WEBVTT

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Well, Tim, welcome to the show.

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I'm super excited to talk to you.

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I'm over here in North Carolina.

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Tim's in Colorado.

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And Tim is somebody that

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I've had an opportunity to

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get to know a long time now, ago.

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It feels like it shouldn't

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be that long ago now,

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but it's exciting to have

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him on the show today and

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really get to talk about

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some things I think that

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are really important,

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especially with regards to

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manual therapy and education

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and sort of what manual

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therapy education looks

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across the educational lifespan.

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And I can't imagine anybody

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being able to really have

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this conversation better than Tim,

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because he really has been

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on all sides of the education adventure,

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being both consumer and as

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well as a deliverer of

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education and various

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pathways and journeys in people's lives.

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And so, Tim, welcome to the show.

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Well, thanks for having me.

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I'm really looking forward

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to the conversation today, Derek.

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And yes, we go back, I guess,

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a long ways now,

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which is kind of wild for sure.

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I still remember that it was

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two thousand and eight when

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Evidence in Motion was, you know,

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kind of getting off the

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ground and you trusted a

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few of us lowly schleps to

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be a part of a part of the

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organization in regards to

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fellowship training and such.

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And I'll always value that time very well.

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Well,

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I think that since we are talking

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about education, I mean, I look at, I,

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like you,

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have been super fortunate that I

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was put into positions to

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teach way before I thought

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I was capable of doing it

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by people that I were very well respected,

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you know, Phil Greenman, John Bedellin,

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you know, John Minnell.

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You know,

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I'm around these people and I'm

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way too young.

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And, you know,

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I guess they call it

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imposter syndrome now.

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But, you know, you're just saying, wow.

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Having said that, you know,

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that's really what our role

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has always been, I think, is to empower,

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you know,

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those around us to just do

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better and to be better

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than we are in terms of

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both the practice of what we do, but also,

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you know, teaching others going forward.

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And I'm glad you brought all that up.

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And I think one of the

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things that I've always

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respected about your

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position is that you've

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always maintained sort of

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the foot in the door of

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clinical relevance as well too.

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And so I think that that's

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always meaningful.

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I think we all start in some

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way or form with educating PTs

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you know, in that clinical setting.

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I remember when I first got

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my first student,

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I think I was only out six

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months of PT school.

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So talk about imposter syndrome.

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I was teaching a student as

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a CI from somebody who, you know,

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was only going to graduate

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six months before me.

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And somebody asked me how that went.

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And I was like, well,

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I don't think I could

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really teach them much,

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but I could kind of help

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guide them a little bit.

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But I felt like there's

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always been that imposter syndrome,

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even for everyone,

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I think is kind of refreshing to hear.

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Indeed.

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So the, I have a,

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the topic of our conversation today is,

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you know,

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and it's about physical therapy

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and probably more importantly, I think,

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especially for our listeners here,

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orthopedic manual physical therapy,

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future in education and how

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it starts with

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the education setting and environments.

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And I think we wanted to

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talk about it from the

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professional side of education.

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So entry-level education

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going through

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post-professional education.

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And I might even add,

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little bit in there.

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This wasn't part of our initial discussion,

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but post-professional educational journey,

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because I think a lot of us

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are now starting to face

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that part of our career paths.

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And so I guess before we

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even get into that,

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let our listeners know how

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you really kind of became

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interested in manual

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therapy specifically?

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I think we all are familiar

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with the work that you've

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done and the research that

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you've contributed to the field.

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But like, where did it all start?

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How did you how did you get

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interested in this?

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How'd you get the bug?

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Well,

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it's funny because I often joke my

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manual therapy training.

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I went to Marquette,

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graduated in nineteen eighty three,

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and we had a four hour

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block on manual therapy.

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That was the extent.

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And not only was that the

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extent of the block,

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it was on a Friday morning.

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and the thursday night

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before my wife and I had

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gotten engaged she was in

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pt school and of course we

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were provided with way too

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many uh cheap shots so I

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just remember that next

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morning being super hung

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over and that was our only

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manual therapy block we got

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I mean I was super excited

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given my state and uh um so

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that was really my initial

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entry into manual therapy

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but it was just a sliver

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How that won you over, I don't know.

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But actually, you know, I was in ROTC,

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so I went into the Army

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right out of PT school and

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was stationed down in San

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Antonio at Brook Army Medical Center.

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And

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I was you know life is a lot

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you know people say it's

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hard work but it's luck as

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well I mean I could have

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gotten sent somewhere

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differently but at the time

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it was just kind of a bevy

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of super outstanding

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physical therapists um

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musculoskeletal imaging you

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know uh but manual therapy

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as well there's a couple

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steve stratton was one and that just was

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you know,

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going to Michigan State

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Osteopathic Program at the time, you know,

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their continuing education

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program and just saying, hey,

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this is where you need to be at, you know,

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this is where you got to go, et cetera.

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But I was just immersed in

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this muscle skeletal world

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and you just were expected.

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you know to to know this

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material and to be good

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with your hands and um so I

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think I was lucky in that

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regard but you know my

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first exposures uh were you

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know teaching you know just

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extremity manipulation and

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spinal manipulation people

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with acute pain uh

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syndromes coming in and and

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then very quickly I think it was a year

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two in I went to michigan

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state for a five-day

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principles of manual

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medicine course and that

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was a game changer because

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it really first it was a

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small group of primarily

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dos couple mds and a

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handful of physical

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therapists but the again

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the faculty was you know I

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mean it was phil greenman

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john minnell john bordillon

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I think Carl Steele,

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who was a PT but then went

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on to become a DO.

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It was like a student

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faculty ratio about one to

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six or six to one.

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It was just an immersion.

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I realized how little I knew,

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but how, how powerful it was.

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And that these folks too had,

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which been orthopedic

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surgeons and had given up

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essentially surgery because

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they just believed in manual medicine,

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non-operative care, you know, back in the,

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you know, this is now the mid eighties.

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So,

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It was very powerful,

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both from the technical aspect,

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but also from the

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professionalization of what

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manual medicine really was.

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So that really launched my career.

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And when I ended up going

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back for my master's,

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I guess it was in eighty eight to ninety,

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I went to Michigan State in

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the osteopathic school.

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they had a biomechanics department,

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which was somewhat

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traditional biomechanics in

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the fact that we're doing a

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lot of tissue mechanics and

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stress strain curves and the like.

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But Phil Greenman,

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Dr. Greenman was a member

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of that faculty.

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And I knew if I went there,

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I could take more of these

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courses while I was there.

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And I just kept pestering

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him until he said, well, Tim,

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why don't you just come to

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clinic with me a couple of days a week?

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I'm like,

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Yeah.

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And so that was like, you know,

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the beginning of the quote

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classic kind of mentorship of, you know,

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one-on-one in the clinic, you know,

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you know, twelve,

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sixteen hours a week just

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watching a truly master clinician.

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And that's when you realize

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manual medicine is

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described there and manual

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therapy or manual physical

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therapy as we now know it.

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It's holistic.

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And, you know, technically, yeah,

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he was a skilled manipulator,

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but it was all the other stuff.

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His patient interaction that

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we now call therapeutic

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alliance was off the charts.

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You just wanted this guy to be your doc.

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I mean,

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it was just connectivity with

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people and could be very firm on,

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you know, hey,

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you got to do your homework,

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but came from a place that, you know,

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you just trusted.

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And so, yeah,

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you look back and those elements just,

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you know,

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launched my passion and career

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and which goes to say how important it is,

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I think, that early career therapists,

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you know,

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Even if it's harder yards

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and not getting paid as much,

00:10:10.937 --> 00:10:12.798
it does shift your entire

00:10:12.839 --> 00:10:14.440
trajectory if you can have

00:10:14.480 --> 00:10:15.500
those first couple of years

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around people that actually

00:10:17.962 --> 00:10:19.244
are doing it the right way.

00:10:20.804 --> 00:10:21.785
and are really

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patient-focused and understand,

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despite the system that's really broken,

00:10:28.894 --> 00:10:31.297
that we can still make a difference.

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And that will truly launch your trajectory,

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I believe.

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It's interesting that one of

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the things I picked up on

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when you said there,

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and I've heard this from a

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lot of people who have gone

00:10:43.000 --> 00:10:45.501
on to be successful in their careers,

00:10:45.701 --> 00:10:49.283
is they pester, they beg,

00:10:50.004 --> 00:10:52.585
they yearn for the mentorship.

00:10:52.904 --> 00:10:56.086
They take charge in their own education.

00:10:56.147 --> 00:10:56.746
And I've had a lot of

00:10:56.767 --> 00:10:58.067
conversations around that with

00:10:58.888 --> 00:10:59.989
dbt students and I'm sure

00:11:00.009 --> 00:11:00.869
we'll get into some of that

00:11:00.969 --> 00:11:02.349
conversation later about

00:11:02.568 --> 00:11:04.169
some of the generational

00:11:04.190 --> 00:11:05.269
changes and differences and

00:11:05.309 --> 00:11:06.130
things like that but I

00:11:06.150 --> 00:11:06.931
still think that there's

00:11:06.971 --> 00:11:10.371
value in you know taking

00:11:10.412 --> 00:11:11.552
charge of that and

00:11:11.591 --> 00:11:12.413
everybody that I've met

00:11:12.432 --> 00:11:13.812
that's done something very

00:11:13.873 --> 00:11:14.754
well is they're basically

00:11:14.793 --> 00:11:15.974
like just they don't stop

00:11:16.014 --> 00:11:17.173
knocking on the door and

00:11:17.234 --> 00:11:18.095
eventually somebody's going

00:11:18.115 --> 00:11:19.095
to open that door and say

00:11:19.154 --> 00:11:21.336
okay fine I'll let you in

00:11:21.395 --> 00:11:22.975
but if you look across the

00:11:23.015 --> 00:11:24.376
board that seems to be one of those

00:11:25.177 --> 00:11:28.419
character traits of a, you know,

00:11:28.461 --> 00:11:29.422
somebody that has gone on

00:11:29.461 --> 00:11:32.404
to become a great clinician and then,

00:11:32.585 --> 00:11:34.447
you know, have some level of impact,

00:11:34.466 --> 00:11:36.028
wherever that impact might be defined as.

00:11:36.067 --> 00:11:38.370
So nice and refreshing to

00:11:38.410 --> 00:11:39.851
hear you say that.

00:11:39.991 --> 00:11:41.234
And it just occurred to me

00:11:41.354 --> 00:11:42.315
as we're talking that

00:11:43.182 --> 00:11:43.984
Part of, I think,

00:11:44.043 --> 00:11:49.667
that trait is you are vulnerable.

00:11:49.846 --> 00:11:51.148
You're going to get told no.

00:11:51.288 --> 00:11:52.489
You're going to be putting

00:11:52.509 --> 00:11:53.809
yourself out there.

00:11:54.770 --> 00:11:58.994
And I think there's an openness in that.

00:11:59.134 --> 00:12:00.434
I think maybe it displays a

00:12:00.495 --> 00:12:02.176
bit of openness in how you

00:12:02.196 --> 00:12:06.258
then view science, how you view learning,

00:12:06.619 --> 00:12:08.940
how you view growth.

00:12:09.320 --> 00:12:10.620
And so maybe part of that is

00:12:10.640 --> 00:12:12.722
just a trait that you kind of need.

00:12:13.443 --> 00:12:15.908
That needs to be there in order to grow,

00:12:16.089 --> 00:12:16.831
I think, you know?

00:12:18.082 --> 00:12:18.163
Yeah,

00:12:18.202 --> 00:12:18.844
it's one of the things that I

00:12:18.884 --> 00:12:20.625
actually tell even our

00:12:20.664 --> 00:12:23.447
students when they're learning things,

00:12:23.506 --> 00:12:24.388
either if it's either an

00:12:24.447 --> 00:12:25.528
entry-level PT student or

00:12:25.548 --> 00:12:26.589
if I'm teaching fellows or

00:12:26.609 --> 00:12:28.049
whatever it might be, I always say,

00:12:28.711 --> 00:12:29.871
here's two things you got to do.

00:12:29.892 --> 00:12:31.212
You have to give feedback

00:12:31.293 --> 00:12:33.193
and then you have to crave feedback,

00:12:33.254 --> 00:12:34.274
even if it's feedback that

00:12:34.294 --> 00:12:36.216
you don't necessarily want to receive,

00:12:36.235 --> 00:12:37.576
but you have to beg for

00:12:37.677 --> 00:12:39.538
that level of feedback

00:12:39.558 --> 00:12:40.539
because ultimately that's

00:12:40.620 --> 00:12:43.461
going to help you grow as well too.

00:12:43.581 --> 00:12:46.663
So I think that that's a big part of

00:12:47.825 --> 00:12:51.427
that educational adventure.

00:12:51.726 --> 00:12:53.347
Um, so, you know,

00:12:53.807 --> 00:12:55.149
I know your career track

00:12:55.168 --> 00:12:57.570
and your trajectory, um, a fair amount,

00:12:57.890 --> 00:12:58.091
you know,

00:12:58.130 --> 00:13:00.111
and so coming out of the military,

00:13:00.491 --> 00:13:01.491
you know, obviously you,

00:13:01.773 --> 00:13:03.933
you were a consumer of education,

00:13:04.354 --> 00:13:05.534
you were taught.

00:13:06.014 --> 00:13:07.836
And then at some point, you know, and you,

00:13:07.875 --> 00:13:08.796
and you're always a learner.

00:13:09.177 --> 00:13:09.356
Um,

00:13:09.456 --> 00:13:10.576
so I'm not going to say that you're not

00:13:10.616 --> 00:13:11.437
still learning,

00:13:11.477 --> 00:13:14.559
but at some level you then, um, changed.

00:13:14.580 --> 00:13:16.660
And I know that you went into sort of

00:13:17.614 --> 00:13:19.777
almost a post-professional

00:13:20.337 --> 00:13:22.279
focus of education and then

00:13:22.400 --> 00:13:23.761
kind of shifted into some

00:13:23.883 --> 00:13:24.903
entry level back again.

00:13:24.964 --> 00:13:27.687
But talk to us a little bit about,

00:13:27.947 --> 00:13:28.168
you know,

00:13:28.207 --> 00:13:30.270
what I guess was the next

00:13:30.410 --> 00:13:31.253
catalyst if I'm going to

00:13:31.273 --> 00:13:32.433
think about phases in

00:13:33.335 --> 00:13:34.157
educational journey.

00:13:34.657 --> 00:13:35.738
where you started to say, Hey,

00:13:35.778 --> 00:13:36.557
you know what we need,

00:13:36.758 --> 00:13:38.519
we need to do something bigger.

00:13:38.558 --> 00:13:40.639
Maybe we need to educate at

00:13:40.679 --> 00:13:42.221
a larger scale or a larger

00:13:42.280 --> 00:13:43.400
shift or something like that.

00:13:43.441 --> 00:13:44.741
And that was probably the

00:13:44.782 --> 00:13:45.602
early two thousands.

00:13:45.643 --> 00:13:46.783
I'm sure that that happened,

00:13:46.802 --> 00:13:48.043
but talk to us a little bit

00:13:48.063 --> 00:13:49.445
about what kind of went into your,

00:13:49.565 --> 00:13:51.905
your mindset around all of that.

00:13:54.427 --> 00:13:55.206
Well, I mean,

00:13:55.226 --> 00:13:57.649
there's a few things there

00:13:57.828 --> 00:13:58.649
wrapped in there.

00:13:58.729 --> 00:14:00.090
I think it has been,

00:14:01.828 --> 00:14:03.850
I think as it relates to AOMT,

00:14:03.889 --> 00:14:04.951
I think there is a story

00:14:04.971 --> 00:14:06.672
there that we'll get to that.

00:14:06.692 --> 00:14:08.572
Because I really think my

00:14:08.753 --> 00:14:10.614
passion for manual therapy, I mean,

00:14:11.335 --> 00:14:12.514
my PhD was not that.

00:14:12.596 --> 00:14:13.635
I learned a lot about a

00:14:13.716 --> 00:14:15.256
little which PhDs are.

00:14:15.297 --> 00:14:17.619
You learn a method, you learn a lot.

00:14:17.639 --> 00:14:18.818
And it was really in bone

00:14:18.839 --> 00:14:20.659
stress injuries and things

00:14:20.679 --> 00:14:22.421
that were away from manual therapy.

00:14:22.461 --> 00:14:23.581
And this is in the nineties.

00:14:24.001 --> 00:14:25.763
So I come out in ninety seven,

00:14:26.144 --> 00:14:28.024
the ACPAR guidelines are saying, you know,

00:14:28.065 --> 00:14:29.745
PTs don't do anything.

00:14:30.566 --> 00:14:32.768
for back pain, except, you know,

00:14:32.788 --> 00:14:33.967
this manipulation thing

00:14:34.008 --> 00:14:36.089
seems to have a little bit of benefit.

00:14:36.129 --> 00:14:37.250
And our own professional

00:14:37.269 --> 00:14:39.110
association didn't jump on that and say,

00:14:39.150 --> 00:14:40.831
well, hell yeah, that's what we do.

00:14:40.932 --> 00:14:42.913
So we kind of fought those

00:14:42.952 --> 00:14:44.014
guidelines as well as

00:14:44.053 --> 00:14:45.495
everybody else that didn't

00:14:45.514 --> 00:14:47.034
like what the answer was.

00:14:47.095 --> 00:14:49.917
And so I came out during

00:14:49.937 --> 00:14:51.437
that time a little like

00:14:51.898 --> 00:14:53.759
whoa, I'm, I'm a manual therapist,

00:14:53.818 --> 00:14:54.799
even though I've kind of

00:14:54.840 --> 00:14:55.900
done this PhD and I was

00:14:56.000 --> 00:14:58.101
back in the entry level teaching.

00:14:59.003 --> 00:15:02.424
And I felt strongly that, you know,

00:15:02.445 --> 00:15:04.187
these skills are basic

00:15:04.206 --> 00:15:06.488
skill sets of entry level

00:15:06.567 --> 00:15:07.788
professionals that you need

00:15:07.828 --> 00:15:09.250
to know how to manipulate the spine.

00:15:09.269 --> 00:15:10.091
You need to know how to

00:15:10.931 --> 00:15:13.113
manipulate the extremities.

00:15:13.273 --> 00:15:14.553
And that's just the basic

00:15:14.573 --> 00:15:15.714
skill set to manage.

00:15:15.813 --> 00:15:17.375
One of the prime largest

00:15:17.416 --> 00:15:18.856
conditions we see is that a

00:15:18.876 --> 00:15:20.157
spinal disorder.

00:15:20.236 --> 00:15:20.697
So, um,

00:15:21.758 --> 00:15:25.259
That, to me, was obvious as I entered.

00:15:25.820 --> 00:15:27.041
I was now at Army Baylor,

00:15:27.081 --> 00:15:28.701
and so I was teaching there.

00:15:29.701 --> 00:15:33.144
But I also became a member of the academy.

00:15:33.364 --> 00:15:35.164
And at that time,

00:15:35.465 --> 00:15:37.806
I just assumed we were

00:15:37.865 --> 00:15:39.486
pushing manipulation and

00:15:39.547 --> 00:15:41.447
entry-level practice,

00:15:41.488 --> 00:15:43.328
that that was just a basic skill set.

00:15:44.029 --> 00:15:45.171
And it was,

00:15:45.692 --> 00:15:50.057
I wasn't met with quite the

00:15:50.217 --> 00:15:52.561
excitement that across the academy.

00:15:52.600 --> 00:15:55.585
And again, I don't, it was well intended,

00:15:55.625 --> 00:15:57.086
but a lot of folks felt that this was a,

00:15:57.106 --> 00:15:57.587
you know,

00:15:57.628 --> 00:15:59.730
a higher level post-professional skill.

00:16:00.331 --> 00:16:01.993
And clearly you get better

00:16:02.013 --> 00:16:03.614
and better post-professionally,

00:16:03.653 --> 00:16:05.655
but there are a skill set

00:16:05.696 --> 00:16:07.437
that are really all of us

00:16:07.476 --> 00:16:08.958
need to have an entry level.

00:16:09.019 --> 00:16:09.798
And we now do that.

00:16:10.100 --> 00:16:12.841
But that wasn't at the time

00:16:14.263 --> 00:16:16.245
the prevailing wisdom.

00:16:17.285 --> 00:16:18.746
And why I was passionate

00:16:18.767 --> 00:16:22.791
about it was because the need was there.

00:16:23.822 --> 00:16:25.063
And I look back to my

00:16:25.163 --> 00:16:28.128
education where my mentors,

00:16:30.029 --> 00:16:32.331
osteopathic physicians, one in particular,

00:16:32.351 --> 00:16:32.913
Phil Greenman,

00:16:33.293 --> 00:16:35.554
caught hell for teaching PT

00:16:35.575 --> 00:16:36.956
spinal manipulation because

00:16:36.976 --> 00:16:39.119
they felt that a lot of the

00:16:39.418 --> 00:16:40.841
osteopaths felt that, no,

00:16:40.880 --> 00:16:43.504
that's within their realm, you know,

00:16:43.524 --> 00:16:44.684
and that shouldn't be done.

00:16:44.725 --> 00:16:46.125
And he was like, well, hey.

00:16:46.726 --> 00:16:47.607
who's gonna be doing it

00:16:47.648 --> 00:16:49.308
because he was seeing way

00:16:49.349 --> 00:16:50.811
back in the eighties that

00:16:51.250 --> 00:16:52.692
physician graduates of DO

00:16:52.731 --> 00:16:54.714
schools were migrating into

00:16:54.754 --> 00:16:56.154
traditional residencies and

00:16:56.274 --> 00:16:58.057
really becoming more

00:16:58.116 --> 00:17:00.839
traditional silo based

00:17:00.979 --> 00:17:03.100
specializations and losing

00:17:03.120 --> 00:17:04.602
their manual medicine skills.

00:17:05.163 --> 00:17:06.923
And it was very intentional that says,

00:17:07.724 --> 00:17:09.987
if we don't continue to teach these skills,

00:17:10.007 --> 00:17:11.446
they will be lost and we

00:17:11.467 --> 00:17:13.528
will not have this skill

00:17:13.548 --> 00:17:16.171
set in US healthcare.

00:17:16.810 --> 00:17:19.011
And so that's why I, you know,

00:17:19.152 --> 00:17:20.133
in the back was very

00:17:20.192 --> 00:17:21.354
passionate about having

00:17:21.374 --> 00:17:25.076
that be a skill set of PTs

00:17:25.215 --> 00:17:25.936
and entry-level.

00:17:26.517 --> 00:17:29.078
But to your question now, then, you know,

00:17:29.138 --> 00:17:32.361
scaling up post-professionally, you know,

00:17:32.401 --> 00:17:34.162
I was just fortunate, you know, again,

00:17:34.563 --> 00:17:34.762
you know,

00:17:34.803 --> 00:17:36.624
somebody picks up the phone and

00:17:36.663 --> 00:17:39.846
wants to be part of your, wants you,

00:17:40.046 --> 00:17:41.027
them on your committee.

00:17:41.067 --> 00:17:42.027
And the person on the other

00:17:42.047 --> 00:17:43.749
end of the line was a guy

00:17:43.769 --> 00:17:44.709
named John Childs.

00:17:45.210 --> 00:17:48.432
And, you know, he wanted to do this RCT.

00:17:48.471 --> 00:17:49.792
And I'm like, well, yeah,

00:17:50.032 --> 00:17:51.554
I'd be happy to be on your committee.

00:17:51.594 --> 00:17:51.673
And

00:17:52.213 --> 00:17:54.075
And he describes it as being

00:17:54.095 --> 00:17:56.915
a very nervous call to someone, you know,

00:17:56.955 --> 00:17:58.297
like this expert, you know,

00:17:58.317 --> 00:17:59.718
I was looking like, oh, this young,

00:18:00.178 --> 00:18:02.538
eager person wants to collaborate.

00:18:02.578 --> 00:18:03.859
That's awesome, you know.

00:18:03.940 --> 00:18:06.820
And so, but from that, you know,

00:18:06.861 --> 00:18:08.362
we did research together

00:18:08.382 --> 00:18:10.061
and clearly evidence in

00:18:10.122 --> 00:18:11.722
motion begins to formulate.

00:18:11.803 --> 00:18:13.183
I was already doing some CD research.

00:18:13.903 --> 00:18:15.405
production back in the day, you know,

00:18:15.467 --> 00:18:17.489
doing a little digital Mavica, Sony,

00:18:17.528 --> 00:18:18.871
fifteen second video clips

00:18:18.891 --> 00:18:20.613
and smashing them on a CD.

00:18:20.692 --> 00:18:21.513
I don't know if they have

00:18:21.534 --> 00:18:22.355
those little discs.

00:18:22.375 --> 00:18:23.376
They're called CDs.

00:18:23.777 --> 00:18:24.898
They have those things anymore.

00:18:24.959 --> 00:18:26.901
But yeah, so that was so weird.

00:18:29.023 --> 00:18:31.326
Oh, indeed.

00:18:31.346 --> 00:18:31.467
So.

00:18:32.188 --> 00:18:32.488
But yeah,

00:18:32.508 --> 00:18:34.809
so that quickly we realized the

00:18:34.829 --> 00:18:36.810
demand for, you know,

00:18:36.830 --> 00:18:38.090
continuing medical

00:18:38.131 --> 00:18:40.932
education was continuing to be there.

00:18:40.972 --> 00:18:42.473
But ultimately,

00:18:43.273 --> 00:18:44.654
the data also was showing

00:18:44.714 --> 00:18:46.655
that wasn't changing behaviors, right?

00:18:46.695 --> 00:18:47.737
You just didn't change

00:18:47.777 --> 00:18:52.818
behaviors with just one-off CEs.

00:18:52.838 --> 00:18:55.060
You needed more ongoing

00:18:55.260 --> 00:18:56.681
connectivity with people.

00:18:56.741 --> 00:18:57.382
And that really...

00:18:57.842 --> 00:18:59.602
From that stemmed really

00:18:59.701 --> 00:19:00.962
residency and fellowship

00:19:01.002 --> 00:19:03.022
training and certifications

00:19:03.063 --> 00:19:03.923
and post-professional

00:19:03.962 --> 00:19:06.503
training that was more skin in the game,

00:19:06.544 --> 00:19:07.124
if you will.

00:19:07.144 --> 00:19:08.864
It was longer so that you

00:19:09.324 --> 00:19:13.025
had to commit a bit to doing that.

00:19:13.105 --> 00:19:15.046
I look back at my career and

00:19:15.185 --> 00:19:16.066
even though I wasn't in the

00:19:16.125 --> 00:19:17.385
formalized system,

00:19:17.546 --> 00:19:18.246
I was going through a

00:19:18.346 --> 00:19:20.047
series of courses that

00:19:20.086 --> 00:19:22.086
would be certificate-like.

00:19:23.067 --> 00:19:25.127
But the people around you

00:19:25.208 --> 00:19:26.468
were equally hungry.

00:19:27.248 --> 00:19:28.328
And you'd go to class all

00:19:28.368 --> 00:19:29.749
day learning these

00:19:29.788 --> 00:19:30.849
techniques and then you'd

00:19:31.089 --> 00:19:32.290
eat and then you'd grab a

00:19:32.351 --> 00:19:33.330
table and then you spend

00:19:33.371 --> 00:19:35.711
the next three hours practicing, you know,

00:19:35.751 --> 00:19:37.373
with three or four of you,

00:19:37.633 --> 00:19:39.493
like making sure you really had it,

00:19:39.933 --> 00:19:41.454
you know, before the next day.

00:19:42.214 --> 00:19:45.037
And that passion, you know,

00:19:45.596 --> 00:19:47.938
I think really makes the expert, you know,

00:19:47.978 --> 00:19:49.858
where you got it, you got to get reps,

00:19:49.878 --> 00:19:51.519
you know, I mean, you know,

00:19:51.539 --> 00:19:52.881
you do it one or two times.

00:19:53.040 --> 00:19:55.001
It's now I'm learning to play golf and,

00:19:55.162 --> 00:19:55.582
you know, man,

00:19:55.902 --> 00:19:57.804
I can tell you that the

00:19:57.844 --> 00:19:59.365
amount of reps to just get

00:19:59.605 --> 00:20:03.008
minimally competent is a ton.

00:20:03.388 --> 00:20:03.548
I mean,

00:20:03.568 --> 00:20:05.830
that's just to get minimally competent.

00:20:05.971 --> 00:20:08.212
And I think it's like any motor skill.

00:20:08.873 --> 00:20:09.374
You know,

00:20:09.554 --> 00:20:11.295
you got to be passionate about it.

00:20:11.355 --> 00:20:13.257
You got to do the reps.

00:20:13.636 --> 00:20:14.657
And so that really led to

00:20:14.718 --> 00:20:16.799
more of the certification

00:20:16.859 --> 00:20:18.181
residency fellowship kind

00:20:18.240 --> 00:20:19.982
of training that we got involved with.

00:20:21.528 --> 00:20:24.630
You know, it's so that's a little sidebar,

00:20:24.930 --> 00:20:26.611
because you mentioned your PhD.

00:20:26.711 --> 00:20:28.991
And so for our listeners out there,

00:20:29.352 --> 00:20:30.832
I actually uncovered

00:20:31.011 --> 00:20:34.313
unearthed some of your original PhD work,

00:20:34.333 --> 00:20:35.413
because I personally had a

00:20:35.493 --> 00:20:36.693
bone stress injury.

00:20:36.773 --> 00:20:37.233
And I was like,

00:20:37.654 --> 00:20:38.974
that can't be that Tim

00:20:38.994 --> 00:20:40.776
Flynn on those studies, right?

00:20:40.796 --> 00:20:41.476
Yeah.

00:20:42.276 --> 00:20:43.196
And it ultimately was.

00:20:43.217 --> 00:20:44.377
And I was like, wow, that's pretty cool.

00:20:44.419 --> 00:20:45.318
I didn't know that you had

00:20:45.359 --> 00:20:46.621
that sort of background

00:20:46.661 --> 00:20:47.942
that obviously now I know

00:20:47.961 --> 00:20:49.344
how it really just morphed

00:20:49.364 --> 00:20:51.105
really quickly back to manual therapy.

00:20:51.145 --> 00:20:52.547
But there was a brief

00:20:52.567 --> 00:20:53.949
flirtation apparently with

00:20:53.989 --> 00:20:55.210
bone distress injuries.

00:20:55.490 --> 00:20:58.473
And I'm still quite interested in them.

00:20:58.693 --> 00:20:59.575
And had I...

00:21:00.617 --> 00:21:02.318
gone a different route,

00:21:02.378 --> 00:21:03.720
I probably would have continued on.

00:21:03.759 --> 00:21:06.502
But I was in the era of PhD

00:21:06.522 --> 00:21:08.124
where you have to do something novel.

00:21:08.183 --> 00:21:09.984
And so I was trying to

00:21:10.025 --> 00:21:10.806
figure out if this

00:21:11.165 --> 00:21:12.707
vibrational characteristics

00:21:12.747 --> 00:21:15.348
of tibias would be related

00:21:15.509 --> 00:21:18.571
prognostically to bone stress injuries,

00:21:18.612 --> 00:21:20.093
which were very common in the military,

00:21:20.133 --> 00:21:20.673
the tibia.

00:21:21.753 --> 00:21:22.355
And, you know,

00:21:22.515 --> 00:21:25.616
we got the instrument to be reliable.

00:21:25.696 --> 00:21:28.218
And then once I got back into the Army,

00:21:28.258 --> 00:21:29.739
we did some studies at Army Baylor,

00:21:29.759 --> 00:21:32.500
and it just didn't pan out.

00:21:32.780 --> 00:21:34.642
I mean, there's so many factors involved.

00:21:36.403 --> 00:21:38.124
But I was always big, and still am,

00:21:38.163 --> 00:21:40.546
that bone quality is a very

00:21:40.665 --> 00:21:43.287
different measure than bone density.

00:21:43.346 --> 00:21:46.729
Density is a contributor to quality,

00:21:46.769 --> 00:21:47.529
but that is just...

00:21:48.150 --> 00:21:49.833
one marker, you know,

00:21:51.015 --> 00:21:52.617
of health and of quality.

00:21:52.738 --> 00:21:54.662
And so, yeah, still interesting.

00:21:54.741 --> 00:21:56.044
I read stuff here and there on it.

00:21:56.852 --> 00:22:00.452
It was just funny to see out there.

00:22:00.472 --> 00:22:01.232
Bone stress injury might

00:22:01.252 --> 00:22:01.874
have been a little bit

00:22:01.993 --> 00:22:02.814
easier to handle than

00:22:03.213 --> 00:22:06.275
something ubiquitous like low back pain.

00:22:06.535 --> 00:22:07.755
A little bit easier to

00:22:07.795 --> 00:22:10.175
diagnose and have an actual

00:22:10.635 --> 00:22:13.896
real patho-anatomical medical explanation,

00:22:14.196 --> 00:22:15.178
really, in some regards.

00:22:15.857 --> 00:22:16.438
So you chose something a

00:22:16.458 --> 00:22:17.798
little bit more difficult and challenging,

00:22:17.837 --> 00:22:18.259
which is good.

00:22:18.278 --> 00:22:19.179
We're all happy you did.

00:22:20.719 --> 00:22:21.920
So, yeah,

00:22:22.019 --> 00:22:23.819
I think there's been a lot to

00:22:23.880 --> 00:22:25.721
sort of unpack here already a little bit.

00:22:26.519 --> 00:22:28.661
I want to take you now to

00:22:28.701 --> 00:22:32.403
where you are at currently, you know,

00:22:32.443 --> 00:22:33.904
providing entry level

00:22:34.506 --> 00:22:36.646
education to manual therapists.

00:22:36.948 --> 00:22:38.769
And as you said, you know,

00:22:38.808 --> 00:22:40.089
when you went through PT school,

00:22:40.130 --> 00:22:41.751
and even when I went through PT school,

00:22:41.791 --> 00:22:42.813
even though it was, you know,

00:22:42.853 --> 00:22:43.692
some years later,

00:22:45.054 --> 00:22:46.355
it wasn't much different, you know,

00:22:46.395 --> 00:22:47.876
like we, we didn't learn,

00:22:48.497 --> 00:22:49.938
we certainly didn't learn manipulation.

00:22:50.759 --> 00:22:51.500
We did not learn,

00:22:52.050 --> 00:22:53.092
And then the manual therapy

00:22:53.112 --> 00:22:55.492
that we learned was, you know,

00:22:55.653 --> 00:22:56.772
obviously based on a lot of

00:22:56.792 --> 00:22:57.894
theoretical models that

00:22:57.933 --> 00:22:58.855
would just typically

00:22:59.355 --> 00:23:00.515
confuse the heck out of

00:23:00.875 --> 00:23:01.955
somebody not smart enough

00:23:01.976 --> 00:23:03.797
like me to understand those things.

00:23:04.277 --> 00:23:05.637
And so, you know,

00:23:05.698 --> 00:23:07.679
here we are now in a whole different era.

00:23:08.138 --> 00:23:08.859
And you're in a different

00:23:09.039 --> 00:23:11.921
era of your educational and

00:23:12.161 --> 00:23:14.522
teaching sort of career with that.

00:23:15.143 --> 00:23:16.844
You know, what do you...

00:23:17.932 --> 00:23:19.152
What do you love, I guess,

00:23:19.192 --> 00:23:21.532
about teaching in entry level?

00:23:21.553 --> 00:23:21.932
I mean,

00:23:22.012 --> 00:23:23.273
I think that's where you're having

00:23:23.294 --> 00:23:24.334
a lot of impact.

00:23:24.374 --> 00:23:25.275
And I think, you know,

00:23:25.434 --> 00:23:26.714
I love the topic of this

00:23:26.755 --> 00:23:28.796
because I do think that

00:23:29.336 --> 00:23:31.196
it's really important for

00:23:31.737 --> 00:23:33.597
our next generation of

00:23:33.678 --> 00:23:34.778
manual therapists to

00:23:35.285 --> 00:23:36.846
to gain some sort of footing

00:23:37.286 --> 00:23:38.967
in entry-level education

00:23:38.987 --> 00:23:40.346
and we can do that now,

00:23:40.366 --> 00:23:41.448
whereas we couldn't do it before,

00:23:41.508 --> 00:23:43.449
yet we still were successful.

00:23:45.170 --> 00:23:45.650
I guess, yeah,

00:23:45.690 --> 00:23:47.111
what's your passion and what

00:23:47.191 --> 00:23:48.911
do you see as sort of the

00:23:48.951 --> 00:23:50.352
future of education in

00:23:50.672 --> 00:23:51.932
manual therapy and entry-level?

00:23:52.614 --> 00:23:53.294
Well, I mean,

00:23:53.755 --> 00:23:56.596
I'm extremely passionate about it.

00:23:56.695 --> 00:23:59.617
And it is what I, you know,

00:24:00.258 --> 00:24:02.098
our health system is so bad.

00:24:02.259 --> 00:24:03.000
And it just,

00:24:03.579 --> 00:24:05.060
it's just crying for people

00:24:05.101 --> 00:24:05.901
that can think,

00:24:06.461 --> 00:24:08.682
that can have therapeutic hands,

00:24:09.123 --> 00:24:10.423
and that can, you know,

00:24:10.503 --> 00:24:12.184
connect with human beings.

00:24:12.684 --> 00:24:14.665
Because that's just, to me,

00:24:14.826 --> 00:24:16.067
part of the skill set

00:24:16.086 --> 00:24:17.288
allows us to actually move

00:24:17.307 --> 00:24:19.229
people to optimal health.

00:24:19.328 --> 00:24:19.689
And but...

00:24:20.189 --> 00:24:21.750
you have to, to me,

00:24:21.809 --> 00:24:24.271
it's a window in to that,

00:24:24.511 --> 00:24:26.614
despite just the basics of treating, say,

00:24:26.993 --> 00:24:28.275
neuromuscular conditions

00:24:28.776 --> 00:24:29.836
with hands-on care.

00:24:31.817 --> 00:24:33.239
I think the biases,

00:24:33.398 --> 00:24:35.080
what I like about intro level, we can,

00:24:35.361 --> 00:24:36.321
you know, we're all biased,

00:24:36.342 --> 00:24:38.063
but we can at least not

00:24:38.123 --> 00:24:40.825
bias them according to even, I mean,

00:24:41.625 --> 00:24:43.747
within the century, people, you know,

00:24:44.147 --> 00:24:44.688
are saying, you know,

00:24:44.728 --> 00:24:46.890
the dangers of manual therapy and

00:24:47.309 --> 00:24:48.810
programs not teaching it

00:24:48.830 --> 00:24:50.313
because it's dangerous, you know,

00:24:50.373 --> 00:24:51.353
and I'm like, you know,

00:24:51.393 --> 00:24:54.816
it's just a wild thing that

00:24:54.836 --> 00:24:56.217
when you look back the history,

00:24:56.597 --> 00:24:57.597
we were doing manipulation

00:24:57.637 --> 00:24:59.140
the beginning of, you know,

00:24:59.819 --> 00:25:01.040
in the nineteen twenties at

00:25:01.060 --> 00:25:02.883
the beginning of our profession, you know,

00:25:02.942 --> 00:25:03.083
I mean,

00:25:03.123 --> 00:25:05.805
that was the basics of our

00:25:05.825 --> 00:25:07.046
profession was hands on

00:25:07.105 --> 00:25:09.107
manual manipulative type care.

00:25:09.468 --> 00:25:12.549
So it's weird how things got distorted.

00:25:13.371 --> 00:25:15.731
But I really don't want to

00:25:15.771 --> 00:25:17.413
leave this talk or

00:25:17.792 --> 00:25:19.733
discussion without saying

00:25:19.753 --> 00:25:23.174
that as the academy in the

00:25:23.234 --> 00:25:24.395
manual therapy group,

00:25:24.776 --> 00:25:27.737
our role is that of teachers.

00:25:27.936 --> 00:25:29.077
And I'm so excited.

00:25:29.117 --> 00:25:31.078
There's so many fellows that

00:25:31.098 --> 00:25:33.339
are on faculty throughout the country.

00:25:34.119 --> 00:25:35.661
And you look and talk to

00:25:35.740 --> 00:25:39.324
programs and everybody, you know, says,

00:25:39.544 --> 00:25:39.743
you know,

00:25:39.763 --> 00:25:41.384
they're excited about their

00:25:42.365 --> 00:25:44.968
orthopedic or musculoskeletal faculty,

00:25:45.048 --> 00:25:45.288
you know.

00:25:45.448 --> 00:25:47.249
Well, there's a couple reasons.

00:25:47.689 --> 00:25:49.451
Almost all these are still clinicians.

00:25:49.770 --> 00:25:50.570
They're actually still

00:25:51.071 --> 00:25:53.393
seeing patients in some capacity,

00:25:53.913 --> 00:25:55.094
limited often just due to

00:25:55.114 --> 00:25:56.634
the other responsibilities,

00:25:56.694 --> 00:25:57.615
but are clinicians.

00:25:57.875 --> 00:25:59.017
They have stories about real

00:25:59.057 --> 00:26:01.719
patients right now, currently.

00:26:01.739 --> 00:26:02.138
Right.

00:26:02.798 --> 00:26:04.099
Their passion for what they

00:26:04.160 --> 00:26:06.201
do exudes through.

00:26:06.520 --> 00:26:07.721
They're not telling stories of,

00:26:07.741 --> 00:26:08.781
''Twenty years ago when I

00:26:08.821 --> 00:26:09.722
saw this patient.''

00:26:10.942 --> 00:26:14.424
Students react to that.

00:26:15.365 --> 00:26:16.046
I'm curious,

00:26:16.526 --> 00:26:18.267
the number of fellows that are on faculty,

00:26:18.287 --> 00:26:19.708
it has to be quite high.

00:26:21.828 --> 00:26:23.569
What's even more exciting to

00:26:23.630 --> 00:26:25.911
me is so many programs now

00:26:26.411 --> 00:26:27.672
are finally shifting.

00:26:28.011 --> 00:26:30.113
whether they're residency or

00:26:30.493 --> 00:26:32.375
blended models that, you know, say,

00:26:32.394 --> 00:26:35.215
you know,

00:26:35.236 --> 00:26:36.916
those that should be teaching

00:26:37.097 --> 00:26:39.959
clinical skills should be clinicians.

00:26:40.298 --> 00:26:40.539
You know,

00:26:40.579 --> 00:26:42.401
they should be expert clinicians.

00:26:42.441 --> 00:26:42.681
You know,

00:26:42.861 --> 00:26:45.962
I don't want my surgeon taught by

00:26:46.042 --> 00:26:48.223
someone that doesn't do surgery.

00:26:48.403 --> 00:26:49.384
I just don't feel that's a

00:26:49.684 --> 00:26:50.925
good way to do business.

00:26:50.965 --> 00:26:53.507
You know, it shouldn't be, you know,

00:26:53.567 --> 00:26:55.868
the anatomy professor that's teaching it.

00:26:56.788 --> 00:26:57.609
It should actually be the

00:26:57.670 --> 00:26:59.250
surgeon that's teaching how

00:26:59.269 --> 00:27:00.050
to do surgery.

00:27:01.191 --> 00:27:03.031
And I think it's crazy how

00:27:03.092 --> 00:27:04.751
distorted our profession

00:27:04.811 --> 00:27:07.733
got away from the expertise

00:27:07.773 --> 00:27:08.894
of the clinician really

00:27:08.953 --> 00:27:11.994
driving the educational system.

00:27:12.434 --> 00:27:13.736
And so that's kind of what

00:27:13.796 --> 00:27:15.115
I'm most passionate about.

00:27:15.155 --> 00:27:16.457
And I think that manual

00:27:16.497 --> 00:27:19.018
therapy is really leading that charge.

00:27:19.637 --> 00:27:21.038
in that through the

00:27:21.098 --> 00:27:23.220
fellowship programs and

00:27:23.240 --> 00:27:23.940
that many of those

00:27:23.980 --> 00:27:26.000
graduates go on to be

00:27:26.442 --> 00:27:28.782
either full-time faculty or

00:27:28.942 --> 00:27:31.344
adjunct faculty leading, you know,

00:27:32.444 --> 00:27:34.806
various components of the curriculum.

00:27:35.915 --> 00:27:37.296
Yeah, you know, it's fascinating.

00:27:37.316 --> 00:27:37.876
Like you said,

00:27:38.196 --> 00:27:39.396
manual therapy has been a

00:27:39.457 --> 00:27:40.336
part of what we do.

00:27:40.376 --> 00:27:40.777
And, you know,

00:27:40.817 --> 00:27:42.038
it's certainly a part of

00:27:42.117 --> 00:27:43.417
orthopedic management.

00:27:44.278 --> 00:27:45.999
You know, you're not, you know,

00:27:46.019 --> 00:27:46.999
by putting your hands on

00:27:47.038 --> 00:27:48.138
somebody and you establish

00:27:48.159 --> 00:27:50.759
that relationship as well,

00:27:50.819 --> 00:27:51.500
and you learn how to

00:27:51.980 --> 00:27:53.080
communicate and have

00:27:53.300 --> 00:27:54.621
empathy and all the other

00:27:54.661 --> 00:27:55.721
components that are around it.

00:27:56.201 --> 00:27:59.501
But it's not even just orthopedic care.

00:27:59.582 --> 00:28:00.502
I've actually talked to a

00:28:00.563 --> 00:28:03.844
lot of the faculty within our program who,

00:28:04.223 --> 00:28:05.324
you know, employ orthopedic

00:28:05.703 --> 00:28:07.684
manual interventions across

00:28:07.825 --> 00:28:09.905
other types of settings.

00:28:09.945 --> 00:28:10.905
And I think, you know,

00:28:10.925 --> 00:28:13.386
and one of the things that for me,

00:28:13.467 --> 00:28:15.008
when it was time,

00:28:15.407 --> 00:28:17.488
when I moved from primarily

00:28:17.508 --> 00:28:18.429
teaching post-professional

00:28:18.449 --> 00:28:19.689
education to moving into

00:28:20.068 --> 00:28:22.250
entry-level education, I think I remember,

00:28:22.269 --> 00:28:23.230
I can't remember who it was

00:28:23.250 --> 00:28:24.131
that gave me this advice.

00:28:24.151 --> 00:28:24.431
They're like,

00:28:24.891 --> 00:28:25.711
but you gotta be careful

00:28:25.730 --> 00:28:27.152
because you're going to have, you know,

00:28:27.817 --> 00:28:30.198
neuro geriatric pediatric

00:28:30.377 --> 00:28:33.818
interest from students in these programs.

00:28:33.878 --> 00:28:35.038
But I have found that so I

00:28:35.078 --> 00:28:36.739
teach an advanced manual

00:28:36.778 --> 00:28:38.819
therapy class and about

00:28:38.920 --> 00:28:39.880
ninety percent of the

00:28:39.920 --> 00:28:41.881
students in our program

00:28:42.141 --> 00:28:43.840
take that advanced manual therapy class,

00:28:43.941 --> 00:28:45.101
even if they're going into

00:28:45.221 --> 00:28:48.221
pediatrics or neuro or some other realm,

00:28:48.241 --> 00:28:48.961
because I think even

00:28:49.001 --> 00:28:49.382
they're starting to

00:28:49.442 --> 00:28:51.423
recognize the importance of

00:28:51.663 --> 00:28:53.423
hands on care across all

00:28:53.462 --> 00:28:53.943
different kinds of

00:28:53.983 --> 00:28:55.784
specializations and areas.

00:28:56.576 --> 00:28:56.935
You know,

00:28:57.757 --> 00:29:02.722
I'm so hopeful that that is the case.

00:29:02.762 --> 00:29:05.285
It's not a musculoskeletal skill.

00:29:05.464 --> 00:29:05.986
Yeah,

00:29:06.105 --> 00:29:08.048
we use it a lot in musculoskeletal care.

00:29:08.067 --> 00:29:10.530
But, you know, I love when I see...

00:29:12.011 --> 00:29:13.972
the predominant neurological

00:29:14.053 --> 00:29:15.473
diagnosis patient.

00:29:15.554 --> 00:29:16.055
I mean, again,

00:29:16.875 --> 00:29:19.115
most of these disorders end

00:29:19.195 --> 00:29:21.258
up affecting the movement system.

00:29:21.758 --> 00:29:22.798
When the movement system

00:29:22.878 --> 00:29:24.398
doesn't get to go through its range,

00:29:24.900 --> 00:29:26.540
it has impairments that

00:29:26.661 --> 00:29:29.823
need some hands-on care to

00:29:29.863 --> 00:29:33.244
get them through and to ease movement.

00:29:33.325 --> 00:29:36.767
And it makes so much sense.

00:29:36.787 --> 00:29:37.067
I mean,

00:29:37.527 --> 00:29:40.108
our pediatric team at Colorado Motion,

00:29:40.128 --> 00:29:40.229
they

00:29:40.749 --> 00:29:42.371
very hands-on focused.

00:29:42.631 --> 00:29:44.932
They are manual therapy oriented.

00:29:44.972 --> 00:29:48.355
They don't think anything of it.

00:29:48.395 --> 00:29:50.678
So much have restricted movement systems.

00:29:50.739 --> 00:29:51.699
If you're not doing some

00:29:51.739 --> 00:29:53.280
type of manual intervention,

00:29:53.641 --> 00:29:55.262
you really are not offering

00:29:55.282 --> 00:29:57.464
them top-of-the-line skill set.

00:29:58.526 --> 00:29:58.885
And again,

00:29:58.925 --> 00:30:01.669
you can move on into Parkinson's,

00:30:01.729 --> 00:30:04.011
another example where, again,

00:30:04.311 --> 00:30:06.233
loss of full movements

00:30:06.273 --> 00:30:08.616
begin to create impairments

00:30:08.696 --> 00:30:10.778
at the joint soft tissue

00:30:10.960 --> 00:30:12.580
levels that make it even

00:30:13.041 --> 00:30:15.344
further difficult to move, right?

00:30:16.925 --> 00:30:17.686
Yeah,

00:30:17.707 --> 00:30:20.128
I just wish we'd get out of our silos.

00:30:20.409 --> 00:30:21.490
I mean, people are,

00:30:21.830 --> 00:30:22.832
and I just hope this new

00:30:22.892 --> 00:30:24.393
generation just sees it as, you know,

00:30:25.634 --> 00:30:27.596
this is just, it's not a silo.

00:30:27.696 --> 00:30:27.876
You know,

00:30:27.916 --> 00:30:30.038
we treat human bodies and these

00:30:30.159 --> 00:30:34.623
skill sets cross all of our quote unquote,

00:30:34.643 --> 00:30:36.325
you know, specialties of care.

00:30:37.010 --> 00:30:37.090
Yeah,

00:30:37.111 --> 00:30:37.951
I think that's something that we're

00:30:37.971 --> 00:30:38.851
kind of seeing there.

00:30:39.490 --> 00:30:39.811
All right,

00:30:39.872 --> 00:30:42.051
so we're moving along in the

00:30:42.132 --> 00:30:43.672
journey and talking about

00:30:43.711 --> 00:30:47.012
the importance of manual

00:30:47.032 --> 00:30:48.692
therapy education as a

00:30:49.573 --> 00:30:52.153
professional student level.

00:30:52.773 --> 00:30:54.874
Post-professional education

00:30:55.413 --> 00:30:56.515
is something that you're

00:30:56.555 --> 00:30:58.674
still involved in.

00:30:58.714 --> 00:30:59.755
Certainly, when we think about that,

00:30:59.795 --> 00:31:00.634
we think about orthopedic

00:31:00.694 --> 00:31:02.415
residency or residency, I should say,

00:31:02.455 --> 00:31:03.415
and fellowship education.

00:31:03.596 --> 00:31:06.781
training and what are your

00:31:07.323 --> 00:31:10.849
thoughts on that and how

00:31:10.890 --> 00:31:14.056
important that is for our profession?

00:31:15.208 --> 00:31:18.290
you know here I'll go up a

00:31:18.351 --> 00:31:19.991
level here in big picture I

00:31:20.011 --> 00:31:21.373
think you know

00:31:21.993 --> 00:31:23.214
post-professional training

00:31:23.474 --> 00:31:24.855
ongoing learning is just

00:31:26.557 --> 00:31:27.679
it's the nature of being a

00:31:27.739 --> 00:31:28.960
professional you know so

00:31:29.140 --> 00:31:31.061
whether or not you go to

00:31:31.122 --> 00:31:33.663
residency or fellowship uh

00:31:33.923 --> 00:31:35.204
hopefully at a minimum some

00:31:35.244 --> 00:31:36.707
type of certification

00:31:36.747 --> 00:31:38.667
pathway where you you go

00:31:38.909 --> 00:31:42.451
deeper into an area of practice I mean

00:31:43.251 --> 00:31:43.932
Yeah,

00:31:43.952 --> 00:31:45.594
a superficial knowledge of certain

00:31:45.634 --> 00:31:47.476
things like, you know, a patient comes in,

00:31:47.496 --> 00:31:49.136
they have a diagnosis I've

00:31:49.176 --> 00:31:50.038
never heard of.

00:31:50.057 --> 00:31:50.317
You know,

00:31:51.939 --> 00:31:53.420
I can look up to get a basic

00:31:53.460 --> 00:31:56.363
understanding of what this diagnosis is.

00:31:56.482 --> 00:31:57.604
But, you know,

00:31:58.364 --> 00:31:59.365
and I don't necessarily go

00:31:59.945 --> 00:32:01.467
deep down into that.

00:32:02.347 --> 00:32:03.328
specialization,

00:32:03.909 --> 00:32:05.530
but some specializations

00:32:06.813 --> 00:32:08.074
that are core to who I am

00:32:08.114 --> 00:32:10.316
as a professional, I need to,

00:32:10.517 --> 00:32:12.077
and you pick whatever that is,

00:32:12.137 --> 00:32:13.880
but I just feel that depth

00:32:15.201 --> 00:32:17.044
versus breadth coming out

00:32:17.084 --> 00:32:20.567
of a professional program is necessary.

00:32:20.988 --> 00:32:22.809
because you you got to go in

00:32:22.930 --> 00:32:25.051
deep and sometimes you know

00:32:25.071 --> 00:32:26.353
you go down a rabbit hole

00:32:26.393 --> 00:32:28.153
and it you find you're

00:32:28.193 --> 00:32:29.295
frustrated that you didn't

00:32:29.315 --> 00:32:30.757
get as much out of it as

00:32:30.797 --> 00:32:32.678
you wanted but actually you

00:32:32.758 --> 00:32:34.259
did because it's the

00:32:34.480 --> 00:32:36.801
discipline of driving

00:32:37.041 --> 00:32:40.085
deeper into an area of practice

00:32:40.585 --> 00:32:41.866
That allows you then to come

00:32:41.906 --> 00:32:44.410
back out and be, frankly,

00:32:44.490 --> 00:32:45.872
more efficient when you go

00:32:45.912 --> 00:32:47.153
down others as well.

00:32:47.213 --> 00:32:48.535
So I'm a big believer in

00:32:48.575 --> 00:32:51.459
whatever your passion is to

00:32:51.618 --> 00:32:53.240
go down a pathway.

00:32:53.260 --> 00:32:55.344
And I think programs have

00:32:55.364 --> 00:32:56.625
gotten better at that.

00:32:57.625 --> 00:33:01.027
of putting into modules ways to do that,

00:33:01.207 --> 00:33:01.426
again,

00:33:01.467 --> 00:33:03.326
where you could maybe do such a

00:33:03.426 --> 00:33:05.468
certification and maybe

00:33:05.488 --> 00:33:07.887
that can build on into a residency model,

00:33:08.169 --> 00:33:09.028
can build on into a

00:33:09.088 --> 00:33:10.388
fellowship type model.

00:33:10.749 --> 00:33:11.828
So I think, you know,

00:33:12.328 --> 00:33:14.230
various post-professional

00:33:14.289 --> 00:33:15.490
training programs,

00:33:15.890 --> 00:33:16.609
whether they be at the

00:33:16.730 --> 00:33:17.750
university level or

00:33:19.010 --> 00:33:20.531
private level are getting

00:33:20.592 --> 00:33:21.932
better at doing that.

00:33:22.393 --> 00:33:24.733
And I think as a consumer or student,

00:33:25.134 --> 00:33:25.673
you know, can,

00:33:26.094 --> 00:33:27.855
has more opportunities that

00:33:27.875 --> 00:33:28.875
that graduate has more

00:33:28.895 --> 00:33:30.656
opportunities to find those.

00:33:31.696 --> 00:33:34.157
So that, that's my main, I guess,

00:33:34.218 --> 00:33:35.798
takeaway of that.

00:33:36.929 --> 00:33:39.990
Yeah, no, and that's, you know,

00:33:40.029 --> 00:33:40.970
so good and so great.

00:33:41.029 --> 00:33:41.789
I know that, you know,

00:33:41.809 --> 00:33:43.049
every student is going to

00:33:43.069 --> 00:33:43.970
be a little bit different.

00:33:43.990 --> 00:33:45.891
I always talk to them about, you know,

00:33:45.931 --> 00:33:47.830
you have to self-reflect,

00:33:47.891 --> 00:33:49.050
but at some level,

00:33:49.310 --> 00:33:51.951
if you find yourself not

00:33:52.332 --> 00:33:55.192
passionate or interested in, you know,

00:33:55.652 --> 00:33:57.112
seeking more,

00:33:57.211 --> 00:33:58.893
then it's probably a

00:33:58.932 --> 00:34:00.012
reflection of other things

00:34:00.073 --> 00:34:01.553
going on as well, too,

00:34:01.573 --> 00:34:03.713
that you have to kind of think about.

00:34:03.894 --> 00:34:05.653
But there is, you know,

00:34:06.594 --> 00:34:07.955
I think you even said earlier,

00:34:07.996 --> 00:34:08.655
sometimes you have to make

00:34:08.675 --> 00:34:10.498
those those investments a

00:34:10.538 --> 00:34:11.338
little bit different in a

00:34:11.398 --> 00:34:13.460
way that maybe isn't what

00:34:13.541 --> 00:34:15.702
they're quite ready and comfortable for.

00:34:15.782 --> 00:34:16.844
But then the payout,

00:34:17.945 --> 00:34:18.766
whether it's financial

00:34:18.806 --> 00:34:19.746
payout or maybe it's just

00:34:19.766 --> 00:34:21.688
professional satisfaction,

00:34:21.768 --> 00:34:23.311
certainly comes into play

00:34:23.391 --> 00:34:25.012
as you go through those those paths.

00:34:25.592 --> 00:34:26.673
I don't speak to too many

00:34:26.713 --> 00:34:28.335
people who have gone through that.

00:34:28.956 --> 00:34:30.137
who have gone into the depths,

00:34:30.157 --> 00:34:31.498
like you've said,

00:34:31.538 --> 00:34:32.538
who have gone deep into the

00:34:32.577 --> 00:34:35.059
caves of things, come back out,

00:34:35.199 --> 00:34:36.239
maybe they come away with

00:34:36.280 --> 00:34:38.681
some some new letters, certifications,

00:34:38.721 --> 00:34:39.782
some fellowship training

00:34:39.822 --> 00:34:40.541
and things like that.

00:34:41.041 --> 00:34:41.902
They tend to be the ones

00:34:41.943 --> 00:34:46.005
that I find to be the the happiest,

00:34:46.025 --> 00:34:48.085
the healthiest, in a sense,

00:34:48.126 --> 00:34:48.905
even though it seems like

00:34:48.945 --> 00:34:50.306
they wouldn't be because of

00:34:50.327 --> 00:34:51.007
the amount of like,

00:34:51.427 --> 00:34:52.547
effort that it took to get there.

00:34:53.851 --> 00:34:56.074
And it relates to, I mean,

00:34:56.215 --> 00:34:57.577
we won't go deep into, you know,

00:34:57.958 --> 00:34:59.579
the problems of higher education,

00:34:59.619 --> 00:35:02.344
the costs, et cetera, but it's well known,

00:35:02.423 --> 00:35:02.704
right?

00:35:02.824 --> 00:35:05.427
And so part of it is, well, financially,

00:35:05.449 --> 00:35:06.389
you know,

00:35:06.530 --> 00:35:08.172
it just doesn't make sense to

00:35:08.211 --> 00:35:10.295
continue to pour more in.

00:35:11.436 --> 00:35:13.360
I clearly see the argument,

00:35:13.960 --> 00:35:15.862
and yet sometimes we don't

00:35:16.204 --> 00:35:18.146
talk about the fact that if

00:35:18.487 --> 00:35:21.190
you leave the profession, you burn out,

00:35:21.291 --> 00:35:23.994
and you leave due to dissatisfaction,

00:35:24.335 --> 00:35:25.637
which is often because you

00:35:25.657 --> 00:35:32.907
feel like you're not –

00:35:27.199 --> 00:35:29.119
successful with clients.

00:35:29.159 --> 00:35:29.699
You know, you just,

00:35:30.099 --> 00:35:30.900
you burn out because you

00:35:30.940 --> 00:35:34.603
don't get the hit that you

00:35:34.643 --> 00:35:37.083
get when people are successful, right?

00:35:37.123 --> 00:35:39.405
When you have success around

00:35:39.445 --> 00:35:41.585
you and your patients and clients are,

00:35:42.085 --> 00:35:42.967
you know, are

00:35:43.527 --> 00:35:44.748
have gratitude and show

00:35:44.788 --> 00:35:45.788
gratitude towards you,

00:35:46.108 --> 00:35:47.068
you feed off of that.

00:35:47.309 --> 00:35:48.670
And, you know,

00:35:49.489 --> 00:35:51.590
it now does not become work.

00:35:51.650 --> 00:35:52.652
It becomes passion.

00:35:52.692 --> 00:35:54.773
It becomes truly your

00:35:54.813 --> 00:35:55.873
professional journey.

00:35:56.494 --> 00:35:59.054
And I do think that there's

00:35:59.074 --> 00:36:00.675
a cost if you don't have that,

00:36:00.695 --> 00:36:01.996
because you probably will

00:36:02.317 --> 00:36:03.838
leave the profession early, you know,

00:36:03.858 --> 00:36:05.818
which is a financial issue.

00:36:05.978 --> 00:36:06.760
hit whether you have to

00:36:06.800 --> 00:36:08.601
retrain your skill set,

00:36:09.501 --> 00:36:11.423
which you will into something else or,

00:36:11.824 --> 00:36:13.485
you know, some other type of thing.

00:36:13.545 --> 00:36:15.527
And so I think that's,

00:36:15.586 --> 00:36:18.188
it is that long game where you, you know,

00:36:18.809 --> 00:36:20.030
you have to kind of play

00:36:20.070 --> 00:36:21.052
and there's no right answer

00:36:21.092 --> 00:36:24.014
for an individual, these big,

00:36:24.034 --> 00:36:24.934
broad statements,

00:36:24.974 --> 00:36:26.155
but I do think it's worth

00:36:26.836 --> 00:36:28.117
looking at it that way.

00:36:28.177 --> 00:36:29.518
The people that go in deep,

00:36:30.083 --> 00:36:33.085
They generally come out passionate,

00:36:33.806 --> 00:36:34.646
understanding,

00:36:35.467 --> 00:36:37.210
and have this longer

00:36:37.630 --> 00:36:39.351
longevity in the profession

00:36:39.652 --> 00:36:42.614
because they just, they, they,

00:36:43.394 --> 00:36:44.635
results improve.

00:36:44.996 --> 00:36:46.577
And because of that, you know,

00:36:46.637 --> 00:36:48.639
feedback from patients improves.

00:36:49.764 --> 00:36:50.744
So I want to take us on a

00:36:50.784 --> 00:36:51.505
little bit of a different

00:36:51.525 --> 00:36:53.188
adventure before we conclude this show,

00:36:53.548 --> 00:36:54.570
because I think, you know,

00:36:54.590 --> 00:36:55.210
there was an article that

00:36:55.231 --> 00:36:56.572
just came out in JOSPT.

00:36:56.652 --> 00:36:57.494
It was a really good one.

00:36:57.534 --> 00:36:59.137
It was advice to the new grad.

00:36:59.177 --> 00:36:59.376
Right.

00:36:59.416 --> 00:37:01.400
It was, I think, Jeremy Lewis,

00:37:01.440 --> 00:37:02.501
Chad Cook and a few others

00:37:02.541 --> 00:37:03.583
were on that paper.

00:37:03.643 --> 00:37:04.202
Really nice paper.

00:37:04.943 --> 00:37:06.304
um but here's what I want to

00:37:06.445 --> 00:37:10.126
ask you because uh I think

00:37:10.146 --> 00:37:11.586
a lot of our listeners

00:37:11.746 --> 00:37:12.907
especially academy

00:37:12.947 --> 00:37:15.248
listeners potentially are

00:37:15.489 --> 00:37:16.469
you know a lot of our

00:37:16.509 --> 00:37:18.110
membership is fellows um a

00:37:18.130 --> 00:37:18.909
lot of our mentor

00:37:19.070 --> 00:37:20.431
membership are people who

00:37:20.471 --> 00:37:21.110
may be thinking about

00:37:21.130 --> 00:37:21.851
fellows of course not

00:37:21.911 --> 00:37:22.751
everybody there's also

00:37:22.851 --> 00:37:24.693
non-fellow members but they

00:37:24.713 --> 00:37:26.253
also have potentially have

00:37:26.273 --> 00:37:27.873
gone down a lot of depths and and

00:37:28.855 --> 00:37:30.596
holes in their lives as well.

00:37:31.175 --> 00:37:33.157
So I want to go into the

00:37:34.478 --> 00:37:35.960
post-professional

00:37:36.440 --> 00:37:38.181
educational journeys and

00:37:38.221 --> 00:37:40.563
get some of your thoughts on that.

00:37:40.663 --> 00:37:43.565
So you're the seasoned person.

00:37:43.585 --> 00:37:45.427
You have had some successes.

00:37:45.467 --> 00:37:46.728
You do feel like you are

00:37:47.208 --> 00:37:48.789
effective in a sense,

00:37:49.630 --> 00:37:52.231
but you're no longer in that sort of

00:37:52.711 --> 00:37:55.817
you know, game of trying to, you know,

00:37:55.896 --> 00:37:57.338
build sort of this

00:37:58.659 --> 00:38:00.081
repertoire or resume of

00:38:00.483 --> 00:38:01.985
certain types of things.

00:38:02.405 --> 00:38:02.945
You know, what,

00:38:02.985 --> 00:38:03.686
what does that post

00:38:03.746 --> 00:38:05.329
post-professional education

00:38:05.730 --> 00:38:08.353
look like in your mind, I guess?

00:38:08.393 --> 00:38:08.673
Curious.

00:38:09.329 --> 00:38:10.210
Yeah, I mean,

00:38:10.230 --> 00:38:11.431
I think that's when you enter

00:38:11.471 --> 00:38:13.373
the phase that you truly

00:38:13.413 --> 00:38:15.494
are a self-directed learner

00:38:15.536 --> 00:38:18.458
that you can really continue to grow by.

00:38:19.940 --> 00:38:21.320
You seek out new knowledge

00:38:21.360 --> 00:38:22.802
and you get more efficient

00:38:22.842 --> 00:38:24.304
at seeking out new knowledge.

00:38:24.925 --> 00:38:27.668
But I think that person, you know.

00:38:28.889 --> 00:38:29.009
It.

00:38:29.809 --> 00:38:31.811
I don't look at it as an

00:38:31.911 --> 00:38:33.552
obligation to teach,

00:38:34.074 --> 00:38:36.235
whether it be being a

00:38:36.275 --> 00:38:39.157
clinical instructor for an entry level,

00:38:39.478 --> 00:38:40.739
whether it be a mentor for

00:38:40.759 --> 00:38:42.139
a resident or fellow.

00:38:44.222 --> 00:38:46.204
I think it's very selfish

00:38:46.784 --> 00:38:48.846
that you should do it for selfish reasons,

00:38:49.085 --> 00:38:52.768
because that to me is that next phase.

00:38:54.190 --> 00:38:55.791
And you may have been doing it all along.

00:38:56.206 --> 00:38:57.606
but you're doing it with a really,

00:38:58.166 --> 00:39:00.268
you know, different intent of, you know,

00:39:00.407 --> 00:39:01.869
I want that new learner to

00:39:01.909 --> 00:39:04.670
challenge me on what is my

00:39:04.690 --> 00:39:06.610
belief structure and what's

00:39:06.911 --> 00:39:09.791
going on and this back and forth nature,

00:39:09.831 --> 00:39:13.713
which then, you know, keeps me learning,

00:39:13.873 --> 00:39:15.474
if you will, going on.

00:39:15.534 --> 00:39:17.315
So, I mean, I think that's, you know,

00:39:17.335 --> 00:39:19.297
just continuing to be engaged with,

00:39:19.677 --> 00:39:19.976
you know,

00:39:20.117 --> 00:39:21.858
from a teaching perspective in

00:39:21.918 --> 00:39:22.657
whatever form,

00:39:22.697 --> 00:39:24.498
whether it be at the university or in the

00:39:24.798 --> 00:39:25.980
clinical environment.

00:39:26.521 --> 00:39:29.242
The second thing I would say

00:39:29.443 --> 00:39:32.945
is going in different directions.

00:39:33.206 --> 00:39:35.447
And that I think is key.

00:39:36.849 --> 00:39:40.391
I really have broadened, I mean, I've been,

00:39:41.032 --> 00:39:43.894
I think, holistic and open to a lot of

00:39:44.514 --> 00:39:45.755
New ideas, you know,

00:39:46.695 --> 00:39:47.896
as we learn more about the

00:39:47.936 --> 00:39:49.038
neuroscience of pain

00:39:49.057 --> 00:39:50.157
mechanisms and things in

00:39:50.177 --> 00:39:53.480
the last two decades and learning that.

00:39:53.519 --> 00:39:55.561
But then that exposes you to the fact that,

00:39:55.621 --> 00:39:56.802
oh, my gosh, you know,

00:39:56.961 --> 00:39:58.922
look at the gut and the gut

00:39:59.023 --> 00:40:00.923
microbiome and how, wow,

00:40:01.123 --> 00:40:02.505
how this is affecting you.

00:40:02.804 --> 00:40:05.146
you know, all these systems that I've been,

00:40:05.648 --> 00:40:07.630
you know, teasing and using my hands with,

00:40:08.130 --> 00:40:10.972
and I haven't really been addressing that,

00:40:11.333 --> 00:40:11.632
you know,

00:40:12.034 --> 00:40:14.056
the same with breath work and breathing.

00:40:14.135 --> 00:40:15.916
I haven't been as detailed

00:40:16.177 --> 00:40:18.860
and had a deep understanding of that,

00:40:18.940 --> 00:40:20.922
how that interplays in what

00:40:20.961 --> 00:40:23.003
I'm doing with my manual interventions.

00:40:23.463 --> 00:40:25.465
And so taking those elements

00:40:25.485 --> 00:40:28.509
that compliment my core, you know,

00:40:28.909 --> 00:40:31.789
a clinical acumen and making

00:40:31.829 --> 00:40:35.771
sure I'm bringing those into my skill set,

00:40:35.992 --> 00:40:37.032
you know, and again,

00:40:37.072 --> 00:40:38.213
the same way you got to go

00:40:38.333 --> 00:40:41.835
deep sometimes to kind of

00:40:41.875 --> 00:40:43.195
end up only pulling one or

00:40:43.235 --> 00:40:44.695
two things that, oh yeah, this is my,

00:40:45.135 --> 00:40:46.556
I always kind of do this

00:40:46.637 --> 00:40:48.496
now with patients, you know, it's,

00:40:48.697 --> 00:40:49.217
you know,

00:40:49.277 --> 00:40:51.139
and I think our role obviously

00:40:51.159 --> 00:40:52.119
is distiller, right?

00:40:52.139 --> 00:40:52.318
You know,

00:40:52.338 --> 00:40:53.539
we start with a wide range of

00:40:53.599 --> 00:40:54.340
information and

00:40:54.833 --> 00:40:55.592
which is out there,

00:40:55.612 --> 00:40:56.554
but how do we make it

00:40:56.634 --> 00:40:58.514
really actionable to my

00:40:58.574 --> 00:41:00.355
patients in front of me?

00:41:00.815 --> 00:41:02.076
So I think that's the next

00:41:02.255 --> 00:41:02.835
phase of the

00:41:03.876 --> 00:41:05.257
post-professional phase is

00:41:05.336 --> 00:41:07.757
really taking newer ideas

00:41:09.199 --> 00:41:12.760
and integrating those into

00:41:12.820 --> 00:41:14.280
practice and then

00:41:14.840 --> 00:41:16.961
challenging the folks

00:41:16.981 --> 00:41:18.643
you're working with and teaching,

00:41:19.282 --> 00:41:20.483
what do you think about this?

00:41:20.563 --> 00:41:21.204
And this is my

00:41:22.023 --> 00:41:24.585
mindset is that out there, this is why,

00:41:24.626 --> 00:41:26.447
you know, watch me do this with a patient,

00:41:26.527 --> 00:41:29.168
you know, is what do you think of that?

00:41:29.208 --> 00:41:31.710
Is that, you know, good, bad, indifferent,

00:41:32.010 --> 00:41:32.771
you know, again,

00:41:32.952 --> 00:41:35.353
asking for feedback and

00:41:35.393 --> 00:41:37.494
hopefully feedback that is not just,

00:41:37.835 --> 00:41:39.675
you know, as I say, good job,

00:41:41.836 --> 00:41:43.117
something that's actionable

00:41:43.177 --> 00:41:45.880
and actually critical that allows you to,

00:41:45.900 --> 00:41:47.300
to, to, to improve.

00:41:48.338 --> 00:41:49.179
No, I'm glad you did that.

00:41:49.199 --> 00:41:51.440
It was actually, I kind of,

00:41:52.300 --> 00:41:53.360
you took the bait because I

00:41:53.400 --> 00:41:55.362
wanted you to go down that path.

00:41:55.382 --> 00:41:56.222
The only reason I wanted you

00:41:56.242 --> 00:41:56.963
to go down that path is

00:41:57.003 --> 00:41:58.202
it's something I've actually seen,

00:41:58.704 --> 00:42:00.143
not just from you, but from other,

00:42:00.503 --> 00:42:03.626
you know, folks who I have respected,

00:42:03.686 --> 00:42:05.626
where it's not just rinse

00:42:05.666 --> 00:42:07.166
and repeat after you've had

00:42:07.186 --> 00:42:08.467
your post-professional education,

00:42:08.487 --> 00:42:08.827
where you just

00:42:09.940 --> 00:42:11.503
I've made it to the mountain

00:42:11.903 --> 00:42:12.603
and now I'm just going to

00:42:12.623 --> 00:42:13.826
kind of do what I'm going to do.

00:42:13.846 --> 00:42:14.567
And I think that that

00:42:14.746 --> 00:42:16.568
becomes sort of frustrating

00:42:16.588 --> 00:42:17.150
for the post

00:42:17.510 --> 00:42:19.213
post-professional phase of

00:42:19.253 --> 00:42:19.833
somebody's career.

00:42:19.853 --> 00:42:20.474
That's something that I've

00:42:20.514 --> 00:42:22.737
always seen that I think

00:42:22.797 --> 00:42:24.518
very healthy people start

00:42:24.539 --> 00:42:25.740
to look at things very differently.

00:42:25.780 --> 00:42:27.083
And you can be sort of,

00:42:27.643 --> 00:42:29.045
focused and myopic in some

00:42:29.125 --> 00:42:30.987
sense and still go into a

00:42:31.027 --> 00:42:32.090
lot of depths or you can

00:42:32.570 --> 00:42:33.672
now start to expand your

00:42:33.692 --> 00:42:35.855
breadth like you have done and certainly,

00:42:35.934 --> 00:42:36.235
you know,

00:42:36.315 --> 00:42:37.858
look at things a bit differently.

00:42:37.918 --> 00:42:39.300
But I think that that's part

00:42:39.340 --> 00:42:40.481
of that excitement for a

00:42:40.521 --> 00:42:42.905
lot of folks is that now you can go and

00:42:43.365 --> 00:42:44.286
And see how everything

00:42:44.347 --> 00:42:45.628
functions and integrates a

00:42:45.648 --> 00:42:47.269
little bit differently there as well.

00:42:47.490 --> 00:42:48.652
But so I wanted you to

00:42:48.672 --> 00:42:49.472
actually say that because

00:42:49.492 --> 00:42:51.474
that's something that I've seen you do.

00:42:51.514 --> 00:42:53.577
I'm like, oh, what is Tim doing now?

00:42:53.597 --> 00:42:55.298
Like this was not Tim from

00:42:55.358 --> 00:42:56.360
two thousand two.

00:42:56.780 --> 00:42:58.762
This is Tim from twenty twenty four.

00:42:58.822 --> 00:42:59.583
And it's and it's got a

00:42:59.603 --> 00:43:01.204
little it's got some Tim still,

00:43:01.244 --> 00:43:02.085
but then it's got a lot of

00:43:02.126 --> 00:43:03.887
other integrated things as

00:43:03.907 --> 00:43:04.748
a component to what you do.

00:43:05.916 --> 00:43:07.777
And I think that is that

00:43:07.818 --> 00:43:08.878
lifeline learning.

00:43:09.119 --> 00:43:10.780
I mean, it's thrown around all the time,

00:43:10.820 --> 00:43:12.222
but frankly,

00:43:12.681 --> 00:43:16.945
I do it for pure selfish reasons.

00:43:17.005 --> 00:43:20.608
I mean, from a neurocognitive perspective,

00:43:20.688 --> 00:43:23.150
I want to be as bright and

00:43:24.331 --> 00:43:26.414
keep my brain as healthy as I can, right?

00:43:26.934 --> 00:43:29.175
We know that that's do novel things,

00:43:29.315 --> 00:43:30.275
learn new things.

00:43:30.335 --> 00:43:32.777
I mean, and why not learn things that,

00:43:33.177 --> 00:43:33.498
you know,

00:43:33.818 --> 00:43:35.159
you're passionate about and can

00:43:35.260 --> 00:43:37.561
actually make a difference, you know,

00:43:37.621 --> 00:43:40.222
and I do a lot of these things just,

00:43:40.402 --> 00:43:42.744
you know, and chat with people, you know,

00:43:42.784 --> 00:43:43.005
at the,

00:43:43.525 --> 00:43:45.686
a cocktail party or dinner party about,

00:43:45.987 --> 00:43:47.186
Hey, I read about this.

00:43:47.226 --> 00:43:48.168
This is pretty cool.

00:43:48.208 --> 00:43:49.268
Or I listened to this podcast.

00:43:49.288 --> 00:43:50.208
What do you think?

00:43:50.728 --> 00:43:51.409
And, you know,

00:43:51.849 --> 00:43:54.090
do you integrate this into your life,

00:43:54.130 --> 00:43:56.072
you know, and how does that play?

00:43:56.132 --> 00:43:57.652
And I think that's just that

00:43:57.693 --> 00:43:58.994
natural curiosity.

00:43:59.034 --> 00:43:59.653
You gotta,

00:43:59.833 --> 00:44:01.554
you have to have in that

00:44:01.815 --> 00:44:03.036
post-professional area.

00:44:03.597 --> 00:44:04.097
And it's,

00:44:04.677 --> 00:44:05.318
I'll say this.

00:44:05.398 --> 00:44:06.119
It's interesting.

00:44:06.139 --> 00:44:07.239
When I went to Fort Collins

00:44:07.280 --> 00:44:08.721
in two thousand three,

00:44:10.083 --> 00:44:11.684
there's Colorado has some

00:44:11.744 --> 00:44:12.824
excellent clinicians.

00:44:13.365 --> 00:44:14.686
I'll say that straight up.

00:44:14.746 --> 00:44:16.009
Just really,

00:44:16.268 --> 00:44:17.971
it was a very open state for

00:44:18.010 --> 00:44:19.952
private practice for, you know,

00:44:19.992 --> 00:44:21.994
from the sixties and seventies.

00:44:22.014 --> 00:44:22.235
You know,

00:44:22.275 --> 00:44:24.996
so it's a very open state in that regard.

00:44:25.018 --> 00:44:26.639
You know, lots of people, you know,

00:44:26.659 --> 00:44:28.501
hanging shingles and doing things.

00:44:29.010 --> 00:44:29.592
And there was a good

00:44:29.771 --> 00:44:33.195
practice in town and that was doing,

00:44:33.215 --> 00:44:33.436
you know,

00:44:34.157 --> 00:44:35.518
was really into the certain

00:44:35.719 --> 00:44:38.262
technique set and that

00:44:38.523 --> 00:44:40.224
started in the mid nineties.

00:44:40.585 --> 00:44:42.027
And now it's already, you know,

00:44:42.088 --> 00:44:42.989
now let's say about two

00:44:43.009 --> 00:44:44.670
thousand five starting to

00:44:44.690 --> 00:44:47.474
see patients coming from that.

00:44:48.135 --> 00:44:51.219
area and an excellent clinician,

00:44:52.019 --> 00:44:53.942
but a couple of patients would say, well,

00:44:54.501 --> 00:44:56.143
yeah, I'd go, I was going to him,

00:44:56.184 --> 00:44:57.766
but he's still doing the

00:44:57.806 --> 00:45:00.588
same things he was doing back then.

00:45:01.309 --> 00:45:02.771
And it stuck with me.

00:45:03.612 --> 00:45:04.873
And

00:45:06.255 --> 00:45:07.416
Doing it well, and again,

00:45:07.596 --> 00:45:09.536
because I don't believe whatever you do,

00:45:09.597 --> 00:45:10.697
you do it well,

00:45:10.958 --> 00:45:12.278
you're going to get good results.

00:45:12.298 --> 00:45:13.940
And I do think there's some

00:45:14.400 --> 00:45:18.083
agnostic nature to the technique,

00:45:18.123 --> 00:45:18.704
if you will.

00:45:18.744 --> 00:45:22.206
But it stuck in my mind like, well,

00:45:22.606 --> 00:45:23.586
I don't want to be that.

00:45:23.766 --> 00:45:25.128
I don't want to just be

00:45:25.168 --> 00:45:28.550
doing the same thing, you know,

00:45:28.590 --> 00:45:30.032
ten years from now that I'm doing now,

00:45:30.132 --> 00:45:31.353
even five years from now.

00:45:31.733 --> 00:45:32.972
you know that I need to

00:45:33.012 --> 00:45:34.193
continue to grow because

00:45:34.594 --> 00:45:35.534
man the explosion of

00:45:35.574 --> 00:45:37.153
knowledge if if I'm doing

00:45:37.193 --> 00:45:38.713
the same thing I'm all this

00:45:38.753 --> 00:45:39.954
stuff I've read about that

00:45:40.474 --> 00:45:42.315
you know that I don't want

00:45:42.355 --> 00:45:43.936
to be you know so I do

00:45:43.956 --> 00:45:44.896
think there's a lot to be

00:45:44.956 --> 00:45:46.335
said for that and we have

00:45:46.376 --> 00:45:47.775
to challenge our colleagues

00:45:48.135 --> 00:45:49.956
and friends more our friend

00:45:50.217 --> 00:45:51.336
friendly colleagues say man

00:45:51.757 --> 00:45:52.737
you know don't you gotta

00:45:53.077 --> 00:45:55.137
you gotta move on and I always I'm

00:45:56.057 --> 00:45:57.438
to the point where sometimes I'll,

00:45:57.958 --> 00:45:59.458
I have a really good lecture and I,

00:45:59.579 --> 00:46:01.320
I won't repeat it because I'm like, Oh,

00:46:01.380 --> 00:46:02.159
if there's one or two

00:46:02.199 --> 00:46:04.260
people that have heard it, um, you know,

00:46:04.280 --> 00:46:06.701
I don't want to, you know, you know,

00:46:06.721 --> 00:46:07.621
I want to bore them.

00:46:07.701 --> 00:46:07.940
Right.

00:46:07.981 --> 00:46:09.121
You know, and there's,

00:46:09.141 --> 00:46:09.942
I think there's a fine

00:46:09.981 --> 00:46:11.282
dance because like knowledge,

00:46:11.342 --> 00:46:14.983
you have to get some reps at stuff and to,

00:46:15.422 --> 00:46:17.463
to embody it both as the giver,

00:46:17.503 --> 00:46:19.204
but also as a receiver, you know,

00:46:19.304 --> 00:46:20.465
but you just don't want,

00:46:20.505 --> 00:46:21.625
I just don't want to be stale.

00:46:21.864 --> 00:46:21.965
Yeah.

00:46:23.978 --> 00:46:24.780
You don't have those same

00:46:24.820 --> 00:46:26.300
stories all the time coming across.

00:46:26.780 --> 00:46:27.681
I don't think you're going to be stale.

00:46:28.342 --> 00:46:28.822
Well, Tim,

00:46:28.963 --> 00:46:29.903
I know that we're getting close

00:46:29.923 --> 00:46:31.284
to the end of this,

00:46:32.166 --> 00:46:33.246
the time that we had here.

00:46:33.266 --> 00:46:35.429
And I just want to, you know,

00:46:35.449 --> 00:46:36.369
thank you very much for

00:46:36.489 --> 00:46:39.032
spending time with us today

00:46:39.271 --> 00:46:40.833
to have this conversation.

00:46:40.853 --> 00:46:41.594
I know that we can probably

00:46:41.614 --> 00:46:42.253
have a lot of other

00:46:42.293 --> 00:46:43.414
conversations about a lot

00:46:43.454 --> 00:46:46.097
of other things that I wanted to today.

00:46:46.797 --> 00:46:48.539
But my hope is that at least

00:46:48.579 --> 00:46:50.141
folks can kind of see, you know,

00:46:50.161 --> 00:46:51.384
the importance of, you know,

00:46:51.603 --> 00:46:52.905
not just manual therapy education,

00:46:52.925 --> 00:46:53.826
but just education in

00:46:53.885 --> 00:46:56.369
general and how that, you know,

00:46:56.429 --> 00:46:59.012
enhances what we can do.

00:46:59.072 --> 00:47:00.994
And I appreciate your

00:47:01.014 --> 00:47:01.976
spending time with us today.

00:47:02.987 --> 00:47:05.588
Well, it's been a pleasure as always,

00:47:05.628 --> 00:47:06.128
Derek.

00:47:06.268 --> 00:47:07.628
It's fun to have these conversations.

00:47:07.668 --> 00:47:10.509
And I do hope the listeners out there,

00:47:11.168 --> 00:47:11.489
you know,

00:47:12.170 --> 00:47:14.309
will have these conversations

00:47:14.429 --> 00:47:15.730
amongst themselves.

00:47:15.791 --> 00:47:16.851
And please reach out to me

00:47:16.891 --> 00:47:19.692
if you want to chat because

00:47:19.851 --> 00:47:21.371
this area is I'm passionate about.

00:47:21.391 --> 00:47:22.351
Awesome.

00:47:22.411 --> 00:47:23.193
We will do.

00:47:23.273 --> 00:47:23.532
All right.

00:47:23.552 --> 00:47:24.413
Well, thank you so much, Tim.

00:47:24.432 --> 00:47:24.672
There we go.