DPTreality

Been a while since my last blog post. We had one hell of a fucking Spring semester, so certain things had to take priority, ya know? And when certain things take priority other things must be sacrificed. A yin and a yang, if you will.

I don’t really feel like writing a long technical, ‘science-y’ post right now, but I did want to give some additional links and details to those of you interested in learning more about heat alteration techniques, and specifically those of the cold variety, such as cold showers, cryotherapy, cold water immersion, etc., etc., etc. (I have interest in the hotter side of heat alteration as well but that is a post for another day).

My initial exposure to this information came from watching interviews and videos with Dr. Rhonda Patrick and Wim Hof. This lead me to look in to some of these ideas further and get additional information on the potential benefits. I like self-experimentation, so a while ago (maybe about a year or so ago) I also started trying out these concepts. I was taking cold showers daily. I also am a lazy fuck sometimes, so some of my experiments don’t last very long because I just don’t make them a habit, I don’t feel they are working like I want and I want to try something else, I forget to do it for a few days and then keep insisting “what’s one more day of not doing this. Just get back to doing it tomorrow,” etc. And that is exactly what happened with my ‘n of 1’ cold shower experiment. I just stopped doing them. But not because I didn’t think they worked. I actually had a pretty positive experience with them. But, ice cold showers aren’t exactly a great time. Not exactly something you are overjoyed to take part in every day. So, it’s pretty easy to leave them behind and not look back.

But then recently I had listened to an interview with Dr. Patrick regarding sauna use and its benefits. I did some more reading about it on her website and really wanted to try it out for myself, but then I realized I have no access to a sauna and could not get to one regularly enough to legitimately gauge its effectiveness. But I thought to myself, “Hey, I also remember that there are benefits to using the cold too. And shit, I do have a shower that I can use every day. Let’s give the cold a shot again.” So, that’s what I’ve done. I would say for about a week and a half now I have done cold showers every day. I will come back to this topic in future posts and give a bit more detail on my personal experiences with them, exactly how I do them, and what I am noticing regarding any benefits, but I want to give it more time before I do that. For now, I just want to provide some links and further direction to get you started in learning about this if it interests you. So here we go…

** BUZZ WORDS you may want to look in to and search for when researching possible benefits of “cold exposure,” “cold showers,” “heat alteration techniques,” etc. These are all potential benefits of using the cold: norepinephrine release, improved metabolism, inflammation, cold thermogenesis, cold shock proteins (ie RNA binding motif 3), inhibiting inflammatory cytokines (potentially helping with anxiety and depression).

** LINKS:

• A good article to start with from selfhacked.com providing 12 health benefits seen from cold exposure. Each one with reference articles for support: https://www.selfhacked.com/blog/12-reasons-embrace-cold/
• Science Daily article on the cold and gut microbes: https://www.sciencedaily.com/releases/2015/12/151203135832.htm
• Rhonda Patrick YouTube video with Wim Hof: https://www.youtube.com/watch?v=389c31dD9xg
• Rhonda Patrick’s speech at the BioHacker Summit in 2016 discussing heat and cold exposure benefits: https://www.youtube.com/watch?v=if-J8w2ay94

Now…a quick blurb about this relating to physical therapy. First, I believe any tool that can provide potential physiologic benefits to our physical health and performance can act, at the very least, as a compliment to physical therapy treatment. Also, with what we understand now about the neurophysiologic experience that is physical pain and how anxiety, depression, etc. can play a role in that process, anything that can positively affect someone’s mental health should at least get our attention and be examined further. We owe it to our patients to be well-versed in all aspects of health, wellness, and performance to provide them the best care possible. And we also owe it to our patients to consider all avenues and possibilities for helping them in reducing or eliminating the pain that brought them in to see us. This, in my opinion, is how we grow our profession and gain the respect we want within the medical community.

Stay cold my friends…

1. Kelly Starrett (mobilitywod)

As Biggie once said, “It was all a dream.” At one point that’s all being a physical therapist was to me, a dream. Specifically, back around the Fall of 2014 when I decided being a personal trainer was not for me and that I was going to, instead, become a physical therapist.

Kelly Starrett’s mobilitywod project had a major role in creating that dream within me at that time. I came across his material a few years prior when he initially started mobilitywod with free youtube videos. Initially I saw it, thought it was interesting and cool, but never really tried applying any of the principles. I was too interested in being fat, but thinking/pretending I was jacked to be worried about mobility. You fucking kidding me bro? Mobility? I’m trying to be JACKED I don’t give a fuck about mobility. Fast forward to 2014 when I’m personal training. Now I’m doing more in the way of research that will help benefit my clients. And through that process I gained an appreciation for the role mobility and corrective exercise had in making someone a well-rounded performer no matter what the fitness goal. I also have always been a “practice what you preach” guy. So, this time around I dove in and started doing some of the mobility drills and exercises Kelly posted about on mobilitywod. Afterall, I have always been pretty “tight.” I could definitely benefit from this shit. So, I start doing it consistently and start seeing improvements in my own function both in and out of the gym and thought, “wow this could help out a lot of my clients that have your normal aches and pains most people have AND help them perform better in the gym during our sessions.” Through this process, I became a much better trainer, I started to become more well-rounded and started using well thought out warm-ups and putting a real emphasis on programming mobility work and corrective exercises into my clients’ programs. And it produced great results with my clients.

Anyway, this is all a long-winded way of saying Kelly had a huge impact on me and is a legit bad motherfucker when it comes to the physical therapy and human performance game(s). I highly recommend any and all of his materials and teachings. What initially impressed me so much about Kelly is his ability to make videos that perfectly blended being engaging and entertaining with extremely high level understanding of anatomy, biomechanics, etc. One view of any of his mobilitywod videos will make this very evident.

Here is a guide to get your started on Kelly’s materials:

1. His website – mobilitywod.com – everything and anything mobilitywod can be found here. You can find his free videos here, information on mobility courses offered, order his books, etc. He also has a very affordable monthly membership you can sign up for too
2. His Books – Becoming A Supple Leopard (The book I recommend starting with. Gives you a complete intro to the mobilitywod system all in one place, pictures of the exercises, and strategies for working it into overall programming), Deskbound, and Ready to Run.
3. YouTube – just search something like “mobilitywod Kelly Starrett” and plenty of free videos will pop up.
4. Social media – simply search mobilitywod on twitter, facebook, Instagram, etc.

2. Ron Hruska (Postural Restoration Institute)

Ron is the creator and founder of Postural Restoration Institute (PRI). He is the only person on this list that I have actually met in person. Last February (2017), I took the first of PRI’s 3 major core courses, Myokinematic Restoration, which Ron was one of the instructors for. Meeting him only further confirmed that he is someone in this game that I will drop whatever I’m doing to listen to when he has to say about physical therapy. Partly, due to him being incredibly nice, humble, and willing to offer his expertise and knowledge to anyone interested. Hell, he even took time to talk to me for a few minutes. That’s all the proof you need.

PRI is all about taking anatomical and biomechanical knowledge of respiration, myokinematics and posture and assessing these areas to uncover dysfunctional patterns and imbalances and then perform specific interventions to return these systems to functioning properly.

Those are my words above, which may not be worth a whole hell of a lot to you, so let me also provide their words explaining what they do, which can be found in the mission statement on their website, where they state, “The Postural Restoration Institute® (PRI) was established to explore and explain the science of postural adaptations, asymmetrical patterns and the influence of polyarticular chains of muscles. Our mission is based on the development of an innovative treatment that addresses the primary contributions of postural kinematic movement dysfunction.”

Here is your guide to getting started with Ron’s and PRI’s materials:

1. Their website – posturalrestoration.com – here you can find various articles and videos explaining some of the core tenants of PRI and how it is integrated into patient treatment. You can also find information on the courses they offer and the dates/locations of each course for the calendar year.
2. YouTube – once again, a simple YouTube search of “PRI” or “Ron Hruska PRI” will offer you plenty of PRI content.
3. Social Media – @RonHruska on Twitter. And find PRI on Instagram – @posturalrestorationinst and on Twitter – @postrestinst

 3. Mike Reinold

I was introduced to Mike’s material due to my first love in life – baseball. Mike was formerly the head physical therapist for the Boston Red Sox and now owns his own physical therapy practice named Champion Physical Therapy and Performance up in Boston. I was initially drawn to Mike’s material when physical and athletic performance were my main interests. I have always enjoyed the straight forward and easy to comprehend approach to his content. Both articles and videos. He does a great job of explaining the science behind the movement and performance principles he is discussing, but also offers straight forward advice and ways to take immediate action for implementing what he is talking about. If you are a baseball guy or someone who is interested in working with baseball players, Mike should be at the top of your list for professionals to take advice and learn from.

Mike is also a great physical therapist and provides a lot of content relating to topics in physical therapy. He has a weekly podcast, “The Ask Mike Reinold Show,” where he and the other PT’s at Champion take listener questions, often being asked by students in PT school. This is a GREAT podcast to listen to if you are currently in school, as it offers a look inside the mindset with which Mike and the other PT’s at Champion approach various aspects of patient care and rehabilitation.

Here is your guide to getting started with Mike’s materials:

1. His website – mikereinold.com – The “Start Here” tab on his website basically gives you a step-by-step breakdown of how to find all of Mike’s materials and content online
2. His podcast – The Ask Mike Reinold Show – Can be found on YouTube, iTunes, etc.
3. His newsletter – which you can sign up for on his website
4. “Inner Circle” offerings – find out more on his website.
5. His book – The Athlete’s Shoulder – Mike teams up with Kevin Wilk and Dr. James Andrews for this one. That should tell you all you need to know there.
6. Social media – just search his name on twitter, Instagram, and facebook. Plenty of free content here.

4. Gray Cook (Functional Movement Systems)

Gray Cook is a co-founder of Functional Movement Systems, or FMS, which many are probably familiar with at this point. I believe FMS provides a great, straight forward approach to being able to objectively assess movement pattern strengths and weaknesses and then put a plan in place for improving on an individual’s weaknesses to improve overall function and performance.

If you are not familiar with the FMS system I highly suggest looking into it and considering it as an option when treating patients. It began, I believe, as mainly a system for assessing athletes and improving athletic performance, but I believe it has its place with other populations as well. The basic movement patterns that form the foundation for athletic performance are also used in various functional activities throughout anyone’s typical day.

FMS offers a ‘level 1’ and ‘level 2’ certification that are open to anyone interested. They also offer a more advanced course/system called the SFMA for specific healthcare professionals (DPTs, chiros, etc.).

Here is your guide for getting started with material from Gray Cook and the FMS system:

1. His website – graycook.com – all of Gray’s materials, tons of free articles, videos, etc. can be found here.
2. FMS website – functionalmovement.com – information about the various courses offered and when/where they are offered this year.
3. Social media – Twitter – @GrayCookPT @FunctionalMvmt – Instagram – @FunctionalMvmt
4. His book(s) – “Movement” by Gray Cook is the main one to start with IMO.

Here is the next entry in my series of posts explaining how I study for exams. This time around I am covering our Neuro midterm practical. It was on 2/28/18. Here is what I did to prepare:

• Fri. (2/23) – Met with a couple classmates before our Friday afternoon class to talk through some different cases we might see on the practical and how we would handle them. Which exam techniques/objective measures to choose and what interventions would be appropriate.
• Sat. (2/24) & Sun. (2/25) – Studied for our written midterm exam, which was on Monday (2/26). This studying basically doubled as studying for the practical. It was all on the same material.
• Mon. (2/26) – Went over to the lab at night after our classes with some other classmates. Spent 1-2 hours with everyone going over possible cases, what to remember about certain outcome measures and when to use them, how to perform certain tests, etc. The lab at night before practicals is always good for some good laughs as well. And what is said in the lab, stays in the lab.
• Tues. (2/27) – Went over to the lab again with everyone Tuesday morning. Hit another 1-2 hours of doing the same stuff as Monday night.
• Tues. (2/27) – You guessed it. Another 1-2 hours Tuesday night fucking around in the lab with a little bit of practice thrown in too.
• Tues. (2/27) – After I got back to my apartment that night I spent another hour or 2 by myself going over some last minute things that I wanted to review. Mostly things I felt I, personally, wasn’t as strong with. Also spent this time going over all patient case possibilities and how I would handle them.

Test Result: 97% (This is just in the spirit of full disclosure. Not sure you would be inclined to put as much weight in to what I do to prepare if I’m barely scraping by.)

Notes:

• Practical was on Wednesday morning. How they set up our practicals is to have groups of 4 students going at a time. Our 2 professors are graders and then for this one they had 2 outside clinicians there as well as graders. The graders also acted as the patients we were “treating.”
• The first part of our semester was spent on geriatric PT screens, Vestibular disorders, and BPPV. So cases revolved around these topics.
• So, what they do is put together 4 different cases/patient scenarios. We get to the practical 15 min. early and have that time to review the case, take a few notes, and put together a game plan for what we want to do during the practical.
• Based off of the subjective info. we get in the case beforehand, we have to choose 2 objective measures to perform. After performing these, we have to give our differential diagnosis and then go through 2 treatments/interventions with our “patient.”
• After I am comfortable with the actual “book” knowledge that is necessary for doing well on the practical then I start to practice skills. So, I will practice each skill individually until I am comfortable with the actual physical performance of the exam technique, intervention, etc. Then I practice performing the skill while talking through what I am doing and what I expect to see when things are “normal” and what I would see with various pathologies.
• My last step in ‘physical practice’ for practicals is to usually set up a sample patient case and run through it as if its actually the practical.
• My FINAL step in prepping for practicals is ‘mental preparation.’ At this point I am comfortable doing the individual skills required of us. I am comfortable with the likely patient cases we will see and how I would go about handling them and how the patient would likely present (what functional deficits, etc.). So then I just run through each possible patient scenario in my head multiple times. How I would sequence the session, what I would say, how I would explain things, etc. I will call this ‘practical memorization.’
• So the overall theme here is…OVER PREPARE. It is only natural to be nervous during a practical. It is not like treating an actual patient. You are treating and being graded by some one who knows more about physical therapy than you. Do I get nervous? Yes, at times. You will not perform things as well on the practical as you do when you are practicing them. Know this and accept this. Plan ahead. Know your shit inside and out so when you inevitably fuck up a few things on the actual practical you still do well enough to get a good grade.
• Final note…be CONFIDENT. Teachers will be understanding of the nerves that come along with a practical. Even if you are nervous it doesn’t mean you have to SHOW you are nervous. Walk in to the room and act like you are a god damn physical therapist and not just a timid student who doesn’t know what the fuck they are doing. You put in the work to do well, let your work show. I truly believe in the power of body language and non-verbal communication. If Student A goes in to the practical and makes a few mistakes with technique or answering follow-up questions, but is confident, clear in their communication, and takes ownership of the situation and Student B goes in to the practical to be graded by the same examiner and verbally says things like “Sorry I’m really nervous,” doesn’t make eye contact, and is visibly unsure of themselves when performing skills, with all other things being equal, I think Student A would get the A and student B would get the B. Or worse…

Anyways…little rant there at the end. But that was what I did for our Neuro midterm practical. Up next in this series is our Musculoskeletal written midterm.

Alright, so I’m going to do a series of posts detailing how I go about studying for exams. I will try to do one of these for all of our exams from here on out until I’m finished school.

If your getting ready to start PT school hopefully this will give you a feel for what you need to do to be properly prepared for exams. If your in school, maybe it will give you some ideas if your looking to switch up your strategy.

This is the 3rd (and final) neuro course within our curriculum. Our exam was on 2/26/18.

Here’s how it went down:

• The Wed. before (2/21) – read through all 6 of the lectures included on the exam 1x
• Over Thurs. (2/22) and Fri. (2/23) – read through all 6 lectures 1x
• Saturday (2/24) – read through all hand-written class notes and highlighted the important points
• Saturday (2/24) – went through all outcome measures reviewed in class that I thought there might be questions on. Went through these 2x.
•  Saturday (2/24) – reviewed/read through all case studies covered in class and all online reference articles our professor(s) had posted on our BlackBoard page up to that point.
• Saturday (2/24) – Went through all 6 lectures 1x
• Sunday (2/25) – Reviewed all highlighted hand written notes 1x
• Sunday (2/25) – went through all 6 lectures 1x
• Sunday (2/25) – read through all online reference articles 1x
• Sunday (2/25) – reviewed all outcome measures covered in class 1x
• Monday (2/26) – woke up at 6 and did one final review of the outcome measures. Also did one last glance through one of the online articles that we were required to read on exercise prescription for geriatric populations.

Test Result: 91.6%

Notes:

• This test covered 6 different powerpoints/lectures from the beginning of the semester up to the last class before the exam.
• Outcome measures included tests like the MiniBEST, FGA, DVA, ABC, etc.
• I would describe my study style as blue collar with a dash of OCD and intuition thrown in. The bulk of my studying is just reading through the power point slides from lecture and memorizing important points by just saying shit over and over in my head until I know I have it memorized. This is the blue collar side of my studying. Just good old fashioned hard work, looking at things over and over.
• My OCD side comes in the form of me generally approaching each exam knowing an exact amount of times that I want to go over each category of material that could show up on the test. My thought process goes something like this, “If I go through these lectures “x” amount of times, go through the online articles “x” amount of times and go through the outcome measures we covered in class “x” times, then I will probably do well on the exam.”
• I also have a pretty good feel at this point for what topics and concepts will be covered on our tests. So, as I am going through the power points I am spending a lot of time on some slides and basically just glancing over others. Or I will completely skip over some slides if I have already been through a certain lecture once or twice already. I also start to get a feel as I am going through the lecture slides for the 2nd, 3rd, 4th time, etc. that I know things well enough to get a high B or A. So if I reach that point, I might not review the material the exact amount of times I originally went in thinking I would. This is the intuition aspect of my studying style.
• I’m also a big mnemonic guy. So, anytime there is a list of multiple words or concepts that need to be memorized, you can bet your ass a mnemonic is going to be created. This will be done for things like “these 4 symptoms are the major identifying factors for “x” injury” or something along those lines. You get the point. The dirtier and more absurd the better.
• Another thing I like to do is hand write notes in class. This keeps me better engaged in class and also helps me to focus my studying when test time comes around. In my notes, I usually will write something like “Slide 21” and then a bullet point underneath might be, “go back and review this” or “this slide will be on test” or I will add other important points our professor makes about the topic that isn’t included on the slide.

So there’s my process. Next up in this series will be our midterm practical in neuro.

The Medicare Therapy Cap repeal and tripling down on our strengths as DPTs

So, if you haven’t heard, the Medicare therapy cap was recently repealed. This post isn’t intended to give you a detailed description of what the therapy cap is or give a break down of what it means that it was repealed, but instead to make a point that I was thinking about when reading some of the comments on-line after the news broke. If you have no clue what the fuck the Medicare therapy cap is….do you even PT bro? Just kidding, the basic gist is that it was a bundled amount of dollars given to Medicare patients for speech and physical therapy services (most recently as a $2010 total). Once the patient used up that dollar amount, they had to go through exceptions processes to be able to continue to receive therapy services via Medicare. ANYWAY…I have linked a few articles at the bottom if you want to do some further reading on the therapy cap and what the repeal means.

But the big thing that jumped out at me when reading some of the comments people were making was the amount of negative comments. A lot of people were happy with the news, yes, but there were also a lot of comments about how weak the APTA still is as a lobbying group and how our profession, as a whole, doesn’t have the lobbying power that physicians do, which lead to comments about how the profession needs stronger membership in our professional organizations (the APTA), etc., etc., etc.

Now, personally, I do agree with some of those ideas. We could stand to have a stronger voice…it would be great to strengthen the membership numbers…and we should continue to work towards the advancement of our profession within society. BUT, are we missing a huge piece to this equation?? Yeah, I actually think we are.

And that piece is focusing and executing on the strengths we ALREADY have. One of my favorite people to read for learning about business is Gary Vaynerchuk (@garyvee on twitter and instagram) and one of his beliefs is to triple down on your strengths. Don’t focus on the shit you don’t do well, focus on what you DO do well. And, in my opinion, one of our main strengths as PTs is TIME. And more specifically, the amount of time we have with patients. What is one of the main complaints many patients have about their physician? – “Oh yea they never spend more than a few minutes with me and never listen to what I have to say.” Something along those lines. You have heard that too, right? Well, then maybe we should TRIPLE down on this strength of ours. We do have the time to spend with patients.

Maybe we should actually spend time getting to know our patients as individuals. Maybe we should put effort in to learning what makes them tick. Maybe we should hear them out on what they have to say and show a genuine interest in what they want to accomplish. We have the ability to form much stronger connections with patients. And I think if we do this, make it known that we do this, AND show, through our skills as clinicians, that we truly are THE medical professionals to go to for movement related disorders and injuries, then we just may see the changes we want in how the public views our profession.

Sure, we always want improvement and advancement, but I think some of that can come from actually using the strengths we already do have more effectively.

This is also why it is fucking mind boggling to me when hearing about companies that schedule patients every 15 minutes (maybe rare, but I have heard of it happening). And then you wonder why some people view us as nothing more than a step above a personal trainer. But, that’s a topic for another day I suppose.

Further Reading on the Medicare therapy cap and its repeal if you’re interested:

1. http://www.apta.org/FederalIssues/TherapyCap/
2. https://www.apta.org/PTinMotion/News/2018/02/16/BudgetDeal5Things/

Year 2, Spring Semester

If you’re applying to PT school, one thing you may be wondering is what your schedule will look like. Well, you gon’ learn today…

Here is our current spring semester schedule to give you an idea of what your upcoming semesters could look like:

Mondays:

• Neuro (3) Lecture 7:00-9:00 AM
• Cardiopulmonary (2) Lecture/Lab 9:15 AM-1:15 PM
• ** Pro Bono Clinic (Ortho patients) 2:00-6:00 PM

Tuesdays:

• Musculoskeletal (3) Lecture 7:00-9:00 AM
• Cardiopulmonary (2) Lab 9:15-11:15 AM
• Part-time clinical 1:00 PM-4:00 PM

Wednesdays:

• Procedures/Modalities Lecture 7:00-9:00 AM
• Neuro (3) Lab 9:30 AM-1:30 PM
• ** Pro Bono Clinic (Ortho patients) 2:00-6:00 PM

Thursdays:

• Musculoskeletal (3) Lab 8:00-12:00
• Part-time clinical 1:00-4:00 PM

Fridays:

• ** Pro Bono Clinic (neuro patients) 9:00 AM-12:00 PM
• Procedures/Modalities Lab 12:30 PM- 4:30 PM

Notes:

• The numbers next to some of the classes mean where we are in the overall curriculum with that subject. So, right now we’re taking our 3^rd musculoskeletal class within the overall curriculum, our third neuro class, and our 2^nd cardiopulmonary class. “DPT 617” Probably would mean nothing to you, so hopefully this makes sense.
• We split treating at the pro bono clinic up amongst the class. Without boring you, it breaks down to everyone in our class doing a total of 4 days at the pro bono clinic treating patients.
• Aside from these classes, we also have a research project that spans all 3 years of our time in the program and counts as a class each Spring/Fall semester. We basically were assigned a group and a faculty advisor in our first year and we have to produce a research project/study that can potentially be presented at a conference or published in a journal. My research group meets at 7:00 AM on Thursdays this semester. We don’t meet every single week, but we have met most weeks so far.
• My research group is doing our study/paper on SI joint dysfunction. Hi SI haterz.
• Yes, that is 4 days straight of starting at 7 AM. No, I am not a morning person. Yes, it fucking sucks. Embrace things sucking if you want to make PT school an easier time for yourself.
• Part-time clinicals only go for the first 6 weeks of the semester. After that, those are just open times in our schedule. We have had part-time clinicals every Fall & Spring semester since starting school.
• This is by far our busiest semester so far.
• Right now (during our first 6 weeks while we have part-time clinical), pretty much all of my school work/studying is done on Mondays, Fridays, Saturdays, and Sundays. Tues-Thurs is pretty much shot because I get home from part-time clinic and don’t feel like doing a damn thing school-related the rest of the night. This should get much better once clinical is over.

That’s all I got for now…

Anatomy. Physiology. Biomechanics. 

The 3 areas of knowledge that I think are the most important for being a truly GOOD (not just a 9-5’er) therapist. Out of all the therapists I have come across, between working as a tech before school, being in school, and through reading online, that I view as being really good, I have realized they all share something in common. They all have well above average knowledge in these 3 areas. Not just entry level knowledge. Well above entry level.

Pretty much any treatment approach in physical therapy boils down to taking an understanding of anatomy, physiology, and biomechanics and manipulating one or more of the 3 to produce a return to “normal” (or not pathological) in the patient we’re trying to treat.

The more and more I learn about how to properly treat different musculoskeletal, neurologic, and cardiopulmonary disorders, the clearer this idea becomes to me. If you understand anatomy, physiology, and biomechanics, you understand WHY certain things work for certain problems. And that allows you to be a free thinker. A true autonomous practitioner. You don’t have to just blindly follow what other say to do. Or pigeon-hole yourself into always using one specific approach. It also allows you to take one person’s ideas and find ways to connect their methods to other patient populations you might be working with. Outside the box thinking.

So, I would highly suggest to those about to start PT school or those in your first year…give your classes that teach about these topics the majority of your time and attention. And then go back to these subjects whenever you can. I try to use winter break and summers to do this.

Review anatomy. Review physiology. Go over your biomechanics.

Things like…What are the major muscles involved in some of the most common injuries we see. What is the origin, insertion, innervation, and action of those muscles? What are the mechanics of the joints those muscles cross. What are the arthokinematics of those joints? How do nerves communicate? What is the anatomy of the brain? What is the anatomy of the heart? How does muscle contraction occur? How does blood pump out of the heart and then return? What are proper gait mechanics?… You get the point.

Anyways. Just some of my thoughts…

Pre-class stack

I’m going to fill you in on a little secret about me. I don’t read text books. I’d say out of my (almost) two years in school I have probably done less than 10% of all the readings assigned. There have been stretches of a week here and there that I will do the readings and I admit that I do see a benefit. So, I’m not going to completely shit on reading the texts for class. And I know some people probably get a lot of value out of doing the readings. But for me, at the end of the day, the ROI just isn’t there in the long run. Both in finances and in time. Books are fucking expensive and it takes a long time to read dense, dry textbooks. Just not something I’m willing to allocate time to. I have other things I would rather be doing.

** I should add – this goes for MOST textbooks and assigned readings. There are always exceptions.

So, what this means for me is that I need to get the most out of class/lecture that I can. I need to make sure I am really dialed in to what our teachers are saying and that I am understanding the key concepts they are covering. Knowing that and being that I personally love the pursuit of optimizing performance, I am always looking for ways to perform even better. Recently I have found something that has really been working well, so I want to share it.

Every morning I take 2 things:

• 2 capsules Lion’s Mane
• 1 can sugar free monster

The big one here is the Lion’s Mane supplement. This is actually a species of mushroom. I was first introduced to this by Paul Stamets when he was on the Joe Rogan Experience (JRE shout-out 2 blogs in a row). He explained there was this particular species of mushroom that appears to improve memory and cognitive function, reduce fatigue, reduce anxiety, and have a positive effect on the nervous system (specifically nerve regeneration) among other things. It’s called Hericium erinaceus. Or Lion’s Mane.

So, I finally order it over winter break and I have to say I’m a believer.

I will also say I have tried quite a few different supplements of all kinds over the years. From celltech (smh) and N.O. explode to waxy maize, highly branched cylic dextrin and hydrolyzed caseinate protein powder. Even individual vitamins and minerals at specified doses to create a certain desired effect. So, I know from experience a lot of supplements are pure horse shit…cough cell tech cough…and a lot of other supplements probably aren’t really needed. And most LEGAL supplements you aren’t going to FEEL a major difference from even if they are helping.

But Lion’s Mane is one of the few supplements I have taken that I actually notice working. Something I can actually FEEL. It’s hard to describe exactly. But, my focus is really on another level. My ability to keep up with lectures and be “in the zone” actively listening to what is said is better than its been in the past. I’m not drifting off in my head thinking about other random stuff. I don’t become mentally useless during the last half hour of class. Obviously, the monster helps too. But, I know what a pure caffeine buzz/focus feels like. Your boy has dabbled quite extensively in the caffeine game. But this is not the typical caffeine buzz. It’s a different type of mental focus and energy (that I think I’m just enhancing by adding caffeine into the mix).

Anyways…this has been my go-to this semester and something I don’t foresee myself stopping any time soon. Maybe it will help you too.

And if nothing else, check out some of Paul Stamets’ materials online if you have an hour or two to kill and want to hear some interesting ideas. He is incredibly smart and some of his ideas relating to the use of different mushroom species for various health and performance benefits are very intriguing.

To get you started…

The Lion’s Mane supplement that I take: http://www.fungi.com/product-detail/product/host-defense-lions-mane-capsules-30ct.html (can be found other places also)

There are a ton of articles you can find on google if you search “Lion’s Mane mushroom health benefits”

Paul’s website: http://www.fungi.com

A TED Talk Paul did: https://www.youtube.com/watch?v=Mjv8Zj1ABAc

Paul’s JRE episode: #1035 https://www.youtube.com/watch?v=mPqWstVnRjQ

 “Life isn’t a game. It’s a series of games…”

I was driving home last Friday after class and heard this said.

I go home to Maryland on most weekends, so I have plenty of time in the car to catch up on my favorite podcasts between the ride home Friday and the ride back to school Sunday. So this week, that meant listening to the most recent interview with Dr. Jordan Peterson on Joe Rogan’s podcast, The Joe Rogan Experience.

So for about 10-15 minutes of this podcast the two of them go back and forth on the topic of competition and competition’s role in life. And during this conversation what they were saying really stuck out to me as having a major connection to physical therapy and especially experiences we go through as students when we’re in school. So here’s the gist of what they said…

Jordan Peterson (paraphrasing): One definition of a winner is someone who never let losing stop them. Life isn’t a game…it’s a SERIES of games. Be the winner of the series of games. And part of that is learning how to be a good loser because your not going to win every single game.

Joe (paraphrasing): If your not willing to lose, your not willing to LEARN. He then went on to talk about his experiences bombing on stage as a stand-up comedian and how those were some of the moments he learned the most from.

This hit home for me. During my part-time clinical in the Fall, I was helping a patient do a 4-way ankle with a band. She starts to do inversion and my CI asks me, “so what is the main muscle responsible for inversion?” In my head I’m saying to myself..”Uhhh shit. How can I not remember this? Here I am a second year PT student and I dont fucking know what muscle does inversion?!? Bruh why couldnt you have asked me this shit when she was doing eversion – peroneus longus and brevis.” But what actually came out was, “Ummm Anterior Tib?” Nope. Posterior Tib. I was literally pissed off about getting that wrong for the next 2 days. But guess what. Every god damn time I see someone doing an inversion ankle exercise now, in my head I’m going, “posterior tib.”

THAT’S LEARNING. And that’s when I find things stick the best. When I make an absolutely bone-headed mistake that creates an emotional response, which is usually to be pissed at myself.

Not to say that has to be your reaction. But I do think the mistakes we make, especially the one’s we internalize as BIG mistakes (whether they really are or not) is where we learn the most.

I don’t like being wrong. So it goes against my nature, but I now try to SEEK out opportunities where there is at least the possibility of me making a mistake that would create that same reaction as the posterior tib experience. I may not win some of those individual games day-to-day in the clinic, but…I want to win the series. So bring them on.

I highly recommend listening to this entire podcast episode. It’s FULL of great insights from both Jordan and Joe. I learned a lot, so hopefully you will get some value from it also.

Find the episode here on youtube: https://www.youtube.com/watch?v=6T7pUEZfgdI

Also, if you go into the podcast app on your phone and search for the Joe Rogan Experience, it is episode 1070.

Who is this guy

So, I think before I get in to other topics, it’s a good idea to give a little more info about me. Whenever I am coming across someone new online or there is a guest speaker coming in to class, I like to have an idea of their background and accomplishments. First impressions are important and especially important when there is so much information out there and so many different people sharing their ideas. I’m sure I’m not the only one who thinks this way . So, I feel it is only fair to give you some background info.

** As a disclaimer, this is just me providing some facts about myself so that you get to know who is writing all this nonsense a little bit better, that’s it. There are people ahead of me in terms of what they have accomplished during PT school. There are possibly people who have accomplished less. There are a bunch of people also, I’m sure, who have a very similar resume to me. Playing the comparison game is not a game to get consumed in and not one I intend to play here.

• I finished my undergraduate degree in Kinesiology from the University of Maryland, College Park in December of 2011 (sup though Terps) and didn’t start PT school until August of 2016.
• From 2012 to 2014 I worked full-time as a personal trainer at a small, private personal training studio working with mostly your every day guys and girls who wanted to lose some weight, get a bit stronger, etc. I was certified through ACE for personal training. I also handled the studio’s nutrition programming (along with individual client’s plans) and was certified with Precision Nutrition. From 2014, until I started school, I worked as a clinic assistant (TECH LYFE) at a pretty big out-patient sports medicine clinic in Maryland. During this time, I was taking the GRE as well as some pre-requisite classes that I had not completed yet (didn’t think I wanted to do PT school when I was in undergrad, so not only did I have pre-reqs to finish, it was chem, physics, etc. FUN).
• I’m thinking I will do a more specific/comprehensive post at some point about the exact details of my PT school application (grades, reference letters, observation hours, work experiences, etc.), but for now a quick idea is my cumulative undergrad GPA was somewhere around a 3.5-3.6, science GPA was like a 3.4, maybe? GRE was like right at 300 maybe a few points higher.
• I love sports and was pretty serious about baseball growing up, which ultimately helped steer me towards kinesiology in undergrad and personal training after graduating. I started to get frustrated with my job as a personal trainer and around this time also started getting really interested in Kelly Starrett’s mobility wod website, FMS, etc. I found their ideas and principles started helping some of my personal training clients and I started to think about PT school as a possibility. More on this at another time.
• I can tell you for a fact, because I’m looking at my school account right now, that my current cumulative GPA for PT school is a 3.817 and my GPA last semester was a 3.914. What does that mean? probably doesn’t really mean shit. Still haven’t had a patient ask me my GPA at any of my clinicals.
• I am the clinic coordinator, this year, for our program’s pro bono clinic. Our university has a partnership with a local community health center, which allows for us to have our pro bono physical therapy clinic located at the health center, which is about 5 minutes away from campus. Other physicians and nurses work there as well, and we are referred patients by doctors working within the health center’s network. We’re there 2 days per week, from 2:00-6:00 pm treating ortho patients and have had up to 14 patients scheduled to come in on a given day. This semester we just added 2 additional days & times for treatment of neuro patients.
• I’ve taken one continuing ed. course so far while in school with a buddy of mine from my class. It was Postural Restoration Institute’s Myokinematic Restoration course.
• Up to this point in school, I have had 4 part-time clinicals (one each semester, the 4^th having just started this semester) and one full-time clinical (for 6 weeks last summer).

So that’s me right now. My main goal is to just become a little bit better of a therapist each day and hopefully that leads to a career that I consider successful. To quote one of the great wordsmiths of our time, Wale Folarin, “…my only fear is mediocrity.” I agree with him. More to come…