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Host Kyle Kargis talks with Trevor Hicks about his shift from physical therapy into real estate investing, lending, and entrepreneurship. Trevor shares how community, partnerships, and local relationship-building helped him move from his first flip into multiple active projects across Florida. He also breaks down a Belle Isle fix-and-flip, including how he found the lead through a neighbor, negotiated with an agent, handled rehab challenges, and protected profit by knowing his numbers. Trevor also discusses his next moves in private lending, selective flipping, and exploring hospitality business acquisitions. Follow Trevor Hicks: https://www.instagram.com/trevor_ryan7/ https://www.linkedin.com/in/trevor-hicks-orlandorei/ ► Join The SubTo Community & Learn Creative Finance Directly from Pace Morby: https://subto.sjv.io/X42Y94 ► Learn How to Make Money on Other People's Deals - Join the FREE Live Training: https://gator.sjv.io/n4WL6o ► Turn Real Estate Transactions Into a Real Career. Learn How to Become a Top Tier Transaction Coordinator - Start Here: https://toptiertc.pxf.io/OYyrdz
On this teach me something Tuesday, Dr F Scott Feil reviews why cramming doesn't work, and spaced studying is the way!
Being medically cleared does not always mean someone feels capable of returning to the life they actually want.In this episode of PT Pintcast, Jimmy McKay sits down with Dr. Sean Pastuch, founder of Active Life and author of Live More, Hurt Less, to explore the “messy middle” between physical therapy and fitness.A patient may be able to work, drive, sleep, and complete every activity of daily living. But can they run competitively? Lift heavy weights? Play with their children? Trust their body again?Sean argues that temporary restrictions can quietly become permanent beliefs. A diagnosis may provide relief and clarity, but without the right conversation, it can also become an identity and a permission slip to live smaller.Jimmy and Sean discuss:• The difference between being cleared and being capable• Why discharge is not always the end of recovery• How healthcare language can unintentionally make people feel fragile• Why chronic pain has physical, psychological, and social dimensions• How PTs can find fitness professionals they trust• Why patients need to clearly communicate the life they want to return to• The problem with telling someone their pain is “all in their head”• How PTs and fitness coaches can collaborate without competing• Why Sean believes people are both the cause and solution to many of their problems• The ideas behind Sean's book, Live More, Hurt LessABOUT SEAN PASTUCHDr. Sean Pastuch has spent more than two decades working at the intersection of healthcare and fitness. He began his career as a personal trainer, became a clinician, founded Active Life, and built his work around helping people move from medically cleared to genuinely capable.CONNECT WITH SEANWebsite: https://www.drseanpastuch.comInstagram: https://www.instagram.com/drseanpastuchLinkedIn: https://www.linkedin.com/in/sean-pastuch-02ba88109Learn more about Active Life professionals and the coach network discussed in the episode at ActiveLifeProfessional.com.Find Live More, Hurt Less through Sean's website or wherever books are sold.ABOUT PT PINTCASTPT Pintcast is where smart people in healthcare come to make noise. Hosted by Jimmy McKay, PT, DPT, the show delivers conversations, not presentations, about the people, ideas, and uncomfortable questions shaping physical therapy.Follow PT Pintcast and share this episode with a physical therapist, coach, or healthcare professional who works with people trying to return to the activities that make life feel like theirs.
Matt and Allie sit down with patient Josh Purnell to talk about his experience in physical therapy, as well as the injury and journey with other physicians that got him here. Josh shares his background and his love of playing softball and other sports as he walks us through all the treatments and different doctors he visited to find relief from his foot pain. Josh gives a shout out to Dr. Bryan Fallis who ultimately referred him to our Physical Therapist and Florence Clinic Manager, Marie Graves, who both worked together to get Josh back on the softball field. Now knowing his Direct Access rights, Josh wishes he had just skipped all the previous doctors visits and came straight to PT first.Did you know that you don't need a doctor's prescription to receive physical therapy? You can schedule here . The laws of Direct Access allow you to receive physical therapy without a referral and still use your insurance benefits! Learn more on how Direct Access can help YOU! Our website: https://www.oxfordphysicaltherapy.com/
Dr. Peter Dionisopoulos is a physical therapist and performance rehabilitation specialist focused on injury prevention, rehabilitation, and performance optimization. He emphasizes the value of finding the right exercise threshold where discomfort exists but pain doesn't, and the importance of progressive exposure to stress in a safe manner to build resiliency. He shares that different body types have genetic predispositions toward certain movement patterns, the need for individualized approaches rather than one-size-fits-all solutions, and the significance of maintaining fitness levels even during recovery from injuries or surgery. Pete explains his approach at Dynamic Performance Rehab, which bridges basic rehabilitation with performance enhancement to help people achieve optimal function rather than just returning to normal. To connect with Dr. Peter Dionisopoulos visit dynamicprri.com or follow on Instagram @dynamicpr.ri Visit ConfidenceThroughHealth.com to find discounts to some of our favorite products.Follow me via All In Health and Wellness on Facebook or Instagram.Find my books on Amazon: No More Sugar Coating: Finding Your Happiness in a Crowded World and Confidence Through Health: Live the Healthy Lifestyle God DesignedProduction credit: Social Media Cowboys
Q Willey is a Doctor of Physical Therapy and Certified Strength and Conditioning Coach who joins me to discuss barbell training, back pain, injury risk, metabolic health, rehabilitation, and the way strength training is often portrayed online.Q joins me to discuss:• Why no existing studies show that squats or deadlifts cause back pain• Whether barbell lifts are inherently riskier than other forms of exercise• How the loadability of barbells can get some lifters into trouble• Why training systems matter more than individual exercises• Load management, fatigue, and individual capacity• Why pain can feel random even when contributing factors exist• How sensational injury stories shape public perceptions of lifting• The self-driving-car metaphor for anecdotes about barbell injuries• Why lifting is often demonized more than other physical activities• What imaging can and cannot tell us about back pain• Spine surgery, structural findings, and pain• The value of physical therapy beyond simply “fixing” injuries• The relationship between metabolic health, obesity, pain, and rehabilitation outcomes• How to discuss body weight respectfully in a clinical setting• GLP-1 medications and a physical therapist's professional scope• And much moreFollow Q on Instagram:@coach_q_physioCHAPTERS00:19 Meet Coach Q01:08 Do Squats Hurt Your Back?02:48 Load Management Basics06:57 Why Pain Can Feel Random10:45 Sensational Stories About Injury Risk13:24 Spine Surgery and Medical Imaging17:43 Why Lifting Gets Demonized20:21 Barbells Versus Training Systems30:37 The Value of Physical Therapy Beyond Fixes37:22 Metabolic Health and Pain42:38 Discussing Body Weight Respectfully51:33 GLP-1 Medications and Professional Scope55:33 Where to Find Q56:54 Final Thanks and Wrap-UpSUPPORT THE SHOWIf this episode helped you think differently about barbells, injury risk, pain, or rehabilitation:• Subscribe and check out more episodes• Share the episode on social media and tag @andrewcoatesfitness• Send it to someone who is afraid that squats or deadlifts will automatically damage their backFOLLOW ANDREW COATESInstagram: @andrewcoatesfitnesshttps://www.andrewcoatesfitness.comPARTNERS AND RESOURCESRP STRENGTH APPUse code COATESRP:https://www.rpstrength.com/coatesJUST BITE ME MEALSUse code ANDREWCOATESFITNESS for 10% off:https://justbitememeals.comMACROSFIRST — FREE PREMIUM TRIAL• Download MacrosFirst• Begin setting up your account• When asked, “How did you hear about us?” enter: ANDREWKNKG BAGS — 15% OFFhttps://www.knkg.com/Andrew59676VERSA GRIPPShttps://www.versagripps.com/andrewcoatesTRAINHEROIC — FREE 90-DAY TRIAL• Visit: https://www.trainheroic.com/liftfree• Reply to the email you receive or email trials@trainheroic.com• Let them know Andrew sent youL1 BIOMECHANICS AND ASSESSMENT COURSEUse code COATES:https://pro.activelifeprofessional.com/assessmentworkshopevents
One text message. That name...and suddenly everything unraveled.Here's what most people don't realize: it was never really about the text. What's actually happening runs much deeper than words on a screen and until you understand it, you'll keep finding yourself hijacked by moments exactly like this one.In this episode, I'm breaking down the real reason one message can take you from grounded to spiraling in seconds and the one question that changes everything.ABOUT DR. KELLY KESSLERI'm Dr. Kelly Kessler, a Doctor of Physical Therapy, nervous system educator, and host of the Rewiring Health® Podcast. I help high-achieving women stop abandoning themselves after setting boundaries by creating safety in their body, rebuilding self-trust, and developing the capacity to stay loyal to themselves, even when it's uncomfortable.Connect with Kelly:If this episode resonated, start with my free Self-Abandonment Audit: a powerful first step to uncover where you may be putting everyone else first, overriding your needs, or talking yourself out of what you know is right for you.Get the audit here:https://drkellykessler.com/selfauditReady for more support? The Self-Respect Reset is my 4-week self-paced course designed for women who know what they need but struggle to follow through. You'll learn how to navigate guilt, build self-trust, create healthier boundaries, and stop abandoning yourself in the moments that matter most.Learn more here: https://drkellykessler.com/selfrespectresetLooking for personalized support? The Self-Loyalty Mentorship is for the woman who is ready to stop second-guessing herself, stay true to what she knows, and build the capacity to hold her boundaries and decisions with confidence even when it's uncomfortable.Learn more here:https://drkellykessler.com/selfloyaltymentorshipWebsite:https://drkellykessler.com/
Will sits down with Paul Cords, physical therapist, adjunct professor, and PRN clinical excellence rep, live at APTA CSM. The conversation centers on primary care physical therapy: the idea that PTs aren't just a referral stop after a doctor's visit. In states like Arizona, they can be the first call for a musculoskeletal emergency, ahead of the ER.Paul and Will get into what's actually possible under current PT licensure (imaging referrals, differential diagnosis, same-day triage), why regulations differ so much state to state, and why PTs still don't own this authority in practice. They talk about the "seat at the table" problem: PTs are often left out of the referral and care-team conversations that happen naturally between physicians, and that has to change through both confidence and relationships, not just legislation.In this episode, they cover:What primary care PT actually means, and why it's more than "skip the family doctor"How PTs in states like Arizona can already send patients for same-day imagingWhy musculoskeletal cases might be triaged better by a PT than an ERThe "seat at the table" problem, and why it's personal before it's professionalA patient story: going from 100mg of daily Oxy to opioid-free in one monthWhy academia is starting to teach case ownership, not just documentationWhat it looks like when a PT is paid for wellness visits, not just injury visitsWhere Paul sees the profession heading, and what has to change to get therePaul Cords is a physical therapist, adjunct professor at NAU, and clinical excellence rep with PRN. He also does nonprofit and leadership development work in Tanzania through Zoe Hope International.Thanks to PRN for supporting this episode.Lead with love. Never give up.Send us Fan MailVirtual Rockstars specialize in helping support or replace all non-clinical roles.Learn how a Virtual Rockstar can help scale your physical therapy practice.Subscribe here to our completely free Stress-Free PT Newsletter for your weekly dose of joy.
In this episode of Health, Wealth and The Ultimate Self podcast, we sit down with Dr. Payal Mehta, a Doctor of Physical Therapy specializing in pelvic floor health and scoliosis. Dr. Mehta shares her professional journey from her beginnings in India to her current work in the U.S., delving into the challenges and breakthroughs she's encountered along the way.Dr. Mehta opens up about her personal struggles with pelvic floor dysfunction, the lack of awareness surrounding the condition, and how this experience inspired her to explore beyond traditional physical therapy methods. She explains the crucial connection between breath, core stability, and pelvic floor function, highlighting why issues are often rooted higher up in the body and not just isolated to the pelvis.Listeners will learn the importance of breath work, core training, and proper movement patterns for preventing and managing pelvic floor dysfunction—far beyond relying on Kegels alone. Dr. Mehta discusses common symptoms, the impact of stress, sedentary lifestyles, and hormonal changes, especially around menopause. She also addresses the challenges she faces shifting perspectives in physical therapy, emphasizing the need for ongoing learning, individualized care, and integrative approaches to health.Whether you're experiencing low back pain, hip tightness, urinary issues, or are planning for pregnancy, this episode is packed with practical advice and empowering insights for women and men alike.Connect with Dr. Payal Mehta:Instagram: @PowerOverPainFree discovery calls and personalized guidance available.Follow Health, Wealth and The Ultimate Self for more expert discussions on movement, integrative health, and practical wellness strategies.Find us on iTunes, Spotify, or YouTube. Full show notes and resources are linked in the episode description.
In this episode of the Optimal Body Podcast, Doctors of Physical Therapy Doc Jen and Doctor Dom sit down with board-certified plastic surgeon Dr. Robert Whitfield, founder of the Sharpe Method. Dr. Whitfield shares his expertise on breast implant illness (BII), explaining how bacterial contamination, biofilm formation, and genetic factors can contribute to symptoms like fatigue, brain fog, joint pain, and hormonal disruption. He also explores natural alternatives to breast implants, such as autologous fat transfer. Whether you currently have breast implants or are considering your options, this episode offers valuable, science-backed insights to help you make informed decisions about your body and long-term health. Dr Whitfield's Resources: Dr Rob's Circle Dr Whitfield on IG Dr Whitfield on YT Dr Whitfield on FB Dr Whitfield's Website We Think You'll Love: Free Week of Jen Health Jen's Instagram Dom's Instagram YouTube Channel For full show notes and resources visit https://jen.health/podcast/471 What You'll Learn: 3:46 An explanation of using a patient's own tissue for breast implants reconstruction, comparing it to organ transplants between genetically identical twins. 7:33 Why implant-based reconstruction is the most common method worldwide, especially in community hospitals, due to less required technical support. 9:37 Dr. Whitfield recounts a 2006 case where removing implants and using the patient's own tissue resolved her chronic inflammation symptoms. 11:53 A 2016 case where a patient's only symptom was fatigue, which was linked to a hidden E. coli infection. 15:07 Discussion on the three ways infections can occur with medical devices, with the most common being bacteria entering the bloodstream. 16:17 Explaining how bacteria form biofilm on implants, causing oxidative stress, and how genetics can influence a person's inflammatory response. 20:40 Addressing whether all implant recipients should worry, highlighting the role of genetics, lifestyle, and the challenge of diagnosing symptoms. 21:59 Dr. Whitfield emphasizes prioritizing sleep hygiene, nutrition, and reducing toxin exposure as foundational steps for improving overall health. 28:33 A list of top symptoms associated with breast implant illness, including fatigue, brain fog, joint pain, and gut issues. 32:04 Discussing the psychological and Hosted by Simplecast, an AdsWizz company. See pcm.adswizz.com for information about our collection and use of personal data for advertising.
Send us Fan MailPride is often celebrated with glitter, music, and rainbow flags—but at its heart, Pride has always been about something much deeper: showing up in love and solidarity so that no one has to wonder if they're alone. Today, we're talking with some of the Mama Dragons who set up booths at Pride festivals across the country, creating spaces where families could find hope, connection, and unconditional love. Joining Sara In the Den are three incredible volunteers: Yanira from Puerto Rico, Jill from Kansas, and Maria from Maryland. Though their communities are hundreds of miles apart, they share a common mission: to make sure every LGBTQ+ person, every questioning child, and every parent who feels overwhelmed knows there's a place where they belong. Whether you've marched in dozens of Pride parades or have never attended one, this episode is a reminder that sometimes the most powerful act of allyship is simply showing up—with an open heart, a listening ear, and the promise that no one has to walk this journey alone.Special Guest: Maria SmithMaria currently serves on the Board of Mama Dragons. Her 15+ year career in the financial services industry has been defined by a deep commitment to building inclusive, supportive environments within the workplace. She joined Mama Dragons to learn how to best support her queer child and has become an even more passionate advocate for LGBTQ+ youth and families. Maria lives in Maryland with her husband, their two children, and two Puggles. Her life is guided by empathy, action, and the belief that every person deserves to be seen, loved, and supported for exactly who they are.Special Guest: Jill ClementsJill is a mom of 3 living in the Midwestern United States. She coordinates the Mama Dragons Embracelet program. An Embracelet is a handmade bracelet that is like a warm hug around your wrist to remind you that you are loved. Since its inception in 2023, over 42,000 embracelets have been given out by Mama Dragons at events. Over the past four years she's helped coordinate the Mama Dragons Pride Booth in Kansas City, MO which hosts over 25,000 attendees each year. A social worker by trade, Jill often can be found giving of her time and resources to a variety of causes whether it is parents of trans kids or kids affected by a parent's cancer. In her dream world, Jill would be living in Iceland spending her days hiking and making art and her nights photographing the Northern Lights. Special Guest: Yanira VegaYanira lives in Vega Baja, Puerto Rico, and is the mother of a young transmasculine son and a daughter. She has been a member of Mama Dragons since 2021, when she sought self-help resources and education to address her gender-diverse family's experience with an affirming approach. That same year, she volunteered to help coordinate MD groups and assist with the vetting and moderation processes for some groups. Puerto Rico has had its own regional group since 2024, and on March 28, 2026, they held their first local community education event at the closing of the True Self Camp for Respect, where they shared Mama Dragons' mission to support mothers and families in their journeys and highlighted all the programs available to assist them. Their next event will be on June 27 at the All Out 5k. Yanira is a doctor in Physical Therapy working in home health settings.Links from the Show:Join Mama Dragons todayIn the Den is made possible by generous donors like you. Help us continue to deliver quality content by becoming a donor today at www.mamadragons.org. Support the showConnect with Mama Dragons:WebsiteInstagramFacebookDonate to this podcast
Most clinicians think about return to sport as the finish line. What gets missed is everything that happens before that — the off-season decisions, the testing philosophy, and the role clarity that actually determines whether an athlete comes back stronger. In this episode, John Allan, DPT sits down with Dr. Alex Hubelbank, DPT, ATC, CSCS, to break down what elite-level rehab and performance really looks like inside professional sports.What they cover:How the line between PT, athletic training, and strength & conditioning is based on role, not skill — and where that breaks downWhy staying off the court matters: using GPP and unrelated movement skills, like hand-fighting or dance, to build capacity without repetitive loadHow to structure a 4-5 month off-season into phases, from lowest-hanging fruit to sport-specific prepWhy testing every 4-6 weeks beats chasing constant data, and the question to ask before every test: am I testing for me, or for their care plan?Reading context — sleep, nutrition, life stress — before deciding whether a testing day is even worth runningBuilding trust and credibility with professional athletes when the stakes, and the scrutiny, are highestIf you've ever wondered what separates a good off-season from a great one, this episode reframes how elite performance is actually built, one deliberate decision at a time.Social Media:Rehab2PerformR2P AcademyDr. Alex Hubelbank
Dr. Sariya Saabye is a Doctor of Physical Therapy, bestselling author, and minimalist strategist known for her work helping high performers eliminate overwhelm. She is also a barefoot ultramarathoner and keynote speaker.
When we think about core stability, digestive efficiency, or functional breathing patterns, we rarely consider the foundational muscle group resting at the base of our pelvis. Yet, pelvic floor health directly dictates everything from diaphragmatic excursion to bowel regularity, posture, and systemic stress management.In this episode, Hallie sits down with Dr. Svetlana Mehlman, a physical therapist specializing in pelvic health, back pain, and lymphatic drainage. Dr. Svetlana breaks down the complex anatomy and mechanics of the pelvic floor, explaining why a tight, tense pelvic muscle is often a hypertonic, weakened one rather than a strong one.About the Guest: Svetlana Mehlman, PT, DPT, MLD-CDr. Svetlana Mehlman is a physical therapist specializing in pelvic health, back pain, and lymphatic drainage. She earned her Bachelor's degree in Human Development from Cornell University and completed her Doctorate of Physical Therapy at New York University. Her passion for pelvic floor physical therapy was ignited early in her career while treating pregnant and postpartum patients suffering from pain and pelvic dysfunction.Key Topics & TakeawaysThe Pelvic Core Connection: Understanding how the pelvic floor acts as the true base of your deep stabilization system, working in tandem with the diaphragm and abdominal wall.Tightness vs. Strength: Demystifying the myth that a tight pelvic floor is a strong one, and why muscle hypertonicity restricts blood flow, movement, and functional length.Breathing and Digestive Motility: Exploring how diaphragmatic movement mechanically massages internal organs, directly impacting gut motility, constipation, and bowel transit time.Soundbites"The pelvic floor is an integral part of your deep core system. It cannot function in isolation from how you breathe or sit.""Muscles need to move through a full range of motion. A tight pelvic floor is not a strong pelvic floor—it's a fatigued, restricted one.""When we fix the breathing mechanics at the top, we relieve the mechanical pressure on the pelvic floor at the bottom."Timestamps 000:01:04 — Hallie Bulkin introduces guest Svetlana Mehlman (DPT, CSCS).00:02:41 — What is the pelvic floor and how does it function as part of the core?00:05:00 — The role and mechanics of using a Squatty Potty.00:08:08 — The link between chronic constipation, bladder issues, and incontinence.00:10:46 — Practical tips: The "I Love You" abdominal massage.00:12:00 — How diaphragmatic breathing regulates the pelvic floor and nervous system.00:15:16 — Why travel and routine changes trigger constipation.00:22:30 — Common symptoms of pelvic floor dysfunction (and why tight doesn't mean strong).00:29:31 — Why you should never "hover" or rely on "just-in-case" peeing.00:32:14 — Postural Restoration Institute (PRI) principles and how posture connects to pelvic health.Links & ResourcesConnect with Dr. Svetlana: Explore specialized care programs, resources, and consultation details at Pelvic Harmony.If this episode changed how you see the body, that's just one case. Inside The Integrated Therapist™, you grow the clinical reasoning to spot the root cause, think past your own discipline, and feel sure about what to assess, treat, refer, and co-treat. Come join us at: https://theintegratedtherapist.com/WORTH A LISTEN: CONTINUE YOUR JOURNEYEpisode 233: Understanding Your Pelvic Floor with Britnie Hornsby, PT, DPT, Cert DIN, Cert VRS, PCES.Episode 185: Laura Glazebrook, DPT The Pelvic Floor and Jaw Connection.STAY CONNECTED
Selina Morgan holds a doctorate in physical therapy, a board certification in neurological physical therapy, and is an assistant professor in the Department of Physical Therapy at UT Health San Antonio. She believes that there are thousands of people out there in wheelchairs who don't have to be.
In this episode, Dr. Karen Litzy talks with Dr. Karen DeSimone, physical therapist and owner of KD360 Wellness and Physical Therapy, about building a hybrid practice that combines insurance-based care with cash-based wellness services. Karen shares how she shifted from treating visits to delivering outcomes, why that change helped her reduce burnout, and how other clinic owners can apply a similar model without adding staff, locations, or more marketing spend. Why it works: outcome-focused messaging makes the value feel concrete and emotionally compelling, which helps listeners see the episode as a practical solution to a problem they already feel. Key topics covered: · Why declining reimbursements pushed Karen to rethink her business model · The difference between treating visits and treating outcomes · How to introduce cash-based services without abandoning insurance · Why fewer patients and fewer visits can lead to better results · How to have confident, patient-centered conversations about pricing · Why the model works for solopreneurs and small clinics · The mindset shift needed to step off the insurance treadmill Timestamps: · 0:01 — Welcome to the Healthy, Wealthy, and Smart Podcast and the episode's focus on healthcare and business · 0:29 — Karen DeSimone's background and the shift toward an outcome-based model · 1:53 — What drove Karen to build a new model · 2:54 — Why she stacked cash-based services on top of physical therapy · 4:58 — How to talk to patients about cash-based care · 6:43 — How those conversations happen in practice · 8:09 — Why this model can work for other areas like knee pain and surgery avoidance · 9:29 — What is included in the cash-based offering · 11:25 — Bundling services into one package instead of adding visits · 12:32 — Building profitable programs from existing patients · 13:25 — Why this approach can work without more marketing · 14:56 — Why she did not want a larger business or more locations · 16:40 — Why clinicians should think beyond growth for growth's sake · 18:39 — The difference between selling and serving · 19:46 — Why it should never feel like a hard sell · 20:27 — Building conviction and confidence through repeatable outcomes · 21:46 — Practicing how to talk about pricing · 23:03 — How to keep patients moving forward in a 12-week program · 24:30 — Long-term results and patient return visits · 25:03 — Deciding who the model is right for · 26:42 — Why timing matters in the clinical conversation · 28:49 — The first shift: decide · 31:49 — Who can implement this model · 33:51 — Lightning round: money beliefs, metrics, and burnout advice · 36:47 — What Karen is doing to stay healthy, wealthy, and smart · 37:30 — Where to find Karen and learn more · 38:24 — Free starter framework for clinicians · 39:12 — Final encouragement to share the episode Notable takeaways: · "We're not treating visits, we're delivering outcomes." · Cash-based services can be stacked on top of physical therapy to improve results and revenue. · Patients often pay for faster outcomes when the value is clearly explained. · The first step is a decision: choose the model you want, then commit to it. · Confidence comes from repeatable results, not from perfect wording. Resources & Links: · Clinical Architecture Website · KD 360 PT and Wellness · Instagram · LinkedIn · Free Gift: The Freedom From Back Pain Starter Framework, More About Karen: Karen DeSimone, PT, DPT, has practiced physical therapy for 26 years. She earned her Doctor of Physical Therapy from the MGH Institute of Health Professions, began her career at Massachusetts General Hospital, and in 2009 opened KD360 Wellness & Physical Therapy in South Yarmouth, Massachusetts, where she still practices today. A solo clinician running a hybrid cash and insurance model, she helps clients avoid surgery and heal faster using a structured, outcome-driven program. After years inside the insurance-based model, Karen reached a hard conclusion: you can't build a successful system on a broken model. So she built her own: a defined clinical pathway with enrolled patients and predictable outcomes. That pathway became the Freedom From Back Pain Clinical Success System, the online implementation program she now teaches through her company, Clinical Architecture, helping other PT clinic owners deliver the same cash-based care inside their own practices, without adding new patients, staff, or marketing. Her work centers on one principle: we're not treating visits, we're delivering outcomes. Jane Sponsorship Information: Book a one-on-one demo here Mention the code LITZY1MO for a free month Follow Dr. Karen Litzy on Social Media: Karen's Instagram Karen's LinkedIn Subscribe to Healthy, Wealthy & Smart: YouTube Website Apple Podcast Spotify SoundCloud Stitcher iHeart Radio
With Buffalo Bills training camp next week, Gene is zeroing in on the WR group, specifically Keon Coleman.
Charlie Shuman from Lattimore Physical Therapy stops by the show to help diagnose & break down key injuries with the Bills, Yankees and more. Plus, which Buffalo Bill was Charlies' roommate at Penn State?
Full Show Broadcast: Keon Coleman is top of mind for Gene as Bills training camp is next week. Charlie Shuman, from Lattimore Physical Therapy joins Gene to help examine some players who are dealing with injuries. Tim Schneider shares a clever take on college basketball. Shots & headlines to begin hour 2. PJ Glasser has your best bets & don't forget Last Call.
This morning I want to share some witnesses of healing with you. Before I share them, I want to talk with you about how important it is to enlist others to pray with you and for you as well. I am on several prayer chains. In case you aren't sure what that means, let me explain. It is a group of people who offer to intercede on your behalf. A lot of churches have a prayer line where you can call in or email in a prayer request, and then whoever is in charge will email it out to all who volunteered to help pray. Also, it may be the members of a prayer group, or another group that has a group chat. I am in three different WhatsApp groups, and we send prayer requests when we have them, and then everyone on the chat prays for the person requesting prayer. If your church does not have a prayer line, consider starting one. It is as easy as setting up an email address where people can send in requests. For instance, I started one at St. J's collaborative in MA. So I went on Gmail and created an email account name that is St.Jsprayerline@gmail.com. Then I put an announcement in the bulletin looking for people who would be willing to pray for any requests that came in. There are 42 people who volunteered to be on that email list. Now, people send in prayer requests, and at least 42 other people are praying for them. For the various WhatsApp groups, there are different numbers of people in each group. There are a lot of reasons why we may not want to ask for prayers. We may not want people to know we are struggling. We may not want to worry people. We may not think our struggle is important enough to bother people with. We may think God has more important prayers to answer. We may think other people are too busy to pray for us. Whatever it is that we might be thinking, the truth is, no one is too busy to say a quick prayer. Another truth is that there is so much power in asking people to pray for you. There is so much power in multiple people interceding on your behalf. You do not have to suffer in silence. You do not have to just deal. Ask people to pray. Also, we get graces every time we pray. So asking others to pray is actually helping them out too! Here are a few prayer requests and responses from the various prayer groups. This woman had asked for prayers because she had to go to the eye doctor. The pressure was high in her eyes, and they said she needed to come back for a follow-up. If it was still high, they were going to need to do surgery. The doctor seemed pretty sure that they were going to need to do surgery. Here was her text the next day. “Good evening, Prayer Warriors. JESUS DID IT AGAIN! The test for my eyes was normal - the pressure was low, under 20! YES - HE DID IT AGAIN - what a wonderful GOD we serve. Thank you for your prayer this morning. God bless you all.” Next is a woman whose uncle has been refusing to eat. He was having dreams of his wife who had passed away telling him not to eat, so he wasn't. We prayed at our prayer meeting that he would start eating, and here is her text message afterward. “Good morning, Watchmen. My uncle just asked for food. Thank you for your intercession. May God continue to bless all of you, and may He answer your prayers speedily!” Next, I have the specific prayer request and the text message reply. Dear Sisters, I ask for your prayers for my friend. He is young, in his late 40s. Tomorrow morning he is having a very complicated open-heart surgery to replace one of the valves. This is his third surgery, and it's a complicated one because of complications from an enlarged heart/aorta. Her reply after the surgery? “I wanted to update you that my friend has come through his open heart surgery successfully yesterday and is in the ICU. Thank you for your prayers and intentions. God bless you all.” Here is the next prayer request and answer. “Good morning, watchmen. Please keep me in your prayers. The director of the agency that I work for has recommended me for a promotion at the agency's headquarters. There are two other candidates, but the director just told me she would rather have me in that position due to my work ethic. Good morning, beautiful people of God. God has done it! The prophecy came to pass. I got the promotion!!! Please help me praise God for his divine mercy and provision. May God do unto you all the marvelous things he has done for me.” This woman did not even know there was a promotion available. She did not seek it out; her boss came to her, told her about it, and told her to apply. She not only got this promotion, but she got a second job that she had been looking for! God is so good! This same woman was in prayer group one morning and mentioned her daughter was sick. Her daughter had been experiencing intense ear pain for the previous 8 hours or so. She was going to have to take her to the doctors. We took time to pray over her daughter. After prayer, her daughter said it felt a little better. Later that day I got a text from the mom saying her daughter felt so much better she wanted to go to school that day. Here is a prayer request from another group. “Healing for my niece Kathy who broke her back 2 months ago. She is in a lot of pain, and can't be treated until some healing can happen. Please pray for healing.” Here is the text we received a few months later: “Regarding my niece Kathy who broke her back in February, I asked for her because there was no hope the surgeons could restore anything. The sutures finally came out today; she will start Physical Therapy soon and will hopefully go back to work in August. A miracle thank you for your prayers!!!” Here is another prayer request: “Please pray for Ann, who is in the hospital and having surgery on her back to repair chipped bones to help lessen her back pain. Thanks” And the text afterward: “Update- Ann's surgery went well. She might come home today. Thanks for the prayers.” Here is another one: “Prayer request for Tom having cardiac ablation tomorrow at 12:30 pm. Thank you, everyone.” The reply: “Thank you, everyone, for your prayers. Tom had his heart procedure; so far, he is doing well and needs to be careful. 5 days of being careful, then back to normal! Praise God” These are just a few of the many prayer requests that come in. As you can see, some of them are really big, and some might not feel so big. There is no criterion for when we should ask for prayers and when we shouldn't. If you ask me, you always should; what could it hurt to get extra prayers? I remember in my Encounter Ministries classes Deacon Joe would always say it doesn't matter if we are praying for a healing of cancer or a healing of a hangnail. God cares just the same about both and can heal them both. He doesn't have to pick. When we are praying to God about the things we might think are small, it doesn't take anything away from other people's prayers. God can hear all of our prayers. He is not limited in any way. I pray this episode of Witness Wednesday does three things for you. First, I pray in encourages you to ask others to pray for you whenever you have a prayer request. Second, I hope you search out a prayer line or prayer chain you can join so you can start interceding more for others. And finally, that when you do ask people to pray for you, you update them on how the situation turned out. When we tell others about how God answered our prayers, it builds their faith in God and also reinforces that prayer does work! I love you all, and I want you to know that even though I may not know you, I am praying for you and your families. Please pray for others, it is so important!! www.findingtruenorthcoaching.comCLICK HERE TO DONATECLICK HERE to sign up for Mentoring CLICK HERE to sign up for Daily "Word from the Lord" emailsCLICK HERE to sign up for my newsletter & receive a free audio training about inviting Jesus into your daily lifeCLICK HERE to buy my book Total Trust in God's Safe Embrace
Most of us treat pain as something to eliminate, but what if it's actually trying to protect you? Physiotherapist and MSK health expert Jessie Podolak breaks down the difference between acute and chronic pain, why the brain plays a surprising role in how we feel it, and why walking may be the most underrated medicine we have. A practical, hopeful, and insightful discussion for anyone living with pain.See Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.
Dr. Tommy Wood, BM, BCh, PhD, is a professor of neuroscience at the University of Washington and an expert on brain health, neuroplasticity, and cognitive performance. Dr. Wood explains how to use specific forms of exercise, dietary strategies, and compounds to enhance the rate and stability of mental and/or physical skill development. We also discuss science-based tools to preserve cognitive function, reduce dementia risk, and offset loss of memory after a concussion or other brain injury. This episode provides practical, science-based tools for learning new information and skills and for improving your overall ability to learn. Read the episode show notes at hubermanlab.com. Thank you to our sponsors AG1: https://drinkag1.com/huberman David: https://davidprotein.com/huberman Function: https://functionhealth.com/huberman Rorra: https://rorra.com/huberman Timestamps (00:00:00) Tommy Wood (00:04:05) Neuroplasticity; Neurogenesis; Synaptic Pruning (00:11:11) Aging & Neuroplasticity; Familiar vs Novel Tasks (00:14:33) Protocols Book; Sponsor: David (00:16:49) Aging, Training & Processing Speed (00:21:56) Enhancing Neuroplasticity with Age, Tool: Motor & Cognitive Challenge (00:26:56) Learning New Skills, Dance, Sports, Arts; Psychological Benefits of Challenge (00:36:50) Flow, Clutch States; Virtuosity (00:46:59) Power of Practice (00:50:55) Sponsor: AG1 (00:52:14) Tools for Focused Work & Learning; Distractions (01:00:17) Nutrition for Brain Health, Dementia; Critical Nutrients (01:06:56) Nutrient Timing, Supplementation; Omega-3s, Tool: Blood Tests (01:16:41) Sponsor: Function (01:18:19) Enhancing Brain Health, Nutrition & Supplements (01:23:10) GLP-1s, Peptides, Supplements & Evaluating Efficacy (01:32:56) Stimulants: Feeling vs Performance (01:37:18) Exercise & Enhancing Cognitive Function, Tool: Optimize Exercise Volume (01:43:18) Long-Term Cognitive Health & Exercise, HIIT (01:47:17) Sponsor: Rorra (01:48:31) Cortisol Benefits, Acute vs Chronic Stress (01:54:24) Resistance & Aerobic Exercise, Brain Gray & White Matter, Cognitive Health (02:03:37) Cognitive Decline, Dementia, Alzheimer's Disease, Modifiable Risk Factors (02:09:47) Shingles Vaccine & Dementia Risk; Tool: Avoid Illness for Cognitive Health (02:18:28) Concussion, Traumatic Brain Injury (TBI), Creatine (02:24:04) Treating TBI, Supplements, Physical Therapy (02:32:16) Strongman Competition (02:38:51) Zero-Cost Support, YouTube, Spotify & Apple Follow, Reviews & Feedback, Sponsors, Protocols Book, Social Media, Neural Network Newsletter Disclaimer & Disclosures Learn more about your ad choices. Visit megaphone.fm/adchoices
Dr. Joe Damiani — Doctor of Physical Therapy, TMJ and head-neck pain specialist, and founder of Physio Loops — joins Dr. Will Cole in New York for a deeply practical conversation on why chronic pain persists even when the injury has healed. Dr. Joe explains his Physio Loops framework, the three root drivers of nervous system dysregulation in pain (emotions, trust, and awareness), how to tell whether a headache is coming from the jaw or the neck, why most TMJ patients don't have a bite problem, and what actually makes people better — both in person and virtually. Plus: the occipital lift exercise, 30-minute position changes, the chair he recommends after testing 14 of them, and why consistency is the one biohack you cannot buy. For all links mentioned in this episode, visit www.drwillcole.com/podcast.Please note that this episode may contain paid endorsements and advertisements for products and services. Individuals on the show may have a direct or indirect financial interest in products or services referred to in this episode.Sponsors:Use code WILLCOLE at puori.com/WILLCOLE to get 32% off your first Puori Grass-fed Whey Protein order when you start a subscription.Head to MANUKORA.com/WILLCOLE to save up to 31% plus $25 worth of free gifts with the Starter Kit, which comes with an MGO 850+ Manuka Honey jar, 5 honey travel sticks, a wooden spoon, and a guidebook.So before Metabolism Ignite sells out again, control your cravings and boost your energy the natural way. Head to VeracityHealth.co and use code absolutely for up to 65% off your order!Produced by Dear Media.See Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.
In this empowering episode of the Optimal Body Podcast, Doc Jen and Doctor Dom tackle the realities of aging head-on with research-backed insights. They debunk common fears around MRI findings like disc bulges and osteoarthritis, explaining—using research-backed evidence—that many are normal age-related changes, not reasons to stop moving. From research-backed benefits of weighted vests for improving strength and posture, to the critical role of strength training for bone density and joint health, the hosts emphasize that movement is medicine. Whether managing osteoporosis, herniated discs, or arthritis, a proactive, guided approach to exercise can help you age with strength, confidence, and independence. Zulu Weighted Vest: Upgrade your everyday movement with the ZULU Weighted Vest — designed to increase calorie burn, naturally engage your core, and improve posture with every step. Perfect for walks, workouts, and daily errands. Use code OPTIMAL for 20% off at checkout. Lifting for Longevity Discount: Check out our NEW movement longevity course -> Lifting for Longevity! Build your Strength, Mobility, Power, Balance and more regardless of what stage or age you're at! Podcast listeners get a bonus discount with code OPTIMAL20 We Think You'll Love: Lifting for Longevity Jen's Instagram Dom's Instagram YouTube Channel What You'll Learn: 1:54 The Truth Behind Aging 3:42 The Power of a Provider's Words 6:07 Misconceptions About Aging and Exercise 7:13 Understanding MRI Findings 11:07 Knee Osteoarthritis and Exercise 14:21 Running with Osteoarthritis 15:45 Osteoporosis and Heavy Lifting 18:23 The LIFTMOOR Trial for Osteoporosis 20:58 Herniated Discs and Fear of Movement 25:47 Red Flags for Back Pain 27:11 Four Pillars of Healthy Aging 28:19 Pain Monitoring Rules for Exercise For the full show notes and resources visit https://jen.health/podcast/470 Hosted by Simplecast, an AdsWizz company. See pcm.adswizz.com for information about our collection and use of personal data for advertising.
Back pain affects almost everyone at some point, but why do some people recover while others deal with chronic pain for years?Dr. Nicholas Rolnick joins Ralph Sutton and Marcus Antebi to break down the biggest misconceptions about physical therapy, why movement is often the best medicine, and how blood flow restriction training is changing the way athletes and everyday people recover from injuries.They also dive into weight cutting in combat sports, bodybuilding, flexibility versus strength, posture, sitting all day, spinal mobility, and why MRI results don't always explain your pain.Whether you're dealing with nagging aches, trying to stay active as you age, or simply want to move better, this episode is packed with practical advice you can actually use.0:00 Welcome & introducing Dr. Nicholas Rolnick1:06 How Zac Amico led Ralph to today's guest3:33 Dr. Rolnick's journey into physical therapy6:09 What is blood flow restriction training?8:16 Is blood flow restriction actually safe?9:14 Weight cutting, bodybuilding & combat sports12:48 Why chronic back pain is so difficult to treat15:04 The biggest mistakes physical therapists make18:34 Should you exercise through pain?20:06 Why spinal mobility matters more than most people realize23:45 Marcus shares his recent back injury26:07 How Dr. Rolnick diagnoses pain without relying on imaging29:14 Why MRI results don't always tell the whole story33:28 Is sitting causing your lower back pain?36:14 Final thoughts & where to find Dr. RolnickTEXT us your questions at 718-306-3906!The goodsugar store is the epitome of cool, nestled at 3rd avenue + 69th street!
Matt and Allie on site at our Montgomery center to interview student PT, Tanner Johnson. Tanner shares his background, PT school experience and previous clinical round stories, as well as his interest in being more involved in sports for his future career. Matt asks him to share his experience in Dry Needling, seeing Direct Access patients, and using Ai assisted documentation. Tanner also gives his advice to aspiring PTs and even to Tanner's past self now that he's almost completed his second clinical round.Did you know that you don't need a doctor's prescription to receive physical therapy? You can schedule here . The laws of Direct Access allow you to receive physical therapy without a referral and still use your insurance benefits! Learn more on how Direct Access can help YOU! Our website: https://www.oxfordphysicaltherapy.com/
This one falls into the "anything else we want to talk about category," as Jeff tells the story of how chronic pain nearly derailed his running goals. After dropping 100 pounds and finishing his first marathon, Jeff developed knee and shin pain that traditional therapies could not fix. Enter Bonnie Wilder, DPT, the physical therapist and coach behind Running the Extra Miles. Dr. Wilder showed Jeff that his debilitating pain cycle would continue as long as he only addressed his symptoms. Instead, her work with Jeff focused on biomechanics and the root cause of his knee and shin pain. As a runner and Division 1 athlete, Dr. Wilder knows from experience that recurring injuries and setbacks can be frustrating. As a result, she has developed an evidence-based approach to efficient, personalized rehab and training. You can connect with Dr. Wilder and Running the Extra Miles via email (preferred) and the social media channels below: Email: connect@runningtheextramiles.com @bonniewilder.dpt on Instagram, Facebook, YouTube, and TikTok WHAT YOU NEED TO KNOW (00:00) Introduction: Bonnie Wilder, DPT (02:28) Physical therapist and run coach (05:30) From D1 athlete to marathoner (07:00) Reaching thousands of runners with virtual PT (09:31) How Jeff found relief from chronic knee and shin pain (11:44) Personal experience meets PT meets entrepreneurship (14:10) Biomechanics and fixing the root cause of pain (16:12) Progressive overload and updating therapies as needs change (17:53) Rethinking traditional running therapies (19:41) A public journey and a public thank you (20:50) How to reach Dr. Bonnie Wilder and Running the Extra Miles (22:07) Providing inspiration for runners everywhere ABOUT BELLOMO & ASSOCIATES Jeffrey R. Bellomo, the founder of Bellomo & Associates, is a licensed and certified elder law attorney with a master's degree in taxation and a certificate in estate planning. He explains complex legal and financial topics in easy-to-understand language. Bellomo & Associates is committed to providing education so that what happened to the Bellomo family doesn't happen to your family. We conduct free workshops on estate planning, crisis planning, Medicaid planning, special needs planning, probate administration, and trust administration. Visit our website (https://bellomoassociates.com/) to learn more. LINKS AND RESOURCES MENTIONED Bellomo & Associates workshops:https://bellomoassociates.com/workshops/ Life Care Planning The Three Secrets of Estate Planning Nuts & Bolts of Medicaid For more information, call us at (717) 845-5390. Connect with Bellomo & Associates on Social Media Tune in Saturdays at 7:30 a.m. Eastern to WSBA radio: https://www.newstalkwsba.com/ X (formerlyTwitter):https://twitter.com/bellomoassoc YouTube: https://www.youtube.com/user/BellomoAssociates Facebook:https://www.facebook.com/bellomoassociates Instagram:https://www.instagram.com/bellomoassociates/ LinkedIn:https://www.linkedin.com/in/bellomoandassociates WAYS TO WORK WITH JEFFREY BELLOMO Contact Us:https://bellomoassociates.com/contact/ Practice areas:https://bellomoassociates.com/practice-areas/
Send us Fan MailMaria and Katie, physical therapists with St. Luke's, join Dr. Arnold to discuss an experience that touches so many women and families: pregnancy, birth, and the transition into postpartum recovery. Support is available from the moment a woman walks through our doors through our inpatient and outpatient therapy clinics. To learn more about Birth Care services, pelvic health therapy, and postpartum support, visit unitypoint.org. If you have a topic you'd like Dr. Arnold to discuss with a guest on the podcast, shoot us an email at stlukescr@unitypoint.org.
Burnout is one of the most talked-about challenges in physical therapy, but what if the conversation is missing something? In this episode, host Elisabeth Brown sits down with physical therapist, clinic director, educator, and sports residency director Tyler Goslinga to explore how clinicians can create careers that remain energizing over the long term. Tyler shares how identifying his passions, advocating for new opportunities, investing in his community, and building meaningful relationships helped him grow a career that extends far beyond patient care alone. Together, they discuss the difference between purpose and passion, why community connection matters, how clinicians can uncover opportunities they didn't know existed, and what leaders can do to help therapists stay engaged and fulfilled. If you're a new grad, seasoned clinician, practice leader, or anything in between, this episode offers a refreshing perspective on career growth, professional fulfillment, and creating a future in PT that lasts. Learn more: https://www.linkedin.com/in/tyler-goslinga-616915316/ https://www.webpt.com/podcast
Are deadlifts bad for your back? Why do some people get injured lifting weights while others don't? Can resistance training actually reduce pain and injury risk? Find out in this can't-miss episode of the “NASM CPT Podcast” featuring Dr. Stefi Cohen — 27-time powerlifting world record holder, pro boxer, Doctor of Physical Therapy, and founder of the Institute of Strength Training. Host Dr. Rick Richey and Stefi dive deep into: · The biopsychosocial model of pain and why pain isn't always about tissue damage · The real difference between “injury” and “pain” and what that means for your workouts · Stefi's personal story overcoming chronic back pain — and what REALLY works for recovery · Why your mindset can amplify or dampen pain signals (backed by neuroscience!) · How to avoid the most common training mistakes that lead to injury · Proven strategies for building resilience, managing training load, and keeping clients (and yourself) strong and healthy · Why deadlifts and other barbell movements aren't inherently dangerous — plus evidence-based tips to use them safely · Actionable advice for trainers and everyday lifters on progressing after injury, breaking the pain-avoidance cycle, and becoming a “movement optimist ”Don't miss Stefi's expert insight on: · Foam rolling, manual therapy, and pain relief hacks that work · How to safely return to intense training after injury · Using resistance training to reduce pain from osteoarthritis and other chronic conditions · Busting the top fitness myths holding you back from your strength goals If you like what you just consumed, leave us a 5-star review, and share this episode with a friend to help grow our NASM health and wellness community! The content shared in this podcast is solely for educational and entertainment purposes. It is not intended to be a substitute for professional advice, diagnosis, or treatment. Always seek out the guidance of your healthcare provider or other qualified professional. Any opinions expressed by guests and hosts are their own and do not necessarily reflect the views of NASM. Introducing NASM One, the membership for trainers and coaches. For just $35/mo., get unlimited access to over 300 continuing education courses, 50% off additional certifications and specializations, EDGE Trainer Pro all-in-one coaching app to grow your business, unlimited exam attempts and select waived fees. Stay on top of your game and ahead of the curve as a fitness professional with NASM One. Click here to learn more. https://bit.ly/4ddsgrm
Why does choosing yourself feel so wrong... even when you know it's the healthiest thing to do?If you've ever set a boundary, honored your needs, or finally chosen yourself...only to be flooded with guilt, anxiety, or the urge to take it all back, this episode is for you.The problem isn't that you're weak.Your body may simply not feel safe choosing you.In this episode, I explain the biology of self-abandonment and why your nervous system can mistake self-loyalty as danger. You'll learn why awareness alone isn't enough to break old patterns, why you keep overriding yourself even when you know better, and what it actually takes to create lasting change.You'll discover:• Why choosing yourself can activate your survival system• The hidden biology behind people-pleasing and self-abandonment• Why your nervous system prioritizes safety over authenticity• How childhood adaptations become adult relationship patterns• Why guilt doesn't always mean you're doing something wrong• How to begin creating safety in your body so you can stay loyal to yourselfIf you've spent years putting everyone else first, this conversation will help you understand why your body reacts the way it does—and how to stop abandoning yourself without feeling like you're losing everyone else.ABOUT DR. KELLY KESSLERI'm Dr. Kelly Kessler, a Doctor of Physical Therapy, nervous system educator, and host of the Rewiring Health® Podcast. I help high-achieving women stop abandoning themselves after setting boundaries by creating safety in their body, rebuilding self-trust, and developing the capacity to stay loyal to themselves, even when it's uncomfortable.Connect with Kelly:Ready to go deeper?If this episode resonated, start with my free Self-Abandonment Audit: a powerful first step to uncover where you may be putting everyone else first, overriding your needs, or talking yourself out of what you know is right for you.Get the audit here:https://drkellykessler.com/selfauditReady for more support? The Self-Respect Reset is my 4-week self-paced course designed for women who know what they need but struggle to follow through. You'll learn how to navigate guilt, build self-trust, create healthier boundaries, and stop abandoning yourself in the moments that matter most.Learn more here: https://drkellykessler.com/selfrespectresetLooking for personalized support? The Self-Loyalty Mentorship is for the woman who is ready to stop second-guessing herself, stay true to what she knows, and build the capacity to hold her boundaries and decisions with confidence even when it's uncomfortable.Learn more here:https://drkellykessler.com/selfloyaltymentorshipWebsite:https://drkellykessler.com/
In this episode of the Optimal Body Podcast, Doc Jen and Doctor Dom, both doctors of physical therapy, welcome back Doctor Courtney Conley to discuss her new book, Walk. Together, they explore why walking is considered the "sixth vital sign" and how gait speed can predict health issues like cognitive decline. Doctor Courtney breaks down the importance of power in walking, how to improve gait speed for greater efficiency, and why the 10,000-steps goal isn't scientifically based. She also shares practical advice on footwear choices and encourages listeners to start simply — by taking their shoes off at home to reconnect with their feet and build a foundation for better gait speed and movement. It's not just foot health, it's about our movement longevity. Needed Discount: Jen trusted Needed Supplements for fertility, pregnancy, and beyond! Support men and women's health with vitamins, Omega-3, and more. Used by 6,000+ pros. Use code OPTIMAL for 20% off at checkout! Dr Conley's Resources: "Walk"Book Gait Happens on IG Gait Happens on YT Gait Happens Website We Think You'll Love: Free Week of Jen Health Barefoot Mini Course Jen's Instagram Dom's Instagram YouTube Channel For full show notes and resources visit https://jen.health/podcast/469 What You'll Learn: 2:17 Doctor Conley discusses writing her book with a physical therapist and how their different perspectives created a well-rounded final product. 8:04 Walking speed is discussed as a key indicator of overall health, predicting issues like cognitive decline years in advance. 11:11 The conversation shifts from strength to power, explaining how power exercise is a one of the most crucial health tips for efficient gait and everyday movements. 12:36 Doctor Conley offers simple ways to assess and improve walking power, such as tracking steps per minute and walking uphill. 17:50 The mechanics of an efficient gait... Hosted by Simplecast, an AdsWizz company. See pcm.adswizz.com for information about our collection and use of personal data for advertising.
Most clinicians focus on what they do to a patient. What they miss is everything happening before that ever starts. In this episode, John Allan, DPT sits down with Dr. Katie Dabrowski, co-owner of Old Bull Athletics and neuroscience faculty at Nova Southeastern University, to break down the controllable factors that shape a patient's nervous system, and why performance-focused rehab beats the standard model. What they cover:How the clinical environment itself raises or lowers threat before a single exercise happensWhy "convincing" a patient they're wrong about their pain backfires, and what to do insteadThe two-question filter for every intervention: is it changing physiology, and is it changing psychology?Why ice and prolonged passive treatment fail to prepare athletes for the demands of return to sportHow to choose objective tests that actually mean something instead of chasing data for its own sakeReading a patient's confidence and fear without asking them to spell it out for youHow to shape a patient's perception of rehab before they ever walk through the doorIf you've ever wondered why two patients with the same injury heal at completely different rates, this episode reframes what actually drives outcomes, and why it starts long before the first rep.Social Media:Rehab2PerformR2P AcademyDr. Katie Dabrowski
Hello all! We're back yet again with another certified Noracore banger: Lucah! Born of a Dream!! Also featuring: Gaming! Moving! Physical Therapy! And more!
Nicole Ternay (aka Nikki T) Helps women over 40 lose weight for the last time. Without dieting, restriction or other crazy diet stuff. She helps them lose weight by teaching them her proven mindset method, Master Your Mind to Change Your BodyTM which is her foundational work of over 24 years of experience in the weight loss industry. Nicole is also the host of the highly ranked Weight Loss for Women Over 40 podcast, a two time TEDx Speaker, Personal Trainer, Behavioral and Health Coach, degree in Physical Therapy, former professional ballet dancer and founder of MavenHeart. Nicole has been featured in Medium, Women's Health, IDEA Fitness, Rachel Ray in Season, Real Simple, Runner's World, Bicycling Magazine and MSN.
In this episode of the Optimal Body podcast, Doctors of Physical Therapy Doc Jen and Doctor Dom explore the critical link between walking speed and overall health in older adults. They discuss research showing that resistance training can significantly improve gait parameters, emphasizing that muscle power is the most important modifiable factor influencing walking speed. The hosts highlight key exercise like calf raises, hip abduction, and squats, stressing the need for progressive overload to stimulate real muscle adaptation and improve gait. They encourage listeners of all ages to prioritize strength training to reduce fall risk, support cognitive health, and improve longevity. Ultimately, the episode underscores health tips on how targeted exercise can improve gait and overall quality of life. Zulu Weighted Vest: Upgrade your everyday movement with the ZULU Weighted Vest — designed to increase calorie burn, naturally engage your core, and improve posture with every step. Perfect for walks, workouts, and daily errands. Use code OPTIMAL for 20% off at checkout. Needed Discount: Jen trusted Needed Supplements for fertility, pregnancy, and beyond! Support men and women's health with vitamins, Omega-3, and more. Used by 6,000+ pros. Use code OPTIMAL for 20% off at checkout! We Think You'll Love: Free Longevity Webinar Jen Health Discount Jen's Instagram Dom's Instagram YouTube Channel For full show notes and resources visit https://jen.health/podcast/468 What You'll Learn: 2:01 Gait Speed as the Sixth Vital Sign 4:43 Why Walking Speed Matters 6:16 Gait Speed and Longevity 8:50 The Importance of Muscular Power 9:37 Preventing Age-Related Muscle Loss 11:05 Key Findings from the Research 12:42 The Importance of Progressive Overload 15:30 Most Effective Exercises for Gait Speed 16:10 How to Progress Exercises Safely 19:20 Applying These Principles to Daily Life 20:14 Starting a Strength Training Routine 21:41 Training to Failure Explained 23:27 The Value of Supervised Training Hosted by Simplecast, an AdsWizz company. See pcm.adswizz.com for information about our collection and use of personal data for advertising.
Would we open a cash-based PT practice in 2026? Absolutely. In fact, we'd argue there's never been a better time. In this episode, we discuss why we're such strong believers in the cash-based model, from escaping the headaches of insurance to building a business that's both profitable and rewarding. We break down the low startup costs, high earning potential, and ability to create a better experience for both clinicians and patients. We'll also share what we'd do differently if we were starting from scratch today, the opportunities we see in the industry, and why so many PTs are realizing they don't have to settle for burnout, low reimbursement rates, and endless paperwork. If you've ever wondered whether cash-based PT is worth it, this episode is for you. Download the FREE cash based practice checklist: https://tinyurl.com/5xxtd2xpYou can follow us on Instagram @businessmusclepodcast, @elisecaira and @dr.ariel.dpt. Get your FREE Business Starter Checklist: https://www.businessmusclepodcast.com/freechecklistFIXXED: https://www.fixxedstudios.com/Sweat Fixx: https://www.sweatfixx.com/
Most physical therapists graduate with exceptional clinical skills and almost zero business training. Nobody teaches you how to have a sales conversation. Nobody teaches you how to coach someone through making a decision about their health. And nobody tells you that those two skills are actually more connected than you think.In this episode, I sit down with Sam, our sales and coaching specialist here at DPT to CEO, to pull back the curtain on what actually happens inside the conversations that help clinicians decide to build their own cash based physical therapy practice.Sam has a unique perspective because she works on both the sales side and the coaching side of our program. That means she sees what holds clinicians back from taking the leap, what happens when they finally decide to go for it, and what separates the practice owners who build something sustainable from the ones who stay stuck thinking about it.We talk about what sales conversations with clinicians actually look like, the fears and hesitations that come up most often, and why so many physical therapists have a complicated relationship with the idea of selling their services. We also dig into why sales and coaching are more similar than most people realize, and how getting better at one actually makes you better at the other.If you're a clinician who works with patients every day, this conversation will change how you think about communication, buy-in, and patient adherence too. Because the skills that make someone a great coach are the same skills that make someone a great clinician.And if you've been thinking about starting your own cash based practice but keep finding reasons to wait, Sam's answer to one question in particular might be exactly what you need to hear.Connect with Sam here:Instagram | Website--- Morgan Meese, the founder of a successful out-of-network physical therapy practice, has transformed her expertise into a role as a dedicated business and marketing coach. Specializing in cash pay physical therapy, Morgan owns a digital business where she collaborates with fellow clinicians, guiding them in launching and expanding their own cash-based solo practices. Her coaching extends to helping new business owners navigate the complexities of owning a physical therapy practice, incorporating elements like mobile physical therapy and telehealth. Morgan's unique approach incorporates niche marketing strategies, addressing the specific needs of clinicians and entrepreneurs. As a woman in business with ADHD herself, she also offers insights on time management for business owners, emphasizing the importance of digital marketing to attract more clients. Join Morgan on her journey of empowering women entrepreneurs, physical therapists and healthcare providers, combating burnout, and building a thriving business so you never have to go back to the clinic again.Find me on IG: DPT to CEO and Dr. Morgan Meese---To learn more, visit our website.Free eBook “So You Want To Start a Solo Practice” DPT to CEO: YoutubeApply for the DPT to CEO 1:1 Coaching Program with Morgan.Just getting started? The Therapy Business Basics Mini Course is the place to start!Buy me coffee
Plans Have Changed AGAIN!
Nicole Ternay (aka Nikki T) Helps women over 40 lose weight for the last time. Without dieting, restriction or other crazy diet stuff. She helps them lose weight by teaching them her proven mindset method, Master Your Mind to Change Your BodyTM which is her foundational work of over 24 years of experience in the weight loss industry. Nicole is also the host of the highly ranked Weight Loss for Women Over 40 podcast, a two time TEDx Speaker, Personal Trainer, Behavioral and Health Coach, degree in Physical Therapy, former professional ballet dancer and founder of MavenHeart. Nicole has been featured in Medium, Women's Health, IDEA Fitness, Rachel Ray in Season, Real Simple, Runner's World, Bicycling Magazine and MSN.Visit Nicole's Links:FB: www.facebook.com/nicole.ternayIG: @nicole.ternay
0:00 - Dustin's Physical Therapy adventures.8:30 - REVIEW - “Toy Story 5” (2026). We give some quick thoughts on the 4th film, for context, and then our spoiler-free thoughts on this movie.26:00 - BEGIN SPOILERS. We discuss the plot in detail. 43:00 - We decide to write the 6th film…and boy do we. First, we get out all our bad ideas.59:40 - But seriously, here we go. Anything short of this idea is simply not good enough. We're cooking now.-----Executive Producers: Conner Dempsey • Dustin WeldonTheme Music by Dustin WeldonProduced & Engineered by Conner DempseyPowered by Zoom, QuickTime, Adobe Audition, & Adobe Premiere ProSpecial Thanks to Anchor FM (or “Spotify for Podcasters”, whatever)FOR ENTERTAINMENT PURPOSES ONLY. This is critique, protected under Fair Use.I DO NOT OWN THIS CONTENT. CONTENT IS IN THE PUBLIC DOMAIN.Copyright Disclaimer Under Section 107 of the Copyright Act 1976, allowance is made for "fair use" for purposes such as criticism, comment, news reporting, teaching, scholarship, and research. Fair use is a use permitted by copyright statute that might otherwise be infringing. Non-profit, educational or personal use tips the balance in favor of fair use.
Dr. Carlos Reyes, PT, DPT, SCS, is a Board-Certified Sports Clinical Specialist and the founder of Reyes Performance Institute in Austin, Texas. A former collegiate runner at the University of Texas, he built RPI to give every athlete — from weekend warriors to pros — the kind of one-on-one, performance-focused care usually reserved for elite competitors. In this episode of the Medical Entrepreneur Podcast, host Adam Sewell, MD sits down with Carlos to talk about walking away from the traditional high-volume clinic model and building a practice that blends relationship-driven care with pro-level technology — from force-plate testing (ForceDecks) and Blood Flow Restriction therapy to RacquetFit and BlazePod. Topics we explore include: Why he left the high-volume, insurance-driven PT model to start his own practice Building trust in an industry where referral loyalties are already tied to bigger systems Learning to be an entrepreneur, marketer, and business owner — not just a clinician Using force plates and objective data to deliver measurable, pro-level results Treating ACL recovery, runners, and the fast-growing world of pickleball performance Why mental resilience matters as much as physical recovery About the guest: Dr. Carlos Reyes, PT, DPT, SCS, MS, CSCS, TPI is a Board-Certified Sports Clinical Specialist in Physical Therapy — a designation held by only about 3% of PTs nationwide — and the founder of Reyes Performance Institute in Austin, TX. Learn more at https://reyesperformanceinstitute.com/ or on Instagram @reyes_performance_institute. The Medical Entrepreneur Podcast is hosted by Adam Sewell, MD. Healthcare professionals are overworked and underpaid — this show is here to tell you it doesn't have to be that way. Learn more at https://medicalentrepreneur.org/.
Walking After Stroke: What Your PT Knows That Your Doctor Doesn’t A doctor walked in, ran a reflex test, and told the patient they would never walk again. That same day, a physical therapist from Dr. Kory Langwell’s team arrived. The patient was in tears. And then they walked 70 feet. “I hope you go back and tell that doctor,” Kory said, “that they missed that.” Dr. Kory Langwell is a Doctor of Physical Therapy with over 15 years of experience. He runs a mobile home therapy practice across Southern California, and now coaches stroke survivors worldwide through his virtual program at Unlimited Potential Physical Therapy. In episode 410 of the Recovery After Stroke podcast, Kory broke down the realities of walking after stroke what’s actually possible, where the system fails survivors, and what a good physical therapist knows that most doctors don’t. The Moment the System Stops For most stroke survivors in the United States, recovery starts with intensity. In the hospital, you might receive three hours of therapy a day. Then you go home. Within weeks, that drops to thirty minutes, once or twice a week. “Insurance doesn’t know when your brain stops recovering,” Kory says. “Therapy ending doesn’t mean progress ends.” The problem is that for many survivors, the message lands the other way around. When the funding stops, the belief follows: that recovery is over, that this is where they plateau, that there’s nothing left to do. That belief, more than the stroke itself, can stall everything that comes next. The Plateau Is Not a Full Stop One of the most damaging phrases in stroke recovery is “you’ve plateaued.” It implies that the brain has reached its ceiling, that whatever function you have now is what you’ll have forever. Kory pushes back hard on this. “I’ve seen progress years, decades, 10 to 20 years after a stroke. Arms, hands, legs, walking ability. People just get fed up and stop looking for resources.” What a plateau usually means is that the current approach has stopped working, not that progress itself is impossible. The clinical response isn’t to discharge the patient. It’s to audit what they’re doing and change something. Different exercises, different load, different feedback. Reassess in six weeks. See what moves. Walking After Stroke: Why More Isn’t Always Better Walking after stroke is where survivors often get their first taste of both independence and confusion. The instinct, and it’s a good one, is to walk more. Further, longer, more often. But Kory draws an important distinction between the acute stage and everything that comes after. In the early weeks post-stroke, more isn’t always better. If someone can walk five steps, pushing them to twenty-five on back-to-back days may overtax the neurological system rather than rebuild it. Fatigue compounds quickly. Quality collapses. And when quality collapses, the brain reinforces the wrong patterns. “I’d rather have somebody walk 50 feet really well than 150 feet terribly,” Kory says. Visual feedback changes this completely. When survivors watch themselves walk in a mirror, or on a phone recording, they often see something very different from what they feel. Bill Gasiamis described exactly this: convinced his running gait was dangerous, he watched the footage and found it was far better than he’d thought. The problem wasn’t the movement. It was the feedback. Once a survivor moves into the chronic stage months or years post-stroke, the calculus shifts. Walking remains one of the best exercises available. Kory also recommends walking backwards in a safe environment like a hallway or near a kitchen sink: it challenges balance, engages the brain differently, and creates new neurological input. Why Falls Happen – And What Actually Prevents Them Falls after stroke aren’t random. They follow a pattern. The clinical term is proprioception: the brain’s sense of where the body’s joints and limbs are in space. After a stroke, this system is often disrupted. Survivors may not feel their foot on the ground, or may not register that a leg isn’t bearing weight the way it needs to. Add a divided attention task carrying a plate, thinking about turning off the television, reaching for something, and the risk multiplies immediately. Bill described this directly: he’d made a sandwich, sat down, finished eating, and went to stand up. His attention was on getting the plate to the sink without dropping it. His left leg wasn’t registered as being on the floor. He fell before he’d taken a step. The countermeasure is simple: stop, feel the floor, confirm the leg is active before moving, then carry the plate. Step by step, not simultaneously. Foot Drop, AFOs, and Electrical Stimulation Foot drop, where the muscles that lift the front of the foot are weakened or uncoordinated, is one of the most common walking challenges after stroke. Many survivors are placed in an AFO (ankle foot orthosis) to manage it. Kory’s view on AFOs is measured: they’re a tool, not a sentence. Whether to wear one, when, and whether to eventually stop using one depends entirely on the individual. “Take it off every once in a while if you’re in a safe environment,” Kory advises. “That gives new input to the brain a chance for things to improve.” Electrical stimulation is another tool worth exploring. Kory recommends starting with an affordable unit available on Amazon for around $40 to test whether the technique produces results before investing in higher-end systems. You can find Kory’s recommended unit at linktr.ee/unlimitedpotentialpt. The “Life Athlete” Mindset Kory calls his stroke survivor clients “life athletes.” Not because they run marathons or lift heavy, but because athlete thinking produces athlete results. Athletes track. They audit their approach. They celebrate small gains. They adjust when progress slows. And they don’t let one bad assessment from one clinician define what they believe is possible. “If somebody told you you’d never walk again, you can take that feedback and use it as motivation,” Kory says. “Or you can let it get you down. That’s up to you.” What to Do With a Limiting Prognosis When a doctor says “you’ll never walk again,” it’s rarely cruelty; it’s usually outdated thinking. General practitioners have limited training in neurological rehabilitation. Some are still working from research that concluded recovery stops at six months or a year. That conclusion was drawn from patients who stopped therapy and stopped trying, not from the brain’s actual ceiling. “I just want to leave the door open,” Kory says. The research on neuroplasticity is clear: the brain continues to adapt when given the right challenge, the right environment, and enough time. A prognosis isn’t a prophecy. It’s a snapshot of what one clinician observed on one day. Walking after stroke real, functional, independent walking is possible far longer and far later than most doctors suggest. And sometimes, it happens the same day they said it never would. If this episode has helped you, Bill’s book The Unexpected Way That A Stroke Became The Best Thing That Happened shares the tools and mindset that made the difference across his own recovery. If the Recovery After Stroke podcast has been valuable to you, you can support it financially at patreon.com/recoveryafterstroke. This blog is for informational purposes only and does not constitute medical advice. Please consult your doctor before making any changes to your health or recovery plan. She Was Told She’d Never Walk Again – Her PT Proved Them Wrong | Dr. Kory Langwell (Interview) Dr. Kory Langwell on the therapy gap, foot drop, and why the plateau after stroke is a label not a limit. Highlights: 00:00 Introduction – Walking After Stroke 07:24 Insurance and Therapy Limitations 11:22 Supporting Survivors and Caregivers 16:45 Community and Support in Recovery 26:57 The Impact of Electrical Stimulation in Rehabilitation 29:17 Walking: Quality Over Quantity in Recovery 30:25 Understanding the Stages of Recovery 36:39 Navigating the Challenges of Falling Post-Stroke 42:05 Setting Realistic Goals for Recovery 44:46 The Role of Medical Professionals in Rehabilitation Transcript: Introduction – Walking After Stroke Kory Langwell (00:00) So we had a client recently there. Doctor told them they were never gonna walk again. And literally, like they our therapist showed up, the patient was in tears, and then they walked 70 feet with our therapist. And it was all because it was a doctor that didn’t know them. They did like some reflex testing and said, you’re hyporeflexic, you’re never gonna walk again. And then literally that same day walked 70 feet. I was like, I hope you go back and tell them, BIll Gasiamis video 25, image (00:23) Before we get into today’s conversation, I want to extend a genuine thank you to everyone who supports this show. Whether you’ve joined as a YouTube member, contributed through Patreon, left a review, shared an episode, commented, or picked up a copy of my book, You Are the Reason This Podcast Keeps Going. Today’s guest is Dr. Corey Langwell. A doctor of physical therapy with over 15 years of clinical experience. Corey runs a mobile therapy practice across Southern California and now coaches stroke survivors worldwide through unlimited potential physical therapy, a virtual program built for people who can’t access the in-person care they need. In this conversation, we get into the gap that opens up the moment you leave hospital. While the word plateau might be the most dangerous word in stroke recovery, What physical therapists know about walking after stroke that most doctors do not, and what it actually takes to keep making progress, years or even decades post-stroke. If you’ve ever been told there’s a ceiling on your recovery, this episode is going to challenge that. Here’s my conversation with Dr. Corey. BIll Gasiamis (01:39) Kory Langwell, welcome to the podcast. Kory Langwell (01:42) Thanks for having me. BIll Gasiamis (01:43) Tell me a little bit about your background. Kory Langwell (01:47) Yeah, I’ve been a doctor of physical therapy for over 15 years and I’ve had my own mobile therapy practice for a little over five years. So helping people in their homes throughout Southern California with my staff of PTs, OTs, and speech therapists. And now we’re expanding to worldwide really with our virtual coaching program for people that have had strokes. So BIll Gasiamis (02:12) Worldwide. That’s awesome, right? So that’s where I found you on the TikTok app. And it’s a pretty decent channel to follow. Tell me just while we’re here and I remembered to ask, what is the TikTok handle? Kory Langwell (02:14) Yeah. Yeah. Yeah, yeah. It’s Dr. Kory Stroke Recovery PT and I can I can send you the link later on. But yeah, so I started two months ago and it’s been growing ever since. So BIll Gasiamis (02:38) Yeah, it’s really good because I think your information comes from the clinical background, something that I can’t do. I can put a lot of information out about my personal experience with stroke, what other people tell me about their experience, but your specific instructions around how to improve or how to do something differently or how to achieve an outcome with regards to whatever physical deficit people have after stroke. Is really helpful. So for people who are watching and listening, go to TikTok and probably the other social media channels, yeah, Kory? Kory Langwell (03:12) Yeah, yeah, I started a YouTube recently, unlimited potential physical therapy. And yeah, I’m also on Facebook, Unlimited Potential Rehab. So yeah. BIll Gasiamis (03:22) Yeah. You’re one of those people. I often get asked where can I find somebody that’s going to help me with my stroke recovery? I can’t get there or whatever. And I’m I’m often the middleman. People think that I know everything about everyone, especially from Australia to the United States, right? But what’s weird is I do know a lot of people and I can connect people. So it’s great that we connected and I found you. And I think it’s really important that. Kory Langwell (03:39) Yeah. Yeah. BIll Gasiamis (03:50) It’s your perspective and the way you think about recovery that’s different. And that’s why I reckon people A, should follow you and B, listen to this podcast episode. So don’t leave yet. F listen to the episode and then go and follow Kory on TikTok and all the socials. We’ll have all the links in the show notes. My first question is about the gap. Okay. So we’re often Kory Langwell (04:01) I appreciate that. BIll Gasiamis (04:17) Find ourselves as stroke survivors get sent home from hospital. Everyone does amazing things before we leave hospital. The care is amazing. They try and rehabilitate us as much as they can. They keep us alive. They send us home. But then the gap at home is we’re kind of left alone. Nobody to check in with us to make sure that things are kind of on track, that we’ve settled in. And it feels for a lot of people like recovery ends after therapy ends. But Can you give us a bit of a your your thoughts on that? Kory Langwell (04:54) Yeah, usually at least here in the States, people go from getting three hours of therapy a day in the hospital to literally dropping down to thirty minutes once or twice a week. So there is this huge gap where they just feel like they’re not getting enough and then that it really slows down their progress, or so they feel. and that’s where we’ve come in with our in-home care. But what I’ve seen is people just they need that accountability, whether it’s virtually or in person. And so that’s one thing that we really strive to do is just provide that that one-on-one support virtually. And also, you know, what I see with a lot of people is they think that, stroke recovery. Stops at you know, three months, six months, a year. We’ll probably talk about this more later on. But you just got to keep challenging yourself, doing new things. And I find a lot of times people get stuck on just finding random things on the internet, and then they just they don’t reach out or have the support that they need to move forward and make progress. So grant you just don’t want insurance to tell you when therapy ends or when progress ends. So that doesn’t mean your brain just immediately is yeah. Yeah, therapy’s done because insurance says it is and the brain just shuts off. I mean, I’ve seen progress years, decades, you know, 10 to 20 years after a stroke. I’ve seen progress with arms, hands, legs, general walking ability, you know, stuff like that. So it’s a lot of times they just people get fed up, they get frustrated, and then they stop doing or looking for resources. So BIll Gasiamis (06:26) Y the thing that you said is very interesting about insurance telling you when therapy ends. Now what they’re doing, what are they doing? Are they like I know what they’re doing fundamentally, right? They can’t forever pay somebody to have rehabilitation. And maybe they’re encouraged to pay them for as little as possible as well, because it costs money, right? So they they Kory Langwell (06:49) Yeah. Yeah. BIll Gasiamis (06:53) come up with some kind of a conclusion or whatever, and then they say to people, Well, y that’s about it. You’re not going to really improve any more than that. And we need you to we we’re going to stop funding it. So how does that conversation go from what you understand? And can anyone intervene in that moment and continue the therapy? Is there a way to kind of argue your case to get more therapy? Insurance and Therapy Limitations Kory Langwell (07:24) Yeah, it’s a tough one. So having worked in hospitals in acute rehab units, having worked in outpatient clinics, and then now as my own mobile practice in people’s homes, I’ve seen the whole spectrum of therapy and the issues that come along along each step of the way. in the hospital, you know, it used to be therapy they would get six to eight weeks in the hospital a lot of times here in the States. And now it it used it dropped down to like three weeks for a lot of acute rehabs, and now they’re pushing it down to like 10 to 14 days. which is not a lot of time. And, you know, we used to be able to get people to near independence with a lot of their their skills, you know, the activities or ADLs, activities of daily living. But what I see now is a lot of times hospitals when I left the hospital world in November of 2021, at that point, it was like, let’s just get people to like minimum assistance, meaning they need about 25% or less, and let’s we gotta ship them out of here because it’s like it’s like a churn. It cause hospitals, to be honest. They’re big business. They they are, you know, it’s unfortunate. and they have some of the most highly trained therapists, but the therapists are kind of hamstrung from upper management, middle management, you know, being told probably from people above them that they can only do so much. in the states we have private equity buying out a lot of hospitals and stuff like that. So there are things are changing in the length of stay that clients get. Once somebody goes to home health, they usually only get like two to three weeks, once or twice a week, because the goal of home health is usually get them to outpatient, get them to a clinic. and when they go to a clinic, most of the time somebody will reach like a maintenance level where like they’re not really making a ton of progress and the therapists know they’re not gonna be getting reimbursed as well for that. So that gets really challenging and they have to write really good goals to help. you know, progress things or continue with therapy. So if your therapist is telling you in the outpatient clinic, that’s the one area where you can oftentimes have the best chance of extending therapy. They might be able to, you know, wiggle their way around writing new goals, higher level goals that you can work towards and progressing. And then other times they want to stop therapy for one to two months, three months and then reassess, you know, down the road, which is where a lot of times people seek us out for private therapies on the side. So It’s unfortunate, but yeah, the insurance game does have a their hand in it a lot of times, telling people when they can discharge or not. So yeah. BIll Gasiamis (09:50) How hard is it for a therapist to know that the stroke survivor patient is not ready to go home, but you have to wind it up for them. Kory Langwell (09:59) Yeah. Whew, it’s really challenging. And usually, I mean, in out most outpatient clinics, you might get somebody two or three days a week if you’re lucky. Usually 30 minute sessions in in the clinic. Sometimes you have one-on-one places for an hour, which are great, or 45 minutes, but you’re it’s a volume game in the clinics because the reimbursements have shrunk in the outpatient world too. So they’re like, We need more volume here. And it’s unfortunate. It’s not on the therapist. It’s more on the, you know, just the the whole game that they have to do in order to survive, or else they would have to close up shop. But as far as like extending somebody, it it it can be a challenge. It’s it’s really you see it coming as a therapist, you know, and you’re in the outpatient insurance-based game. you’re like, ooh, you know, I I in about two to four weeks I can tell this is gonna be an issue with your insurance or whatnot. And most therapists, if you can get somebody to like 90% better. You know, that’s pretty darn good, especially after a stroke. there’s a lot of factors that go into that, a lot of variables. But yeah, so it’s it’s tough and getting somebody back to a hundred percent is can be challenging with the insurance game. BIll Gasiamis (11:07) Yeah, getting back to a hundred percent is Kory Langwell (11:12) It’s hard. It’s like the new one hundred percent or yeah, it’s another topic for yeah. BIll Gasiamis (11:13) my gosh. Yeah. The new hundred percent I pref yeah, that I love that. That’s a great statement actually, because a hundred percent, I mean Supporting Survivors and Caregivers BIll Gasiamis video 25, image (11:22) If this podcast has helped you in any way, here’s how you can help it reach more people. Share this episode with a survivor, a carer, or anyone who needs to hear that recovery doesn’t have an expiry date. Leave a review. It makes a massive difference. And if you’d like to support the show financially, you can do that through Patreon at patreon.com/recoveryafterstroke or by becoming a YouTube member. Now it’s back to the show. BIll Gasiamis (11:50) I I have that challenge with a lot of stroke survivors who are early on in their recovery. They reach out and they say, you know, how long is this going to take for me to get better? And like, dude, like it might never get better. in that what they want is they want to go back to where they were before the stroke. And there’s n nobody’s going back there. Nobody at all. Kory Langwell (11:59) We don’t know. Yeah. Yeah. BIll Gasiamis (12:11) Not a single person. And if there’s damage in the brain and the damage is permanent, which damage is in some instances, then you cannot reverse that damage. You have to accept that damage and then adjust and recover and overcome the challenges that you’ve been left with. And it’s such a difficult thing. But the new 100%, I love that, Kory, because I kind of am there. And if people ask me how do you feel, which nobody nobody understands to ask how do I feel after my stroke, my left side is completely numb. You know, I get spasticity. It doesn’t look visibly like other people experience spasticity. So I got away with that part of it. I don’t look like I’ve had a stroke, but I have the fatigue, I have the balance issues when I get tired, I have all these challenges that are always there and they’ve been there since two thousand and fourteen. Like it’s not going away. Kory Langwell (13:07) Yeah. There’s There are those silent problems too that like you said, like you’re doing so well in general that a lot of people just can’t see the fatigue or the how tight your arm feels or different things, which is oftentimes really challenging. But if you put it even, you know, towards like an orthopedic injury where somebody has like a shoulder surgery or a knee surgery, typically they also have like that new one hundred percent where it’s you know, it’s never gonna it’s hard to have it feel a hundred percent like it was before. There are certain instances where somebody might make this miraculous recovery. It does happen. Maybe they’ve had a TIA, a mini stroke, or you know, just made this miraculous recovery. Those those people do exist and it does happen. But what I find in the stroke community that happens a lot is there’s this everyone wants to compare themselves to other people, or they’re they’re wanting to get the answers from things, but there is no crystal ball on these recoveries, you know, for for neuro issues. It’s more like let’s see how it progresses in one month, three months, six months, a year, and then just continue to track because it is a lifelong issue that you have. have to manage and and continue to, you know, have things come up over over time. So yeah. BIll Gasiamis (14:14) Yeah, I agree with that. So this next question I thought about how I’m gonna ask it a lot. So I’m gonna ask it just the way my gut’s telling me to ask it, which is how much bullshit is that you’ve reached the plateau? Kory Langwell (14:31) yeah, that’s a that’s a fun one. I I love the I love the the BS part of that. yeah, it’s tough. I mean, you can see a lot of times what you’ll see is like there’s almost, you know, you think of plateau as like a flat line. And a lot of times what we do see is you’re there’s still room for progress. Like maybe somebody’s feeling like they’re 60% back to their normal self. Well, if we can get you to 65%, would you take that? Like most people would say. You know, it’s either sixty or sixty five percent. Like, yeah, let’s do that. But a lot of times what I see is Progress has just slowed down, they get upset, you know, the doctor’s like, whoop, this is as good as it’s gonna get. This is where you’re at. You’ve plateaued and you’ve entered a maintenance stage. And what I often see with that is it’s that’s the time to shift something up, mix something up, do something different. so what we like to do is take into account what kind of audit what somebody’s doing when their exercises, their daily routine and all that, and then shift things in some certain way and reassess in six weeks to see if we can progress that or make any other changes. So just like with any other training, like if somebody was a bodybuilder going for a competition or a professional athlete, we take that kind of same approach to our stroke recovery. We call athletes in general. Like they’re life athletes, you know. So we wanna help people feel as independent and as strong as they can. So yeah. BIll Gasiamis (15:50) That’s a great mindset shift, right? So if you consider yourself somebody who’s injured, somebody who’s never gonna be the same, all that kind of stuff, well, it might be accurate, but it may not be helpful in the way you approach your recovery. But an athlete, that’s very cool. Now I know some people say what an athlete runs on a track and field you know, facility. An athlete does this, an athlete does that. Well, Maybe, maybe they don’t, you know, maybe you can be your own version of an athlete that allows you to think about that constant and never ending pursuit of getting better and improving. And whether you’re getting better and improving your physical side or your mental attitude or your emotional side or your or your nutrition, you know. Community and Support in Recovery Athletes have all these things that they always constantly forever focus on and their gains come from, you know, that really last part, which is almost unattainable, but it’s about going for it. It’s about going for the last one percent. And then reflecting back, like you said, maybe twelve months later and going, Look how far I’ve come, rather than look what I can’t do or look what I haven’t achieved yet. It’s like, look what I have been able to achieve. That’s Kory Langwell (17:03) Yeah. Yeah. Yeah. And that’s where and that’s where tracking comes into it. Are there, you know, your what what are your BIll Gasiamis (17:15) Such a different mindset. Kory Langwell (17:21) you know, your KPIs, your key performance indicators that you’re looking into as far as, hey, I was only lifting one pound with my arm and now I’m do lifting three pounds. Like that’s huge improvement in a, you know, what however long it’s been. So those whatever you’re tracking, it helps to you know, it could be your diet. Am I making good choices eighty percent of the time? Am I so making sure in like all of your life assets assets and that or facets of life, that’s what we try to do as well. And like you said, mindset, movement, muscle, all that. all those things together. we we you know, tie all those things into our our program. And I think everyone needs to do that as far as, you know, their strengthen those the mental muscle, the physical muscle, you know, they’re just as important. And having that support, whether it’s with a coach or whether it’s with family, friends, outsiders, you know, other stroke survivors, it’s really important. So BIll Gasiamis (18:14) Yeah, community is the I think biggest thing for me. because then with the right community, the one that I’ve created for myself, at least I get to talk about the things that bug me about what happened to me with people who one hundred percent understand it. And then that way, even if we’re different in our attitude in the way we go about things, at least we understand. Kory Langwell (18:35) Yeah. BIll Gasiamis (18:45) And you’re totally being heard. Do know what mean? Like it takes one minute to listen to the story of a stroke survivor and to fully understand where they’re coming from because they’ve been through a a similar, a very similar experience to to myself. Kory Langwell (18:52) Yeah. Yeah, yeah, absolutely. for sure. It’s so true. I mean, as a therapist, I I never really I mean, I knew there was a mental toll to it, but having worked with people for, you know, they come on and they’re with us for several years, you really see the mental aspects, like the ups and downs that occur with that. And it’s so huge to you know, important to to focus on that as well. So and not lose sight of it. So those silent symptoms of the stroke, you know, like we were talking about as far as the the emotional aspect or other things of that. So yeah. BIll Gasiamis (19:26) Yeah. Yeah, one of the biggest complaints that I get from stroke survivors, not about their spouse, but about people about people who haven’t had a stroke, right? So often it’s the spouse that gets the raw end of the stick. But it’s that they just don’t understand me. And it’s so true, right? There’s no way that that person can understand you unless they’ve had a stroke, and we do not want that for them. That’s better that they don’t understand you and that you have to learn how to explain yourself in a way Kory Langwell (19:53) Yeah. Yeah. BIll Gasiamis (20:04) that gets the message across even if they don’t get it. Like it’s okay because they’re never gonna get it. We don’t want them to really ever get it. What we wanna do is accept that they can’t understand something that they have never experienced, which we don’t want them to experience. Kory Langwell (20:20) Yeah, that’s so true. I mean, the it a lot of times it comes from a good place. They’re like, just get up and move. Why are you so tired? or you know, things of that nature. And it y you’re right. They just they don’t understand it. It’s it’s tough. There really should be more caregiver support and education. I’ve tr I’ve strived to do that on my page or on my different resources that I’ve included on my bio. But yeah, it’s it’s in sh it’s a challenge for people to to see the whole picture and the recoveries process that’s going on with that. So yeah. BIll Gasiamis (20:51) Yeah. How common is foot drop? Kory Langwell (20:56) yeah. Strokes you you do see it a fair amount. it’s what I see a lot of times with that. You know, when in the hospital, a lot of times I don’t like to immediately put somebody in like an AFO. Everyone knows ankle foot orthosis and stuff like that. but it’s something that I like to see how the body reacts initially to to the the weaker ankle or whatnot, and how is somebody compensating? So you’ll see somebody, you know, try to march their leg up to clear their foot through the gate cycle, or they’ll kick their their leg out to the side so that they don’t drag their foot or their toe. so I like to see. See what’s going on for the first week or so before we start trying to, you know, put a bunch of equipment on somebody. But honestly, it it’s it’s pretty common. it just depends on the nature or severity of the stroke. Most muscle recovery starts proximally, meaning like at the hip and then works its way down, or in the shoulder and then works its way down to the hand. so the ankle and the hand are usually the last to recover. but yeah, so it’s obviously it’s very noticeable on somebody’s walk gate or whatnot if they have it, or you know, as you just see their AFO and you’re like, that guy’s got foot drop, most likely, or whatnot. So yeah, just trying to figure out where’s is there are there other weak links up the chain and the knee, the quad, you know, your your your glutes, your hip, what other areas could use some help to help you get that leg through and help you be more independent? So BIll Gasiamis (22:28) Mm. Kory Langwell (22:29) really treating the whole ankle or the whole walking pattern, not just the ankle or the foot. Cause we a lot of times we get laser focused into one area after a stroke like my hand or my foot, but we gotta look at the whole body. So yeah. BIll Gasiamis (22:41) So there is a conversation that happens again in the community about whether I should be wearing AFO or I shouldn’t. And you often hear people saying, I got rid of my AFO. it was causing me to walk badly or incorrectly and it was decreasing the muscle activity in the correct way. Kory Langwell (22:51) Yeah. Yeah. BIll Gasiamis (23:08) And then you hear the exact opposite. Well, you know, you should definitely have an AFO so you don’t trip over, you don’t do this, you don’t do that. Like, how do you determine that whole should I or should I not have an AFO? And do some people definitely need an AFO? And then also are there some people who can transition out of an AFO? Kory Langwell (23:20) Yeah. Yeah, it it really is with a lot of neurotype issues, it it really does depend. You’ll hear the answer, it depends a lot of times in the neuro world, neurological issue or you know, in the stroke world. But on a case by case basis, it’s really how does somebody look? How independent are they with and without it? How much strength do they have in their the muscles on your shin and on the outside of your leg that help lift your ankle up? is it something that maybe you just wear it when you’re outside? And then when you’re inside the house, you’re getting that input. with your shoes off. I I really liked the shoes off, you know, kind of full input on how your foot’s moving. You can really see it visually, get some feedback there on what’s going on. So it it and it can change over time. Maybe somebody ditches it after a while or maybe they w they know like, hey, I’m gonna be going on this longer walk. I’m gonna use my AFO so I don’t get as tired because it can be more taxing and energy draining to have to, you know, lift your leg up more, kick it out to the side or whatnot. So we’re really trying to figure out what’s the best quality over quantity for for most folks so that they’re not overdoing it, but they still are getting you know, the appropriate amount of feedback and and to help them live their life, be as independent as possible. So I’m not against or for it. It’s just wanna it depends on the person. So yeah. BIll Gasiamis (24:45) Sounds like it’s a tool to be probably continuously assessed and determine its usability and then also for some people determine whether or not it’s short term, long term thing. And then also keep looking at it. What I seem to also see is people get told something, they do it, and then they do it for a long, long time and nobody kind of ever intervenes a year later to say, where are we at with that? Kory Langwell (24:51) Yeah. Yeah. It you know, it it’s it’s good to take it off every once in a while if you’re especially if you’re in safe environment and just reassess things, you know, on your own or with a therapist or whatnot. That again gives new input and sensory, you know, feedback to your brain of like, what’s going on here? And that that’s a chance for that neuroplasticity to occur, which you know, is a is a is a big buzzword in the in the neuro world. But yeah, so we’re just trying to create those environments and those chances for, you know, things to improve and and reassess. assess things as as you’re going along. So yeah. BIll Gasiamis (25:49) Can you explain to me briefly if you can, like what happens with foot drop, why does it occur? and why don’t I hear about the opposite of foot drop, which is the foot changing and going in the other direction? The Impact of Electrical Stimulation in Rehabilitation Kory Langwell (26:06) Yeah. so your your muscles on your shin, you know, like those those are the ones that people get shin splints on from working out or whatnot, your anterior tibialis muscle, those are a prime mover of lifting your foot up. And oftentimes the feedback and the timing, the coordination down to those muscles is just weakened or impaired. So you’ll see a lot of issues with that. You also have muscles on the outside of your shin. They’re called everters. So they evert or turn the foot out. So the combination of those everters and then the dorsiflexors that lift the foot up, those muscles are the two prime movers of that motion. They’re oftentimes affected with different strokes. And then so a lot of times what we end up using is like things. like electrical stimulation. I have a really good video on my YouTube, about eight to ten minutes long on how to set that up. but you can You c I I see a lot of good impact with the with the E stem, whether somebody’s laying down or sitting, or then there’s other things like the bioness for the leg and the arm, but the one for the leg to help with the timing and coordination, all that, all those things that go into it. So it’s just not just weakness, it’s that timing, coordination, balance, all those things combined. So yeah. BIll Gasiamis (27:19) Got it, got it. So you’ve seen some positive, helpful, supportive kind of outcomes from those electrical stimulators at like Bioness and other other types. Kory Langwell (27:33) Yeah, yeah. I’ve even like I’ve I have one that I use with clients that I I bought on Amazon for like forty bucks because the the range is anywhere from thirty to forty bucks up to like hundreds of dollars. Or, you know, the Bioness is you I think they can get that covered with insurance, at least a partial bit of it, but those are a lot more expensive. like thousands of dollars from to my knowledge. But I what I’ve seen is I don’t see a huge difference between some of those cheaper versions and then the larger ones. some of the bigger ones, like the Bioness, you do get a little more feedback or like that since like it will come on at a certain point of your gait cycle. So it’s like, lifts the toes at a certain point. helps you go through whereas versus you know a standard ESTEM unit, you’re usually it’s on for like 10 seconds, it’s off for 10 to 30 seconds depending on the settings. So but as an exercise tool in the general, in general, if somebody’s having issues and they have good sensation to that area. So you don’t want to put it on somebody that like can’t feel their leg or whatever. But it can be very beneficial at like getting that sensory and then the motor or muscle input back to that area. So not saying it’s going to get to that 100%. But it’s gonna help you. it oftentimes does help people, even, you know, if it’s ten to fifty percent better, great. You know, that’s a huge difference with somebody getting around. So yeah. BIll Gasiamis (28:53) Okay. So worth people considering the possibility of getting a forty dollar version just to sort of try it out and see whether or not it might be supportive. And then if it is and they want to get something more expensive, then go f go from there. your homework after this conversation is going to be to send us the links to every single thing you mentioned. So we can put it in the show notes and everyone can have a look at it. Now, with walking, Kory Langwell (29:12) Yeah. Yeah, absolutely. Walking: Quality Over Quantity in Recovery BIll Gasiamis (29:23) I’m of the I’m I I’m I’m in the camp of do more in the from the perspective of if you’re only walking for a minute, try and get to two. If you’re walking for two, try and get to four and so on. And then if you can get to thirty minutes or an hour at some stage, doesn’t matter when, then that’s even better. but when we started that conversation about Kory Langwell (29:39) Yeah. BIll Gasiamis (29:53) you joining me on the podcast and we share ideas about what we’re gonna talk about. You came back with me with regards to something about walking that people miss that could mean that walking further, longer, and more could actually be causing a problem. Tell me about about walking and the things that we can run into that make well, not things worse necessarily, but Not from an exercise perspective, but from a rehabilitation’s pers perspective. Understanding the Stages of Recovery Kory Langwell (30:20) Yeah. Yeah, I think it there’s a little differentiator in there. It’s like where what stage are you at in the recovery? So if somebody’s in that really acute stage, it’s you know, pretty fresh on the stroke, maybe it’s like somebody less than a month post stroke. We don’t want to get to the point where they’re just like you know, nearly exhausting themselves every single walk, you know, so there’s a time and a place for that. So you know, if somebody can only walk like five steps, we don’t want to go try to, you know, you’re gonna walk 25. And like you can do that every now and then, but don’t do it on like back to back days. Don’t do it on like back to back therapy sessions or whatever. So there’s a there’s a combination of like early on we want to make sure things are good quality. And then as we get moving forward, we want to progress in a fashion that’s comfortable and not over Taxing the neurological system, because a lot of times, as you know, fatigue plays a huge role in that. And how is that affecting you? Are you like you went for a super long walk, but now you’re down for the count for two days or you know, at least a day. So you know, walking a hundred feet can feel like a marathon early on. So it’s just making sure that you’re getting the right feedback, that accountability, support, where you’re it’s quality. in not just overdoing it. So I find that a lot where people want to do a ton of reps or like they’re doing an exercise, like they’re trying to lift their arm up, but they’re doing this the whole time, you know, and I’m like, you’re just you’re not lifting your arm, they’re just like tiring out their trap muscle as opposed to like some of the the delt or bicep or different areas. So like you’re just gonna get really bulky but traps up here, but you’re not really necessarily helping yourself versus if you did good quality and like keep that shoulder down. I’m just using that as an example. But for walking, you know, same thing. Like are you using a mirror for feedback? To see, like, I’m actually, I’m every step, I’m kind of falling off to the side. Why is that? I’d rather like have somebody walk 50 feet really well than like 150 feet terribly, you know. So it’s and that that again goes into more of the acute stage. Now, if somebody’s sub-acute, more of a chronic, it’s been 10, 15 years, go for it. Like, if you want, if you feel good about it, you’re not overtact taxing yourself, getting overtired or anything, you know, do what you can. Walking is one of the best exercises for you. I also like I I’m a big fan of walking backwards. So in a safe area like by the kitchen sink or a hallway or something, it just challenges your mind and it’s a really good balance exercise for somebody post stroke or with any neurological issue because it just told you you see somebody try it the first time, they’re like, What do you want me to do? Walk backwards. And then there’s tons of ways you can adjust the the intensity on that as well. So yeah. BIll Gasiamis (33:01) So also I remember being in outpatient rehab and feeling like I actually wasn’t able to walk well. And then the therapist saying, Well, why don’t we just record it and have a look at how you’re walking? And it was also about running because I I wanted to run, but I didn’t want to run marathons. I just wanted to be able to run across the road if a car’s coming or something. And I said, Well, I’m a bit concerned about how that Kory Langwell (33:15) Yeah. BIll Gasiamis (33:30) goes ’cause I don’t want to injure myself running, et cetera. And well he said, Well, why don’t we do a run, I’ll record you and I’ll then we’ll break it down and I’ll show you what you’re doing or what you’re not doing. And it turns out that my running style was fine. What wasn’t fine was the feedback that I was getting because it was completely different to the previous thirty seven years of my life. And I and because it felt different and my brain registered it differently, it It was scary. Like it was like, well, this doesn’t I’m gonna probably injure myself is how I I thought it. But when I saw the video, it was completely different. And sure, there was some instructions still about how to do it correctly, what I might be able to improve, especially with my left leg, but the but the overall picture was more positive than I t made it out to be. And that’s the challenging part. Sometimes we think we’re less capable than we are. Kory Langwell (34:06) Yeah, yeah. Yeah, and that’s why the visual feedback is so important, whether you record it with your cell phone or you know, just getting the real time feedback on with a mirror or something like that. It’s you know, you see that used in therapy a lot because you may not notice that you’re doing something and just having somebody tell you that isn’t gonna help as much as if you’re somebody’s telling you plus they’re showing you what you’re doing. Yeah, that that can be a huge, you know, help of like, you know, that I can feel that now. It’s good biofeedback. I can, you know, move on from there. So yeah. BIll Gasiamis (35:01) Yeah. And so it sounds like there’s two parts to that conversation. Is sometimes we think we’re doing it better than we are, and sometimes we think we’re doing it worse than we are. So it’s really important to have somebody assess you or at least give you feedback and give you the opportunity to check your assumptions about yourself and then also to check via perhaps a recording to check, you know, how you are actually doing things. So you can see it from Kory Langwell (35:10) Yeah. BIll Gasiamis (35:31) their perspective and then you can adjust as you’re going forward. Kory Langwell (35:35) Yeah, absolutely. BIll Gasiamis (35:37) So what about falling? That’s a huge issue after stroke. I fell quite a few times after surgery. The first time I fell, Kory, was about I don’t know, less than twenty-four hours after I woke up after brain surgery. And the nurse said to me, Have you been to the bathroom to movie bowels? And I was like, No, I haven’t been anywhere. And she said, Well, great, get up, I’ll let I’ll help you. get there and now she was a lot smaller than me and a lot thinner framed and she said just put your arm around me and I’ll help you get to the bathroom. Okay, cool. I did that and when I stepped out onto my left leg, from the left side of the bed, as soon as I put weight on it, without her having any idea, I completely fell straight to the ground, in the ward, screaming Kory Langwell (36:32) no. Yeah. Yeah. BIll Gasiamis (36:36) I’ve got a fresh h scar and patch on my head from brain surgery literally twenty-four hours ago. so it became quite a concern after that because it was the first time I realized that my left side doesn’t work. And it was the first time I realized that th falling after a stroke with a cr a fresh craniotomy and all that kind of stuff is also very dangerous, right? So when I came home Navigating the Challenges of Falling Post-Stroke Kory Langwell (36:37) Yeah. BIll Gasiamis (37:04) I was pretty independent and I felt really good about the fact that I was able to walk on my own. but when I got up from the couch one time and many other times when I’ve fallen, when I got up from the couch on time, I forgot to connect my new leg to my my standing up, my getting up from the couch. I had just eaten a sandwich. It was in a plate. I was the one that went and made the sandwich, sat down and started eating it. And then as soon as I finished it, I went to get up to take the plate to the sink. And my left leg wasn’t aware that it was on the ground. And I fell immediately. And I dropped the plate, I broke the plate, I smashed my ribs on the arm of the couch. I thankfully didn’t injure myself terribly, but it was a close call. And I always after that, I always made a point and still do in the morning when I wake up to get out of bed. Kory Langwell (37:41) Yeah. Wow. Yeah. BIll Gasiamis (38:01) make sure my foot is on the ground before I stand up so that I don’t lose balance and fall. So that’s my that’s my story about falling, but also it’s very common in stroke survivors. I hear that a lot. Tell me about why falls happen after stroke. Kory Langwell (38:05) Yeah. Yeah. Yeah. You know, first off it Kinda hurts my therapist heart to hear that what you know, the nurse and you will fall in there. That’s where I’m like, he needed a PT evaluation to see how strong his legs are, where his, you know, sensation is and all that. Usually when we get somebody up, we want to make sure they’re safe at the edge of the bed. And then maybe we’re transferring just to like a a bedside commode in the the first time. And then you’re you you check that box then. We start moving towards walking once we make sure it’s safe. But sometimes the nurses get a little gung ho with things and get a little excited. we try to stay in our lane and, you know, just do the That PTS needed. but as far as like, you know, making sure somebody’s safe, it’s creating the right environment for them that, you know, like I mentioned, making sure they’re strong enough with their legs to, you know, and the most people will know as they started physical therapy what level they’re at, how much help they need, all those things. So, and then not over challenging somebody where we’re doing like very advanced balance exercises or doing very, you know, doing three tasks at once or like you carrying that dish, you know, and that’s a more your brain is like thinking, we’re good and I’m just gonna carry this dish and I’m gonna go turn off the TV while I’m getting up or whatever. And your brain’s like, nope, no you’re not, and you just fall over. So it’s like creating, you know, those too many environmental stimuli probably and then just where it kind of I don’t tricked your brain into to not focusing on where your your leg is at. We call that the proprioception or just realizing where your joints are, your limbs are in space. And sometimes that can be very affected after strokes. So we just wanna, you know, see how that looks, see how you’re moving, and and you know, go from there. So yeah. BIll Gasiamis (40:08) You probably describe that better than anybody, actually. Proprioception is my is a challenge that I have, but nobody ever connected that to what you just said, too many things happening at once. And it was exactly that. I had a plate, I just finished a meal, and my goal was to get the plate back to the sink safely without dropping it. And it was my my attention was Kory Langwell (40:33) Yeah. BIll Gasiamis (40:36) diverted away from making sure my leg was in the right position for me to stand up and was the muscles were activated, which I had been doing every day before that, right? I’d been making sure. But right now I had a plate in my hand and it was get up without dropping the plate. Kory Langwell (40:37) Yeah, Yeah. Yeah, yeah. Yep. Yeah. Pun pun intended, step by step, right? Just looking into like, okay, my feet are on the ground. I am able to push myself up to stand. Now we’re gonna take a step slowly, you know, go through that. So yeah, it’s it’s making sure everything looks appropriate and is, you know, safe for that specific client. So yeah. BIll Gasiamis (41:12) In my case I think now reflecting back on it, it would have been better if I’d gotten up and then reached over to pick up the plate and then moved to towards the the kitchen sink. And I think I was at home alone that day. And again, I screamed because before I knew it all was on the ground. Kory Langwell (41:27) Yeah. It happens. Yeah. Yeah. Setting Realistic Goals for Recovery BIll Gasiamis (41:35) It’s a very interesting thing to reflect back on it. under these sort of conditions where you and I are talking about things that seem they’re very glossed over. They’re not often spoken about in detail and people miss the the point. And sometimes people think I can’t do something properly, therefore I’m not gonna do it at all. But with regards to walking, what’s the best thing to do? about a walk that you haven’t been able to get back to the normal sort of style and and feel uncomfortable about doing. Some people will go, well, I’m opting out, I’m not gonna do that anymore because I can’t do it properly. It’s too difficult or it’s uncomfortable. Kory Langwell (42:21) Yeah. Yeah. I think it’s making goals that are you know, you hear about those specific, measurable, attainable, realistic time frame, the smart goals. So making sure that applies here. So It you gotta be able to walk before you can run, like with anything in life. So and that’s just you know, symbolic quote or whatnot, but you just wanna be able to do stuff that you can be working towards, but it’s also not so far out there that it’s like really hard. And then I see a lot of times people move those goalposts on themselves too much where they’re like, I got here. Now it’s like I wanna, you know, it’s you got to celebrate those small wins and then go from there as like far as you know, moving forward. So we had a client recently there. Doctor told them they were never gonna walk again. And literally, like they our therapist showed up, the patient was in tears, and then they walked 70 feet with our therapist. And it was all because it was a doctor that didn’t know them. They did like some reflex testing and said, you’re hyporeflexic, you’re never gonna walk again. And then literally that same day walked 70 feet. I was like, I hope you go back and tell them, you know, that that you missed that. So it’s BIll Gasiamis (43:15) Mm. Kory Langwell (43:36) really just making sure that you’re creating these sustainable goals that You know, and not letting people like that doctor that may not know you, a family member, you know, get in your ear and and cause these things that are detrimental to your your progress and take it in the right way. So yeah. BIll Gasiamis (43:55) You can’t actually answer this and I’m putting you on the spot, but I’m gonna ask it anyway. Like I assume that doctors, therapists, everybody is about rehabilitating, supporting, helping people and all that kind of stuff. I I not assume they definitely are, right? But what do you think is behind a questi a statement like you’re never going to X again? Like I hear that so, so much and I thought that by the time we get to twenty twenty six that that won’t be a thing that I hear about so often. Like, but I I don’t think it comes from being nasty or trying to give people setbacks or whatever. But do you have a sense of what that might be? Is it training? Is it a lack of training? Kory Langwell (44:30) Yeah. The Role of Medical Professionals in Rehabilitation I think yeah, you see a lot of like GPs, general practitioners, they don’t really have great training in like neurological rehab. So if it’s a PM and R doc, like a physical medicine and rehab doc, I find usually they’re a little more open-minded or or willing to s you know see the the progress or or whatnot over time. If you go into a doctor’s appointment, you show up in a wheelchair and it’s been, you know, six months, the doctor’s probably your general practitioner is probably gonna be like, well, this is what it is. It’s been six months. And I think some of that is from old research that came out that you can’t make progress after six months to a year, which was more because they just stopped therapy, they stopped doing things and you know, didn’t see progress because of that. So it’s, you know, yeah, if you don’t do anything and you just sit on your butt, all day you’re you’re not gonna see progress or you’re not gonna change. So but yeah as far as from a doctor’s standpoint it it can also be case by case with the doctors as far as their own experience and whatnot. And I don’t think necessarily they ever mean like harm or anything. Maybe they are trying to be realistic with clients as far as like this is what I’m seeing. I don’t think you know, the chances of this are slim, but they they it’s probably just a way of wording it better versus saying you’re never gonna do something again because there’s so many different things that are coming out, like research wise, treatment, you know, like things change drastically now. so it’s I I just like to to leave a at least leave the door open for people to see that improvement. So yeah. BIll Gasiamis (46:16) And walking doesn’t have to be the way you walked before. It could be a different version. It looked differently, feel differently, but it can still be walking. also I think it’s from ignorance, right? And again, ignorance, I don’t throw that out as a way to attack somebody, but it’s like literally that person hasn’t been in the space where Kory might work. They haven’t been in a space where they have seen people overcome some difficult challenges. Kory Langwell (46:23) Yeah. BIll Gasiamis (46:41) So they just make a assumption based on old thinking or something they heard in the past or old research that just stuck. And they’re just telling you, your job, your responsibility is to find new research to overcome that challenge because that research, it’s so bad if there was some and if they disseminated it to all the population in the medical community, and that has been continued to be passed on. I mean, that is so crazy that it persists and now. I just want to encourage people, do not believe anyone that tells you, A, you’ve hit hit a plateau, B, that you’re never going to do something again. And even though that might be true, just don’t believe it because there might be a technology around the corner that happens to solve that problem for you. You just don’t know about it yet. And always work towards the solution rather than focusing on the problem is kind of how I see it. And that’s generally what you guys tend to do. You guys tend to help people focus on. Kory Langwell (47:27) Yeah. Yeah. BIll Gasiamis (47:41) How do we overcome a problem? What’s the solution to this? Kory Langwell (47:46) Yeah, I think using it as motivation is is huge. So like you can take anything somebody tells you, you can take it one of two ways. And if you let it get you down, that’s up to you. Or if you’re like, Okay, I take that feedback, I appreciate it, but I’m not gonna accept it and use it as motivation to to strive to do better and move better. Like that that’s up to you. and who somebody is in their own, you know, life. So I always tell people it’s like, Well, what do you want to work on? You know, if some people are like, I don’t wanna do this anymore, I don’t wanna exercise, it’s like that’s up to you. So And other people they’re like, I want to push as hard as I can, I want to do what I can do. And so it’s really, you know, up to the what that somebody wants to do with their life and their progress, their recovery. BIll Gasiamis (48:28) Kory, it’s been an awesome conversation. Thanks so much for joining me on the podcast and saying yes when I reached out to have you on here and share your wisdom. Can you tell me where can people go and find th information about you? Kory Langwell (48:44) Yeah, so our our main website is unlimitedpotential.biz and you we have a health coaching page on there where people could message me on there if they want. I’ve had some people reach out. I’m pretty active in TikTok on on like DMs if people in my private messages of people reach out there as well. Dr. Kory, K-O-R-Y, stroke recovery PT. and then I’ll we’ll try to get you the handle there, the links on all that stuff. Those are probably the two best ways to reach me. I will say it’s really hard to give specific advice over a text or an email or whatnot. So I and there obviously I understand like there’s a lot of people that have financial issues or they they want the free advice or whatnot, but it’s just it’s really hard as a therapist to give a lot of that. I try my best and I can’t reach everyone doing that, but we really are able to to make a difference when we do work with people one on one. So yeah. BIll Gasiamis (49:36) Yeah. There might be programs that people can look into that you are offering either in house or somewhere else. That’s probably why I would encourage people to reach out to get an answer about your specific issue. Dr. Corey’s not going to do that. just like many people can’t answer a specific question about a problem that you may or may not have un unless they have information about your data or you know, they’re your physician or they have your scans and all that kind of stuff, that’s not gonna happen. But that’s okay. people can still follow you because your tips on TikTok are really cool. They’re on the mark and that’s where I love listening and learning from you. Kory Langwell (50:16) Thank you, I appreciate it. I’ll keep coming. BIll Gasiamis (50:19) Yeah, definitely keep them coming, man. it’s been a great thing, this social media thing because it brings information to people that otherwise wouldn’t be able to access it. Some people might be stuck with the doctor who said, You’re never gonna do this again. And that would be the most terrible place to be stuck and have nobody else to kind of throw a spanner in the works in that type of thinking and then suggest something more, more hopeful, more positive. Kory Langwell (50:34) Yeah. Yep. Yeah, absolutely. And it’s always good. I mean, I learn from stroke survivors all the time on what they’re going through. And it’s just, you know, it’s everyone working together around the world now. So I’m in I’m in California and we have, you know, like we’re talking you’re in Australia. I’ve talked to people all over the world now and it’s it’s just been great to to open those doors to a lot of people and you know, at least have conversations with them. So BIll Gasiamis (51:09) Doctor Kory, thank you so much for joining me on the podcast. Kory Langwell (51:11) Yeah. Thanks. Thanks for having me. BIll Gasiamis video 25, image (51:13) Well, that was Dr. Corey Langwell, Doctor of Physi
In this episode, Will sits down with Dan, Vice President of clinical services, live at APTA CSM to talk about the leadership philosophy that built something rare in private practice, a company where people actually want to stay, grow, and build a future.Dan shares how losing his father at 26 shaped everything about how he leads. How a second grade teacher taught him the power of memorization and names. Why he gives the book "I Love It Here" by Clint Pulver to every new clinic director. And how knowing the names of his employees' kids is not a nice extra. It is the whole strategy.This is an episode about what happens when you build around people instead of process. And what it looks like when retention is not a metric but a reflection of a culture where every person feels genuinely seen.Topics covered in this episode:Why knowing your team's why is the starting point for everythingHow JAG built programs like their 8 week new grad ramp by listening to what people actually neededThe LinkedIn stat that says 88% of people leave a job because they could not see a future there, and how Dan flips that script from day oneWhy Dan still treats patients after all these yearsWhat it really means to build a company where people want to take your jobIf you are a practice owner who is burned out or feeling like growth is just more weight on your shoulders, this one is for you.Send us Fan MailVirtual Rockstars specialize in helping support or replace all non-clinical roles.Learn how a Virtual Rockstar can help scale your physical therapy practice.Subscribe here to our completely free Stress-Free PT Newsletter for your weekly dose of joy.
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A meniscus tear can feel confusing because the diagnosis does not always make the next step obvious. In this episode, Ted explains what the meniscus does, the difference between degenerative and acute tears, why tear location matters, and how to think about physical therapy, surgery, and long-term knee health. For men over 40 dealing with knee pain, injuries, or the rest-reinjury cycle, this episode offers a practical way to understand the options and make a more informed decision. Listen to the episode now. You'll learn: Why meniscus tear location matters when deciding between rehab and surgery The difference between degenerative and acute meniscus tears When physical therapy may be the best first step for knee recovery Why surgery still requires a proper progression back to strength, sport, and activity Chapters: (00:00) Introduction (00:50) Meniscus Tear Options (02:26) What the Meniscus Does (03:44) Degenerative vs Acute Tears (06:14) Tear Location Zones (08:08) Physical Therapy Path (09:35) R3 Restore Rebuild Return (11:14) When Surgery Makes Sense (12:10) Surgery Types Explained (13:41) Rehab Is Nonnegotiable (14:38) Wrap Up and Next Steps Links Mentioned: Legendarylifepodcast.com/knee
Dr. Altman is a Functional Medicine Doctor with expertise in Energy Medicine, Bioelectric Signaling, and Regenerative Orthopedics. He shares his own story that started his path towards becoming a doctor treating pain patients. Dr. Sean Altman is a Functional Medicine Doctor with expertise in Energy Medicine, bioelectric signaling, and regenerative orthopedics, whose work focuses on identifying the root cause of injury and restoring the body's internal communication networks so healing can resume naturally and durably. With an academic foundation in Molecular Biology from Colgate University and a Doctorate in Physical Therapy from Stony Brook University, Dr. Altman's training reflects a rare integration of cellular biology, biomechanics, and clinical medicine. Graduating Summa Cum Laude, he established early on a commitment to scientific rigor, clinical excellence, and innovation in patient care. As a Functional Medicine Doctor, Dr. Altman focuses on identifying and correcting the root biological drivers of pain, injury, and dysfunction rather than simply suppressing symptoms. His approach blends root-cause diagnostics with advanced bioelectric and regenerative therapies to restore communication within the nervous system, tissues, and cellular networks. Each patient receives extended, in-depth evaluations and a highly personalized plan designed to activate the body's own healing capacity and promote durable recovery. With over 15 years of clinical experience, Dr. Altman has treated a wide spectrum of complex and chronic conditions, including Lyme disease, fibromyalgia, migraines, autoimmune disorders, orthopedic and spine injuries, chronic pain syndromes, neurologic conditions, prenatal and post-partum conditions, and high-level athletic injuries. His advanced training in regenerative and neuromodulatory technologies — including shockwave therapy, Frequency-Specific Microcurrent, ultrasound-guided interventions, and bioelectric therapeutics — allows him to treat conditions that often fail conventional care. Dr. Altman's work has been featured in CBS and PBS documentaries highlighting integrated medical models at Integrated Pain Solutions in Greenwich, Connecticut, where he collaborated closely with specialists in physiatry, regenerative medicine, physical therapy, massage therapy, yoga, and meditation. This experience shaped his belief that durable healing requires a multidisciplinary, systems-based approach that addresses structure, biology, nervous system regulation, and energy simultaneously. Resources: drseanaltman.com The Cox 8 Table by Haven Medical
Nicole Ternay helps women over 40 lose weight for the last time. Without dieting, restriction or other crazy diet stuff. She helps them lose weight by teaching them her proven mindset method, Master Your Mind to Change Your BodyTM which is her foundational work of over 24 years of experience in the weight loss industry. Nicole is also the host of the highly ranked Weight Loss for Women Over 40 podcast, a two time TEDx Speaker, Personal Trainer, Behavioral and Health Coach, degree in Physical Therapy, former professional ballet dancer and founder of MavenHeart. Nicole has been featured in Medium, Women's Health, IDEA Fitness, Rachel Ray in Season, Real Simple, Bicycling Magazine and MSN.Contact Nicole Ternay:weightlossforwomenover40.netMavenHeart.nethttps://www.facebook.com/nicole.ternayhttps://www.instagram.com/weightlossforwomenover40/https://www.instagram.com/mavenheart_nicolehttps://www.linkedin.com/in/nicoleternay/Dr. Kimberley LinertSpeaker, Author, Broadcaster, Mentor, Trainer, Behavioral OptometristEvent Planners- I am available to speak at your event. Here is my media kit: https://brucemerrinscelebrityspeakers.com/portfolio/dr-kimberley-linert/To book Dr. Linert on your podcast, television show, conference, corporate training or as an expert guest please email her at incrediblelifepodcast@gmail.com or Contact Bruce Merrin at Bruce Merrin's Celebrity Speakers at merrinpr@gmail.com702.256.9199Host of the Podcast Series: Incredible Life Creator PodcastAvailable on...Apple: https://podcasts.apple.com/us/podcast/incredible-life-creator-with-dr-kimberley-linert/id1472641267Spotify: https://open.spotify.com/show/6DZE3EoHfhgcmSkxY1CvKf?si=ebe71549e7474663 and on 9 other podcast platformsAuthor of Book: "Visualizing Happiness in Every Area of Your Life"Get on Amazon: https://amzn.to/4cmTOMwWebsite: https://linktr.ee/DrKimberleyLinertThe Great Discovery eLearning platform: https://thegreatdiscovery.com/kimberleyl
All Home Care Matters and our host, Lance A. Slatton were honored to welcome the team from Rock Steady Boxing as guests to the show. About Ryan Cotton, President/CEO: Ryan Cotton currently serves as President & CEO for Rock Steady Boxing. His involvement with the organization started in 2009 when he served on the Board of Directors for a decade. Although he serves all RSB boxers around the world, his favorite RSB boxer was his father who was a Parkinson's fighter until his last days. Ryan's education is in physical therapy where he had a 22-year clinical career before moving into his role at RSB. He holds a Masters in Physical Therapy from the University of Evansville, and a Doctorate in Health Science from the University of Indianapolis. About Chris Timberlake, Director of Education & Training Rock Steady Boxing: Chris has been with Rock Steady since 2006 and currently serves as the Director of Training and Education at RSB developing and delivering training in the RSB method to new coaches around the world. She is a caregiver to Tom, who was diagnosed with Parkinson's in 2000, and understands all too well the needs of people struggling with Parkinson's. Having trained hundreds of people with Parkinson's as well as being immersed as a care partner has given Chris a uniquely intimate perspective on how to battle this disease. She is a Certified Personal Trainer through the American College of Sports Medicine and her personal experience is an instrumental part of Rock Steady's "Cornerman" support. About Sandra Benton, RSB Boxer, Retired business owner and hairstylist: Sandra Benton was a business owner for 48 years working as a hairstylist and retiring at age 67. She was diagnosed with PD in April of 2023 and started RSB in July of that year. About Jim Lindgren, RSB Boxer, Retired reporter and editor: Jim Lindgren had a career as a newspaper reporter and editor for 25 years before becoming an editor for a market research company and retiring 2 years ago at age 66. He was diagnosed with PD at the age of 61. About Rock Steady Boxing (RSB): Rock Steady Boxing (RSB) is a nonprofit organization dedicated to improving the lives of people with Parkinson disease through a specialized, non-contact boxing-based fitness program developed to specifically address the symptoms of Parkinson disease. Founded in Indianapolis in 2006, RSB is built on the belief that individuals with Parkinson's can fight back against the progression of their disease through rigorous, targeted exercise The RSB program is multimodal and incorporates boxing techniques, strength training, balance work, and cognitive challenges to address the motor and non-motor symptoms of Parkinson's. Backed by growing evidence that high-intensity exercise can slow symptom progression, RSB has become a leader in exercise-based approaches to managing the disease. Today, Rock Steady Boxing supports a global network of more than 800 affiliate programs that deliver its training in local communities, including gyms, rehabilitation centers, and community organizations. Through comprehensive coach training, ongoing education, and a strong support system, RSB ensures that its programs are accessible, adaptable, and effective for individuals at all stages of Parkinson's. Beyond physical improvements, the organization fosters a powerful sense of community and empowerment among participants, helping them build confidence, connection, and resilience. As it continues to expand its reach, Rock Steady Boxing remains committed to its mission of enabling people with Parkinson's to live healthier, more active lives.
In this episode of the Optimal Body Podcast, Doc Jen and Doctor Dom explore foot pain and injury through Dom's personal experience with a Lisfranc ligament tear and two surgeries. Dom shares how a recent pickleball injury during a session triggered sharp midfoot pain, prompting him to self-assess and begin conservative treatment. They discuss potential diagnoses, footwear adjustments, and rehabilitation strategies including mobility work, strengthening exercises, and balance training. The episode highlights the value of physical therapy, direct access care, and structured programs like Gen Health's foot and ankle roadmap for achieving safe, effective long-term recovery after a pickleball injury. Jen Health Annual Membership Discount: Huge discount on Jen Health Annual Membership! Podcast listeners get over 50% off with code OPTIMAL10. Access 12 Therapy Plans and start your free trial now—move with us! We Think You'll Love: Jen Health Discount Jen's Instagram Dom's Instagram YouTube Channel For full show notes and resources visit https://jen.health/podcast/466 What You'll Learn: 3:23 Doctor Dom begins to share his personal experience with his pickleball injury, a recurring foot injury, starting with his history of surgeries. 4:15 Dom details his high school Lisfranc ligament tear, the two surgeries he had, and the hardware placed in his foot. 5:59 Dom describes how a long session of pickleball likely triggered his recent foot pain, causing a sharp mid-arch pain. 7:23 Dom discusses ruling out plantar fasciitis and considering other potential diagnoses like a Lisfranc injury or arthritic flare-up. 9:46 Dom explains his reasoning for not immediately seeking a formal diagnosis, anticipating the likely conservative recommendations he would receive. 11:16 The speakers discuss how switching to more cushioned shoes for high-impact activities might have contributed to their recent foot issues. 13:34 Dom shares the first steps he took for relief, including toe spreading, manual mobilizations, and big toe mobility exercises. 16:06 Dom describes progressing his exercises to include short foot activations, isometric toe flexion, and single-leg stance work to normalize gait. 18:51 Dom explains why his rigid foot needs both mobility work and strengthening through its new ranges to prevent future injury. 20:45 A week after the injury, Dom details his current exercises, including heel raises, single-leg reaches, and what still causes pain. 24:52 The hosts advocate for seeing a physical therapist first for conservative treatment to potentially avoid costly and unnecessary medical procedures. 26:49 Dom outlines his plan to... Hosted by Simplecast, an AdsWizz company. See pcm.adswizz.com for information about our collection and use of personal data for advertising.