ask like. Oh, my Gosh and started work for you. What about that fail? They were trying to get me to do squats. Oh my gosh, why would they doing that? and. She's like I don't know I don't need to see squat. So what can you do to my knee, can you? She was trying to get me to rub her. We're at a rehearsal dinner. At a wedding or very nice place by the way. And she's like. What can you do to feel better and I was like I. Don't you know I? Don't know it on the intricacies of your of your of your situation, but sounds like the PT trying to strengthen and do. Squats really I don't know I don't know if it's bt but the goal Salik strengthening and she's like. But when am I going to need to squat? She she won't leave me alone and I was looking ahead and I'm like. I'm going to be talking to you for the next forty five minutes almost ever. Give you some stuff and I gave her a few opportunities. Let's change the subject and I said. Do you like going to the bathroom alone? And she's like. What do you mean an? When when you need to go to the bathroom. Do you want someone to go with you and she's like well. No and I was like great, getting on and off. A commode is a squat. Back probably the most. But the reason you're going to seek Anita do a squad. Ever hopefully hopefully every single day, and that literally shut her up look on her face, but the funny part is look at her husband's faces like. If. You didn't shut her up. She was gonNA keep going. Up probably defended bt there. We need. Asians need context and that's what it gives them right. If if we're seeing, things are teaching them to lift why in it's not lie to what it means to their functional life. We're still using on function and its strength this function. Yeah I think that's it right strength function. And that's. That's what I was trying to do. In that situation where I was like listen I'm gonNA. Put this in context because yeah I I'm getting it I don't you're not GonNa? Go to the gym and you're not gonNA. Max Dead Lifts I get it, but like do you want to be strong? They need to sit up and stand stand up and sit down and I needed to put it in context of formerly. Advice, Re Stacey for perfection take back ownership of being movement specialists, because it's not not get ahead of ourselves, but if the research is showing that there is improvement. What's the next step? They say you want to start. By saying I'm not sure we have to be complete ownership I think we can share it like I think more professions need to be. Able to hand off to also, we dealt with that. That does are mostly Imbert. Reimbursement based, and there needs to be continuing of care so I think we need instead of taking ownership. We need to say hey. We can help prescribed, and we can help guide, and we can work with the other professions to make sure there is continued care after the acute event or content continued. Significant chronic events people with stroke with chronic disability, right? They can't. They only have so many visits especially when Medicare limited. You know, how do we handle? Where do we go next? and Are we making sure we're getting off the right evil? Well said. I like that three S.'s right there. When you hear that question on screen right there, what do you think re? so I tell the Stacey and I also think that we're not always the the one provider, so if it's not your wheelhouse, you could care less about debits squats, but that's what your patient needs and they need that extra continuum of care strength coaches, you know. Send it to that next. person him down the line Ideally you'd you know you'd be a role model here? Patients and you'd have a little bit background of knowing how to do that, but if it's not as that's okay, and if you have no interest in learning that. Another way is just continuing education. There's plenty of stuff out there. The best option in my opinion and it's free is to learn yourself kind of explore movement yourself if you're not used to. Some of these movements I think that's the way to do it. Then, there's plenty of continuing it out there as well if you want to. Become more actively. We also refer out within the field right I'm not gonNA. See someone for women's health issues I'm going to refer out to another bt if have someone that needs different strength training. Expertise than I have referred to read. Well he's the trainer on the track. He's the Guy, movement. Like it? So. When when people take this survey and again the the link to take this and I would encourage anybody like just go and be honest and take this. The more information we have the better we can. We can extrapolate decide where to go next. What's the next step once? You guys are done with this. And when is it done? What the next up after that? Yes our look into probably an eight week window so probably week three ish in there so probably by Tom Fall Semester Start for some program will wrap it up and then we're submitting A. If. There is a CSM IN ORLANDO We were submitting. An aspect of that says some preliminary results will be there and then. Probably. You know trying to push manuscript. I'll get the actual evidence out there by the end of this year. And I don't think this is a good time to get a shoutout to the students that have really run this project. nets itself Lauren Tabby and Emma and they've really dented nice job putting the survey together, doing multiple practices of it and ruined insure at words, eight of 'em and There may timeline eduation, so that's going to limit our our windows. Well, it's awesome. More questions coming in this one completely anonymous. Patients with neurologic diagnoses are being under dose as far as strength training. This kind of goes along with what Stacey alluded zoo and you picked you populations right? You could have easily added neural, but you pick geriatric and pediatric neurologic Mike a lot of times. We like we almost skip what we know were like. Hey, this person in front of me. They're medically stable, right medically stable right now and sometimes we still under dose. Answered, the question and Answer. So we have. We have a colleague who she says that people with Chronic spinal grinder chronic stroke at that point it's it's kind of orthopedic right you're. You're not necessarily reading via the functional deficits yourself working on some of that stuff, but. Why not strength I think there's a the Ortho narrow. It should be completely blended especially as far as aerobic training strength training. We all hearts, we all belong as well muscles, and they're gonNA work in similar fashions so. We, don't we don't? We don't know if they're being under desk? But there was one study that looked as all by counting repetitions in it was an outpatient, and it was people with stroke, and that they were the number of repetitions was was abysmal. It was like one hundred repetitions in forty five minutes or something of of. Functional movements and I was someone needs to do that study in other settings as well because it's like. I. I don't think they reported away. But who knows what the wait was. It was probably honor reps of of a therapy resistance, which there is a time and a place. Don't get me wrong. I think it was anything those were just the gate steps had reached one hundred, but like upper terminal were in the lower single digits, and we're just were under dosing on a lot of levels whether it be repetition a string ninety and Think we actually know research wise if we're under dosing, neuro, but I think we know that were under dosing him. You know it was the last time you had your stroke. Patients do multiple sponsor. Desert's because that's what they needed to allocate of Oh. Yeah and there was the one thing that I still remember. Remember what my professor looked like when she said it was like saying you need lots and lots of reps with patient with neurologic is like how many inches like thousands? And then we just had nick Housley on the show last week. Who is is a physical therapist PhD in neuroscience. Had A traumatic brain injury himself, and now working on a device that can actually like. The device doesn't get tired and if you game a fi the device. That's what they were talking about with motives. Nova gamified the device. Because, if you just do a thousand times a week like I would I would just Walmart I would do zero. I wouldn't do. It was like a thousand from never gonNA. Get there, I'm not going to do it, but he's like. We made it a game minute. A Golf game littered an airplane game. It's like all right cool if the game is fun, you got a chance, but we know this is what we know from research is you got to have a lot of reps and if we're under? Under dosing no good absolutely and you were expecting our patients with neurological disorder to lots of reps and strength training ourselves. You know if if you're someone that has a healthy body and still has obstacles to physical activity. Think about adding stroke on their worrying about having another stroke while you're lifting falling down or all the things that we may not have to worry about. As able bodied did to be able to get out there and string, so it's important to give them that confidence, and to be confident of delivering it. Yeah, if you know, someone needs more because of because of an injury or because because of an issue, i. just that's where I'm just like think of every reason you throw out of why you can't work out and then that person has that plus. Plus getting to the gym finding someone. Maybe they can't drive themselves getting to wherever they need to do. Do do the thing that they need to do. They have more reasons and that's why I love Sharon freaking videos on twitter of someone with with with a deficiency and for the podcast audience I'm using air quotes. Here is not and they're just like I'm just crushing it I'm like what's your. What's your excuse? Related things it's really appropriate with the patients that are recovering from. We're going to have patients that have been hospitalized in investing for a long time, and it's not just about the disease, and it's not gonNA. Be just. It's going to be about recovery. And that's going to be really important with strength, training and aerobic training. Coming back in is making sure we're hitting this new population. Right I hope nobody. Nobody experiences. Watching. This has to experience Kobe. Firsthand I could not get tested, but let's just say I was sick for a month. That's all set had covert, but I'm a forty year old male who does Ironman triathlons and I took a thousand steps and seven days. Seven days and how long does it take to be able to walk my brother's dog around the block like two weeks like? To walk like to the point where I was like I. Don't feel winded, and that was a quarter mile. These these individuals are like. We said this before I'm working with the centennial. Steering Committee for the data throw the. Yearlong Party for the so that's why I'm like. Fingers crossed for CSM, but if it's not safe, we should do it. But our profession, like rose out of a pen of a giant epidemic right the polio epidemic. This is where a profession came from this great moment I think for us. If we cannot, if we can make sure we get this out of our way, don't under dose. These people are going to need you to make them work. I'm excited. A question about curriculum stationed. Maybe you can help us just because you weren't with the program. Addressing DP careers talked about this before kind of through that hypothetical out. Like how long would it take to? Teach a class on the s or something like that. Do I mean do even places even have that? Can you get your? NPT's call we'll find out what your survey which is why people should take it. Still I know a lot of UNDERGRAD exercise. Science programs have classes to do that to do that within I'm sure there's something can keep programs does not i. tell you what it's more and more challenging with. With your furnishing requirements, the edition habit to fit something that in One thing we've been flirting with an is maybe making an an opportunity to do it outside of school. So. Students have been avenue, but the challenges we know. How hard schools isn't how busy they are. So it is, it is definitely difficult and I'm GonNa back up my PT. Educators out there because and this is I have never educate I've never been a professor at a PT program ever. Just saying hey, take out a bunch of stuff and then put in other stuff it's it's more complicated I mean. This is a Lehman saying. Listen Trust me people that I know in education would do it. Or would you? It's more complicated than that right. I mean it's everything can to consider from student debt to link the classrooms to contact hours to faculty load do. You know it's all those things that have to be considered as you're planning program and you. WanNa Funds. Is I hire the people to teach? That have great expertise, so read is a PhD student in hired him as a TA. And their ex course, great progress was able to bring a lot of that energy into the course, and so the that's one way to deal with it, but if you don't have enough time, and with peachy shortening and and in. Each other only two years only two and a half years. It's it's hard to compete and make sure the students are getting everything. We think they need I'm if you want throw like the term a slippery slope around right so now now people you can, you can do the Walmart method, which is like I'm going to compete on price, almost going to drop the price of Madrid. Price Right, but PT schools are competing on time. You're jamming all this information into two and a half years two years. Someone's GonNa come out with a year and a half right? There's ten minutes APPs one not seven-minute APPs one ounce. I WANNA APPs. I think that people think they know to short is if you say Oh, one and two years isn't too short while one year tour. is to get all the middle well. Maybe we require more prerequisites. Re this project man I'm going to give you full screen mode. Most, green! You get thirty seconds to tell people why they should take the survey. Why it's important. They should take your survey. To find out and I'll bring it up on. Syria attitude, strength, training, attitudes, behaviors, and knowledge current future exercise professionals, no pressure whatsoever this. Is it right here? Okay, I'll hold on. We'll get. We'll get the timer on here. We go thirty seconds ago. I'm wondering if I should start with a power analysis, but I don't think that'd be time wherever the but. He blew five seconds on that, but more more data points. It's GonNa. Give us more more questions to answer so if you're someone in, I'll give you a sneak peek of the survey. A lot of people think bats many people think that strength training is not being done well in physical therapists. Let's let's prove. Let's disapprove that or prove that one of the other by taking this survey remember there's no pressure. It's anonymous, so we don't know who you are not going to come five or anything like that, but let's move the profession for. Let's move the needle. Let's figure out this first step. What do we know and do? We need to make improvements, and then then we can make improvements after that so. You got to within thirty seconds wolf on. The link to the study is going to be available in the show notes of podcast episode. It is right now in the comments below the other facebook video. If you're if you're watching this thing online, I'm excited that you guys are that you guys are doing this. We get questions. Do you mind if we share the link? Serbia on personal social media accounts probably not at all right share. Share any burning. Share the more responsive we can get if your members of a group you can post your DVD program yet. Other students to share it We're GONNA go to the Ortho section and get them to share it for us anywhere that you think you can reach other exercise professionals. Please do so. We've reached out our colleagues in our our means, but ended out. Get it out there. All right Let's do three questions right now bridge. Would you three questions? Let's have some fun with some fun stuff, not that this wasn't fun. This is fun. We'll do three questions. We'll student now. Three questions brought to you by our friends at Arias medical staffing. It's a you are us, medical dot, com, leaders and travel. Were like wow, trial PTA. I can't be doing that right now. Well, there's a lot of areas in the country that need physical therapists who come there. You are essential. Go their. Physical therapists physical therapist assistants a you are US medical dot com website. Check them out right there. first question I love three questions because it really gets, you can ask the same person same three questions over and over again. They give you different answers, so first question will go. Stacy is aware question. You're in South Carolina, but if you go anywhere in the fifty United States and this is, this is an important question now because we're all dying grow places. If you could go spend three months right a short-term travel assignment. Where would you want to go in the US? Those of at the University of Hawaii if you went an adjunct instructor. Yeah. I would do that Hawaii. Not that read same question where which wear. At summer, it's really hot. Let's go to Alaska. To read reads like literally dripping right now in South Carolina. I see a damn polar bear. Second question is a what question that's helped me. Help me build my Netflix. Queue my reading list. What's something you've watched? Read downloaded anything that you think the audience could benefit from. Far Stacey because whoever goes, take it. Go I I got to think. Of the name of the book is listed I just listened to a historical nonfiction book. That ruling Kinda Tigers together some racial justice going on, and it was a very motivational, and if you read answer for. Asian of wheels so. The book called Missoula I. Forget the author of it, but it looks at It looks at essentially it looks at. It looks a rape in college systems, and basically what that looks like far as sexual abuse, and all that kind of stuff, but it's really eye opening thing where you would you be like? Wow, I didn't know that was actually happening in the US like that, so it's an eye opening thing and it gives you an insight into judicial system, a little bit, and then also the the system within colleges and how that operates. Being talked about that. We literally like well. Let's just not talk about that for a little while and now we're like you know what I don't know. Feels like the gates are just like you know what let's just talk about it. And students want to in Class Day there we have a small group of students that set up a group to talk about some of the racial injustices going on and how to address those in the beekeeper. Passion is wonderful, did you? Did you find what yours was? It is called the invention of wings by summum pit. It is historical fiction, but it's, but it's still brings to light with those issues I like all right perfect. Thank you for sharing those and last question is we like to start and end with people is a WHO question who should the audience know more about? I intentionally make that question very open ended. Raid you person. Sure. There's a as like a PhD. Chris Beard Beardsley I, believe it is so it leaves website strengths by science, strength and conditioning strengthening conditioning research I think it's dot com so that's a good place to go. If you're looking at the science, aspect of it getting, get away from the kind of the more borough. Steph, where there's not evidence based out, but it. It's a really nice job, and it's awesome. Bro Staff to but it science back. The bro Bro Bro, science to a major umbro science. What do you want to go to school for Bro Science debt. That's what I'm doing. They. Broke. Look up! Mine. Is I think you need to watch out for he's. Getting Ready to get his. PhD Is GonNa Be Teaching at a program somewhere and he has the mind to ask those clinical base reflections. basin strangling. What do we know is? p.t is where we're going to go, so he has challenged me in a good way as my PhD student in excited to see, where were his career takes them I'm excited all right so again. I will hammer this again. The the link for the surveys in the comments it'll be in the The show notes of the podcast is well take please by all means share share it share like the more we figure out. Take a really good look at ourselves. The more we can prove hopefully, and then ultimately our patients benefit so stay. Read appreciated Guy Stopping by for for the episode. Let's do a foul will sit date. Let's have another drink in a when whenever this is over. Let us know we'll get. We'll talk. We'll talk results. Know results on this show. One right fingers crossed. Arc I think share. See you guys. Love. The PT Pine Cast Yes. 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