Come on.
There we are.
And we're live.
I did that myself.
I shot the aerial drone.
No, I didn't.
That's just stock imagery.
You flew by.
I flew by.
That was me flying in on the jet,
which was nice.
Metaglasses.
I feel like it's hangover day.
You get all excited on day one of
CSM, and you can tell.
It sounds like I...
had some gravel i got some gravel in
my voice uh lewis has been on the
show before lewis welcome back bright and
early i appreciate people who come here
and they're like i'm gonna schedule nine
a.m because i want to knock this out
because there's five hundred other things
yes how many csms is this for you
ballpark i don't know why i always ask
that but i'm always curious first one
speaking no good for you thank you and
then tell everybody what we're talking
about
So today I think we're going to talk
about the importance of growing as a new
grad before jumping into anything from a
business sense.
I think you've got to find your mentors,
be a mentee,
get your feet wet and then learn the
ropes before trying to learn different
ropes.
Yeah, I mean,
because in the first couple of years,
it sounds like in the profession you're
Studying a thing and doing a thing are
two different things.
So you're doing a new thing,
and then business is also wild.
Yeah, totally, totally.
And obviously speaking firsthand,
just opened up a practice,
but that's a whole new learning curve in
and of itself.
And I don't think that it could have
been done without having felt established
as a clinician first and foremost.
Yeah, it's hard to...
It's hard to produce force when both feet
are off the ground.
So you gotta be stable on one,
not to make the metaphor,
but you have to be,
you can't be worrying about both.
Yeah, one hundred percent.
I mean,
I think I had a pretty strong clinical
foundation coming right out of school.
Did a fellowship with Kevin Wilk.
Even then,
the second I get to my initial practice
where it was somewhat of a volume-based
clinic,
there was multiple times where I'm
spinning my head and thinking to myself,
where is he?
Can I ask him a question?
That's not quite the case.
If you don't have that foundation already
and now you're trying to also understand
insurance or payroll or cash or taxes or
rent and that check comes and it's not
going away and you got to figure it
out.
I think getting established first and
foremost and realizing that you got into
this profession to be a professional first
and foremost so Getting that getting that
grounded is first and foremost important I
so so our students which I just heard
him a loudspeaker make up three thousand
you know, people here at CSM,
which I think that attendance was
announced as fifteen.
So students between three and four
thousand.
Are they being sold the wrong success
narrative?
Like,
are they being are they being directed in
the wrong way?
I think to some extent.
Right.
I mean, you know,
and maybe it's just my my algorithm and
my feed,
but it's like you're a doctor of physical
therapy.
You have every right to go out and
make your own keep and be a business
owner and you don't need X,
Y and Z years experience.
But
that becomes all too different when
someone's potentially coming in, you know,
I'm in a cash-based setting and they're
coming to me and paying out of pocket.
They're not utilizing their insurance
benefits and they expect results.
And if you don't know how to get
those and you haven't gotten your feet wet
enough, and I think, you know,
we talk about the metaphor of ten thousand
hours to become an expert or whatever it
is.
And if you don't have those ten thousand
hours under your belt, you know,
how are you going to provide value for
someone,
especially when they're
The only thing I was really worried about
is like going on your own.
Who are you going to do the looking
around the room for?
Yeah.
And it doesn't need to be the same
person,
but it should be someone who's maybe a
few miles down the road or at least
you said, I've seen that before.
I've heard that before.
I've done that before.
I've failed that before.
Yeah, totally.
And I get that question asked all the
time, you know, from new grads.
It's like, you know,
know what should i take from this
conference or how do i go about like
my clinical growth or development and i
think first and foremost is find the
person that you resonate with who you
think has made those same mistakes is in
that same position that you want to be
with and then have the understanding of of
you know mentorship should not always be
spoon fed to you you have to be
a good mentee and understand that you know
a person providing mentorship that's
that's another job for them right uh as
well so there's a right time and a
place to kind of seek that mentorship ask
those questions expect to
receive answers from them as well,
because they have a life,
they have a profession,
they have goals as well,
and now you're an additional part of that
goal,
so don't just assume that it's always
gonna be there.
That I will give a little grace,
because that was the same thing.
When you're in sixth grade,
the next grade you go to is seventh
grade, and then there's eighth grade.
There's always a thing for you,
and then all of a sudden when you're
done, it's like, well,
then you go to college,
and there's another step,
then you're in graduate school,
and then that's beaten into you.
There's always a step.
Where's the syllabus?
And I'm like, my man, the syllabi.
have left the building they have left the
chat um and that's not easy to get
used to when you've done well let's do
the twelve years in you know through high
school another four number three you're
you're you're in you're in yeah you know
close to twenty years worth of being led
and fed and that ain't that ain't how
it happens anyway you've got to now seek
out
Yeah.
There's no more yellow brick road.
Right.
Yes.
That's a great,
that would be a great title for a
talk.
The yellow brick road ends right here.
Meet the Oz himself, but it is,
it is, uh, that's a great point.
And, you know, I think,
I think having your own goals and that
that's kind of the importance of coming to
conferences like this.
And, you know, I think personally,
even as a practicing clinician,
I always try to have something separate on
the docket to stay motivated,
whether that's
preparing for a conference or a small talk
like this or just something that's
non-clinical focused,
even if it's a personal goal,
professional goal, in-clinic goal,
but something to break the monotony per se
and keep that path moving.
Why is more not always better in rehab?
Because some is good, none is bad,
but more must be better.
Why is that not actually...
I flip that model and I say better
is better.
I treat young active adults and youth
athletes and
More is more is more is more is
more.
I mean,
the very first thing that I bought when
I opened the clinic was a whiteboard.
And we're going to break down what it
is that you're doing today, tomorrow,
this week, this month, this year for X,
Y, and Z tournament.
That's the next most important thing that
we all know doesn't really matter.
uh all in all too much so i
i always try to flip it as better
is better uh at certain points more is
better when it's appropriate when it's
appropriate when more is needed more is
good yeah yeah i think a lot of
the time these individuals they need to
almost flip it off you know they're so
high stress driven so motivated at least
the population i see
And half the conversation I'm having is
let's tap into that parasympathetic.
You need sleep.
You need hydration.
You need recovery.
You need stress management.
And then they want the next recovery
modality, which you can find here.
Oh, yeah.
That'll fix me.
And I think those are all a part
of rehab.
I think modalities get a knock to some
extent, but they're great adjuncts.
You know,
they can be extremely beneficial as an
adjunct.
You know,
you can't avoid the basic principles and
you're loading and you're.
you know,
your formula to get back with some return.
But at the end of the day, recovery,
sleep, hydration, nutrition,
stress management.
Well,
you brought up something I didn't know we
were going to go in that direction.
You're on Long Island.
Yeah.
I'm from New York.
And, like,
now the time in twenty twenty six youth
sports is not these kids today was not
me.
I mean,
I the look on my parents face.
If I said I'm going to go on
a baseball tournament and it's three hours
away,
my parents would still be on the floor
laughing.
And now I got buddies.
My buddy's kid is on a hockey team.
I live in upstate New York.
He's on a team in Boston.
That's his home team.
So Long Island is hockey, lacrosse,
baseball.
I mean, there's softball, everything.
How much of the education is that to
the parent first and the kid, which is,
hey, listen,
more playing is actually the reason you
are here.
Yeah, totally.
So my clinic is located within an indoor
performance facility.
Oh, a check pot.
I mean, teams rent out the turf space.
There's a gym in the back,
but it is, I mean,
it's a very good random of just kids
coming in.
And sometimes you don't see kids leave
because they're there all day.
And I try to explain to the parent
is, and the kid is,
you have to be a kid first.
You have to be an athlete second,
play all the things, but don't overdo it.
And then be a blank player.
Cause when they come in for me and
it's like, oh, my leg hurts or my,
this hurts.
It's like, well, what do you play?
And they're like,
baseball or soccer and I'm like okay what
else they're like no dummy like I'm that
player and I'm like really you're twelve
like why don't we like get good at
being a child and then get good at
like moving exploring doing things and
then hone in on
a sport itself, but yeah,
parental education, I think is the key.
You got to tap into them because,
you know, from a,
I'm not quite a parent myself yet,
but from a parent's perspective,
they just want to do the best for
their kid and their friends are playing,
they want them involved and they want to,
you know, see them succeed.
But, uh, to an extent, you know,
there's gotta be a line.
Yeah.
And we know like the fun part is,
and I've actually read research and I'll
find the paper,
which is research says that statement is,
turns people's brain off so when you're
like well research says people are just
like like you've just muted me for twenty
eight seconds but you know the research
probably better than me like when you
track Cy Young winners Super Bowl
quarterbacks and you like hey what was
your high school career they're like I
played soccer and this and this and this
it's never I was just a quarterback never
never never the best athletes I see are
the ones that have done it all because
they're an athlete they've had movement
exposure they've had the ability to adapt
and explore and do and
And then they hone in on a specific
skill because they have an overall skill
set.
Who's your talk for?
Who are you excited when that person
walks?
Who are you hoping shows up and sits
down?
Here or in my clinic?
In your clinic.
Like, who are you excited for?
Oh, I mean,
I love treating the young active
individual,
whether that's an adult who's still trying
to, you know,
play with their friends on the weekends or
with their kids or whatever it may be
or the youth athlete.
But my passion is in shoulder, elbow,
knee.
Seasonally,
it varies what I'm going to get the
most of.
ACL, UCL,
I try to say I treat the CLs
and then labrums as well.
How funny is it that, like,
twenty years ago, you could...
Nobody knew it.
Like the average person did not know what
an ACL was.
Right.
They knew Tommy John surgery.
They didn't know what a UCL was.
And now parents, I mean, my friends, kids,
like the coach said,
I should get an MRI.
And I'm in the back,
just biting my lip going, listen,
I don't even, I don't practice anymore,
but I'm going, ask the coach.
What are the two things that could happen?
Yeah.
So it's, it's injured or, you know,
it's torn or it's not.
What do we do then?
What if we just pretend like we're going
to get the MRI?
It's going to cost a grand.
And I'm like,
Okay.
Yeah, I mean,
I've had the scarier situation of a
physician even telling me that someone
walked into the clinic and was like, yeah,
we're ready for the surgery.
He's like, what do you mean?
They're like, well,
he's going to throw harder after.
So we're ready for it.
I'm like, excuse me.
Well,
he's going to throw harder because he's
going to finally take rest and he's going
to readapt to his entire body.
He's going to train his legs.
He's going to train his core.
He's going to finally train his shoulder,
get a good routine and learn how to
be an athlete that is required for that
sport.
You know what ruined it?
Angels in the outfield.
Henry Rowan Gardner.
Right.
I still see that.
Oh, yeah.
How about talking here?
Who are you excited to who do you
want to walk into the room?
Well, we had a great turnout yesterday.
It was awesome as myself, Kevin Wilk,
and then two fellows after me from ASMI,
Zach Thomas,
who's now with Stedman Hawkins and part
time with the PGA and Morgan Ivey,
who is currently serving as the rehab
coordinator for the St.
Louis Cardinals.
So
A lot of them with better credentials than
I have.
I'm just a simple PT from Long Island,
but those three have the credentials
beyond me.
We spoke about the integration of
neurocognitive or neuromuscular rehab as
it pertains to the upper extremity
athlete.
So a lot of literature out there
pertaining to the lower.
We know that with ACLs,
you kind of have to provide these
external...
cues,
this visual feedback to sort of override
the individual system,
but same thing starting to happen at the
shoulder.
And we just tried to take a framework
from a clinical commentary that we wrote
last year, you know,
giving ideas on how to put those
principles in from early phase through
return to sport as it pertains to the
knee, and then just try to, you know,
reintegrate that same framework as someone
can do it for the upper extremity,
you know, both shoulder and elbow too,
because it goes overlooked.
One of the last things I'll ask.
The more people I talk to with resumes
that are crazy, like professional this,
that, and everything,
the more when I do this,
tell me if I'm right or wrong,
they talk about the simplest stuff.
And I'm like, where's the crazy fancy?
And they're like, yeah.
So I almost feel like they get...
They're the guys testing the fancy,
though.
The fancy comes out, they go,
we're going to put it in the NFL.
And they're like, okay, cool, but...
where's the basics yeah i think and social
media does a disservice i think you know
if i put out what i do day
to day in the clinic i would have
zero following because that's something
it's simple hands-on range of motion it's
simple manual resistance exercise it's
banner it's it's your basic building
blocks and then at the end if we
have some time yeah we'll have some fun
we'll make it interactive that way my
patient stays engaged and keeps coming
back to me for sure and
Half the time it's them wanting to do
those fancy fun things.
But I say boring, basic, better first,
then more.
Spoonful of sugar, right?
Like, hey man,
when do we get to the cool?
I was a Pete's PT.
I had to make it,
it had to be fun.
But the whole time I was aiming at
like, what's the reason they're here?
Great.
How do I make that what I need
fun?
But let's pretend you've got a thousand
bucks.
What are you excited?
We'll just call them toys.
Fun-wise, what excites you?
What do you already have in your clinic
that you're like, that's the fun?
Oh, yeah.
I mean, the reactive lights,
the neurocognitive stuff.
I mean, blaze pots have been great.
From a recovery perspective, hyper ice.
I mean,
I'm a big shockwave person as well.
Laser.
So those adjunct modalities are awesome.
Obviously,
those are on the higher end of the
spectrum, but...
Um, I think,
I think you need a set of blaze
pots, especially for five hundred bucks.
I mean, yeah.
And then people get on you about the
subscription.
It's ten bucks.
Yeah.
Don't go to lunch that day for a
month.
It's one hundred and twenty bucks a year.
Right.
And like,
but it's not an ad for blaze pots.
But what I realized was.
it's because you get a library.
Like whenever you see the BlazePod ads,
you're like, that's cool,
but how would I program that?
And then you find out people are just
always, users are like, oh,
I did it like this.
And then you can search by sport or
whatever.
So I was like,
you're sort of buying the backend support,
so the thing works real well.
Totally.
Yeah, totally.
I mean,
and you could just search the activity,
the age group, the this, that,
and there's hundreds.
And then just the ability to make what
you want.
I mean, if you can think it,
you can make it.
And then half the time you get your
athletes who are like, oh, we did that.
Can we do it this way?
Can we make it harder?
Can we do it this?
And it just creates a competitive
environment.
Especially if you're treating athletes,
you have to create a locker room setting.
Yeah, they're used to it.
Speak the language.
The first question I get asked the second
we do it is,
what's the high score and who has it?
And the next time I see them,
I'm going to talk about it for sure.
Yeah.
I did that at a low tech,
the first clinic I was at out of
school.
It was a dry erase board with exercise
or like a game of the week.
And then it was either time-based,
rep-based.
It was never weight-based.
It was always time-based or rep-based to
keep people involved.
And then, you know, we had longevity.
So it was like when you're discharged from
PT, it was, what do you come in?
Do you want to keep going?
Because, you know, we have that.
And people will always come in their first
week.
peak was always what's on the board what's
what's the what's the worm which make
things up yeah and be like now it's
the worm what's it what's it doing we're
going to do this this this great make
an exercise based on that is it distance
or is it time yeah and i think
reiterating back i mean it doesn't have to
be fancy it doesn't have to involve tech
it just has to involve creativity and an
environment that allows for individuals to
come in
The first thing your patient sees when
they think rehab is, I'm hurt,
I'm injured, I don't want to be here,
I want to get out of here.
And trying to flip that mindset of
creating this longevity-based perspective
helps keep them in the clinic.
I mean,
my favorite question I get asked from a
patient is, do I have to stop coming?
Yeah, there you go.
Because you've set up an environment.
Of course.
I want to come back even when I'm
back because I know I can continue to
get better.
Uh, this seemed like a weird question.
What are,
what's the color of the walls on your
clinic?
Are they beige?
They are beige, but black accents.
That's the difference.
Okay.
Because we were talking about how, uh,
P green, P green was the classic, right?
P green and, uh, uh, children's, uh,
magazines or sports illustrated from six
years ago.
That's what we look at when we walk.
Yeah,
so my clinic has a lot of natural
lighting,
so I kept it beige but black accents
so it pops.
You made it look like a gym.
Yeah, like a gym.
You want to make it feel like that.
All right,
last thing we do on the show,
we call it the parting shot.
This is the parting shot.
One last mic drop moment.
No pressure.
Just your legacy on the line.
Parting Shot brought to you by US Physical
Therapy.
I'll say thanks because they're letting me
use their booth.
I was like,
I need six square feet to talk and
stand and a plug.
Find them online at usph.com.
Parting Shot,
just your last chance for a mic drop
moment.
What do you want to leave people with?
Yeah,
I think the three major points we spoke
on was better is better.
If you're a student,
find a mentor and understand what it takes
to be a good mentee.
And lastly,
create an environment where your patients
actually want to come to therapy.
And for the second one,
most people in this profession are not
looking to sell you a mentorship package.
Most people are like, how can I help?
And it doesn't have to be super structured
or formal.
And if you find people along the way,
one of our profession's weaknesses is we
just give stuff away.
But if you're going to...
takes himself mentorship is one of those i
still to this day seek out clinicians in
my area and i go shadow them i
mean two weeks ago i was at lenny
and mike's clinic in boston and fly on
the wall hey i'm just here to watch
what you guys do and learn that's it
i mean i've got a full caseload and
i still i just want to get better
yeah love to hear those appreciate you
stopping by man thank you