There are 7 core full body functional movements that you should be able to perform.…
Fitness to Rehab is a system Dr. Teter calls “a linear load application continuum approach”. Utilizing this method, the practitioner can take patients through a process that starts with injury care to soft tissue treatment to rehabilitative exercise. As opposed to tracking symptoms like most standards of care models Fitness to Rehab seeks to find where the root cause is coming from and address it.
He built this program out of necessity when asked to create a collegiate fitness and wellness degree program from scratch.
Ideal audience to learn from Dr. Justin Perspective :
Physical Therapist who was doing joint replacement or strokes but is now on their own doing sports and athlete injuries. They like spinal manipulations but it’s just a tool in their belt not the bread and butter like a chiropractor. They are in need of learning more exercises, a program, and a system to implement.
Chiropractor is technique heavy (could be instrument based or not). They know rehab is important and gets paid by insurance so they want to learn more. Their current active care wheel house is… PNF stretches geared for home use, McGill big 3 and extremity problems are given Resisted ROM with resistance bands.
Applying an external load to a biological organism, see how that person responds to that stress, and if they can get chronic and consistent exposure to that stimuli, then there will be some long term adaption.
Big component of rehab to fitness is quantifying the load and stress that a particular activity has on a person and progressing and regressing them as time goes on.
6 Stages of Load Application for a Linear Care Continuum
Acute Management – Fundamental Kinematics – Motor Control – Functional Integration – Progressive Kinaesthetics – Foundational Capacity
Dr. Teter walks us through a sprain/ strain ankle with what treatment would look like for this linear 6 step load application progression. Also he breaks down the process for a basketball player that needs to get back to jumping at a professional level.
Do we need to take any prerequisite courses to understand rehab to fitness? FAKTR is recommended because it’s like his class picks up where Dr. Todd Riddles ends.
Dr. Tom talks about rehab but he really teaches fitness, while Dr. Todd talks about fitness principles but teaches rehab.
We are biological creations designed to move that respond to stress loading in very specific and predictable ways. Each patient has different needs: one may only want better motor control but a basketball player needs functional control based on that sport.
There is a deficit in function, that they need to improve upon, so they can be tolerant to the load of their day.
Patient Profile – Need Analysis – Exam
He even goes through a mock history of questions he wants answered and of course the goals the patients want to achieve and why or how they can’t do them now. It’s a nice patient profile he gives insight into. The needs analysis is figuring out what are the Functional needs and movements you have to do to perform normal function for their goal.
Minimal Effective Dose
What are the movement, fitness and skill tasks you need to do XYZ?
Start off giving a person the Minimal Effective Dose that will get the desired results.
People’s Aliments Classified Broadly into 4 Categories
- Pathological (fractured, torn)
- Irritable (inflamed tissue)
- Dysfunctional (joint or tissue not injured but not functioning quite right and it hurts)
- Weak (joint, muscle etc is just not strong)
Activity Intolerance – what is that one thing you want to do but pain is stopping you from doing it?
Know the Language of the professionals or people you are targeting to get referrals from or to have as patients.
Coaches and trainers are key referral partners for this type of load application and fitness based chiropractic clinic.
Always appreciate your spouse for how they contribute to the relationship and show them gratitude for it
Movement,- Supertraining,- Sapians,- Why We Sleep,- Allostasis Homeostasis and the Costs of Physiological Adaptation
rehabtofitness on facebook and rehab_to_fitness instagram
People Mentioned in the Show:
Josh Satterlee DC Clinic Gym Hybrid www.adoctorsperspective.net/126
Todd Riddle DC FAKTR www.adoctorsperspective.net/85
Rob Pape DC Quadrant Analysis www.adoctorsperspective.net/174
Show notes can be found at https://adoctorsperspective.net/175 here you can also find links to things mentioned and the full transcript
00:00:06 – 00:05:04
Episode 175 functional loading rehab exactly. Does the first layer cake in a doctor, Tom Peters prospectively, Right? Way Seventeen. And on camera, Wards nominate hold and best-selling author on Amazon as we get it behind the curtain. Look at all types of doctoring. Guess, especially down here, a doctor’s perspective. Thank you for tuning in. Hope everybody’s day is going fantastic. Today on the show we’re going to hear from Fitness. 2000 have the system that doctor calls at linear load application. Continuum approach, that is a mouthful but don’t worry. He breaks it down very nicely with massive amounts of examples so that you can grasp what it is that he is trying to teach over at Southeast Sports seminars, as you can do last week was the quadrant analysis part. So we’re going to talk about that a little bit as well as factor with dr. Todd riddle, those shows if you’re interested after Todd’s is dead. Episode 85, talk to peeps, is episode 174. We mentioned Josh satterlee, his episode is 126 my goal. So by the time you hear this on the web page, there should be a link for a like a rehab series. Just like I said, acupuncture and Podiatry industry. We’re going to have one for rehab and it’s going to have people that we just mentioned plus about five others. So it’s going to have so many different types of topics approaches reasons why. So, if you were to listen to this, you would definitely want to spend the money to equip your office to change up some things and definitely to take one of these courses. So all the books that the guess have recommended in the past including this one, you go to a doctor’s perspective book list and that will take you directly to Amazon, just search through those books and you’ll find them as well. If you ever interested in supporting the show financially, whether it’s a one-time payment, buying some merchandising, which ensures like dr. Rob did on the last episode with the in equals one shirt want to see a quick reference for all the seeds. Just the top tens of each year that are downloaded. And even the affiliate links that I have for all the products that I recommend, whether I use them personally, or just really like them, they’re all in that thing. So it’s a doctor’s perspective. Net / guide. Yes, that’s right. Guide like I will guide you. Let’s get to the show load. Application is definitely a theme. You vent. All the show notes and the transcript at a doctor’s perspective 1005 let’s go hashtag behind the curtain live from Germany in Kansas City, Missouri. Today on the show we need to have a doctor who is created this whole program from rehab to Fitness and things would be a really good thing. If you’re just haven’t done a lot of rehab in your clinic and that’s something that interests you, let’s give them some credentials, he bought a certified as a corrective exercise specialist and performance enhancement specialist from the national County of sports medicine, strength, and conditioning specialist, by the nsca certified functional strength coach. He’s dead. And functional movement screen, select the functional movement assessment, that’s that sfm may, you may have heard me talk about from time to time graston, Smart Tools factor, which is a, that’s a pretty cool one. We taped a rep association with that while back and also kinesio taping. So this guy knows what he’s talking about. Please welcome dr. Tom Teeter. Hello doing well, that was a big mouthful for me. You know, I always enjoyed learning and depending on my education and at the end was there, I think that’s kind of all why we’re in this business, is kind of grow and and learn our craft, a long letters, always hate those vaio’s because I think each of us sat down and write all the stuff that we spent time learning, it could be five pages long, but I am definitely an avid student and I try to get better everyday life. Well, it makes a lot of sense when you’re going to have your own program to teach people when you have this many certifications. You know. I think that only makes sense I would never do something like this, like a lot of necessity of birth. The truth. I was a professor at a local University and I was tasked and hired. When I became a associate professor to start off Fitness and Wellness degree program from scratch. Well, so I developed a four-year curriculum for this University and taught it out for five years. I never had the intention of being a full-time Professor, I just literally kind of fell into the job and I mean that literally I was handed the job and asked if I could create a curriculum based on my experience and I’ve accepted off and I just found, I loved teaching. And when I decided that I was going to leave University life back to the in private practice, I wanted something to do with my my teaching energy. And I kind of feel like there’s a need in this Niche void that needs to be filled for re-entry, Fitness course. And that’s kind of what led me to develop the curriculum. So let me set this up for the listeners and for your name. So, when you’re, when we’re giving answers and things, you know, like kind of have a sword, I were talking to for this episode.
00:05:04 – 00:10:00
If we think of physical therapists, maybe there’s the person who was doing joint replacement and stroke rehab, and they’re like, I’m done with this off. A police are my passion, maybe they like spinal manipulation and they just had that as a tool in their belt, but they want to do more of the rehab. And maybe there’s not that, you know, up-to-date with it because they hadn’t done it for like five or six years. And then for the chiropractor, their technique heavy, maybe they’re just instrument based. They know, rehab is important. They get paid by insurance. So they’ve learned things like PNF stretches that you can teach their house down the girls, big three extremity problems. They give like range of motion with resistance bands and that’s kind of their will house and that’s really all that they do. So, does that make sense? Yeah, I I think one of the things we try to talk about is one of the things I talk about in general, when I speak in, when I teach is, I don’t really care what profession you’re coming from or that’s Chiropractic physical therapy. Josh therapy, athletic training. We’re really talking about some very basic principles of the human body. At the end of the day, we are all biological organisms. And we all have a very specific way. We respond and adapt to stress. So what I try to teach is this idea of load application, all of those techniques, within certain professions that you just mentioned, are fantastic, and off different people, use different techniques, at different times, with different people, but really what? We have to boil it down to is this idea of applying external load to the biological organism, see how that person responds to that stress. And then ultimately, if we do that repetitively over time, we get chronic and consistent exposure to stimuli then there’ll be some type of long term adaptation wage. So I kind of boil everything I do back to this idea of load application even to the point of one of the things that we’re teaching in our new new updated version of my course is taking all of those interventions job. You just described and placed them on placing them on almost like a periodic table of what interventions have the highest or lowest systems LED within each of the stages of care. And we can talk about that in detail if you’d like. But my point being I think, at the end of the day whether you’re let’s say, you’re dry, needling, someone or you’re doing a joint manipulation, or you’re doing enough stretching. Those would all classically been be described as rehab, and we do rehab to restore function. But all of those have a specific quantity of low that goes into the biological system and she can look at everything. We do on a load Spectrum or Continuum, then we can start to make really interesting choices about when were applying certain interventions with people on why if that makes sense, it does seem to whet our appetite. What would that be someone who wants to do full squats, but can barely get out of their chair at the moment or had some kind of injury. You we can take those example. One of the things that would be teaching job, Is that there are basically six. I call them six stages of care, but it’s only think of a linear line across a page. It’s a Continuum on the Left End of the spectrum, is what we call a cute management. Now, these are people that would come in, have a, a q pain, swelling, inflammation cetera. So there are techniques and things we would do with that person. And in that stage of care, the next agent care is what we’re calling. Fundamental kinematics, antibiotics is just talking about motion, so we have stuff that’s not moving and we want to make it move. So these are things you might do like Georgia mobilization manipulation instrumentation any manual soft tissue techniques and let you in factor which is obviously say my preferred method. Those are things that would use in that category are the next stage would be motor control and that is where we’re doing. Whereas, we’re getting with with the summation kinematics. We’re applying neurological input with our image. Agent in weather control, we’re trying to get some low threshold neurological or or motor output. So that’s where you might use things like you were talking about with p&f. Isometric, contractions off different types of upgraded, isometrics or eccentric, and certain joint positions, and that’s kind of our motor control bucket. And then as we get into the next day, this is where the line gets really blurry. We’re off stage is functional integration and this is where we’re starting to load. Body relative, movement patterns, we’re looking at Valley relative strength and we’re really looking at the right progression of resented that question of load application under the force of gravity. So this might be your example of trying to get someone back to squatting. So if we use that example and we can go down that road, let’s say someone wants to squat in the gym that they Twisted her ankle and they’ve got a cute swelling and inflammation. I’m just using this as one example. So we might do some things under acute management. Maybe we’re going down To do some things.
00:10:00 – 00:15:00
Like if these are resources you have available you might do something like a cold laser. You might do something like some compression flossing or you might do some dry needling to help decrease pain and inflammation and might start to do some ankle mobilization and manipulation we might try to do some low-grade isometrics and then ultimately in order to get them towards their goal, we’re going to have to put them under body weight load. So what we took our courses, we teach a series of progressions starting at the last thing you would do with Rehabilitation and then taking them up to the most advanced progression of loading that particular pattern, which is a squat down. It is my belief. Again that if we’re going to look at all of these things, as an application upload on a Continuum, I’ve just provided a very thorough and comprehensive linear application of love to get them from acute, pain up to squatting. Now in some instances that there’s other stages of care that we might need to go through. Let’s say that person needs to be able. There may be a basketball player and they need to be able to squat to jump for basketball. Well then we’re going to the next stage of care. After a functional integration would be Progressive. Kinetics connects is just about forces and rainy which development, so we’re going to have to get that person jumping again with a very specific progression of what application with jumping. And then once we’ve got them body, relative strength, with the squat per se wage and we’ve got we got their ankle moving because we’ve decreased pain and inflammation, we mobilize The Joint. We’ve got them back squatting and now we’ve got them jumping. Ultimately, they’re going to have to go back to practice or go back to competition with the last stage of care, which is foundational capacity. Like we want to get them performing skill acquisition, we want to get them doing change of direction. We want to get them doing some type of work capacity. So if we use those six stages of care, a long this linear Continuum every intervention that we see and Chiropractic Physical Therapy. Rehabilitation athletic training Falls somewhere within those six stages of care off. In that linear application Road. And so what I teach my course, that’s how we try to frame this idea of of rehab to Fitness if that kind of makes sense. Yeah, take your course. Are we expected to have taken other classes, McKenzie or sfma or factor, or anything like that? Or can we learn it all from you? So let’s let’s play without a little bit. My course was originally designed cuz the way. So let me backtrack a second. I teach my course through Southeast Sports seminars, it’s dr. Todd riddle. And his wife, Jessica, they’re fantastic to work without a doctor, riddle teaches that the the factor of course, which is functioning can actually moves rehab. So it’s basically teaching the principles of Rehabilitation, right? So I think is very helpful. If someone has had that course and then we can build other things off of that because they’re taught teaches the rehab and Sports Medicine side of our equation. Right choice. A little bit of everything to like from the band’s to the type bands to everything. Looks like, that’s exactly what I’m going to say is when I have discussed this with Doctor riddle and he was on here, he would, we would have the same conversation and that when I came up with these ideas of looking at the stages of care, and then, looking at what one would need to know. Now, there are other courses that you might want to take to have a better understanding of each of the intervention stages of gear. But ideally in our mind, if you can take something like a factor course that does go over things like in that class, I do believe they talk about vibration and percussion they talk about talks about cold laser and acoustic wave. Although it’s not something they’re particularly teaching. He does go over manufacture, decompression was puffing comprised flossing and Page, Street location, with movement. Those are all very important parts of the rehab, Continuum. So what my class does is starts where his class leaves off Paul’s room off. I lost connection apparently and you just said it Bridges, Todd stuff with your stuff. Sorry. So what what do we have to Fitness class does? Is it’s trying to bridge the gap. Sports medicine and conservative care. There’s a bridge between Rehabilitation and fitness. Now is my belief and many others that think like me. That if there’s a bridge between your faith and fitness, you’re doing the whole thing wrong. So what we tried to do and and, and and dr. Riddles Factor course, he goes over all of the principles of Rehabilitation and and touches on many different aspects of things that would fall under the first three stages of care acute management kinematics and motor control. But I tried to do with, my course is pick up where he left off meeting. If you have this example of someone who Twisted her ankle needs a cute management mobilization, and you’ve got them without putting motor control. This is typically where most people were wrong. Simple care.
00:15:00 – 00:20:06
But this is not a fully functional basketball player in our example, because in order, for that person to be functional, they need to be able to squat need to be able to jump, and they need to be able to have work capacity. Baptists. So we try to develop my class using these ideas of load application in the rehab, Continuum to literally pick up where doctor riddles class leaves off. And so that’s why I enjoy life partnership with factor in southeast Port seminars because we really now have this whole Continuum of Care. What I do is, I talked about rehab principles but I teach Fitness. And what he does is talk about fitness principles that he teaches rehab. So what we really do together kind of, it’s a very nice and convenient marriage, and it actually goes, people taking our classes of em well-rounded thought process around the application of load and rehab and fitness for anybody who wants to go back. And listen to what factors all about from the horse’s mouth. If you will doctor’s perspective. Net worth, Eight 5. So what you’re saying is interesting. It’s kind of like Factor teaches you how to do stuff, but you kind of teach you how to implement it in a linear fashion. And then to take you from, like you said, most people just kind of drop off or out of pain. You’re doing some some bird dogs, great. And then you just quit, when really like, there’s a whole progression of you gotta be able to Pivot twist, jump, and slam, and come back, and have your ankle actually working as well as not having your back pain. Just flare up to from it. Well, I think everything to me in my world and the way, I think everything comes down to biology and evolution, right? We were designed to move. We are buying a vehicle creatures. When we apply stress to our system, we respond in very specific ways. So that clinicians we have to choose which stress we price strategically in order to get the outcome that we’re looking for either, the reason the only reason why and this is my opinion, I know Todd agrees with me, but and I’m Doctor riddle agrees, but the only reason why I in my clinic that I do things on the left side of the equation, in the first three buckets wage, To get to the point where I can do things on the right because that’s where you’re going to make a long term adaptation. It’s great in our example, if that basketball player has no more ankle swelling and pain. He we mobilize. He’s got normal ankle motion and he can contract the tissues around that joint efficiently, that’s awesome. But it also has to be able to have body relative strength to be able to produce forced to jump. He asked to increase his kind of force development to jump, and then he has to be able to jump in practice with appropriate skill. So the only reason why I do things on the left and Rehab is to give me the opportunity to do things on the right that acts as a long-term success. There’s nothing wrong with some people stopping at the end of the rehab process, which in most cases would just be once they have appropriate motor control, but what ends up happening in most cases, if you have this athlete and that’s where you stopped, you’ve got so much stuff on the table, but they’re ultimately going to be back in your office with a similar or the same complaint cuz you never really block them back. Norm to their normal function. And that’s one of the things. I also try to teach is function, is context-specific Right. Normal ankle motion is just one part of His function. So as squatting jumping and so his work capacity, you know, sprinting up and down, the course repetitively and, and rebounding, like those are that’s normal function for this particular person. So when we leave things on the table, we’re not wrong in restoring function. And when we won’t restore function appropriately, people end up getting hurt again. So I like to take things all the way down the Spectrum, for whatever that means, contextually for that person. So they don’t leave anything on the table. So when you’re doing your initial workup on a patient. So, let’s take it away from being an athlete. Let’s kind of bring it to Susan, who works at the office. Has headaches has a problem. Maybe they do Sports, maybe they don’t, but there’s obviously some functional load that they need to improve upon so that they can handle the whole day without just having headaches, three or four times a week. So I want you to hold that thought in your head because what you just said was the most important thing you’re going to save. Full time we speak today. What you said was? They have a functional deficit. I’m paraphrasing, right? They have a deficit and function so that they need to have improved upon so that they can be taught to load throughout their day. So we’re bringing it back to load for me. I don’t have to do that but but I do the same thing with everybody that the principals don’t change. Only the context of their specific terminal task off the restoration of functions. So, for instance, when someone comes into my office, let’s use, you know, Sally office worker, I’ve got headache. Okay, so the first thing I always do and this is one of the things we talked about. In course, is patient profile. I want to know your Chief complaint. I want to know what the mechanism of injury was. I want to know if you have any past medical history that might make this, a complicated case, I would like to know. If you have any thoughts, any concerns or fear avoidances that might make therapy, not successful. And then ultimately, I want to know what what are your activity intolerance as meaning? What’s the thing you want to be able to do a job? That you can’t do right now because of pain or dysfunction and then I want them to tell me what their treatment goals are.
00:20:06 – 00:25:01
So when I perform this patient profile, which is basically just doing a history, if you if you’re doing it wrong, doing all this stuff already, when I perform a history and create my patient profile, this tells me who my patient is and what they want to be able to do now. Maybe for her, she says, I’m having neck pain work but it’s interfering with my ability to work out a make a, not a break, that’s important to know. Then I say, well what specifically about your workouts? Can’t you do that? You want to I’d like to be able to overhead or whatever that may be. So I do a patient profile and then the next thing we do depending on the context is what I call it needs analysis. If the patient profile tells me who you are and what you want to be able to do the means. And just now is this tells me what you need to be able to do. So if we take this back to maybe our basketball player is better example in the needs analysis. I do a federal investigation of what are the move. Fitness and skill tasks. You need to be able to play your position in basketball and I write them down. So if I know you have to be able to repetitively, jump up and down to play your position, five times in a row or you need to be able to squat X percent of your body weight in a squat pattern. Those are things that I want to use, cuz that’s normal function for that person. So patient profile with our needs analysis. And then we do our exam. Now the exam I think is where it gets really interesting because depending on your profession a lot of us attack, the exam part, and many different ways. Now, I am sleeping buyers cuz I’m a chiropractor. But I would say that the way doctor riddle and I practice are definitely not what we would classify as traditional Chiropractic here. When I do my exam. First thing I always do is just call. See if we’ll do some some mechanical sensitivity Orthopedic testing. Now, obviously Orthopedic testing, doesn’t always tell the whole story but at least gives us an indication of what tissue. Maybe pathological, irritable dysfunctional etcetera and so we’ll do some Orthopedic testing looking for mechanical sensitivity. Then we’ll see if there’s any contraindications. If you do offer an ACL drug test and you have massive pain. Well, you may have an ACL tear and there may be an indication for some other type of special testing right now in the absence of any type of medications, then we’re going to move forward into our assessment. Now, this is where you mentioned things like the sfma. That was obviously my preferred method. I think it’s a very thorough investigation of global movement and reduction of movement to try to isolate particular problems. But that is by no means the only way to get to the end point of where you’re going to intervene. This is also places where things like MacKenzie she comes in like if you having a person with chronic or acute back pain, you might try some in range loading to see if that alleviates some of their symptoms. If that does it might take us down a different Road. Yep. I wasn’t, we may want to look at a more Global movement pattern to determine if that’s contributing to the person’s pain and you teach some of this stuff in your course to know so that so that we don’t teach in the course at all that’s just my thought process of where we’re at home. So once I do my exam assess the problem we come up with are either functional or structural diagnosis and then we have to pick an intervention and in the intervention part. What we’re really looking at is off of that stages of cure. Where do we need to start? What is the intervention I can pick in each of those categories? That has the lowest systems load and we talked about load. I think it’s important to think of it. Like, the last name, it’s like medication. If you have a headache, will go back to your headache person. If you have a headache, and you go to the doctor and they said, you said, I have a headache doctor. What do I do? Well, we want you to take Advil, but take a minimum of four hundred milligrams, and the maximum of eight hundred milligrams and that should alleviate your headache or relieve, your pain. Well, in this instance, four hundred milligram is the minimum effective dose. That’s the minimum wage I’m out of dose of thing. You need to take to feel some type of systemic effect, an 800 would be the maximum effective dose. Now, at some point past that you have the maximum tolerable limit wage is the most. You can take without adverse effects happening. So whenever we choose interventions that fall Within These stages of care, we always want to pick the intervention, as the minimum effective dose, we don’t want to give someone nine hundred milligrams of ibuprofen or Advil. In this example, if four hundred milligrams going to do, just fine. I also, like to use the description if about alcohol, if you and I were going out to the pub were going to do some shots, I equate load two shots. If you’re going to have some drinks, you want to have just enough to have a good time to feel a little buzzed. Not enough to be passed down on the floor. Yeah, I think too often what we do with our interactions, and I have been guilty of this. In the past is sometimes we jump automatically to the maximum effective dose and it’s too much for the body to adapt to an acute amount of time. You see adverse side effects instead of making sure, Continual forward progress.
00:25:01 – 00:30:08
We apply too much of a dose. And now we’re stuck in this kind of holding pattern while the body has to recuperate from them. So what I try to teach is thinking of things change in terms of minimum effective dose. Now, again, when my class starts with rehab to Fitness is if we’re going to talk about body, roads, fundamental movement patterns, body relative strength and progressions in regression for each individual movement, pattern. That’s where we start. We kind of discuss these topics that we just touched upon, but that’s not the majority of our course. If you wanted more information about them, it’s in the course, but that’s where things like factor and dr. Riddles class comes in. I’m not going to teach you how to do a patient exam because most of us should at least have some semblance of it. We will talk about it and we’ll talk about the importance and where it fits into our overall model. But I’m not going to teach you how to do a patient history. I’m going to teach you how to appropriately apply load to these particular contextual situations when I like what you’re saying is dead. Let me put it this way. What type of visits are we talking about here? Most of us are, insurance-based, are trying to become cash or whatever. But we always have to worry about finances. This kind of sounds like something that could be a six to eight-week situation is that the case or can be done in eight visits. It depends like everything has contacts. And that, that’s one of the things I I try not to answer broadly because everything is a contextual situation, but I can give you some some, some ideological principles that we can at least have a discussion about if we’re going to agree that we’re biological organisms and we’re going to agree that chronic and repetitive exposure to stimulate jobs is what elicits, long term adaptation and that’s what we’re shooting for, right? If a tendon is irritated or it’s degenerative for some reason, we’re trying to stimulate some type of long term adaptation that tend to make it more or less distress. We know that chronic and repetitive exposure to stimuli takes time, you can’t. And, and let’s say, you do two visits a week for a month, in eight visits in this, in this page. Google is not enough time for a tendon to adapt to that type of stress. So sometimes things take longer than I’m very upfront with the people that I work with about not only what, I think the practice of their condition will be but how much time I think it’s going to take and one of the other things that I’ve really and I don’t know, I haven’t talked about this part too much, but one of the things I’m kind of doing a practice is I’ve really been describing people’s ailments and kind of four categories. Something’s either pathological, meaning it’s damaged, it’s torn, we could say, you have an ACL tear. That’s that’s pathos a fracture that to me, that’s pathology with pathology. There’s a certain time frame for each tissue, that it takes to heal whether whether or not there’s a surgical intervention or we enter being clinically through Rehabilitation or something could be irritable if something’s inflamed and pissed off. There’s a Time Factor associated with how long it takes for that to get better. If something’s dysfunctional. Cool. That’s a little bit easier to treat because it’s not broke down. It’s not pissed off, it just hurts, and it just because something’s not working the way it’s supposed to. And kind of, as we know, as clinicians paying such a multifactorial thing that in my world as long as it’s not something that pathological or irritated. That’s a whole whole lot of the easier road to apply load for long-term change, but it is if something’s broke or, or inflamed, right? I mean, the last thing would be if something’s week or just not very strong, you need to get stronger. Well, great. I have that is the app. That is the fundamental concept of load application. As we need to adapt issue to improve, or see, we call that word, strength, me to get you stronger. You’re just weak. You’re not saying they have to come every three days for the next six weeks. It could be, hey, you’re at a spot where you can go do this at your house or at the gym. I showed you how to do do it. Unless you kind of subscribe to like a Josh satterlee? No, no we are the gym. Well, you know, so here’s the thing. I’ll, I’ll be honest. I do both of those. I know Josh and I obviously respect. The work these doing and we’d have conversations about this. But in my practice and I can backtrack, this too, is I do not believe in the idea of maintenance care. I think that is the, the Crux of the problem with the Chiropractic profession. I don’t want to speak for other professions, but I can only speak for my own. Is we have people hooked on the idea that a consistent weekly bi-weekly, or monthly load application of force into a m. I even emulation is going to create long-term Health and Longevity. That’s nonsense, it’s nonsense. The only way to create long-term, Health and Longevity is through consistent and repetitive application of load me, which we call exercise, right? So, my practice, I will use remember what I said. I’ll use rehab to get someone to the point where they can exercise, cuz I know that’s where I can create long-term. The idea of maintenance care in my practice is a structured consistent exercise program. So I have, for example, and I love telling the story, I have a client that I will see you this evening at 5:30 a.m. In my time and I teach a twice a week, I teach in a golf at this class and I have for the last fifteen years, pretty much the same people, same five, six people that’s been for 15 years.
00:30:08 – 00:35:04
All of these people are fifty-five, sixty plus and all of them are healthier, stronger and fitter. Fifteen years later than they were when we started. And I can tell you consistently of these five or six people that are in my class. I think the last time that I saw both of them clinically and my practice is probably five to seven years ago today. That’s maintenance here. Once I get you out of pain and moving with normal function, when you’re going to contain the long-term application of road to your system that creates long-term biological change, that makes you more resilient to stress and makes you more capable of Performing life tasks at a higher level to me that Millions care. So I do absolutely espouse to to doctor Saturdays at the suggestion that we all should own a gym. Yes, I agree with that. Who better wage. Assuming you have the requisite knowledge. And that’s why I have a course to teach the requisite knowledge. But assuming you understand these ideas, who better than people in our profession to talk about long-term maintenance package through application of low. Because if you agree with everything, I just said that. If we break down every intervention, we do on the six stages of care down to an application load, who better to have that discussion than people in our profession. I wholeheartedly agree with Doctor satterlee, a matter of fact, I I listened to his podcast and every time I I listened to it, I take a little nugget away because I we’re speaking the same language, but it’s also the same thing that I talked about, with Doctor riddle. And, and, and obviously, I have a variation in a biased towards factor in doctor riddle. But that’s because we have the exact same thoughts when it comes to this idea. Everything we do is just go practice about the application of load. If we can get our colleagues to start thinking about what we do as load application to a biological organism. Now we can have conversation and then all dead. Discussing or debating, is which intervention has the appropriate system load for a particular problem? That’s a great place to be. We’re not quite there yet. And hence, that’s why I have a course. Do you think that you could take a bus station? Only chiropractor, who was doing 36 visits three times a week for ten years? Take Factor take your course and they could actually do this. Just that’s a loaded question. Do they don’t want to do it or by making them do it? Yes, they want to they they realize that this is not what they’re should be doing and they need to learn rehab and soft-tissue work because whatever reason they’ve had a life change. And they think this is the best way for the wage thing for their patients. But there just behind the eight-ball and the knowledge. Yes, if all you’re lacking is knowledge, then we can t. Cuz the guy can I say is give me a new graduate as an example, right off. Pretend they’re, they’re experienced in practices zero, so they have no particular bias coming into this. They need systems. That Simon Says, is if a lack of knowledge is the problem. We can’t log. You systems to do everything that were describing it. My course alone, we have 30 hours of content. 16, modules of which the first three are entirely based on the creation of systems to implement this idea. So absolutely believe that you could take a sub location-based chiropractor and teach them how to do load applications that Rehabilitation a hundred percent. I think it’s possible. The problem with that. Contextual question is most subluxation based higher factors? Don’t want to do what we’re describing because it doesn’t make them as much money somehow work, and it’s a lot of work and it off in the beginning, it doesn’t make you enough money. Now let’s try everything back to what we were talking. If you’re talking about doctor Saturdays, systematic his idea of Clinton hybrid like if if you have less people you’re seeing on a weekly basis for maintenance care. So those are less hours that you’re spending applying interventions two, people at a lower price point than what you would. Let’s say. It’s, I don’t know why it is. We’re yo, Let’s say if you do have adjustments, 50 bucks, right? Whatever? Okay. So you’re seeing someone for have a long ten, fifteen, ten minutes for an adjustment fifty bucks. If that person is giving you three hundred bucks or $350 a month or jump, right? Is that not very appealing, to means less work. I have to do, and they’re going to get better care because they’re getting long term adaptation. Why would that not be appealing to someone 12,000 wise cuz they either don’t know what to do and sometimes that’s embarrassing because if you’ve lived your whole past practice existence based on this outdated subluxation model, and there’s nothing wrong with it, I know a lot of great docs that manipulations. Only thing they do just refer out when it’s necessary. That’s was going to say, is those people also go look. All I want to do is adjust people. If someone comes into my practice and need something a little more involved than, I’m going to send them someone else, and they have a team of people that they refer to. That’s one of the things we talked about Ad nauseam. And I think that’s okay, okay, know your lane, that’s one of the things off. About the second module, it’s all about creating a system and part of that is building an integrated support team.
00:35:04 – 00:40:01
So, in, in my world, I like to do a lot of the stuff myself, but in some environments, I have Athletics in other environments. I’ve worked, I’ve had medical doctors that I’ve worked with that. I referred to, for certain things, I’ve had athletic trainers. I’ve worked as, for certain things, I’ve had peaches, I’ve worked with for certain things, and then I’ve had Fitness coach’s job. I work with certain things, so if you don’t want to be the one per say, let’s say you’re just the one that you want to adjust the ankle in our basketball analogy. That’s great. Be the best ankle adjuster in the world, but I do know that there’s more to care than just that one bucket and be able to refer to other people for the other things that you can’t or not willing to do. That’s just good care. And what happens is your practice starts to grow because you’ve I just happened with the last little trainer. I’m really good at genuine and really good a taping and I’m really good at ankle exercise but I can’t adjust the ankle. So I’m going to do those things off. So the person you for more information or just send them back to me and we’re going to keep going down that Spectrum. I’m like okay cool, I’m just one person I have to do one intervention with. So to get back to your, your statement like, oh, absolutely think you could teach subluxation based chiropractor to do this. They just have to want to do it and unfortunately, it takes a lot of work. An average visit for me can be about when I’m actually doing rehab is about half an hour. Sometimes even more than half an hour, 40 minutes, 45 minutes. Usually my business for about half an hour and I’m doing a lot of work. It’s 30 minutes of Hands-On care. We met some acute management. We may do some kinematics with Mobility. We may do some motor control. I’m going to put you under load. My office is pretty unique that I have like fitness equipment in my office so I’m off every day. Someone’s under some particular progression, regression overload application because that’s where I need them to be. So yes, I think you could do it, they just have to want to be able to do it, all right? If you’re interested. Through Saturdays episode, he was on the show as well. Episode 126, let’s switch gears. I want to respect your time, you have your own Clinic as well like you see patients, you don’t just teach you have any marketing tips when you’re trying to have this type of practice, what seems to be working? That’s a great question. That’s a switch gear for you know. That is that’s that’s one thing that practice is part. And part telling people what you do and usually most of us struggle with the telling people what you do part and that’s one of my own personal struggles as well. I find just getting out and talking to people, second-half introduction. So for instance, I recently got introduced to a local, one of the best local golf coaches in my city. Matter of fact, when my colleagues introduced me to this person, we had a conversation. We we kind of hit it off and I invited them over to my clinic is. Okay, come over. Let me do an evaluation on you and I can see maybe how I can help your volume. Now, I’m obviously not going to teach her technique of golf, but one of the things, What we determined was that she lacked emotion in a certain joint that she needed and because of that she was seeing the faults in her own golf swing as the coach. So I said, look, here’s how I can help you when your client if it’s a birthday or a fitness issue. Those are things where I can intervene if we rule out movement as a cause of deficiency, or if we rule out fitness, maybe your hip doesn’t move into internal rotation. Need that to get your bachelet, maybe you have internal rotation. You just don’t have the force production to create power out of the backswing. But those are things that can help with, and if it eliminated those of the cause of the fault, then it has to be a technique issue. But along the spectrum of care of movement, Fitness and skill. I can help you with two of those. And so, a lot of times I find it best, just having conversations and getting people to come in and see what you do. Wow, okay, let me do an evaluation on you and you will find something and usually if you can find some type of dysfunction relate it back to the thing that they can’t do very well. And that’s why my patient profile always ask about activity job. I want to say, what is it? You want to do that? You can’t do right now because of pain or dysfunctional, say, well, I’m slicing the golf ball and I’d like to hit it further right? Okay. Well, we can always look at the mechanical cause of why you’re having that type of fault. And so when I talk to other coaches or this example of golf coach, I was trying to tie it back into things that they talk about and doing their own language. I also find that a lot of times results is is the biggest word of mouth thing you’re ever going to have once you have one person and like hey I got ten yards on my drive while back and changing my hip problem. The next thing you know, on the next round of golf that person plays, you got five people calling me like, hey, your health Kevin. Can you help me with my problem? Now, I’m obviously just relating that back to golf but it goes what kind of average in general. Yeah, so long. But you know, marketing is one of those things where I know language matters and which I’m very strategic about the things that I say when I’m talking about what I do. But I think at the end of the day personal religious Chips with coaches and trainers.
00:40:01 – 00:45:09
Has been the biggest thing that I’ve ever done going out and talking to coaches, telling them what I do and showing them how I can get them results and then going out, and meeting personal trainers. Because now I have a box in teaching personal trainers, how to do exercise related things. I can go speak the language with them and I’m like, okay, you know what what’s the biggest issue you have with your clients and like what? My very good friends is a local personal trainer and we’ve had this conversation, he’s like, you know, a lot of times people will stop working with me because they get hurt. Not that he’s doing anything wrong, it would be something externally like off. They went skiing and they frequently and now they can’t come back and work out with neat Squat. And it’s like, okay, well we can have a process where if that does happen, we can identify where some of those problems are and we have a system of care where they can come see me, I can help them restore. In this case, the emotion or whatever it may be, reduced paying restore function and then I can send them back to you. So, if yo, Just problem is people have pain and that allows them not that because of that they can exercise. I can resolve that for you and then just showing them out. So it’s basically forming relationships and having conversations is tonight, is the absolute best thing you can do. Yeah. Unfortunately, it’s a little bit of a slower climb. If you’re new to an area, but for sure. But if you’ve been around and you’re trying to switch gears or just need to start marketing more with what you’re doing, start kicking the bushes. Who do you know, in my world coaches and trainers have been like a goldmine coaches. Particularly, I’ve been lucky and and again, I don’t want to like, say that my experience has been the norm, but I’m, I’m actually great area, my city, a pretty affluent area. A lot of people know, a lot of people and as I’ve introduced myself to coaches and had conversations it just been relatively, not, it’s not always easy, but word gets around. And if you do a good job, People start seeing results, the phone starts ringing. And, you know, I’ve been pretty fortunate. I’ve been really lucky with coaches. And, and if I were to have some advice to a young person, starting a practice, or off someone who’s going to an area, make a list of all the coaches in the sports or activities, you have interested and just start making phone calls. And eventually you only need two or three, really solve the coaches to start referring a patient before you get a busy schedule. Perfect, you’re into the last two questions? Yeah, go ahead. All right, you’re married. One of the things I’ve talked about on the show. Always is who cares? If you have the 30,000 students underneath your belt and then you lose your wife, you lose your kids and you have half your money. So is there any tips that we can do to keep our marriage healthy and happy? Oh, that’s a great question. How do I answer that best? I think I would say always appreciate your spouse for how they contribute to the relationship. I think sometimes if you’ve been married a long time sometimes, yep. Our to lose an appreciation for who your partner is. And, and really what they bring to the relationship. And then just make sure you find time to show gratitude to that person for the positive things that they do for your marriage. I, I feel very lucky that, you know, my wife and I have such distinctly different personalities and not marriages hard and it’s not always easy. But I think if you find someone you respect and you commit to creating a life of someone and you work hard at off data to depreciation, I think you’ll make it and my marriage. You know, my wife is The Logical. I call her Spock because it’s basically all logic no emotion in motion motion along. Like you, if you start talking about my kids or you get me talking about a certain subject matter, I definitely get emotionally involved and sometimes when we do that, we start to lose all dead. Rational thought, you know, I mean that’s just how people are. Yeah. And she’s illogical one. So I I think if you find someone where you both bring positive attributes to the marriage, you can constantly show off appreciation, for those particular attributes and just show love and kindness to your partner, I think you’ll be okay, it’s a fantastic answer. Okay. In the last question books, they could be about education ships. Personal development are even rehab etcetera, anything you want to lay on us. Oh man, that’s a hard question cuz there’s so many amazing books. I don’t know, right off. I’m talking about rehab and then there’s other ones, but it depends on their flavor. But I’ve literally liked the movement book by Greg cook. It was a real good starting point in my thought, process and application of just movement principles. I really like and then there’s other ones in Fitness. Like if you’ve not read Supertraining my most Seth but that’s a if you’re going to talk about late application, that’s like the Bible of books, it’s it’s Hefty, and it’s it’s heavy.
00:45:09 – 00:50:08
But definitely worth the read something. I’ve had to read quite a few times. When my favorite books honestly right now is is sapience and I’m going to order the the gentleman’s name who wrote the book but basically talk about the history of homo sapiens and evolutionary biology and which one of the things I talk about a lot in our class because if we’re going to talk about function we have to talk about what what man intended to do on hand as a homo sapiens earlier on. We were hunter-gatherers so we would do a lot of gathered certain people, right? We would walk long distances with aerobic endurance and then for the hunting we would do intermittent sprinting for work capacity to hunt down buffalo and a group of a packet of people and get food. So, if we’re going to talk about dead, Biology and and how man was intended to function because I have to understand those things a little bit and I think it was a really good read about the historical history of, push pins and how man was intended to function, as well as they can use that information. If we were meant to walk long distances like early Homo sapiens, would walk 11:00 to 13 miles every day every other day. So who are meant to have aerobic capacity and we don’t the further we get from our intended function, the closer we get to pathology huh? So it’s kind of an eye opener just looking at the history of homo sapiens. There’s a lot of really good books out right now that I have a list like you and I don’t remember all the author’s names and I could send them to you. If I thought it might have, but there’s a really good book on sleep right now, doctor riddle, part and I can send it to you when I think of the, the author’s name. But why? I think it’s called why we sleep. Yeah, I think that’s what I thought. And there’s a couple of books on sleep, but if one of the things we teach in the class is there is a hierarchy of things that we need from. We have Fitness and athletic, develop and the same thing on the list sleep. If we are going to be able to adapt this biological organisms, we have to be able to cover from stress. The only the main way which we do that is homo sapiens is by sleeping. And so if we can understand why we sleep, how we sleep in ways, to improve those functions, will be able to recover better and be able to adapt to long term stress. So there’s it’s just a great subject matter. It is we just work our way up the pyramid. There’s so many other that’s a really loaded question cuz there’s so many great books out there. I don’t think I’ve prepped, you enough time to pick the five. You like the best wage. Yeah. And I mean, I, I just, there’s, I mean, literally have a list in front of my computer at home. It’s like first name here and and obviously, if I if I could go look at the list, I can tell you more but there were some ones that really like kind of resonated with me and Jose Yeah, I’ll be honest I’m not a huge reader of like, self-help kind of books or or like who had a personal growth books that are on the list. But I suppose most of my time reading more clinically oriented science-based, books, that those books are great and and I know they help a lot of people. I only have so much limited times. I have to pick and choose wisely like a right to vote my my time for, you know, reading those kinds of things. So see I read those books that way I can just go to your seminar since you’ve read all that other stuff, that’s what I do. Well, I’m sure I would love to hear what doctor riddle had to say about his books because he probably has some, a different list. But again, the thing that I would go back to is that at the end of the day, what we’re really talking about, whether it’s real life, Fitness, whatever your flavor is just we’re talking about the application of the load, there’s another great book now that I think about it called boy and planning on. It’s going to come to me but it’s it’s beige. About adaptation homeostasis in a long term adaptation long-term physiological addict. It’s basically about the stress response and how our body creates a hundred years. Our stasis, and the cost of long-term physiological adaptation. That’s name of the book. It’s basically about stress and long term adaptation, which is everything that we’re talking about right now, that’s perfect to give up its Heaven, it’s a really great book, I’ll add all of those to the Amazon book lists that I have on there for people to look at so they can easily access it. Well, where can people get more information? I will have a link to everything on our show notes page, including the long URL, to your exact course on South East towards seminars as well. But any short URLs or anything else that you want to promote before you go. If you do get more information about the course, obviously, you can go to Southeast Sports seminars.com and there’s a dash between south east, south east, desk, Sports desk seminars. Com, you can go to the FAQ Website and learn more information. And again, if you want just a really well-rounded uh, fantastic course on Rehabilitation a highly recommend.
00:50:08 – 00:53:57
Taking doctor riddles, Factor course. I’m not saying that because I have an affiliation, I’ve taken it four times now and every time I learn something new because it’s constantly being updated. So I highly recommend that course. If you want to reach out to me, personally, you can go on Facebook. It’s computer. Or you can go to rehab Fitness on Facebook and on Instagram, it’s me to rehab underscore Fitness off on Instagram. If you have any questions, please feel free to reach out to me. I will answer any questions. I love talking about this particular subject matter, and I could literally be on here for hours having this discussion. A. So, if you have any questions, please feel free to reach out to me. I’ll answer questions about her day. The top-seeded can’t thank you enough for coming on, sharing your passion, for what you teach, and what you’ve learned throughout your life so far. And I do hope that you’ll get some click. And some people asking some questions. So, thank you again for being on the show. I appreciate you. Thank you for having me. Another great interview has ended while you’re on your phone, click that review button, right up a nice review for me. Five stars. If you could as everyone says an industry, it’ll help other people to find us when we have enough juice inkings, not to mention, I’ll mention you and your review one of the upcoming episode. If you follow me at all on Instagram, you know, you only get one link. So I use a link tree and so it’s a Dodge respective. Net links with an S and that’s going to give you everything you need to know the top episodes or 2017 and 2018 the Podiatry series. Dennis acupuncture series found a 2017 Financial series, how to write a review, how to support the show, like buying a cup of coffee. Give you Swag Like t-shirts the today’s choices, tomorrow’s health book home blueprints for Better Health, exercise, picking food, correctly, and financial. And then of course, bundle packs, which can get you the no needle acupuncture book. 40, common conditions, including the electric acupuncture, Your PIN a great deal. The resources page has some of the products that I like, it’s a, a affiliate style. So if you buy something from them, I get a piece of that just like on the show, most Pages. If you buy a book from clicking that link, I get a small piece of that as well, so I really appreciate that. Things like Screencast-O-Matic. VPN missing letter, J Lab speakers provolone, Edge or hot, grips off. Once again, if you do need, any coaching on how to improve some of your blood work. Drop weight and the provolone diet fast mimicking diet, 5-day plan, let me know, as well as if you just need some coaching, whether it’s Health, whether it’s marketing, whether you need some practice, growth et cetera, reach out Facebook, Justin trosclair MCC, of course at a doctor’s perspective. Net on the top right you got all the social media icons that you can. Imagine click your favorite and reach out. Thank you so much for tuning in. Please tell a friend pass it along. You can go to. Net, it’s just dead. Easy, it’ll open up right in your app and don’t forget, I appreciate you. Listen correctly. Think and integrate see on the minisodes on Thursdays and Saturdays. Hope you’re enjoying those. I’m definitely having fun summarizing these podcasts and less than 10 minutes for you. You get the Nuggets without having to waste your time have a great week. And in Boise. May I help you shine song.
- E 57 Move Well Functional Movement Rehab Dr Todd Pickman DC
- E 85 Rehab Focused Chiropractic Professor Dr. Todd Riddle DC
Combination of soft tissue modalities and rehab is Dr. Todd Riddle's specialty as he teaches…
- E 110 Vestibular Research and Dizziness Rehab PhD cand Dr. Carlo Rinaudo, DC
Dr. Carlo Rinaudo, DC Phd (cand)talks to Dr. Justin Trosclair DC on A Doctor's Perspective…