Live Q&A Webinar

The latest Inner Circle webinar recording in now available.

Live Q&A

mike reinold inner circleThis month’s live Inner Circle webinar was a live Q&A with members.  These are always some of my favorites because we talk about so many different things, it just turns into a whirlwind hour of questions and answers!  This year we talked about things such as:

  • Dry needling
  • Lumbopelvic control
  • Designing rehab and performance programs
  • Assessing core strength
  • Treatment for epicondylitis
  • FAI
  • Posture shirts
  • How to know when to push harder or change your treatment plan
  • Thoracic manipulation
  • Knee extension devises
  • Advice on building blog readership
  • Strengthening the shoulder
  • And more!

To access the webinar, please be sure you are logged in and are a member of the Inner Circle program.  If you are currently logged in, you will see the webinars below.  If not, please log in below and then scroll down to the “webinar archives” section.  If you are not a member, learn how to access this and ALL my other webinars for only $5.

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7 Habits of Highly Effective Rehab and Fitness Professionals

The latest Inner Circle webinar recording on the 7 Habits of Highly Effective Rehab and Fitness Professionals.

7 Habits of Highly Effective Rehab and Fitness Professionals

7 Habits of Highly Effective Rehab and Fitness ProfessionalsI’m always getting questions from young professionals (and older ones too!) about what they can do to get ahead in our profession.  It’s one thing to simply want to get ahead and another to actually make daily habits designed to help you get there.  It takes effort.  Here are what I consider 7 of the habits that I see many of the top rehab and fitness pros stick to in their lives to get ahead.

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The Power of 1%

Today’s post is a guest post from a good friend of mine Pat Rigsby.  Pat is a fitness business genius and has helped us enormously at Champion PT and Performance.  This article really resonated with me, as I am a big believer of constantly tweaking my systems.  This goes for all my “systems” – my manual therapy system, my corrective exercise system, my program design system, and even all my business systems.  I’m constantly trying to improve myself everyday, and this article really put it in perspective for me.  If you aren’t trying to get 1% better today, you are falling behind.

The Power of 1%

The Power of 1%One of the biggest differentiators between the great business and the average ones is that the great ones keep improving.  They kept evolving their training system and making it 1% better, over and over.

Someone who looks at their sales system or their assessment system may say “that doesn’t look that different from what I do.”  But again – the great ones keep improving things, 1% at a time.

And if you look at their businesses, all the things that they do from their Initial Consultation to their Referral Systems to their Training System don’t necessarily look like something you’ve never seen before…they just do them all a little bit better than most everyone else.

That’s why the best businesses succeed…they take what works, they plug it into their businesses and they ‘plus it’ over and over…improving each component by 1% time and time again.  And when it’s all said and done you have a business that has maybe 20 different components which are each 10-20% better (at minimum) than the competition.  But because of the compound effect, this doesn’t make their business 10-20% better.  Because every piece works synergistically with the others their improvement actually multiplies the improvement of the other areas.

It’s the difference between 100 clients and 400.  The difference between $150,000 a year and $750,000.

If that seems hard to believe, here’s how a 20% increase compounded changes things, illustrated another way:

  • 10 X 10 x 10 x 10 x 10 x 10 x 10 x 10 x 10 x 10 = 10,000,000,000
  • 12 x 12 x 12 x 12 x 12 x 12 x 12 x 12 x 12 x 12 = 61,917,364,224

12 is only 20% bigger than 10, but compounded the difference is HUGE.

So how can you put this into action?

Model Success

That’s what you’re doing by reading this, so you’re already off to a good start.  The best business owners I know may have invented a few things from scratch, but most of the components of their businesses were things that they learned from other successful fitness pros and businesses that they adapted, improved and made their own.

So study what’s working.  Borrow from successful businesses.  Model their success.

Implement

We all see dozens of good ideas…in products, at events, in Mastermind Meetings. But I’d guess most people actually implement about 2% of what they learn. The best businesses are living, breathing pictures of implementation.  All the things people say they’re going to implement – the best ones actually do.

Remember – It’s not what you know.  It’s what you do.  You can say you’re a relationship business, but if you drop the ball over and over – you’re not.  You can say you’re all about referrals, but if you don’t have referral systems in place that are working – you’re not.

The best implement. So should you.

Plussing

‘Plussing’ is a Walt Disney term for continually improving and it should be a regular part of your vocabulary.  You may learn a referral system from someone and implement it, but you shouldn’t settle for it ‘as is.’  You should always be looking ways to make it a little more effective.  We often talk about getting 1% better.  This is getting 1% better in action.  Improving your referral reward or the way you ask.  Improving your internal language.  Improving your training system.  1% at a time.  This ‘plussing’ will eventually give you that 10-20% edge in every area that the best business owners have.

So that’s it.  Your ‘all too simple’ way to build a powerhouse business.  So put it into action and reap the same rewards that the industry’s best business have reaped.

Get Started Today, 1% At A Time

fitness business blueprint[Note from Mike] Here is your first step towards 1%.  When I was just starting Champion PT and Performance, I sought out as much information as possible to assure I started in the right direction.  I’m not a fan of making rookie mistakes when I can learn from the mistakes of others.  One of the best resources I discovered was the Fitness Business Blueprint by Pat Rigsby, Eric Cressey, and Mike Robertson.  Even if you aren’t starting a “fitness” business, this is a great resource for physical therapy business.  It is very comprehensive.  It covers everything you need to start a successful business with things like:

  • How Eric Cressey performs his assessments to build his programs
  • How Mike Robertson designs his programs, sessions, and staff meetings
  • How Pat Rigsby identifies his ideal clients and gets them in the door

I asked Pat if he could offer anything special to my readers on this product so they could benefit as much as I did and they responded with a huge discount!  I love being able to help my readers get access to things like this at such a discounted price.  The program is normally $299.95 but they are offering my readers ONLY a special price of $99.95 if you use the link below:

About Pat Rigsby

Pat RigbsyPat Rigsby is the CEO and Co-Owner of the several of the most prominent brands in the fitness industry including the Fitness Consulting Group, Fitness Revolution, Athletic Revolution and the International Youth Conditioning Association. Along with partner Nick Berry and an incredible Team, Pat has helped Fitness Revolution develop into the fastest growing training based franchise in the world and Athletic Revolution develop into the fastest growing youth fitness and sports performance based franchise. Together they have also led the Fitness Consulting Group to becoming the world’s leading business coaching and development organization for fitness professionals and establish the International Youth Conditioning Association as the world’s leading educational organization on the topic of youth fitness & sports performance.

Pat is the author of the only book on the topic of Fitness Business ever to reach #1 Bestseller status, The Little Black Book of Fitness Business Success. He’s also authored or co-authored several other best selling books, is a popular public speaker on the topics of business and marketing and writes the most widely read newsletter on the business of fitness in the industry, reaching over 60,000 fitness professionals.  Learn more about Pat Rigsby here.

How to Work with Professional Athletes

The latest Inner Circle webinar recording on the How to Work with Professional Athletes is now available.

How to Work with Professional AthletesHow to Work with Professional Athletes

Last month’s Inner Circle webinar was on How to Work with Professional Athletes.  A good portion of our clientele at Champion PT and Performance are professional athletes.

In this presentation, I discuss some of the many things I have learned in my career about working with professional athletes.  I’ll discuss what this involves, pearls from the perspective of the player, agent, and team, as well as recommendations on how to break in with professional sports.

To access the webinar, please be sure you are logged in and are a member f the Inner Circle program.  If you are currently logged in, you will see the webinars below.  If not, please log in below and then scroll down to the “webinar archives” section.  If you are not a member, learn how to access this and ALL my other webinars for only $5.

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5 Things We Can All Learn from Derek Jeter

5 Things We Can All Learn From Derek JeterGrowing up in Boston as a Red Sox fan, I never thought I’d be writing an article about Derek Jeter (we all know that Nomah is bettah than Jettah…).  I think that working in Major League Baseball for so many years and having the opportunity to work with players from every Major League team has made me a bigger fan of the game in general.  (Photo Credit)

Perhaps I’ve lost some of the magic, but I’m just as much of a Yankees fan as I am a fan of the Red Sox and a fan of every other MLB team. 

I’m a fan of an excellent performance.  I’m a fan watching young players blossom.  I’m a fan of watching the game played the right way.  I’m a fan of the players I work with and help become better.  I’m a fan of the game, so I’m a fan of Derek Jeter.

5 Things We Can All Learn from Derek Jeter

As Jeter says his farewell to baseball, it made me think about what we can all learn from his amazing career.  Here are 5 things about Derek Jeter that stand out to me.

Discipline

There is a big difference between willpower and discipline.  Chris Brogan speaks about this well in his latest book The Freaks Shall Inherit the Earth.  People often ask me how I have the time or willpower to contribute to my website, make more programs, own a physical therapy and performance center, and still somehow have a life and family.

As Chris says, it has nothing to do with willpower, it’s all discipline.  Chris says:

“Willpower is when you want to do something different and force yourself to do what you believe is the better choice.”  Discipline is actually working hard to REPEAT the task that you know will make you better.

Do you think Jeter took a lot of days off from batting practice?  Do you think Jeter had donuts for breakfast every morning?  You think Jeter showed up late to the park and was unprepared for the game?

Nope.

I get it, there are a lot of conflicting interests in this world.  Discipline is crafting your long term vision of what you want out of your life and then making decisions based on this vision.

Consistency

Honestly, what good is discipline with out consistency?  I would say the two things that impressed me most about Jeter’s career were his discipline and his consistency.

Take a look at Jeter’s career stats over at Baseball-Reference.com.

Notice a trend here?  There are really no significant dips and jumps in his performance.  Sure there are some years that are better than others, but that is one heck of a consistent career.

To illustrate this, lets compare his rookie year of 1996 to 2012:

  • 1996 – 157 games, .314 batting average, 104 runs, 10 home runs, 78 RBIs, and 14 steals
  • 2012 – 159 games, .316 batting average, 99 runs, 15 home runs, 58 RBIs, and 9 steals

Pretty impressive to be that consistent over 20 years and 2700 games. 

Consistency breads dependability and trust.  We are developing a systemized approach to our model of integrated physical therapy, fitness, and sports performance at Champion Physical Therapy and Performance.  Why?  So we can build a reliable service to our clients with repeatable and predictable results.

Want to get ahead in life?  Focus on consistency.

Lead By Example (Positively)

There are many different kinds of leaders in this world.  There are the loud and vocal leaders, the motivators, the “pump up the crowd” kind of people.  The ones that want the attention and lead to gain the spotlight.  The manic-depressive crowd.

There are also the quite and consistent leaders that lead by example.

Leading isn’t necessarily a good thing, there are many examples of “negative” leaders.  People that are captivating and engaging and actually set the WRONG example!  Like it or not, these are leaders. 

But luckily there are also the “positive” leaders.  The leaders that set the example, that push others just by being so disciplined and consistent. 

In the long run, I’ll take the type of leaders like Jeter, the positive leaders that consistently lead by example.  To me, this is as much educating and motivating, as it is leading.  This is what young professionals need to learn.

And don’t forget, this applies to anyone.  You can lead others in any direction, meaning you do not have to be in a position of authority to be a leader.  John Maxwell has an excellent book on this call The 360 Degree Leader

Don’t Rock the Boat

One of the most interesting things about Jeter to me is how neutral he has stayed on everything throughout his career.  While I’m sure he had plenty of opinions, it’s usually not in anyone’s best interest to blurt them out every night on SportsCenter.

Many of the “guru’s” on the internet should really take this one to heart.  Unfortunately controversy sells.  However, realize we are all probably going to change our opinions and adjust our thought process based on past experiences and knowledge gained.

Don’t be that person that is so definitive in their thought process AND doesn’t mind telling the world about it!  Have an open mind and try to avoid rocking the boat, it always comes back to haunt you!

When you are so vocal about something, you start to focus on defending your stance instead of keeping an open mind.

Treat Everyone the Right Way

One of the sentiments within baseball is that Jeter is a “good guy.”  I’ve had the opportunity to meet Jeter several times.  I’ve seen him walk into the training room of an All-Star game just to introduce himself and say hello to the staff.  Not everyone does that, in fact most don’t.

Baseball has a funny way of changing people.  The players have everything in the world given to them and are treated as rock stars at all times.  Imagine arriving at a hotel at 4:00 AM and having a line of people asking for your autograph as you get off the bus!  It’s hard to stay grounded.

Treating people the right way is the corner stone of any relationship.  You are not a better human or person in this world because you can hit a fastball, or because you have accumulated $275 million dollars over your baseball career.  These may be extreme examples, but it applies to us all.

 

As we move on today as the first official day in the last 20 years that Derek Jeter is not a professional baseball player, keep these 5 principles in mind.  Yankee fan or not, there are plenty of things we can all learn from Jeter’s amazing career.

One Step Back to Take Two Steps Forward

Lately, I’ve found myself using a certain phrase with many of my clients to emphasize a point I’m trying to make, “sometimes you need to take one step back to take two steps forward.”  I specifically emphasize that this is a lot different than the phrase “two steps forward, one step back,” which often has a negative connotation.

Perhaps it’s our always-on, go-go-go, society that we live in now that wants nothing but progress, but this concept has many meanings to both myself and my clients.  Here are a few ways I incorporate this concept into my training, rehabilitation, and even personal development.

 

Fitness and Performance Training

As fitness trends continue to evolve and fads come and go, there are always two common complaints that I hear from people in regard to their training programs:

  • I’m not making progress
  • I’m breaking down

Either of these two complaints is enough for me to consider that you may need to take a step back.  These tend to occur when your programming is not individualized based on your own specific needs and goals or when your always focused on “emptying the tank” every session.

workout exhaustion

Assuming you have a well-design strength or performance training program, the error tends to occur by always focusing on pushing the limits and not allowing your body to recover.  If you are training to failure or competing at fitness every day, you have to be conscious of the fact that eventually this breaks down your body.  This is normal, required to make progress, and advantageous, at least when used correctly.  (photo credit)

However, to continue to make long lasting gains and avoid wearing and tearing on your joints and muscles, you need to incorporate some sort of deloading into your programming.  I won’t go deep into the concept of deloading, as other people that are smarter than I am have said it well before.  Here is a great article by Tony Gentilcore on why and how he incorporates deloading into his programming, for example.

When do you need to unload?  It varies based on your training experience, intensity, and frequency.  Rather than standardize a deload period, I have a simple criteria to determine if you need a deload week – are you plateauing your progress or are you breaking down?  Simple.

But realize that deloading does not mean resting.  Our deload periods at Champion take advantage of the time and work on enhancing efficiency and cleaning up movement patterns.

Also note, this concept applies to sports performance training.  If you are 12 years old and long tossing in October to enhance your pitching velocity for next April, you really need to get better advice from someone that understands the concepts of periodization.

 

Injury Rehabilitation

I’m a big fan of “regen days.”  Often times during injury rehabilitation, people are trying to get back as soon as possible.  For the highly motivated person, like the professional athlete, they often feel like they have to get after the rehab program every day to get back as fast as possible.  I have actually found that this often SLOWS the process down!

As an example, in professional baseball, we play everyday.  Maybe we have 2 or 3 days off a month.  Sunday is usually a day game and getaway day, meaning that we need wake up early, pack our bags, check out of the hotel, play the game, then travel to another city.  I was always a fan of taking Sundays off from rehab in professional baseball, and I was often looked at like I had two heads.

I seriously doubt we are going to make any significant gains on a Sunday morning waking up at 7:00 AM and rehabbing when last night’s game ended at 11:00 PM and you were in bed at 2:00 AM.  We just crushed it all week in rehab, it’s time for a break.  Get some good sleep and take the day off – both physically AND mentally!

That’s just one example.  For the athlete that may be rehabbing daily, I often build my rehab programs with altering variables throughout the week depending on what phase of the program they are currently performing.  For example, I often do a three day split with my baseball players:

  • Day 1 – Strength based
  • Day 2 – Stability based
  • Day 3 – Regen

Again, “regen day” does not mean rest, but I can’t keep taxing the system every day.  During the early phases of rehab, perhaps the first month or two after Tommy John surgery, we don’t need this as the training stimulus is not high enough, but once you start incorporating more advanced exercises and eventually throwing, this concept becomes important.

I always tell my clients – take a step back and you’ll come back twice as ready to go.  By the end of the week, most of my clients are pretty beat down and ready for a nice weekend to recover.  On Monday morning, they are ready to roll again.  This is how you make big gains week-to-week in the rehab process.

 

Personal Development

studyingLastly, I use this concept all the time in my own personal development.  We’ve all probably been in a place where we felt that the programs we are writing or how we were coaching our athletes was perfect.  And I bet it was.  But it was only perfect for that single day.  As we continue to learn, grow, and develop, I push all of the team at Champion PT and Performance to challenge themselves.  I want them all to look back at a program they wrote several months or years ago and think “I would write that completely different now.”  (Photo credit)

That doesn’t mean that your program was poorly designed before, it means you have evolved your thought process and progressed yourself.

If you are writing the same programs all the time or can look back and your programs a year later are the same as last year, you are better than that.  Take a step back, challenge yourself intellectually, learn something, evolve, and take two giants steps forward.

 

Taking a step back to take two steps forward doesn’t have to be negative.  It’s still progress.  Consider these tips and incorporate theses concepts into your training, rehabilitation, and personal development.

 

 

Assess Don’t Assume

SFMAI was fortunate last week to swing by and watch my friend Mike Voight teach the SFMA in Boston.  I met Mike’s co-instructors Josh Satterlee and Brandon Gilliam and was impressed with the course.  I have been SFMA certified for some time but I wanted to hear Mike’s take on the system.

I wanted to share with everyone a key theme that was presented that I thought was worth expanding on and sharing.  During one of the introductory presentations, Josh talked about how important the assessment process was and without it, we are just guessing.  This goes along with what I always say, “assess, don’t assume.” [Click to Tweet]

One of the points that was made was that sometimes we get lucky.

Perhaps your client can’t touch their toes and you instruct them to stretch their hamstrings.  Now this person can easily touch their toes.  Take a guess what you are probably going to tell the next 50 people that can’t touch their toes to do?  Probably stretch their hamstrings, because it worked so well on that first person!

We have all been guilty of getting stuck in our box of techniques.  Every time we go to a new seminar or learn something new on the internet, we try it on everyone.  Perhaps we get lucky and hit a bullseye on a few of those people.

We all know there are dozens of reasons why you may not be able to touch your toes, and realistically, hamstring flexibility is not often the reason!  You can’t recommend hamstring stretching unless you have identified that this is the specific reason why your client can not touch their toes.

Don’t be guilty of being stuck in your box of techniques.  Just because it works on one person, doesn’t mean it will work on the next person.  Everyone is unique and has unique needs.

Don’t get stuck in your ways.  As Josh said, chiropractors are great at mobilizing already mobile people and physical therapists are great at stabilizing already stable patients.  I thought that was hilariously accurate!  It really comes back down to your assessment.  I do use the SFMA but also many other assessments techniques (you can see some of them in my Functional Stability Training system).  They help guide me towards what my client needs, I’m not satisfied with being lucky, neither should you.

 

 

The Use of Rehabilitation Protocols in Physical Therapy

Today’s guest post “The Use of Rehabilitation Protocols in Physical Therapy” comes from my good friend and frequent contributor, Trevor Winnegge.  Trevor writes a nice article discussing the use, and often times over-reliance, of rehabilitation protocols by physical therapists.  I’ll add some comments at the end of the article as well.  Hope you enjoy!

In writing this post, I am going to stray away from the normal educational posts on this blog.  I would like to take this opportunity to provide my commentary on the use of orthopedic and sports medicine protocols by physical therapists, and a problem I am seeing more common of late:

Physical therapists are not using their brains!

Too often, I get referrals and phone calls asking to take a second look at a physical therapy patient. Most of them are post operative and have been doing their rehabilitation elsewhere. Upon evaluation, the patient is behind schedule and doing poorly. When I ask the patient what they have been doing in physical therapy, the answers are often all over the map.  The patient will say the therapist is “just following the doctor’s protocol.”

It is that statement that inspired me to write this post.

 

The Use of Rehabilitation Protocols in Physical Therapy

We as physical therapists have gone through a lot of schooling and hard work to earn our degree, pass our board exams, and remain licensed each year.  We possess knowledge of anatomy, kinesiology, biomechanics and rehabilitation like no other.

Unfortunately, I see and hear stories of physical therapists not using this knowledge base and simply following a protocol.

Lets use an example of a patient who recently had a medium sized rotator cuff repair.  The referring surgeon sends them to physical therapy 10-12 days post operative and the therapist initiates the surgeon’s protocol.  The protocol states passive and active assisted range of motion only for six weeks.   This patient comes into the clinic twice a week to be stretched and is compliant with his home exercises. The therapist performs passive and active assisted range of motion only, as stated on the protocol.

The therapist took the phrase “range of motion only” literally and did not perform any other aspect of therapy.  While this patient may end up with a decent outcome, the therapist is following the protocol and not utilizing their education to the best of their ability.

 

Don’t Be Afraid to Think!

rehabilitation protocolsIn addition to the range of motion, there are many beneficial treatments that could be performed to help the patient feel and function better.

You could perform soft tissue mobilizations to areas that are sore or tight from guarding all day, such as the rhomboids, subscapularis, latissimus, and pectoralis.  Postoperative patients are often guarded, in a sling, and not moving their arm normally. By performing soft tissue, you can help them relax and increase tissue extensibility.

Ultimately, we should be helping the patient become more comfortable and return to their functional activities.

You can also perform scapular mobilizations to start getting the scapula free of restrictions and allow it move through full range of motion. This patient is not actively moving their arm, therefore the scapular is also not moving through it’s normal range of motion. Think of this as passive range of motion for the scapula, which is absolutely necessary.

In addition to these interventions, you can also perform scapular PNF manual resistance for scapular retraction and depression. The protocol states ROM only, so many therapists won’t perform this technique.  However, this is not resistance for the shoulder or rotator cuff.

This PNF pattern works the rhomboids, middle trapezius, and most importantly the lower trapezius.  By utilizing my knowledge of anatomy and kinesiology, I know the lower trapezius attaches to the medial border of the scapula, forming a force couple with serratus anterior to upwardly rotate the scapula when elevating the arm above ninety degrees.

Lower traps are a key muscle group to target for a successful rehabilitation program.  While we can’t have the patient use their arm to perform lower trap exercises, you can have them get in the sidelying position with the affected arm towards the ceiling.  Place your hand over the inferior angle of the scapula and provide manual resistance into depression and retraction, on a diagonal pattern.  You can then passively bring them back to the starting position. I will do multiple sets per visit. This starts activating the lower traps without putting any harm or strain on the rotator cuff.

 

Let Protocols Direct You, Not Dictate to You

None of the above mentioned interventions were written on the protocol. Yet I know all of them are safe, effective, and a much better use of my patient’s time and money. It will allow for a better and faster recovery, while keeping the integrity of the surgery intact.

So I encourage all therapists to start thinking more with your hard earned physical therapy degree.  Become less complacent while following a protocol. Challenge yourselves to develop more comprehensive treatment interventions for the post operative patient, whether it is a rotator cuff, ACL, fracture, joint replacement or any other surgery. Approach protocols as guidelines, not all inclusive to what you can do. You will be pleased with the results.

I invite others to comment on this and give feedback on your experiences using protocols. Have you seen therapists simply following the protocol without thinking? Do you think outside the box when developing treatment plans with a post operative population?

 

Mike’s Thoughts

Excellent article, Trevor, and much needed!  When all is said and done, rehabilitation protocols are very important components of post-operative physical therapy.  Certain standards of care following a surgery must be set and communicated to assure patients progress appropriately after surgery.

SEE ALSO: Rehabilitation Protocols by Kevin Wilk, Mike Reinold, and James Andrews

However, a protocol simply gives you guidelines as to what you can and can NOT do.  What you “can” do is not restricted to what is within the protocol.  Think of them as guidelines to assure that you are not going too slow or too fast.

Realistically, a protocol does not list every treatment and exercise that should be included.  This is where your skill and experience comes into play.  You must determine what other interventions you can safely perform to help the patient, while assessing if that chosen intervention fits safely within the protocol restrictions.

We should not follow a rehabilitation protocol without thought, that is not “skilled” physical therapy.

 

About the Author

Trevor Winnegge PT,DPT,MS,OCS,CSCS  has been practicing PT for over 13 years. He graduated from Northeastern University with a Bachelors in PT and a Master of Science Degree. He also graduated from Temple University with a Doctor of physical therapy degree. He is a board certified specialist in orthopedics and also a certified strength and conditioning specialist. He is adjunct faculty at Northeastern University, teaching courses in orthopedics and differential diagnosis. He currently practices at Sturdy Orthopedics and Sports Medicine Associates in Attleboro MA, where he treats many orthopedic and sports medicine patients.