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Jose Acevedo didn't set out to be a storyteller—but life had other plans. In this insightful recap, Lesley and Brad reflect on his deep commitment to community, the unexpected lessons of fatherhood, and how honoring your roots can guide your purpose. Tune in for a powerful reminder that connection is built one story—and one step—at a time. If you have any questions about this episode or want to get some of the resources we mentioned, head over to LesleyLogan.co/podcast. If you have any comments or questions about the Be It pod shoot us a message at beit@lesleylogan.co.And as always, if you're enjoying the show please share it with someone who you think would enjoy it as well. It is your continued support that will help us continue to help others. Thank you so much! Never miss another show by subscribing at LesleyLogan.co/subscribe.In this episode you will learn about:What to actually use (or substitute) when starting Pilates at home.Why storytelling is essential for culture and connection.How fatherhood reshaped Jose's mission and mindset.The value of flexible goals and steady routines.How legacy is built through small, meaningful actions.Episode References/Links:April UK Mullet Tour - https://opc.me/ukSpring Pilates Training - https://opc.me/eventsPilates Studio Growth Accelerator - https://prfit.biz/acceleratorCambodia October 2025 Waitlist - https://crowsnestretreats.comFinding Arizona Website - https://findingarizonapodcast.comFinding Arizona Podcast - https://beitpod.com/findingarizonaFinding Arizona YouTube - https://beitpod.com/findingarizonayoutubeEp. 499 wit Kristen McGuiness - https://beitpod.com/kristenmcguinessEp. 5 with Amy Ledin - https://beitpod.com/amyledin If you enjoyed this episode, make sure and give us a five star rating and leave us a review on iTunes, Podcast Addict, Podchaser or Castbox. https://lovethepodcast.com/BITYSIDEALS! DEALS! DEALS! DEALS! https://onlinepilatesclasses.com/memberships/perks/#equipmentCheck out all our Preferred Vendors & Special Deals from Clair Sparrow, Sensate, Lyfefuel BeeKeeper's Naturals, Sauna Space, HigherDose, AG1 and ToeSox https://onlinepilatesclasses.com/memberships/perks/#equipmentBe in the know with all the workshops at OPC https://workshops.onlinepilatesclasses.com/lp-workshop-waitlistBe It Till You See It Podcast Survey https://pod.lesleylogan.co/be-it-podcasts-surveyBe a part of Lesley's Pilates Mentorship https://lesleylogan.co/elevate/FREE Ditching Busy Webinar https://ditchingbusy.com/ Resources:·        Watch the Be It Till You See It podcast on YouTube! https://www.youtube.com/channel/UCq08HES7xLMvVa3Fy5DR8-g·        Lesley Logan website https://lesleylogan.co/·        Be It Till You See It Podcast https://lesleylogan.co/podcast/·        Online Pilates Classes by Lesley Logan https://onlinepilatesclasses.com/·        Online Pilates Classes by Lesley Logan on YouTube https://www.youtube.com/channel/UCjogqXLnfyhS5VlU4rdzlnQ·        Profitable Pilates https://profitablepilates.com/about/ Follow Us on Social Media:·        Instagram https://www.instagram.com/lesley.logan/·        The Be It Till You See It Podcast YouTube channel https://www.youtube.com/channel/UCq08HES7xLMvVa3Fy5DR8-g·        Facebook https://www.facebook.com/llogan.pilates·        LinkedIn https://www.linkedin.com/in/lesley-logan/·        The OPC YouTube Channel https://www.youtube.com/@OnlinePilatesClasses Episode Transcript:Lesley Logan 0:00  I love, I love big, badass, bodacious goals. But I also think, like, don't get discouraged when you find yourself noodling in on the goal and the deadline gets moved, it doesn't mean you failed, right? Lesley Logan 0:13  Welcome to the Be It Till You See It podcast where we talk about taking messy action, knowing that perfect is boring. I'm Lesley Logan, Pilates instructor and fitness business coach. I've trained thousands of people around the world and the number one thing I see stopping people from achieving anything is self-doubt. My friends, action brings clarity and it's the antidote to fear. Each week, my guest will bring bold, executable, intrinsic and targeted steps that you can use to put yourself first and Be It Till You See It. It's a practice, not a perfect. Let's get started.Lesley Logan 0:56  Welcome back to the Be It Till You See It interview recap where my co-host in life, Brad, and I are going to dig into the inspirational convo I had with Jose Acevedo. I wanted to say, like defining convo, or the journey, a discovery, because, I mean, like that, he's the host of Finding Arizona, and that kind of just makes sense. But anyways, he's so fabulous, and it was such a fun conversation. You were on it? Yeah. We had a great time. Brad Crowell 1:20  No, no, I was on his. Lesley Logan 1:21  Oh, you were on. I was like, how are you recapping? You were there, but anyways, you were on his with me. Got it. I'm here, you guys. I, we had a really good time. So you want to listen to that episode and also listen to episode Brad and I were on with Finding Arizona, but. Brad Crowell 1:37  Which was his episode 435. Why do I know that? Great question, but I do.Lesley Logan 1:43  Wow. That is, I don't know, like 435. So you guys, before we get into Jose's amazingness. Today is April 17th 2025 and it's the International Day of Mastering Conversations That Matter. Okay. Brad Crowell 1:55  That's what it is. Lesley Logan 1:56  Let's all learn this together, folks. International Day of Mastering Conversations That Matter is on April 17th, I just said that, but it's okay. Important conversations are the reason why humanity stands where it is today. The ability to communicate is what separates us from all other species in the world. The advancements in medical science and technology testify to what humans are capable of. All these achievements can be traced back to an idea, an idea that was shared, discussed and debated. Important conversations have helped build empires from scratch, and the lack of them has resulted in their fall. Not just empires, but relationships tend to break apart with poor communication. It is important for the survival of the human race to constantly share ideas and bridge gaps. It is important to learn and discuss things in the past so that we have a better tomorrow. Well.Brad Crowell 2:39  So, I couldn't agree more. International Day of Mastering Conversations That Matter. Lesley Logan 2:44  I know but we, you know what? Whoever invented this day, you better go buy a platform so that the other ideas people might want to control actually can come to the top of an algorithm. That's all I'm going to say about that. Brad Crowell 2:57  No, I'm not. I'm going to say a whole lot more. So I'm frustrated that we stop sharing information as a country, especially when it comes to health and medical research. I'm frustrated that. Lesley Logan 3:08  I was gonna say that our country has done a really good job sharing things they shouldn't share, so. Brad Crowell 3:12  Right. They're fucking texting war plans to reporters, but they're not willing to share information among hospitals so that they can make the right flu vaccine. It's mind blowing to me. And the reality is that when we stop sharing medical information with the rest of the world with an isolationist policy, we are putting ourselves at risk, because the next pandemic, we might not have any forewarning, because since we're not sharing information with them, they're certainly not going to share information with us. Lesley Logan 3:38  People have already just said they, you can't share with us anymore, because you can't trust that we'll do the right thing with it.Brad Crowell 3:43  Well, that's with spy stuff, but like, healthcare stuff, don't we want to know if there's something coming? Don't we want to know these things? And I think that when we wall ourselves off, when we think that we're better than the rest of the world and that we're going to be better off by pretending the rest of the world doesn't exist, we're deluding ourselves. Lesley Logan 3:58  Yeah, I think every Be It listener is like nodding along. I mean, I don't think you listen to this podcast if you think people should be deported who are just here living. Anyway. Brad Crowell 4:07  Well, so, so honestly, how do we fix this? Like, how do we. Lesley Logan 4:10  Okay, do we have steps? Brad Crowell 4:12  Yeah, we do. And the reality is, if you're in the United States with us, we live in a representative republic. We call it democracy. But the reality is, we don't get to vote every day, you and I as normal citizens, we voted for someone to go to the Congress for us, to represent us, to vote for us. And they vote all the time. They vote on things all the time on our behalf, right? And the only way that we have any power right now between the election cycles where we vote those people in or out, such as the president of the United States, or our congressperson or house of representatives person, the only way that we have power today is to call them and to make sure they know what we think. Right? It's the only power that we have until the elections come back around. And that's the best possible thing that you can do, is to make it known to the people who represent us what we care about, right? The more of us that call and contact our reps, the better, because the reality is that.Lesley Logan 5:07  Whether you voted for them or not, they work for you. Brad Crowell 5:10  That's right, whether you voted for them or not, they work for you, and especially if you're in their district or their region, right? If you're in their state, if they're the senator, then they represent the whole state. The house also represents the whole state, but local, there's local governments as well. Lesley Logan 5:22  But you, just because you didn't, if you were like, I think my person's an asshole, you should still be a nail in their, thorn on their side, a thorn on their side, a nail and a thorn on their side the same time. Also, you guys, go to city council meetings like a handful of assholes go, and you can be there to be the person. So I also wanted to say. Brad Crowell 5:39  That's more local, but yes, absolutely. Lesley Logan 5:41  I'm getting this woman on the pod. Just don't you worry, I'm so fucking, I'm a fan girl and a fan girl. She's so smart. I'm not lesbian, but this girl is so smart, if I was, I'd want to learn from her every day. Anyways, her podcast is called Unlearn16: Class is in Session. Her wife, she's got a wife, but I'm not trying to get in on this. But I was listening to her. Lesley Logan 5:59  I don't think any of us were assuming that. Okay. Lesley Logan 6:01  I was listening to her podcast, because it came up and I was like, okay, class is in session. That's how it goes. I was and I would listen to it, and I was like, oh, I kind of know about democracy stuff. No, you guys, you guys. She lays out what is a democracy. She explains it for Canada and the U.S., and she explains what are the pillars that create one? What has to be in there? To me, going on a conversation that matter, I think you have to actually know what a true democracy is, to actually have a conversation with someone who's trying to take things away. And so her episode that came out today, not today, when you're listening, a month ago, but though it's called The One Where I Make Democracy Behind the Scenes. I love her titles. They're all like that. So it's Unlearned16: Class is in Session, fuck yeah, The One Where I Make Democracy Behind the Scenes, I learned a ton, and she's a Canadian High School teacher, so clearly my teachers didn't do great job. But that's okay. I think it goes with the topic. Okay. Brad Crowell 6:53  All right, moving on. Lesley Logan 6:54  Go have a conversation that matters. Brad Crowell 6:55  Thank you for listening. I'm gonna get off my soapbox here. Here's what we've got coming up on our travel schedule. Lesley Logan 7:02  Right now. Brad Crowell 7:03  You're currently, Lesley is currently gone from our house. She's recording from the stars. Lesley Logan 7:08  I know, I'm like living it up in Santa Barbara.Brad Crowell 7:11  She's in Santa Barbara, y'all.Lesley Logan 7:11  I'm at the beach. I'm filming for Pilates Anytime again. Thank you to everyone at Pilates Anytime who loves my stuff. We got a bunch of classes coming at you. I'm really excited for what we have with Pilates Anytime. And when I come back a few days later and it's spring training.Brad Crowell 7:25  Well, yes, if you are in the U. K. or in the E.U., Lesley and I are coming in September, and we want to make sure you know about it. So go to opc.me/uk, opbc.me/uk, we're going to be teaching in the UK. It's just a short flight for those of you who are across the pond there. I mean, the channel, really. Lesley Logan 7:44  Which pond? Brad Crowell 7:45  Yeah, the channel. Lesley Logan 7:46  You know, people on the East Coast to (inaudible) that is the pond. And also, it is so easy for you. We're doing double.Brad Crowell 7:54  Yeah, six hours, but anyway, y'all should come join us. We don't get there very often, and we're really fired up to be coming back. We're going to be in Leeds and in Essex, and it's gonna be awesome. So come join us on the Mullet Tour, opc.me/uk, and then at the end of this month, Spring Training. That's OPC's Spring Training. It's our first ever annual event for Spring Training. And what is Spring Training?Lesley Logan 8:17  So, Spring Training is kind of like how baseball has a couple weeks of playing each other, and it doesn't really matter. So. Brad Crowell 8:23  Preseason, baby. Lesley Logan 8:24  Preseason. So this is like a Pilates week of spring training. And the theme this week for this one is The Push-Up. And so we're planking, and we're talking about it, but all the classes are going to be around building up your push-up, which, by the way, Joe put at the end of the mat order. So,why? You could stand up and walk away from your practice and be really awesome and top. So it's really cool. Everything's going to lead gonna lead to that. You don't have to be a Pilates enthusiast to even join us. There's a mat ticket, so meaning you just go to the mat classes, because that's all you have access to, is some room on your floor. And then there's an all access ticket, which gets you the 10 classes. And that will be mat, reformer, tower, Cadillac, chair. Obviously, if you only have a reformer or mat, you still want the all access that's gonna be at the six, the price is so cheap, you won't, you don't even need to worry that you don't have the other pieces of equipment. Brad Crowell 9:08  But here's what you do want. We're gonna make it even more reasonable if you're on the waitlist so that you can get that really bird discount. So go to opc.me/events, opc.me/events, come join us. It's gonna be a heck of a party. We're doing that this year instead of Summer Camp, okay? Lesley Logan 9:26  Because we're doing summer tours and winter tours, and we needed a different season. Brad Crowell 9:30  Yeah, we wanted a different season. So, if you are a Pilates business owner in any way, meaning you're taking money from anyone for any reason, whether that's in your home or in the park, or you have a studio. If you are the one that's actually taking the money from a client, you're technically a business owner. So come join us for a free webinar where we're gonna help support you with the growth of that business. We're gonna help you understand, how do I get more clients? How do I raise my rates? How does it all work? Like, how do we actually make this happen? This is for brand new people. It's also for people who've had like a studio for 20 years with a major team, because we kind of just stumble our way through this. There wasn't anybody guiding us. And Lesley and I have had the chance over the past seven years to stand alongside more than 2500 business owners, just like you, and go through the mud with them, try to figure out the problems that they're experiencing, problem clients or problem lease holders, or my insurance or my marketing is terrible. I don't have any people coming in. My phone stopped ringing. My website isn't bringing clients. All these kinds of things. We've had the opportunity to be there right alongside people in trenches, and from that, we've pulled three major secrets that we want to share with you. So come join me for this free webinar. Go to prfit.biz/accelerator. That's profit without the O dot B-I-Z slash accelerator. And finally.Lesley Logan 10:50  We're going to Cambodia in October, and we want you to come. Do not pass go. Just go straight to crowsnestretreats.com and snag your spot. Stay at our house, do Pilates with us, go see the temples of Ankor and all the other ones that are surrounding it that most people don't see. They fly all the way there and they don't see it. They just go on by. They don't even see it. We're gonna take you there. And we're gonna go to Lotus Farm and do all these different things.Brad Crowell 11:10  Actually, this upcoming one, y'all, we have a new temple that, that's not new for them, but a new one for Lesley and I. It's a new temple they built last week. Brad Crowell 11:19  New thousand-year-old temple. Brad Crowell 11:21  Lesley and I've never been to this temple, and I was, we were driving by it in our retreat earlier this year, and I asked our tour guide, like, hey, what's the story with this temple? How come we always skip it? And she said, we just run out of time. But let's make this a priority. So in October, this upcoming October, we're going to be adding one more temple to the list that Lesley and I haven't even visited. I'm very excited. I'm like, super, super excited about it. It's gonna be amazing. Go to crowsnestretreats.com crowsnestretreats.com and make your deposit today, right now, to save your spot, because space is limited. Lesley Logan 11:54  Okay, we gotta get into the interview with Jose, but before that, we have an audience question, don't we, Brad? Brad Crowell 11:59  Yes. Ilikecats123BB from YouTube asks, hey, do I need any equipment for the mat Pilates classes on OPC other than the mat?Lesley Logan 12:11  I love this question, because I think it's really easy to think, oh my God, I'm gonna have to have all these different things to get started in Pilates. Most of the props that someone could use in a Pilates mat class you can use from your house. So I even create it for the accessories deck. So technically, no, you can do mat Pilates without anything. Joe created it. So you just need you and your mat. And if you want to invest in your Pilates practice, like the mat is where I'm a, with the OPC episode that's coming out, everyone's like, I'm a mat rat. I'm like, okay, we need to come up with a different animal. I don't want to be a mat rat, but like, we were all like, I'm a mat rat. I only love the mat. So anyway, if that's who you are, you might want to invest eventually in a Contrology mat with handles and a strap, because it does change your practice, especially for the advanced exercises. But if you're never going overhead, you don't need to make that investment. So you technically don't need anything. However, one pound weights, a squishy ball, like a fitness ball, you let the air out of in a magic circle, and a heavy duty TheraBand, those things. Brad Crowell 13:08  How about a block? Lesley Logan 13:10  Ah, no, the squishy ball.Brad Crowell 13:12  Squishy ball instead of block. Lesley Logan 13:13  It's not yoga. Brad Crowell 13:14  Got it. Lesley Logan 13:14  Yeah. No. You use the squishy ball because you'd put the block between your ankles, and it's not gonna be as fun as a squishy ball. They just squish, it would be really great. So. Brad Crowell 13:21  But what if you don't have one pound weights? Lesley Logan 13:23  You can use water bottles. Brad Crowell 13:24  What? Fill it with water? Lesley Logan 13:26  And if you don't have.Brad Crowell 13:27  Or like beans? Lesley Logan 13:29  You can use beans, just make sure the same beans, you know, like.  Brad Crowell 13:31  I got tomato in here, I got apple seeds in here. Lesley Logan 13:32  I had a client using two beers, you know, two cans of beers. And I was like, just put it back in the fridge after you're done. You're not gonna want to open those up. Brad Crowell 13:39  That's brilliant. Lesley Logan 13:39  Yeah, just make sure they're the same product, so that the weight of them is the same. But one pound is what we're going for. If you don't have a TheraBand, you can use an old pair of leggings. If you don't have a squishy ball, you can use a couch cushion or a dog's toy, kid's toy. Your kids probably have a ball that you could let some air out of. You know, a magic circle. That's the harder one. You kind of do have to buy that, but there's so many cheap ones now it's pretty easy to grab one of those. Brad Crowell 14:02  Yeah, totally. Well, awesome. Great question, Ilikecats. Lesley Logan 14:05  By the way, if you go to onlinepilatesclasses.com you can join OPC for 40 days for $40 and guess what? You can experience several weeks of mat classes of ours. You can ask questions. You can send in a video of you doing a mat exercise, and I'll give you feedback on your form.Brad Crowell 14:18  Okay, I just want to take a super quick pause, and I want to call this out. There is no other platform on the Internet where you can submit a specific video of you saying what am I doing here, am I doing it right, and get feedback from certified Pilates instructors. There's no other place online, okay? So OPC has something that is magical that not enough people take advantage of. So come join OPC, and then if you're struggling with an exercise, no problem. We are here to support you. We excludes me. I'm not a certified Pilates instructor. Lesley Logan 14:53  And I give you like other things that you can do. I'm like, oh, go grab this and go do it like this. And so you just have more homework. It's really like having a private session for nothing, you pay nothing. You just be a member.Brad Crowell 15:04  Well, stick around. We're gonna be right back. We're gonna dig into this fantastic convo we had with Jose Acevedo and Finding Arizona. BRB. Brad Crowell 15:13  All right, welcome back. Let's talk about Jose Acevedo. Jose is the host of finding Arizona, a podcast spotlighting entrepreneurs, creators and leaders, shaping Arizona's local landscape. Driven by a genuine love for connection and community, he provides guests with a welcoming platform to share their journeys in their own words. What began as a screen printing passion project ultimately drew Jose into podcasting where he found his true calling, giving people space to tell their stories. Today, he and his wife Britt run the show together, making Finding Arizona a thriving hub for inspiration and local voices. And funny enough, Lesley and I had the opportunity to be interviewed on that podcast, even though we don't live in Arizona, but we actually go to Arizona pretty regularly, a couple times a year, usually. That's where we got a chance to meet them. We were down there speaking at an event. Britt and Jose were also speaking at the same event, and we had a chance to just chit-chat with them off stage. And it was great. And that's how we connected with them. Yeah, Finding Arizona is cool because it's, it really grew organically. And I think. Lesley Logan 16:15  I also think what a great if you're just going to visit Arizona, what a great podcast to go listen to. You can go through the different, they have so many episodes, you can search through it. They're a wealth of knowledge of different local businesses and entrepreneurs and really supportive. And I think that's what makes you want to go to a place. It's like when you can know the insiders spaces to go, the coffee shops, the pizza restaurants, all that kind of stuff, like, who's doing what? Just think it's really, really impressive. I love that our conversation with Jose, I think he's, first of all, the nicest person. I think he might be the softest, but I don't mean soft like he doesn't have about, I just mean like, his energy is soft, his voice is soft, like, he's just endearing. I really enjoy him. So anyways, he talked about storytelling, and he said, like, what it can do for society and culture that has been on this earth for so long and has thrived just from hearing these stories and using that as a religion, and that kind of goes into the day that we're kind of celebrating right now, the conversations that matter, so, good job, Brad. And he talked a little bit about his grandfather, an elder in the Hopi community, so we're First Nation, and he got to, in like that community, from what I understand about people who are native, and like they're grandkids of a native, everyone talks about the storytelling, and they learn so much through storytelling. And so I think it's really cool that Jose learned that from his grandfather and from his culture and from his community, and then is using that for other people. So I really enjoyed, I really enjoyed him talking about the importance of storytelling and (inaudible).Brad Crowell 17:44  He talked about how it shapes religion and culture and society, and how he was really impacted by that. And then. Lesley Logan 17:51  I think that's like, one of the things that I wanted to even have him on is not just, let's talk about Finding Arizona, but how do you get into being this person and like that be it till you see it, and it's like, well, I'm starting with storytelling. I wanted to tell the stories. And I just think that that's like, you know, most of us are wondering, like, what we could do at this point, and you could, you could tell stories about experience that have happened in your life and the lives before you. And that's how we learn, and that's how we keep, that's how we keep repeating the past.Brad Crowell 18:14  Yeah, it's how we remember the past too. I mean, it's how you do everything all the way up to sell. It's how you sell these stories. You know, people are captivated by stories. It's why the movie industry is so powerful and big and huge, and podcasts are, you know, like even happening, right? It's all about storytelling. It's fun to see that his excitement for storytelling shaped who he's become today and what he does today. So I really loved where you started talking about fatherhood. He said fatherhood has changed a lot about how I see the world, how I perceive the world, how I go about the world. He said becoming a father shifted his entire perspective on life and his purpose. He wants his son to grow up seeing a world filled with opportunity, with kindness and meaningful conversations. And he shared a story where he said podcasting has affected his family in the perception of even his son is now like, are you gonna go have a conversation? Are you gonna go have a podcast now? You know, and his son's like, three, and so it's helping him share this concept of storytelling with his son, and his son gets to see how much his dad loves to do this and all this kind of stuff. And Jose's approach to work and life has been influenced by this idea of setting a positive example, right? Because now he's intentionally meeting people he doesn't know. He's asking questions, he's being curious, he's demonstrating all these things. Rather than chasing success for personal gain, he sees his work as a way to build a legacy for his son, and he said he wanted him to know that there are good people out there and there's a community that will back him. Lesley Logan 19:47  I mean, we've talked about this before with other women on this show, like we talked about it with Kristen, the episode, I think 500, 501 it's so good for your kids to see you in the world doing the thing that you love, because it lets them know what's possible, but also, like, they do learn from it, they do pick it up, right? Amy Ledine said in her episode five, actions are caught not taught, and so I think it's just really cool. I love that he picked that up and he shared that with everyone. Brad Crowell 20:13  Yeah, well, stick around. We'll be right back. We're gonna dig into Be It Action Items that Jose shared and very heartfelt, so we'll be right back. Brad Crowell 20:22  All right. So finally, let's talk about those Be It Action Items. What bold, executable, intrinsic or targeted action items can we take away from your convo with Jose Acevedo? He said t,ry your best to set a big goal, but also make sure that you're taking those routines that are going to help you achieve that big goal, right? Do small steps forward. Also, you have to allow yourself for your goal to shift over time and move, but along the way, you still have to be taking steps, right? Here's a good example. We set a goal to take our physical products and sell them in another country, right? And at first it was like, oh, we have this opportunity. We should do this right now. We gotta go, go, go, go, go, go, go. You know. And someone on our team was like, hey, wait a minute. We have a lot of other things going on. We probably could pull this off. However, what do we do with these other things? Should we be back burning them? And I was like, oh, wait, wait a minute, you know, is it really necessary for us to go, go, go, go, go right now with this thing, or can we delay that launch of that initiative in a time where the team can handle the workload, the marketing calendar is a little more open, we can have a better conversation about it with our customers, and so it still allows us to go after that big goal, but just in a different way. Lesley Logan 21:38  And also we can adjust the routines to make sure that that goal happens, and then talking about it, we actually got to explore like, well, is there another way to achieve this goal, to test the goal, to even experiment with it. So I love big, badass, bodacious goals. BHAGs. Brad Crowell 21:53  Forgot about those. Lesley Logan 21:54  Forgot about the episode number, but it's a great one. But I also think, like, don't get discouraged when you find yourself noodling in on the goal and the deadline gets moved, it doesn't mean you failed, right? It didn't mean it. So I love that. I love it. Jose mentioned a life responds to effort. He said, if you look back on the little steps you're taking, you'll actually see that you're providing yourself the opportunity to move forward. And so if you're not making an effort, you're not moving anywhere. You're kind of stagnant. But when you make little, tiny steps, even if, for this particular goal that Brad is talking about, some of the steps are like literally doing nothing for a couple of weeks, like a conversation. I'm having a conversation. But as long as we take those little steps, it's like peeling an onion back. We get to another layer of working towards that goal, very different than going, okay, well, I love this goal. It's gonna happen in September, and then not talking about it again for until August, that would be stagnation, and the goal isn't going to move forward in September because we didn't take the little steps along the way. So I really think that's really great. I think whenever I talk about habits, it's always like tiny habits works, and a lot of us are this all or nothing people. If I'm not doing everything toward making this goal happen, then I'm doing nothing. That's not how it goes. So, anyways. Brad Crowell 22:59  That's not how it goes. Lesley Logan 23:00  I'm Lesley Logan. Brad Crowell 23:01  And I'm Brad Crowell. Lesley Logan 23:01  Thank you so much for listening today. Thank you, Jose, for being on our episode, our show. You're so wonderful. I hope to run into you in Arizona when we're there for summer tour. You guys, yep, cat's out of the bag. We're gonna, we're probably gonna start our summer tour in Arizona. That's the goal. So, thank you, and you know what to do with this episode. Share this with a friend who needs to hear it. Go listen to a bunch of episodes we just talked about on this one episode. And until next time, Be It Till You See It. Brad Crowell 23:25  Bye for now.Lesley Logan 23:27  That's all I got for this episode of the Be It Till You See It Podcast. One thing that would help both myself and future listeners is for you to rate the show and leave a review and follow or subscribe for free wherever you listen to your podcast. Also, make sure to introduce yourself over at the Be It Pod on Instagram. I would love to know more about you. Share this episode with whoever you think needs to hear it. Help us and others Be It Till You See It. Have an awesome day. Be It Till You See It is a production of The Bloom Podcast Network. If you want to leave us a message or a question that we might read on another episode, you can text us at +1-310-905-5534 or send a DM on Instagram @BeItPod.Brad Crowell 24:10  It's written, filmed, and recorded by your host, Lesley Logan, and me, Brad Crowell.Lesley Logan 24:15  It is transcribed, produced and edited by the epic team at Disenyo.co.Brad Crowell 24:19  Our theme music is by Ali at Apex Production Music and our branding by designer and artist, Gianfranco Cioffi.Lesley Logan 24:26  Special thanks to Melissa Solomon for creating our visuals.Brad Crowell 24:29  Also to Angelina Herico for adding all of our content to our website. And finally to Meridith Root for keeping us all on point and on time.Support this podcast at — https://redcircle.com/be-it-till-you-see-it/donationsAdvertising Inquiries: https://redcircle.com/brandsPrivacy & Opt-Out: https://redcircle.com/privacy

On Episode 395 of The Tennis Files Podcast, you'll learn how to train smarter, move efficiently, and avoid injuries with Lane Evans. Lane has been teaching tennis for over 45 years, bringing a wealth of knowledge and experience to the sport. He's a Master RSPA Professional and Level 3 Certified Tennis Specialist with the Professional Tennis Registry. He is a Master Tennis Performance Specialist with the International Tennis Performance Association and a Master Trainer with the International Sports Sciences Association, holding six certifications in fitness and performance. Lane also played a key role in developing the RacquetFit curriculum and is certified in Serve by the Kovacs Institute. A highly sought-after speaker, he shared his expertise on tennis, fitness, and performance at events across the U.S. and around the world. He is currently working on a book set to release in 2025 and has authored numerous published articles.  Despite enduring multiple injuries and surgeries—including two Achilles ruptures, knee and hip replacements, and a temporary loss of sight—Lane remains dedicated to helping athletes improve their tennis and golf performance. On the show, you'll dive into Lane's tennis journey and career path, discover smarter and more efficient tennis training strategies, gain valuable advice for players overcoming injuries, learn what inspired him to write his books, and so much more! I hope you enjoy my interview with Lane! Let us know what you think about this episode in the comments below! And be sure to subscribe to Tennis Files to receive the latest tennis content to improve your game straight to your inbox! Theraband - https://amzn.to/4jWjbIn red or green LEtennisandgolfperformance.com LEvans290@gmail.com Learn more about your ad choices. Visit megaphone.fm/adchoices

This episode takes us into the weekly astrological energetics of January 20th - 26th, 2025 with practical and magical tips and tactics to help resource and support you through all the energies. Last week was one to savor. There was a distinct lack of off kilter shifts. Hooray! Did you get to savor the bits of soul calm by working with the full moon in Cancer? Last week did you: Get on the mat? Listen to 3 NEW episodes on The Magic Spark! Watch your Full Moon Tarot Reading? This week has the sun shifting and one wildcard. In theory, it too offers bits of soul grounding....and... that wild card could change every bit of that vibe. Let's prepare for grounding and stability, focus on benevolent blessings, and support our navigation if things take a really weird swerve. This week: Get on the mat Listen to my guest appearance on The Queen's History Podcast Listen to 2 NEW episodes on The Magic Spark! Monday, January 20th: -

This episode takes us into the weekly astrological energetics of January 13th - 19th, 2025 with practical and magical tips and tactics to help resource and support you through all the energies. Last week was the beginning of the weird of 2025 astrology and energetics. Did you put your frequency scuba suit and goggles on? Did you place or strengthen boundaries? Did you initiate constructive flow mode Last week did you: Get on the mat? Watch your Full Moon Tarot Reading Pick one thing from the list below to practice every day this week? This week is one to savor, in its lack of off kilter shifts. It's certainly not simple, and yet it offers a soul calm if we're willing to work with it. This week: Get on the mat Listen to 3️⃣ NEW episodes on The Magic Spark! Watch your Full Moon Tarot Reading if you haven't already Monday, January 13th: -

This episode takes us into the weekly astrological energetics of December 30th, 2024 - January 5th, 2025 with practical and magical tips and tactics to help resource and support you through all the energies. What's the energy? How can we harness and work with it? Last week was more mellow than the weeks prior. There were energetics offered for processing and integration, some liminal space to allow clarity on new ways forward. There was plenty to grow from. Last week did you: Get on the mat? Drink warm herbal teas? Make time to contemplate last year, and next? This week is still pretty mellow. Use this slower space, that offers a dash of Aphrodite sweetness, to keep sifting, sorting, dreaming, mapping, and planning into your weird, yet evolved 2025. This week: Keep contemplating last year, and next Get on the mat Watch your New Moon Tarot Reading Monday, December 30th: -

Dr. Julie Brauer // #GeriOnICE // www.ptonice.com  In today's episode of the PT on ICE Daily Show, join Modern Management of the Older Adult lead faculty Julie Brauer discusses important tools for acute care PTs: a good attitude, a backpack, a white board, resistance bands, sticky notes, and gait belts. Take a listen to learn how to better serve this population of patients & athletes, or check out the full show notes on our blog at www.ptonice.com/blog. If you're looking to learn more about live courses designed to better serve older adults in physical therapy or our online physical therapy courses, check our entire list of continuing education courses for physical therapy including our physical therapy certifications by checking out our website. Don't forget about all of our FREE eBooks, prebuilt workshops, free CEUs, and other physical therapy continuing education on our Resources tab. EPISODE TRANSCRIPTION JULIE BRAUER Good morning crew. Welcome to the PT on Ice daily show. My name is Julie. I am a member of the older adult division. and I am coming to you live from my garage. So this morning what we are going to dive into are fitness forward tools that you can use in acute care and I'm going to do my best to demonstrate some of these tools that you can use to start loading these really sick folks up early. All right so We are going to dive in first by talking about the most important tools that you need to have with you as you go through the hospital and you go visit your patients in their rooms. TOOL #1 - THE RIGHT ATTITUDE So number one, the most important tool that you need is the right attitude. You have to have the right attitude about this. So let me unpack that. Bringing fitness forward care to sick older adults in the hospital. It is not about getting them to do a sexy deadlift with a dumbbell. It's not the sexy thing. It is not, holy crap, I just got this patient, they're in a hospital gown, they're super sick, and they're doing a deadlift with a dumbbell in the hospital. It's not about that. It's not about being able to get the video of that or the picture of that and being able to share that. That is sexy and that is cool and it is badass. However, the meaning is deeper. What the attitude you need to have is, is that you have this beautiful, amazing opportunity to plant a fitness forward seed in this patient who is sick, who has a ton of medical complexity, and you only get to see them potentially one time. You've got one shot to plant that seed and potentially be the catalyst that sets this person up on a better trajectory of health. That's an amazing opportunity. And I would encourage you all to be obsessed with that opportunity. Okay. Every single time I would go into a room, I thought, wow, I have this opportunity. I've got one shot. I could be the catalyst that changes their lives. And the thing about you all who work in acute care, man, you are doing some dirty work, right? You are seeing folks, whether they're young or old, they have multiple types of diagnoses and medical complexities. You are seeing them at their worst and you are seeing them in a very, very vulnerable situation. The fact that you are able to plant that seed yet you don't get to see the sexy outcome and yet you give them your whole heart and whole soul is so important. And it's hard to be in acute care and know that you're not going to get to see a sexy discharge where a patient is lifting a super heavy barbell or they are going all out on an assault bike. You're not going to see that. And that's tough, but you have to reframe it to be, I'm going to be obsessed with having the attitude that I could go into every single one of these rooms, plant the seed, and the patient is able to walk into an outpatient clinic. They want to do fitness-forward care because I planted that seed. And I think that's an incredibly, incredibly important story to tell yourselves so that you can continue to have the motivation to go in and see these folks who are sick day after day. And many times you may not actually get to get them to do the cool fitness board stuff. Okay. So that's the most important thing is having that right attitude. Okay. TOOL #2 - A BACKPACK So the second tool that you're gonna need to bring along with you to every single room is a backpack, all right? You absolutely need a backpack. So this is not the backpack I used in acute care. I used the backpack that they gave us as like a Christmas gift one year. This is a Nomadic. This is my travel backpack. This is a very sturdy, but very expensive and nice backpack. I do not recommend getting something like this to go into hospital rooms, okay? But I do recommend that you get something that's sturdy because you're going to be carrying around a lot of stuff in it. So get yourself the backpack. So what are we putting in the backpack? You're going to put weights in the backpack. No, most acute care therapy offices do not have weights. But you can bring your own. So I would bring a 15 pound dumbbell. and an eight-pound dumbbell, and I would put that in my backpack. Now, some of you are not able to bring a backpack potentially into the patient's room. Cool, then you bring it around and you leave it at the nurse's desk, okay? But the idea here is that you're bringing everything with you so that there is no excuse that you don't have the equipment because you're in the hospital. So you have your weights. Now, I've had people say, well, Julie, isn't that tough to carry around? And I say, yes, it is tough, it's heavy, but who else would want to be able to go rucking through the hospital with weights more than fitness-forward clinicians who are here listening this morning? I thought it was awesome. I felt like I was getting a lot of fitness in by carrying this stuff around throughout the hospital all day. TOOL #3 - THE WHITEBOARD Okay, so after weights, you're gonna have a whiteboard, okay? I'm using a whiteboard right now for my talking notes for this podcast. you all are going to want to use a whiteboard to create workouts with your patient. So have your dry erase markers and as you are digging into their meaningful goals and you're coming up with functional movements that match those meaningful goals, you are writing this stuff down, you are coming up with reps and sets, you are doing this with your patient. Now, I will say, you're not going to buy these and leave these in patient's rooms, right? This stays with you, okay? You can take a picture of this and give it to your patient, or the really cool thing about acute care is that they typically have whiteboards in the patient's rooms, and they're usually filled with some random information many times they are covered up with Call don't fall signs Those become great whiteboards. Okay, so I usually they're not helpful We all can can agree that call don't fall signs are not something that prevents somebody from falling. So I they're great whiteboards so I would take those down turn them around and with my dry erase markers cut right down the whiteboard on those signs then I would leave that in the patient's room maybe I would go find a couple extras and I would put some motivational phrases on there like uh i remember one very specifically i'm trying to kick covid's ass so i can get home in shopwood something like that or something that lets the providers know a little bit more about this patient their name is something that i always put on these signs their name and something about them a goal an interesting fact i want to try and have every provider who walks into the room treat this person a little bit more like a human than a number or a diagnosis and that's a way to do that so whiteboard, slash use the hospital whiteboards, use those signs that are all around the room, turn them over, use those as your whiteboard. TOOL #4 - RESISTANCE BANDS Okay, next, resistance band and TheraBands. Okay, so both. So resistance band is something like this, okay? These offer a lot more resistance than a TheraBand. However, I usually would bring a bag of theravans because i want to be able to leave some with patience right you can do endless things with the TheraBands. I would tie them to the bed rails many times. So even folks who are typically they're just lying supine majority of the day because they're so deconditioned, you can tie those around on the bed rails. They can pull from above, they can pull from the side, there's a lot of stuff you can do with them just tying them to the bed rails. with the resistance bands, this is where I would many times get people up into standing and I would do something like a paloff press. So if they're standing here and this is attached to the bed rail, I can have them do a paloff press to work some core. I can have them do some rotations, you can do rows, you can do a whole bunch of stuff with those resistance bands, but those come with me. I'm not leaving those in the room. TOOL #5 - STICKY NOTES Okay, next are sticky notes. Okay, sticky notes are amazing because they're versatile. So I have sticky notes and then even better than sticky notes, I have a really bright, uh, note card. And then I've also used paint swatches that you can get for free at Lowe's or Home Depot. Okay. So what I do with sticky notes or these things, they become targets, right? So if I'm gonna have folks be reaching for things or stepping to things and maybe I'm calling out colors or I will write on a sticky note a number and then they're not only doing a motor task, they're also doing a cognitive dual task perhaps, These are great tools. They're light, they're easy, they're cheap. The other thing I like with the sticky notes is I'd like to put little notes on them for people. So if I'm using targets with a sticky note, perhaps to show them exactly where I want them to do their deadlift, pick the weight up from and put it down on, I will put a note here that just says like, you're a badass or never give up or something like that. And then that's something that the patient can keep. So they're wonderful for targets. They are wonderful to do some dual tasking. So you can have people reach for yellow or reach for a number that is written on one of the colors. So you can yell out the color or the number. Very versatile tools, very easy to carry around with you. TOOL #6 - GAIT BELTS All right, and then also obviously a gait belt. You need to have a gait belt. obvious reasons for safety but also i have used a gait belt before and i have put it around the bed rail and okay i have never ripped a bed rail off of anything by putting the gait belt around it and tugging on it okay so i'll just say that are they the most sturdy things in the world no i've never ripped one off so that's my preface there. But I have looped this around the bed rail and then perhaps someone is sitting in a wheelchair and they have a really hard time just sitting up tall in their wheelchair, their core is very weak, I will do almost a modified rope climb where the gait belt is around the bed rail and they are pulling themselves up to sit tall, and then going back to the back of their seat, the back of their wheelchair, and then pulling themselves up to sit tall. I've done this in home health, where I looped this to the end of the bed, the bed frame, what am I calling it, footboard. But typically, in acute care, there really isn't a big enough space in those footboards, maybe some of them, but definitely a really cool tool to use to do unmodified rope climb really get that core activated for someone who is so weak that they barely can even sit tall in their wheelchair. TOOL #7 - SNACKS Okay and then lastly You need snacks, okay? Don't forget your snacks. I became so much more efficient and so much more productive when I started bringing food up on the floor with me and putting that in my backpack. So, get you some nuts, get you a bar, a little bit of healthy sugars, maybe some, I always had like clementines or mandarins, those were one of my favorite snacks. Make sure that you have some fuel so you are not having to really put a big stop in the middle of your day. You're not going down to the cafeteria, getting crappy cafeteria food, and it just kind of keeps you focused. When you take that break and go down to get a snack or a coffee, I think it just puts you in that mindset of like, I'm going to just chill and not work as hard. When you just keep hammering throughout your day and you're able to do that because you have fuel, it's really important. Okay, so that is what I put in my backpack. All right, so let's talk about some specific acute care hacks to load up your patients when you don't use the weights. Okay, so let's throw the weights out. My favorite hack, one of them, is to use towels. All right, now this is a towel that I have soaked in water. All right, because a soaked up towel is really heavy compared to a towel that's not soaked in water. So I will roll a towel up and I will put it in the toiletry buckets that are in every single patient's room. So usually these buckets come with soaps and little doodads, things like that. I just get rid of that and I soak up towels and I put them in the basin. Now, you can do a whole bunch of stuff with this. So for someone even in sitting, even having to hold on to this basin, can be very challenging. We can increase the difficulty by going overhead. We can increase the difficulty by doing some marching in sitting. We can do a deadlift from sitting. We can then get up into standing and we can do a deadlift as well. So the great thing about this is it's a great way to introduce the hinge to a patient who is post-op lumbar fusion. Yes, I am loading up someone who is post-op lumbar fusion day one. Why? Because they're going to be discharged. They were probably never taught how to do a hinge in the first place, which contributed to them ending up having surgery. and I want to be the person to break that cycle, right? They're gonna go home, they gotta empty the dishwasher, lift up Fluffy's kitty litter box, whatever it is, why not teach them here and now? So I will put the towel in the basin, and then I will teach them how to properly hinge with an elevated surface in the basin. So I'm teaching them a hinge pattern, loading it up a little bit so that they know how to properly hinge when they go home, okay? And less amounts of things you can do with that basin. The next piece of equipment that I love are your bedside commode buckets. Yes, the things that poop usually goes in. But this is not what we're using them for. We are using clean bedside commode buckets, okay? So the cool thing, buckets, they usually have a handle, okay? So it makes it a lot easier to hold on to than potentially the basin. So what I will do is I will put a bunch of crap in the bucket. So I will put my weights in there or I will go and get a bunch of ankle weights because typically therapy departments and acute care have ankle weights, put them in the bucket and now we got some load. So you can do the same thing. You can deadlift with the bucket, okay? you could do my favorite, which are carries. Okay, so loaded carries. So as you're walking with your patient, they could carry on to the bucket. And the cool thing is that it adds a little bit of a perturbation. Okay, so they're getting an internal perturbation just by holding on to an object. There's a truck coming by, I'm sorry. I am out in my garage. and there is destruction going on in my neighborhood. And it's disruptive. So I'm gonna wait until they go by. Okay, they're hanging out. I'm just gonna talk louder. Okay, so with the bucket, Come on, my friends, keep it moving, keep it moving. Don't say no on a live podcast. Okay, with the bucket, what you can do is if someone is non-ambulatory, they can hold on to the bed rail and they can go like this, back and forth with that bedside commode bucket full of equipment and full of weights, okay? They could hold on to it, hold on to the bed rail and march, just like this. They can swing that bucket forward and backwards. There's a lot of things you can do with the bedside commode buckets to add in a little bit of a perturbation. Okay, lastly, we'll talk a little bit about how to put all this stuff together. So when you are with your whiteboard, right? And you're talking and you're sitting with your patient and you're figuring what movements that you're going to do. This is where you can start introducing what an EMOM is every minute on the minute. You could start introducing what a rounds for time is. So very, very early on, typically patients don't hear about this stuff or feel what intensity is like or load until they're way into their journey and they go into outpatient potentially, right? So the amazing thing is that you get to start introducing them to what a workout is like this early on. Imagine that seed that you've planted, then your patient will understand what it's like to lift heavy and to work hard. They go to home health or they go to inpatient rehab and then they go to outpatient and they're able to advocate for themselves and understand, okay, This is too easy. I don't need that yellow TheraBand or I'm not working hard enough. This isn't challenging enough for me. You are able to give them that opportunity, which is absolutely amazing. And remember, you can be the one that has an impact on them. Farther down the road, you are not going to see that sexy discharge, but you were able to be the catalyst to spark some change. Okay. All right, my friends, that is all. The next time I come on here, I will actually show you an example of like an EMOM or a rounds for time, some examples of what I would actually do with patients in acute care. I will also, on the ice stories, I will post some of my reels I made back when I was in acute care, going back into the archives. I will post on our story my reels that show some of this stuff in action. Lastly, talking about our courses that are coming up. MMOA Live will be in Alabama, we will be in Minnesota, Wyoming, and Oregon for the rest, not the rest of September, we're not in September yet, but in September, so many opportunities to catch us live on the road. Alright everyone, have a wonderful rest of your Wednesday. OUTRO Hey, thanks for tuning in to the PT on Ice daily show. If you enjoyed this content, head on over to iTunes and leave us a review, and be sure to check us out on Facebook and Instagram at the Institute of Clinical Excellence. If you're interested in getting plugged into more ice content on a weekly basis while earning CUs from home, check out our virtual ice online mentorship program at ptonice.com. While you're there, sign up for our Hump Day Hustling newsletter for a free email every Wednesday morning with our top five research articles and social media posts that we think are worth reading. Head over to ptonice.com and scroll to the bottom of the page to sign up.

Dich erwartet hier eine gediegene Yogaeinheit für Schultern und Nacken mit Theraband und gehaltenen Übungen sowie Sonnengruß und Savasana. Das alles wünscht sich Christine in ihre persönliche Podcastfolge nach unserem Personal Training. Start im Sitzen mit Wechselatmung, Nervenmobilisation für den Nacken, Armkreise, Adler, Kuhgesicht, Nackenübungen im Liegen, Schulterkräftigung im Vierfußstand, halber und ganzer Sonnengruß A. Für den Seitwinkel, den Stuhl und das Rudern wird der Widerstand des Therabandes genutzt. Kurze Endentspannung im Savasana. Du hast auch Lust auf einen personalisierten Yoga-Podcast – dann melde dich gerne bei mir :) Namaste, viel Spaß, deine Thali von Yoga Flow to Go. Verbinde dich erst mit dir selbst und dann gerne mit mir. Lass mir sehr gerne deine Gedanken oder Fragen dazu da, bei Instagram: thali.happyyoga oder über www.yogaflowtogo.de und info@yogaflowtogo.de

Das Personal Training von Franzi lässt mich einen kräftigenden, Handgelenks-schonenden, flowigen Podcast kreieren. Gut wären 2 Blöcke und einen Gurt bzw. einen Pilatesball und ein Theraband. Ein kleiner Armflow aktiviert die Schultern und die Wirbelsäule. Nach der Aufwärmung fürs Handgelenk arbeiten wir im Vierfußstand auf Blöcken an Hüftmobilisierung und Stärkung der Körpermitte, fließen dann weiter in den Unterarmstütz mit halten und ranziehen, Delfin und Taube lösen sich auf in die Sphinx hin zu Heuschreckenvarianten und Nackenkräftigung. Schulterbrücke und Boot sowie diagonale Coreaktivierung münden dann in einer kurzen Entspannung im Liegen. Für eine kraftvolle gesunde Yogapraxis in den Tag. Du hast auch Lust auf einen personalisierten Yoga-Podcast – dann melde dich gerne bei mir J Namaste, viel Spaß, deine Thali von Yoga Flow to Go. Verbinde dich erst mit dir selbst und dann gerne mit mir. Lass mir sehr gerne deine Gedanken oder Fragen dazu da, bei Instagram: thali.happyyoga oder über www.yogaflowtogo.de und info@yogaflowtogo.de

3x10 mit dem Theraband reicht in der Reha, oder? In der Physiotherapie findet zunehmend ein Umdenken statt. Therapeuten realisieren, wie wichtig Krafttraining in der Physiotherapie ist. Das Problem: In der Ausbildung lernen sie wenig bis gar nichts über Trainingslehre. Darum sprechen wir in dieser Folge über 3 wichtige Punkte für zielführendes Krafttraining in der Physiotherapie. Infos und Anmeldung zu den Assessment Seminaren: https://myomechanics.de/seminare/ Kostenloses Online Seminar "Schmerzanalyse bei Rückenschmerzen": https://www.felixkade.de/schmerzanalyse-online-seminar/

Dr. Christina Prevett // #ICEPelvic // www.ptonice.com  In today's episode of the PT on ICE Daily Show, #ICEPelvic division leader Christina Prevett discusses Take a listen to learn how to better serve this population of patients & athletes or check out the full show notes on our blog at www.ptonice.com/blog. If you're looking to learn more about our live pregnancy and postpartum physical therapy courses or our online physical therapy courses, check our entire list of continuing education courses for physical therapy including our physical therapy certifications by checking out our website. Don't forget about all of our FREE eBooks, prebuilt workshops, free CEUs, and other physical therapy continuing education on our Resources tab. Are you looking for more information on how to keep lifting weights while pregnant? Check out the ICE Pelvic bi-weekly newsletter! EPISODE TRANSCRIPTION INTRODUCTIONHey everybody, Alan here. Currently I have the pleasure of serving as their Chief Operating Officer here at ICE. Before we jump into today's episode of the PT on ICE Daily Show, let's give a shout out to our sponsor Jane, a clinic management software and EMR. Whether you're just starting to do your research or you've been contemplating switching your software for a while now, the Jane team understands that this process can feel intimidating. That's why their goal is to provide you with the onboarding resources you need to make your switch as smooth as possible. Jane offers personalized calls to set up your account, a free date import, and a variety of online resources to get you up and running quickly once you switch. And if you need a helping hand along the way, you'll have access to unlimited phone, email, and chat support included in your Jane subscription. If you're interested in learning more, you want to book a one-on-one demo, you can head on over to jane.app.com. And if you decide to make the switch, don't forget to use the code icePT1MO at signup to receive a one-month free grace period on your new Jane account. CHRISTINA PREVETT Hello everybody and welcome to the PT on ICE Daily Show. My name is Christina Prevett. I am one of our lead faculty within our pelvic health division. Sorry for coming on here a little bit early. We are in the throes of young kids finishing school and trying to work around new schedules. So apologies for being a little bit early. But today what I wanted to talk to you all about was what do we really know about resistance training in pregnancy. And as many of you who have kind of followed the podcast in the past know, I'm a postdoctoral research fellow at the University of Alberta looking specifically at resistance training in pregnancy, which means that a big part of my job in my postdoctoral fellowship is to be very aware of the state of the literature and then where my role is as a person trying to build a program of research to be able to add to the existing body of literature. And I'm going to start this episode talking a little bit about my story getting into this because I think that it's relevant. So my PhD research was in high load resistance training in a geriatric population. I love my older adults. You know that I'm part of the older adult division. And I had two children while I was going through my doctoral studies. I was going part time. And then I was also a national level weightlifter before I got pregnant with my daughter. So I was doing a lot of heavy resistance training during my pregnancy. And I had a committee meeting during my pregnancy talking about, you know, obviously that I was going to go off on that leave, et cetera. And one of my committee members, whose name is Stu Phillips, many of you know him from the protein metabolism and resistance training literature. He said, you know, Christina, if you think that there isn't any research in loading the older adult appropriately, wolf when it comes to what we know in pregnancy. And I thought that was super fascinating and of course being the nerdy researcher that I am, I looked into the research and I recognized that he was right. And So I kind of want to talk today about what we truly do know, what the state of the literature is, a little bit about me trying to change that, I'm going to talk a little bit about some of my research studies, and then where we can go going forward. So we know in a general population that resistance training is one of the best things that we can do for our overall health. I don't tend to try and put people into specific buckets that you have to exercise in a specific way because the best exercise is the one that you do. But in terms of longevity and maintaining independence into older age, supporting whatever exercise you like to do with resistance training is definitely a recommendation that I'm gonna make with a lot of passion. Whether you choose to prescribe to that exercise program or not, Resistance training is one of these exercise modalities that is going to allow us to have independence. It's going to stave off a lot of chronic disease and musculoskeletal injury. And we know that, you know, the best exercise program is the one that we start as early in our life as possible and go into older adulthood. I'm going to try and put on as much muscle mass as I can before the age of 40 and then hold onto it for dear life into hopefully 100. And so we have a lot of really positive evidence for resistance training in a general, like reproductive age population, but then also into older adulthood. We've talked a lot about it in the Jerry segment. But when we don't have evidence, right, around exercise, or we don't have any evidence in any type of intervention in pregnancy, we freeze, right? And I say this all the time. If we don't know, the answer is no. and when we aren't sure we freeze, which is where bed rest and pelvic rest recommendations have come in when complications can creep up in pregnancy because we don't really know what we can do, right? We're not really sure what we can do. So we want to give a recommendation that we're doing something. And so we pull people back from activities of daily living, sport, exercise and we say like, let's not do anything because you know, there's this complication happening. And where evidence is starting to show now is that many of our complications have pro-inflammatory cascades and therefore exercise might be a really important mitigating factor or modifiable influence on a person's experience of complications during pregnancy. But the baseline is that if we don't know that the answer is no. And so that knee jerk reaction has trickled into a lot of our recommendations around exercise in pregnancy and specifically around resistance training. So when we look at public perception of resistance training or exercise in pregnancy in general, it's really interesting because aerobic training is generally seen as more positive as something that you're doing to benefit the health of mom and baby. But there's a lot of fear-focused messages that are put into the resistance training space. And gosh, we've seen this all the time, right? Like we see when a person lifts a heavy deadlift and they're pregnant, like go into the comment sections and you just are gonna heave because you see everybody telling you that your baby's gonna die and that you're being reckless and all this type of thing. And so if we're going to combat these messages, and we know that the perception is generally more negative because of a lot of fear and thoughts of danger around resistance training and pregnancy, we have to one, know where the state of the research is. And then two, we have to build levels of evidence that are going to gradually gain us more confidence and being able to remove some of those fears around resistance training. I've done podcast episodes before where I talk about risk tolerance of providers to allow individuals to flex their own decision making during pregnancy and how in low to moderate intensity exercise, we tend to feel very good in that risk tolerance zone, but where we get a little squeamish is in these higher intensity zones. Part of the reason for that is the state of the literature currently. So right now I can't speak specifically to my results because I haven't published this yet, but I am working on a systematic review on resistance training during pregnancy. And we have pulled about 50 studies on resistance training during pregnancy, which sounds like a lot, which it is. And it's been a lot of work to get the systematic review under control. But what we have noticed and what I have seen over and over and over again is a couple of things about the resistance training literature. Number one is that we have very few studies that look at resistance training in isolation. And you may not think that's necessarily a bad thing, because a lot of people are exercising in multiple modalities. Think about functional fitness, they're doing aerobic training and resistance training. But when we know that there's a lot of incurred benefit of aerobic training, especially when it's dosed appropriately, there's an interference effect that we see in the literature. So what I mean by that is that we know that there is benefits of aerobic training on rates of gestational hypertension and preeclampsia. We know that individuals who respond and continue to do aerobic training have less rates of gestational diabetes. We know all of these things already. So when we put in a known benefit and then kind of add in resistance training, we can't say with confidence that resistance training reduces our risk of gestational diabetes because we know that aerobic training does and aerobic training is in that multi-component program. So it's a big issue right now that we don't have a ton of research that's on resistance training in isolation, because then we can't isolate and say resistance training benefits X, Y, Z outcome, and aerobic training, there may be overlap, and they also do X, Y, and A, B, C, but without studies done in isolation, interventional studies done in isolation, we can't really say that this is incurring some sort of benefit. The second thing about our current state of the literature is that the resistance training research is unbelievably underdosed. So I'm gonna make a comparison for you. So the evidence that we have right now around resistance training in those with congestive heart failure in their 70s and 80s is higher dosed than a lot of the resistance training literature in pregnancy. Let me say that again. A lot of our dosing for resistance training is higher in our older adults with frailty, multi-morbidity, and complexity than it is for our uncomplicated pregnancies. When I am looking at that research, that makes me sad, and it just shows how much we need to do. When there is a randomized control trial that comes out in 2024, and the aerobic dosing is 70 to 80% of heart rate reserve, which is a great intensity for the aerobic training, and the resistance training part of the exercise program is using a yellow Theraband, I see red and I start to rage. And so the dosing here is unbelievably poor, especially for somebody, right, who we are not thinking has low musculoskeletal reserve going into their pregnancy, right? In general, individuals are not having trouble with activities of daily living as soon as they find out they're pregnant. And so we are going in almost with this assumption that individuals who are pregnant cannot have higher loading on their skeleton. And we're worried about strain, but a strain is not happening on the body with a yellow TheraBand for a person who's of reproductive age who is pregnant. Like that is not an appropriate dose. And so it's concerning that there is not an appropriate dosage for our resistance training interventions, especially when it is dosed appropriately. the aerobic side. So this brings me to our next problem. is if resistance training isn't dosed appropriately, if I am getting an individual who is pregnant with no complications to do a 16-week exercise program where the max amount that they are allowed to lift is two kilos or 4.4 pounds, and I wish I was lying about that prescription, can I realistically, as a provider and as a researcher in that space, say resistance training was the part of that exercise program that incurred the positive benefit? Right, going back to my first point about how when we have multi-component programs and there's a known benefit for aerobic training, it's hard to see the additive effect of resistance training. In combination with the fact that the resistance training prescription is not sufficient, what I would deem sufficient, to drive musculoskeletal adaptation or maintenance to prevent deconditioning in a pregnant individual. That creates a problem. It creates a problem and it creates all the downstream issues that we're seeing where pregnant individuals are restricted, right? Like when our max is a yellow fare ban on a 2024 randomized control trial, that don't lift more than 20, don't lift more than 30 pounds. that's gonna hold, you know, that's not gonna get better because we don't have any evidence to back us up, right? And so this is like a call to action around how we need to change some of our thought processes around the way that we are prescribing exercise for pregnant individuals, but we also need to push back on academia and be like, hey, like, this is not okay for this to be the state of our literature because I hate that I have to say this and my postdoctoral supervisor and I were having this conversation. Do we even have enough evidence in resistance training in pregnancy to truly be able to include it in our guidelines? And the answer is we don't. Not really. We're extrapolating from our general population literature and we're saying, well, based on some of the preliminary literature we have right now, light toning exercises seem to be okay. Literally the term in a big conglomerate of our RCTs was saying that they did aerobic training and light toning for our resistance training interventions. That drives me. It drives me with just unbelievable amounts of passion about why it is so important for this clinician science bridge to happen. It is why I will not step away from literature and doing research because we just need to demand so much better. And so what does that mean going forward? we need more research in this area. And so that is where my postdoctoral work has really taken off. So when we are thinking about our literature base, when the state of the literature is a two pound dumbbell, and I'm saying, I want to do an RCT where women are deadlifting over a hundred pounds, you can imagine that that amount of gap can create issues with an IRB board or an ethics board saying, whoa, whoa, whoa, whoa, whoa. We don't want to put mom and baby at risk. here's what we need to do. And so because of that, we need to build layers of evidence. So if you guys remember from your schooling, right, we have our levels of evidence from level five, which kind of our clinical commentaries, our professionals who are doing this in practice, that when the evidence isn't there to back us up, and then we go retrospective, prospective, RCT, and then systematic reviews and meta-analyses are kind of at the top of this evidence pyramid. And so when we are trying to build an area that does not have a ton of research to back us up, we need to start building levels of evidence. And that's what I'm trying to do. And so this started with our cross-sectional survey. You've heard us talk about this on our podcast, this podcast in the past, where the first thing that we have to do is show that there are individuals who are heavy lifting during their pregnancy. And so the cross-sectional survey that was published last year was the first step in that process. say, hey, look, we put out a survey for a couple of weeks online. We got almost 700 women who had lifted heavy during their pregnancies to tell us about their experiences. Great. Look, there's this need. They are very confused about what they're allowed to do and what they're not allowed to do. Like they're getting advice, like don't lift more than 20 pounds. Two, if you were doing it before, you can continue doing it now. Just don't strain your body. And even the strain on the body is a little bit question marks because, you know, there's so much that goes into it, et cetera. Right? It creates a situation where we recognize that there is a need because there is an absence of literature and there are people who need the answers to that. The next part is that we're going to start doing retrospective data taking and so right now I have two research studies that are open for enrollment and I am going to beg all the clinicians who are listening to this if you have a person who fits these bills if you could please please please send them our studies because I hope that the first part of this podcast tells you that there is just so much we need to do. There is so much that we need to do in this area, and I need your help in order to do it. So our retrospective study is taking individuals who have given birth within the last year and tracked their exercise through a training app. So if that was Wattify, if that was an Excel spreadsheet, if that was, you know, pen and paper, whatever it may be. If you tracked your exercise during pregnancy, specifically your resistance training, and you gave birth in the last year, we want you in our research study. So what we're going to do is we're going to ask you a whole bunch of questions about your pregnancy, your labor and delivery, how you felt about it, all those types of things, and then we're going to ask you to upload your training logs. And so what we're gonna try and do is descriptively see how did people modify? Are there any issues with resistance training that are popping up as patterns that clinicians or providers or obstetricians need to be aware of? And then how can we use that information to start help counseling individuals on strength training during pregnancy? And so that's a retrospective study. We also have a prospective study that is open for analysis. This is gonna take me about three and a half years to get out, but that is okay. So we are taking individuals who are less than 20 weeks pregnant, so in that first trimester, first half of their pregnancy, and we are following them forward over time. So every trimester, we are asking individuals questions about exercise during pregnancy, and we are asking you to upload your training logs. And so what that's going to do is it's going to build on our level of evidence, right? So now we have cross-sectional snapshots in time. There are recall biases that happen with that. We have our retrospective study that because we were using the training log, that recall bias is worked around because we have evidence of what they did over time. And then the prospective study, we are getting their thoughts in real time going forward. And so now we've gone from a level five of evidence and we're going to be pushing up to level With that evidence, my next goal is something interventional. Right now, we're going to have this building of evidence that we're seeing that is going to allow me to apply for funding for a randomized control trial that looks at different dosing schemas for individuals who are deciding that they want a resistance train during their pregnancy. SUMMARY And so if you have any individuals or if you are listening and you are in one of these two camps, I would love for you to join our army to try and build the level of evidence on resistance training in pregnancy. It is so necessary. It is so needed. And we are going to be leading the way in our pelvic division. We are very actively involved in research. Obviously, I'm a postdoctoral research fellow, so I'm there in the weeds of it, but also our other faculty are involved in the trenches as well. And it's just so, so, so important that we do this the right way and that we gradually build a level of evidence. And I am not okay with where we are right now. We need to do better. I will be part of the trying to make this better. And I'm recruiting you all to my cause to try and help me out. So I will post these research links in the captions, or you can head over to my Instagram at drchristina underscore private, and you can hopefully sign up for some of our studies. All right, if you are wanting to hear me get all fired up about other stuff or you wanna hear some of our faculty on the road, we have two courses in July that are still open for participation if individuals wanna sign up. I am in Cincinnati, Ohio. That is a smaller course. So if you are interested, July 2021, I'm in Cincinnati, Ohio. If you are interested and you are closer to Wyoming, we have a course July 27th, 28th in Wyoming. If you cannot get on the road because of kiddos like me who is coming early because kiddos are home for the summer, we have our next online cohort starting July 6th. So we are past 90% sold out for that course. So if you are looking to get in, please don't wait because there may not be the opportunity and then you'll have to wait until the fall. All right, that's all I got. 19 minutes. I'm sorry, I just get so passionate talking about resistance training in pregnancy. I hope you all have a wonderful week, and we'll talk to you all soon. OUTRO Hey, thanks for tuning in to the PT on Ice daily show. If you enjoyed this content, head on over to iTunes and leave us a review, and be sure to check us out on Facebook and Instagram at the Institute of Clinical Excellence. If you're interested in getting plugged into more ice content on a weekly basis while earning CEUs from home, check out our virtual ice online mentorship program at ptonice.com. While you're there, sign up for our Hump Day Hustling newsletter for a free email every Wednesday morning with our top five research articles and social media posts that we think are worth reading. Head over to ptonice.com and scroll to the bottom of the page to sign up.

Kaya Herstad-Carney returns to the podcast but this time she's brought her Mary Poppins bag of tricks. Join Alexa and Kaya as they discuss the gadgets and props you can use as a singing teacher, the benefits they have to the student's voice and learning, and how best to utilise them in your singing lessons. KEY TAKEAWAYS Using props in singing training provides a kinesthetic experience, prompting students to consider technique and form habits that feel innate. Physical engagement aids memory recall, reinforcing learning through tactile stimuli. This approach enhances understanding and skill development in vocal performance, it's also more fun.  Balls aid singing teaching by enhancing breath control and support through exercises like tossing or squeezing. They engage students physically and mentally, adding a playful distraction that fosters focus and skill development. Straw warm-ups, blowing air through a straw into water or the air, enhance singing by focusing airflow and promoting proper breath support. They gently prepare the voice, reducing strain, improving resonance, and enhancing vocal control for better performance. Ask the singing student how using props like a TheraBand feels: does it improve, worsen, or maintain their vocal control and support? Assessing their experience helps tailor exercises for optimal vocal development. BEST MOMENTS  "Because of its expandable nature, I like to use this with singers who feel constriction in the throat” “I love my singing straw” “The important thing is that you know the research and why” EPISODE RESOURCES Guest Website: kayamusic.com Social Media: Handle: @kayamusic Relevant Links & Mentions:  Vocology in Practice: https://www.vocologyinpractice.org/ (Youtube) Singing Teachers Talk Podcast: https://www.youtube.com/@SingingTeachersTalk Dr Shannon Coates: https://drshannoncoates.com/ (Podcast) Singing Teachers Talk: Eps. 155 & 156 - Building Neurodiversity-Inclusive Voice Studios with Dr Shannon Coates (Parts One & Two) Mindy Pack: https://www.mindypack.com/ Dana Lentini: https://www.born2singkids.com/ (Podcast) Singing Teachers Talk: Ep.77 - How to Teach Singing to Children with Dana Lentini  Singing and Teaching Singing - A Holistic Approach to Classical Voice by Janice L. Chapman Estill Voice Training System: https://estillvoice.com/ Voce Vista: https://www.vocevista.com/ Matrix VocalizeU Spectogram: https://matrix.vocalizeu.com/spectrodev/ Heidi Moss: https://www.heidimosserickson.com/ Actions - The Actor's Thesaurus by Marina Caldarone & Maggie Lloyd-Williams  Amelia Carr: https://www.ameliacarrvoice.com/ (Podcast) Singing Teachers Talk: Ep.50 - Managing ‘Pushy Parents' and Teaching ‘Legit' with Amelia Carr The Morrison Bone Prop: https://www.themorrisonboneprop.com/ The work of Ken Bozeman: http://www.kenbozeman.com/ (Podcast) Singing Teachers Talk: Ep.146 How to Understand and Apply Vocal Acoustic Pedagogy with Ken Bozeman The work of Ian Howell (Podcast) Singing Teachers Talk: Ep.145 Style Vs Technique with Kaya Herstad-Carney BAST Book A Call ABOUT THE GUEST  Kaya, a Norwegian artist based in the UK since '99, excels in original music, vocal coaching, and artist development. Her career includes performances on The Royal Variety Show and the BBC Songwriting Showcase. Passionate about mentoring, directing festivals, and teaching, she serves as a board member for Vocology in Practice, training singing teachers globally. Specialising in singing, songwriting, and artist development at Waterbear and esteemed institutions. ABOUT THE PODCAST BAST Training is here to help singers gain the knowledge, skills and understanding required to be a great singing teacher. We can help you whether you are getting started or just have some knowledge gaps to fill through our courses and educational events. basttraining.com Updates from BAST Training

Dr. Julie Brauer // #GeriOnICE // www.ptonice.com  In today's episode of the PT on ICE Daily Show, join Modern Management of the Older Adult lead faculty Julie Brauer discusses workout ideas for acute care patients, including those who are confined to bed, able to move at the edge-of-bed, and those who can transfer & ambulate with assistance. Take a listen to learn how to better serve this population of patients & athletes, or check out the full show notes on our blog at www.ptonice.com/blog. If you're looking to learn more about live courses designed to better serve older adults in physical therapy or our online physical therapy courses, check our entire list of continuing education courses for physical therapy including our physical therapy certifications by checking out our website. Don't forget about all of our FREE eBooks, prebuilt workshops, free CEUs, and other physical therapy continuing education on our Resources tab. EPISODE TRANSCRIPTION INTRODUCTION Hey everyone, this is Alan. Chief Operating Officer here at ICE. Before we get started with today's episode, I want to talk to you about VersaLifts. Today's episode is brought to you by VersaLifts. Best known for their heel lift shoe inserts, VersaLifts has been a leading innovator in bringing simple but highly effective rehab tools to the market. If you have clients with stiff ankles, Achilles tendinopathy, or basic skeletal structure limitations keeping them from squatting with proper form and good depth, a little heel lift can make a huge difference. VersaLifts heel lifts are available in three different sizes and all of them add an additional half inch of h drop to any training shoe, helping athletes squat deeper with better form. Visit www.vlifts.com/icephysio or click the link in today's show notes to get your VersaLifts today. JULIE BRAUER Good morning crew. Welcome to the PT on ICE daily show. My name is Julie. I am a member of the older adult division. Excited to be talking to you all this morning about a few workout ideas for your hospitalized patients. All right. So what we're going to dive into this morning is first, we're going to talk about why it is so incredibly important to bring a fitness forward approach to our medically complex sick older adults in the hospital. and then we're gonna dive right into how to do it. So I am going to give you three different workouts. They're simple. They only consist of three exercises and they're going to be for three different individuals. FITNESS FORWARD ACUTE CARESo the individual who is the bed level patient, so they are not ambulating, they are not transferring. Then I'm going to give you a workout for the individual who can sit edge of bed, so who can tolerate those positional changes, but again it's not someone who is transferring or ambulating. And then lastly for the individual who is able to transfer out of bed. Okay, Let's dive in. First and foremost, team, what I think we can all agree on is that patients are being sent home sicker and sicker and sicker. Insurance is denying acute rehab left and right. And once patients do make it to acute rehab, if they're lucky enough to get there, they're only getting enough days to just barely make them functional. We have to agree that these patients need to get as strong as possible and they need to do it as quickly as possible. If we can agree on that, then we have to realize the massive opportunity we have in the acute care setting to bring a fitness-forward approach. Now, I know what a lot of you are thinking. Fitness in the hospital What the heck? No way. It doesn't belong there. I don't have the equipment. They're too sick. That's for down the road. I want you to come along with me and get a little curious. I want you to be open minded and perhaps shift that perspective. Think about it this way. You are a fitness forward clinician. You are working in the hospital setting. You have hundreds and hundreds of patients handed to you on a silver platter. All these patients are in one place, door after door after door, literally right in front of your eyes. And they are just waiting for you to walk in, inspire the hell out of them, and guide them to the land of wellness and fitness. You do not have to hope that these patients who need you walk into your clinic doors. You do not have to hope that your Facebook marketing or your Instagram post is seen by your target avatar. They're all there waiting for you. You literally have a captive audience. Literally, these patients are in their hospital rooms. They are in their hospital beds. They have alarms on. They are tied to lines and tubes, et cetera. They're all there at your disposal. Team, the patients who need you the most, the ones who are medically complex and sick, They are waiting for you. They are handed to you on a silver platter in the hospital. Do not waste this opportunity. We have to realize that ankle pumps and glute sets, walking to the door and back, doing 10,000 tenettis a day, are not going to get the job done. Those are not going to increase our patient's reserve and resiliency, so they don't end up back on your caseload in a week. Fitness forward therapy is absolutely critical for these sick folks. Okay, so we've gotten curious. We're starting to shift our perspective. The most important thing that comes next is, well, how the heck do we do it? So let's dive into three different types of workouts we could do. WORKOUTS FOR BED-LEVEL PATIENTS Workout number one, this is going to be for your bed-level patient. So this is an individual who is in the ICU, perhaps, or they are in inpatient rehab. They cannot tolerate positional changes. Maybe their vitals go totally wild when they try to sit up. The alarms are going off, the nurses are running in. Vitals go wild, you gotta lay them back down. Perhaps they're incredibly orthostatic when they do sit up. Their blood pressure absolutely tanks, and you have to lay them back down. or they may have significant fear or pain. They just refuse to get out of bed. Hell, this could be the patient who, you know, your last session should hits the fan. You went way over time and now you have barely any time with this human. You do not have the time that it's going to take to get this person up and out of bed. Okay, so think about a couple of those scenarios that you may walk in to your patient today and this perfectly fits that description. This workout is for them. Okay, so what are we going to do? This individual supine is pretty much all they got. The bed is all they got. What we're gonna do is turn that bed into a workout machine. The hospital bed turns into a home gym. What do you need? You need a Sally tube slide. So what is that? You've seen them if you've been in the hospital. They're yellow, they're plastic. Individuals and the staff will use them to transfer patients because it decreases friction. You need that and you're gonna need a wedge or a slide board. and a gait belt. So three pieces of equipment, sally tube slide, a wedge or a slide board, or and a slide board, and a gait belt. Okay, so what are the three movements that we're going to do? We are going to do a modified pull-up, we are going to do a modified leg press, and we are going to do a modified rope climb using the gatebell. Okay, so how do we set this up? You get that sally tube slide underneath them. For our modified pull-up, you're going to tilt the bed. They are going to reach to the bed rail that's above their head and they are going to pull themselves up. That sally tube slide is going to allow them to slide and we're going to add some gravity onto them so we get them to a degree of a vertical pull. For our leg press, you're going to set that on the slide board, sometimes the wedge on top of the slide board at the bottom of the bed. We're going to tilt that bed again. They are going to kick and press to do a leg press, and then they'll slide back down, and then they push again, slide back down, etc. For our rope climb, you're gonna use that gait belt. You're gonna tie it to the foot bed rail. You're gonna tie that gait belt on there, and then they are going to grab onto it. They are going to pull themselves as much as they can to get to an upright, long sitting position, and then slowly let themselves down. Okay, so that's how those three exercises with the equipment are gonna be set up. Now, how do we dose this? Remember, this is an individual who has very low tolerance. We are just trying to get that blood flowing. We are trying to do very short bouts of activity and they're going to need a lot of rest. So how I would set this up is an EMOM, maybe an EMOM for six or nine minutes. Minute one, we're going to do that pull-up. I'm going to have them work for 20 seconds, and then I'm going to give them a full 40 seconds of rest. What am I doing during that time? Taking their vitals, right? Watching to see that they are responding okay to the exercise. I'm going to want to know what their blood pressure is, their heart rate, their oxygen saturation. Minute two, they're going to do that leg press, 20 seconds, and then they get 40 seconds of rest. And then lastly, they're going to do that rope climb for 20 seconds, 40 seconds of rest. What is beautiful about a workout like this is that many times what you will find after you're able to increase the intensity with them in the bed where their vitals are staying at a reasonable level, they're not going wild, then you sit this individual up and you will find all of a sudden their blood pressure actually stabilizes here. And now they're someone that you can safely get out of bed. Okay, there's your bed level workout for that individual. WORKOUTS FOR EDGE-OF-BED Next, now you have someone who can tolerate a little bit more. We're going to do a combination of a bed level exercise and sitting edge of bed. So they can tolerate positional changes. This is for that patient who can transfer out of bed, but it totally exhausts them. One rep and they're absolutely toast. This is for the patient who you know would thrive at acute rehab, but you really need to build their tolerance. You need to be able to say to those acute rehab liaisons, hey, this patient can tolerate multiple sessions of therapy per day. So we're going after endurance here. All right, so what do we need for this one? We need a heavy TheraBand or a resistance band. And that's it. One piece of equipment. So what we're going to do is we are going to do a AMRAP here. A 15-minute AMRAP. As many rounds as possible. Three exercises. Why are we doing that? Because we want to show, hey this individual tolerated 15 minutes of non-stop work. What are our three exercises? First, we are going to do a resisted bridge. How do you set up a resisted bridge in a hospital bed? You take your TheraBand and you anchor it one side of the bed rail to the other side of the bed rail. Now, when they go to bridge up, they have some resistance there. You can do it double leg, you can do it single leg. Exercise number two, we are going to do repeated supine to sideline to sit transitions, all right? And then exercise number three, while they're sitting on the edge of the bed, they're gonna scoot laterally to the foot of the bed and then to the head of the bed, okay? So those are your three exercises. How are we gonna dose this? Again, the goal is endurance. So we want them to be doing only enough repetitions to where that RPE at the end is only like a four to five. We don't want them to be seven, eight, nine. Remember this is endurance we want them to be able to sustain for 15 minutes total because that is going to be the buzzword that helps get them to acute rehab. So for that entire 15 minutes you're going to do as many rounds of those three exercises and you're going to try and keep the rep scheme to as many that keeps that RPE about four to five. That you're going to go ahead and document about why this person is perfect for acute rehab because they can tolerate 15 minutes and then you are going to progress them from there, try and get to 18 minutes the next time you see them and then get to 22, etc. Okay, that's your second patient. WORKOUTS FOR AMBULATORY PATIENTS The third patient, this is an individual who can transfer out of bed all right so they only need a little bit of help they can transfer out of bed but when they get really fatigued their can their performance is really inconsistent so this may be where the physicians or the case managers are like hey they can transfer out of bed like they're high level, they can go home. But you know that when they get fatigued, their knee buckles, or they really lose that eccentric control, their balance starts to go out the window. You know they need acute rehab in order to improve their tolerance so that they are able to do safe transfers throughout the day. Mimicking when someone throughout their day is going to have high and low levels of fatigue, you want to know that that consistent performance is safe. So, what are we gonna do here? In this workout, what we're gonna do, three exercises, we're gonna do an overhead press, a standing march, and then a stand-step transfer, okay? So that overhead press, what do we need? You are gonna get that toiletry bucket that every patient is given, you're gonna dump all the crap out of it, you're gonna take a towel, you're gonna roll it up, you're gonna soak it in water. That makes that toiletry bucket now have some load. This is what we're going to use for the overhead press. It's going to be done sitting on the edge of the bed. Next is going to be the standing march. This can be a standing march that doesn't have any load to it. You can have your arms on the walker for upper extremity support or you can use something like a bedside commode bucket. clean that you put a bunch of weights in like ankle weights load it up and they can do a one-handed uh carry or a hold while they march okay and then with the stand step transfer you just need their assistive device and a chair set up next to the bed all right so in This type of workout, what we are wanting to do is we are wanting to really increase the intensity of those first two exercises, the overhead press and the standing march, and then have them do the transfer because we want to show Hey, this is what it looks like when this person is under fatigue and then tries to do a transfer. You want to prove to those acute rehab liaisons, balance gets really poor. I have to jump in and I have to give them some support in order for them to not lose their balance when they do that transfer. So you're showing the deficit here. So in those first two exercises, you want intensity to be really high. So comparatively to our first imam, it's going to be the same exact thing, but work and rest is going to be reversed. So you are going to have them work for 40 seconds, and then you can give them only 20 seconds of rest. and that 40 seconds, you want it to be sprint effort, okay? You want them to be working at RPE 789. You want them to really, really push it. So similarly, you can do this for 6, 9 minutes, 12 minutes, 15 minutes, and the goal here is that when they get to that stand-step transfer, they're under fatigue, you are going to see what happens. Then you can document and show acute rehab, hey, This is all the assist that they need. This is how their technique breaks down when they are under fatigue. That is going to be the buzzword that you're going to be able to use to advocate for them to get to acute rehab. You're going to also use that and progress them to just try and build that endurance. So let's say acute rehab is still like, screw you, we're not letting you in. Now you have a baseline workout. You continue to hammer in on improving their endurance so that when they get to that transfer, they have stability. SUMMARY All right, three workouts for you. That bed-level patient who cannot get out of bed, supine's all you got. You turn the bed into a workout machine. You got your second workout for that individual who can tolerate transfers, transitionals, and can get to that edge of bed. And then the third, you got a workout for someone who is able to get up and transfer out of bed. I have multiple reels that I've made about each of these individually. I'm going to put them together and post it. You will have that soon so you can get a visual of what all this looks like with my actual patients. And I cannot wait to hear how you guys use some of this stuff out there in the clinic this week. All right, to finish this off, we've got courses coming up. We want to see you guys out on the road. We would absolutely love to see you. We got tons of spots left in Missouri. That is this weekend. Alex will be out there. That course is going to be absolutely amazing. We got multiple courses coming up in February. I will be in Minnesota. It's going to be a freaking blizzard. I cannot wait. And then our online courses are going to be starting up in March. So we'd love to see you online or on the road. All right, y'all, that's all I got for you. Get out there, bring that fitness forward approach to your hospitalized patients. I cannot wait to hear about it. OUTRO Hey, thanks for tuning in to the PT on Ice daily show. If you enjoyed this content, head on over to iTunes and leave us a review, and be sure to check us out on Facebook and Instagram at the Institute of Clinical Excellence. If you're interested in getting plugged into more ice content on a weekly basis while earning CUs from home, check out our virtual ice online mentorship program at ptonice.com. While you're there, sign up for our Hump Day Hustling newsletter for a free email every Wednesday morning with our top five research articles and social media posts that we think are worth reading. Head over to ptonice.com and scroll to the bottom of the page to sign up.

Der Boom hält an, Schneeschuhlaufen ist populär. Aber es ist nicht einfach nur ein bisschen durch den Schnee stapfen. Schneeschuhlaufen setzt eine gewisse Fitness voraus, sagt der diplomierte Sportlehrer und Personaltrainer Savo Hertig. Fitness, das heisst Ausdauertraining, wie Joggen oder Schwimmen. Aber auch der Rumpf und die Oberschenkel sollten gut trainiert sein, damit man den Berg hochkommt.  Rumpf- und Kniebeugen kann man gut zu Hause machen. Auch das langsame, mehrmalige Aufstehen vom Stuhl ist eine gute Übung, wenn man die Kniebeugen nicht mehr schafft.  Fit fürs Schneeschuhlaufen wird man auch mit dem Theraband oder Hanteln. Letztere muss man aber nicht extra kaufen. «Zwei anderthalb Liter PET-Flaschen können gut als Hanteln gebraucht werden und intensivieren das Kniebeugentraining», sagt Hertig.

In this Episode we sat down with CEO and Fonder of Straffr Stefan.The idea was born in the hotel: As a former competitive athlete, Stefan was looking for a balance after long working days and a lot of travelling. Countless fitness apps could not motivate him extensively. After some time, the Theraband was his constant companion. Then he had an idea: the elastic band has to become smart!Your traditional workout band has been elevated by Straffr! A perfect gift for those fitness people in your life who travel, are short on time, need to workout when it's convenient for them. Can be found at:https://en.straffr.com/en-us/pages/about-usUse code:HE25 at checkout. 

Dr. Jessica Gingerich // #ICEPelvic // www.ptonice.com  In today's episode of the PT on ICE Daily Show, #ICEPelvic faculty member Jessica Gingerich discusses simple, but often overlooked interventions for treating patients with symptoms of pelvic prolapse including the Kegel, unilateral hip strengthening, and proper breathing & bracing. Take a listen to learn how to better serve this population of patients & athletes. If you're looking to learn more about our live pregnancy and postpartum physical therapy courses or our online physical therapy courses, check our entire list of continuing education courses for physical therapy including our physical therapy certifications by checking out our website. Don't forget about all of our FREE eBooks, prebuilt workshops, free CEUs, and other physical therapy continuing education on our Resources tab. Are you looking for more information on how to keep lifting weights while pregnant? Check out the ICE Pelvic bi-weekly newsletter! EPISODE TRANSCRIPTION 00:00 - JESSICA GINGERICH Welcome to PT on Ice Daily Show. My name is Dr. Jessica Gingerich and I am on faculty here at Ice with the Pelvic Division, which means that it is Monday again. We are getting super close to Halloween. I'm really excited. I'm definitely a Halloween girly. Today we are going to talk about what may be missing during the plan of care when it comes to prolapse. So this is another hot and relatively scary topic for a lot of mamas, but also for a lot of clinicians in this space. So we're going to talk about a few housekeeping items before we get started. We are currently in our last cohort of the year for the online course. This is something we are gonna put the pedal down come January. We've got a lot of exciting things coming up. So if you have not signed up for this course, head over to ptonice.com, just sign up. We also have a few more courses, live courses, to round out the year. So, if you're looking to dial in your internal assessment with that kind of higher level population, that athletic population, head over to PTOnIce to sign up there as well. My hope after this podcast is that you guys want that. You want to sign up for that live course. You want to dial in your internal assessment, dial in your interventions, and just guns a-blazin' out in this population. For those of you in the ICE Students Facebook group, you will hear more about the revamped certifications from Jeff tonight. Otherwise, stay tuned to Hump Day Hustlin' emails for details. So if you haven't signed up for Hump Day Hustlin' emails, again, that's all on the website. It's free. We just want to get out as much information to you guys as we possibly can. So we have some really fun new certifications coming up that Jeff is gonna dive into later tonight. So as we begin our PT careers, a lot of us prefer a specific population, right? We want to treat the older adult, the pregnant person, et cetera. We want to dial in our skills. And we love to see that, right? Like that, I love that. I want to get really good at that one thing. I want to go to the provider that is that provider. I am the person that you want to see if you are experiencing X, Y, and Z. We hear that a lot as faculty, especially in the pelvic space is, you know, well, I only want to kind of treat this type, this, the urinary incontinence or, you know, low back pain. And as a faculty, we've all kind of experienced those same thoughts and feelings. Again, it's intimidating when you get into this space. Well, we quickly learned that you can't just pick and choose. If you have someone that's experiencing urinary incontinence, they also are likely experiencing something else as well. If you are in the pelvic space, you're going to see all things. PELVIC PROLAPSE The ones that are at the top of the list, at least that we hear about as faculty, are the ones that are scary are pelvic pain and prolapse. So today we're going to focus on treating prolapse and specifically what we may be missing in our plan of care. It is going to be outside of the scope of this podcast to talk about the assessment of, um, like the subjective or objective assessment of prolapse. So if you are unfamiliar or you feel like you're just kind of shaky on this, again, that live course is waiting for you. Once we know the pelvic floor is strong or weak, or that it's a timing issue, or that they may or may not be tender to palpation internally or externally. And when I say externally, I mean hips as well. And that they may or may not have objective signs of prolapse. we then get to develop our plan of care. Now notice that I said may or may not because these clinical patterns are not identical. You will see so many different clinical patterns when it comes to symptoms of prolapse. So let's just say your patient comes in with feelings of heaviness, pressure, or dragging, and it feels like they may be sitting on something. That's something how they're describing it. When they're in the shower, they feel, as they're bathing, they may feel something physically. The heaviness gets worse after they have a bowel movement, void, go to the gym, or have been on their feet all day. So what's your next plan of action? Well, first and foremost, we wanna encourage you guys to stop focusing on the biomechanical components of a prolapse. Of course, there is that person or that type of prolapse. We're maybe talking about surgery. That does happen, but it doesn't happen without needing that pre-physical therapy, the stuff that they're doing beforehand, getting stronger, learning how to poop and pee. learning how to brace. So all of this stuff is still happening, even if surgery is part of the discussion. So first and foremost, let's stop focusing on the biomechanical components. Let's start focusing on the symptoms. So understanding what makes the pressure heaviness better, what makes it worse. Can we, part of their plan of care, ramp up the things that make it feel better and ramp down the things that make it feel worse? That has to be followed with this is not gonna be your forever. This is not gonna be you never doing that thing because it ramps up your symptoms and always having to like sit and be immobile because it ramps down your symptoms. We have to think about this on an irritability scale just like we do with pain. We have to be able to bring down their irritability, so then we can make them better by loading them. So now that we know that, I'm gonna give you four points to go home with today that are great points to start with. When you have that person come in with a script that says pelvic organ prolapse, or doesn't say that, it says pelvic pain, but then you start asking them questions and you're like, hmm, they may have symptoms of pelvic organ prolapse. REMEMBER THE KEGEL We have to remember the Kegel. This is number one, the Kegel. It has gotten so much hate over the past few years, especially on social media. I don't think that was anyone's intent to just say never do Kegels, but it matters. Teach your client how to do a Kegel. Lift and squeeze, shut off the holes, come to the attic. But we have to remember the relaxation component to the Kegel. Teach them how. to relax. Have them focus on this. A lot of times people feel like they can multitask a cubicle. If they are new to this and they don't know and they didn't even know they had a pelvic floor, they need to go in a room where it's quiet with no kiddos running around and focus on the up and the down component of a cubicle. Something that I love to say in the clinic is the relaxation component of a Kegel is sometimes more important than the contraction. Everyone always thinks we need to go up, up, up, up, up. And when I say everyone, I mean typically our clients. And they forget that this actually has to happen as well. Or, not that they didn't forget, but they think that they may be in that relaxed position and they're not. and that's where that internal palpation can be golden. Again, people tend to focus on the contraction, so being constantly contracted can also lead to symptoms of heaviness. So maybe their symptoms of heaviness are coming from this versus actually symptoms of prolapse. UNILATERAL HIP STRENGTHENING Number two, single-sided hip strengthening. get their hips stronger, always, but even here, get their hips stronger. And I don't mean with a TheraBand. Throw it out. If you want to warm them up with it, great. But we've got so many options. Step downs, step ups, we've got single leg RDLs, we've got variations of that. We have Core stuff that we can do, like the options are endless. We can do side planks, we can do hip thrusters. Don't forget about strengthening their hips. INSTRUCTING THE BRACE Number three, teach them how to brace. Symptoms of heaviness can happen due to faulty bracing strategies. Bracing is not only for lifting heavy either. We need to prepare mom for the demand of life. And mom is holding Johnny who has a runny nose and she's trying to wipe his nose and he's flinging his head back. She's going to be bracing her core and she's not even gonna think about it. So let's prepare her for that. Number four is find and encourage frequent rest positions that ease or make their symptoms go away. This could be lying on their back. This could be seated, this could be laying on their stomach, it could be leaning over the counter, anything that makes their symptoms ease. Again, follow this up with this is not forever, this is a for now, we wanna get those symptoms, the symptom irritability down. And once we get those symptoms down, what can we do? Everything that we just talked about in one through three. So to recap, find the symptom aggravators, find the things that make their symptoms go away or ease. There may be multiple clinical patterns to prolapse-related symptoms. Prolapse can be scary to a lot of women. It is, if they've Googled it, they are gonna come in wide-eyed, or if the doctors told them that, there might be tears. But it can also be really scary to clinicians if we don't know how to treat this. You have four places to start. The Kegel. Gets a lot of hate, but we need to start using it. Don't forget about the hip. The hip muscles are gonna be supporting structures to the pelvic floor. Bracing is not only used for heavy lifting, and using positions that ease symptoms to lower irritability, which will increase our loading capacity. That is it. Start there. So team, I hope this helps. I hope you have a great week and enjoy your Halloween and we'll see you next time. OUTRO Hey, thanks for tuning in to the PT on Ice daily show. If you enjoyed this content, head on over to iTunes and leave us a review and be sure to check us out on Facebook and Instagram at the Institute of Clinical Excellence. If you're interested in getting plugged into more ice content on a weekly basis while earning CEUs from home, check out our virtual ice online mentorship program at ptonice.com. While you're there, sign up for our Hump Day Hustling newsletter for a free email every Wednesday morning with our top five research articles and social media posts that we think are worth reading. Head over to ptonice.com and scroll to the bottom of the page to sign up.

Dr. Julie Brauer // #GeriOnICE // www.ptonice.com  In today's episode of the PT on ICE Daily Show, Modern Management of the Older Adult faculty member Julie Brauer emphasizes the importance of executing obstacle courses in a specific, dynamic, objective, and progressive manner. The purpose of these obstacle courses is to prepare patients for the chaos of their daily lives and help them confidently overcome these challenges. To make obstacle courses specific, Julie suggests replicating the functional demands of the patient's specific goals. This means creating exercises and challenges that directly mimic the movements and tasks the patient needs to perform in their daily life. By doing so, the patient can develop the skills and confidence necessary to navigate these challenges effectively. In addition to being specific, obstacle courses should also be dynamic. This involves incorporating a combination of exercises and layering dynamic challenges. By introducing variability and unpredictability into the obstacle course, patients can improve their ability to adapt and respond to different situations. This dynamic nature of the obstacle course helps simulate real-life scenarios and prepares patients for the unexpected. Objectivity is another crucial aspect of executing obstacle courses effectively. Julie suggests leveraging subjective and objective outcome measures to make the obstacle course objective. This means using measurable criteria to assess the patient's progress and performance. By having clear and measurable goals, both the therapist and the patient can track improvement and make necessary adjustments to the obstacle course. Lastly, obstacle courses should be progressive. This involves gradually increasing the difficulty and complexity of the challenges as the patient improves. Progression ensures that patients are continually challenged and can continue to develop their skills and abilities. It also helps to keep the obstacle course engaging and motivating for the patient. Overall, executing obstacle courses in a specific, dynamic, objective, and progressive way is essential for helping patients develop the confidence and competence to effectively navigate the challenges in their daily lives. Take a listen to learn how to better serve this population of patients & athletes. If you're looking to learn more about live courses designed to better serve older adults in physical therapy or our online physical therapy courses, check our entire list of continuing education courses for physical therapy including our physical therapy certifications by checking out our website. Don't forget about all of our FREE eBooks, prebuilt workshops, free CEUs, and other physical therapy continuing education on our Resources tab. EPISODE TRANSCRIPTION 00:00 - JULIE BRAUER Welcome to the Geri on Ice segment of the PT on Ice daily show. My name is Julie Brauer. I am a member of the Older Adult Division, and we are going to be talking this morning about obstacle courses and leveling up our dynamic gait training. So I've been really passionate about creating meaningful obstacle courses for a really long time, and I've become even more excited about this topic since our live course has gotten this massive revamp where we spend an entire lab focusing on dynamic gait challenges and how to layer. So I'm so excited to dive into this today because obstacle courses can be a really challenging, fun, creative way to implement dynamic gait training into our plans of care. With the purpose of preparing our patients for the chaos that is their daily lives, right? We want them to be able to move confidently through the chaos of their lives. And if we really think about it, What better exercise could we give our patients than a combination of exercises, a combination and layering of dynamic challenges that exactly replicate the functional demands of their specific goal, right? However, I think we many times really missed the mark here on executing this in an effective way. And when I say executing in an effective way, I mean in a way that is specific and dynamic, objective and progressive. So when I reflect back on the past eight years of my practice, 02:37 OBSTACLE COURSE LIMITATIONS When I think about all the obstacle courses that I have seen throughout various settings, most of them are variations of stepping over cones, or stepping over hurdles, or many times it's stepping over canes. Many times it's one rep, the patient goes through that obstacle course forwards, and then the next time they go through it sideways. Many times it's weaving around cones as well as stepping over them or maybe stepping in and out of an agility ladder. And when we think about that, we have to realize it's pretty unidimensional, right? It doesn't exactly look like real life. Most of these patients are not on a clock. We aren't often capturing our PE while the patient is going through the obstacle course, right? Like I could go on and on about a list of things that are wrong with our typical obstacle courses that we see in our clinics, in our profession. And while stepping over cones and navigating around them is a really solid place to start, we really have to start thinking about moving beyond that, right? I consider stepping over cones and navigating around cones very similarly to our other underdosed exercise. I will go as far as to say that I think that cone stepping is the ankle pump of dynamic gait training. Stepping over cones is the ankle pump of dynamic gait training. And so why? So let's unpack that. Because many of you would probably say, like, what do you mean stepping over cones is challenging for my patients? And I'm going to respond with, well, yeah, I mean, tandem standing is challenging for a lot of my patients, but I'm sure as hell not going to waste multiple weeks of a plan of care with my patient in tandem stance, right? The question becomes, is it the right challenge? Is it the right challenge? Similarly to tandem stance, Do the demands of stepping over cones match the entirety of the chaos and the dynamic demands that comprise our patients' lives? We have to realize that stepping over cones only hits one aspect of dynamic gait and balance, right? It only hits on anticipatory balance. And we know that balance can break down in multiple different areas. And there's so many other components of balance and dynamic gait that we want to pay attention to. we have to realize that stepping over cones is not super specific, right? It doesn't look like real life. Our older adults are not moving around in an environment where these very bright orange cones are sticking out to alert them they need to step over that thing, right? And then also, you know, just thinking about If I am able to get my patient really competent and confident in stepping over cones or weaving around cones, does that actually translate to our patients feeling incredibly confident to take on the adventures in their world? 06:08 ROOM TO GROW WITH OBSTACLE COURSES So we have to first reflect on why there's just a lot of room to grow when it comes to our typical obstacle courses, all right? So now that we've set that framework, let's talk about how to level up our dynamic gait training from assessment to implementation and creating in dialed in workouts, focusing on how to make these obstacle courses specific, objective, dynamic, and progressive. All right. And we're going to put this in the framework of focusing on two different types of goals. And these were goals and dynamic eight challenges that students who were part of our MMOA live course a couple weeks ago in Oklahoma came up with. absolutely stellar students who came up with really awesome dynamic challenges. So I'm going to share some of these with you. So these two goals that we'll be talking about back and forth, um, that many of you can relate to with your patients are the goals of one, being able to independently navigate through the airport and board an airplane independently to be able to go on vacation. And then two, to be able to independently tend to a garden. All right. So two goals that are very common among older adults. And we'll talk about how to make it specific, dynamic, objective and progressive. All right. 10:21 SPECIFIC OUTCOME MEASURES So starting out with making our obstacle courses really specific. This is where we need to dig deep. So if you're part of our MMA crew, you hear us talk about our formula, make it meaningful, load it, dose it all the time. So this is that make it meaningful part, right? So we need to dig deep into what that goal actually looks like. I want to peel back all the onion layers. So if my patient is telling me, well, I want to be able to go on vacation. I am having my patient take me through from start to finish. I want to know exactly what that looks like for her or for him to go from getting out of that car into the airport through the airport onto the plane into into their seats right so I am asking question after question after question because I want to visualize what that goal looks like, right? If it's gardening, I want to know exactly what the functional movements are that comprise that goal because there is where I'm starting to create my obstacle course. I am in my head taking mental notes about what are all the pieces and parts that are going to comprise this obstacle course to make it very specific for the patient. Now, sometimes going seven layers deep with our patients is really, really difficult, right? They just, they have a hard time answering these questions or having that conversation with us. This is where we can leverage our outcome measures such as the PSFS or the FES and the ABC, right? Those are going to give us some insight into some components of their daily lives that are really scary or they feel like they're going to lose their balance or fall or components that they're actually really confident in. So you can use those outcome measures when perhaps the conversational part and you're asking a million questions and digging deep, is a little bit difficult for your patient. And then we want to really leverage our objective outcome measures, right? So our mini-best and our DGI, because that's going to give us very, very, very specific information. If our patient is telling us that, yeah, I'm having a difficult time because I'm afraid people are going to knock into me at the airport, well, I'm sure as heck gonna want to look at their reactive balance with their mini best, right? So we wanna use both digging deep, asking the questions, using those subjective outcome measures, and then definitely using those specific objective outcome measures to see where perhaps the balance is breaking down, right? So to give a couple of specific examples, If our patient, maybe in their PSFS, are saying that lifting that suitcase over their head is really the part that is limiting them from feeling confident and being able to go on that trip, maybe it's a strength component that we really want to focus on. So maybe I'm going to look at a press or a push press and see what that looks like in isolation and maybe coach that up, right? But then I know that I'm going to add a push press or a press into my obstacle course, because maybe it's not that the strength component of that push press is the big issue, but more that they are so fatigued after going through the entire airport that they just don't have the energy to get that suitcase up into that overhead bin, right? And so, again, to bring it back to the balance component, if they're telling us, I am so scared of getting bumped by someone at the airport, because I'm afraid it might fall, I want to know, hmm, what does their reactive balance look like? I want to look at forward. I want to look at backwards. I want to look at lateral. And then to put that into the obstacle course, maybe I can do something like our stellar students did a couple of weeks ago, where they use TRX straps. And as the patient's walking, they swing those TRX straps at spontaneous times, to see how the patient reacts to that, right? Or you could do something like as your patient is walking, you offer an external perturbation and see what their stepping strategy is. All right, so that's how to make your obstacle course as you're figuring out what the pieces and parts are very, very specific to what they're telling you and what you're finding throughout your assessments. Next, we have to talk about how to make it dynamic. And what I mean by dynamic is not just the patient is moving, right? Like, you know, I can see a lot of you being like, well, yeah, well, you know, stepping over cones or hurdles like that is dynamic. But we have to think more about just the patient moving, right? Yes, that is dynamic, but we have to remember that we need to mimic a dynamic environment, not just our patient being dynamic and our patient moving, right? And in addition to that, what I mean by dynamic is layering. 14:21 MIMICKING REAL LIFE CHALLENGES We want to combine anticipatory balance, reactive balance, vestibular fitness, strength, power. We want to combine all of those things together in our obstacle course, because that's real life. And that's when balance breaks down, when we were trying to navigate through all these different components. Remember that older adults are not waking up in the morning. And for the first two hours of their day, they're only doing a single task. And then the next two hours of their day, they're doing a dual task in reactive balance, right? Like they are constantly moving in and out of forward gate, sideways gate, making 360 degree turns, reactive balance, anticipatory balance, cognitive tasks, motor dual tasking. All that stuff is happening constantly. So we want to mimic that type of chaotic environment. We want to layer all of those challenges on. So what would that look like? Let's think about our gardening example. So if we're thinking, and our patient is telling us, okay, so I have to pull the hose, right? And I have to pull the hose and walk along the grass. And so you're thinking about this, hmm, how can I mimic that? Could I have my patient pull a rope? Could I also then have them do head turns where they're looking behind their shoulder to make sure that their hose isn't totally annihilating all of their flowers, right? You're making it that specific, but you're layering on challenges. What about for the individual who wants to go on vacation, they're really scared about stepping onto the escalator with their suitcase, right? So how do I replicate that? Can I step onto a variable terrain, like stepping onto a BOSU ball, while I'm lifting a weight or doing a suitcase deadlift, right? So now we have that sensory orientation, we're adding in that vestibular fitness, we're adding in the strength to step on and get stability on a moving object while also having the strength to lift an object. If we think about our gardening example, think about the act of pulling weeds. Maybe we're getting our patient down into a half kneel and we're doing a rowing exercise for strength. Or maybe it's more of the balance component our patient is worried about when they go to pull those weeds. So we do something like utilize squigs or we get a really heavy dumbbell and we tie a TheraBand around it and we have them pull the TheraBand and release. or we put a resistance band around them in half kneeling, and we go ahead and give them perturbations. So we layer on all different types of challenges, anticipatory, reactive, vestibular fitness, strength, power. That is how we layer. And we want to layer and layer and layer because that is what real life is like. Next, we have to find a way to make this objective, right? We have to dose it appropriately. We have to find a way to progress our obstacle courses. So we got to think about our goal, right? If we think about gardening or the airport example, if the goal is to be able to continuously move through, let's say 20 minutes, because let's say it takes 20 minutes to get through the airport. Gardening usually takes 20 minutes of time to do all those tasks. Okay, that's our long-term goal. So maybe we start out by, we want to see how many rounds you can get through when you continuously move for six minutes. That's more of the short-term goal. And we're recording how many rounds did they get through? How many breaks were required? Or if you have someone who, for example, gets to the airport really, really, really last minute, which just, like, my anxiety goes up even thinking about it, and you know they're going to be racing through the airport, maybe you want to design the workout so that that intensity is really, really high. And maybe you're doing something like three rounds of that obstacle course for time. We also want to be tracking our PE and using that to progress our goal. So if our patients, you know, capacity is really struggling, for example, you know, within three minutes of the obstacle course, it feels like an RPE of seven or eight, then maybe one of our goals is that it takes eight minutes of doing that obstacle course until that RPE of seven to eight come up. If we're focusing on balance capacity, are we using something like the balance stability scale to ensure that the variable terrain that you have mimicked, right, by perhaps having them walk on foam is enough? Or do we need to progress that by maybe underneath the foam, putting in some ankle weights or some other objects or having stepping stones to increase that balance challenge. So it actually elicits a step reaction, which maybe we saw in our mini best that we want to improve. If our patient more has a strength deficit, right? So that push press to get that suitcase in the overhead bin or the deadlift, maybe to get that mulch up from the ground or like a clean up from the ground to the shoulder and up overhead. Are we looking at our patient's estimated one rep max and making sure that we're working them at least 60% of that so that we can elicit positive strength adaptations? We have to make sure that we are dosing appropriately and that we have ways to progress this. Putting a patient on a clock is the easiest, easiest way to do it. Getting that RPE, really making what you're measuring be specific to what their goal is. And then the last part here is we can really utilize part practice of this big obstacle course to even more specifically dial in where our patient is having trouble, right? And it allows us to be very efficient because to create a big obstacle course can take a lot of space and a lot of time. So what we can do is as we're assessing and looking at this patient going through an obstacle course, we can see the pieces and parts that they have the most difficulty with. We can be asking them again from our questions and our subjective measures, like where are they having the most difficulty or where do they feel the most confident? And then we can pick out those pieces that we see and that they tell us and create like an EMOM or an AMRA. right? Making it very, very, very dialed in. So this is where I would take like three to four functional movements that comprise the goal, that comprise that entire obstacle course. So if we look at our gardening example, minute one, we, for an EMOM, we could do a sled push, or that could be a walker or resistance band, right? And we could be trying to mimic pulling that hose. Minute two, we could have our patient do some quadruped rows. So thinking about being down on the ground and doing some weed pulling or picking up different gardening tools. Minute three, we could be doing some external perturbations while they are in half kneeling. That could be mimicking pulling that weed and having to really catch themselves as they move backwards. Minute four, we could do something like a clean and press that could mimic trying to get that heavy bag of mulch from the ground up to the shoulder or up overhead. So that's how you can take your entire big obstacle course, pick out the important parts and create a workout that is much more succinct and easier to set up and doesn't require a whole bunch of space. Okay. That is what I got for you all today to come back around and wrap that up. When it comes to our dynamic gait training and creating obstacle courses, think about how you have to dig really, really deep. Leverage your subjective and objective outcome measures to focus on making your obstacle course specific, objective, dynamic, progressive, and then utilize EMOMs and AMRAPs to dial in the components that they are specifically having difficulty with. Now, talking about all this obstacle course stuff, I know it's getting some of you excited to think about dynamic gait training and all the different things you can do. You've got to come see us on the road to one of our live courses and check out our new revamp where, like I said, we spend an entire lab just on dynamic gait training and showing you all how to add in a lot of these layers. So on the road, there are tons of opportunities in October. My gosh, yes, it's October already. We will be in Virginia, California, and New Jersey. And then in November, we are in Maryland, South Carolina, New York, and Illinois. Plenty of options across the country to catch us out on the road and check out that super cool fun lab. On the flip side, our online courses, both Essential Foundations and Advanced Concepts are starting, gosh, next week. So October 11th and October 12th. Head to ptinice.com, message any of us. We'll be happy to answer any questions for you. We hope to see you on the road or online next week. Have a good day, guys. OUTRO  Hey, thanks for tuning in to the PT on Ice daily show. If you enjoyed this content, head on over to iTunes and leave us a review and be sure to check us out on Facebook and Instagram at the Institute of Clinical Excellence. If you're interested in getting plugged into more ice content on a weekly basis while earning CEUs from home, check out our virtual ice online mentorship program at ptonice.com. While you're there, sign up for our Hump Day Hustling newsletter for a free email every Wednesday morning with our top five research articles and social media posts that we think are worth reading. Head over to PTOnIce.com and scroll to the bottom of the page to sign up.

Alan Fredendall // #LeadershipThursday // www.ptonice.com  In today's episode of the PT on ICE Daily Show, ICE COO Alan Fredendall discusses average arrival rates in physical therapy, what the research says about how to improve arrival rates, leveraging technology to improve arrival rates, and creating policies & systems that ensure your clinic still gets paid for missed appointments. Take a listen to the podcast episode or read the full transcription below. If you're looking to learn more about courses designed to start your own practice, check out our Brick by Brick practice management course or our online physical therapy courses, check out our entire list of continuing education courses for physical therapy including our physical therapy certifications by checking out our website. Don't forget about all of our FREE eBooks, prebuilt workshops, free CEUs, and other physical therapy continuing education on our Resources tab. EPISODE TRANSCRIPTION 00:00 ALAN FREDENDALL Good morning, everybody. Welcome to the PT on ICE daily show. Happy Thursday morning. Hope your morning is off to a great start. My name is Alan. I'm happy to be your host today. Currently have the pleasure of serving as the chief operating officer here at ICE and the faculty member on our fitness athlete division. We're here on Thursdays. We talk all things leadership Thursday, small business ownership, practice management, that sort of thing. Leadership Thursday also means it is gut check Thursday. This week we have a 17 minute AMRAP, as many rounds and reps as possible in 17 minutes of the following 21 plate ground to overhead. Our Rx weight there for guys 45 for ladies 25. So grabbing a bumper plate, hinging down, tapping one side of the plate between your feet and then up and over overhead, almost like a snatch. Moving into 15 cows on the rower for guys 12 for ladies and then finishing with a small dose nine burpees to plate. So looking for somewhere between three to five rounds of that great workout for home, the garage, the basement, the clinic. Just need a rower and a bumper plate. Great to maybe take out to the park as well and sub the row for some running or something like that. So that is gut check Thursday. Course is coming your way. We have so many about to enter a very, very busy season for ICE here as we get into the fall, get away from the summer, school starts back up, that sort of thing. We have a couple hundred courses coming your way between now and the end of the year. So if you're looking for live courses, head on over to p10ice.com, click on our courses and check out our map to see what's coming to your neck of the woods. Some online courses I want to highlight. Pretty much all of our entire catalog of eight week online courses are starting back up after Labor Day. So if you don't know about our online courses, they are eight weeks online. They are synchronous, which means that you meet with us every week. They are not completely self study, a mixture of lecture, of reading, of homework and of live meetups. They're meant to simulate the feeling of a two day live course, but stretched across eight weeks to make it a little bit more accessible, save you a little bit of money on travel. So online courses, pretty much like I said, all of them are starting after Labor Day. We have ICE Pelvic Online. That's our entry level online pregnancy and postpartum course. That's going to start September 4th. We have Fitness Athlete Essential Foundations taught by yours truly Mitch Babcock, Kelly Benfee and Guillermo Contreras. That's going to start September 11th. The very next day, September 12th, Brick by Brick is going to start very relevant course to this day of the week to Thursdays. We talk all things practice, startup and ownership and management in that course. Injured Runner Online also starts September 12th and then Virtual ICE will open back up September 26th for our next quarter of enrollment. So let's get into today's topic. Let's talk about how do we handle, how do we get better at when a patient reschedules, cancels or no shows. I want to talk today about three main topics. I'm going to talk about what are the average no show cancellation rates, what we would call an arrival rate across the country, across physical therapy, what's normal, what's abnormal. I want to talk about how to improve those arrival rates. And then I want to talk about how to get paid when somebody does not show up for those appointments. 05:46 ARRIVAL RATES IN PHYSICAL THERAPY So let's start at the beginning and let's talk about what is a normal rate. If you have been practicing physical therapy for a while, if you have been practicing in a traditional clinic, you may have heard that the common recommendation for the maximum arrival rate is about 93%. That is to say that 93% of your appointments show up for their appointment that day. That there's some margin of error. We recognize that 100% of people probably won't make it, but pretty typical. 93% is the standard that's set and sometimes enforced by the clinic that you work for. Maybe if you fall below that, maybe you get a warning, maybe you get a talking to, or maybe they actually dock your pay for visits underneath that 93%. What's awesome about this topic is that we actually have a lot of research, surprisingly, supporting the numbers that I'm about to tell you. So we have a great survey back from 2015 of about 7,000 outpatient physical therapists. This is from Bo Kinski and colleagues, sorry if I mispronounced this, of 7,000 outpatient PT's looking at a couple of different things. Looking at finding the average cancellation no-show rate, but also finding what things seem to help fix that. So across the country, we see an average no-show cancellation rate of actually about 10 to 14%. So thinking you may have been told 93% is the gold standard, in reality, somewhere between 85 to 90% is actually probably more realistic. If you had 10 patients scheduled for the day, you could expect maybe eight of them to show up for the appointment. You could expect maybe one to two appointments to be unfilled. I like this survey because it goes a couple levels deeper. It asks why. Now knowing that rate, knowing that 10 to 14% rate, why do people not show up for the appointment? What is the number one cause? The number one reason why patients do not attend their appointment is not that they can't afford it, not that they don't like you, it's that they forgot and that the clinic that they went to physical therapy to had no reminder system. So that's a huge error, that's a very easy fix. When we delineate outpatient physical therapy from hospital-based outpatient physical therapy, so private practice versus hospital-based, we see that hospital-based clinics actually the no-show cancellation rate of a private practice clinic. Why is that? I would imagine it's probably due to having a modern reminder system, but again, that number of 93% isn't the gold standard that we think it is. In private practice, we can expect maybe 85 to 90% arrival rate, a little bit lower in hospital-based, maybe 75 to 80% arrival rate. Now this survey looked at the concept of a multi-method reminder system. What does that mean? That means that the patient received multiple reminders across multiple communication methods. That they usually received some sort of automated phone call reminding them of their appointment. They received probably a text message and then maybe also an email message. So they received two to three different reminders ahead of their appointment across different modalities, basically reminding the patient as much as possible of their upcoming appointment. Now they found that those clinics that used a multi-method reminder system had a significant reduction in no-show cancellation rates, about a 50% reduction. So they cut their no-show cancellation rate in half just by having a reminder system. And we're going to talk about how to set that up at your clinic here in a minute. The second reason that clinics did better with no-show cancellation rate was those clinics who had a 24-hour appointment change policy. That is inside of 24 hours, you will be penalized if you cancel or reschedule or no-show your appointment versus if you give more than a 24-hour notice that you need to reschedule your appointment or otherwise cancel it. So those clinics which had a 24-hour policy and enforced that policy on their patients also had a reduction in their no-show cancellation rate. So that brings us to the question of if 10 to 14% is the mean of the average of no-show cancellation rates across the country, then how realistic is 7%? The answer is not very, right? Even if you are treating one-on-one for an hour and you maybe only have eight patients on your caseload for the day, it's probably unrealistic to expect 100% of those people to show up every day. That we have to recognize at some level that the reason we see so much overbooking in traditional physical therapy clinics is it's just that leadership strategy to limit the impact of those inevitable no-show cancellation rates. That if you see eight patients in a day and 10 to 15% don't make it, you may see five to seven patients. So kind of the aggressive leadership solution here is just to make you see more patients. That if you see twice as many patients and you still have that 10 to 15% no-show cancellation rate, then you'll still see more patients than originally intended and scheduled to and the clinic won't lose as much profit. But that being said, that is an aggressive way. That is a way that puts all of the burden of the work on the therapist and none of it on the ownership, none of it on the leadership and none of it kind of on the backend logistical side of the clinic. Instead of making you see more patients, why don't we just have a 24-hour policy that we enforce? And if we're not using a reminder system, why don't we start using one? Why don't we do some more conservative approaches to reduce that no-show cancellation rate, especially now knowing that we have research that supports, does those actually improve our no-show cancellation rates? So let's talk about that. 08:48 IMPROVING ARRIVAL RATES Let's talk about aside from having a reminder system, aside from strategies to remind patients to get to the clinic and aside from having a policy, how can we approve improve those arrival rates? You know us here at ICE, if you've been listening to us for a while, Jeff Moore, our CEO says it best. The first thing you can do to make patients show up to physical therapy more is make sure that you're focused on getting good and not getting busy. That when people see results, when they begin to associate value with their physical therapy appointment, they come to their appointment more often. I think this is so overlooked, especially in a higher volume clinic where a therapist may be expected to see multiple patients per hour. By providing lower quality care, patients aren't able to get results or they're not able to get results as fast as maybe they want to. They don't really associate physical therapy as a valuable use of their time and it makes sense that they find better stuff to do and that you get that message at 4.55 p.m. that your 5 p.m. patient is not going to make it in today. So really focus on getting good, not getting busy. We also need to recognize that people are not stupid. When they show up to PT and they see that you are working with three other people at the same time and you have forgotten about them in the corner at the TheraBand station or on the recumbent bike or the pulleys, again, that really begins to lower the value proposition that patients have with physical therapy and it's not surprising again that they begin to find better stuff to do with that hour of their time. The counter argument here is that you can get so good as a physical therapist, I'm good enough that I can see multiple patients at once or patients aren't as fragile as we think. We don't need to give them one-on-one care, but we need to recognize that at some level, patients are paying for it, especially if they're paying cash for a one-on-one visit. They are expecting one-on-one treatment. Even if you are an insurance-based clinic and using a patient's insurance, that insurance is still paying you based on one-on-one care. And not only that, but the patient expectation is that you are going to give them the care that they need. And I often relate this to other professions of you would lose your mind if you had a therapy appointment with a psychologist, a mental therapy appointment, if you showed up and there were three other people getting mental health therapy at the same time as you. No one would put up with that, but for some reason, it's just expected and normalized that that's the kind of care that we give in physical therapy. So then it's no wonder that patients, again, find something better to do with their time for the hour. So really focus on getting good and not getting busy, of taking really quality care of that patient that you have on your schedule for that hour. And you'll be surprised how much they come back to physical therapy when they see their range of motion improving, when they see their balance improving, when they feel stronger, when their pain is getting better, whatever their goals are, as they can see progress towards their goals, it's much more likely that they're going to come back to physical therapy. And I think that is often overlooked. My second point with improving arrival rates is to leverage technology, implement that multi-method reminder system. It's 2023. There is no reason why your clinic does not have automated reminders, text, email, phone, whatever. It's all built in to a modern EMR. If your EMR does not do this, you need to get an EMR that does this. If your front desk person is still calling people by hand to remind them of their appointment, you're a little bit behind the curve, right? to do the work for you so that you can focus on treating your patients while the technology sends out those reminders for you. We need to recognize that people are busy and that the more we can be prominent in front of mind with reminders, the more likely people are to attend their appointments. We have research that supports this, right? We can cut these no-show cancellation rates in half with a multi-method reminder system, but also it gives the patient a chance to reschedule if they know they already can't make it, right? That text reminder, when they get that phone call, when they get that email, it gives them multiple chances to reschedule. And if they don't, it also kind of builds the case for you against them that you gave them plenty of chances to reschedule and they still did not. And that makes it a little bit easier to charge them money, which we'll talk about in a few seconds here. So remember, we can cut that rate in half, that no-show cancellation rate in half with a multi-method reminder system. So if you're still using Google Drive as your EMR, if you're still using paper documentation and scanning it into a computer, consider getting a modern EMR. They're not that expensive. EMRs, we're big fans of Jane here, obviously, at ICE, other EMRs, Prompt, PT Everywhere, pretty much all the modern web-based EMRs are going to offer reminders and more often than not, they're free for you to use. So why not use them, right? It's one more push of a button when you're building out that patient chart for them to get reminders. In addition to reminders, leverage technology to create an online booking and waitlist system so that when you do send that reminder, it should come with a link where it says, hey, if you can't keep this appointment, please click here, right? So that your appointment comes off my schedule and that you get a little link to rebook at a time that works better for you. So we still keep that visit on the schedule, but we also open up that visit to maybe somebody else who can use it so that we don't have a missed slot on our schedule. Pretty much just like reminders, modern EMRs are very good at having automation with waitlists of where when a patient reschedules and a slot opens up, usually automatically or with the push of a button, you can pull people in from your waitlist and make sure that that slot stays filled without having that patient get charged for cancellation or no-show because they were able to go in on their own and reschedule their own appointment. So make sure we're leveraging technology whenever possible to do this work for us. My last point here on improving arrival rates is probably something that we don't consider very often of making sure in that initial evaluation that the patient actually has the time and or money to come to their physical therapy appointments. I feel like a lot of time patients feel beholden to maybe a referral they had from a doctor or what you tell them of some sort of verbal contract of the doctor said I have to come here three times a week for six weeks or maybe that's what you wrote on your documentation is the physical therapist and they feel like they have to come no matter what, even if they know they do not have the time or money. I feel like this is something that should be discussed as we're wrapping up our initial evaluations that just doesn't get done. As we're building the bike for that patient, we're explaining our findings, we're demonstrating that we can help that person reach their goals by showing them some improvement in that first visit and as we begin to discuss what that plan of care might look like, also making sure that the patient is on board, right, including the patient that conversation of hey, Diane, this seems to be a pretty irritable tendinopathy. You know, I think I would like to see you here in the clinic twice a week, probably for at least the next four weeks. And instead of stopping there, take it one step further. How do you feel about that? Right? What do you think about my plan for your care? And we don't necessarily have to ask, hey, can you afford this? Or do you have the time for this? But that's what we're hinting at of how do you feel about coming here twice a week for four weeks? How do you feel about coming here once a week for the next four weeks and getting the patient's input because that's a great time for them to say, that's going to be tough with my schedule. You know, I have 17 kids or I work 30 jobs. I won't be able to do that, right? That's a great time to make sure that person does not get put on your schedule for a bunch of visits that they're not going to attend. And then making sure we're following the law, right? No surprises act that was passed last year that were very transparent with how long we think the plan of care is going to take and what that's going to cost that patient. Whether you're charging cash, whether you're billing insurance, you need to provide that information upfront to the patient. I would argue you should be doing it even if it's not the law, just so you don't have people on your schedule who are not going to show up. But being very forthright and how long you think it's going to take and what's that going to cost and get that patient's input on it before we talk about scheduling out for their visits. 19:05 GETTING PAID FOR MISSED APPOINTMENTS My last point here of talking about what average arrival rates are, what improves arrival rates is how do we get paid when somebody does not show up to the clinic? This is another area where I think physical therapists are very uncomfortable with asking people for money to come to rather not come to their appointment. And it's an area where again, when we look at the research, what improves arrival rates, multi-method reminder system and having a rescheduled cancellation policy that is enforced. If you don't enforce it, you can't get paid for these missed visits. And if you try to enforce it like halfway through the plan of care, the patient is probably going to be upset versus if you're straightforward from the start in your intake paperwork and with your expectations before they begin physical therapy, it's not as jarring to that patient when you charge them for that canceled or rescheduled appointment. So remember, combination of a reminder system and a clearly stated 24-hour rescheduling policy that's enforced are the keys to reducing your no-show cancellation rate by as much as 50%. So first things first, create a policy. What do you want your policy to be? Make sure that policy is very clear, very transparent and that patients see it before they actually come to the clinic. So for us here at Health HQ, this is the first thing that patients see when they go through their intake paperwork. They see our cancellation no-show policy. They see our rates. They know what they're going to be charged. They know the maximum they can be expected to pay out of pocket if they do have insurance and they're going to see what they can be expected to be charged if they cancel or reschedule appointment within 24 hours. So ensure you have a policy, make sure it's actually written out, make sure that it gets in front of patients before they commit to a plan of care and then decide on what you want to charge that person. Decide on what your rate will be. I would argue it should be what you would want to get paid for that hour even if the patient had come. A lot of clinics will have what I would call a dinky, kind of a really lackluster enforcement policy where maybe if you don't show up to your appointment, you're charged $10 or $15. That's really not enough for people to have skin in the game. Being charged $10 or $15, especially if you don't actually enforce it, is really not going to set the expectations for your patients the way you want it. For us, we want to be sure the patient, sorry, the therapist gets paid as if they had seen that patient even if the patient no shows or cancels. So we charge $75 and we enforce it. Right? How do we enforce it? Well, you should probably start obtaining payment methods before the plan of care begins. So again, somewhere in your intake, transparent, clear, laid out should be what you charge for cancellation, a no show, a reschedule, the amount, and that you should take a payment method and have that payment method on file even before the initial evaluation happens so that even if they don't show up to the evaluation, your therapists are able to get paid for that hour. And then actually enforce it. You have to enforce it. You have to rip the bandaid off and actually do it. If you don't do it until somebody has done this to you 19 times, it's going to be difficult to actually start enforcing it because you've let them get away with it so many times. Maybe your personal policy in your mind is that everybody gets one freebie. Whatever that is, stick to that and then start actually enforcing it. What you'll find is that when you enforce it, guess what? The first time that patient gets charged that money, guess what they never miss again? Physical therapy. Or they reschedule so that they don't leave an empty spot on your calendar book. So recognize that we have to enforce this. Yes, it's uncomfortable, but the more you do it, the sooner you do it in the plan of care, the more you'll find patients will either adhere to it or they might decide therapy with you is not for them and that's okay too because the end result is we want people on our schedule who are actually going to come to physical therapy. We need to recognize that this is not unusual. Oftentimes we said, well, this isn't something physical therapists do. They don't charge people for not coming to appointments. Literally every other industry on the planet does this. When you make an appointment to get your haircut or whatever personal beauty grooming thing you do, they have a reschedule cancel no show policy where if you don't show up to your appointment for whatever reason, you're probably going to get charged a little bit of money. Massage therapists do this. Lawyers do this a lot. You have to pay money upfront to even talk to a lawyer, right? You have to have that retainer money on file. Dentists do this. Other healthcare providers do this. This is very, very common across a wide range of industries except for physical therapy. People often ask me, why do you think that is? I think it's because we spend a lot of time with our patients and we begin to almost view some of our patients maybe as friends or at least acquaintances, which makes it that much harder to begin to charge that person for missing a physical therapy appointment. So we need to recognize that yes, it is difficult, but again, every other business does this. Every other industry does this. The sooner and more comfortable you get with enforcing this, the less awkward it's going to feel. And remember, leverage technology to fill those missed appointment slots so that ideally the therapist still gets paid for that person not showing up, but maybe they can also fit another patient into that spot still. I love when I pull up our schedule and I see that somebody has canceled, they've been charged for it, and we've been able to pull another patient from the wait list to fill that same slot. That therapist went to work, came to work here that day thinking, I'm going to see seven people and they actually got paid as if they had seen nine. That's fantastic, right? That's way better than systems where you may be expected to clock out if a patient doesn't show up and not get paid at all for your time, or you may be expected to clean the toilets or something like that in that missed time versus actually getting paid for that time and either being able to use that time for whatever you want or trying to fit another patient into that slot. So remember, it's really important here. This is all an end, not or situation that there are different components to this that we need to implement. It's not just we need to charge people for not showing up. It's not just we need to have a reminder system that we need to understand that at some level, having 100% arrival rate is unlikely. People not showing up is unavoidable, whether kids, family emergencies, that sort of thing. But there are things that can be done to reduce those rates. They're not unavoidable that we can deliver great outcomes to patients so that they do not find other reasons and other things to do instead of coming to physical therapy. We absolutely have to get with the program and begin to leverage technology, begin to send these reminders out if we're not doing it already, begin to use technology to have a waitlist system so that we can fill empty slots quickly, create and actually enforce a policy, get credit cards on file, begin to actually charge people for not coming to those appointments, hold them accountable, hold their feet to the fire, but also recognize and have that conversation early on of what is realistic for that patient. Do they actually have the time and money to come to therapy two or three times a week? Or do we need to look at maybe, hey, I can see you once every other week, but you're going to have to be really judicious at home with your homework because you're not coming here as much. So having those conversations early and often in the plan of care so they don't come back to bite us later on and then utilize technology to get paid for those visits and fill those empty slots. So reschedules, cancels, no shows, not to the end of the world, things we can do better to get better at them, I should say. Leverage technology, enforce a policy. So I hope this was helpful. I hope you all have a fantastic Thursday. Have fun with Gut Check Thursday. If you're going to be on a live course this weekend, have a wonderful weekend with our faculty on the road. We'll see you all next time. Bye everybody. 24:17 OUTRO Hey, thanks for tuning in to the PT on ICE Daily Show. If you enjoyed this content, head on over to iTunes and leave us a review and be sure to check us out on Facebook and Instagram at the Institute of Clinical Excellence. If you're interested in getting plugged into more ICE content on a weekly basis while earning CEUs from home, check out our virtual ICE online mentorship program at ptonice.com. While you're there, sign up for our Hump Day Hustling newsletter for a free email every Wednesday morning with our top five research articles and social media posts that we think are worth reading. Head over to ptonice.com and scroll to the bottom of the page to sign up.

Dr. Julie Brauer // #GeriOnICE // www.ptonice.com  In today's episode of the PT on ICE Daily Show, Modern Management of the Older Adult lead faculty Julie Brauer discusses the idea that passion alone is not sufficient for thriving in a career. She mentions that while it is possible to sustain a career solely based on passion, it is not sustainable in the long run. Julie shares personal experiences and acknowledges that many colleagues and friends have also encountered this issue. She emphasizes the importance of considering the entire ecosystem, including supportive management, colleagues with similar philosophies, and a network of supportive friends, family, and partners. Without this support system, Julie warns that burnout is likely to occur and that the initial passion will start to diminish. The episode emphasizes the need for a supportive ecosystem, where managers value and understand the contributions individuals bring to their work. Julie also mentions the importance of growth and opportunities for advancement, as well as being surrounded by like-minded individuals who share a fitness-forward approach. Take a listen to learn how to better serve this population of patients & athletes. If you're looking to learn more about live courses designed to better serve older adults in physical therapy or our online physical therapy courses, check our entire list of continuing education courses for physical therapy including our physical therapy certifications by checking out our website. Don't forget about all of our FREE eBooks, prebuilt workshops, free CEUs, and other physical therapy continuing education on our Resources tab. EPISODE TRANSCRIPTION 00:00 INTRO What's up everybody? Welcome back to the PT on ICE Daily Show. Before we jump into today's episode, let's chat about Jane, our show sponsor. Jane makes the Daily Show possible and is the practice management software that so many folks here at ICE utilize. The team at Jane knows how important it is for your patients to get the care they need. And with this in mind, they've made it really easy and convenient for patients to book online. One tip that has worked well for a lot of practices is to make the booking button on your website prominent so patients can't miss it. Once clicked, they get redirected to a beautifully branded online booking site. And from there, the entire booking process only takes around two minutes. After booking an appointment, patients get access to a secure portal where they can conveniently manage their appointments and payment details, add themselves to a waitlist, opt in to text and email reminders, and fill out their intake form. If you all are curious to learn more about online booking with Jane, head over to jane.app slash physical therapy. Book their one-on-one demo with a member of their team. And if you're ready to get started, make sure to use the code ICEPT1MO. When you sign up, that gives you a one-month grace period that gets applied to your new account. Thanks, everybody. Enjoy today's show. 01:43 JULIE BRAUER Good morning, crew. Welcome to the Geri on ICE segment of the PT on ICE Daily Show. I'm brought to you by the Institute of Clinical Excellence. My name is Julie. I am a member of the older adult division. Excited to talk to you all this morning about five things I've changed my mind about in Jerry PT over the past, I think it's like eight-ish years now of my career. So I actually have a list of like eight or nine. It keeps growing as I keep thinking about things, but I'm going to try and keep it to around five. And so my hope is that over the past eight years of all the mistakes I've made and the paths I went down and the things I've learned, I'm hoping that someone out there listening today, if I can inspire and encourage you to think a little bit differently, to do a little bit differently, if I can save you a little bit of heartache that I've experienced, then I will call this a 100% success. Okay, so these aren't necessarily in order of importance except this first one. So number one of five things that changed my mind about in Jerry rehab, changing settings will fix your burnout. Changing settings will fix your burnout. It will not. If you are in a situation where you feel really unhappy, you feel burnt out with the job that you currently have and the setting that you currently are in, please know that the grass is not always green around the other side. I promise it's not. 03:08 "CHANGING SETTINGS WON'T FIX BURNOUT" It's not necessarily that changing settings is going to fix your burnout. Identifying why you are burned out and doing something about the root of the problem is going to fix your burnout. So I'm not going to get into this too, too deeply because I've done an entire podcast specifically talking about burnout and those of you who are thinking home health will fix that. So if you are interested in that specific podcast, send me a message and I will send you the link. But as an overview, I just want you all to know that you have to identify why first before you jump ship. So the why could be a multitude of different things. Is it truly that you are not passionate about an athletic population and you actually are passionate about a more acute, medically complex population of older adults? Is it that you really want flexibility in your schedule and you can't stand the back to back, the back to back schedule of inpatient rehab? You have to be able to verbalize and write these things down about why you are so burned out in your job. 04:51 BURNOUT IN DIFFERENT THERAPY SETTINGS I spent many years starting out in acute care, getting burned out, thinking that I was going to love inpatient rehab. I was convinced I'm going to have more time with my patients. I'm going to be able to follow them. I'm going to be able to do higher level therapy with them. It's going to be so much better. I went into inpatient rehab. I absolutely hated it. And then I was like, all right, home health, total flexibility. I'm going to be able to see less patients a day. That's definitely going to be the setting for me. Nope, that wasn't it either. What I was doing is thinking that changing up setting was just what I needed to do. And in reality, for me, I came to the conclusion that full time clinical care is what was burning me out. It did not matter what the setting was. And I wish that I would have realized that very, very early on in this process. Now, I learned a lot and I'm really happy that I have experience in all of these settings. However, I could have been much further along in really dialing in what I want to spend my time and effort towards. If I would have thought of that earlier. So those of you that are really burned out, you're thinking about jumping ship. Don't do it. Start to really evaluate those things. Okay, next, you can give a really high quality session and a really efficient session without timing yourself. This is simple. No, you can't know. You absolutely cannot give a really high quality session that is also efficient unless you have yourself on a clock. For the entire session and truly throughout your entire day of doing your job. I think it's really hard because we go from PT school where all we have to do in a day is study, right? Like if our eyes are open, we are like, well, I have to learn the brachial plexus today. And that's all I have to do. So all I'm going to do is sit here for hours upon hours upon hours and study and memorize things from a book. And then we get into clinical and then we get into the real world where we have this thing called productivity. We have to meet while we are also trying to maintain our sanity. And all of a sudden, it is very overwhelming to try and bring quality at the same time as being efficient. So my call to action to you all is put a clock on yourself for your entire day. When you are with your patients, when you are not with your patients, it will change your life. I promise you when I started doing this in home health and you start this just like you start anything, like if you are starting to train for a race, for example, and you know you have to hit certain macros, you need to just start by tracking. What do you normally eat? How many calories are you actually bringing in? So you don't change anything at first. You just track. So you time yourself all of your breaks, your bathroom breaks, your snack breaks, your chatting with colleague breaks, the amount of time it takes you if you are in home health to drive to patient to patient, the amount of time that you are sitting in acute care at the desk and documenting. You time everything. In addition to how long you are actually spending with your patient and how long you are actually doing those subtitles of your session like education or neuromuscular read or gate training, whatever it is, you time everything. You will realize all of your inefficiencies. You will realize, wow, my hourly rate is actually crap. So when I timed myself when I was in home health, I timed everything. And I realized that if I was spending 60 minutes with the patient and I was actually hustling to get everything else done, calling doctors, etc, etc. I was making $40 an hour. Not ideal. Once I started timing myself and figuring out where I could cut, I went from $40 an hour to over $60 an hour. I have an entire podcast just on how to improve efficiency in home health. Again, if you were interested in that, message me and I'll send you the link. So again, my call to action for you all is use your phone. Your lap timer on your stopwatch is really helpful. Wear your Apple watch time every single thing. Start there, track it for a week, and then start chipping away at where you can cut places where you're really inefficient. Not only will you be able to give time back to yourself, which is what we want at the end of the day because taking care of humans all day is exhausting, but your patient sessions, you will get them so much more fit in so much less time. That's a win-win. So start timing yourself. 10:53 PT's DON'T NEED TO TAKE PATIENTS TO THE BATHROOM All right, next. PTs don't need to take patients to the bathroom. PTs don't need to take patients to the bathroom. That is an OT's job. That is a nurse's job. That is a tech's job. Man, this is one thing that I may be like the most sorry about. What I feel so guilty about for years in my career is that I'm with the patients and I'm wrapping things up, right? I know that I want to get out that door so I can get to my next patient. I'm done. I've done my PT thing and they ask me to take them to the bathroom. It's that moment you're like, I really need to get out this door. And what would I say many times? You know what? OT is coming to see you later this afternoon. They will take you to the bathroom and work on toileting. Then for right now, I'm going to press that button and your nurse is going to come and take you to the bathroom. So many of you have been there. I know you are. I know you've done this. But guys, what do we know happens or not happens? We press that button. Nobody comes. Our patient is sitting there uncomfortable. They may not actually get to the bathroom for a very, very long time. What we know from the literature why we have to change our mind about this and start doing this differently is that many falls in acute care. A very high percentage of them happen in the bathroom. This is avoidable because what is happening? Our patients ring the bell. Nobody comes. And then they have the choice of urinating on themselves or continuing to, and sitting there and waiting or breaking the rules and trying to rush to the bathroom where maybe they're on pain meds, their balance is off, they slip, et cetera, et cetera. We need to realize that is our job. We are not above any freaking job when we are with those patients in acute care. They need their butt wiped. We wipe their freaking butt. That is our job. It is patient care. We are all in this together to get that patient out of this DM hospital and back to their life wiping their butt, taking it in the bathroom. That's included. The very basics of giving this dignity back to this human. It is not a particular person's job. And think about it, even from a self-serving perspective, how much information you learn from taking a patient to the bathroom. You are watching them transfer. It gives them motivation to get out of bed versus like, let's get out of bed and go on a walk and lift these weights, right? You get to see how their ambulatory capacity, right? You get to see their balance. You get to see their problem solving, their stand pivot, how they have e-central control getting down to that toilet. Are they able to problem solve how to sequence those steps? Can they grab the toilet paper? Do they know how to use it? You get so much valuable information. And maybe watching someone toilet and saying, I know that looks off. It seems like they don't know how to sequence this, but I don't know the language to put to it. And I don't, this isn't really something that I understand how to treat, right? Yes, your OT partners are going to be able to take that baton that you hand them after you give them an information. And they're going to be able to do a much better job in that specific task, right? It's collaboration. We need to be setting our patients up for success. Never, ever, ever, ever from today forward, please PTAs ever tell your patient, that is someone else's job, someone else's job. I'll go tell the nurse when I leave. It is your job. You should start planning for this in your sessions. Just give some time before you absolutely have to get out that door. Give five, six minutes to a lot for this patient needing to use the bathroom. It is your job. We are part of a team and you can prevent something drastic happening like falls or someone losing their dignity by literally having to urinate on themselves. 18:21 ALTERNATIVE HOME EXERCISE OPTIONS Next, weights are the best pieces of equipment to initiate loading with older adults. Weights are the best pieces of equipment to initiate loading with older adults. Look, I love being able to get my older adults, especially those who are pretty medically complex and deconditioned, lifting weights, right? All of you all, this ice crew, your fitness forward, you are incredibly enthusiastic about this. However, if we focus too much on that, I think we can be actually increasing the barrier to loading versus decreasing it, which is our job. We need to realize that the best equipment older adults are using to introduce loading are not necessarily weights. The best equipment are the objects, the animals, the people, the boxes, whatever the odd things are that are in someone's life, an older adult's life, that they will lift, push, carry, pull, hinge. Those are the best pieces of equipment to introduce loading for an older adult. That may not be a weight ever, ever. If it is, amazing. I love it. Bonus points. The best equipment is the one that our patient is actually going to use. I love how enthusiastic we are. And if we can get our older adults lifting weights, wonderful. But ask yourself, like, is this sustainable? Is this only going to be something that they do with me? What am I doing to allow sustainability and longevity of loading with this older adult that they will continue to do after I am no longer caring for them? When our plan of care is over, have I decreased the entry point to loading so much that they have a technique that they can use on their own? Are they going to buy those weights off of Amazon that you've told them? Are they going to have a family member go and buy the dumbbells from Walmart? If they're not, then you better have another option. You better have something that they can use around their home that's less intimidating, that's cheaper, whatever it is. And not over here. Try to introduce the weights, but also give them something that's incredibly, incredibly convenient, right? Where you're decreasing the barrier of making the right choice, which is introducing loading, and we need to make it convenient. So I would argue that while I would bring weights in my backpack, walking around the hospital, I will bring weights in my trunk when I go to see my patients in home health. A resistance band, not a TheraBand, a rogue resistance band, many times was the best piece of equipment to introduce loading to an older adult. It's not intimidating. It's versatile. Not only can you use it to introduce loading and resistance, but I love to use those resistance bands for balance reactions. You can do a lot of perturbations with them. You can put them on the floor and use them as like an agility ladder. They are incredibly versatile. They're light. They're easy to carry around with you. Many older adults are not intimidated by them. Many times, a resistance band is the way to go. Many patients, I am not getting weights into their homes for these really sick folks in home health. It's just not going to happen. They're not going to make it there. So you need to make sure that you have something that is going to be practical for them and it's going to be sustainable. For me, it has been a resistance band. Give that some thought. Maybe go onto Amazon today when you're ordering your other stuff and getting your cart ready for Prime. Add a rogue or some other brand. It doesn't have to be rogue, but a actual resistance band to your cart. Okay. Last one here before we go. 23:53 SUPPORTIVE ECOSYSTEMS IN YOUR CAREER Last one, most unpopular opinion. You can thrive in your career on passion alone. You can thrive in your career on passion alone. I don't think this is true. I have experienced, and I know many of you have experienced this, many of my dear friends and colleagues have experienced this, that you can survive in your career on passion alone, but it's not sustainable. You have to think of your entire ecosystem. If the only thing that is able to get you up and get you out of bed and get you going to your clinic, your hospital, your patient's home is that you love treating older adults. You love the relationships you build. You were so called to better serve this population. If that's it, if you do not have supportive management, if you do not have colleagues that think in the same way that you do and share your same philosophy, if you don't have supportive friends, family, partners, you are going to really start to burn out. That passion is going, that fire is going to start to diminish. It may not go out completely, but damn, it's going to be a lot harder to keep that going. It is absolutely critical that you are in a supportive ecosystem, that your managers value you. They understand the value that you're bringing. They offer you opportunities to grow and advance and to really stretch your skills that you are surrounded by other people who feel the same way, who want to charge forward with a fitness forward approach. You need to have friends and family and people that you're maintaining your relationships with, and they need to be supportive of what you're going after. You need to create that ecosystem. When you don't have that, I think so many, and I believe this for a long time, as much as I care about this mission, this thing, this job, older adults, as much as I care about it, it will be tempered. That fire will not burn as bright if we do not have the support from all those different parts of our ecosystem. It just gets to a point where maybe you're just running on fumes. Start to think about who your ecosystem is within your job, your managers, your colleagues. Do you have growth? Are you challenged? Are you very passionately connected to your team, to the mission, and about your personal relationships? How are they supporting you? How many individuals have you built up around you that are there to support you? Really start thinking about that. Okay, that's it. I think that was five. Just to review, five things I've changed, or maybe six, five things I've changed my mind about in Jerry Rehab. Changing settings will fix your burnout. You can be efficient and give a high quality session without timing yourself. PTs don't need to take patients to the bathroom. Weights are the best pieces of equipment to use to introduce loading to older adults. You can thrive in your career on passion alone. Five things I've had a massive, massive thought switch as I've gone through my career. Hopefully you all found some of those things to be really helpful. It gave you some things to think about. Please, if any of that spoke to you, do one thing today to change how you think or change what you do. To close this out, I will let you guys know what we have coming up in the older adult division. We have tons of courses. We are going to be in Lexington next weekend. That's our MMOA summit. The entire crew is going to be there. We get to check out Stronger Life with Jeff and Dustin. They're spot there. We absolutely can't wait. We are in Texas, Minnesota, and California for the rest of August. Then MMOA Central Foundations starts next Wednesday. One week from today, our online cohort starts. That cohort is filling up rather quickly. We took a little bit of a break in June and July. If you're interested in that course, I would not wait. I would get your ticket ASAP. All right, guys. Have a wonderful rest of your Wednesday. 25:49 OUTRO Hey, thanks for tuning in to the PT on Ice Daily Show. If you enjoyed this content, head on over to iTunes and leave us a review. Be sure to check us out on Facebook and Instagram at the Institute of Clinical Excellence. If you're interested in getting plugged into more ice content on a weekly basis while earning CUs from home, check out our virtual ice online mentorship program at ptonice.com. While you're there, sign up for our hump day hustling newsletter for a free email every Wednesday morning with our top five research articles and social media posts that we think are worth reading. Head over to ptonice.com and scroll to the bottom of the page to sign up.

Ich werde ganz oft gefragt, wie man so richtig schöne Muskeln durch das Training bekommt. Es gibt ganz viele unterschiedliche Trainingsmethoden, die man anwenden kann. Wichtig ist, dass man die einzelnen Muskelfasern, die man gerne „schön“ hätte, mit speziellen Trainingsvarianten trainiert. Variation spielt hier eine große Rolle. Du bekommst in diesem Podcast alle Infos zu
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This is part two of my Q and A sesh. I apologise in advance to the people whose questions I didn't get to. I answered them in the order I received them and simply ran out of time. Here's what I explore this time (and who asked)..   MAGDA: Vibrational energy. Quantum physics. Please explain, I just want to know a true Aussie bloke's take on this. *BTW (Harps here), asking me this question is liking asking your toaster to explain time travel. Prepare to be underwhelmed. ALISON: You don't eat lunch so interested to know what sort of breakfasts you have to keep you going all day? JAIMEE: Thoughts on GP's prescribing exercise literally on a script pad and visiting and exercise physiologist and exercise equipment purchases (eg. TheraBand) instead of leaving with a script for medications from a pharmacy. KYLIE: Piggy backing off Martin and Matt in regards to purpose. I have heard Harps talk some about purpose and purpose does come up in my own discovery of myself and journalling and with professionals. I'd like to hear Harps view on… Is your purpose and goals the same or are they different things? Is purpose what you are on earth to do and goals ways of achieving this purpose. ERIN: What are your best ideas for breaking out of a funk? Random ones, not run-of-the-mill stuff like sleep or exercise or meditation or the like. KYLIE P: What are you views on “manifestation” after Geoff's views on part 2 of his podcast. FRANK: What do you do for your rotator cuff that brings relief? Op or no op.. that is the question! Enjoy.See omnystudio.com/listener for privacy information.

Im Winter sind die Tage kurz, oft dunkel, kalt und schmuddelig. Das Trainieren und Bewegen an der frischen Luft fällt schwer und am Ende des Tages ist es nicht gelungen, rauszugehen. Du ärgerst Dich und nimmst Dir vor, es am nächsten Tag zu tun. Da ist das Wetter bestimmt besser… kennst Du das? Ich gebe Dir in diesem Podcast motivierende Tipps, wie es Dir gelingt, TROTZDEM zu trainieren und Dich zu bewegen. Ganz einfache Punkte, die auch Du umsetzen kannst und die Dir helfen, fit, gesund und vital zu werden. #KerstinHardtPodcast #healthyfitandconfident #motivationzumtrainieren #fitdurchtrainingauchimwinter #trainingimwinter #trainingstipps #trainingdraußen #

Im täglichen Leben ist es leider nicht so, dass Unfallopfer in der Heilbehandlung begleitet werden. Durch die fehlende Struktur und der Tatsache, dass die Betroffenen den Ärztinnen und Ärzten ausgeliefert sind, kommt es immer wieder zu Verschlechterungen der Unfallfolgen. Dies beeinflusst dann zum einen die Haushaltsführung aber auch die Teilhabe am Arbeitsleben. Eigenübungen sind nämlich nicht immer zielführend, so sehr sich auch ein Unfallopfer anstrengt mit Theraband und Co. zu arbeiten. Im konkreten Fall ist es zu einer Verklebung der Schulterstrukturen gekommen. Für das Unfallopfer bedeutet dies eine erneute Operation.

Ausgesprochen wird Barre-Workout «Bar-Workout». Das Wort Barre ist das englische Wort für den Barren, genauer den Ballettbarren. Und an dem wird das Training gemacht. Mit Musik und Hilfsmitteln wie dem Theraband werden Elemente aus dem Ballett mit Fitnessübungen kombiniert. Andrea Blumenthal ist Fitness- und Barre-Workout-Trainerin mit eigenem Studio in Bern: «Barre-Workout ist zwar schweisstreibend, aber ein Training für alle.» Ein Workout für alle und alle Problemzonen Barre-Workout ist auch ein Training für die Problemzonen Bauch, Beine, Po, es werden Kraft und Ausdauer trainiert. Besonders sportlich muss man nicht sein und Ballettvorkenntnisse braucht es auch nicht. In der Gruppe oder Online Barre-Workout kann man auch zu Hause online üben. Einfach Barre-Workout in die Suchmaschine eingeben. Zu Hause dienen dann ein Stuhl oder ein Tisch als Ballett-Barren. Vorteil, wenn man im Studio Barre-Workout macht: Man macht die Übungen wirklich, die Instruktorin kann korrigieren und der Ballett-Barren gibt Stabilität. Zudem ist auch ein Blick in den Spiegel hilfreich, wenn man ein Plié aus dem Ballett macht. Was bei einer Primaballerina federleicht aussieht, ist für nicht trainierte Laien ganz schön streng. Sich dabei im Spiegel korrigierend zu betrachten, hilft ungemein.

Death to the Theraband Want to make sure you stay on top of all things geriatrics? Go to http://PTonICE.com/resources to check out our Free eBooks, Lectures, & the MMOA Digest!

Dr. Alex Germano // #GeriOnICE // www.ptonice.com 

In diesem Podcast bekommst Du ganz viele Tipps von mir, was Du tun kannst, dass die Hose nach dem Urlaub nicht kneift. Urlaub ist schön und soll für Körper und Geist eine Erholung sein. Man gönnt sich was, ruht sich aus und lässt die Seele baumeln. Und genau hier liegt das „Problem“. Sich etwas gönnen ist toll, allerdings sollte man darauf achten, dass sich auch der Körper erholen kann. Gönnt man sich leckere Süßigkeiten, trinkt ein „Schlückchen“ zur Entspannung oder labt sich am Büffet, ist das für unseren Körper purer Stress. Kommt dann noch wenig Bewegung hinzu, schlägt es sich schnell auf unseren Hüften nieder und die Waage schlägt aus. Das muss nicht sein. Meine Tipps sind leicht umsetzbar und funktionieren richtig gut. So kannst Du ganz beruhigt in den Urlaub fahren, Dich entspannen und danach trotzdem noch Deine Lieblings-Jeans tragen. #KerstinHardtPodcast #healthyfitandconfident #schlankimUrlaub #tippszumschlankbleiben #schlankbleiben #

Über Monate hinweg plagten Jürgen Reis Schulterprobleme. „Klassische“ Reha- und Korrekturübungen wie Face-Pulls oder Außenrotation mit dem Theraband konnten keine Abhilfe schaffen. Doch dank des entscheidenden Ratschlags von Thomas Wulff, seines Zeichens auch Physio und Kletterer, bekam der Power-Quest.cc Mitbegründer die Schulterschmerzen wieder in den Griff. Die Lösung? Der sogenannte „Ring-Support“. Eine Übung aus dem Turnen, die von außen betrachtet, häufig als „zu einfach“ abgetan und doch von so vielen eben falsch ausgeführt wird. Daher erläutern Jürgen Reis und Athletiktrainer Sebastian Förster im sechsten Teil der Bodyweight-Training-Serie neben den Grundvoraussetzungen vor allem die korrekte Ausführung des „Ring-Supports“. Was es in diesem Zusammenhang mit Shoulder-Dislocations, Handgelenksmobilität sowie Stabilität, „Lockout“ der Ellenbogen und Schulter-Depression auf sich hat, erfahrt ihr in dieser mit Tipps und Fakten prall gefüllten Sendung, die im August 2019 live on tape ging.

In diesem Podcast erfährst Du, warum es so wichtig und gut ist, regelmäßig zu trainieren. Oft existieren (innere) Widerstände - das ist ganz normal. Ich erzähle Dir, wie Du diese Widerstände überwinden und transformieren kannst. Ich erzähle Dir von einer unglaublichen Geschichte zum Thema „Wertschätzung Deines Körpers“. Es ist die Geschichte eines Menschen, den ich im Urlaub kennenlernen durfte, der alles verloren hat und wieder auf die Beine kam. Ich gebe Dir Tipps an die Hand, wie Du Deine Motivation aufbauen und aufrecht erhalten kannst und wie Du unterschiedliche Trainingsreize setzen kannst, um die gewünschten Erfolge zu erzielen. ##kerstinhardt #kerstinhardtpodcast #healthyfitandconfident #regelmäßigesTraining #Trainigsmotivation #trainingTiefenmuskulatur #

Ausgesprochen wird Barre-Workout «Bar-Workout». Das Wort Barre ist das englische Wort für den Barren, genauer den Ballettbarren. Und an dem wird das Training gemacht. Mit Musik und Hilfsmitteln wie dem Theraband werden Elemente aus dem Ballett mit Fitnessübungen kombiniert. Andrea Blumenthal ist Fitness- und Barre-Workout-Trainerin mit eigenem Studio in Bern: «Barre-Workout ist zwar schweisstreibend, aber ein Training für alle.» Ein Workout für alle und alle Problemzonen Barre-Workout ist auch ein Training für die Problemzonen Bauch, Beine, Po, es werden Kraft und Ausdauer trainiert. Besonders sportlich muss man nicht sein und Ballettvorkenntnisse braucht es auch nicht.  In der Gruppe oder Online Barre-Workout kann man auch zu Hause online üben. Einfach Barre-Workout in die Suchmaschine eingeben. Zu Hause dienen dann ein Stuhl oder ein Tisch als Ballett-Barren. Vorteil, wenn man im Studio Barre-Workout macht: Man macht die Übungen wirklich, die Instruktorin kann korrigieren und der Ballett-Barren gibt Stabilität. Zudem ist auch ein Blick in den Spiegel hilfreich, wenn man ein Plié aus dem Ballett macht. Was bei einer Primaballerina federleicht aussieht, ist für nicht trainierte Laien ganz schön streng. Sich dabei im Spiegel korrigierend zu betrachten, hilft ungemein.

Today, I am going to be bringing to you information about Cyclops Syndrome in your orthopedic patients. I will be talking about...▶ How it presents in the clinic.▶ How to prevent Cyclops Syndrome▶ Causes of Cyclops Syndrome▶ The difference between a cyclops lesion and cyclops syndrome and much more!!

Let's pull out the old theraband and get to work!!  

Guest: Mr Paul Timko Dr. Jay and Brad talk to InReach's founder, Paul Timko, who began his career in medical device sales and marketing over 15 years ago as a commercially-focused financial analyst at Radiometer America. His experience then led to multiple roles ranging from strategic planning to sales management to class III medical device product launches. Most recently, Paul led the growth and expansion of two leading clinical brands, TheraBand and Biofreeze, during his tenure at Performance Health. He has developed a network of leading clinical influencers and distribution partners across the hands-on health care markets. His experiences have allowed him to work with all sizes of companies from small, medium, and large medical device companies to startups to private equity to Fortune 500. With a B.B.A. in Finance from Ohio University and an MBA from Kent State University, Paul continues to stay abreast of the latest trends, strategies, and innovations in the hands-on health market segments by surrounding himself with leaders in the industry. Today, Paul's focus and passion lies with assisting companies like yours to not only succeed but to grow profitably.

On this episode of the Healthy, Wealthy and Smart Podcast, I welcome Dr. Chris Johnson to discuss empowering runners through rehab. He is a Seattle-based physical therapist, performance coach, speaker, and multiple-time Kona Qualifier.    In this episode, we discuss: Is resistance training needed for runners? Are training errors to blame for running injuries?  How can clinicians guide the decision-making process around pain and return to running? Chris's best advice to be a running injury expert.  How can the profession of Physical Therapy be thought of as your best friend in healthcare. The importance of being present and curious.     Resources: Chris's Instagram  Chris's Facebook Chris's Website How to Improve Profits AND Profit Margins in Your Practice Webinar from New Health Running Round Table Talk    More About Dr. Johnson:  Chris Johnson completed his undergraduate studies at the University of Delaware, where he earned a bachelor of science with distinction while completing a senior thesis in the physical therapy department under Dr. Lynn Snyder-Mackler. Chris was a member of the varsity men’s tennis team, scholar athlete, captain in 2000, and recipient of the Lee J Hyncik award for excellence in athletics and academics. He remained at the University of Delaware to earn a degree in physical therapy while completing an orthopedic/sports graduate fellowship under Dr. Michael J. Axe of First State Orthopedics. Following graduation, he relocated to New York City to work at the Nicholas Institute of Sports Medicine and Athletic Trauma of Lenox Hill Hospital as a physical therapist and researcher. He remained there for the ensuing eight years until 2010 when he opened his own physical therapy and performance facility, Chris Johnson PT, in the Flatiron District of Manhattan. In May 2013, Chris and his wife relocated from New York City to Seattle to pursue a more active, outdoor lifestyle. In addition to being a physical therapist, Chris is a certified triathlon coach (ITCA), three-time All American triathlete, two time Kona Qualifier, and is currently ranked 16th (AG) in the country for long course racing. Chris is also extensively published in the medical literature and has a monthly column on Ironman and an elaborate youtube channel.   Subscribe to Healthy, Wealthy & Smart: Website:                      https://podcast.healthywealthysmart.com Apple Podcasts:          https://podcasts.apple.com/us/podcast/healthy-wealthy-smart/id532717264 Spotify:                        https://open.spotify.com/show/6ELmKwE4mSZXBB8TiQvp73 SoundCloud:               https://soundcloud.com/healthywealthysmart Stitcher:                       https://www.stitcher.com/show/healthy-wealthy-smart iHeart Radio:                https://www.iheart.com/podcast/263-healthy-wealthy-smart-27628927   Read the full transcript here: Speaker 1 (00:00): Hey, Chris, welcome back to the podcast. I'm so happy to have you on in our month. All about running and running injury and running rehab. So thank you for carving out the time. Speaker 2 (00:11): It's fun to be back it's it's always a pleasure to connect with you. And it just snaps me back to New York city and I still don't know how we never crossed paths when when we were both there, but here we are, and I'm glad we connected and also happy women's history month. You're someone who's sort of spearheading a lot of great stuff in this space. And I think a lot of people, especially women look up to you and that you're a role model. So things that you've accomplished and continue to work on. Speaker 1 (00:47): That's very kind. Thank you. And now today we're going to do a basic Q and a with Chris Johnson. So Chris gets tons of flooded with questions and comments and things like that from emails to social media. And so I thought, well, let's see if we can make life a little bit easier, reach a wide audience and get some of these questions and concepts under control for you and out to the public. So let's start with a common question that you get is all is kind of around resistance, training and running. Do you need it? Do you not need it? I know that's a really broad question. So I'll throw it over to you around the the, the concept of resistance training and Speaker 2 (01:40): Yeah, and it's a, it's such a great question. I think that everyone's default answer is, you know, basically resistance training is a Holy grail for runners. And I do think it, it has its place, but I think that there are a lot of gaps in the research. And is it something that I prioritize myself as well as in working with the athletes I coach? Absolutely. But I think that anytime you're working with the runner, the primary goal is to get them into a rhythm with their training and to establish consistency of training. And then you can consider to start layering things in this is assuming someone's training and they're healthy. They have no remarkable past medical history. I, I think that, you know, the answer to that question differs especially if we start to get into master level runners who typically have a remarkable past medical history because most of these injuries and conditions go under rehab. Speaker 2 (02:41): You and I both know that as clinicians. So I think that a lot of the resistance training may just be cleaning up sloppy rehab that perhaps they didn't get around to addressing things at the tail end of the rehab. So there's a quote that I love, which is, you know, resistance training is really coordination, training under load. So, so yeah, I do think it has its place but it should be there to support our running, into build our capacity to run, but I've seen a lot of people get it wrong and they end up whether it's, if they're racing, they go into races where they're a little bit sluggish or they're carrying some residual fatigue. I've seen people get injured in the weight room if they're not perhaps if they're, you know, younger and more green. So yeah, I, I do think it has its place, but like everything you have to approach that, that runner athlete on an individualized basis and just understand where they're coming from. Speaker 1 (03:40): And in your experience, working with runners, what are the biggest barriers to resistance training for runners? Because not everyone has, you know, access to the same equipment and time and everything else. So what, what have you found to be the biggest barriers to resistance training? Speaker 2 (04:00): I think a lot of runners are intimidated by it unless they come from perhaps a multi-sport background where they've spent time in a weight room. I think right now with the pandemic, obviously resources and equipment or gyms are not as accessible or gyms opened in New York city right now are on a limited basis. Speaker 1 (04:22): They're open on a limited basis. I think you have to make an appointment a certain times and things like that. Speaker 2 (04:29): Yeah. And then I think that when people do get to the gym, they may not know what to do, and they may resort to something that they see on social media, some of the time, which might be fine. But I think that with running running has predictable performance demands. So it shouldn't be a mystery in terms of what we're trying to do. We're trying to challenge the calves, quads, lateral hip. And we're also we're not layering this in a ton. We're layering it in maybe twice a week on average. So but yeah, I think a lot of runners lack direction, and that's something that, you know, I try to put out a ton of content online. So people start to see how I'm approaching it. And I'm trying to essentially synthesize the literature and translate it to to just the everyday runner. Speaker 2 (05:18): And I think that there's also this element of rhythm and timing with running and that doesn't always get addressed through resistance training. I think perhaps a little bit more since some of Ebony Rio's research, but again, that's really in the rehab sector space talking about tendons, but I think that a lot of the TNT work or the tendon neuroplastic training work just has such salience to resistance training programs as well. So anytime, you know, people work with me, they're, they're going to get accustomed to using a metronome. It's just one more factor variable that I think that we can control for when we're prescribing. I Speaker 1 (05:58): Love the metronome. I love it. Love Speaker 2 (06:01): It easy. After a while though, I Speaker 1 (06:03): Give to everyone, even with my, even with my younger athletes, they get it, you know, and actually with those younger athletes, I'm talking teens, it's using the metronome, although they're like, Oh my God, I have to listen to this again. But it is actually good to give them a little bit of discipline around the, around the movement, around the exercise. But I love, I love the metronome. I have my patients like download the metronome, get used to it when you're exercising. I know it can be a little monotonous, but I think like you, like you said that with the research of Ebony Rio and others, I think it gives people, I don't know, like a, a little bit more discipline around their training. Speaker 2 (06:49): Yeah. I use it a lot when, if I'm giving someone calf raises something like a rear foot elevated split squat. If we're basically doing like a three zero three where it's like down on three seconds, up on three seconds without pausing yeah. It helps to maintain this rhythm. And a lot of the times I'll stop the exercise when they break that rhythm. Because it's telling me that, you know, maybe we're starting to reach the upper end of their abilities for that given exercise. Speaker 1 (07:18): Right. And we all know that three seconds to one person is very different to another. Speaker 2 (07:22): Yeah. Well, and this is what, you know, when Scott Morrison talks about anchoring and I just did that Instagram post on, you know, stop being awake or start to anchor. I'm starting to realize I'm becoming a dissenter. But you know, that's where the metronome comes in. And I've played with this so much. I mean, my, my neighbors probably think I'm crazy because I'm like out front with a metronome going, and I'm doing all these weird exercises. Well, weird to them. Speaker 1 (07:49): What sort of things do you implement to get over the barriers? Well, you just answered that. Anything else that you may implement to get over barriers to resistance training for runners? Like, like you said, in that runner who is very intimidated, maybe never used resistance training before. Speaker 2 (08:06): Yeah. I mean, I, a lot of the times when patients show up to my house, I mean, I'm working out of my garage. We have a space on our property, you know, when they arrive a lot of times I'm deliberately training. So they see what I'm doing and they see that this is a normal part of my routine. And then they get a lens into my racing background, yada yada. And so I want them to realize that this is something that is normal. And I think in a lot of running circles, and I think this is starting to change that it's not prioritized to the extent that it is. And maybe I'm just getting older because, you know, as a master athlete, it's amazing having dealt with some patellar tendon issues, like my body craves resistance training, where if I don't do it, I start to sort of get reminded. My knee feels so much better after I load it and load it relatively heavy. Now you have to be cognizant for reasons I mentioned before, in terms of like, you're not going to want to do a bunch of heavy squats. If you have a race coming up you can keep your body under load, but you need to be a little bit more calculated with your exercise selection as well as your dosage. Speaker 1 (09:12): Yeah. And, and that's where I think working with a coach or therapist or someone who understands understands one resistance training and two race training and how you can kind of blend those together is really important. And now sticking with training, let's talk about training errors. Can we just blame everything on training errors? Is that, is that an okay thing to do now? Or am I, is that not good? And I say, I say that with a wink for those people who are listening. Speaker 2 (09:40): Yeah. I mean, I think it's a convenient thing to do, but I think that I'm going to get myself in trouble here. I think it's a little bit lazy too. In, in, I think that having lived in New York city that you realize the life load factor, right. You know, there's different stressors in New York, between loud noises, you know, smelly things, you know, financial stressors in crowded spaces, you know, maybe your sleep has fallen by the wayside. So you may have a training program that's very sensible. And, and then all of a sudden you have something come up. I think to one of my, I'm an athlete who I'm working with right now, and this guy's just been just so tough and durable. And recently things have started to take a turn in a bad way. You know, he, he lost his mom. Speaker 2 (10:38): He's been having to contend with that. He's had some other job-related issues and and then he he's come down with the patellar tendinopathy and his training didn't change that much. And we actually dialed it back a little bit and it just shows it sometimes all of these other factors, you know, play such an important role in the overall being or totality of that athlete. So, you know, I, I, I think that we'd be much better off calling them ecosystem EHRs where perhaps there's a disconnect, but I think that we have to be careful, always blaming it on training. And I, I get the point, I think that, you know, from a, from a research standpoint, maybe the reviewers are requiring the authors to, to present it in that manner. But I just think there's a lot more moving parts. And I find myself having worked with a ton of athletes over the course of my career, being an athlete that you have to really be in touch with your ecosystem. Speaker 2 (11:39): And I don't know who first came up with that word. I know Greg uses it quite a bit, but I think it's something that, that is great to consider. And anytime I start working with an athlete, I have a conversation and it doesn't end during that initial consultation or phone call, but I'm saying, tell me about your life. What was it like growing up? You know, what, what was your relationship with food? You know, what kind of sports did you play? You know, were you in public school? Did you go to private school? What was college like if you went to college, you know, what's your current situation? Are you single? Are you married? Do you have kids? Are you a single parent? You know, I need to capture all this information and that's just scratching the tip of the iceberg in that conversation's never ending. So I feel like the more I know where people are in life, the easier it becomes to start putting down sensible workouts on paper and make sure when you put them down on paper, they go and pencil nodding. Speaker 1 (12:34): Yeah. I love that. Getting deeper into those questions and, you know, we had a conversation a couple of weeks ago with the surrounding a female athlete on clubhouse and Tracy Blake, who is just fabulous. I don't know if you're familiar with Tracy. She's a physical therapist in Canada. She's worked with a lot of professional athletes there, including their Olympic volleyball team. And she was talking about questions to ask. And I think oftentimes this is sort of floated over kind of skimmed over by a lot of PTs because we asked, tell me about, tell me what happened, what happened with your injury? Tell me what happened here, not the questions you just said. Tell me about your life. Are you married? Like Tracy said, you know, a question she always asks is, do you have children? Do you have pets? What, cause that gives you an idea. What are your responsibilities throughout the day? Yeah, Speaker 2 (13:29): I always say, you know, look, give me a lens into your situation and let the conversation unfold from there. And I think, you know, whether you're a physical therapist or coach, I think all physical therapists or coaches, whether they realize it or not, you know, you're, you're trying to basically capture that ecosystem. And to, to just have, you know, talk to people about, you know, I just have a candid chat with folks and from there, then we can start pulling levers. Speaker 1 (13:59): Right? Cause then you're getting a, really, a more holistic view of this person. And then you can say, okay, they have two small children they're working from home. Their kids are being at school, school, they're at home. They don't have the time to spend two hours a day between training and running and everything else. And how can you make things work for them? Is that about right? Yeah. Speaker 2 (14:25): And I think that any, any time a patient or athlete consults us, they're looking at us as an agent of change and the true agent of change is themselves. And it's trying to help them plot out their own course. And maybe you, you know, you're shining a light on the path here and there, or making sure that they don't step into a pothole along the way. But that's something that, you know, I find myself more and more. I have any expectations to, I don't do things to people. I sit there and troubleshoot with them. And, and I think that that's what we, as physical therapists are phenomenal with. And not only do we have the skillset, but a lot of times it most of us have positioned us to have the time to do that. And you can't rush that process. So but yeah, we're, we're not in a system that incentivizes that, you know, you don't get paid to talk to people, you get paid to do things to people. And that's the fundamental problem with, for the reimbursement structure, for people who are in network. I mean, you and I are a little bit spoiled in the sense that when we're providing care, it's just ourselves and the patient, but that's, I think that needs to be the standard or approximate the standard. Yeah. Speaker 1 (15:41): And isn't it like amazing when that aha moment comes as you're sort of talking through things like you said, troubleshooting, and the patient goes, Oh, wait a second. I can do blah, blah, blah, blah, blah. Or, Hey, maybe that I didn't even think about that. Maybe that is contributing to XYZ. Speaker 2 (15:57): Yeah. And I, that's a lot of motivational interviewing and sometimes, you know, I was talking with a couple of people yesterday. Sometimes people who've already arrived, you know, if we're, if we're discussing surgery, you know, I think our goal is to always try to help people avoid surgery, but sometimes people are just dead set and you say, look, you know, I get the sense that you've really just you've arrived at the fact that you're going to have this surgery. Am I correct in saying that, and you know, if that's what you've elected to move forward with, this is your decision. What questions do you have about the surgery? You know, and, and then you may start getting into a conversation and say, Hey, can I, can I share my experience? You know, this happened to me with my clavicle. I was in Hawaii, we'll be traveling to Argentina to speak. Speaker 2 (16:44): My wife was pregnant. We had a little one, I was going to have to do a lot of physical tasks. And I'm like, I just need the surgery. I didn't have it on my right shoulder when I, my clavicle fracture. And I was just dead set. I'm like, I'm in Hawaii, there's a competent doc. This is not a super involved procedure, like a soft tissue procedure of the shoulder hip. And I had this and I could have been kicked myself for doing it in hindsight, but no one would have talked me out of that at the time. So sometimes people have to learn through their mistakes and sometimes that can be a tough pill to swallow, but that, that patient ultimately controls that decision. So sort of bobbing and weaving, but, Speaker 1 (17:25): And, you know, you just led perfectly into the next topic I wanted to cover. And another question that you get asked often and that's, and that is surrounding pain and pain and decision-making, so we, you, I feel like you led perfectly right into that. So let's talk about how we as clinicians and practitioners, where our role is when it comes to pain and decision-making for that client or that athlete. Speaker 2 (17:53): Yeah. It's it's one of the first things, if not the first thing that I discussed with people I did a book chapter for this it's called clinical care of the runner. Dr. Harris. Who's a physician at university of Washington was the editor. And he asked if I would read a chapter on training principles. And I essentially said, the first thing that we needed to discuss is someone's relationship with pain and what their understanding of it is and how they approach decision-making in around pain. Because if you're running, you're going to be dealing with pain at some point, you know? And and I think people have an inaccurate understanding a lot of the times. So, and I think sometimes we, you know, I'll use an analogy that Mike Stewart or you used which I think is brilliant. You know, sometimes when we're out training and we're driving through a school zone, right? Speaker 2 (18:48): School's in session, the lights are blinking, slow down. All right. Sometimes you may be driving through that crosswalk. School's in session lights are blinking and you have a crossing guard. Who's standing in the middle of the stop sign. Maybe that's a case of someone's dealing with the bone stress injury. So you need to really hate that. Other times you may be driving through that school zone. It's a weekend, no blinking lights proceed as is usual. And I think that's a good way to think about training, but you know, you and I both know that if someone has a lower limb tendinopathy, you know, we want to monitor their pain and understand how it's responding as a function of a particular training session, whether that's a run, whether it's a plyometric training session or a heavy, slow resistance, but we don't want to shut that person down in it. Speaker 2 (19:37): As much as we in our profession may be, high-fiving each other thinking that we're doing a good job of this. Most of the people that consult me, even people perhaps worked with me in the past for short periods of time. They still, when they experience pain, they assume damage and inflammation. And what do they do? A lot of times they, they they'll resort to taking anti-inflammatories and here we go. I mean, this is a, this is where things go South. So I think it's just important to say, Hey, what sense do you make of this? You know, what do you, what are your reservations? Are you okay working through some pain? And I think from there then the stage is set to proceed. But with a lot of, I've worked with a lot of master athletes and they're, they've had a history of lower limb tendinopathy. Speaker 2 (20:23): I know that with my left knee, that, you know, I, I worked through almost a year of pain, but I never stopped training. And I was just sensible in how I was staggering, my workouts to afford appropriate recovery time. And and also just knowing how college and synthesis behaves. So yeah, I think that people have a, a skewed understanding and it's also something very personal, but yeah, if you're working with athletes, it's a critical conversation to have. And I do think that this is where I know Ellie was on talking about bone stress injuries, that if you are remotely concerned about a bone stress injury, and it involves a high risk site, like zero out of 10 pain is the goal. Most other instances, I'm a little bit more cavalier, but if I know, if I see some of the signs that I would associate with the bone stress injury, especially if we haven't had imaging, I'm going to be conservative as hell. Yeah. Speaker 1 (21:19): And I think it's important to, to note that understanding the runner and that's where understanding the ecosystem comes in and understanding, especially for bone stress injuries, where those high likelihood of those injuries occurring. So it also like you have to know your stuff as well is what I'm getting at when it comes to runners and, and having that conversation around pain can be uncomfortable for that runner or for that person. Cause you may have to dismantle a lot of long-held beliefs. So how do you go about that with your, your athletes? Speaker 2 (21:57): I just asked everyone who who connects with me. I say, can you give me w what, what's your understanding of your situation? You know, and I think runners, a lot of times may not come clean if they're dealing with pain, because if they go to see a healthcare professional, they're going to be concerned that they're going to get shut down work. Perhaps they interpret it as a sign of weakness. If they're out on a group run, they don't want, want to be the one complaining. So I just say, Hey, you know, what's your understanding of your situation? And no one's ever asked him that. And that's when the conversation unfolds. So, and I think the way people respond is going to be different pending the person, the situation. But I think it's remissive anyone who's working with a runner or an athlete if they don't ask that question. I feel like I started to answer your question, but I don't know if I do. Speaker 1 (22:48): No, you did. That's exactly what I wanted. That's exactly what I wanted to hear. Cause I want the listeners to get as much of this like great little tidbits of information from you as they can. And you know, all of the questions, the questions to ask the patient that you've given so far, I think are great jumping off points for any therapist, regardless of whether you're working for, with a runner or an athlete. But that question of give me the, let me know, what is your understanding of what's going on? And that opens up a whole lot of doors for you. And then, you know, as the therapist, you have to be well versed in the science behind pain and, and how to talk to people. And, and of course it's a whole other conversation, but you know, I think what you're highlighting here is that you can't wing it. Speaker 2 (23:36): No. And I think sometimes, you know, I had a question from a third year DPT student who watched a presentation. I gave at some and they're like, Hey, I feel like I'm starting to ask the right question, but then I don't know how to respond and follow up. And and I think that, you know, you can't rush this process if you're in, if you're a young clinician that you're going to get better at this through reps, through life experience and just through sort of being in the trenches with people. But you know, the other thing I tell folks is I say, look, you're a smart person, you know? And I, you know, when I first acknowledge the fact, I think it's good that you're being proactive and addressing the situation, but left to your own devices. What do you feel like you, you need to do to get on the other side of this and they start to formulate a plan and I do, I don't need to do anything. Speaker 2 (24:27): I just need to pose these questions and say like, I think that's pretty sensible, you know? Are you okay if we nudge a little bit and you start to basically prepare them for the fact that this plan has got to be progressive, if we're talking about getting them back to running, because they have to get back to a low-level plyometric activity. And I just love these conversations. And, you know, people ask me, they're like, where you learn motivational interviewing. And I'm like, I lived in New York city for decade. I'm like, I just talk to people and I have no agenda. I'm just curious, you know, it drives my wife crazy. Cause if we're ever out in public this happened yesterday. I went to, I had to get a new watch because my watch crapped out and this guy was checking out some watches and we just got to talk to me. And my wife was looking over at me, like, where are we go? Speaker 1 (25:12): Your wife is looking at her watch, like, come on, Chris, get it together Speaker 2 (25:18): And things off the shelves. Speaker 1 (25:21): But it's true. I think that, you know, asking good questions, motivational interviewing a lot. Yes. There's a lot of books. You can pick any book on motivational interviewing and read it and it will definitely give you some insight, but it's the more you do. It's the more people you talk to and not just your patients, anybody, the more you talk to anybody, it will help you be a better motivational interviewer. And the more that you listen and like really listen and start to formulate it's practice. I guess you start to formulate your follow-up questions in your head as you're listening. And again, it's just practice, practice, practice. Speaker 2 (25:57): Yeah. And it's, it's fine. I think that it takes on a slightly different flavor as a function of, you know, what generation the person's coming from too, you know? So but yeah, it's just fun to help troubleshoot with people and to really get them to trust in themselves. Because most of the, the folks that consult me, I mean, they're endurance athletes, namely runners and triathletes these days, and they're going to manage their situation conservatively. Sometimes I feel like they need to be talked off the ledge. If they're going to opt for a more invasive procedure, if that's not really appropriate or perhaps an injectable of some sort. So, but yeah, getting people to trust in their body and and not drag them in for therapy all the time, you know, and I, I have to prepare people for that to say, you know, how do you anticipate this is going to go? Speaker 2 (26:49): And they're like, well, maybe I'll see you two to three times a week for six to eight weeks. I'm like, who's footing that bill. No, no, one's good. Yeah. So I say, you know, but this, this requires a lot of work on us on the back end because when I write an email, I mean, email, I wrote to this person yesterday, it was basically like, you know, two pages and cause it, kids dealing with the bone stress injury, the parents don't really understand the implications of it. He's going to be running competitively in college. And, and I think that he was under the notion that he was going to be back to running in four weeks. And I'm like let's talk about more like four months. And I lay this out and I'm like, you know, I know this is probably a little bit, you know, overwhelming, or you weren't expecting to hear this. What are your thoughts on this? You know, to engage him, to just know where he is after I've presented this information and he got the memo. But that's, that's a tricky thing about bone stress injuries is people fall under the, you know, the idea that they're just gonna take a couple of weeks off and plugged back in. Speaker 1 (27:49): Yeah. Yeah. And again, that's where you, as a, as a therapist and a coach comes in and helps the decision-making you're ultimately, you're not that runner, you're not that athlete. So you're not the ultimate decision maker, but your job is to give as much information and, and your professional opinion as to their situation as you can. Speaker 2 (28:14): Yeah. And I, I think that it traces back to that question is like, what are your expectations or questions around this surgery? I mean, this is a very involved procedure. They're putting you under anesthesia and they're cutting your body open. Never we'll frame it like that, you know, when I'm working with people. But you know, I, I rehabbed all of these people after these very involved, soft tissue procedures of the shoulder when I was in New York, coming from Dr. Nicholas in his staff. And yeah, I'm like, this is going to be six months to a year before you feel like your, your shoulder is like firing on all cylinders. Speaker 1 (28:47): Yeah. Yeah. I had, I had a complex soft tissue shoulder repair and it was a year anyway, we can go on and on when it comes to a patient mindset, fear, trepidation, everything else. I think that's for another podcast. But I think you definitely got across the decision-making process on behalf of us as a therapist or coach and how we can influence that process for the patient. Speaker 2 (29:12): Yeah. And I think that if patients aren't on board, I mean, if they are around muddy water where there's a sinister situation and they start sort of dilly-dallying, I think that we need to really put our foot down his therapist too and say, look, you know, you've consulted me and here are my recommendations or here's my professional advice. And if you're not going to take it, let's just, let's just part here. And sometimes we don't need to do that a lot, but I think sometimes we drag our feet as clinicians and we need to, we need to put our foot down if we have to protect that person from themselves, because we can't get tangled up in that mess. I can't think of the last time that's happened, but it has happened over the course of my career. Speaker 1 (29:57): So those, I mean, those are sticky conversations to have, but for the safety, I mean, our job is to protect that, protect our, our athlete, our patients. So if that is our job, then you have to have those sticky conversations. Yeah. And that's it. All right. So I think that was thank you for that conversation on decision-making and hopefully it sparks plant some seeds in our listeners here. And now we'll go on to two more questions that you usually, that you get the easy ones. You will we'll breeze through these too. These are easy. How do you become a runner running injury expert To how many times do you get that question? How can I do what you do? Speaker 2 (30:41): Yeah, I it's, I, I love getting it it's flattering. You know, and, and it's something that it was sort of, I looked back and all, I, there, there were a couple of defining moments in my life. And one was when I was told that I'd never be able to run again. You will never run again. Right. I heard that a couple of times from very world-renowned orthopedists. And I think that's what ultimately put me on a trajectory to do this. And I never ran competitively when I was younger. I probably should have been channeled into a little bit more of a, a running program, but I was always playing sport, different sports, you know, from skateboarding to soccer, to tennis, to baseball, to basketball, to lacrosse, to, you know, rollerblading snowboard, like you name it. I played it. And except football, just because my high school didn't have a football team. Speaker 2 (31:39): So I always relied on running to help me in sport. But I feel very fortunate in hindsight that I never started really formal distance running until I moved to New York city around like maybe 24, 25. But I, I think that when I started getting into triathlon is when I started working with a lot more runners. And I think when I started distance running, that was around the same time and it's just a fun bunch to work with. And I think that initially I was overconfident and it got to be frustrating when I'm like, geez, this is a healthy person. Like I would send them out. I'm like, Hey, I think you're doing good. And they would come hobbling home. Or they would call him and be like, Oh, I blew up on that run. And I'm like, why are these people blowing up on these runs? Speaker 2 (32:25): Like I thought they were doing a good job. And then it just really forced me to stare at myself in the face and say like, what do I need to be doing to really help these people? And, you know, I started reading a lot of the research. I started spending time around runners. I started speaking a lot with this fellow Bruce Wilke, who was sort of like a savant with running who unfortunately has since passed. But I started to really get a handle on running and not only on running, but just the mindset of runners, how they approach training how they've sort of just been dismissed by the medical community. Because you're like, Oh, here's a runner here comes another crazy runner. And then you start to realize that runner, when someone tells you they're a runner, you don't have other athletes. Speaker 2 (33:09): When you meet someone, you know, you could meet someone, you could meet a world-class athlete and they may not come claim that the fact that they play a competitive sport professionally, or they play a professional sport until you talk to them, runners like I'm here, I'm a runner, you know? And so they really stuff, they go through an identity crisis. So you have to look at this from so many different lenses. You have to understand the performance demands of the sport. You have to understand, you know, just running communities. You need to understand that these people's identity revolves around their running. So they become fragile when they're not running. So I just loved the challenge of, you know, addressing all these different factors and and it helps that I, that I'm still training and racing competitively because I sort of go through, I think a lot of the same struggles and challenges that they face so I can speak to them. Speaker 2 (34:01): But I think that if people want to go, go in on running as a young clinician, coach running is having a moment go all in, right. We saw an uptick and running with the, you know, with the pandemic. And I think that if you're going to work with runners, you don't want to say like, Oh, I do general outpatient orthopedic, orthopedic rehab. It's like, no, my whole practice revolves around running. You know, people are like, they come to me because they know that, you know unfortunately I've had a pretty rich experience in terms of my, my didactic training. And, you know, when I was getting reps under my belt in New York city. So I feel like now I can look at things through a very global lens when a runner presents and we can troubleshoot most of the time, I'm seeing people for one, maybe two sessions. But I think that that running rehab is challenging in a lot of different ways, but if people have a, an interest go all in, Speaker 1 (35:02): I think that's great advice. And I also really liked that. You just mentioned, Hey, I'm not seeing runners three times a week for six to eight weeks. You know, I'm not, this is not how I'm, I'm, I'm building my practice. And I think that's important to let people know, because I think a lot of newer graduates or students might be thinking, Oh, this is going to be great. I'm going to be working with people several times a week for six weeks. And then they're all better. Not so much the case when it comes to running injuries. Speaker 2 (35:31): Yeah. And their runners just seem to perpetually get these niggles and aches and pains. But, you know, I, I, I think it's doing a disservice because if you bring someone in, if you say, Hey, look, I need to see a couple of times a week for the next six to eight weeks. You know, someone told me that I'm like, man, I must have something serious going on. So I just say, Hey, look I'm not concerned. Anything sinister is present. I want you to be sensible. You're around muddy water, but carry on. All right. In calling me if you need me. And I think that they're like, wow, I've had people reach out and are, you know, this person told me they were running five to six days a week and their quads were a little bit sore. I'm like, Oh, you're good, man. Speaker 2 (36:10): You don't need to see me. You know, I said, and I asked him some, some more involved questions, but I'm like, you don't need to see me. That's a really empowering message, you know, because the person's like, Hey, I'm here ready to pay you. And you're telling me that you don't want to see me. I, one of a guy who's become a good friend of mine. He was dealing with some hip pain. He was in a bicycle accident and he had some films in between x-rays MRR because of a woman who who's pulling out of a parking lot, had collide with him for whatever reason. And you know, and I got a lens, you know, I saw his power profile on his bike. I saw the lifts that he was doing because we were training at the same facility. And he's like, I, I need to come and see you for physical therapy. Speaker 2 (36:52): I'm like, no, you don't. I'm like, I'm watching you lift, man. You don't need to come and see for, you know, let's, let's just chat. If we cross paths here and he's become a very good friend, he, he always jokes. He's like, you're the only PT you've told me not to come and see you. He's like all these other people are like trying to get me in and get me on these programs and tell me, I need hip surgery and PRP and yada, yada. So, but you need to know that nothing sinister is going on the flip side of the coin. Speaker 1 (37:19): Right. And that's where experience comes in and confidence as a clinician comes in as well. And that takes time. So you're not going to be, so what I'm getting is if you want to be a running injury expert, go all in, read the research, do the things, take the classes and take time. It takes time and leave your ego at the door. Speaker 2 (37:39): Yeah. And I think the patterns will become, they'll become pretty straight away in terms of where runners are getting into trouble. You know, where are these injuries are manifesting? And, you know, I, I think that most of it is being disconnected or out of touch with your ecosystem and not laying down programs that sort of reflect your ecosystem and realize that target is always moving. Right? Speaker 1 (38:03): Yeah. Yeah. Excellent. Okay. Final question of our interview here. And again, it's, it's an easy one. So, so we talked about this ahead of time. This is an easy one. So, well, how do I even phrase this in looking at the profession of physical therapy, what can we do better to define what we do and kind of stake our claim on what we do as a profession? Speaker 2 (38:37): Yeah. I still am organizing my thoughts around this. I went into physical therapy because I thought it put me in the best possible position to help troubleshoot with people through a conservative approach. And I think that the challenge we have is physical therapy is a very tricky thing to define. And I think that where we're ultimately, and this is a quote from Jen Shelton, who was you know, in born to run, she was a young gifted ultra runner at the time. I don't know what she's up to these days, but she's she's a trip in all great ways, but she said physical therapists are your best friends in healthcare. And I think that we're well positioned to be the first line of defense because we're trained across such a broad through such a broad range. So, you know, you may see us working in cardiopulmonary capacity. Speaker 2 (39:40): You may see us working in wound care. You may see us working in a neurologic geriatric with geriatric population. You may see us basically with working with pro sports teams you know, pelvic floor. I mean, it's tricky when you have all these moving parts, but I, I don't think that we've defined who we are as a profession, to the extent that we need to. And and I think that's why a lot of other people end up defining us sometimes in good ways sometimes in bad ways. But I think that it's sort of like, you know, I'm in Seattle, I'm going to use a microbrew example. You know, you have run of the mill rehab. And I think some people lump physical therapy ended up, but physical therapy to me is sort of like a microbrew, right. We need to tell people what to think about it. Speaker 2 (40:34): We can't let them conjure up their own ideas. We need to really define who we are as a profession. And and I, I don't think we've done that yet. I think that we're, we're getting there, but I don't, I don't think we've done a really good job defining physical therapy. Cause if you ask people, you know, people are like, yeah, I've tried physical therapy and we know the same, the response, it's a heat ultrasound TheraBand. And it's always funny when people connect with me, they're like, this is so different from like what I expect to physical therapy to be. And I'm like, well, what did you expect it to be? And it was generally the response is what I just mentioned. And they're like, you just helped me troubleshoot and in sort of the seamless way. And, and that's what I think we do. Speaker 2 (41:21): We triage and troubleshoot. But we look at things through the people who I really respect in life. They're able to look at challenging situations through multiple lenses. And I think that that's how we're trained as physical therapists. And I think that that's why we're in such an incredible position to troubleshoot with people. So I don't know why you've got my gears grinding even more. And I, I, I think about this morning, noon and night is, you know, how do we better define our profession? So we don't let people conjure up their own ideas of what it is, because I think a lot of times if they've had a bad experience, that it becomes very skewed in physical just saying physical therapy doesn't capture it. Speaker 1 (42:09): Yeah. I agree with that. And so what can we do as a profession to change that? I agree it needs to be changed. And I agree we need to be the ones out in front talking about what we do and how we do it and why we do it. So when, when you think about that, what sort of ways can we be out in front and take control of the narrative? Speaker 2 (42:33): I mean, I think it needs to be orchestrated. And I think that that's, that's a major challenge right now. Because I think that is a profession we're a little bit more fragmented than, than one might think. So I think that we have to have a lot of people come together from different sectors of the field and have have a long, hard staring in the mirror and talk with each other to try and arrive in a definition for what we do. And I think it's a really challenging thing, but I think it's something that is very important, but I think also individuals like yourself where you start to represent the profession. You know, I try to do the same thing. I think that holds a lot of weight too. So I, I think it, you sort of have to take a multi-pronged approach. Speaker 1 (43:23): Yeah, yeah. So you have to take that 30,000 foot approach by having a lot of people from different areas come together and give that wide umbrella. But then from a micro position, individuals can also be out there and trying to, to change, to make a change. Speaker 2 (43:40): Yeah. And and I, I'm confident that we're going to do that. I don't know. I feel like I'm in my early forties now and I'm starting to become more reflective in life. Right. And and really think about, you know, a lot of things, one of which is a profession and, you know, I just feel like a pig in poop having landed in this profession because I'm such a diehard PT, but I also, like, I feel like the perception of physical therapy needs to change too. Speaker 1 (44:09): And, you know, I will say that I do see it changing slowly. I mean, this is a big ship to turn and I'm talking from a societal standpoint. And I say that because I see more and more in mainstream media, whether it be on television, print, blogs, podcasts, et cetera, that journalists are now reaching out to physical therapists. Whereas they would have reached out to a trainer, a chiropractor, a yoga instructor, or something like that when it comes to their articles on everything from training to, I just did an interview yesterday about pillows, you know? So it seems like, well, what, why would they reach out to a PT about pillows? You know, but it's nice that they are reaching out to PTs about things like that. And things about training and things about COVID rehab and, and long haul COVID patients, you know, physical therapists are now being part of that conversation. I'm seeing that more and more from main street, main stream journalists. So I feel like that's a good sign. Speaker 2 (45:12): Yeah, for sure. Speaker 1 (45:14): A good sign, for sure. And, and also showing that journalists are open to hearing from different groups. So I always say to physical therapists like contact your local newspaper, if you live. And, you know, I'm from a small town in Pennsylvania contact that local newspaper asked to write an article, ask to, you know, be a contributor, get onto your local news stations find, cause that's, that's the way the general public finds out, you know, on social media, there are some people like yourself and others that have great social media followings and are putting out great content designed for the consumer. But a lot of physical therapists on social media, probably myself included do social media posts for other therapists. So it's a little different, right. Speaker 2 (46:01): Yeah. And I think that's okay. And I think it's Speaker 1 (46:03): Okay. Yeah. But I think we, it could be broader. Speaker 2 (46:07): Yeah. I just, I think that when I work with folks and I, I'm not alone here, but when people start getting a lens into my thoughts on a particular situation, if they're like, Hey, I have some calf pain, they call me on the phone. They're like, they may be an athlete. And they're like, Hey, I have some calf pain, but a great example. This guy reached out to me the other day. And he was dealing with what he was told was an Achilles tendinopathy. And he was under the care of a physician and other rehab professional outside of the profession and I'll leave it at that. And when he came to see me, his primary complaint was he was starting to lose coordination in his left, lower extremity on the run. And he started to feel more disjointed on the bike. This isn't an Achilles tendinopathy. Speaker 2 (46:54): He may have symptoms that, you know, that are consistent, but that's not what's driving. So, you know, you start to think of, okay, well what could this be? You know, is there something going on maybe like from a differential diagnosis, you're starting to run through like, Hey, is he's telling you this, like okay, is this unilateral? Is that bilateral? You know, is there any loss of sensation, strength, power you know, is this, like if we just start asking a different set of questions, you know, could this be a runner's dystonia? Could it be something like multiple sclerosis, it could be ALS. So you have to, when someone says, Hey, I have this complaint, we're asking in terms of what's running through our mind and the questions we ask, they're very different. So I'm going to start challenging him from different coordination tasks. Speaker 2 (47:44): I'm going to take them through lower quarter screen. I'm going to get a lens into his running. You know, I'm going to understand how an Achilles tendinopathy would present if he's not having issues doing calf raises. And he's able to sit there and jump in place. I'm like, you're killing is, is pretty, pretty good, man. You know? So for whatever reason, there's this timing issue in his Achilles is probably seeing a different or an unaccustomed rate of loading that, that he's not withstanding from a timing perspective. So, you know, he's someone that probably ultimately needs to consult a neurologist, right? So why is no one told him that for a year? And they're telling him that he needs to do a more aggressive form of scraping and he's a candidate for a PRP, excuse my language, but that. Right. So this is where our role is just so critical because we sit, we spend an hour with people or at least, you know, a lot, and we, we can sit there and troubleshoot with people and really get them into the right hand. Why is no one ever he's like your assessment makes so much sense to me. And so many examples. Yeah, Speaker 1 (48:51): Many, many examples. Well, Chris, this was great. What a good conversation. I think there's a little bit of got a little bit of everything in here, and hopefully we answered a lot of w V a lot of the questions that you get on, on a daily, weekly, monthly basis. So thank you so much now, where can people find you? Speaker 2 (49:11): I can't tell you no, Speaker 1 (49:13): I'm going off social media now. Speaker 2 (49:17): Instagram is good. I'm just at Chris Johnson, the PT, and I'm in the process of revamping my website and that should hopefully be done at some point in the next couple of weeks. And and that's gonna really just, I think, make it easy to understand what some of my offerings are and how to sync up with me. And yeah, for folks, if, if you want to sign up for a crazy newsletter please join my newsletter. It's a little bit of reverence. So I'm preparing it now in, in good ways. So, Speaker 1 (49:49): And how can they sign up for your newsletter? That'll be on the website and Chris Johnson, pt.com or Zara and PT. Speaker 2 (49:56): Chris Johnson, pc.com. Yeah. Going back to my roots, Speaker 1 (50:01): Go keeping it simple. Right? Well, this was wonderful. Last question, knowing where you are now in your life and career, what advice would you give to your younger self now that you're, you're pondering, you're pondering life in your early forties. Speaker 2 (50:18): Oh, stop taking yourself so seriously be present with people, equally people, power, power, your phone off, and and be present with people. And for folks who are who are coming to see you understand that a lot of what brings about changes in what helps people are these non-specific effects, you know, during a clinical interactions. So don't feel like you need to have this gnarly didactic knowledge. That's going to come in time by continuing to read the research, spending time around other mentors or clinicians. You respect taking courses from them. But if you can just be present and engage with someone, take a genuine curiosity in their situation, that's going to do wonders and and yeah, take the pressure off yourself. Speaker 1 (51:07): Excellent advice. Excellent. And I thank you so much again, Chris, for taking the time out. And we will see you in a couple of days next in a week or so for a round table discussion, which I also think will be phenomenal. So thank you so much. Speaker 2 (51:22): Yeah. Thanks again for having me on Karen and keep up the great work. It's fun to, to just sort of follow your, your journey and calling me if I can do anything to support you. Speaker 1 (51:31): Thank you so much. And everyone, thanks so much for listening. Have a great week and stay healthy, wealthy and smart.

Kraft-Training zaubert schöne Muskeln und formt deine Figur. Kraft-Training kann aber noch viel mehr: - Es pusht deinen Stoffwechsel auf ein neues Level - du bekommst einen ausgeglichenen Hormonspiegel - du fühlst dich aufrecht, selbstbewusst und schön in deiner Haut. Wenn ich dir eines von Herzen wünsche, dann ist es, dass du Kraft-Training für dich entdeckst. Denn für mich war und ist Kraft-Training der absolute Game-Changer in meinem Leben. Ich sehe nicht einfach anders und schlanker aus, seitdem ich zu den Hanteln und zum Theraband greife. Ich FÜHLE mich ganz anders. Und damit du dieses Gefühl auch erleben kannst, bekommst du heute eine Riesenportion Sport-Motivation auf die Ohren! Auf dich! Und auf deinen wunderbaren, wertvollen Körper. Du hast es verdient, dich gut und stark in deiner Haut zu fühlen!

In unserer heutigen Folge wollen wir das Theraband kennenlernen. Dieses wollen wir nutzen, um unseren gesamten Körper zu kräftigen. Dafür werden wir vorrangig im Stehen arbeiten.

Theraband virtual session. Ready recovery ride and run. Working on breathing techniques. Completed modifications for few trainees. Misal Pav for dinner.

Deine Gelenke, Muskeln und Bandstrukturen benötigen eins: Bewegung! Wie holst du dir diese Bewegung ohne Fitnessstudio zu Hause? Springseil, Theraband und Co. können dabei helfen, fit zu bleiben. Welche Geräte in dein Zuhause gehören und was die Vorteile sind, erfährst du in dieser Folge. Thema: Fitness, Sport, Bewegung, Gesundheit, Muskulatur, Muskelaufbau zu Hause, Homegym, Training, Trainingsgeräte ◾Mein Instagram Accout https://www.instagram.com/connorbrand_personaltrainer/?hl=de ◾Meine Website https://c-p-personal-training.de/connor/ ◾Registriere dich für meinen Newsletter in dem du auf meiner Website das Kontaktformular mit dem Stichpunkt: Newsletter, ausfüllst. Ich freue mich riesig über jedes Feedback. Lasst mir eine 5 Sterne Bewertung da, wenn dir diese Folge weitergeholfen hat. Das würde mir helfen meine Reichweite zu vergrößern und noch mehr Menschen zu einem langen und gesunden Leben zu verhelfen. Vielen Dank Hier meine Produktempfehlungen: ◾Therraband:  https://amzn.to/2ZotJKu ◾Blackrolls: https://amzn.to/2LnF0Rs ◾Springseil: https://amzn.to/2ZvzshA

In this episode, Jayson chats with Hopemarie Hower, OTR/L, the winner of the OT School House School's Out Giveaway conducted in June of 2018. Together, Jayson and Hopemarie discuss the similarities and differences between practicing OT in California and Florida. Hopemarie also shares how she collaborates with her school team to conduct assistive technology assessments and how she garners buy-in from her teachers when implementing sensory strategies.  Don't want to miss out on future giveaways, be sure to subscribe to our email list!  Links to Show References: Contact Hopemarie Hower, OTR/L at Hopemariehower@yahoo.com Products mentioned on the show (Amazon/iTunes Affiliate Links that support the OT School House): Jelly Bean Buttons - Briefly mentioned in the episode, Jelly Bean buttons are used to help non-verbal kids communicate. You can record something like "Hello!" using your voice, then every time the student activates the button you will hear "Hello!" Simple as that.  Proloquo2Go - Also briefly mentioned during the episode, this is an iPad app that allows non-verbal students a more advanced system for communication. Think of the old bulky communication devices, but on a sleek iPad or iPad mini. It's a great app, but it's not cheap.  Velcro Dots - while designed to use together to make something like a poster easily stick to a wall. Us school-based OTs can use them in many ways. One way both Hopemari and I use them is as a sensory tool that kids can rub their fingers on. Just stick them to the underside of the desk and no one will never even know the student is regulating themselves by rubbing his or her fingers on some velcro.  Theraband - Often used to develop strengthening in sub-acute rehab settings, Theraband also can help kids stay in their seats while getting the movement they need. Take a 2-foot stand of this stuff, tie the ends together and wrap it around the child's chair legs. Now the child can keep their feet busy while attending to classroom activities.   Exer-saucer (aka ExerExer-bug, aka Flying Turtle) Scooter: It's funny how so many of the tools we use have so many different names. Hopemarie introduced me to this little tricycle which is powered by trunk movements. I can only imagine how many obstacles courses I could have used this in over the years! Purpose Therapy Box Find the perfect OT gift for yourself or your favorite OTP! Use promo OTSchoolHouse for 10% off!Back To School ConferenceLearn more & register for the OT School House: Back to School Conference before early bird registration ends!

Ask Win is a podcast where you are a VIP. Win wants to focus and teach people more and Cerebral Palsy. You’re welcome to ask questions about anything that you want. CP questions but mainly life questions on how to deal with CP or not. Win can ask you base questions if you want. Please let us know or there will be no base questions. If you have any questions for Win please email her at askingwkelly@gmail.com. In 2018 let be open and honest on Ask Win. To learn more about Ask Win visit http://askwin.weebly.com.  To buy an Ask Win top go to https://www.bonfire.com/askwin/?utm_source=intercom&utm_campaign=L2C_launch_success&utm_medium=email. Be sure to FOLLOW this program https://itunes.apple.com/us/podcast/wins-women-of-wisdom/id1060801905. To learn how Win walk and about Ekso go to http://www.bridgingbionics.org/, or email Amanda Boxtel at amanda@bridgingbionics.org.    On Ask Win today (Monday, April 30, 2018), Best-Selling Author, Win C welcomes Jonathan Pritchard. Jonathan help companies connect with their people. Jonathan have learned how to do that after nearly 25 years’ experience on and off stage. As a professional communicator, it’s his job to know how to connect with anyone, anytime. Ask Jonathan’s friends, they’ll tell you it’s his superpower, but Jonathan don’t come by it naturally. Jonathan had to learn it the hard way. Jonathan grew up as a poor kid in the mountains of North Carolina where he was painfully shy. Eventually Jonathan learned how to overcome it, and developed strategies for building confidence, and finding common ground with anyone. As a mentalist Jonathan have been on America’s Got Talent, entertained United States troops stationed overseas, performed on Vegas main stages, cruise ships, and on down the list goes. Eventually Jonathan figured out that the same psychological techniques that he use on stage to make people believe Jonathan can read minds, are the same techniques the best business people use in sales, marketing, and every other part of business. Now, companies like State Farm Insurance, Wells Fargo, General Assembly, Theraband, or Avant Credit hire Jonathan to help them connect with their employees at events, training conferences, and any time people gather; with their clients at tradeshows, customer appreciation events, or hospitality suites; and with their prospective customers through sharpening their marketing efforts. Jonathan now take people behind the curtain and teach them how to connect like a mind reader. Jonathan love helping people discover the same magic of connecting with others as I have for 25 years. When Jonathan is not on the road he get his mail in Chicago, maintain my black-belt martial arts teaching certification, and paint in Jonathan’s free time. Thanks for the time you’ve spent reading this. Jonathan appreciate you stopping by, and he look forward to hearing from you. Let’s connect! To learn more about Jonathan visit https://www.likeamindreader.com. To learn more about Win Kelly Charles visit http://wincharles.weebly.com/ and https://www.redbubble.com/people/wcharles. To talk to Win please call her at (970) 618-8840. To follow Win on Twitter go to @winkellycharles. To follow Win on Instagram go to winkcharles. To follow Win on Snapchat go to Wcharles422. To follow Win on Snapchat go to Wcharles422. To see Win's art go to https://fineartamerica.com/profiles/2-win-charles.html. Interview with Mel Marton: http://traffic.libsyn.com/winwisdom/LAF3494_08172017150526412_1189015.mp3. "Books for Books," you buy Win's books so she can purchase books for school. "Getting through school is a 'win' for her fans and a 'win' for her." Win is a professional writer and in 2018 she is going to get a new MacBook to write her books and do the podcast. With every book she sells and the donations from Ask Win will go to her new MacBook. Please support her in getting her new MacBook. Win Kelly Charles’ book “She is CP” will get to the New York Times somehow and to help her either by voting or send her good vibe. Please vote at https://soopllc.com/blog/book-ideas/cp-win-charles/. Please send feedback to Win by email her at winwwow@gmail.com, or go to http://survey.libsyn.com/winwisdom and http://survey.libsyn.com/thebutterfly. To be on the show please fill out the intake at https://goo.gl/forms/aS4L6FuHyDSUhvrj2. If you would like to support Ask Win go to https://www.patreon.com/wcharles. Ask Win is sponsor by The Teeki Ambassador Program: http://mbsy.co/teeki/35149532. Superwomen Secrets Revealed: Successful Women Talk About Fitting in Fitness and Dare You to Join Them on Amazon http://amzn.to/2gImve5. :) I have a Facebook page for the book http://facebook.com/SuperwomenSecretsRevealed Instagram http://instagram.com/SuperwomenSecretsRevealed and book page on the website: http://FitArmadillo.com/books. If you want to check out what Win’s friend, Dannidoll, is doing (a.k.a. Dannielle) go to https://www.facebook.com/dannidolltheragdollclown/?notif_t=page_invite_accepted¬if_id=1492366163404241. To learn more about Danielle visit http://www.dancanshred.com. For iOS 11 update: https://www.youtube.com/embed/HNupFUYqcRY. To learn about the magic of Siri go to https://www.udemy.com/writing-a-book-using-siri/?utm_campaign=email&utm_source=sendgrid.com&utm_medium=email. If you want to donate Ask Win, please send a PayPal donation to aspenrosearts@gmail.com or aspenwin@gmail.com. Please donate to the Bridging Bionics Foundation. Please send a check in the mail so 100% goes to Bridging Bionics Foundation.    In the Memo section have people write: In honor of Win Charles. Thank you in advance, Win.   Send to:   Bridging Bionics Foundation  PO Box 3767 Basalt, CO 81621   Thank you Win

Click here for this episode's show notes Watch our video on Foot Strengthening Please leave us a review at http://openskyfitness.com/review   Why Barefoot or Arch Support Shoes? On today's episode of the Open Sky Fitness Podcast, Devon and I are tackling the ultimate clothing question: Is it better to walk or exercise while wearing barefoot, minimal shoes are shoes with tons of arch support? Either way, why did we even begin to wear shoes in the first place and what makes barefoot or arch support shoes so important to our foot's health? Not only will we be discussing the pros and cons of either shoe,  but also: Anatomy of the human foot The structure of a shoe Traditional shoe problems How to transition into wearing barefoot shoes Some of our favorite barefoot/minimal shoe brands How to heal the foot   Anatomy of the Human Foot   "The arch structure is only as strong as where it's connected to the ground." - Rob Dionne   The human foot has three different arches: One on the inside of the foot (medial - longitudinal arch) An arch on the outside of the foot (the lateral - longitudinal arch) A third that spans across the pad of the foot (anterior transverse arch) Sometimes a pair of shoes that has good arch support isn't necessarily the best purchase choice for everyone.     Why Wear Shoes? The first shoes were introduced when our ancestors created Moccasins. Made out of animal hide, these shoes were meant to protect our feet from the outside elements. Since then, so many different types of shoes have been marketed to our desires. Shoes for perfect alignment, to improve our bodies appearance (I'm looking at you Skechers Shape Ups which have no beneficial value), or for work. Unfortunately, there's no magic shoe that can help our bodies. We have to work on our own to strengthen our feet and body.   The Structure of a Modern Shoe The modern shoe has three key parts: Soft toebox Heel lift Arch supprt A soft toebox with lots of padding is supposed to help improve comfort and shock absorption. A heel lift in the back of the shoe is meant to help align the body. For those who need it, the arch support is meant to help weak arches and to help keep the integrity of the arch.   Traditional Shoe Problems   "Your foot is designed with all of these different, small bones that help you balance and support your entire body. By wearing arch supports, your shoes are doing all of the work that the arch is naturally supposed to do and it weakens the foot." - Devon Dionne   If the toe box is too narrow, then it won't allow for the expansion of the feet. Your feet shouldn't be crammed in your shoe. Instead, you should be able to comfortably open and close them. The toe box might also be too soft and therefore it doesn't support the arch of the foot. When a shoe has an excess amount of arch support, it simply makes the foot lazy and weakens the arch. It keeps your foot in one position instead of allowing it to flex and move. Shoes with poor designs can also negatively affect our bodies. By constantly wearing shoes with little support such as flip flops, sandals, wedges with no heel back, or heelless shoes can harm the foot's health if they're worn regularly for long periods of time. In fact, these shoes change how we walk because we need to clench our toes to grip the shoe. Each step forces us to change our feet to be in a fixed, improper position.    Pros and Cons of Barefoot Shoes   "Because there's minimal padding between your foot and the ground, you have as much contact as you need to activate the feet's arches. When the feet make direct contact with the ground, it sends stronger signals to the brain. The foot and brain connection is more sensitive because it allows for more nerve waves to talk to each other."  - Rob and Devon Dionne   Barefoot shoes like Vibrams and other minimalist shoes offer zero to minimal padding so that you have full contact with the ground. There's just some rubber and a bit of fabric that makes up the bottom of the shoe for comfort.  This allows for all of the muscles in the foot to stay engaged and therefore it for forces the arch muscles to stay active. By relying on your feet to balance your entire body, you also become fully aligned and don't have to solely rely on the shoe to help stabilize you. However, you have to take it very easy when wearing barefoot shoes for the first time. Unlike regular shoes, there is no heel cushion which forces the wearer to strike on the ball of their feet when they walk or run. These can easily harm the foot if a person doesn't change their gait.   How to Transition to Wearing Barefoot Shoes We can't stress it enough, but it's vital to have a slow transition to wearing barefoot shoes. You don't want to wear them all day or to go for a hike when you first wear them because your feet and calves will be in so much pain the next day. Instead, start by wearing the shoes for short periods of time. If you want to run with them, practice with a walk-run routine for 5-10 minutes by walking with them for 5 minutes, 1 minute jogging and so on. Recommended Barefoot and Minimal Shoe Brands Some of the different brands of barefoot or minimal shoes for walking and running that we recommend include: Merrell Vibram New Balance MT10 Xero Sanuk Vivo Barefoot Nike Free   Nike Free has more padding and a bit softer and is a great transition shoe for full range of motion and wear those for 6 months to get used to them and THEN start that process over again with minimalist shoes. Make a slow transition and be smart about it as well as patient.     Arch Supported Shoes Pros and Cons   "Our feet have such an incredible design. The way that the arches are designed allows us to absorb impact with each step, run, or jump. Our feet relate to our entire body's structure - how our knees bend, how our hips bend;  it's all connected." - Devon Dionne   The main reason why some people need to wear shoes with arch support is because it picks up the slack for our feet's weaknesses. Many doctors will also say that it can help our body's alignment and improve pain management. However, the external support can create weakness and muscle atrophy because you're not allowing your foot to do its job to support the body.   How to Heal Foot Problems We can heal our feet by focusing on opening  and strengthening the muscles. Some easy tools can include a foam roller as well as a lacrosse or tennis balls to help roll out your foot and relax the muscles. Golf balls are also great  to stretch out individual toes. We also recommend practicing toe articulation and calf raises regularly. The Yamuna foot wakers and and TheraBand products are also great to use whenever you experience aches and pain in your feet.     Join The Open Sky Fitness Podcast Group! That's right! We have a closed Open Sky Fitness Podcast group  on Facebook where you and everyone have the opportunity to talk about your health and fitness goals in a safe environment. We post workouts and start discussions about how to be strategic around finding a healthier you. Check it out! Start Building Your Own Workouts and Meal Plan! Download Results Tracker here! Click To Download Home Workout Templates or text the word, "lifting," to 33444 to download the templates.  Download the OSF Food Journal Now! Have a Question or Review for Rob or Devon? We love answering questions and getting feedback from you, our listener! If you have any questions to ask us, want to share a review of the show, or tell us any suggestions for guests/topics that you think would be great to have on the show, just email Rob at rob@openskyfitness.com or Devon at devon@openskyfitness.com or you can also leave us a review at www.openskyfitness.com/review, ask a question in the closed Open Sky Fitness Facebook Group and even text OSFreview to 33444 to get the link.   What You'll Hear on This Episode 00:00 Open Sky Fitness Introduction 1:15  Opening comments with Rob and Devon 1:30  Check out last week's episode -OSF 161 Joe Stout: Goat's Milk vs Cow's Milk - Which is Better? 2:20  About today's episode on barefoot running shoes vs traditional arch support running shoes. 2:50  Learn more about our Open Sky Fitness Facebook Group 4:40  Fill out an application for One-On-One Coaching Sessions with either Rob or Devon 6:10 Barefoot Shoes vs. Arch Support 7:35  What is an arch? 9:50  Why do we conventionally believe that we need shoes with good arch support? 12:00  Cons of arch support 15:00  Our feet's connection with the rest of our body from walking to jumping. 21:40  The structure of a modern day sneaker 25:40  Traditional shoe problems 36:40  Comparing arch supported shoes with barefoot shoes 39:00  The non-existent heel cushion in a barefoot shoe 42:20  The flexibility of the barefoot shoe 44:20  The problem with how  some shoe designs can negatively affect our bodies. 47:55  What do shoes provide and why do we even wear them in the first place? 52:00  Why and how to strengthen your feet. 57:30  How do we transition into barefoot shoes? 1:02:30  Different brands of barefoot shoes for walking and running 1:08:45  How to heal your foot problems. 1:14:30 Closing comments with Rob and Devon 1:15:55 Open Sky Fitness Closing   RESOURCES MENTIONED DURING THE SHOW: Leave us an iTunes review Join the The Open Sky Fitness Podcast Group on Facebook Contact Rob and Devon to apply for One-On-One Coaching Sessions Check out last week's episode - OSF 161 Joe Stout: Goat's Milk vs Cow's Milk - Which is Better? Listen to OSF 51 - Learning Parkour with Dan Edwardes Buy your own copy of Born to Run by Christopher McDougall Check out our recommended barefoot and minimal shoe brands: Merrell Vibram New Balance MT10 Xero Sanuk Vivo Barefoot Nike Free Heal your feet with Yamuna foot wakers Strengthen and stretch your feet with TheraBand products   Get Fit with Free Downloads! To Download Rob’s FREE workout templates click below** Download Templates Ask Rob a Question or tell him what is working for you: Email Rob@OpenSkyFitness.com   Support This Podcast To leave a Review for Rob and the Open Sky Fitness Podcast CLICK NOW!  Ratings and reviews are extremely helpful and greatly appreciated! They do matter in the rankings of the show and I read each and every one of them. Contact our amazing sound engineer Ryan? Send him an e-mail here: info@stellarsoundsstudio.com Thanks for Listening! Thanks so much for joining us again this week. Have some feedback you’d like to share? Leave a note in the comment section below! If you enjoyed this episode, please share it using the social media buttons you see at the bottom of the post. Do you have any questions (and would like to hear yourself on the Open Sky Fitness Podcast)? Click on the link on the right side of any page on our website that says “Send Voicemail.” And finally, don’t forget to subscribe to the show on iTunes to get automatic updates. It’s free! Thanks for listening/reading Episode 162 - Barefoot vs Arch Support Shoes: Which is Better? We hope you have gained more knowledge on how to be a healthier you.

Kolton Kersten was a two-time All American wrestler in the 197 lb weight class at Midland University in Fremont Nebraska, but no match he'd ever won could have prepared him for his battle with bacterial meningitis, which he came down with at the end of his junior season. It all started after contracting mono (for a second time) while completing his student teaching requirements at a local elementary school.  At this point in time, Kolton was in-season, ranked #2 in the nation and had hopes of winning a national title in the 2012-2013 season, so you could imagine he wasn't going to let this illness get in his way. Let's be honest, most athletes would share that same mentality... So Kolton continued to push his body to the limits in training and practice. During this time he was also cutting weight, which sometimes meant working out 3 times in a day. In our discussion, Kolton talks about how taxing the weight cutting process is on your body, especially while "recovering" from mono.  Kolton ended up suffering with the typical mono symptoms for close to a month before he was officially diagnosed, relying heavily on coffee to get him through each practice.   One day while training with his brother, Kolton told him he didn’t think he would get through this particular workout (could this be gut instinct speaking?).  He recalls his brother telling him to "tough it out" and during our interview, he says they both embraced that mentality.  This is not an uncommon mindset in athletes, but it can often be a double-edged sword.  It was in my case and it turned out to be one for Kolton as well.  After this workout, he then began to feel much worse than he had been previously and thought there might be something seriously wrong.   Kolton still had weight to lose so he ran on the treadmill, but said he began hallucinating.  While driving back from the gym Kolton decided he needed to seek medical attention.   The doctor diagnosed him with mono and sent him home with Tylenol.  Kolton then proceeded to vomit all throughout that night and his symptoms kept getting worse. In the morning, Kolton was basically paralyzed with purple rashes all over his body (see below) and one of his roommates then rushed him to the hospital. Kolton was eventually diagnosed with bacterial meningitis, which usually kills you in 24 hours.  He was given a 10% chance to live and was put in a coma.  Kolton's family and team were told to prepare for his death. During our interview Kolton describes the intense and unescapable pain associated with bacterial meningitis and how at times he wished it would all just end. Kolton explained that people who contract meningitis generally have compromised immune systems due to either illness or unhealthy lifestyles.  The combination of intense training, cutting weight, stress from student teaching and contracting mono turned out to be the perfect storm for Kolton to breathe in the meningitis particles excreted by a carrier (explained HERE) and ultimately contract the deadly disease.  It was a miracle that Kolton survived his fight with meningitis.  During our interview he goes into detail about the life-saving and limb-saving procedures he underwent. He also discusses the many setbacks he experienced, including his bout with sepsis, which left him with gaping holes in his arms.  Unsure if he would live or be able to keep his limbs, doctors told Kolton he would never be able to wrestle again.  Kolton gives credit to an experimental oxygen chamber procedure for saving his limbs. Side note: Based on this interview, previous interviews and my own story, if you are a health professional, please never tell an athlete they will never be able to get back to their sport again while they are at the lowest point of their lives.  I believe there is something to be said about hope and what it can do in an athletes' recovery.  That being said, Kolton's coach still had hope once Kolton beat death. "I don't care what these doctors are telling you, I recruited you because you're tough and I want you to be a national champ. You're still alive, we still have a job to finish.  I don't care how long it takes to get back on that wrestling mat, we are going to make one last run to be a national champ and we are going to get the job done." Kolton and Coach Vest After being in the hospital for two weeks, Kolton lost 65 pounds.  He remembers feeling devastated after the first time he looked in the mirror and saw gaping holes in his arms instead of seeing the muscle that he worked so hard to gain.  He remembers thinking to himself that no girls were ever going to like him again looking like this.  I remember having similar feelings when I looked in the mirror for the first time after leaving the hospital.  About 20 minutes after seeing himself in this condition, Kolton's coach, Beau Vest (pictured above) came in his room and said "I don't care what these doctors are telling you, I recruited you because you're tough and I want you to be a national champ. You're still alive, we still have a job to finish.  I don't care how long it takes to get back on that wrestling mat, we are going to make one last run to be a national champ and we are going to get the job done."  This is the hope and encouragement that every athlete deserves at their lowest moment! From that point on, Kolton was focused on getting back on the mat, but it took some time to regain the strength and agility he had that made him an All American. During our interview, Kolton takes us through the rehab process which actually started with Theraband exercises in the hospital and eventually just a 5 lb dumbell once he got home. It took him only three weeks to get out of the hospital when doctors told him he'd be there for three months!  Kolton talked about how he regained his strength back pretty quickly, but his agility proved to be more difficult to regain. Because of this, Kolton went back to school part time during the 2013-2014 season and helped out the coaching staff while re-learning how to wrestle again.  Kolton made a miraculous comeback in the 2014-2015 season where he finished 3rd in the nation and earned his 100th career win.  Pretty amazing for anyone, let alone a guy who was read his last rites not once, but twice.  Kolton discusses the closure he felt with his wrestling career because of the success he achieved on the mat in the 2014-2015 season.  During his transition to life after sports he has found pleasure in continuing to workout (the giant biceps are way more distracting than the scars, see above); he additionally found pleasures in outdoor activities like hunting and fishing.  Kolton also had a calling back to wrestling, but this time as a coach.  Believe it or not, in his first coaching gig out of college he had the opportunity to coach another meningitis survivor, Preston Hoebelheinrich.  Unlike Kolton, Preston lost both of his lower legs to the disease.  See video below. Kolton is now a Graduate Assistant at Midland University, his alma mater, once again under head coach Beau Vest. Kolton never missed a practice in his whole life and embraced the mentality that "you better be dying if you're going to miss practice." This is why Kolton continued to push himself when his body was telling him to stop. There is something to be said about gut instinct and my hope is that after listening to this episode, athletes will pay more attention to what their body's are telling them. If I had sat out for my headache, I could have fulfilled my dreams of playing college football.  However, I didn't listen to my body and now I have to sit out for the rest of my life.  Maybe if Kolton rested while recovering from mono, he never would have contracted meningitis. We will never know, but it's great to see Kolton sharing his inspiring story to instill hope in other athletes that they can beat the odds too.  WHERE CAN YOU FOLLOW Kolton Kersten? INSTAGRAM | FACEBOOK Download Episode 66 : iTunes | Stitcher | SoundCloud Permalink

Cristina checks into a listener’s questions about the effectiveness of a product called ‘Theraband Flexbar’ for tennis elbow. Adam looks at some headlines about a new Star Wars flick being filmed near you which are making the rounds on social media. Pat tests the panel’s knowledge with a Remembrance Day themed episode of everyone’s favourite mostly guessing game, ‘name that.’

Jürgens 118-Minuten-Dokumentation „Peak-Days“ gibt's nach wie vor „nur“ auf DVD. Dessen 2015er-Nachfolger ist nun jedoch ab sofort frei verfügbar als 30-Minuten-YouTube-Film direkt auf unserem Youtube-Kanal! „Profi-Coach Meets Climber“, „Erster Video-Podcast“ oder einfach ... unser XXL-Filmgeschenk für Dich!? Unser Tipp: Anschauen, pure Trainingsenergie vonseiten Jürgen, Sebastian Förster, Lukas Fäßler, Michi Reis & Co. „aufsaugen“ und ... auf zu neuen Trainingshorizonten. Nie gezeigte Trainingsstrategien aus dem „Hardcore-Sportkletter- und Own-Bodyweight-trainingsgenre“ in einer unmittelbaren, hoch intensiven Wettkampfvorbereitungsphase von Jürgen – Ganzkörper-Workout am „Eisen“ plus exklusives „Box-Conditioning-Workout“ via Sebastian Förster und ... ein „finale Grande“ via beeindruckender Berglaufszenen am Dornbirner Hausberg „Karren“. Vertont wurde das Ganze, wie die Peak-Days DVD, von Profimusiker Mark Protze, der in diesem Podcast bzw. dessen Vor- und Abspann, passionierter denn je, zu hören ist. Sebastian Förster und Jürgen Reis geben Dir im Hauptteil der Sendung einen Blick „Behind the Scenes“ und natürlich ist ... was SEITHER geschah ein Hauptthema. Viel Spaß beim Zuhören und lebe auch Du Deinen Traum! Und KLAR doch! Hier der in der Sendung erwähnte aktuelle, 1:1 dokumentierte „Beispiel-Warriorday“, anhand eines Beispiels Maximalkrafttag (100% Quality) im Magic Fit Dornbirn Vortag: Nach Top-Restday mit Zanzenberg-Morgenlauf, Propriozeptiv-Workout, kinesiologischem Check bei Mag. Rudi Pfeiffer, Walks, Sauna & Co. kurz nach 20 Uhr Lights Out ... somit um grob geschätzte 5.40 Uhr (kein Wecker ... nur das Vogelgezwitscher als Orientierungspunkt momentan :) Top ausgeschlafen heißt es dennoch zuerst: Ruhe bewahren bzw. noch einmal „Bettenhausen“ genießen :) Visualisierungsübungen und gezielte, geführte Sportmeditation via Audio-Track ... first things first Kurz nach 6 Uhr: Powerjump in den Tag und Stepper-Warmup vor Top-Motivations-DVD. Anschließend diverse Propriozeptiv-, Stabi-, und Warmupübungen vorwiegend Own Body Weight (u.a. Scalpula-Pushups, Strecksprünge, Power-Yoga-Übungen, Ausfallschritte, Balance-Step-Ups etc.), jedoch auch mit Therabändern, der Blackroll, der MFT-Core-Disc, Flexi-Bar etc. 7.00 nach Dusche, Supplementen, Kaffee und Kämpfer-Shake-Vorbereitungen für den Vormittag vorbereiten. Anschließend am Stehttisch-PC Tagesplan-Report an Coach Sebastian Förster. Zwei weitere Mails an Coach Marty Gallagher, Sponsor Body Attack und A-Team-Coachie Klaus, zwecks Terminbestätigung des heutigen Telefoncoachings nachmittags. 7.35 Morgenlauf, leider auch mal bei strömendem Regen – aber wozu gibt's Gore-Tex :)? Mit kurzem Hügelsprint und Krabbelübungen kommen Körper und Geist in Schwung. Integriert sind auch Treppensprünge und -krabbeln, sowie eine Mental-Mind-Übung zum Abschluss (Energiesauger 2.0). 8.05 bis 8.50 Uhr Spezifisches Warmup im Homegym mit diversen Own-Bodyweight-Übungen (Klimmzüge, Hangwaagenvariationen, Liegestützen, Handstände etc.), sowie „antesten“ der Tagesform am Grip-Balancer, den LAPIS-Balls, sowie an der Systemkletterwand. Auch die „Nebenfronten“ wie pronierte einarmige Klimmzüge und Hangwaagen werden gecheckt. In den Satzpausen ist wie üblich Intensivstretching (vollständiger Spagat & Co.) in Kombination mit aktiven Beweglichkeitsübungen (Sidekick-Halten aus dem Karate etc.) angesagt. Der Zusatz-Motivations-Kick? Klar doch: POWER OF MUSIC ist angesagt! Ein „wilder Mix“ von Metallica, Guns N' Roses und klar doch ... einiger „Mark Protze Hardcore-Guitar-Perlen“ ... that's the way I ROCK IT! 8.50 kleiner Shake, Supplemente und Abmarsch ins benachbarte Magic Fit Dornbirn 9.00 nach erster von 8 „Japanischen Runden“ kurzer „Sprung“ auf die Körperfettanteils-Analysewaage: 6.1% bei perfektem Wettkampfgewicht von knapp 57 kg spricht für TOP-SHAPE, auch anhand der „Zahlenfront“ abseits der Kletter-Testpiecebestätigungen. Diese folgen jedoch postwendend: Vor allem in einigen anspruchsvollen Hangelbouldern und dynamischen Bouldervariationen sind Wiederholungen meiner „Personal Bests“ quasi eine „nette Bestätigung“ der konsequenten „Winterarbeit“ mit meinem Coach Sebastian Förster. In den ausgiebigen Satzpausen heißt es dehnen, Propriozeptiv-Übungen absolvieren, Körperspannungsübungen à la Handstand & Co., „wieder-fit-vibrieren“ auf der ProVib oder einfach ... Ruhe bewahren :) Den Abschluss bildet ein recht neues, „25-Sätze-Workout“ am Beastmakerboard und der Turntillburn-Stange. Fazit der Innovation: Auch leicht ermüdet verletzungssicher möglich aber ... am LIMIT der Unterarmfähigkeiten! 12.50 ab in die Bio- und Infrarotsauna im oberen Stockwerk. Atemmeditations- und Visualisierungsübungen lt. Peak-Time 2 Manuskript in der Sauna gehörten schon im Winter zu meinen „Neuheiten am Rande“. Und auch heute – in Anbetracht der Leistungen – klar doch: „atmend Verankern“ ... doch Vorsicht – es funktioniert, wie es mein Mentalcoach auf den Punkt brachte :)! kurz nach 13 Uhr: Private-Coaching-Telefonat mit „Mental-und-Power-Mentor“ Marty Gallagher, gefolgt von der obligatorischen „Report-MP4-Voicemail“ an Sebastian Förster. bis 14.30 Kämpfer-Dinner parallel zum Kämpfer-Snack vorbereiten und letzteren in aller Ruhe genießen. Anschließend Autogenes Training. 14.30 Private-Coaching Telefonat mit A-Team-Coachie, Trainingslager-Gast von März 2016 und Topunternehmer Klaus aus Deutschland. Ich bin stolz auf seine Fortschritte und wie immer ordentlich gefordert von seinen anspruchsvollen Detailfragen. Keeps me DRIVEN :) – ich LIEBE meinen Zweitberuf :) 15.40 Wieder bei nach wie vor strömendem Regenwetter: Walk mit kleiner „Ich-will-frische-Luft-Verlängerung“ zu Biobäck Stadelmann ins Dornbirner Oberdorf. Via Sole-Runner – nach dem Kletterschuhvormittag ein top Fußbetttraining! 16.45 bis 18.15: Antagonisten- und System-Krafttraining auf dem beheizten Homegym-Balkon, hoch über Dornbirn. Abschließend Bruce-Lee-Körperspannungsknaller-Übungen lt. Peak-Time 2 Manuskript und ... ... nach Entspannungsbad, leichten Theraband- und Blackrollübungen und ausdehnen ... ... um 19 Uhr, wieder lt. den in meinem Buchmanuskript inzwischen zu Text gebrachten „Winter 2015/16-Strategien“: XXL-Kämpfer-Dinner und noch einmal Supplementerunde und klar .... Erfolgs-Journal nebenbei schreiben das darf sein! Speziell in der Vorwettkampfphase und an hoch intensiven Trainingstagen „wie diesen“ ist AUFTANKEN und mentales Verankern, am besten mehrfach täglich, angesagt. Lights out, heute „erst“ um 20.30? Die Morgenwanderung morgen steht erst um 7.30 Uhr an ... Somit: Ab ins, wenn es nötig sein sollte, gerne auch fast 11-stündige :) Land der Träume und ... Schlaf ist DIE Regeneration #1! Viel Spaß somit bei Video- UND Audiocast wünscht die www.Power-Quest.cc Crew!

ASK MEGAN  comes to you five days a week and is brought to you by Balancing Pointe Podcast ~ the TOP rated podcast on Ballet and Dance.  The Ask Megan show is hosted by world renowned New York City Ballet's Principal Dancer Megan Fairchild.   Each episode will feature an actual question submitted from someone like you! Today's question come from: Seraphina who calls from Singapore and wants to know how to strengthen her ankles.  She has very “bendy” feet and is worried about an injury. Megan breaks down and describes some very specific exercises to work on daily with the Theraband.  These are great suggestions for any dancer! Find Megan Fairchild ~  website/Twitter/Instagram Do you have a question about Ballet? YOU can be a part of the show by sending us your questions by clicking HERE:  BalancingPointe.com   Twitter/Instagram Please Rate and Review this show  

O prenosnih baterijah, modrozobih sprejemnikih in sploh vseh geek darilih. Povezave The Wirecutter Tools and Toys USB baterija Lightning kabli Polnilne baterije Bluetooth sprejemnik Pihalnik Glif Comply penice za slušake Space pen (sponka) Električna krtačka GorillaPod LeatherMan Juice S2 TheraBand žogica Ikea lučka Nerf Strongarm Special Guest: Alan Rener.

Isabel van Obergen and Hannes Cleppe discuss their prevention platform for sports: a software program (SpartaNova) that is in the ‘e-Health' category for physiotherapy and sports medicine. We begin with an obvious competing interest disclaimer. BJSM has no financial interest or association with SpartaNova. Because clinicians use specific products, such as ‘Theraband' ® for example, BJSM will report on the utility of such products while being open about any competing interests. Have you considered using software in your practice? Feel free to suggest what we should assess. We love to share ‘success stories' – and if a commercial product adds value for you we'd report that information. Our guests in this podcast are the CEO of SpartaNova, (IvO) who was attending London's ‘Leaders in Performance' conference in 2013, and Hannes Cleppe, who trained as a physiotherapist in Belgium and the US before focusing on developing the injury prevention module for this product. The team includes active clinical advisors as well as experts in computer sciences and maths and closely co-operates with science partners from its founding universities and a broader network of researchers. See also: Developing an injury tracking software system specific for volleyball: a case example: http://bjsm.bmj.com/content/45/6/545.3.abstract Visual or computer-based measurements: important for interpretation of athletes' ECG: http://bjsm.bmj.com/content/48/9/761.full

Shoulder pain - what are the causes, and how can you treat it? Are your special tests around the shoulder really isolating and identifying pathology? How can the rotator cuff still function with small and large tears? In Episode 22 of the Physio Edge podcast, Jeremy Lewis and David Pope discuss these questions and more including: What is the value of special tests around the shoulder? What diagnosis can you provide your patients for their shoulder pain How can you identify if you need to focus your treatment on the scapula, glenohumeral joint, cervical spine or thorax? How can you identify a rotator cuff tendinopathy? What is the Rotator Cable, and how is it important in rotator cuff tears? Is the acromion really the cause of “impingement” or subacromial pain? If a patient has a biceps tendinopathy and a rotator cuff tendinopathy, which should be treated first? What contributes to biceps tendinopathy? Theraband - valuable? When imaging of the shoulder is valuable, and when it is a waste of time Frozen shoulder - what treatments work well And much more. Podcast links Dr Jeremy Lewis London Shoulder Clinic Courses with Jeremy Lewis Clinical Edge Become a Clinical Edge member Review the Physio Edge podcast on iTunes Tags: Dr Jeremy Lewis, Shoulder, shoulder pain, subacromial pain syndrome, acromion, impingement, rotator cuff, tendinopathy, theraband, SSMP, pathology, frozen shoulder, muscle tear, rotator cable, physio, physio edge, podcast